Wednesday, February 24, 2016


SLEEPING PILLS: Pills for Blissful Sleep or Early Deaths?

Sleeping pills (sedatives and hypnotics) are commonly used (and abused) by the general population. About 6-10% of adults use prescription sleeping pills. The usage of sleeping pills is higher among women and overweight people. Usage also increases with increasing age and in those with pain or depressive illness.
Insomnia (an inability to get normal sleep) is cited as the commonest reason to use sleeping pills. A normal adult requires 7-9 hours of sleep per night. Sleeping pills help increase the number of sleeping hours providing bliss to people with insomnia. But is this bliss coming at a cost? Are there any health hazards associated with sleeping pill usage? The current article is aimed at finding out the risks and hazards of sleeping pill usage.

Do sleeping pills lead to more deaths?

Several studies have shown that use of sleeping pills is associated with higher death rates. In a large study published in British medical Journal in 2012, more than 10,000 people who used sleeping pills were compared to about 24,000 people who did not use sleeping pills. They were followed up for 2.5 years. The hazard of death was three times more in people prescribed as little as 1-18 sleeping pill tablets per year. The hazard for death increased with higher number of prescriptions per year, and it was five times more for those using greater than 132 doses of sleeping pills per year. This increased risk of death was seen with older benzodiazepines (such as alprazolam, lorazepam, diazepam) as well as newer agents (such as zolpidem and eszopiclone). The comparison was done after accounting for smoking, obesity and other risk factors that could contribute to more deaths.
In another study from UK, about 35,000 patients who were prescribed sleeping pills were compared to about 70,000 people who were not prescribed sleeping pills (control group). They were followed up for a mean duration of 7.6 years and death rates were compared between the two groups. In the first year, twice as many deaths occurred in the “sleeping pills” group as compared to the “control” group. After excluding deaths in the first year, there were approximately four excess deaths linked to drug use per 100 people followed for an average of 7.6 years after their first prescription.

Sleeping pills and cancer

In a large study, the risk of cancer increased by 35% in people who were prescribed sleeping pills, as compared to those without sleeping pills. This puts “use of sleeping pills” as risky as “smoking cigarettes” said, study leader Daniel F. Kripke.

Sleeping pills adversely affect work output

Sleeping pills cause drowsiness and hang over and affect the performance in work the next day too. Concentration is impaired and memory loss may be seen.

Sleeping pills and falls

Sleeping pill use is linked to falls in elderly, which is an important cause of fractures in them.

Sleeping pills increase the risk of road traffic accidents

Use of sleeping pills lead to increased road traffic accidents. This is because it hampers the attention and concentration ability.

Above hazards prove that sleeping pills are unhealthy and dangerous. Long-term use of sleeping pills has never been studied in people and should be discouraged. If sleeping pills are used at all, it should be for a short period of a few days and with extreme caution.

Dr Sudhir Kumar MD DM
Consultant Neurologist
Apollo Health City, Hyderabad
Ph: 0091-40-23607777/60601066

Wednesday, February 17, 2016



1. Polio virus infection was a common cause of paralysis of legs and arms in many people across the world (including India) until the last decade.

2. As of January 2016, polio has been eliminated from all countries of the world except Pakistan and Afghanistan. The last case of Polio in India was seen in 2011.

3. There are 3 types of polioviruses called as types 1, 2 and 3. No polio infection has occurred due to type 2 poliovirus since 1999. The last case of Type3 virus-related polio was seen in 2012. So, at present, all polio infections are caused by type 1 poliovirus.

4. So, now, there is no need to use vaccine against all three types of viruses. The current oral polio vaccine (bivalent oral polio vaccine) gives protection against types 1 and 3 poliovirus types, and that is sufficient.

5. It is important to avoid using the older trivalent polio vaccine (which gave immunity against all three polio virus types), as older vaccine was responsible for rare complications called as vaccine associated paralytic polio (VAPP). In India, trivalent polio vaccine will be removed from April 2016, and only bivalent OPV would be available.

6. There are two types of polio vaccines- inactivated polio vaccine (IPV) and oral polio vaccine (OPV). As the name suggests, in IPV, the virus is in inactive state, and there is no risk of VAPP with this. So, in countries with no polio infection, it is better to use IPV. However, IPV does not prevent outbreaks of polio. So, in countries where polio infection is still present or there is a risk of epidemic, OPV is preferred.

7. In India, OPV is the vaccine of choice, given at birth, 6 weeks, 10 weeks and 14 weeks of age to children. IPV is optional and can be taken at 14 weeks of age along with third dose of DPT and OPV.

8. World Health Organization (WHO) has planned comprehensive strategies aiming eradication of polio to make the world free of polio by 2018. When this happens, polio would become the second infection to be eradicated (after small pox). The last case of small pox occurred in 1975 in Bangladesh.

Apollo Hospitals, Jubilee Hills, Hyderabad-500096
Phone- 0091-40-23607777/60601066
Online consultation:

Sunday, February 14, 2016


Myths and Facts about Sex
Sex is among the commonest practices responsible for procreation and pleasure. It is almost universally practiced from the ancient times in humans. However, there are several myths and controversies surrounding it. Sex, being a taboo topic in our societies, is not openly discussed with elders and teachers. As a result, the myths propagate and the truth remains hidden. In this article, I would discuss the myths and facts about sex.
At what age can sex be started?
Several surveys indicate that teenagers are sexually active since around 15 years of age. However, it should be noted that the legal age for sex after consent is 18 years (in India). So, sex with a person below 18 (even after marriage) is illegal. This age limit may vary in different countries.
What is the normal/safe frequency of sex?
First of all, there is no “one” normal frequency of sex. It depends on a lot of factors, such as moods, daily schedules, location, presence of children or other family members, any physical illness, age of the person, any personal grief, and so on. So, if a couple is happy, it does not matter how often they are having sex. Generally, the fears are “are we having too much or too little sex?” Regarding too much sex, there is no need to worry as long as it is done within the legal framework, and does not jeopardies the daily work/schedule. The average frequency of sex (as per studies) is about once in 3-4 days in younger couples, and once in 6-7 days in older couples. Now, you should not start worrying if your frequency is below the above numbers. What matters is the happiness and satisfaction levels among couples and sex is just one of the many things contributing to satisfaction and contentment.
Is masturbation safe?
Masturbation refers to the self-stimulation of genitals (penis, clitoris or vagina) in order to achieve sexual arousal and pleasure, often leading to climax (orgasm). There are several myths among younger people about masturbation. They feel that it- is immoral, leads to weakness, leads to deformities of penis, or it decreases the chance of good sex after marriage. It should be noted that masturbation is a healthy habit and can be practiced throughout life, even after marriage. Most people (more than 90%) masturbate. With masturbation, there is no fear of pregnancy or sexually transmitted diseases (STDs). Masturbation is, however, wrong, if it inhibits sexual relationship with the partner, or if it is done in public, or if it interferes with daily responsibilities. The guilt associated with masturbation can also lead to problems.
Is oral or anal sex safe?
Health wise, anal or oral sex does not lead to any additional hazards, which are not seen with conventional sex. So, if a couple likes it, they can practice it. There is no risk of getting pregnant with anal or oral sex. The legal status, however, differs in different countries.
Is male-male or female-female sex (homosexuality) safe?
Sex between people of same sexes- homosexuality (in men) and lesbianism (in women) are medically safe. There is no risk of pregnancy, however, the risk of acquiring STDs is similar to that with conventional sex. Homosexuality just indicates a different sexual orientation of these people. Homosexuality, however, is still illegal in India and many other countries. In addition, it is a social stigma too.
Is sex with multiple partners safe?
Sex with multiple partners is a risky behavior and should be avoided. There is a high risk of contracting STDs. In addition, it can lead to instability in a person’s life. In a married person, it can lead to break-ups and divorce.
How long should a normal intercourse last?
The duration of normal intercourse ranges from 3 to 7 minutes. This is the time from entering the vagina upto the time of orgasm, and does not include the time of foreplay. Anything less than 1-2 minutes is considered too short and is labeled as premature ejaculation. Shorter duration intercourse (and premature ejaculation) may leave female partners less satisfied or unsatisfied.
What is the normal penis size?
The penis should be measured when erect, and the average length varies from 5.5 to 6.3 inches (14-16 cm). The penis is considered small only if it is less than 3 inches (7.6 cm) when erect. Anything more than 3 inches is enough to satisfy a woman. Women consider girth (or width) of penis more important than the length. When erect, the normal girth (or circumference) of penis is 12-13 cm (4.7 to 5.1 inches). However, there are many men who are anxious about the size of their penis, which explains the boom of devices and pills that claim penis enlargement effects. It should be noted that the size of penis when flaccid may vary and does not play a role in determining the penis size when erect. This means that men with relatively small penis when flaccid can have the same size when erect.
Is it normal to have a curved penis?
Penis when erect can point upwards or downwards, or slightly to left or right. All these are normal. However, if there is a significant bend in penis, it could point to a disease called as Peyronie’s disease. You should consult a Urologist for evaluation.
Is nocturnal emission abnormal?
Nocturnal emissions refer to ejaculation during sleep among men, often after an orgasm. In women, there is vaginal lubrication along with orgasm. These are normal phenomena and do not indicate any disease.
What is the normal frequency of orgasm?
Men reach orgasm more often than women. Men reach orgasms about 75% of times. There are multiple reasons for the differences between men and women. In addition to social and cultural reasons, it is also that orgasm is not the most important aspect of sex for women. With oral sex and foreplay added to intercourse, women and men orgasm rates are almost similar. Also, orgasm rates are higher in a committed relationship rather than during occasional/first flings. Women are able to attain "multiple" orgasms. Also, it is alright to "fake" an orgasm by a woman to make the overall sex experience better for the couple. 

I have tried to cover some of the most important facts and myths related to sex here. I am sure you may have additional queries, which can be posted here as comments or can be sent to my email.

Dr Sudhir Kumar MD DM
Senior Consultant Neurologist
Apollo Health City, Jubilee Hills,
Hyderabad, India-500096
Phone: 0091-40-23607777/60601066

Online consultation:

Friday, February 12, 2016