Dr Boby Varkey Maramattom

Dr Boby Varkey Maramattom MD, DM (Neurology), FRCP ( Lon), FRCP ( Edin),FICCN (Mayo clinic, USA), EDSI.

25/06/2025

The ‘Pants-sign’-
When Parkinson patients stop putting on their pants while standing and start sitting down to put on their pants. It is associated with future falls in people with PD, along with disease severity and a history of previous falls. Limitations of the "Pants-sign" include a fear of falling, leading to more cautious behavior and possible co-morbidities, such as polyneuropathy or arthritis, which can impact the ability to put on pants while standing.

Ref (Jansen et al. The 'Pants-Sign': A Predictor for Falling in People with Parkinson's Disease? J Parkinsons Dis. 2023;13(8):1321-1327.)

23/06/2025

Benedikt syndrome -due to mesencephalic damage to the ipsilateral red nucleus, substantia nigra, third cranial nerve, and cerebral peduncle.
Presents with
Ipsilateral oculomotor nerve palsy
Contralateral hemiparesis
& Contralateral cerebellar ataxia and/or Holmes tremor and/or choreoathetosis

14/06/2025

Just a reminder
NNT for large vessel occlusion Rx with EVT -2.8
NNT for MeVO ( medium vessel occlusion)- 5.4
NNT for minimally invasive surgery in lobar ICH -11.5.

How Indian firms invent spectacular stuff and then shoot themselves in the foot with atrocious service. I recently bough...
12/06/2025

How Indian firms invent spectacular stuff and then shoot themselves in the foot with atrocious service.
I recently bought a tubeless stethoscope from Chesto by paying upfront
When the Delhivery parcel service delivery person delivered the item, he asked my mother to pay for the item again. Unwittingly she did so. On learning this I immediately wrote multiple messages to both Chesto and Delhivery
There has only been a resounding silence from their sides.
It’s a pity that they are neither accountable nor answerable.

12/06/2025

The simple “5-2-1” rule (Oral levodopa intake ≥ 5 times a day, 'OFF' symptoms at least 2 hours a day, and troublesome dyskinesia for at least 1 hour a day) is a reasonable predictor for patients with advanced PD to screen those who might benefit from invasive therapies such as Deep brain stimulation, .
(Aldred et al.. Application of the ‘5-2-1’ screening criteria in advanced Parkinson's disease: interim analysis of DUOGLOBE. Neurodegener Dis Manag 2020).

10/06/2025

Psoriasis as a risk factor for stroke.
Ps is a Chronic inflammatory skin condition that is Pro-atherogenic.
Ps triggers an immune response with activation of T cells, myeloid cells, and platelets.
Ps increases TNF-alpha, and interleukins [ IL-23, IL-17, and IL-6] which are associated with vascular inflammation and atherosclerosis development.
The risk of cardiovascular disease (CVD) increases in proportion to the severity of Ps.
Ps is an additional risk factor alongside traditional cardiovascular risk factors—Hypertension, diabetes, hyperlipidemia, obesity, and smoking
Ps patients have a 10-year risk of coronary events or stroke that is 6.2% higher than that predicted by traditional cardiovascular risk models.

01/06/2025

For most of my conversation with a patient today, I thought he was a schizophrenic- he complained of epochs where everything and everyone around him appeared to move at twice the speed and time also sped up. He had been referred to multiple psychiatrists and received meds with no effect
It was around the end of our convo that I realised he was suffering from a Zeitraffer phenomenon ( ZP)

The Zeitraffer phenomenon (ZP): a striking illusion of altered motion speed—objects appearing too fast or slow. Often linked to right hemispheric lesions, especially in area V5/dorsal stream. Seen in strokes, trauma, migraines & seizure auras.

28/05/2025

A new option in progressive multifocal leukoencephalopathy (PML). Directly isolated allogeneic virus–specific (DIAVIS) T cells show promise in PML. Adoptive transfer of direct isolation of virus-specific T cells (VSTs) from a donor to the patient. Virus-specific T cells are isolated by in vitro stimulation and expansion or direct selection of specific T cells ex vivo from peripheral blood of a seropositive donor

24/04/2024

Malayalee patients have wierd names sometimes. One of nurses had to go and tap these gentlemen on the shoulder to call them in instead of the customary name shouting. Cause they had names like ‘Titty’ and ‘Sh*tty’. One guy had such an Inglorious Bad word as his name that all of us would roll our eyes whenever he came to clinic.

23/04/2024

Coach USA provides such a crappy customer service. Two families were waiting for the 310 pm bus to Chicago O’hare airport from Milwaukee. The bus driver didn’t turn up and the dispatcher and customer service refused to entertain our pleas. We were left high and dry and had to get someone to drive us to the airport 2 hours away. Quoting their ‘terms of service’ they fleeced us out of more than 200 dollars. Shame on you @ Coach USA

Inauguration of the Joint replacement Robot at Lourdes hospital
06/04/2024

Inauguration of the Joint replacement Robot at Lourdes hospital

06/04/2024

Very disappointing post purchase experience with Kia Incheon , Desom. Aluva , Kerala .Despite multiple calls to them , no one bothers to call back or try to help. The car has run less than 2500 km and is practically brand new. Very disappointing and frustrating customer service. Kia India

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Apollo Adlux Hospital, Angamaly & Ajantha Clinic, Palluruthy, Kochi 6
Kochi
682006

Opening Hours

Wednesday 8:30am - 12pm
Thursday 7am - 7:45am
Saturday 8:30am - 12pm

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