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Dr Sudhir Kumar MD DM Profile picture
@hyderabaddoctor
Mar 29 • 4 tweets • 2 min read Twitter logo Read on Twitter
Depression is associated with higher risk of stroke

1. In a study on 26,877 people (40% women; mean age 62 yrs), people with pre-stroke depressive symptoms during previous 12 months had 46% higher risk of acute stroke.
#MedTwitter #neurotwitter #depression #stroke
2. The risk of hemorrhagic stroke increased by 56% and ischemic stroke by 44%, if people had depressive symptoms in 12 months prior to stroke.
A larger magnitude of association with stroke was seen in patients with a greater burden of depressive symptoms.
3. People with depression also had poorer functional outcome one month after stroke (the risk of physical disability one month post-stroke was higher in people with depressive symptoms).
Reference:
n.neurology.org/content/early/…
4. Take home message
*People at risk of stroke should be screened for symptoms of depression.
*Treatment of depression could reduce the risk of stroke- both hemorrhagic as well as ischemic.

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More from @hyderabaddoctor

Dr Sudhir Kumar MD DM Profile picture
Mar 31
Lowering triglyceride with medicines does not result in better clinical outcome

1. High serum triglyceride levels are associated with increased incidence of heart attack, stroke and death. In a recent research, the effect of pemafibrate (which lowers triglycerides) was tested.
2. 10,497 patients with type 2 diabetes, mild-to-moderate hypertriglyceridemia (triglyceride level, 200 to 499 mg/dL), and high-density lipoprotein (HDL) cholesterol levels, 40 mg/dL or lower received pemafibrate (0.2-mg tablets twice daily) or matching placebo.
#MedTwitter
3. The median baseline fasting triglyceride level was 271 mg per deciliter, HDL cholesterol level 33 mg per deciliter, and LDL cholesterol level 78 mg per deciliter. All patents were on statins.
The median follow-up of patients was 3.4 years.
#CardioTwitter #stroke #HeartAttack
Read 6 tweets
Dr Sudhir Kumar MD DM Profile picture
Mar 30
A few lesser known facts about one of our former Prime Ministers

1. Suffered from Tuberculosis (TB) infection, however, it was kept top secret, and treated at a plush sanatorium in Leysin, in Switzerland. Treating doctor, Auguste Rollier, refused to use the word "tuberculosis".
2. Paid occasional visits to a Swiss hairdresser in New Delhi who designed the attractive streak of white that set off black hair.
3. Was called "Goddess Durga" by Atal Bihari Vajpayee ji in one of his interviews.
Read 4 tweets
Dr Sudhir Kumar MD DM Profile picture
Mar 30
Sperm count in men has been declining over the past 50 years, more rapidly so in the 21st century

1. This decline in sperm count is a global phenomena and has been seen in men across all continents.
doi.org/10.1093/humupd…
#MedTwitter #MensHealth Image
2. Sperm concentration (SC) declined from 101 million/ml (1973) to 49 million/ml (2018). SC declined by 1.16% per year and 51.6% overall. The probability of conception drops off rapidly as SC declines below 40-50 million/ml.
3. The proportion of in vitro fertilization (IVF) births has increased over the study period of this analysis, with eight million IVF babies born worldwide since the world’s first IVF birth in 1978.
Read 5 tweets
Dr Sudhir Kumar MD DM Profile picture
Mar 29
Shaking of hands and burning feet in a middle aged person: look for this treatable cause

1. 56-yr old Mr K presented with shaking of hands for several months, and burning & tingling of feet for 2 weeks. He had been started on trihexyphenidyl for tremors by a neurologist.
2. Clinical examination revealed action (postural) tremors. He had no slowness of moments, rigidity or balance issues.
Tremors were suggestive of essential tremors (ET). Burning feet was suggestive of sensory neuropathy. He had no numbness or weakness of feet.
#Medtwitter
3. Blood tests done earlier showed vitamin B12 deficiency. All meals consumed by Mr K (except 4 meals/month) were vegetarian.
NCV studies confirmed sensory neuropathy (damage to nerves of both feet).
Putting everything together, vitamin B12 deficiency is the most likely cause. ImageImage
Read 5 tweets
Dr Sudhir Kumar MD DM Profile picture
Mar 29
Shaking of hands (tremors) in an elderly is not always due to Parkinson's disease

1. 75-year old woman presented with shaking of hands (tremors) for one year. She had difficulty in having food, tea or water due to shaking. She also couldn't properly write or sign.
#MedTwitter
2. She was referred by her physician to rule out Parkinson's disease (PD). Her tremors were postural and absent at rest. She had no slowness of movements, rigidity or postural imbalance.
Clinically, it was more like essential tremors (ET) & not like PD.
I asked for blood tests+
3. to rule out treatable cause of tremors.
Vitamin B12 was very low. She was almost a vegetarian (had non veg food only once a month). Vitamin D was also low.
Vitamin B12 deficiency can cause tremors. Treatment with vitamin B12 supplements can reduce the tremors. Image
Read 5 tweets
Dr Sudhir Kumar MD DM Profile picture
Mar 29
Genomic analyses of hair from Ludwig van Beethoven

1. Ludwig van Beethoven (1770–1827) remains among the most influential and popular classical music composers.
Image below shows tufts of hair belonging to Beethoven, on which genomic analysis was done.
#MedTwitter Image
2. Health problems significantly impacted his career as a composer and pianist, including progressive hearing loss, recurring gastrointestinal complaints, and liver disease. In 1802, Beethoven requested that following his death, his disease be described and made public. Image
3. Beethoven had a genetic predisposition to liver disease. He was known to consume alcohol in amounts that could lead to liver disease. Metagenomic analyses revealed furthermore that Beethoven had a hepatitis B infection during at least the months prior to his death.
Read 6 tweets

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