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Dr Sudhir Kumar MD DM🇮🇳 Profile picture
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Feb 17 • 10 tweets • 4 min read
Outdoor activity reduces the incidence of myopia in children
1. #Myopia is a refractive error of eyes, which causes near-sightedness (and impairment of far #vision). It is a lifelong disease and sufferers usually need glasses (or contact lenses) for life.
#MedTwitter #eyes
2. The incidence of myopia has been gradually increasing, possibly because children have been spending more time watching screens of computers and smartphones from very close (distance).
3. The incidence of myopia has further increased during COVID 19 pandemic, possibly because screen time further increased during the pandemic (for online classes as well as for recreation/leisure time activities).
4. Higher amount of time spent outdoors reduces the risk of developing myopia in 12-year old children. Type of sport per se did not matter in the research study. There was no association between indoor sport and myopia
doi.org/10.1016/j.opht…
5. Exercise reduces the risk of myopia.
Children (& adolescents) between the ages of 5 and 19, who engaged in at least one hour of daily exercise had 13% lower incidence of developing myopia.
doi.org/10.2147/opth.s…
6. Reading is a good habit and is important for gaining knowledge. However, there is one downside too.
In a research, reading books for more than two hours per day increased the risk of myopia by 69%
doi.org/10.3238/arzteb…
7. More screen time and lesser duration of outdoor activity increases the risk of developing myopia in children aged 5 to 7 years. This was noted in a research conducted in Spain
doi.org/10.3389/fpubh.…
8. Sleeping late increases the risk of myopia.
In a study, children aged 6 to 9, who slept late (after 9:30 PM) had 55% higher risk of developing myopia. The progression of refractive error was also greater in those who slept late.
doi.org/10.1038%2Fs415…
9. Children from urban environments have 2.6 times the odds of myopia compared with those from rural environments
doi.org/10.1136/bjopht…
10. Take home messages
*Prevalence of myopia is increasing over time.
*Reducing screen time, engaging in outdoors sports & exercising offer protection against developing myopia in children.
*Low-concentration atropine and orthokeratology may slow progression in myopic children.

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Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Feb 17
An adolescent who repeatedly used socially unacceptable obscene words

1. 14-year old Nag was a well-behaved child all along, however, a drastic change had been noted for 6 months. He would randomly use socially unacceptable obscene or abusive words multiple times.
#MedTwitter
2. Nag's parents had to face embarrassment on multiple occasions due to his use of inappropriate words. They tried their best and advised Nag to mind his choice of words and his abusive outbursts. They also checked whether one of his friends is teaching him to use foul language.
3. On the other hand, Nag found it difficult to control his language. He informed his parents the same & the fact that he too is ashamed of his behavior, however, he was unable to stop verbalizing obscene words. One month back, he developed other symptoms such as clearing throat+
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Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Feb 13
A barber whose fingers & arm painfully twisted while holding scissors for hair cutting

1. 45-year old Srinu started cutting hair in his teens after learning the trick from his father. He was experienced & popular among his clients. People waited for hours to get haircut by him.
2. All was going well until six months back, when he noticed abnormal spasms of his fingers during hair cutting. The moment he held the scissors in his right hand, index and ring finger would hyper-extend and go into painful spasms. This hindered his work and slowed him down.
3. He changed the scissors used for hair cutting on 4 or 5 occasions, but that did not make any difference in his symptoms.
Abnormal spasms of fingers worsened over time, and after a month, the arm also started going into painful spasms while cutting hair.
#MedTwitter
Read 12 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Feb 13
Resistance training may be superior to walking alone in managing HbA1C levels in patients with #diabetes

1. #exercise is important in diabetic control and leads to lower HbA1C (glycated hemoglobin) levels.
A recent study compared the effects of #walking & resistance training.
2. If walking exercise was performed for >150 min a week (or >5 days a week for 30 min at a time), based on the global guidelines, without resistance exercise, no significant effect on HbA1C levels was observed.
3. On the other hand, if males performed only resistance exercise for ≥5 days a week, it was effective in managing their HbA1c levels, without walking exercise. Therefore, performing resistance exercise is important & beneficial for improving condition of patients with diabetes.
Read 5 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Feb 11
A grand party with friends ended devastatingly for Aruj

1. 33-year old Aruj was visiting home after a gap of 5 years (after landing a job with handsome paycheck overseas). It called for a grand celebration and Aruj was in no mood to disappoint his friends.
#MedTwitter
2. It was an extravagant party with a wide variety of cuisine from around the world. In addition, he had arranged for the best of spirits. Aruj was having a great time with friends- chatting about old times, dancing on popular numbers played by DJ and enjoying food & alcohol.
3. Aruj & his friends were in high spirits under the influence of spirits. However, after having gulped multiple drinks, they were getting unsteady on feet & were finding difficult to properly dance. Very soon, Aruj was unable to properly stand & it was decided to call it a day.
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Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Feb 10
Vitamin D deficiency is a risk factor for dynapenia (poor muscle strength)

1. Dynapenia is an important risk factor for disability and death later in life. A 4-year follow up study looked at association between #VitaminD deficiency and #dynapenia in 3205 people aged 50 or more.
2. Vitamin D deficiency (< 30 nmol/L or <12 ng/mL) increased the risk of the incidence of dynapenia by 70% after 4 years. The risk was even higher in people aged 70-79 (4-times higher) and those aged 80 or more (8 times higher)
#MedTwitter
link.springer.com/article/10.100…
3. Vitamin D participates in both biochemical processes for the maintenance of muscle mass & muscle contraction kinetics. Through its genomic effects, vitamin D exerts an influence on the expression of contractile proteins & differentiation of muscle fibers, which affects the +
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Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Feb 8
Vitamin D is effective in decreasing risk for diabetes in adults with prediabetes

1. In a meta-analysis, the risk of #diabetes reduced by 15% in adults with prediabetes, who were given #vitaminD: 20,000 IU (500 mcg) weekly; OR 4,000 IU (100 mcg) daily, as compared to placebo.
2. The 3-year absolute risk reduction in developing diabetes was 3.3%.
The absolute risk reduction number is small, especially when compared with the risk reduction seen with intensive lifestyle changes (58%) and metformin (31%).
#MedTwitter
doi.org/10.7326/M22-30…
3. There are certain limitations.
*The effects of vitamin D can not be generalized to healthy adults, as it was tested in only those with prediabetes.
*The safety of prolonged vitamin D use on regular basis is not yet fully clear.
Read 4 tweets

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