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Dr Sudhir Kumar MD DM🇮🇳 Profile picture
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Jan 21 • 9 tweets • 4 min read
My resting #heart rate (RHR) during past last week ranged from 41 to 47 bpm (average HR 45 bpm)

1. Lower HR (without use of medications) has several health-related benefits.
#MedTwitter #fitness #Health Image
2. Middle aged people with RHR >70 bpm have 68% higher risk of death and 20% higher risk of coronary events during 10.5 year follow up as compared to those with RHR <70 bpm.
doi.org/10.1007/s00392…
3. Compared to men with RHR ≤ 50, those with RHR > 90 had three times higher risk of death (during 16 year follow up)
With RHR as a continuous variable, risk of death increased with 16% per 10 beats per minute (bpm).
doi.org/10.1136/heartj…
4a. Highest cardiorespiratory fitness with lower mortality was found in people with an RHR of <60 beats/min. Similarly, patients with a higher RHR (≥80 beats/min) were at greater risk for cardiovascular disease and all-cause mortality compared with RHR of less than 60 beats/min.
4b. Reference
doi.org/10.1016/j.mayo…
5. Compared with "fit and RHR <80 beats/minute", deaths due to cancer were 41%, 51%, and 78% higher in "unfit and RHR <80," "fit and RHR ≥80," and "unfit and RHR ≥80 beats/minute," respectively.
RHR >80 bpm is a risk factor for cancer-related deaths.
doi.org/10.1158/1055-9…
6. Conclusions
*Lower resting heart rate is associated with lesser risk of heart diseases, as well as lesser risk of death due to cardiovascular disease or cancer.
*Lower RHR is associated with greater longevity.
doi.org/10.1111/jgs.12…
7. Deaths due to heart disease is higher among people with RHR >75 bpm Image
8. How to achieve a lower resting heart rate?
Endurance exercises, such as running or cycling over long term, are the best to achieve a lower RHR.

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More from @hyderabaddoctor

Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 24
"Burning the midnight oil" the night before exams results in poorer grades
1. It is common to see students studying late nights especially closer to #examinations. But does studying extra at the cost of missing #sleep result in better academic performance?
#AcademicTwitter
2. A survey was conducted among student pharmacists to correlate sleep duration and course grades. About 300 students of pharmacy (first to third years) were included in the survey.
Reference:
doi.org/10.5688/ajpe79…
3. More than half of student pharmacists obtained less than 7 hours of sleep at night during a typical school week (55%) and a large majority on the night prior to an examination (82%).
Read 7 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 23
Time-restricted eating alone may not result in long-term weight loss

1. Time-restricted eating (TRE), a form of #IntermittentFasting (IF), has gained popularity for #weightloss.
However, weight loss was not seen in a recently published study with TRE.
#obesity #MedTwitter
2. 547 participants (78% women, mean age 51 years, mean BMI 30.8) were followed up for 6 years.
*Mean interval from first to last meal was 11.5 hours and was not associated with weight change.
*The number of #meals per day was positively associated with weight change.
3. Total daily number of large (>1000 calories) and medium meals (500-1000 calories) was associated with increased weight over follow‐up time, while total number of small meals (<500 calories) was associated with decreasing weight.
Read 5 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 23
Excess of vitamin B12 may be hazardous

1. Vitamin #B12 deficiency is known to cause anemia, peripheral neuropathy, dementia, psychosis and skin pigmentation. Vitamin B12 supplementation is needed in them, however, #vitaminB12 excess may have adverse effects on health and life.
2. In a recent study, >5500 people (mean age 53 years) were followed up for 8.2 years.
Those with high plasma vitamin B12 concentration had 25% higher risk of all-cause death.
The mechanism of increased death is unknown.
#MedTwitter #nurtition #vitamin
3. Older age, high blood pressure, poorer kidney function, as well as increased concentrations of liver enzymes, were positively associated with higher plasma concentrations of vitamin B12. So, these groups should be more cautious while taking vitamin B12 supplementation.
Read 8 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 19
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)
Read 9 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 19
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
Read 5 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 18
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.
Read 10 tweets

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