Dr Sudhir Kumar MD DM Profile picture
Apr 25 4 tweets 2 min read Twitter logo Read on Twitter
Is Yellow fever vaccine safe for multiple sclerosis patients?

1. Yellow fever vaccine is recommended for people who are 9 months old or older and who are traveling to or living in areas at risk for yellow fever virus in Africa and South America.
#YellowFever #MultipleSclerosis Image
2. There is a doubt whether yellow fever vaccine can be given to patients suffering from multiple sclerosis, who are using disease modifying immunotherapies. There is a concern that yellow fever vaccine can trigger a relapse of multiple sclerosis.
#MedTwitter #neurotwitter
3. A recent study assessed the risk of relapsing-remitting multiple sclerosis worsening after yellow fever vaccine.
One-year annualized relapse rate and time to first relapse were similar among the vaccinated and unvaccinated groups.
doi.org/10.1177/135245…
4. Conclusion:
These results suggest that yellow fever vaccine does not worsen the course of relapsing remitting multiple sclerosis.

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More from @hyderabaddoctor

Apr 26
Eating walnuts for 6 months was associated with better sustained attention and intelligence scores in teenagers

1. A total of 771 healthy teenagers aged 11–16 years were randomized into two equal groups (intervention or control).
#MedTwitter #healthyfood Image
2. The intervention group received 30 g/day of raw walnut kernels to be incorporated into their diet for 6 months. Walnuts are rich sources of omega 3 fatty acid, alpha linolenic acid (ALA)
doi.org/10.1016/j.ecli…
3. Findings of the study:
Significant benefits were found for attention, fluid intelligence, and ADHD symptoms, meaning that consuming 30 g of walnuts daily for 100 days, or more, improved these neuropsychological outcomes.
Read 5 tweets
Apr 25
Cerebral atrophy (brain shrinkage) in an infant: Sad story with a happy ending

1. 10-month old infant was brought by his parents with generalized weakness & lethargy for 4 months. His motor milestones had also slowed down. He was evaluated by a local pediatrician.
#MedTwitter
2. Thyroid profile was normal. MRI brain showed severe, diffuse cerebral atrophy (generalized shrinkage of brain).
Anticipating a neurodegenerative disease, pediatrician referred the infant for a neurologist's opinion.
I took a detailed history and ordered for a blood test.
3. I reserved my opinion regarding prognosis, until the blood report came. I also did not want to send the infant for a series of investigations to rule out rare neurodegenerative diseases before seeing the blood test report.
Mother was a strict vegetarian, which gave the clue.
Read 10 tweets
Apr 24
1. "Dr, do something, I can't live with this shock-like severe pain over my face, repeating every 5 minutes."

This was in 2019. Mr Prasad had been suffering from this pain for >6 months. Days were like hell & nights seemed to have no end for him.
#MedTwitter #NeuroTwitter
2. The pain felt like electric-shocks or intense burning sensation, and occurred around eye, nose, lips, cheek and jaw on the right side. Pain lasted for 30-45 seconds and repeated every 5 minutes.
He had consulted several neurologists but no treatment seemed to work for him.
3. The clinical diagnosis was trigeminal neuralgia (TN). MRI brain was normal (didn't show any neuro-vascular conflict near right trigeminal nerve).
Several medicines such as carbamazepine, baclofen and lamotrigine only made him drowsy, without giving any relief from pain.
Read 11 tweets
Apr 23
Women have a dramatically lower risk of sports-related sudden cardiac arrest (Sr SCA)

1. More people are taking up sports, however, there is a concern about Sr-SCA. A recent study compared the rates of Sr-SCA in women & men in Europe.
#cardiacarrest #MedTwitter #sports
2. Out of 34,826 sudden cardiac arrests (SCA) between 2006 and 2017, 760 (2.2%) were sports-related.
Only 54 (7.1%) incidents of SCA occurred in women as compared to 706 in men.
Men had >13 times higher incidence of Sr-SCA as compared to women (0.19 vs 2.63 cases per million).
3. In addition, women seem to have a lower risk of incident atrial fibrillation (AF) at moderate or vigorous levels of physical activity, as compared to men
doi.org/10.1093/eurhea… Image
Read 5 tweets
Apr 21
1. Abhi got late at office and reached home only by 11 PM. He opened the main door using duplicate keys, so that his wife Priti won't be disturbed.
But he was shocked on entering the bedroom. He asked the woman-"who are you & what are you doing in our bedroom?"
#MedTwitter
2. Now, it was Priti's turn to get shocked- "Abhi, you came home late on the pretext of excess office work, but looks like you had a party with friends. How much alcohol did you have?"
Abhi found the voice & tone familiar; the dress woman was wearing was also familiar to him.
3. Abhi could recognize Priti now, with the help of her voice and dress she was wearing. He also noticed the familiar wedding ring she was wearing.
He could somehow manage to pacify Priti. Priti assumed that Abhi was playing some kind of prank and they both retired to bed.
Read 13 tweets
Apr 21
1. Poverty is the 4th leading cause of death.

*Only heart diseases, cancer and smoking cause more deaths than those related to poverty.
*Poverty was associated with 183,000 deaths in 2019 among people 15 years and older.

Which country are we talking about?
2. It is in USA.
A recent research published in JAMA Internal Medicine looked at the leading causes of deaths in USA. jamanetwork.com/journals/jamai…
3. As per David Brady, the study’s lead author and a UCR professor of public policy, "poverty kills as much as dementia, accidents, stroke, Alzheimer's and diabetes."
Read 5 tweets

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