Dr Sudhir Kumar MD DM Profile picture
May 31 7 tweets 3 min read Twitter logo Read on Twitter
A. Today, one person who recently turned 50 consulted me in OPD. He has no symptoms & is healthy. He has no known diseases. He wanted a check up & advice to ensure he does not convert into a patient for as long as possible. I love this concept of disease prevention.
#MedTwitter
B. It is possible to prevent most of the serious diseases by following healthy lifestyle and proper medical care.
These include:
1. Regular sleep: 7-8 hours per night
2. Regular exercise: 30-40 minutes daily for 5 or more days a week; 9-10 k steps/day; strength training
3. Healthy diet: low carb, high protein diet;
avoid sugar & ultraprocessed packaged foods;
eat fresh fruits & vegetables, handful of nuts per day; early dinner (3-4 hours before sleeping time);
reduce feeding time window;
intermittent fasting at least on a few days per month
4. Reduce stress;
5. Limit working hours to 8-9 hours daily; avoid night shift or rotational shift duties as much as possible
6. Take periodic break from work and go for regular vacations,
7. Avoid loneliness, spend time with family & friends
8. Engage in a hobby for relaxation,
9. Quit smoking,
10. Abstain from alcohol,
11. Target BP <120/80 mmHg,
12. Target HbA1C<5.7%; target normal fasting insulin,
13. Maintain normal body weight, BMI, waist circumference and height waist ratio
14. Maintain cholesterol<200, triglycerides<150, LDL<100 and HDL>50
15. Target homocysteine<15
16. Target normal vitamin B12 & D levels,
17. Cardiac check up (ECG, Echo, TMT) once a year; CT coronary angiogram as per Cardiologist's advice
18. Financial discipline: plan investments as per desired goals; avoid taking loans as much as possible
19. Wear seat belts/helmets while driving car/riding a 2-wheeler
20. Seek doctor's opinion when needed; and follow the medical advice (be compliant with medicines prescribed).
#disease #prevention #healthylifestyle #HealthyLiving #HealthyHabits

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More from @hyderabaddoctor

May 30
Me: "Mr Raj, your wife needs operation, and it needs to be done soon."
Mr Raj: "But none of the previous doctors who treated her depression even remotely hinted at this possibility (of surgery)".

1. 55-year old Mrs Viji had started feeling sad in August 2022.
#MedTwitter
2. Their only daughter had moved to the UK for higher studies. It was assumed that her sadness was related to missing her daughter. However, the feeling of sadness increased over time. She became withdrawn and stopped participating in get-togethers with family and friends.
3. Mrs Viji did not improve even after one month, she was taken to a psychiatrist.
After detailed history, she was diagnosed to have severe depression, and was started on anti-depressant medications.
Counseling by a psychologist was also started.
#psychtwitter #psychology
Read 11 tweets
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.
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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 27
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.
Read 7 tweets

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