Air pollution is an important and under recognised risk factor for cardiovascular events. #HeartAttack
Higher levels of fine particulate matter (PM2.5) lead to endothelial dysfunction and slow flow in coronaries and systemic inflammation, leading to accelerated atherosclerosis and thrombus (clot formation).
Biological pathways through which PM2.5 leads to Cardiovascular disease
The Contribution of Air Pollution Versus Other Risk Factors to Global Mortality
The Zones of Evidence Linking Air Pollution and CV Disease
PM Concentration and Mortality
Exposure-Response Relationship of Short- and Long-Term Effects of PM2.5 and Ozone With Mortality
Personal- and Local-Level Interventions to Reduce Exposures or Susceptibility to Air Pollution
What is important to note is that even acute exposure to increased PM2.5 levels like we are seeing with #DelhiAirPollution increases risk of death due to heart attacks. It is high time the govt takes concrete measures to curb this menace. @PMOIndia @mansukhmandviya
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Mysore is steeped in culture and tradition and the Gombe Habba or the doll festival celebrated during Dasara stands testimony to this.
The most important dolls are the “pattada gombe”. This is a pair depicting husband and wife/ King and Queen. This pair of wooden dolls is decorated and handed over to the daughter of the family during her wedding as a symbolic gesture for her to continue this tradition of the festival #Dasara
We know the story of how Goddess Chamundeswari killed Mahishasura and restored peace and harmony to the universe. Legend has it that in order for her to do so all the other Gods and Goddesses gave their powers to Goddess Chamundeshwari and being devoid of their powers they became statues. It is in their honour that the Gombe habba is celebrated.
The way the dolls are arranged is noteworthy. Tiered structures are built in odd numbers like 7, 9, 11. This is then covered with a white cloth and then dolls are arranged in a hierarchy. The dolls of Gods and Goddesses are placed on the top most tiers. Usually Goddess Chamundeshwari is the centre of attraction
Blockages causing #heartattack are not 90% or 100% to begin with. They're usually 30% or 50% narrowing only. The heart attack happens when the plaque becomes vulnerable to rupture and form a clot causing heart attack acutely. The way to prevent is by addressing risk factors like… https://t.co/0tob86a6zgtwitter.com/i/web/status/1…
Again getting confused between angiogram to perform treatment of existing blocks causing chest pain or heart attack is not the same as screening for risk of developing heart attack in a person not having these problems yet. That is where the advice to do a "CT angio in everyone"… twitter.com/i/web/status/1…
Even if one undergoes a CT whoch shows some plaques and blockages, prevention of heart attack is through medication, diet and lifestyle changes. And they have to be continued life long. The CT may add little above conventional risk assessment. Most of the time it provides false… twitter.com/i/web/status/1…
Name one test to detect heart attack risk?
Name one food to eat to prevent heart problems?
Name one medicine to take to get rid of blocks?
Can I just do one CT angio and thereby predict heart attack in future?
I wish treating and preventing heart disease was that easy!… twitter.com/i/web/status/1…
The human body is a complex system which has evolved over millions of years. It is not a simple machine manufactured by us. It cannot be dealt with like we deal with a TV or refrigerator or a car!
In order to understand disease one needs to understand anatomy and physiology. And then pathology. We need to know how our environment affects our body for good and bad. Diet. Exercise. Smoking. Pollution. Sleep. Stress. Weight. There are hundreds of things which interect either… twitter.com/i/web/status/1…
26y old girl. Working in clinical research. Came with chest pain. ECG was abnormal. Advised to get admitted and undergo angio. Only friends had accompanied. Reluctant. Family had to come from Chennai. Finally got admitted after 3 hours of deliberation.
I insisted on admission… twitter.com/i/web/status/1…
When faced with a young patient with heart attack and not so classical ECG changes, it is not unusual for duty doctors to be little unsure what to do! I would rather take the flak for doing an angio deemed unnecessary when it turns out normal than sending a heart attack patient… twitter.com/i/web/status/1…
At a recent meeting I presented this topic, "How not to miss diagnosing ACS in a patient coming to ER with chest pain?"
"Patient chennagiddaara saar?" (is the patient alright?) - asked my cab driver. I said yes, but how did he know? He said he had picked me up and dropped me before too, at odd hours and realized I'm a doctor. #Humanity
Concern for fellow beings is what makes us human.… twitter.com/i/web/status/1…
Most of the time I'm busy on my phone and writing up a thread on my return home trip in the cab. I've realized most of my tweets on acute heart attacks are written like that. The half hour well utilized.
The simple purpose is to create #health awareness and bust myths. More doctors across specialities should do it and only then mis-information can be eliminated successfully. #MedTwitter
Not to lose heart. Be positive. 1. Sit tight and prepare for entrance if you're interested in PG. 2. If interested in administration get into a MBA or MHA program at a good university - believe me.. You'll be in a very good position 10 years from now, even better than clinical… twitter.com/i/web/status/1…
6. Rural service. If you're OK working in PHCs, there are several options. You can work for few years and then get PG through in-service. 7. Setting up a practice. Being a good GP has its advantages. But difficult to sustain in the long run without PG. Family practice DNB is not… twitter.com/i/web/status/1…
You have one of the best degrees India offers. You can do many things. At every crux point, it is natural to feel lost. We've all been there. Even after becoming a consultant one feels it now and then. So be cool and think with a calm mind. All the best!