Dr Sudhir Kumar MD DM Profile picture
May 27 7 tweets 2 min read Twitter logo Read on Twitter
Sometimes, we doctors need to go beyond our duty of writing medicines

1. 75-year old Mr Reddy: "Dr, we just returned from Char Dham Yatra yesterday and we wish to thank you for enabling us do this Yatra, what seemed impossible for past 4 years. Here is some "prasadam" for you." twitter.com/i/web/status/1…
2. Mr Reddy had been consulting for #Parkinsons disease (PD) for the past 8 years. He was doing fairly well, however, his motor symptoms had worsened for the past 2 years. He walked slowly and tended to lose balance especially while turning. He had fallen twice in past 6 months.
3. Reddy couple had shared about their wish to undertake Char Dham Yatra in the past few clinic visits.
I had suggested that we adjust the medications and take help of physiotherapist (to improve balance, gait & strength).
About three months back, I had given the green signal.
4. However, there was one problem. Their only child was working in the US and he was unable to get leave. He wanted to accompany his parents for this Yatra (should any untoward incident happen, he would be there to take care of his aged parents).
Reddy couple was in a dilemma.
5. In the last visit, I gave them confidence to undertake this Yatra. Mr Reddy was otherwise well (his diabetes was under good control & heart check up was normal).
Mrs Reddy had knee pain, otherwise, she was also healthy.
They had my contact details (if needed).
#Medtwitter
6. Today, seeing the smile & satisfaction on their faces, the effort was well worth it.
These are small efforts on our parts, but can have valuable impact on happiness & fulfilment of our patients (value of which often exceeds the benefits of medicines that we doctors prescribe)
7. Take home message
In medical practice, we sometimes need to get involved in matters beyond treating diseases that add satisfaction to our lives as well as that of our patients.
Happiness of patients due to our effort (small or big) is the best reward for any doctor.

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Dr Sudhir Kumar MD DM

Dr Sudhir Kumar MD DM Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @hyderabaddoctor

May 29
Investing in a second residential flat for earning rental income or for capital appreciation is not a wise decision

1. Annual returns are 2-4% (lower than 10-12% in mutual funds),
2. Lesser tax efficient (LTCG 20% vs 10% for equity beyond gains of 1 lakh),
#investments #Equity twitter.com/i/web/status/1…
3. Large capital is required to invest into real estate (Mutual funds need lesser capital)
4. Investment in real estate is illiquid (takes time to find the right buyer). For mutual funds, amount is credited into bank account within 2-3 days of redemption.
5. For property, additional costs include property tax, maintenance charges, cost of repairs and repainting. Tax needs to be paid even when the flat is unoccupied, and there are no tenants. These situations do not apply to mutual funds/equity investments.
Read 5 tweets
May 29
Food addiction is real and is related to #obesity and #diabetes

1. Food #addiction (FA) syndrome can be diagnosed by using Yale Food Addiction Scale (YFAS). There are 11 possible symptoms, which can be used to diagnose FA, as well as grade its severity.
#Diet #MedTwitter Image
2. Clinical diagnosis of food addiction (FA)
Individuals can meet a “diagnostic” score for FA on the current versions of the YFAS by endorsing at least two of the 11 behavioral indicators of addiction plus clinical impairment/distress.
#psychtwitter
3. Severity of Food addiction
Severity thresholds for this “diagnostic” score are defined by the number of symptoms endorsed
(mild: 2–3 symptoms;
moderate: 4–5 symptoms;
severe: 6–11 symptoms)
Read 6 tweets
May 29
Effective treatment of #depression through psychological therapy is associated with lower risk of #stroke and #heartattack
1. 6,36,955 people with depression were treated with psychotherapy and were followed up for a median of 3.1 years.
#MedTwitter Image
2. Reliable improvement from depression was associated with a 12% decrease in incident risk of cardiovascular disease (CVD) at any given time, with similar results observed for coronary heart disease (CHD), stroke, and all-cause mortality (death).
3. Benefit was maximum in those aged 45-60 years. For this group, the improvement in depression was associated with a 15% decrease in cardiovascular diseases. In patients over 60 years of age, there was only a 6% decrease.
Read 7 tweets
May 28
Type 2 diabetes is associated with increased risk of developing dementia

1. Those diagnosed with diabetes before age 60 years had a nearly threefold increased risk for dementia compared to those who never developed diabetes, as per a recent study.
#MedTwitter #diabetes twitter.com/i/web/status/1… Image
2. Those aged 60-69 years at diabetes diagnosis had 73% higher risk of developing dementia and those aged 70-79 years at diabetes diagnosis had 23% higher risk of developing dementia.
The relationship with dementia was not significant for those aged 80 years and older.
#dementia
3. Mechanisms include glucose toxicity, insulin resistance & microvascular dysfunction of the central nervous system.
Glucose toxicity and microvascular dysfunction are associated with increased inflammatory & oxidative stress, leading to increased blood–brain permeability.
Read 5 tweets
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
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

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us on Twitter!

:(