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Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Feb 25

Regular laxative use is associated with a higher risk of dementia

1. A recently reported study looked at association between #laxative use and new-onset #dementia in >5,00,000 UK Biobank participants.
#MedTwitter
n.neurology.org/content/early/…

2. Regular use of laxative was associated with 51% higher risk of all-cause dementia and 65% higher risk of vascular dementia. There was no significant association with risk of #Alzheimers disease.

3. The risk of dementia increased by 28% in people using one type of laxative, as compared to 90% in people using two or more types of laxatives.
Only osmotic type of laxative use was associated with higher risk of dementia.

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Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Feb 24

Gender equality is good, however, in this situation, it is better that women lag men

1. 45-year old Vani was admitted with complaints of epileptic fits followed by disorientation and confusion. A small brain infarct (clot) was seen, which was presumed to be the cause of seizure.

2. She had no obvious risk factors for stroke, and moreover, the clot was located in cerebellar vermis, which usually does not cause convulsions. So, we needed to look for other causes for her epileptic fits. Vani had become conscious the next day, and history was reviewed.

3. Vani admitted to consuming alcohol on daily basis for more than a year, and had abruptly stopped consuming alcohol one day prior (as she was fasting for a religious festival).
Now, the cause of seizure was obvious- alcohol withdrawal syndrome (ADS).

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Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Feb 23

Young woman with unexpected cause of repeated bouts of vomiting
1. 1999: It was another busy day, when I had seen 60 outpatients, worked up & written case notes for 8 ward admissions and had finished seeing 14 consultations (from other depts). It was 2 AM and I needed some sleep.

2. Residency at CMC Vellore in 90s was tough, which denied even 4 hours of sleep on many nights. Got a call from Gastro ward regarding a 25-yr old woman who had repeated episodes of vomiting for one week. Detailed evaluation by gastro dept could not identify the cause of vomiting

3. Neurology opinion was sought to rule out neuro-related causes of vomiting (such as cyclical vomiting syndrome, brain-stem lesions, migraine, etc).
I took a detailed history. She had no symptoms other than vomiting. On examination, she was dehydrated and looked weak.

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Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Feb 22

A teenager whose left arm & leg would briefly twist without his control
1. 13 year old Ali was brought with complaints of involuntary twisting movements of left arm & leg for three years. This occurred whenever he initiated walking after a period of rest (sitting or lying down).

2. Ali was disturbed with these abnormal movements, as he lost balance a few times resulting in fall on few occasions. These lasted 30-60 seconds and stopped on own. He could speak during these episodes and did not lose consciousness. These movements never occurred while resting.

3. Ali lived with his parents in Doha and he was shown to a few doctors of various specialties. No diagnosis was arrived at. He was referred for neurologist's opinion, as local doctors suspected epilepsy or some psychological problem.

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Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Feb 22

Regular physical activity in adolescence or youth leads to long term benefits on bone health and body composition

1. Participation in competitive sport at age 13-16 was associated with higher midlife lean mass & bone mineral density (BMD), and better physical performance +

2. compared to no exercise or physical activity.
*However, BMD might be impaired if menarche occurs late (>14 years of age)
Reference:
doi.org/10.3390/jcm912…
#MedTwitter #exercise #BMD

3a. The high level of physical activity in female athletes is associated with improved muscle mass, BMD and bone mineral content (BMC), and physical activity during youth seems to have a beneficial effect on bone mass and helps to prevent bone loss due to aging.

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Dr Sudhir Kumar MD DM🇮🇳

@hyderabaddoctor

Feb 22

The risk of bleeding with #aspirin outweighs its benefits in people without Atherosclerotic Cardiovascular Disease (ASCVD)

1. Aspirin is sometimes recommended to prevent #heartattack and stroke in people without ASCVD. A recent research looked at its benefits versus risks.

2. Aspirin reduced the risk of heart attack by 15% but increased the risk of major bleeding by 48%, making effects of aspirin overall negative.
Aspirin did not reduce the risk of death.
#MedTwitter #CardioTwitter
doi.org/10.1016/j.jaca…

3. In the study group, statin use reduced the risk of heart attack without increasing bleeding risk.

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Dr Sudhir Kumar MD DM🇮🇳

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Dr Sudhir Kumar MD DM🇮🇳

Dr Sudhir Kumar MD DM🇮🇳

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