DR BULL

Sources

What each video is built on

Indian data first, newest evidence first. Every paper and guideline behind a video, listed under it.

Why Stroke Hits Indians a Decade Early

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  1. Mathur P et al., ICMR-NSRP Investigators. Stroke patterns, risk factors, management, and outcomes from hospital-based stroke registries in IndiaInt J Stroke 2026;21(6):827–38. PMID 41502107 · doi 10.1177/17474930251393187 · PMC13291390. "One in 7 stroke were in the young."↗
  2. Sentinel Stroke National Audit Programme (SSNAP). State of the Nation 2025, Table 1 (PDF)Stroke hospitals in England, Wales and Northern Ireland (not Scotland), admissions April 2024–March 2025: 92,414 patients, median age 76 (IQR 65–84); intracerebral haemorrhage 12,406 (13.4%). Replaces the Oxford Vascular Study (Pendlebury, Lancet Neurol 2019, PMID 30784556: mean 74.4, one county, 2002–12, incl. TIA)↗
  3. Patil RS, Faruqi AA. A case report of simultaneous intracranial… (CVT)Cureus 2024;16(3):e55642. PMC10996888 · doi 10.7759/cureus.55642. Image licence CC BY 4.0 — attribution required↗
  4. GBD 2023 Diseases and Injuries / Risk Factors Collaborators. Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors… 1990–2023Lancet 2025;406(10513):1873–1922. PMID 41092926 · PMC12535840↗
  5. GBD 2023 Causes of Death Collaborators. Global burden of 292 causes of death… 1990–2023Lancet 2025;406(10513):1811–1872. PMID 41092928 · PMC12535838↗
  6. Jones SP et al. Stroke in India: a systematic review of the incidence, prevalence, and case fatalityInt J Stroke 2022;17(2):132–140 (online 2021). PMID 34114912 · doi 10.1177/17474930211027834. IN — crude incidence 108–172/100,000/yr (9 studies)↗
  7. Rangamani S et al. (ICMR population-based registries)Lancet Reg Health SE Asia 2024;23:100308. PMID 38404513 · PMC10884975. IN — crude 138.1/100,000↗
  8. Saver JL. Time is brain—quantifiedStroke 2006;37(1):263–6. PMID 16339467 · doi 10.1161/01.STR.0000196957.55928.ab↗
  9. (background since the 2026-09-14 audit) van Asch CJ et al. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic originLancet Neurol 2010;9(2):167–76. PMID 20056489 · doi 10.1016/S1474-4422(09)70340-070340-0). 36 studies, 8,145 patients; median 1-month case fatality 40.4%↗
  10. (background since the audit) Wolsink A et al. Incidence, case fatality, and functional outcome of intracerebral haemorrhage, according to age, sex, and country income levelLancet Reg Health Eur 2024;49:101180. PMID 39759582 · doi 10.1016/j.lanepe.2024.101180 · PMC11699750. 70 studies, 19,470 patients, 26 countries; 1-month case fatality 35.5%↗
  11. O'Donnell MJ et al. (INTERSTROKE)Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries. Lancet 2016;388:761–75. PMID 27431356 · doi 10.1016/S0140-6736(16)30506-230506-2). 26,919 participants↗
  12. Lewington S et al. (Prospective Studies Collaboration)Age-specific relevance of usual blood pressure to vascular mortality. Lancet 2002;360:1903–13. PMID 12493255 · doi 10.1016/s0140-6736(02)11911-811911-8)↗
  13. Rao Guthi V et al. Hypertension treatment cascade among men and women of reproductive age group in India: analysis of NFHS-5 (2019–2021)Lancet Reg Health SE Asia 2023;23:100271. PMID 38404520 · doi 10.1016/j.lansea.2023.100271 · PMC10884964. 1,267,786 people↗
  14. Kaul S et al. Intracranial atherosclerosis is the most common stroke subtype: ten-year data from Hyderabad Stroke Registry (India)Ann Indian Acad Neurol 2018;21(3):209–13. PMID 30258264 · doi 10.4103/aian.AIAN_86_18 · PMC6137626. Nizam's Institute of Medical Sciences, 2001–2011; 2,642 patients; of 779 large-artery strokes, 610 (78.3%) intracranial↗
  15. De Silva DA et al. Neurol India 2021;69:1282–4PMID 34747800. 216 South Asian patients; 3.01× adjusted odds of poor 6-month outcome↗
  16. Sharma U, Verma P, Adithan S. Surg Radiol Anat 2023;45(8):939–945PMID 37269412 · doi 10.1007/s00276-023-03148-1. 289 Indian CT angiograms↗
  17. International Institute for Population Sciences / MoHFW. National Family Health Survey (NFHS-6) 2023–24, India Fact Sheet (provisional)Fieldwork 28 May 2023–31 Dec 2024; 716,397 women, 100,977 men. Items 84–89: BP ≥140/90 or taking medicine, age 15+ — women 19.4%, men 22.1%. No cascade rows↗
  18. Patel D et al. Role of lipoprotein(a) in atherosclerotic cardiovascular disease in South Asian individualsJ Am Heart Assoc 2025. PMID 40654252 · doi 10.1161/JAHA.124.040361↗
  19. Koh MY et al. Association of elevated lipoprotein(a) levels with ischemic stroke in young patients — a systematic review and meta-analysisJ Stroke Cerebrovasc Dis 2024;33(11):107960. PMID 39222699 · doi 10.1016/j.jstrokecerebrovasdis.2024.107960. 5 case-control studies (1,345 patients under 65); the ≥30 mg/dL-only analysis, 4 studies: OR 1.43 (1.08–1.88)↗
  20. Tsimikas S et al. Eur Heart J 2020;41(24):2275–84PMID 31111151. Statins raised Lp(a) 8.5–19.6% (6 RCTs, 5,256 patients)↗
  21. Bhatia HS et al. Circulation 2025;151(4):312–21PMID 39492722↗
  22. Misra A et al. Obesity, abdominal obesity, and adipose tissue depots in South Asians with specific reference to Asian IndiansJ Clin Lipidol 2025. PMID 41293937 · doi 10.1016/j.jacl.2025.06.012↗
  23. Mathur P et al. Awareness, behavior, and determinants of dietary salt intake in adults: results from the National NCD Monitoring Survey, IndiaSci Rep 2023;13:15890. PMID 37741845 · doi 10.1038/s41598-023-42694-x · PMC10517942. 3,000 adults aged 18–69↗
  24. Mathur P et al. National NCD monitoring survey (NNMS) in India: estimating risk factor prevalence in adult populationPLoS One 2021;16(3):e0246712. PMID 33651825 · doi 10.1371/journal.pone.0246712. Mean salt 8 g/day (95% CI 7.8–8.2)↗
  25. Johnson C et al. Sources of dietary salt in North and South India estimated from 24 hour dietary recallNutrients 2019;11(2):318. PMID 30717304 · PMC6412427. 1,283 people↗
  26. SSiIS. Am J Clin Nutr 2021PMID 33782684 · doi 10.1093/ajcn/nqab054. 502 rural Indian hypertensives↗
  27. Neal B et al. (SSaSS)Effect of salt substitution on cardiovascular events and death. N Engl J Med 2021. PMID 34459569 · doi 10.1056/NEJMoa2105675. 20,995 people in rural China with a history of stroke, or aged 60+ with high blood pressure↗
  28. Miller MR et al. Inhaled nanoparticles accumulate at sites of vascular diseaseACS Nano 2017;11(5):4542–52. PMID 28443337 · doi 10.1021/acsnano.6b08551↗
  29. GBD 2023 Risk Factors Collaborators. Lancet 2025;406(10513):1873–1922PMID 41092926 · PMC12535840. India stroke-DALY shares from its appendix 3, table 13B (GHDx), rebuilt for all three stroke types: high systolic BP 53.6%, air pollution 34.9% (modelled)↗
  30. Prabhakaran S et al. 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: a guideline from the American Heart Association/American Stroke AssociationStroke 2026;57(8):e316–e436. PMID 41582814 · doi 10.1161/STR.0000000000000513. IV thrombolysis within 4.5 h (Sec 4.6.1); thrombectomy within 6 h and in selected patients 6–24 h (Sec 4.7.2). Correction: doi 10.1161/STR.0000000000000530↗
  31. Dutta A et al. Factors associated with prehospital delay in stroke: a multicentre study from eastern IndiaIndian J Med Res 2026;164(3):412–416. PMID 42690856 · doi 10.25259/IJMR_285_2026 · PMC13541205. 10% of patients or families recognised the symptoms as stroke; 44.1% went directly to a stroke-ready hospital↗
  32. Asif KS et al. Geo-spatial analysis of acute ischemic stroke reperfusion treatment in IndiaInt J Stroke 2025;20(6):708–20. PMID 39719435 · doi 10.1177/17474930241312598. Centre data March 2021; 566 thrombolysis-capable / 361 thrombectomy-capable centres↗
  33. Union Health Secretary Punya Salila Srivastava, National Stroke Summit, New Delhi, 22 Jan 2025: "Nearly 500 stroke units are currently operational across the country" (All India Radio, newsonair.gov.in). Official statement, not a peer-reviewed source↗
  34. Ettehad D et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysisLancet 2016;387:957–67. PMID 26724178 · doi 10.1016/S0140-6736(15)01225-801225-8). 613,815 participants; stroke RR 0.73 per 10 mmHg↗
  35. Kronenberg F et al. (European Atherosclerosis Society consensus)Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis. Eur Heart J 2022;43:3925–46. PMID 36036785 · PMC9639807↗
  36. Service facts: 112 = India's national Emergency Response Support System number; 108 = medical-emergency ambulance (National Health Mission: 35 States/UTs dial 108 or 102)↗

Slim people, fatty liver?

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  1. Shalimar et al. Prevalence of NAFLD in India: systematic review and meta-analysisJ Clin Exp Hepatol 2022;12(3):818-829↗
  2. Desai GS et al. Liver fat in 688 healthy medical students, BelagaviCureus 2025;17(9):e92747↗
  3. Kumar A et al. DiaFib-Liver: liver fibrosis burden in type 2 diabetes in IndiaLancet Reg Health Southeast Asia 2026;47:100753↗
  4. Bhagat N et al. Non-obese MASLD, lifestyle vs lifestyle plus a drug: randomised trial, PGIMER ChandigarhIndian J Med Res 2026;163(4):477-485↗
  5. Tiwari AK et al. Drug or supplement vs lifestyle in MASLD: 3-arm randomised trial, BHU VaranasiIndian J Med Res 2026;163(5):598-605↗
  6. Duseja A et al. INASL guidance paper on NAFLDJ Clin Exp Hepatol 2023;13(2):273-302↗
  7. Duseja A et al. INASL adopts the MASLD nameJ Clin Exp Hepatol 2025;15(5):102590↗
  8. Sharanabasava et al. Structured lifestyle change in normal-BMI NAFLD, JaipurJ Clin Exp Hepatol 2026;16(6):103632↗
  9. Raj PS et al. Lean MASLD: current insightsBest Pract Res Clin Endocrinol Metab 2026;40(4):102107↗
  10. EASL-EASD-EASO Clinical Practice Guidelines on MASLD (Europe). J Hepatol 2024;81(3):492-542↗

When a balloon can't open a heart blockage

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  1. Barbato E et al. Management strategies for heavily calcified coronary stenoses: an EAPCI clinical consensus statementEur Heart J 2023;44:4340-56↗
  2. ECLIPSE trial — orbital atherectomy vs balloon angioplasty before drug-eluting stents in severely calcified lesions. Lancet 2025↗
  3. ROLLER COASTR-EPIC22 — rotational atherectomy vs lithotripsy vs laser. JACC Cardiovasc Interv 2025↗
  4. ICARE OFDI — intravascular lithotripsy vs rotational atherectomy, randomised. EuroIntervention 2026↗
  5. Hill JM et al. Disrupt CAD III — intravascular lithotripsy for severely calcified coronary diseaseJACC 2020↗
  6. Ali ZA et al. Disrupt CAD IICirc Cardiovasc Interv 2019↗
  7. Gupta A et al. Coronary intravascular lithotripsy in contemporary practice (review)Ther Adv Cardiovasc Dis 2024↗
  8. Khattak S et al. Atherectomy techniques: rotablation, orbital and laser (review)Interv Cardiol 2024↗
Older videos carry their sources in the YouTube description. Spotted a figure that looks wrong? Write to contact@drbull.in — corrections get pinned.