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Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Jan 14

1. Arti to me "Dr, when will my husband Anuj start talking & walking?" Her two kids aged 3 & 5 were holding her hands, as Anuj was brought into my OPD for review one month after suffering brain hemorrhage. Anuj had become paralysed on right side and lost his speech due to stroke

2. Anuj, aged 33, had first consulted me three years ago for headache. On evaluation, his BP was 160/110 mmHg. On enquiry, he had a hectic work schedule of 13-14 hours per day and on an average he slept 4-5 hours/night. His job required out-station travelling on 10-15 days/month.

3. As per Anuj "I have breakfast in Hyderabad, lunch at Mumbai & dinner at Cape town. It is rare for me to have all 3 meals in the same city. I am a valuable employee of the multi-national company that I work for and 300 staff work under my leadership. I earn a handsome salary."

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Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Jan 13

Taking frequent walking breaks during prolonged sitting could help lower blood sugar and BP

1. Sedentary lifestyle with prolonged sitting hours (>8 hours daily) is common these days.
Frequent walking breaks (1 min or 5 min every 30-60 minutes) could help lower blood sugar and BP

2. When participants took a 5-minute light #walk after every half hour of sitting, the blood #glucose spike after eating was reduced by 58% compared with sitting all day (reduction one would see in a diabetic using insulin or #diabetes medications to control their blood sugar).

3. The largest reductions in systolic blood pressure were observed when the walking break was 1 minute every 60 minutes (-5.2 mm Hg).

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Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Jan 13

Is direct discharge to home (DDH) from ICUs safe?

1. Patients are usually transferred to hospital wards from the ICUs and discharged to home after another few days. However, there could be delay in getting a ward bed or patient might have significantly recovered while in ICU.

2. Moreover, some families find it difficult to afford longer duration ICU (& hospital stay) costs. This necessitates direct discharge to home (DDH) in some patients. In a recent study, the safety of DDH was evaluated and compared to those who were transferred to wards from ICUs.

3. For DDH from ICU, compared with ward transfers, there was no difference in the risk of-
*Emergency department visits at 30-days (22.4% vs 22.7%);
*Hospital readmissions at 30-days (9.8% vs 9.6%); or
*90-day mortality (2.8% vs 2.6%).
#MedTwitter #CriticalCare #ICU

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Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Jan 12

Woman in whom #migraine #headaches were triggered by financial dependence on husband

1. 35-year old Mahima- "Dr, my husband locks entire cash in a safe and takes the keys to office. I have no back account, so can't use UPI on mobile. I can't even buy a chocolate for my son."

2. Mahima had been consulting me for three months for frequent headaches, which were suggestive of migraine.
She was properly following my prescription, however, she still used to get 2-3 episodes of #headache every week.
I enquired with her about possible #stressors.

3. She had no interpersonal issues with in-laws or other family members and had no problems in marital life.
She was a housewife and had no source of income. She was dependent on husband for every expense, including buying small gifts for her son and even for emergency expenses.

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Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

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.

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Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

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.

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Dr Sudhir Kumar MD DM🇮🇳

Dr Sudhir Kumar MD DM🇮🇳

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