RAMKI

Neurologist , senior citizen

[RAMKI @RAMKIKARUPPU]

PUMPKING

[RAMKI @RAMKIKARUPPU]

Innocent Attitude ♥️

[RAMKI @RAMKIKARUPPU]

Fragrance of Innocence ♥️

[RAMKI @RAMKIKARUPPU]

Post meals walk may be a triggering factor for heart attacks especially those who have silent or symptomatic coronary artery disease because more blood supply to stomach after eating, , Normally after & while you walk after eating heart &pulse rate will increase & more demand for oxygen . In this post meal walking , coronary artery disease will get insufficient oxygen to heart & may end in heart attack spectrum.

[RAMKI @RAMKIKARUPPU]

Everything is atonic except Erection-A fascinating neurophysiological observation: REM sleep produces near-complete skeletal muscle paralysis, yet nocturnal and early morning erections remain intact in REM-phase of sleeping because it is mediated predominantly by autonomic parasympathetic mediated —not somatic—neural pathways.

[RAMKI @RAMKIKARUPPU]

@hyderabaddoctor @Coffeehudigi 👌🏻👌🏻👌🏻Excellent teaching case & interesting narrative Sir, —pure neuritic leprosy usual pattern is an asymmetrical mixed sensorimotor neuropathy involving enlarged peripheral nerves.

[RAMKI @RAMKIKARUPPU]

@hyderabaddoctor Sir, 👏Thank you for your continuous contribution to Neuroteaching.—————-In this case If glabellar tap test is negative- ET, if positive - possibly Tremor predominant PD > better to do TRODAT scan differentiate PD/ET

[RAMKI @RAMKIKARUPPU]

In a world where young lives are often cut short by illness or accidents, families must plan with resilience. Encouraging marriage in the early 20s and having at least three children — ideally five — ensures continuity, care, and strong intergenerational support. Biology favors early fertility, and parents, while still active, can help raise the next generation. This approach safeguards families against life’s uncertainties and strengthens society’s future.”

[RAMKI @RAMKIKARUPPU]

@WorldBladderCan Painless blood in urine is the most common warning symptom of bladder cancer

[RAMKI @RAMKIKARUPPU]

@Jasonphilip8 Sir,Please take care of Your Health . Kind request-Please reconfirm disc pathology is the only reason for pain & or any other added , hidden reversible reasons along with disc pain .

[RAMKI @RAMKIKARUPPU]

@SikandarAdwani Excellent mini blueprint of DMN for Rational clinical practice Sir👍🏻👏

[RAMKI @RAMKIKARUPPU]

Practical boundary (where to give the rope)

Give to AI:

Data aggregation
Protocol suggestions
Differential diagnosis expansion
Documentation

Do NOT give to AI:

Final diagnosis in complex cases
Ethical decisions
Risk acceptance
Context-based judgment (social, economic, cultural factors)

[RAMKI @RAMKIKARUPPU]

The superior sagittal sinus has a triangular cross-section. >Enhancing dural walls + non-enhancing intraluminal clot = empty delta sign.>Typically appears in the subacute phase (after collateral circulation develops).
* Early phase may show only hyperdense sinus (dense clot sign) without the delta

[RAMKI @RAMKIKARUPPU]

@medic_updates SGLT2inhibitor may rarely induce Eyglycemic keto acidosis & Metformin also rarely induce lactose acidosis-Good combination? or Avoidable combination.

[RAMKI @RAMKIKARUPPU]

@SharathKumarGG7 @ManipalHealth In SDAVF-steroids will increase vascular engorgement & the deficit becomes worsening- High index of suspicion should be maintained if steroids worsens paraplegia - first r/o SDAVF.

[RAMKI @RAMKIKARUPPU]

@SikandarAdwani Thanks for Your excellent good practice statement

[RAMKI @RAMKIKARUPPU]

@SikandarAdwani Sir, Please post your experience usage of LMWH in non cardiac ischemic stroke &+ patients are with increased d-dimer