Tweet

More from @hyderabaddoctor

Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Nov 28

Case of a man who almost stopped eating and drinking, as the act of swallowing caused severe throat pain

1. 45-year old man presented with intense episodes of pain in throat, back of tongue and tonsils on the right side for three months. The pain radiated to ear.
#MedTwitter

2. #pain was excruciating and was triggered by eating, chewing or swallowing food, drinking water, sneezing or even yawning. Pain lasted for 30-45 seconds and occurred 10-15 times every hour. He was so scared to eat or drink that he lost 15 kg weight in those 3 months.

3. He consulted ENT and dental doctors, and detailed examination by them was normal.
He became depressed and also had suicidal thoughts. He consulted psychiatrist and was started on anti-depressant medications.
On his sister's (a medico) advice, he decided to take my opinion.

Read 6 tweets

Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Nov 28

White coat #hypertension (WCH) can not be left alone

1. Patient: My BP is high only in hospital, at home it is normal. So, I don't want to do anything about it.
Me: High BP (whether in hospital or at home) can lead to adverse outcomes, so, you should aim for a normal BP 24/7.

2. A study showed that in untreated cohorts, WCH was associated with a 38% and 20% increased risk of #Cardiovascular disease (CVD) and total #mortality (death) compared with normotension (normal BP), respectively.

3. However, in the treated patients (who received medications to keep BP normal at office as well as at home), neither the risk of CVD, nor total mortality was increased in WCH.

Read 5 tweets

Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Nov 27

Regular #exercise effectively reduces #headache days in patients with #migraine

1. Migraine is a disabling disease that causes repeated episodes of headaches.
Exercise is very effective, however, it is uncommonly prescribed in migraine.
#MedTwitter #neurotwitter

2. In a recent research, strength/resistance training reduced monthly migraine days (MMD) by 3.5 days, followed by high-intensity aerobic exercise (3.1 days) and moderate intensity aerobic exercise (2.2 days).

3. All exercise modalities showed higher efficacy compared to placebo.
The reason for strength/resistance training to rank top could be because of targeted muscular strengthening and reconditioning, particularly involving major muscles in the neck, shoulders and upper limbs.

Read 12 tweets

Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Nov 25

Cause of coma in a #woman surprised us!

1. 65-year old woman was brought in an #unconscious state to #emergency dept. She sounded normal over phone to her son about 24 hours earlier. She stayed alone, so, further details were not available.
#MedTwitter #internalmedicine

2. Clinical examination revealed an #unconscious patient. She was afebrile; pulse and BP were normal. Pupils were equal and reacting to light. Meningeal signs were absent. She was electively mechanically ventilated in view of her unconscious state.

3. Serum #calcium was high (13 mg/dL). MRI brain was normal. Lumbar puncture was normal. Investigations were done to determine the cause of high calcium. There was no evidence of #endocrine disorder, infection or #Cancer.
#VitaminD level was very high (160 ng/mL).

Read 7 tweets

Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Nov 24

Can #drinking excess amount of #water lead to death?

1. Water is life-saving and is essential for survival. However, ingestion of excess amounts of water, especially over a short period of time can lead to serious health hazards, including #death.
#MedTwitter #internalmedicine

2. How much water is needed on daily basis?

The normal daily requirement of water is 2.5 to 3 liters.
The requirement may be higher in summer months. Requirement also increases during #exercise (due to sweating), during fever, diarrhea or vomiting.

3. Why do some people drink excess amounts of water?

There is a misconception that drinking more water is good for #health.
Some people can drink more water due to #psychiatric illnesses.
#athletes can overestimate fluid loss and drink an excess amount of water.

Read 9 tweets

Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Nov 23

Long-standing unwanted & unpleasant genital sensations in a woman of neurological origin

1. 41-year old woman presented with 3-year history of persistent abnormal sensations involving vagina, #clitoris and labia, without #sexual interest or #desire.
#MedTwitter #neurotwitter

2. She found it hard to describe the sensations but used terms like vibrating, tingling, painful, throbbing, pulsating and numbness in vagina & surrounding regions. There was a sense of imminent #orgasm. Sexual activity & orgasm, however, did not relieve her symptoms.

3. Symptoms got worse on sitting and on lying down, but were lesser on standing or walking. Tight clothing or underwear aggravated her symptoms. She also had #pain in both legs, and felt the urge to constantly move her legs to reduce pain & discomfort (in legs & feet).

Read 9 tweets

Share this page!

Dr Sudhir Kumar MD DM🇮🇳

People who liked this thread also liked...

Try unrolling a thread yourself!

More from @hyderabaddoctor

Dr Sudhir Kumar MD DM🇮🇳

Dr Sudhir Kumar MD DM🇮🇳

Dr Sudhir Kumar MD DM🇮🇳

Dr Sudhir Kumar MD DM🇮🇳

Dr Sudhir Kumar MD DM🇮🇳

Dr Sudhir Kumar MD DM🇮🇳

Did Thread Reader help you today?

Don't want to be a Premium member but still want to support us?

Send Email!