PUBLICATIONS IN PEER-REVIEWED JOURNALS-DR SUDHIR KUMAR

PUBLICATIONS IN PEER-REVIEWED JOURNALS

Dr SUDHIR KUMAR MD DM

Consultant Neurologist

Apollo Hospitals, Hyderabad

drsudhrikumar@yahoo.com

Publications are an important means of disseminating knowledge. Many scientific journals are available online, making the access easier. In the initial part of my career, I was not keen on publishing, as I thought, the main duty of a doctor is to treat sick patients. As I was a faculty in a teaching college (CMC Vellore) during 2001-2004, teaching postgraduates was an added responsibility, leaving less time for writing and publishing. However, Prof mathew Alexander, my teacher in Neurology at CMC Vellore, stressed on the importance of publishing. This resulted in multiple publications in peer-reviewed journals. These are listed below:

2001

1. V Markandeyulu, T P Joseph, T Solomon, J Jacob, S Kumar, C Gnanamuthu. Stiff-man syndrome in childhood. J R Soc Med. 2001; 94: 296-7. 

2003

2. Sudhir Kumar. Adverse effects due to poor patient understanding of the antiepileptic medication prescriptions. Indian Pediatr 2003; 40: 801-2

3. Sudhir Kumar. Inappropriate prescription of corticosteroids in respiratory infections. Indian Pediatr 2003; 40:1111.

4. Sudhir Kumar. Overdiagnosis of cerebral malaria in patients admitted with neurological dysfunction. Q J Med 2003; 96: 688.

5. Sudhir Kumar. Medically unexplained symptoms. J R Soc Med 2003; 96: 422.

6. Sudhir Kumar. Representation of South Asian people in randomised trials: study results are interesting but not final word. Br Med J. 2003; 327: 394. 

7. Sudhir Kumar. Management of shock in children with severe P. falciparum malaria. Q J Med2003; 96: 778.

8. Kumar S, Alexander M, Markandeyulu V, Gnanamuthu C. Guillain-Barre syndrome presenting in the anti-HIV seroconversion period. Neurol India 2003; 51: 559.

9. Sudhir Kumar. Nimesulide: How safe is it? Natl Med J India 2003; 16: 233-4.

10. Sudhir Kumar. Predicting long-term morbidity in Indian patients with ischemic stroke. Neurol India. 2003; 51:285-6. 

11. Sudhir Kumar. Steroid-induced myopathy following a single oral dose of prednisolone. Neurol India. 2003; 51: 554-6.

12. Sudhir Kumar. Prophylaxis of depression in older people. Br J Psychiatry. 2003; 183:365.

13. Sudhir Kumar. Management of ocular myasthenia gravis coexisting with thyroid ophthalmopathy. Neurol India. 2003; 51:283-4.

14. Sudhir Kumar. Distal asymmetric spinal muscular atrophy involving upper limbs. Indian Pediatr2003; 40:1211-2

15. Sudhir Kumar. Health of indigenous people- health of aboriginal communities can be improved by innovative methods. Br Med J. 2003; 327: 988

16. Sudhir Kumar. Differentiating traumatic neuritis from poliomyelitis. Natl Med J India. 2003; 16: 232-3.

17. Sudhir Kumar. Anticonvulsant-hypersensitivity syndrome in a child. Neurol India. 2003; 51: 427

18. Sudhir Kumar. Prognosis in children with head injury: Inaccuracies in the analysis. Neurol India 2003; 51: 427-8.

19. Sudhir Kumar. Delayed diagnosis of myasthenia gravis due to prior empirical therapy with corticosteroids. Annals of Indian Academy of Neurology 2003; 6:171-2.

20. S Kumar, Hannah V, M Alexander, C Gnanamuthu. Rapidly progressive dementia as a presenting feature of acute disseminated encephalomyelitis (ADEM). Annals of Indian Academy of Neurology 2003; 6:167-70.

21. Sudhir Kumar. Mechanical ventilation in Guillain-Barre syndrome. Neurol India. 2003; 51:559-60.

22. Sudhir Kumar. Factors affecting functional recovery in ischemic stroke. Neurol India 2003; 51:561.

2004

23. Sudhir Kumar. Recurrent seizures: An unusual manifestation of vitamin B12 deficiency. Neurol India 2004; 52:122-3.

24. Sudhir Kumar. Overweight and obesity in children. Indian Pediatr 2004; 41:200.

25. Sudhir Kumar. Missed and delayed diagnosis of neonatal meningitis. Indian Pediatr 2004; 41:959

26. Sudhir Kumar. Vitamin B12 deficiency presenting with an acute reversible extrapyramidal syndrome. Neurol India. 2004; 52:507-9.

27. Sudhir Kumar. Improving clinical course in congenital hypomyelinating neuropathy. Indian Pediatr 2004; 41:1171.

28. Sudhir Kumar. Artemether in children with severe malaria. Indian Pediatr 2004; 41:520-1.

29. Sudhir Kumar. Unusual cause of recurrent flaccid paralysis in a child. Neurol India. 2004; 52:126.

30. Sudhir Kumar. Clinical characteristics of organophosphate-induced delayed polyneuropathy.Neurol India. 2004; 52:128-9.

31. Sudhir Kumar. Nadroparin in acute ischemic stroke. Neurol India. 2004; 52:273-4.

32. Kumar S, Alexander M, Joseph M, Gnanamuthu C. Symmetrical peripheral gangrene: association with adrenaline administration. Critical Care Asia 2004;2(1):19-21

33. Sudhir Kumar. Conversion disorder in childhood. J R Soc Med. 2004; 97:98

34. S Kumar, M. Alexander, C. Gnanamuthu. Recent experience with Rett Syndrome at a tertiary care center. Neurol India 2004; 52:494-5.

35. S Kumar, N. Kesavalu, E. Chandy. Periodic lateralized epileptiform discharges in a child with solitary cysticercus granuloma. Neurol India 2004; 52:523-4.

36. S Kumar, M. Alexander, C. Gnanamuthu. Refractory status epilepticus due to cerebral venous thrombosis during late pregnancy with successful outcome. Annals of Indian Academy of Neurology.2004; 7:305-8.

37. Sudhir Kumar. A trial of antiparasitic treatment for cerebral cysticercosis.N Engl J Med 2004; 350:1686.

38. Sudhir Kumar. Epidemiological study of neurological disorders. J Indian Med Assoc. 2004; 74:108.

39. Sudhir Kumar. When to start drug therapy in epilepsy. J R Soc Med. 2004; 97:208.

40. Sudhir Kumar. Withdrawal of ventilatory support in the intensive care unit. Natl Med J India 2004; 17:28-9.

41. Sudhir Kumar. Acute reversible mania as a presenting feature of vitamin B12 deficiency. Annals of Indian Academy of Neurology. 2004; 7:309-11.

42. Sudhir Kumar. Epilepsia partialis continua stopped by insulin. J R Soc Med 2004; 97:332-3.

43. Sudhir Kumar. Psychogenic non-epileptic seizures. Indian Pediatr 2004; 41:1050-2.

44. Sudhir Kumar. Paradoxical worsening of neurological status after starting d-penicillamine therapy in a patient with Wilson's disease. Annals of Indian Academy of Neurology 2004; 7:401-402.

45. Sudhir Kumar. Why do doctors make errors? Natl Med J India 2004; 17(1):53-4.

46. Sudhir Kumar. Calvarial thickening and cerebellar atrophy following chronic phenytoin usage.Annals of Indian Academy of Neurology 2004; 7:403.

47. Sudhir Kumar. A patient's opinion is often valuable. J Postgrad Med 2004; 50:216.

48. Sudhir Kumar. Memantine:Pharmacological properties and clinical uses. Neurol India2004:52:307-9.

49. Kumar S, Kumar PR. Mimetic facial paresis. Annals of Indian Academy of Neurology. 2004; 7:405.

50. Kumar S, Kumar PR. Skin branding. J Postgrad Med 2004; 50:204.

51. S Kumar, M Alexander, C Gnanamuthu. Manual (low-volume) plasmapheresis: an effective and safe therapeutic procedure in acute neurological illnesses. Annals of Indian Academy of Neurology 2004; 7:439-40.

52. Sudhir Kumar. Bisphosphonate therapy for polyostotic fibrous dysplasia. Indian Pediatr. 2004; 41:1069-70.

53. S Kumar, M Alexander, C Gnanamuthu. Heterogeneity in clinical presentation of acute disseminated encephalomyelitis. Neurol India. 2004;52:518-9.

54. S Kumar, S Aaron. Internuclear ophthalmoplegia as the sole presenting symptom of inflammatory demyelinating lesion of the brainstem. Neurol India 2004; 52:517-8.

55. Sudhir Kumar. Rheumatological manifestations of leprosy. Indian Journal of Dermatology, Venereology and Leprology. 2004; 70:250.

56. Sudhir Kumar. Dermatological findings in chronic alcoholics. Indian Journal of Dermatology, Venereology and Leprology. 2004; 70:317.

57. S Kumar, Rashmi. Psychosomatic illness among patients attending medical outpatient department. J Indian Med Assoc. 2004; 102:330-1.

58. S Kumar, S Nair, M Alexander. Carcinomatous meningitis occurring prior to the diagnosis of large cell neuroendocrine carcinoma of the uterine cervix. J Postgrad Med. 2004;50:311-2.

59. S Kumar, P Ravi Kumar. Multi-segmental Neurofibromatosis. Indian J Dermatol Venereol Leprol2004; 70:360-2.

60. Sudhir Kumar. Differentiating paralytic rabies from post antirabies vaccine polyradiculoneuropathy. Neurol India 2004; 52:270.

61. Sudhir Kumar. Oral glucose tolerance test in patients with unexplained peripheral neuropathy. Natl Med J India 2004; 17:206.

62. Sudhir Kumar. Nimodipine in severe head injury. Neurol India 2004;52:392-3

63. Sudhir Kumar. Communications skills: is there a need for training? Natl Med J India 2004; 17:280-1.

64. Sudhir Kumar. Pituitary in psychosis. Br J Psychiatry 2004; 185:437-8.

65. Kumar S, Jacob J. Variability in the extent of sensory deficit after sural nerve biopsy. Neurol India 2004; 52:436-8.

66. Kumar S. An uncommon cause of shoulder pain in acute ischaemic stroke. J Indian Med Assoc 2004; 102:594-6.

2005

67. Singh S, Kumar S, Joseph M, Gnanamuthu C, Alexander M. Cerebral venous sinus thrombosis presenting as subdural haematoma. Australasian Radiology 2005;49:101-3.

68. Sudhir Kumar. Factors leading to underdiagnosis or under-reporting of AIDS. Trop doct. 2005; 35:124.

69. S Kumar, J Vijayan, J Jacob, S Aaron, M Joseph, M Alexander, C Gnanamuthu. Cervical spine injuries in 64 attempted suicidal hangings in India. Trop Doct 2005;35:198-200.

70. Sudhir Kumar. Factors precipitating breakthrough seizures in well-controlled epilepsy. Indian Pediatr 2005; 42:182-3.

71. Sudhir Kumar. Severe autonomic dysfunction as a presenting feature of Wilson's disease. J Postgrad Med 2005; 51:75-6.

72. Sudhir Kumar. Wilson's disease presenting as status epilepticus. Indian Pediatr. 2005; 42:492-3.

73. Sudhir Kumar. Tongue biting and epilepsy. Indian Pediatr 2005; 42:296.

74. Sudhir Kumar. Painful mononeuritis multiplex in idiopathic thrombocytopenic purpura. Indian Pediatr 2005; 42:621-2.

75. Sudhir Kumar, Rashmi. Branding: A harmful practice. Indian Pediatr 2005;42:721.

76. Sudhir Kumar. Valproate-induced bleeding: report of two cases and review of literature. Indian Pediatr 2005; 42:833-4.

77. Sudhir Kumar. Neurofibromatosis type 1 manifesting with Tourette syndrome. Neurol India2005;53:361-2.

78. Sudhir Kumar. Punding in Parkinson's disease related to high-dose levodopa therapy. Neurol India 2005;53:362.

79. Sudhir Kumar. Thyrotoxic periodic paralysis. Thyroid Research & Practice 2005; 2: 12-8.

80. Sudhir Kumar. Calcified vertebral artery and dense basilar artery sign in a patient with basilar territory infarction. Neurol India 2005;53:125.

81. Aaron S, Kumar S, Vijayan J, Jacob J, Alexander M, Gnanamuthu C. Clinical and laboratory features and response to treatment in patients presenting with vitamin B12 deficiency-related neurological syndromes. Neurol India 2005;53:55-8.

82. Kumar S, Prabhakar S. Guillain-Barre syndrome occurring in the course of Dengue fever. Neurol India 2005;53:250-1.

83. Datta SS, Premkumar TS, Chandy S, Kumar S, Kirubakaran C, Gnanamuthu C, Cherian A.Behaviour problems in children and adolescents with seizure disorder: associations and risk factors. Seizure:European Journal of Epilepsy 2005;14:190-7.

84. Garikapati R, Kumar S, Prabhakar S. ATL in refractory epilepsy with normal MRI-volumetric criteria? Epilepsia 2005; 46:600.

85. Kumar S, Chandy E. Asymmetric depression of amplitude in electroencephalography leading to a diagnosis of ipsilateral cerebral tumor. Annals of Indian Academy of Neurology 2005;8:33-5.

86. S Kumar, G Rajshekher, S Prabhakar. Management of myasthenic crisis. Neurol India 2005;53:241.

87. S Kumar. Preventive therapy of migraine. Neurol India 2005;53:243.

88. S Kumar, G Rajshekher, S Prabhakar. Positron emission tomography in neurological diseases. Neurol India 2005;53:149-55.

89. S Kumar. Recombinant activated Factor VII for acute intracerebral hemorrhage. Indian Journal of Critical Care Medicine 2005;9:11-13.

90. S Kumar, P Ravi Kumar, N Manasseh. Massive pneumocephalus and meningitis following spine instrumentation. Annals of Indian Academy of Neurology 2005;8:55-7.

91. S Kumar. Guillain-Barre syndrome in leprosy patients. Indian J Lepr. 2005;77:162-8.

92. S Kumar. Cranial nerve involvement in leprosy. Indian J Lepr. 2005;77:177-8.

93. S Kumar, G Rajshekher, S Prabhakar. Dense basilar artery sign preceding basilar artery territory infarction. Annals of Ind Acad Neurol 2005;8:321-2.

2006

94. S Kumar, Badrinath HR. Early recombinant factor VIIa therapy in acute intracerebral hemorrhage: Promising approach. Neurol India 2006;54:24-7.

95. S Kumar. Plasmapheresis in acute disseminated encephalomyelitis. Indian Pediatr2006;43:77-8.

96. SS Datta, S Kumar. Hypomania as an aura in migraine: case report. Neurol India 2006;54:205-6.

97. SS Datta, S Kumar. Clozapine-responsive cluster headache. Neurol India 2006;54:200-1.

98. SS Datta, R Jacob, S Kumar, S Jeyabalan. A case of subacute sclerosing panencephalitis presenting as depression. Acta Neuropsychiatrica 2006; 18: 55-7.

99. SS Datta, TS Premkumar, S Fielding, S Chandy, S Kumar, JM Eagles, A Cherian. Impact of pediatric epilepsy on Indian families. Epilepsy and Behavior. 2006;9:145-51.

100. S Kumar, M Alexander, C Gnanamuthu. Cranial nerve involvement in patients with leprous neuropathy. Neurol India 2006;54:283-5.

2007

101. S Kumar. Expansion of traumatic intracerebral hemorrhage: treatment implications with recombinant Factor VIIa. Neurol India 2007;55:81.

102. S Kumar. Basilar artery thrombosis. Annals Ind Acad Neurol 2007;10;61-2

103. S Kumar, G Rajshekher, S Prabhakar. Isolated complete third nerve palsy due to midbrain hemorrhage: clinico-radiological correlation. Annals Ind Acad Neurol 2007;10:187-8.

104. S Kumar. Thrombolysis with tissue plasminogen activator: Protocol violation is not an option. Neurol India 2007;55:174.

105. S Kumar. Pseudoxanthoma elasticum and cerebral ischemic stroke. Indian J Dermatol Venereol Leprol 2007; 73: 433-4.

2008

106. S Kumar, G Sandhya, R Reddy, G Rajshekher, S Prabhakar. Idiopathic transverse myelitis: corticosteroids, plasma exchange, or cyclophosphamide? Neurology 2008; 70:160.

107. G Rajshekher, S Kumar, S Prabhakar. Reversible electrophysiological abnormalities in hypokalemic periodic paralysis. Indian Pediatrics 2008;45:54-5.

108. S Kumar, G Rajshekher, S Prabhakar. Isolated bilateral ptosis as the presentation of midbrain tuberculoma. Neurol India 2008; 56:212-3.

109. S Kumar, G Rajshekher, S Prabhakar. Platelet glycoprotein IIb/IIIa inhibitors in acute ischemic stroke. Neurol India 2008;56:399-404.

2009

110. S Kumar, R Reddy, S Prabhakar. Contralateral diaphragmatic palsy in acute stroke: An interesting observation. Ind J Crit Care Med 2009; 13:28-30.

2010

111. S kumar, G Rajshekher, C R Reddy, J Venkateswarlu, S Prabhakar. Intra-sinus thrombolysis in cerebral venous sinus thrombosis: single center experience in 19 cases. Neurol India 2010;58:225-9.

112. R Lath, S Kumar, R Reddy, G R Boola, A Ray, S Prabhakar, A Ranjan. Decompressive surgery for severe cerebral venous sinus thrombosis. Neurol India 2010;58:392-7.

2012

113. S Bhuvaneshwari, Sujith Chandy, Sudhir Kumar. A prospective, double-blinded, crossover study to determine the equivalence of the serum levels and the peak level toxicity of diphenylhydantoin (Eptoin ER). Journal of Clinical and Diagnostic Research. 2012;6:783-786.

2013

114. Varghese GM, Mathew A, Kumar Sudhir, Abraham OC, Trowbridge P, Mathai Differential diagnosis of scrub typhus meningitis from bacterial meningitis using clinical and laboratory features. Neurol India 2013;61:17-20

115. Sudhir Kumar, Chenna Rajesh Reddy, Subhashini Prabhakar. Striatal toe. Ann Ind Acad Neurol. 2013;16:304-5

116. S Bhuvaneshwari, Sujith Chandy, Sudhir Kumar. Equivalence of the steady state concentrations of two dosage regimens of phenytoin using computer optimisation programme OPT6. International Journal of Pharmaceuticals and Biological Archives.2013;4:899-902. 

2016

117. Kumar S. Hypertension and ischemic stroke. Hypertens J. 2016;2:39-43.

118. Kumar S, Reddy CR, Prabhakar S. Bilateral putaminal necrosis in a comatose patient with metabolic acidosis. Indian J Crit Care Med. 2016;20:745-8.

2017

119. Kumar S. Hypertension and hemorrhagic stroke. Hypertens J. 2017; 3:89-93.

2018

120. Kumar S, Rohatgi A, Chaudhari H, Thakor P. Evolving landscapes of multiple sclerosis in India: Challenges in the management. Ann Ind Acad Neurol 2018;21:107-15.

2019

121. Ramesh V, Narreddy S, Barigala R, Kumar Chennamchetty V, Kumar S, Rao J, Nanda S, Varahala S. 1374. Diagnostic Utility of Whole Body Positron Emission Tomography-Computerized Tomography (PET-CT) in Patients with Suspected Central Nervous System Tuberculosis: A Retrospective, Descriptive Study. Open Forum Infect Dis. 2019 Oct 23;6(Suppl 2):S498–S499. doi: 10.1093/ofid/ofz360.1238. PMCID: PMC6808727.

Books, Chapters, monographs

1. Elizabeth Chandy, Sudhir Kumar. Atlas of Electroencephalography in Adult & Child. Mattethra Group Publications, Cochin, India, 2004.

2. Sudhir Kumar. Cerebrovascular diseases in the elderly. In Progressive General Practice- Geriatrics issue. Ed, Alka Ganesh. CME series of Christian Medical College, Vellore, India, 2002.

3. Soumitra S. Datta, Sudhir Kumar, K.S. Jacob. Clinical approach to dementia. In Textbook of Psychiatry, Bangalore.

4. Sudhir Kumar. Muscular dystrophies in children and adolescents. In Update in Pediatrics Volume 1, 1st edition, Mathur & Mathur Eds, 2005.

5. Sudhir Kumar. Neonatal Meningitis. In Textbook of Neonatal Emergencies. Ed Prof Suraj Gupte, Peepee Publishers and Distributors, New Delhi, 2006

6. Sudhir Kumar, Subhash Kaul. Approach to a patient with hemiplegia and monoplegia. Progress in Medicine 2017. Published by Association of Physicians of India (API) (Can be accessed at http://www.apiindia.org/pdf/progress_in_medicine_2017/mu_27.pdf)

DO THE MARKS IN AN EXAMINATION REALLY MATTER A LOT?

HOW IMPORTANT ARE THE MARKS IN AN EXAMINATION?

Anuja’s suicide

When I was 10 year old, I remember once, there was a crowd gathered around Anuja’s (name changed) house, who lived about 100 meters away from our house. I too wanted to go there to find out what was happening, but was not allowed by my parents. Later on in the evening, I came to know that she committed suicide by hanging, as she scored only 81% marks in her tenth board examinations, which was well below her parents’ and her expectations. We hear several similar stories from different parts of our country. Depression, stress and anxiety are common before & during examinations. If one does not score high marks, they feel worthless, unfortunately leading to suicide in some cases.

Mental problems among students

I have been increasingly seeing young students with various psychological problems, such as sleep disturbance, anxiety, headaches, poor memory, body pains, decreased energy and depression. Fear of exam or fear of scoring low marks in an exam are the main reasons for these symptoms.

But is scoring high marks so important?

Marks have limited importance:
1. One needs to score “pass” marks in order to get promoted to the next class, which ranges from 35-50% in various classes/schools/colleges. 
2. One needs to score “qualifying” marks in order to become eligible to write competitive exams for UPSC, engineering, medical, etc (which ranges from 50-75% in various exams).

3. Class XII marks are taken into account for admissions into graduate courses of a few good colleges (which can be as high as 99% in some cases).

Drawbacks and demerits of marks:
1. There is no perfect correlation between marks and knowledge. A student with good knowledge may score lesser marks and someone with lesser knowledge may get very high marks. 
2. Examinations, unfortunately, do not assess the practical knowledge, intelligence, judgment and application of a student; they mainly assess the retention, recall and memory abilities. Communication skills, ability to deal with difficult situations, and interpersonal skills, which are so important in real life, are also not assessed by the “marks” system.
3. Marks obtained in 10th and 12th board exams do not have any meaning in the job/occupation one chooses later. For example, no patient of mine has ever asked me my marks from school or college days (however, I would be proud to tell those figures, as I scored high in most of the exams).

So, what should students do?
1. One should study to gain and acquire knowledge. Understanding the concepts is more important than just memorizing them. 
2. Marks do not matter much and obtaining high marks in an exam should not be the sole goal. 
3. Studies would be a pleasure, if it is taken as a means of gaining knowledge, rather than a means to score high marks in an exam. 
4. One should study “round-the-year” and not just before the exams. This would reduce the pressure prior to the exams. 
5. There is no need to feel bad, if one gets” low” marks in an examination. Most of the great men & women in the world were not class toppers in their school or college days.

I would be pleased to have your comments on this article.

DR SUDHIR KUMAR MD DM
Consultant Neurologist
Apollo Hospitals, Hyderabad
drsudhirkumar@yahoo.com

https://www.facebook.com/bestneurologist/

WHAT IS AILING THE HEALTH OF OUR YOUNG GENERATION?

WHAT IS AILING THE HEALTH OF OUR YOUNG GENERATION?

Mr Parvesh (name changed), a 33-year old, was rushed into emergency department last night with sudden onset of chest pain and breathlessness. He was at his office at 11 PM, when he felt uneasy. He lied down on the sofa outside his office to take some rest. His friends found him unconscious and rushed him to the hospital. On arrival in ER, his pulse and BP were un-recordable. ECG showed features of massive heart attack. He was given the best cardio-pulmonary resuscitation, followed by the best medical care. All in vain, he passed away within four hours. 

Mr Parvesh is not alone. In my practice over the past 25 years, I have seen many young people (mostly men) in their 30s and 40s coming to the hospital with features of heart attack and brain stroke. This is unusual, as during my medical school training in early 90s, we were taught that heart attacks and brain strokes affect only older people in their 60s and 70s or even later. Now, about 40% of people suffering from heart attacks and brain strokes are young people (<50 years of age). 

So, what factors are responsible for this “undesirable” change?

1. Expectations to achieve everything as early as possible: Achievement and success are good things, but not at the cost of health. Young people work long hours. In my interaction with people, I have observed that 13-15 hours work schedules are not uncommon. Add to this, 1-2 hours of commute time, where is the time to unwind? Where is the time to relax with family and friends? Our bodies are not machines (even machines break down, when overused). Heart and brain work best, when working hours are 8-9 hours, with good breaks in weekends.

2. Working from home, working on weekends and even during holidays: Breakthroughs in communication (internet, mobile phones, etc) have their advantages; however, there are drawbacks too. People are in “work-mode” 24X7, 7 days a week, and perpetually. There is no time, when a person totally disconnects from work. Constant work or thought of work takes a heavy toll on the body, especially the heart and brain.

3. Lack of sleep: We need at least 7-8 hours of sleep in order to refresh and recharge. However, younger people are not getting more than 4-5 hours of sleep per night. Demanding work schedules, use of gadgets and late night socializing are some of the reasons for lesser sleep duration. Lack of sleep is strongly associated with higher risk of diabetes, high BP and cholesterol; all of whom are risk factors for stroke and heart attacks.

4. High stress levels: I see many young people in my clinic, belonging to various industries such as IT & software, banking & finance, education, etc. More than 90% of them say they are under stress. Stress is related to jobs as well as personal lives. So, if one felt that not getting a job or not getting married are reasons to be under stress, think twice; those with good jobs and good spouses are also equally stressed, if not more. This cannot be real. Jobs and families need to be cared for and modeled to give joy & happiness.

5. Greed for material things beyond one’s means: Peer pressure is very high. One wants to own a good car and a good house in 30s and even in 20s. As the incomes are low, many end up taking huge loans to fund these dreams. People are also spending more than their means on education of children and vacations. Paying EMIs are no fun! Any unexpected expenditure and reduction in income takes a toll on health and stress levels rise. One must live within their means and avoid taking loans to fulfill the “desires”. We need to be satisfied with what we have and avoid competing with “neighbours or friends” in acquiring materialistic things.

6. Unhealthy diet and habits: Fast foods, irregular food habits and "eating out" have become common. We need to remember, home food is the best and healthiest. “Outside” food is high on taste (due to high amount of salt, sugar and oil) but low on nutrition. 
Most people are not exercising. Moreover, they use vehicles for travelling short distances. Walking as a habit is dying. Most people use lifts and staircases are “hidden” (only to be used in case of emergency or fire)! People sit for long duration (at work, while watching TV, etc). Sitting is as dangerous as smoking, if not more. 
Pollution is increasing- both air and water. Their negative impact on health is well known.

7. Poor financial planning: Younger people do not invest wisely. Either the savings are kept idle in the banks (for a meager interest of 3-4%, which is taxable at the highest slab) or they invest most of their savings in real estate (bought at high prices, with no scope of growth in the near future). The best investment asset class is equity. For someone with less time, investing in equity mutual funds via SIP (systematic investment plans) are the best. You can expect a return of 10-12 % per year (with current tax rate of 10% on the profits, if redeemed after one year).

8. Ignoring health checkups: Our body does give warnings. Any abnormal symptom such as headache, dizziness, tiredness, breathing difficulty, chest pain, etc should be seriously taken and a doctor should be consulted. Even if there are no symptoms, preventive health checkups can help in detecting diseases in early stage, which can be treated well.

So, what can younger people do to live longer and healthier?

1. Find a job that you like (which may not be with the biggest pay cheque).
2. Work for reasonable hours (8-9 hours on average).
3. Cut-off from work when out of office, on weekends and while on vacation (except for occasional emergencies.
4. Take regular vacations with family and friends.
5. Sleep well (on an average 7-8 hours per night). Avoid doing regular night shift duties.
6. Exercise- it can be anything you like, such as walking, jogging, cycling, etc. At least 30 minutes per day and 5 days per week.
7. Prefer home food as much as possible.
8. Keep expenses as per your income. Avoid taking loans as much as possible.
9. Start investing early after analyzing your financial needs and goals.
10. Don’t ignore small warnings about health. Consult a doctor and have preventive health checkups.

Dr Sudhir Kumar MD DM

Consultant Neurologist
drsudhirkumar@yahoo.com

https://www.facebook.com/bestneurologist/

FREQUENTLY ASKED QUESTIONS ABOUT HEADACHE

FREQUENTLY ASKED QUESTIONS ABOUT HEADACHES

Headache is a common disorder. A large number of people suffer from headaches. Migraine and tension headaches are the commonest causes of headaches. They are not life-threatening, however, they cause significant disability, as pain impairs the quality of life. In some cases, headaches can be caused by serious causes, such as brain tumor, brain hemorrhage, brain fever, etc. 

The current interview focuses on the common causes of headache. How should we diagnose migraine? It can be diagnosed based on symptoms in most cases. When should one consult a doctor for headache? When should one do a brain scan? How do we treat headaches? To get answers to these and other questions, please watch this interview. The link of the youtube video with the interview is:

https://youtu.be/VgBvamY5kS0

Feel free to post your comments or ask any queries.


Dr Sudhir Kumar MD DM (Neurology)
Senior Consultant Neurologist,
Apollo Hospitals, Hyderabad
04023607777
drsudhirkumar@yahoo.com
https://www.facebook.com/bestneurologist/

FREQUENTLY ASKED QUESTIONS ABOUT EPILEPSY (HINDI)

FREQUENTLY ASKED QUESTIONS ABOUT EPILEPSY

Epilepsy is a common neurological illness. It can be easily diagnosed and treated. People suffering from epilepsy can lead normal lives after treatment. Despite this, there are lot of misconceptions about this disease. There is a social stigma attached to epilepsy and epileptic patients. 

In this interview (in Hindi language), I have discussed the symptoms, diagnostic techniques and treatment options for people suffering from epilepsy. The link to youtube video is given below:


https://youtu.be/BzAzkOxecJs


Please go through this video interview to learn more about epilepsy. Feel free to post your comments and queries.

Dr Sudhir Kumar MD DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad
04023607777
drsudhirkumar@yahoo.com
https://www.facebook.com/bestneurologist/

DRINKING WATER FOR A HEALTHY LIVING- All you ever wanted to know

WATER INTAKE AND HEALTH

Water forms 60% of our body weight and is essential for life. It should be consumed in adequate amounts for proper functioning of various organs.

Normal water intake

1.     Men: 3.7 liters per day

2.     Women: 2.7 liters per day (Pregnant and breast-feeding women need more water).

20% of this comes from food (fruits, vegetables, beverages, etc) and the remaining should be consumed in the form of plain water.

When do we need more water?

1.     Exercise- Exercise leads to water loss in the form of sweating. So, we should consume water before, during and after exercise. Avoid drinking too much water as it can be harmful; it could dilute the body fluids leading to hyponatremia (low sodium).

2.     In hot climates- Water loss is more via perspiration and sweating, and hence, more water is needed.

3.     During illnesses such as fever, vomiting and diarrhea. All these conditions lead to water loss and this loss needs to be replenished.

When should the water intake be reduced (less than normal intake)?

In some diseases, water intake needs to be reduced (under the supervision of a doctor). These are:

1.     Chronic kidney disease,

2.     Heart failure,

3.     Chronic liver disease,

4.     Hyponatremia (low sodium)- some cases are treated by restricting fluid intake. 

How do we know whether our water intake is normal or not?

If you rarely feel thirsty and if the colour of your urine is light yellow (or colorless), your water intake is probably adequate.

What is the best way of getting our daily water requirement?

·      Plain water is the best (safe, inexpensive, easily available and has zero calories).

·      20% of water can also come from fruits, vegetables, juice, milk, tea/coffee, etc

·      Soft (carbonated drinks), sports drinks, energy drinks and alcohol should not be routinely relied upon to complete the daily quota of water. Sports drinks may be taken if one does rigorous exercise for one hour or more.

Can more water intake help in weight loss?

The answer is yes. This is because many times, thirst is confused with hunger. So, whenever you feel hungry, drink water first. People, who consume more water, end up consuming less salt, less sugar and less saturated fats (this leads to weight loss).

A bottle of water before main meals could aid in weight loss.

Replace soda with water, tea of coffee to fight diabetes

Yes, you heard it right. The habit of having a “soft drink” (carbonated beverage) to quench your thirst can increase your chances of getting diabetes, as it contains high amount of sugar. Replacing soda/soft drinks with water, tea or coffee (without sugar) leads to lesser chance of getting diabetes.

Is drinking water on empty stomach in mornings useful?

Yes, drinking water in morning on empty stomach is helpful. Most of us have not had water for about eight hours prior to getting up, leading to mild dehydration. So, one should consume 2-3 glasses (600-800 ml) of water in mornings. This helps in improving bowel movements & urination (leading to release of toxins). This would also reduce hunger, leading to lesser consumption of carbohydrates and fats (thus promoting weight loss).

Providing water dispensers in schools could also be a cheap method of reducing obesity in children.

Dr Sudhir Kumar MD DM (Neurology)

Consultant Neurologist

Apollo Hospitals, Jubilee Hills, Hyderabad

drsudhirkumar@yahoo.com

04023607777/60601066

https://www.facebook.com/bestneurologist/

TEST YOUR KNOWLEDGE ABOUT STROKE

TEST YOUR KNOWLEDGE ABOUT STROKE

1. STROKE is a disease that affects:

A. Heart
B. Brain
C. Kidney
D. Lungs

2. Common symptoms of stroke include:

A. severe chest pain
B. Fits or convulsions
C. Paralysis of face, arms, legs, slurred speech
D. Breathing difficulty

3. If someone suffers from stroke at 9 PM,

A. He can go to OPD the next day
B. He should rush to the nearest general physician
C. He should rush to a hospital with 24X7 CT scan and neurologist on call
D. He can try home remedies for the night.

4. Is there a treatment available for patients with stroke, which would minimise disability

A. Yes
B. No

5. Common risk factors for stroke include all the following EXCEPT

A. Diabetes mellitus
B. Hypertension
C. Running on treadmill
D. Smoking

6. Which of the following measures is NOT helpful in preventing a recurrence of stroke in a person who has suffered stroke?

A. Taking Aspirin
B. Controlling BP and sugars,
C. Quitting smoking,
D. Skipping breakfast, if overweight

7. Physiotherapy helps in better and faster recovery of stroke survivors.
A. True
B. False

8. Stroke affects only older people
A. True
B. False

9. Proportion of population that may suffer a stroke in their lifetime

A. 1 in 10
B. 1 in 8
C. 1 in 6
D. 1 in 4

10. Stroke is treated by
A. Neurologist
B. Cardiologist
C. Nephrologist
D. Chest physician

Please go through these questions and answer them. Answers are posted below

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Thank you for going through the questions. Here are the answers:

1. B
Stroke affects brain. It most commonly occurs due to blockage of blood supply to a part of the brain. In some cases, it can also occur due to rupture of a blood vessel.

2. C 
Common symptoms of stroke include sudden onset facial weakness, weakness of arm or leg, slurred speech, loss of vision on one side, imbalance while walking or severe headache.

3. C
Stroke is a medical emergency. The brain tissue can suffer irreversible damage, if not treated within the first four hours. Therefore, the patient should be rushed to a hospital with 24X7 CT scan facility. The treatment is administration of clot-buster therapy under the guidance of a neurologist.

4. A
Clot-buster therapy with tissue plasminogen activator or tenecteplase within the first four and a half hours after stroke onset can minimise disability.

5. C
Running on treadmill is a healthy exercise and protects from stroke.

6. C
Skipping breakfast is an unhealthy habit. Moreover, it does not help in reducing weight.

7. A
Physiotherapy is very helpful in faster recovery of stroke survivors. It should be started as early as possible.

8. B

Stroke predominantly affects older people, however, it can affect all ages, including children.

9. C

Stroke is a common cause of death and disability (along with heart attacks and cancer) in the world, and affects i in 6 people in their lifetime.

10. A
Stroke is a disease of brain and is treated by neurologist.

I hope you enjoyed this mini-quiz. I would love to hear your comments or any further queries.

Dr Sudhir Kumar MD DM
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad
drsudhirkumar@yahoo.com
04023607777/60601066

https://www.facebook.com/bestneurologist/

"BRAIN" FOODS THAT HELP PREVENT NEUROLOGICAL DISEASES

"BRAIN" FOODS THAT HELP PREVENT NEUROLOGICAL DISEASES

Choice of foods is important, when it comes to prevention and treatment of certain neurological disorders. The article on this topic was published in November 2017 issue of B Positive magazine, a health and wellness magazine.

Dr Sudhir Kumar MD DM (Neurology)
Consultant Neurologist
Apollo Hospitals, Hyderabad
04023607777/60601066
drsudhirkumar@yahoo.com
https://www.facebook.com/bestneurologist/

STROKE: RISK FACTORS, SYMPTOMS, TREATMENT AND PREVENTION (Times of India article)

On the occasion of World Stroke Day (29th October), an article published in Times of India newspaper, to raise awareness about the diagnosis, treatment options and prevention of stroke. 

The article can be accessed in Times of India (Hyderabad edition), dated 29th October 2017 (Page 31), at the following link: http://epaperbeta.timesofindia.com/Article.aspx?eid=31809&articlexml=WORLD-STROKE-DAY-Avoid-a-brush-with-a-29102017105014

Dr Sudhir Kumar MD DM

Senior Consultant Neurologist

Apollo Hospitals, Hyderabad

04023607777/60601066
drsudhirkumar@yahoo.com