Problematic #alcohol use is common among #physicians

1. Problematic alcohol use can adversely affect physicians’ health as well as their ability to provide excellent healthcare to their patients.
A meta-analysis was recently published on this topic.
#MedTwitter #psychtwitter
2. Problematic alcohol use included hazardous, potentially hazardous, risky, at-risk, harmful, problematic, or heavy drinking or alcohol use, as well as alcohol misuse, alcohol dependence, and alcohol use more than low-risk guidelines and alcohol use disorder.
3. Survey included 52,000 physicians from 17 countries (from data published between Jan 2006-Mar 2020).

Results showed problematic alcohol use varied widely regardless of measurement method used.

The rate was 0%-34% with AUDIT, 9%-35% with AUDIT-C, and 4%-22% with CAGE.
4. The data showed an increase in reported problematic alcohol use over the past 14 years, from 16.3% (2006-2010) to 26.8% (2017-2020).
In comparison, the prevalence of alcohol use disorder worldwide in 2019 was 1.45%, with prevalence rates highest in males aged 25 to 34 years.
5. Earlier studies showed a higher proportion of males among problematic alcohol users, whereas in more recent studies, female physicians outnumbered male physicians, when it came to hazardous drinking.
6. There was no significant difference in the rates of drinking on the basis of age of physicians, their career stage, or the specialty practiced by them.
7. There is evidence to suggest that doctors are at an increased risk of #Anxiety and #depression compared to the general population.
Study results suggest that problematic alcohol use is also higher in physicians compared to the general population.
8a. Conclusions:
*Problematic alcohol use is self-reported by up to one-third of physicians globally.

*Prevalence of problematic alcohol use has increased over the past 15 years.

*Anxiety, depression and stress could be some of the factors leading to this unhealthy behavior.
8b
It is important to address the issue of problematic alcohol use among physicians so as to safeguard the health of the “healers” and ensure that their “healing work” is not adversely affected.

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Dec 23
Low Blood Pressure (BP) is also a risk factor for ischemic stroke

1. High BP is a well-known risk factor for ischemic and hemorrhagic #stroke .
In a study, low BP was also shown to increase the risk of ischemic stroke.
doi.org/10.1210%2Fjc.2…

#MedTwitter #neurotwitter
2. People with baseline BP<110/65 mmHg had 88% higher risk of ischemic stroke after average follow up of 6.7 years, as compared to those with BP 120-129/70-80 mmHg.

*People with BP>160/100 mmHg had 47% higher risk of ischemic stroke.
3. In another study, low pre-stroke BP was associated with higher risk of all cause death and cardiovascular death.
Patients with average SBP<120 mm Hg and at least one comorbidity (smoking, heart disease, cancer, or dementia) had the highest mortality risk.
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Dec 23
Heavy #coffee consumption can increase the risk of death among people with severe #hypertension

1. In a recent study, drinking 2 or more cups of coffee per day increased the risk of death by 2 times in people with BP>160/100 mmHg.
#MedTwitter
2. There was no additional risk of death in people with normal BP of those with grade 1 hypertension (BP<160/100 mmHg).

*Drinking coffee up to 1 cup/day was found to be safe in people with or without high BP.
3. In contrast, green #tea consumption was not associated with an increased risk of cardiovascular disease deaths across all categories of BP.
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Dec 22
A #runner who would #swing his left arm more than the right
1. I have been running outdoors for two years. Over a period of time, one gets familiar with fellow runners- specially their style, pace & endurance. This post is about one of those runners, who was a regular (like me)😆
2. He had one odd style- he would swing his right arm lesser than the left while #running or #walking.
He would continue in the same style for about 60-70 minutes of his #RUN.
His #pace was excellent- 60 minutes for a 10 km run.
#MedTwitter #neurotwitter
3. Our interaction was limited to "Good mornings".
Six months had passed since I first saw him. At this point, I noted that I could outpace him on a few occasions (I was much slower than him to start with).
I had started to think about possibility of a #neurological #disease.
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Dec 21
Psychosocial #Stress increases the risk of #stroke

1. A longitudinal study (2007-2021) was conducted on 27,000 people from 32 countries belonging to various continents to assess the relation of self-reported stress and risk of various types of stroke
#MedTwitter #neurotwitter
2. Increased stress at home and at work (within the previous 12 months) increased the risk of stroke by 95% (1.95 times) and 170% (2.7 times) respectively, as compared to no self-reported stress. Recent stressful events increased the risk of stroke by 1.3 times.
3. This association was consistent for all stress domains, including work stress, home stress, and financial stress. The association was independent of socioeconomic status, occupation, and educational level & remained significant after adjustment for cardiovascular risk factors.
Read 11 tweets
Dec 20
Case of a woman whose shoe size increased from 5 to 7 over two years

1. It was an usual OPD, when I was counselling one of my patients with back pain about exercise, diet and correct posture. Incidentally, I noticed his wife's face who was sitting beside the patient.
#MedTwitter
2. Her nose & lips appeared a bit larger than usual. When she smiled, her teeth were little spaced out and tongue was also little larger than normal. She spoke with a little heavy voice.
Being a #neurologist, I was imagining the possibility of a brain #disease.
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3. I asked her- "Don't mistake me, but has your shoe size increased?" Her eyes almost popped out. She replied with a shocked expression- "doc, yes! It has increased from 5 to 7 in the past two years. Don't everyone's feet become larger as they grow older?"
She was 37-year-old now
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Dec 20
Sleep more to lose more weight

1. Yes, you heard it right. Researchers found that overweight individuals could lose significant amount of weight by just sleeping for longer duration.
Short #sleep duration is a known risk factor for obesity.
#MedTwitter #weightloss #obesity
2. Adults aged 21-40 years, with BMI 25-29.9, with habitual sleep duration <6.5 hours/night were included in the study.
All participants were instructed to continue daily routine activities at home without any prescribed diet or physical activity.
3. Participants were randomized to either an individualized sleep hygiene counseling session to extend their bedtime to 8.5 hours (sleep extension group) or to continue their habitual sleep (control group).
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