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Dr Sudhir Kumar MD DM🇮🇳 Profile picture
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Oct 25 • 4 tweets • 2 min read
Use of Hormone Replacement Therapy (#HRT) and Risk of #Dementia
1. HRT is prescribed in women after #Menopause (natural or surgical). A recent study looked at the risk of dementia in women taking HRT (estrogen, progesterone or combination)
#MedTwitter #neurotwitter #Alzheimers
2. The risk of dementia was 35% higher in women taking HRT as compared to those who did not take it.
3. The risk of Alzheimer's disease (AD) was 20% higher and Vascular dementia (VaD) was 79% higher in the HRT group.
5. There was a trend toward an increased risk of dementia with a higher cumulative dose of HRT prescription (but not the duration of HRT).
6. Possible mechanism- increased risk of brain strokes and silent micro-infarcts with HRT
Conclusion:
Hormone replacement therapy in post-menopausal women increases the risk of dementia- both AD and VaD. Benefits of HRT should be weighed against the possible risks before taking the decision to start. (Ref: #neurology, Oct 25, 2022)

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More from @hyderabaddoctor

Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Oct 26
How to achieve a lower heart rate (HR) while running?

HR increases while running as with any aerobic activity. Workout is more effective when HR increases. How much increase in HR is ideal? How to achieve a lower HR if it exceeds the recommended maximum HR? Sharing my experience
1/n
What is the recommended maximum HR while #running?
It is 50-70% of max HR for medium paced running and 70-85% of max HR with fast paced running.
Max HR is 220 minus age. (Ref: American Heart Association- AHA)
2/n
 Are there any dangers if we exceed the recommended HR zones while running?
Lower HR generally indicates good heart health, and higher HR suggests the reverse. High HR puts extra strain on the heart and can cause heart muscle damage in the long term, leading to scar formation
Read 8 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Oct 26
Reasons I love #neurology
1. 2022 is my 25th year in Neurology. I enjoy this subject many times more than 1998, when I entered this branch as a #resident at @OffCMCVellore I was dissuaded by many of my teachers to take up DM in another specialty but I stuck to Neurology
THREAD
2. Neurology is vast: If you love reading, there are several topics you can read. There are about 600 common #diseases in Neurology to read about. Newer diseases are being discovered, so there is no dearth of new topics to learn about.
3. History & physical examination are still the most important to arrive at a diagnosis. Whether it is epilepsy, migraine, stroke, Parkinson's disease or Alzheimer's disease, history & physical are more valuable than any investigations. MRI, EEG & EMG contribute but are not final
Read 11 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Oct 25
Awesome October 2021: A month of 31 half #marathons on 31 consecutive days- sharing my experience
1.Starting from 30th September, and ending on 31st October 2021, I completed 32 runs of 21.1 km or longer, with a total mileage of 817 km in 32 days (average of 25.5 km/day).
This included one Full marathon (42.2 km) on 30th October.
2.The purpose was to test my #endurance, and to see the #physical & #mental effects of long distance #running on 32 consecutive days. I present my observations here.
3. How difficult was it? In reality, it was not difficult. Once you get up and start the run, it is easy to complete. The most important is- you need 2.5 to 3.5 hours time to compete the distance. I could manage that in the mornings between 5 and 8:30 AM.
Read 11 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Oct 24
Skipping breakfast or skipping dinner- which of these is associated with weight gain/obesity?

1. Many people skip one or more meals per day in order to lose weight. Here I present data from two recent studies.
#obesity #OverWeight #diet #breakfast #dinner #MedTwitter
2. A retrospective large cohort study revealed that skipping dinner was significantly associated with ≥10% weight gain and overweight/obesity (BMI ≥ 25 kg/m2) in both male and female students. Skipping breakfast or lunch did not result in weight gain. (Ref: Nutrients, Jan 2021)
3a. A recent meta-analyses indicated an 11% increased RR for overweight/obesity when breakfast was skipped on ≥3 days per week compared to ≤2 days per week. The meta-analysis on body mass index (BMI) change displayed no difference between breakfast skipping and eating.
Read 4 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Oct 23
Doctors in India live 10 years lesser than average population- What can doctors do to save their lives?

1/n
 Yes, you heard it right. Studies from Kerala and Pune by Indian Medical Association revealed these shocking statistics- doctors die about a decade earlier that the rest.
2/n
 Life expectancy of a Malayali (native of Kerala) is 74.9 years but according to the IMA study, the mean ‘age of death’ of a Malayali doctor is 61.75 years. Indian doctor’s average lifespan is 55-59 years, almost 10 years lesser than that of the general population (IMA, Pune).
3/n
 Common causes of death: #heart attacks (27%) and #cancers (25%). Other causes include #infections and #Suicides.
Risk factors for diseases and #death: physical inactivity, #obesity, #overweight, #stress, #sleep deprivation and long working hours are common among #doctors.
Read 12 tweets
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Oct 21
10 qualities that make a #doctor popular (among #patients)
Surprisingly, it is not the #NEETPG score, reputation of medical college, gold medals received in medical college or number of research papers published. After 30 yrs as a practicing doctor, I present my observations here
1. Ability to #listen: You will be #popular if you let your patients speak without interrupting them. You should start only after patients have finished saying what they have to. Also, they like it, if you don't interrupt or cut them short, while they are speaking.
2. #Smile: Patients love it, if you smile while receiving them. A serious face puts them off. If you get angry (even if it is their fault such as if they arrived late, or they have not followed your instructions), your popularity as a doctor would diminish. Smile relaxes them.
Read 11 tweets

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