Habit of adding #salt to food is linked with higher incidence of #sleep apnea
1. Sleep apnea is a common sleep-disordered breathing condition that affects an estimated 23% of women and 50% of men aged 40–85 in the general population #MedTwitter
2. Sleep apnea has a major impact on morbidity and mortality and has been recognized as an independent risk factor for motor vehicle crashes and occupational accidents, heart failure, stroke, atrial fibrillation, and cognitive impairment.
3. In a recently published study, association between the habit of adding salt to food and sleep apnea was assessed in 5,00,000 people aged 40-69 years in United Kingdom. rdcu.be/c3J99
4. Compared to participants who never/rarely added salt to foods, those who sometimes, usually, and always added salt to foods had an 11% , 15%, and 24% higher risk for incident sleep apnea, respectively. doi.org/10.1186/s12931…
5. Take home message
The findings of this study support the benefits of a salt reduction program in preventing sleep apnea.
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How a valuable possession slowly damaged a young man's nerve
1. 30-year-old Sidh consulted me with severe sharp shooting #pain from right buttock to the leg & foot for 3 months. Pain was more while sitting and lesser while standing or walking. Pain increased on lying down.
2. He was evaluated elsewhere.
MRI spine ruled out slipped disc and nerve compression in lower back region.
Nerve conduction studies had shown severe damage of right sciatic nerve (see the image below to see the location and course of sciatic nerve).
3. No cause for sciatic nerve damage was obvious. On detailed enquiry, he informed that he always carried a "fat wallet" in his right back pocket, which remained in his pocket while he sat in office during work (10 hours a day).
Now, I could guess the cause.
(Pic from internet)
A teenager who would intermittently rotate around himself for 1 minute
1. 15-year-old Raju was referred for evaluation of unusual behavior. For past one year, he would start rotating around his own body axis in full circles. This would go on for one minute and would stop on own.
2. He would remain fully conscious during these episodes, but was unable to control them. He was seen by a neurologist elsewhere. Brain scan and EEG were normal. He was empirically treated for possible #epilepsy, with no benefit. #MedTwitter#neurotwitter
3. He was then thought to be suffering from conversion disorder (hysteria) and referred to psychiatrist. Psychiatrist ruled out any psychopathology and requested our opinion. While in the OPD, I witnessed an episode.
Consider lead toxicity due to Ayurvedic medications in patients with unexplained abdominal pain
1. In the past 6 months, we saw 5 patients with unexplained abdominal pain associated with weakness of hands and feet. All were taking Ayurvedic medicines for various reasons.
2. Blood lead levels were high in all of them (>25 mcg/dl). There was no history of occupational lead exposure in any of them.
They were treated with d-penicillamine (chelation therapy). Ayurvedic medicines were stopped. #MedTwitter#NeuroTwitter#ayurvedicmedicine
3. Abdominal pain resolved. Weakness of hands and legs partially improved. Four patients had anemia and one had kidney damage (these showed only partial improvement).
1. Mrs Ravi to me: "Dr, you told me if I lose 10 kg weight, 50% cure can be achieved. I thought why not lose 20 kg and aim for 100% cure". This was about two years ago. She came for review today. #IntermittentFasting#healthylifestyle
2. She was diabetic for 12 years, had high BP & asthma for 10 years and was obese. She had consulted me for back and leg pain due to slipped disc in lower back. As expected, she was on multiple medicines.
When I discussed about lifestyle measures, she had made a greater resolve.
3. Two years later- she has lost 20 kg weight, BP & sugar are normal without medicines. She is not requiring inhalers for asthma. She no longer suffers from back or leg pain.
Her diet- fruits at 9 AM, fruits+salad at 2 PM and two phulkas at 6 PM (fasting from 6 PM-9AM).
Young Man in whom a Healthy Habit caused erectile dysfunction 1. 30-year-old Rijo consulted me for 3-month history of problem with erection. He was evaluated by Urologist/Andrologist & no cause for the same was found. Therefore, he was referred to rule out neurological disease.
2. Rijo was well three months ago, when he noticed erectile dysfunction (ED). He also had numbness in penis and surrounding regions, which was worse in mornings and better in evenings. There was no back pain or leg pain. #MedTwitter#erectile#dysfunction#ED
3. On enquiring about his fitness regime, he mentioned that he was passionate about #cycling and he cycled about 400 km per week (including 100+ km on Sundays). I could now guess the reason for his ED.
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."