🧠 The Helios Child Neurology Centre | Child Neurology Care in Vadodara | 📍 Karelibaug, Besides Bansal Mall | 📞 6359418317 / 9016840070
Vadodara, Gujarat
Joined June 2021
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Spinal muscular atrophy - Mini review and sneak peak into therapeutics drshridharjoshi.substack.com…
# Neuro twitter # FOApediatrics #Neurophilia # SMA awareness
🧩 ऑटिज्म स्पेक्ट्रम डिसऑर्डर (ASD) को समझें
क्या आपका बच्चा बोलने में देरी करता है या दूसरों से घुलने-मिलने में कठिनाई महसूस करता है? 👶
ये कुछ ऐसे संकेत हो सकते हैं जिन पर ध्यान देना ज़रूरी है।
#AutismAwareness #ASD #ChildDevelopment #AutismSpectrumDisorder
🧩 Autism Spectrum Disorder (ASD) Awareness 💙
Every child is unique, and every child deserves understanding, acceptance, and support. 🌈
🔹 Delayed speech and communication
🔹 Limited eye contact
🔹 Repetitive behaviours
#AutismAwareness #AutismSpectrumDisorder
📚💙 क्या आपका बच्चा मेहनत करने के बावजूद पढ़ाई में कठिनाई महसूस करता है?
हर बच्चा अलग तरीके से सीखता है। 🧠✨ पढ़ने, लिखने या गणित समझने में लगातार परेशानी होना Specific Learning Disability (SLD) का संकेत हो सकता है।
#SpecificLearningDisability #LearningDisabilityAwareness
क्या आपका बच्चा अपनी उम्र के अनुसार बैठने, चलने, बोलने या चीज़ों को समझने में पीछे है?
तो इन संकेतों को नज़रअंदाज़ न करें। ⚠️
#GlobalDevelopmentalDelay #GDD #ChildDevelopment #DevelopmentalDelay #ChildNeurology #PediatricNeurology #EarlyIntervention #ChildHealth
The Helios Child Neurology Centre retweeted
1.
60♂, CLD, referred for tremor while holding plates|objects, worse during febrile episodes.
O/E: minimal postural tremor, no asterixis, mild EPS & gait instability.
T1 MRI 👇
🌟 Something has Brightened 💎
🧵
The Helios Child Neurology Centre retweeted
Quality education is now thought of as a luxury.
Even though AI-based learning companions such as the one at eklavya.io are free and far better
The Helios Child Neurology Centre retweeted
The correct answer is “None of the above”.
Read this thread for a detailed explanation
xitter.cf/cwruepilepsy/status/21…
The Helios Child Neurology Centre retweeted
Every 24th September, the story gets told the same way. Dhoni's helicopter of a captaincy,Sreesanth catching that skier, Joginder Sharma bowling that last over. India won the first T20 World Cup on this day in 2007 & every year anniversary belongs to men in the frame. The man who built the frame barely gets a mention. Nobody rings up Lalchand Rajput. Nobody ever does.
Lalchand Rajput was never even called the coach. BCCI gave him the title "Cricket Manager", a semantic back door they would later use to walk him out of the job.
He inherited ruins. Chappell had gone, 2007 ODI World Cup had been a disaster, effigies were still warm & Sachin,Ganguly and Dravid had opted out of a format nobody trusted. The squad had played one T20I between them. captain had never captained anything.
Rajput took that mess & along with Dhoni gave it one line to live by. "Pressure lene ka nahi, pressure dene ka". Typical Mumbai words, the kind you hear on a Wankhede maidan on a Sunday morning.
What began as a dressing room joke, Robin Uthappa later admitted, Rajput kept repeating until it became the team's spine. He gave young men permission to fail, which is the only way young men ever play freely. He broke the senior-junior hierarchy over Nando's chicken orders in Dhoni's room. He made PowerPoints on opposition weaknesses and then got out of the captain's way.
Nobody talks about the bowl out against Pakistan properly either. That wasn't luck. Rajput, Venkatesh Prasad and Robin Singh had worked out beforehand that spinners hit the stumps more often than fast bowlers do without a batsman standing there. Sehwag, Harbhajan and Uthappa were picked for exactly that reason. People remember Uthappa's celebration. Almost nobody remembers why he was even bowling.
Then came the erasure. He managed India through Monkeygate & CB Series win in Australia, 2 overseas triumphs in 6 months. Sachin Tendulkar spoke highly of him and even wrote a positive recommebdation for him to Sharad Pawar. A senior player called his sacking "a stupid decision". But BCCI kept Prasad and Robin Singh, dropped Rajput.
He didn't sit around sulking about it. Took that same Khadoos stubbornness to Afghanistan, got them Test status. Took it to Zimbabwe when players were boycotting over unpaid salsries and left them with Sikandar Raza's second career. Now he sits in the UAE camp & help the youngsters with same mindset he helped Dhoni's yoing turks.
So today, when 2007 trophy pictures do the rounds again, spare one thought for the man who was never in the frame. Beacuse some architects don't get their names on the building. They just make sure it stands.
The Helios Child Neurology Centre retweeted
Key Point 2 from the article Inpatient Sleep Medicine by Dr. Mark I. Boulos, from the August #SleepNeurology issue, which is available to subscribers at hubs.la/Q04tTzjS0. #NeuroTwitter #MedEd
The Helios Child Neurology Centre retweeted
Absolutely do not do this.
This is mostly offered by "Cosmetologists" or commercialized Dermatology clinic chains. Cosmetology is not a recognized medical degree or a protected medical title under the National Medical Commission in India. So anyone claiming to be "cosmetologist" is not really a medical practitioner. They are similar to certified "coaches" or "wellness experts".
The clinical evidence supporting IV glutathione is exceptionally poor. Marketing claims rely heavily on anecdotal reports and a single, widely criticized trial that suffered from a tiny sample size, poor study design, and unreliable evaluations.
Because the body continuously produces melanin, any potential lightening effect is temporary. Once the extreme systemic doses are stopped, the skin's natural pigmentation returns.
Because IV glutathione is not approved for cosmetic use, the solutions utilized in wellness clinics and med-spas are typically sourced from "compounding pharmacies". This bypasses standard pharmaceutical manufacturing regulations, introducing severe risks.
A "compounded drug" is a custom medication created by a pharmacist or physician who combines, mixes, or alters ingredients on their own.
In August 2026, the US FDA issued an urgent safety warning after dozens of patients experienced potentially fatal infection (sepsis)-like symptoms - including fever, chills, low blood pressure, and hospitalization, following glutathione IV treatments. Clinics were found to be compounding IV drips using dietary-supplement-grade powder, which contained dangerously high levels of bacterial endotoxins.
Administering high doses has been linked to severe adverse effects, including anaphylaxis, acute kidney and liver dysfunction, and potentially fatal skin reactions like Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS and TEN)
Ultimately, the administration of IV glutathione in dermatology and cosmetology clinics is a lucrative marketing trend that operates outside the bounds of evidence-based medicine.
Like I said, absolutely, do not do this.
People who believe in big Pharma conspiracy theories believe that big Pharma has created these diseases and then developed their solutions. In loko ka kya kare. Kaise counsel kare ? Or just leave them to fate
Big Pharma solved HIV. Big Pharma solved Psychosis. Big Pharma solved diabetes and hypertension. Big Pharma solved many cancers.
Do I love Big Pharma? Yes.
Do I hate Big Pharma for solving problems but making the solutions unaffordable? Also YES.
Nuances exist everywhere. Including my feelings for Big Pharma.
The Helios Child Neurology Centre retweeted
🧠 When turning the head causes a stroke… think beyond the brain.
A fascinating case of Bow Hunter Syndrome (rotational vertebral artery occlusion):
🔹 Recurrent posterior circulation strokes
🔹 Occipitalization of C1
🔹 C1–C2 bony anomaly with an osteophyte at the C2 transverse foramen
🔹 Routine static angiography was inconclusive
🔹 Dynamic cerebral angiography clinched the diagnosis
🎯 The patient was asked to turn the head to the LEFT.
Injection of the right occipital artery demonstrated dynamic compression of the vertebral artery at the C2 transverse foramen.
The key lesson:
The culprit may only appear when the head moves.
In patients with recurrent posterior circulation ischemia + reproducible neck pain/neurological symptoms with rotation, dynamic vascular imaging can be diagnostic—and potentially stroke-preventing.
#BowHunterSyndrome #VertebralArtery #Stroke #Neurointervention #Neuroradiology #DynamicDSA #PosteriorCirculationStroke
The Helios Child Neurology Centre retweeted
A 🧵 on understanding emotional eating-
I recently took a session on “Neurobiology & Neuropsychology of Appetite and Obesity” for a group that included several senior doctors from Vadodara.
One question that generated a lot of discussion was:
Why do our emotions change the way we eat?
1/n
The Helios Child Neurology Centre retweeted
If you wish to watch this session which I took as a part of Saturday club of Vadodara, then this is the YouTube link. Feel free to share. 😊🙌
13/13
youtube.com/live/Q8bYaJYLCLQ…
The Helios Child Neurology Centre retweeted
🧵In #neurology every day is a 🆕 learning
♂ in early 30’s p/w recurrent excruciating fingertip pains involving middle 3 fingers of 𝐋 hand, ring💍finger of 𝐑 hand & 3rd toe of 𝐋 foot x 4 yrs
Tenderness on pinching the fingers from the sides. Clinical 𝔇𝓍: Glomus Tumor
❶of❼
The Helios Child Neurology Centre retweeted
🧠 SPINAL TUMOURS: Don’t Memorise—LOCALISE!
When you see a spinal mass on MRI, the first question is: WHERE? 📍
🔴 INTRAMEDULLARY — inside the cord
➡️ Adult → Ependymoma → central, well-defined, 🩸 cap sign, syrinx
➡️ Child → Astrocytoma → eccentric, infiltrative
#neurorad
The Helios Child Neurology Centre retweeted
People assume the hardest part of making content for 10 years is ideas.
No.
It is repetition.
It is convincing yourself that trhe thing you have said a dozen times before still needs to be said.
Saying the thing you said in 2021 to the person who just arrived in 2026.
The audience keeps refreshing.
The truths do not.
Teachers have known this for centuries.
The Helios Child Neurology Centre retweeted
Cephalosporins (the drugs we give to kill salmonella) were discovered when scientists found that people who swam near a sewage outfall with widespread fecal contamination never got typhoid, even though they often gulped the water while swimming.
Then they found the reason. The water had a fungus growing called Cephalosporium acremonium which produced an antibiotic called cephalosporin C that killed Salmonella. The cephalosporin class of antibiotics was first identified from this discovery. – at Kakkodi, India
The Helios Child Neurology Centre retweeted
We prescribe anti-seizure medicines for years.
But one small question is often missed.
What should we give along with them?
Vitamin D? Calcium? Folate? B12? B6? Carnitine?
I used to think of these as supplements. I now find it more useful to think of them as clues to what the drug is doing elsewhere in the body.
A patient on long-term Phenytoin, Carbamazepine, Phenobarbitone, Primidone or Oxcarbazepine makes me think about bone.
Not automatically about a calcium tablet.
I ask about diet, sunlight, age, menopause, fractures, duration of treatment and polytherapy. I check Vitamin D when appropriate and think of DXA when fracture risk is significant.
Valproate also deserves attention to bone health, although the mechanism is different.
Carnitine with valproate is another commonly misunderstood practice.
I don't routinely prescribe it to every patient. I think of it when there is hyperammonaemia, toxicity, nutritional deficiency or another specific indication.
With Topiramate and Zonisamide, my attention shifts completely.
I think of bicarbonate.
These drugs can produce metabolic acidosis. Persistent acidosis or recurrent stones may occasionally require alkali therapy. Potassium citrate is not a compulsory companion to topiramate.
Then comes Levetiracetam + B6.
We see this combination frequently, particularly when irritability appears.
It sounds logical. Evidence, however, is still not strong enough to make B6 routine.
Folic acid has its own place.
If pregnancy is possible, folate should be considered with any anti-seizure medicine. Current AAN/AES/SMFM guidance recommends at least 0.4 mg/day before conception and during pregnancy.
But folate cannot make valproate safe in pregnancy.
And B12?
I would rather look for a reason.
Macrocytosis, anaemia, neuropathy, poor nutrition, vegetarian diet, elderly patient, metformin or PPI use.
Check it. Replace it when required.
So when I write an anti-seizure prescription, I try not to ask:
Which vitamin goes with this drug?
I ask:
What can this drug disturb in this patient over the next few years?
Phenytoin/Carbamazepine/Phenobarbitone/Oxcarbazepine → think bone
Topiramate/Zonisamide → think bicarbonate
Pregnancy potential → think folate
Valproate toxicity/hyperammonaemia → think carnitine
Levetiracetam → B6 is not routine
Most newer ASMs → no routine supplement
Perhaps that is the easier way to remember it.
We don't need to supplement the prescription.
We need to anticipate the consequence of the prescription. #NeuroX , #MedX, #Epilepsy #ASM
The Helios Child Neurology Centre retweeted
Incorrect.
This sounds convincing because it strings together a lot of true facts with some very false arrows.
Warburg did not win the 1931 Nobel Prize for discovering “the metabolic root of cancer.” He won it for work on the respiratory enzyme. The Warburg effect is real; the claim that insulin resistance is the root cause of cancer is not.
Now comes a misleading chain:
Insulin resistance → high insulin → high glucose → “feeds cancer” → cancer.
This is not physiology. Early insulin resistance usually causes compensatory high insulin precisely to keep glucose normal. Glucose rises later when that compensation starts failing, causing diabetes.
And if high glucose were simply an abundant fuel supply driving cancer, people with long-standing diabetes should be developing cancer almost routinely. They don’t.
Diabetes modestly increases the risk of some cancers; it does not turn cancer into an inevitable metabolic consequence.
The Women’s Health Study cited here is another giveaway. It studied coronary heart disease, not cancer. The famous ~10× hazard ratio was diabetes predicting premature CHD in younger women. Comparing that directly with an LDL hazard ratio and declaring diabetes “seven times stronger” is statistically meaningless because the variables were measured on completely different scales.
And a fasting insulin of 3.7 may indicate good insulin sensitivity. Great. It does not mean you have “starved cancer.” No validated cancer-protective fasting-insulin threshold exists.
The Warburg effect is fascinating. Insulin/IGF signalling and metabolic health do matter in cancer biology.
Risk factor ≠ root cause
Glucose consumption ≠ glucose causation
association ≠ mechanism
mechanism ≠ proven treatment
The most persuasive misinformation is rarely made of completely false facts. It is made of real facts joined by imaginary arrows.
And “medicine silenced this to build a $200 billion chemotherapy industry” is not science.
This is unalloyed conspiracy theory.
I am going to tell you about a Nobel Prize winner who discovered the metabolic root of cancer 95 years ago. The system built chemotherapy instead.
Otto Warburg won the Nobel Prize in Physiology or Medicine in 1931 for discovering how cancer cells produce energy.
Normal cells burn glucose efficiently in the mitochondria. Clean energy. Minimal waste.
Cancer cells do something different. They ferment glucose. Even when oxygen is available. They consume massive amounts of sugar. The process is inefficient but fast. Growth at all costs.
This is called the Warburg Effect. It has been confirmed in virtually every type of cancer studied. It is not controversial. It is taught in every medical school biochemistry course.
What is never taught is the next question. What creates the environment where cancer cells thrive.
Insulin resistance.
When you are insulin resistant, circulating insulin stays high. Blood glucose stays high. The fuel supply for cancer cells is abundant and constant.
But it is worse than that. High insulin activates IGF-1. Insulin-like growth factor. It sends growth signals to every cell in the body. Cell division accelerates. Tumor suppression turns off.
Insulin resistance does not just feed cancer. It signals cells to grow.
The 2021 Women’s Health Study followed 28,024 women for over 21 years. Diabetes, which is advanced insulin resistance, had a hazard ratio of 10.0x for cardiovascular events. It was the single strongest predictor on the chart. Stronger than smoking. Stronger than hypertension. Seven times stronger than LDL cholesterol.
Cancer is on the same chart. Because it shares the same root cause.
The hub image I posted earlier this week showed insulin resistance at the center with ten diseases radiating outward. Heart disease. Type 2 diabetes. Alzheimer’s. Fatty liver. Stroke. Cancer. Kidney disease. High blood pressure. PCOS. Obesity.
One root cause. Ten diseases. One $20 test nobody orders.
Warburg discovered the metabolic vulnerability of cancer in 1931. Thomas Seyfried expanded on it in 2012 with “Cancer as a Metabolic Disease.” The evidence has been building for nearly a century.
The system responded by building a $200 billion chemotherapy industry that poisons the entire body to kill the tumor. Nobody addressed the fuel supply. Nobody tested fasting insulin. Nobody connected the metabolic environment to the disease.
My fasting insulin is 3.7. That number does not just protect my arteries. It starves the metabolic environment that cancer needs to thrive. It keeps IGF-1 signaling low. It keeps glucose from flooding the system. It keeps growth signals quiet.
One number. Protecting against heart disease and cancer simultaneously. Under $20.
A Nobel Prize winner proved this 95 years ago. It was silenced.
The truth heals
