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Dr Sudhir Kumar MD DM Profile picture
@hyderabaddoctor
Jun 2 • 11 tweets • 3 min read Twitter logo Read on Twitter
10 commonly asked questions about migraine answered
1. Is migraine hereditary?
Migraine is hereditary, so if one or both of your parents have it, there is a 50-75% chance you will too. However, in many patients, there is no family history of migraine.
#MedTwitter #migraine twitter.com/i/web/status/1…
2. Can children get migraine?
Ans: Yes. Migraine occurs in about 3% of preschool children, 4-11% of elementary school-aged children, and 8-15% of high school-aged children. Incidence of migraine increases in adolescence.
3. What are the common symptoms of migraine?
Ans: Headache, nausea, vomiting, intolerance to bright lights and noise.
Some people can have flashes of light, zigzag lines or blurred vision prior to onset of headache (called as visual aura).
4. Is migraine more common in women?
Yes, the risk of migraine is 3-4 times higher for women than for men.
Until puberty, the prevalence of migraine is equal among boys and girls, however, the prevalence increases among female gender after puberty.
5. Does migraine affect older people?
Yes. Migraine has a 10% prevalence in older adults and is the second most common headache disorder after tension headache in them.
However, most people have the migraine onset before the age of 50.
6. What are the common triggers of migraine?
Ans: Stress, irregular sleep schedule or lack of sleep, menstrual periods (related to hormonal changes), excess coffee intake, alcohol intake, weather changes, foods that contain MSG, cheese, chocolates, dairy products, light & smell.
7. Is there a test to diagnose migraine?
Ans: No. Migraine is a clinical diagnosis, and it can be diagnosed based on history.
However, a brain scan may be needed to rule out other causes of headache in some cases.
8. Is migraine treatable?
Ans: Yes. There are medicines to abort the acute headache episodes (that relieve the headache/pain). For those with frequent or severe headaches, preventive medications are used to reduce the frequency & severity of headaches.
9. Does migraine increase risk of death?
Migraine with aura is an independent risk factor for cardiovascular & all cause mortality. The risk of mortality from coronary heart disease & stroke is modestly increased in people with migraine, particularly those with aura. (BMJ 2010)
10. Can migraine be cured?
Ans: No.
There is no cure possible for migraine. Medicines can prevent the future recurrence of headache and treat the acute headache episodes.
10-step approach to diagnosis and management of migraine nature.com/articles/s4158… Image

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More from @hyderabaddoctor

Dr Sudhir Kumar MD DM Profile picture
Jun 2
Adverse effects of commonly used medicines (at their usual therapeutic doses)

1. Every medicine has adverse effects, especially if taken in higher doses. Some drugs can cause allergic reactions at the usual dose too. Here I describe non-allergic side effects of a few medicines. twitter.com/i/web/status/1…
2. Vitamin B12 deficiency- can occur due to Metformin use for diabetes.
3. Headache and cerebral venous sinus thrombosis (clotting of blood in brain veins)- can occur in women after using hormonal pills (OCPs)
4. Confusion, disorientation and seizures with levofloxacin & similar+
+antibiotics, especially in people aged 60 or more.
5. Parkinsonism- due to use of anti-vomiting drugs; levosulpiride, and anti-psychotic drugs.
Levosulpiride is added to anti-acidity drugs and can be recognized with letter L, as in Pantocid-L, Razo-L, etc
#MedTwitter
Read 6 tweets
Dr Sudhir Kumar MD DM Profile picture
May 31
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
Read 7 tweets
Dr Sudhir Kumar MD DM Profile picture
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
Dr Sudhir Kumar MD DM Profile picture
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
Dr Sudhir Kumar MD DM Profile picture
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
Dr Sudhir Kumar MD DM Profile picture
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

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