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Dr Sudhir Kumar MD DM🇮🇳 Profile picture
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Jan 10 • 8 tweets • 4 min read
Runners, take it easy, if you aren't able to match your pre-covid level performance

1. #running, like every #PhysicalActivity, got severely impacted during #COVID19 pandemic. Several runners couldn't keep to their training and as a result, aren't able to match pre-covid fitness.
2. Finishes in #endurance and #ultra endurance #running (UER) decreased significantly during the pandemic, with an almost 11-fold decrease in endurance running and 5-fold decrease in UER.
This resulted in lesser opportunities for #Training.
Ref: doi.org/10.3390%2Fmedi…
3. Covid-19 lockdown has negatively impacted the fitness level
The COVID-19 lockdown reduced 1000 meter running and pull-up performances by 11% and 24% respectively, among Chinese college men.
Ref: doi.org/10.3390%2Fijer…
4. Covid infection compromises running endurance.
In a study on female recreational runners, covid-19 recovered runners completed only 56% of the running time achieved by the control group (those with no history of Covid infection), and at a 26% slower steady-state running speed.
4a. Reference
doi.org/10.3389/fphys.…
5. Muscle fatigue and general fatigue are common for weeks to months after recovering from Covid 19. This can compromise even professional football players' capacity to compete at high intensities after COVID-19.
Ref: doi.org/10.14814/phy2.…
6. Lung and heart functions can remain adversely affected for several weeks to months following Covid-19 virus infection, even in those who had no symptoms due to covid (asymptomatic cases). This can result in poor effort tolerance and breathing difficulty while running.
7. Take home message
*A runner can expect a decline in endurance and performance levels as compared to his/her pre-covid levels.
*The intensity and duration of training should be gradually increased.
*Enjoy the runs without worrying about the pace or the distance you can run.

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More from @hyderabaddoctor

Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 11
#Indian patients with ischemic #stroke are 19 years younger than British

1. In a recently published research paper, the mean age of ischemic stroke patients in India was only 52 years as compared to 71.5 years in #British.
Ref:doi.org/10.1111/ene.15…
#MedTwitter #neurotwitter
2. Even among British, Stroke patients of South Asian ethnicity were 9 years younger as compared to White British.
*Ethnicity is an independent predictor of early age of stroke onset.
3. Risk factors such as hypertension, atrial fibrillation, ischemic heart disease, alcohol use & obesity contributed to strokes occurring at younger age in Indians.
Consuming carbohydrate-rich diet and lack of physical activity were other risk factors for stroke among Indians.
Read 4 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 11
#PhysicalActivity and #brain health in patients with atrial fibrillation

1. Vascular brain lesions, such as ischemic infarcts, are common among patients with atrial fibrillation (AF) and are associated with impaired cognitive function.
#MedTwitter #neurotwitter #dementia
2. In a recent study, effects of physical activity and regular exercise on brain infarcts, brain volume and cognition were looked at.
Reference: doi.org/10.1111/ene.15…
3. In AF patients, regular exercise was associated with a lower prevalence of ischemic infarcts and of moderate to severe white matter disease, with larger brain volume, and with better cognitive performance.
Read 4 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 11
Intravenous #thrombolysis (IVT) may be safe in patients taking direct oral anticoagulants (DOACs)

1. DOACs, including apixaban, dabigatran and rivaroxaban, have emerged as the primary #stroke prevention option in patients with nonvalvular atrial fibrillation (AF).
#neurotwitter
2. Every sixth patient with stroke otherwise qualifying for intravenous thrombolysis has a prescription for DOACs. Guidelines recommend the exclusion of patients with recent ingestion of DOACs (within 48 hours previously) from receiving IVT should they have an ischemic stroke.
3. This recommendation to exclude patients on DOACs from receiving IVT is based on the presumption of an increased risk of symptomatic intracranial #hemorrhage (sICH), but data to support or refute this presumption are lacking.
Read 10 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 10
Common Medical #Prescription #Errors

1. Medical errors are unfortunately common, and they can cause patient harm as well as increased healthcare costs. The idea of this post is not to find fault but to caution healthcare professionals (HCPs) so that these errors can be reduced.
2. In an Indian study, out of the total 24,572 medication orders in ICU, 2,624 had prescription errors (PEs), an error rate of 10.7%.
7.2% PEs did not result in patient harm and 3.5% PEs required interventions and/or resulted in patient harm.
#MedTwitter
3. In Emergency department setting, the prescription error rate was 16.5%. Ref: doi.org/10.1016/j.ajem…
Read 10 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 10
Only about 40% of people completely recover their #smell >2 years after smell loss due to #Covid_19 infection

1. In a recent study, data was collected from about 1000 people who suffered loss of smell due to covid 19 infection >2 years ago.
#MedTwitter
doi.org/10.1016%2Fj.am…
2. After 2 years, 7.5 % percent continued to report no recovery.
Most (92 %) reported some recovery – either complete recovery (38%) or partial recovery (54 %).
3. Recovery in smell functions was greater in people aged 40 or less.
Subjects under age 40 reported complete recovery at a higher rate (46%) than those over 40 (33%; p = 0.001).
Read 5 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 7
Young woman who would lose eyesight in left eye each time she took hot water bath

1. 25-yr old woman consulted me with complaints of losing #vision in left eye after hot water bath. This had occurred 8 times in the past one month. Vision would get restored in a few hours on own.
2. Short-duration loss of #eye sight had occurred last Winter too, but she ignored them.
Last week, she was taken for an #ophthalmological examination after one such episode, and no abnormality was detected.
Her family members thought she was making up her symptoms.
#MedTwitter
3. She requested her husband to take her for further expert medical opinion, which he refused.
But the woman was convinced that her symptoms were for real, as she had definite loss of vision in left eye after hot water bath.
So, here she was in my OPD, against her family's wish
Read 8 tweets

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