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Dr Sudhir Kumar MD DM

@hyderabaddoctor

Mar 28

Devouring his favorite #sweets used to leave a young man #paralyzed

1. 33-year old Ravi loved jalebi with rabdi, but there was a problem. Whenever he used to have jalebi-rabdi to his heart's content, his legs & arms would become weak, making him bed bound for several hours.

2. In past 6 months, Ravi faced this problem 3 times. On first two occasions, it was during marriage function, so he passed them off as food poisoning.
A week back, he faced the same problem after having Rabdi-Jalebi hygienically prepared at home. He wanted to exclude a disease.

3.After listening to Ravi, I suspected a medical problem and asked him to return to hospital a few hours after having rabdi-jalebi (after informed consent).
On exam, he had developed weakness of legs & arms. He was unable to get up from squatting position. He couldn't raise arms.

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Dr Sudhir Kumar MD DM

@hyderabaddoctor

Mar 28

For junior #Doctors
Think of common causes before the rare ones

1. 19-yr old was brought with history of muscle pains, cramps and spasm for three months. He was evaluated by neurologist (located in a smaller town). NCV/EMG, serum CPK & thyroid profile were done and were normal.

2. The local neurologist suspected a diagnosis of neuromyotonia (<200 cases have been reported worldwide), and referred for testing of anti voltage-gated potassium channel (VGKC) complex antibody.
However, I wanted to look for a fairly common cause first.

3. Ordered for vitamin D testing, which was reported as 9 ng/mL (normal level >30 ng/mL).
Started him on vitamin D supplements, advised him to adequately expose skin to sunlight; and engage in regular physical exercises.

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Dr Sudhir Kumar MD DM

@hyderabaddoctor

Mar 26

Young woman with progressive muscle weakness was suspected to have muscular dystrophy, but a clinical finding pointed to another diagnosis

1. 22-year old Mini had weakness of legs and arms for two years. Weakness began in legs and after a year involved the arms too.
#MedTwitter

2. Mini had difficulty in getting up from squatting position, climbing stairs, combing hair & reaching for top shelves in kitchen.
She also had myalgia, muscle cramps and fatigue.
She had no numbness and had normal bladder & bowel control.
No one else in family was affected.

3. Mini consulted a local physician, who ordered a few investigations. Serum CPK was high (2600 U/L, normal<190 U/L). EMG showed low/small amplitude potentials suggestive of myopathy. He suspected a diagnosis of Becker's muscular dystrophy & referred for muscle biopsy to confirm.

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Dr Sudhir Kumar MD DM

@hyderabaddoctor

Mar 25

Outcome of sugar reduction strategies for soft drinks

1. A high intake of sugar, in particular from sugar-sweetened soft drinks, increases the risk for #obesity , type 2 #diabetes mellitus, and dental #caries.
#MedTwitter #nutrition #sugar

2. Between 2015 & 2021, the mean sugar content of soft drinks sold in Germany decreased by only 2% from 5.3 to 5.2 g/100 mL, falling short of 9% reduction target. The onus of reducing sugar content was left to the manufacturers of soft drinks.
Ref: doi.org/10.1159/000529…

3. In comparison, in the same period in the UK, the sugar content fell from 5.3 g per 100 mL to 3.8 g per 100 mL (29% reduction).
In 2018, the UK introduced an industry levy on soft drinks to encourage the manufacturers to reduce sugar. This approach has proven highly effective.

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Dr Sudhir Kumar MD DM

@hyderabaddoctor

Mar 24

Class 12th marksheet (1989)-CBSE board
1. About 17 lakh students have appeared for class 12th CBSE board exams this year and you may be anxiously waiting for results.
Here I am sharing my 34 years old mark sheet. Focus on Physics theory marks: 23/70
#examination #CBSE #marks

2. My marks in Biology and Chemistry were 62/70 & 63/70 respectively. I was expecting 67-68/70 in Physics too. However, due to some unidentified error, I was awarded just the pass marks. Nothing could be done to rectify it. However, it didn't matter in the end.

3. I qualified for various medical college entrance exams including CMC Vellore (where I finally joined). The criteria for CMC Vellore admission was 50% or more marks in each class 12th subject (I made it to 53/100 in Physics, credit to 30/30 in practical).

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Dr Sudhir Kumar MD DM

@hyderabaddoctor

Mar 23

Acute effects of coffee consumption on health

1. A research was conducted on 100 healthy residents of San Francisco (mean age 39 yrs, 51% women, median BMI 24) to evaluate effects of #coffee consumption on various #Health parameters.
#MedTwitter

2. Coffee consumption did not cause an increase in the rate of premature atrial contraction (PAC).
PAC can be a risk factor for future development of atrial fibrillation (AF). So, possibly, there is no increased risk of AF with coffee consumption.

3. One cup of coffee consumption did not increase the rate of premature ventricular contractions. However, there might be a possible association between consumption of more than one coffee drink per day and premature ventricular contractions.

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