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Dr Sudhir Kumar MD DM🇮🇳 Profile picture
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Feb 1 • 7 tweets • 2 min read
Poor sleep quality and sleeping <7 hours during adolescence can increase the risk of multiple sclerosis later in life

1. A recent case control study done at Sweden looked at the association between sleep duration (& quality) in teens and risk of multiple sclerosis in later life.
2. Compared with sleeping 7–9 hours/night during adolescence, short sleep (<7 hours/night) was associated with 40% increased risk of developing multiple sclerosis (MS).
3. When patients rated their sleep quality during adolescence as poor, the risk of developing MS in later life increased by 50%.
4. Conclusion
Insufficient sleep duration and poor sleep quality during adolescence can significantly increase the risk of developing MS in later life.
dx.doi.org/10.1136/jnnp-2…
5a. Possible mechanisms of sleep deprivation and MS
*Insufficient sleep may contribute to the risk of inflammatory chronic diseases.
*Sleep restriction and poor sleep quality affect immune pathways with increased proinflammatory signaling, which could increase the risk of MS.
5b. Circadian rhythms are also involved in regulating the immune response and disruption may result in disturbed melatonin secretion and immune dysfunction.
#MedTwitter #neurotwitter #MultipleSclerosis
Adolescents should be encouraged to sleep well at nights (7-9 hours) to reduce the risk of developing multiple sclerosis and other inflammatory diseases (in later life).

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More from @hyderabaddoctor

Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Feb 2
Running is not detrimental to #knee #cartilage

1. The general health benefits of #running are well-established, yet concern exists regarding the development and progression of #osteoarthritis
A recent research examined the effects of running on knee cartilage using MRI scans.
2. Knee cartilage thickness and volume decreased immediately after running, with declines ranging from 3.3% for weight-bearing femoral cartilage volume to 4.9% for patellar cartilage volume.
#MedTwitter #marathon #fitness
3. Tibiofemoral cartilage T2 relaxation times on MRI recovered to baseline levels within 91 minutes.
Existing cartilage defects were unchanged within 48 hours post-run, as examined on MRI.
Read 5 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Feb 1
Uncontrolled #epileptic fits stopped by #insulin

1. A man aged 75 had for five days experienced tonic-clonic #seizures involving the right side of the face and right upper and lower limbs at a frequency of 20-30 per day. He had mild weakness of right arm and leg.
#MedTwitter
2. Patient was admitted in ICU under Medicine Unit. MRI brain and lumbar puncture were normal. New onset diabetes was detected for which he was treated with subcutaenous insulin.
Fits persisted despite treatment with midazolam and phenytoin. He was referred for neurology opinion
3. Patient was conscious but appeared exhausted. Review of blood tests showed high glucose of 350 mg/dL and mildly low sodium levels.
The diagnosis was obvious by now.
Read 8 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 31
Carefully observing a patient walk 20 steps gave clue to diagnosis

1. 1995- I was a first year MD Medicine PG at CMC Vellore.
35-yr old Rami from Midnapore had got admitted with fever of unknown origin of 6 months duration. No cause had been identified despite extensive tests.
2. It was a hectic day with 8 new patients admitted from emergency. It was past midnight, when I managed to examine Rami. During examination, she took a washroom break, for which she walked about 20 steps in all. After she returned to her bed, she was breathless .
#Medtwitter
3. She was unable to talk in complete sentences. Her pulse rate was 140/min. High #pulse rate could be partly explained by #fever, but it was beyond what was expected for a fever of 102 degrees Fahrenheit (pulse rate can rise by 10 beats/minute per degree rise in temperature).
Read 7 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 31
Head Injury increases the Long-term Mortality Risk in Community-Dwelling Adults

1. Even a single #head #injury could increase the risk of all-cause #death by 66%, as reported in a long term (27 years) follow up study conducted in USA.
#MedTwitter
jamanetwork.com/journals/jaman…
2. The association between head injury and death over long-term was dose-dependent.
111% higher risk of death was noted with two or more head injuries as compared to 66% higher risk of death after one head injury.
3. Those with mild head injury had 2.12 times higher risk of death as compared to those with no history of head injuries.
The risk of death increased to 2.87 times, if the head injury was moderate, severe or penetrating (as compared to those with no head injuries).
Read 5 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 31
Moderate-to-heavy #alcohol consumption increases the risk of #stroke in #younger adults

1. Alcohol consumption is one of the important modifiable risk factors for stroke in young adults.
A study was conducted in Korea to determine the association between alcohol & stroke.
2. Of 1536668 patients (mean age 29.5 years, 71.5% male, and median follow-up of 6-years), 3153 experienced an incident stroke (incidence rate, 0.37 per 1,000 person-years).
Adults who consumed more than 105 g/week of alcohol had higher risk of stroke, especially brain hemorrhage
3. Conclusion
Young adults who engaged in moderate-to-heavy drinking demonstrated a higher risk for incident stroke, especially hemorrhagic stroke
n.neurology.org/content/100/5/…
Read 4 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 30
Female physicians have higher infertility rates and pregnancy complications

1. Female physicians, particularly surgeons, have a significantly greater incidence of #miscarriage, #infertility, and #pregnancy complications compared to the general population
doi.org/10.1097/sla.00…
2. In another study, of 692 female surgeons, 290 (42.0%) had a pregnancy loss, more than twice the rate of the general population.
*Female surgeons operating 12 or more hours per week during the last trimester of pregnancy were at higher risk of major pregnancy complications
3. Female surgeons had fewer children and were more likely to delay having children because of surgical training.
Incidence of postpartum depression and musculoskeletal problems were also higher in them
#MedTwitter #Doctors
doi.org/10.1001/jamasu…
Read 5 tweets

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