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Dr Sudhir Kumar MD DM Profile picture
@hyderabaddoctor
May 24 • 4 tweets • 1 min read Twitter logo Read on Twitter
Burden of Common Neurologic Diseases in Asian Countries (Global Burden of Disease Study 2019)

1. The 3 neurologic disorders with the highest prevalence and incidence-
*Tension type headache,
*Migraine, and
*Stroke.
#MedTwitter #neurotwitter
2. The 3 leading causes of death from neurologic disorders were-
*Stroke
*Alzheimer's disease and other dementias
*Parkinson's disease
3. The top 3 burdensome neurologic disorders, as measured by disability-adjusted life years (DALYs)-
*Stroke
*Migraine
*Alzheimer's disease & other dementias.
4. Reference
n.neurology.org/content/100/21…

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More from @hyderabaddoctor

Dr Sudhir Kumar MD DM Profile picture
May 26
Eyes are the windows into the Brain

Here, I discuss 9 situations where symptoms are related to eyes or vision, but disease pertains to brain or nervous system.
1. Sudden onset painless loss of vision- Optic neuritis (inflammation of optic nerve)- Multiple sclerosis
#MedTwitter
2. Sudden onset loss of vision on one half (left or right)- called homonymous hemianopia- usually caused by an infarct (clot) of occipital lobe of brain.

3. Inability to see on outer aspects of visual field (temporal visual field loss)- usually caused by pituitary tumor.
4. Drooping of one or both eyelids- called ptosis, usually caused by myasthenia gravis or third cranial nerve palsy.

5. Double vision (diplopia)- caused by 3rd, 4th or 6th cranial nerve palsies; also myasthenia gravis.
#neurotwitter #eyes #Neurology
Read 7 tweets
Dr Sudhir Kumar MD DM Profile picture
May 24
1. Ambulatory blood pressure, particularly night-time blood pressure, was found to be more informative about the risk of all-cause death and cardiovascular death than clinic blood pressure.
#MedTwitter #hypertension
doi.org/10.1016/S0140-…
2. The conventional method of recording BP is at a clinic. However, that may not be the best way to assess the risk.
Ambulatory BP measurements (both day time and night time) are more valuable in predicting death, as compared to BP measured at a clinic.
3. Night-time ambulatory systolic BP was six times more informative for death than clinic systolic BP and nearly twice as informative as daytime ambulatory systolic BP.
These findings were similar whether patients were treated for hypertension at baseline or not.
Read 4 tweets
Dr Sudhir Kumar MD DM Profile picture
May 23
Shaking of hands: Essential tremor (ET) or Parkinson's disease (PD)

1. Shaking of hands (tremors) are common. The usual question among patients (and doctors) is what is the root cause- ET or PD?
Here I would highlight the clinical differences between the two.
#MedTwitter
2. ET affects both hands, whereas PD affects one hand (asymmetric ET- one hand more affected than other & unilateral ET- affecting only one hand can rarely occur).
If tremors remain confined to one hand for >3 years, one should look for structural brain disease (unusual for PD).
3. Tremor in ET is brought on by doing an activity (holding a cup of coffee or writing), whereas people with PD have resting tremors.
Tremors in ET can be better seen with outstretched arms and hands.
Tremors in PD can be better seen by distracting the patient (and observing).
Read 10 tweets
Dr Sudhir Kumar MD DM Profile picture
May 22
1. One of my patients with epilepsy, who was well-controlled on medicines for 2 years, presented with 2 episodes of seizures.
She was lost to follow-up for past 14 months.
On enquiry, she told that she had stopped medicines prescribed by me, and had started taking Ayurvedic Rx.
2. Me: What was the name of Ayurvedic medicine you took?
Patient: It was powder mixed with honey wrapped in a paper (no packaging). No name was mentioned by the "famous" Ayurvedic doctor of her town.
#MedTwitter
3. Me: Why did you stop taking the medicine?
Patient: I was concerned that medicine would cause adverse effects.
Me: And you felt safe in taking Ayurvedic medicine without knowing even its name or what it contains?
Patient: I now realize it was a mistake.
Read 4 tweets
Dr Sudhir Kumar MD DM Profile picture
May 21
Weight gain before 30 increases the risk of fatal prostate #Cancer

1. Prostate cancer is the second commonest cancer among men (after lung cancer). Advancing age, positive family history & several genetic markers are non-modifiable risk factors of prostate cancer.
#MedTwitter
2. A recent study looked at the association between weight gain and risk of developing prostate cancer among 258,477 men aged 17 to 60.
#weightgain #prostatecancer
3. Overall, men who gained a little over 1 pound per year (1.10 pounds) had, compared with those with stable weight, a 10% increased risk of getting aggressive prostate cancer later in life, and a 29% increased risk of dying from it.
Read 5 tweets
Dr Sudhir Kumar MD DM Profile picture
May 9
When medicines fail, do prayers & positive frame of mind help?
1. Mr Raja to me- “Dr, I won’t die in 6 months. Prescribe the best medicines; I am sure I’ll defeat my disease.” His mother too echoed his words- “Dr, I love my son, and will always stand by his side, come what may.”
2. Mr Raja had consulted me with headache of 10 days duration. While going to a spa for head massage, he thought of getting an opinion of a neurologist. As it was a new-onset headache, I ordered for a CT scan, which showed a mass lesion.
#MedTwitter #neurotwitter
3. Further investigations, including MRI brain, followed by brain biopsy confirmed it to be a high grade glioblastoma multiforme (GBM), an aggressive brain cancer with average survival of 12-18 months.
Read 13 tweets

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