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Dr Sudhir Kumar MD DM Profile picture
@hyderabaddoctor
Apr 12 • 5 tweets • 2 min read Twitter logo Read on Twitter
Lack of sleep as well as excess sleep are associated with increased risk of stroke

1. A recent research looked at the association between sleep disorders (in the previous month) and risk of stroke in 4496 people.
n.neurology.org/content/early/…
#MedTwitter #neurotwitter #sleep #stroke
2. Short sleep (<5 hours), long sleep (>9 hours), impaired sleep quality, difficulty getting to sleep or maintaining sleep, unplanned napping, prolonged napping (>1 hour), snoring & breathing cessation (OSA) were all significantly associated with increased odds of acute stroke.
3. Short sleep (<5 h) was associated with a 3.1 times higher risk of stroke, and long sleep (>9 h) was associated with 2.7 times higher risk of stroke, as compared to those who slept 7 hours.
More the number of sleep disturbances, greater was the risk of stroke.
4. Those napping >1 hour during daytime had 2.5 times higher risk of stroke, as compared to those who did not.
Those with symptoms of obstructive sleep apnea (snoring, snorting or breathing cessation) had 2 times higher risk of stroke.
5. Take home message
*Sleep disorders are commonly associated with a higher risk of stroke (paralysis).
*This study is not confirmatory as it only looked at association and does not prove cause & effect relationship between sleep disorders and stroke. More studies are needed.

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More from @hyderabaddoctor

Dr Sudhir Kumar MD DM Profile picture
Apr 13
#reallife #story

1990: I was hospitalized with severe upper & lower back pain. Pain was so severe that I was bed-bound. It used to take 30 min to get down from bed & enter the washroom (no family member could attend on me).
I had just completed my first yr MBBS.
#MedTwitter
2. Doctors had started 4 different types of pain-killers, which were still ineffective in relieving my pain. To make matters worse, no definite diagnosis had been made. A senior Orthopedic surgeon was consulted to explore the option of giving steroid injection in affected joints.
3. He advised to wait for another two days for pain-relief to begin (15 days had passed without pain relief). Failing that, he would proceed with injections. As per his expectations, pain relief started on day 17.
In addition, HLA B27 returned positive confirming the diagnosis.
Read 12 tweets
Dr Sudhir Kumar MD DM Profile picture
Apr 12
Sugar consumption and its ill-effects on health

1. Recently, a review article was published that looked at the association between sugar consumption & various diseases.
Data was collected from 8601 unique research papers published earlier on this topic. doi.org/10.1136/bmj-20…
2. Highest versus lowest dietary sugar consumption was associated with increased body #weight (sugar sweetened beverages) & fat accumulation in liver.
*Each serving/week increment of sugar sweetened beverage consumption was associated with a 4% higher risk of gout.
#MedTwitter
3. Each 250 mL/day increment of sugar sweetened beverage consumption was associated with a 17% higher risk of coronary heart disease & 4% higher risk of all cause death.
Every 25 g/day increment of fructose consumption was associated with a 22% higher risk of pancreatic #Cancer.
Read 5 tweets
Dr Sudhir Kumar MD DM Profile picture
Apr 11
An elderly woman who would repeatedly count her dresses

1. 69-yr old lady was brought with 1-month history of repeated & excessive arranging and counting of dresses. Patient spent a lot of time searching for clothes & dresses and meticulously arranging them as per their sizes.
2. She would repeatedly count them. She would get up from sleep and repeat this act for several hours. On questioning, the patient agreed that this act of hers was irrational and unproductive, however, she expressed an inability to control her from doing so.
#MedTwitter
3. She had been diagnosed to have #Parkinsonsdisease 13 yrs ago. She was taking various medications including levodopa.
She had no prior history of psychiatric illness.
She was unable to sleep well, as she used to get up multiple times at nights to count her dresses.
Read 12 tweets
Dr Sudhir Kumar MD DM Profile picture
Apr 6
Do anti-seizure medications (ASM) prevent late post-traumatic epilepsy?

1. Traumatic brain injury (TBI) is unfortunately a common cause of disability and death. Seizures after head injury can adversely affect the outcome of patients with TBI. Does early ASM help?
#MedTwitter
2. A recent systematic analysis looked at the possible role of ASM in preventing early & late post-traumatic seizures, and in reducing the risk of death.
cp.neurology.org/content/13/3/e…

#TBI #epilepsy #neurotwitter
3. The risk of early post-traumatic seizures (occurring within the first 7 days after injury) was significantly reduced in the group taking anti-seizure medications. Image
Read 6 tweets
Dr Sudhir Kumar MD DM Profile picture
Apr 5
Middle-aged woman had repeated chest and left arm pain mimicking angina, but the cause was neurological

1. 55-yr old Mrs Viji presented with left-sided chest pain, radiating to left arm for two months. Pain occurred intermittently and it awakened her from sleep.
#MedTwitter
2. Mrs Viji was a diabetic and hypertensive (well-controlled) and was a regular morning walker (5 km daily). She had no chest pain during her walks.
She had occasional tingling sensation and numbness in left arm. She was anxious that she was going to suffer a heart attack.
3. Mrs Viji consulted a cardiologist, who after clinical examination, ECG, Echocardiogram and TMT, opined that her pain was non-cardiac and referred for Neurologist's opinion. Patient requested coronary angiogram, which was deferred by the Cardiologist.
Read 7 tweets
Dr Sudhir Kumar MD DM Profile picture
Apr 5
Serving Alcohol in Medical Educational Conferences

1. I have attended 100s of medical conferences since 2001. Some of them are sponsored & some are not. However, one common theme is serving alcohol in >90% of these academic conferences. Is it a correct practice?
#MedTwitter
2. I know at least one incident where one senior doctor died, possibly triggered by heavy #alcohol consumption.
I also remember several incidents where doctors were heavily drunk and had to be escorted to their rooms by their colleagues or hotel staff.
3. If you happen to witness the table where alcohol is served, it resembles a busy vegetable market or a shop with discount sale, where doctors would be pushing one another to get their quota of booze ASAP (free in most cases, as payment is done by sponsors or organizers).
Read 4 tweets

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