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Dr K K Aggarwal

Do Not Ignore Breakfast

By Dr K K Aggarwal
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Taking a good breakfast made of carbohydrates and lean protein, can help lessen cravings and hunger during the rest of the day, which can lead to significant weight loss.

A research by Dr. Daniela Jakubowicz, a clinical professor at Virginia Commonwealth University and an endocrinologist at the Hospital de Clinicas Caracas in Venezuela has shown that sedentary, obese women lost almost five times as much weight on the “big breakfast” diet as did women following a traditional, restrictive low–carbohydrate diet. While treating obese people we need to treat carb cravings and hunger.

On waking up in the morning, the body is primed to look for food. The metabolism is revived up, and levels of cortisol and adrenaline are at their highest. The brain needs energy right away, and if one doesn’t eat or eats too little, the brain needs to find another fuel source. To do this, it activates an emergency system that pulls energy from muscle, destroying muscle tissue in the process. Then when you eat later, the body and brain are still in high–alert mode, so the body saves energy from the food as fat.

Also the levels of the brain chemical serotonin are highest in the morning and the craving levels are at the lowest and you may not feel like eating. As the day wears on, serotonin levels dip, and you get cravings for chocolate or cookies, and such similar foods. If you eat these foods, your serotonin levels rise, and your body begins to associate good feelings with them, creating an addictive cycle.

The high protein, carbohydrate mix in breakfast gives the body the initial energy boost it needs in the morning. Throughout the rest of the day, the meals are made up of protein and complex carbohydrates, like vegetables. Because protein is digested slowly, you won’t feel hungry.

If you have to eat chocolate or candy, eat them in the morning because if you eat them when serotonin levels are high, they won’t taste as good, and the brain won’t feel the same serotonin boost. This will eventually help cut down on cravings.

Eating breakfast with high glycemic foods may be harmful. After eating cereal or a doughnut, the blood sugar and insulin levels spike. Once that blood sugar is used up, you’ll still have excess insulin circulating, which makes you hungry and makes you crave carbohydrates.

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Why is Ganesha worshipped in every pooja?

By Dr K K Aggarwal
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Every Hindu ritual traditionally begins with a prayer to Lord Ganesh. The wedding ceremony too begins with a pooja of Lord Ganesha invoking him to bless the couple and to ensure that the ceremony goes off well.

Ganesha, the son of Shiva and Parvati, is the harmonious Aacharan or characteristic disposition of man. Remembered and ritually worshipped before starting a new venture, the entity of Ganesha has in store the facets of a complete man.

The elephant head of Ganesha represents wisdom, intelligence and a healthy mind capable of making sound decisions. Think before you speak, implies Ganesha’s head.

The big ears of this elephant deity signify the lending of a patient ear to the echo produced by others’ deeds and speech. It is said that half the dispute is resolved by patiently lending an ear to the words of the other. It also denotes that one must patiently listen to all sides before reaching a decision.

Ganesha’s extremely small mouth characteristically represents the need for a limited dialogue and the vanity of talking too much.

Overexpression through words results in unsought–for problems which could have been avoided.

Ganesha’s small eyes highlight the need for a focused outlook in life. Such an outlook not only re–defines and foresees the right goals, but also relieves one from the stress–manifested episodes in life.

The long trunk identifies with the power of discrimination. Ganesha’s long nose has the strength to uproot a tree and the competency of picking up a pin from the ground. Such should be the approach of an individual who should be capable of perceiving the good and bad for one’s own self, and then have the strength to overcome these against all odds.

The tusks and the small teeth of Ganesha tell us to maintain a balance between loss (broken tooth) and gains (whole tooth) in the life. Man ought to maintain his mental state so that ups and downs do not deter him from his honest endeavors.

The ample stomach of Ganapati Deva advocates the need for retaining information. Acquiring knowledge, utilizing it and retaining it for years to come, is the crux of ‘big–belly commandment’.

The Char–Bhuja Dhari Ganesha, further represents strength by virtue of his four hands in which the Lord entraps his attachments, desires and greed. Two of the arms of Ganesha, which hold a rope, symbolize control over the attachments. The laddoo or sweet in one shows command over desires and earthly delusions.

The mouse sitting near the feet of Ganesha represents greed and gluttony upon which the Almighty rides, exhibiting control over evils.

Ganesha’s physical traits are an assembly of the characteristics most desired in an individual of substance.

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Felicitated for his contribution in the field of medical ethics at the Indian Medical Association’s annual day held in Kolkata

Kolkata, June 29, 2014: Recognizing outstanding contribution in the field of medical ethics, IMA AMS – the research and academic wing of the Indian Medical Association felicitated Dr. KK Aggarwal with the Dr. R.K. Menda Memorial Oration Award at their annual day function held at Hotel Hindustan International in Kolkata on Sunday. The subject of his oration was “How to respond to complaints of medical negligence”.

 

An eminent cardiologist, President of Heart Care Foundation of India and the Senior National Vice President of the Indian Medical Association, Dr. KK Aggarwal has played an active role in streamlining the procedure of handling medical negligence cases and creating guidelines which all doctors must follow through his books and writings. Medical negligence can have a profound impact on the career of a doctor and therefore it becomes extremely important for them to be aware of the steps they must take to avoid any such situation.

Commenting on the oration, Dr. K.K. Aggarwal, Sr. National Vice President of the Indian Medical Association and the President of the Heart Care Foundation of India said, “The number of medical negligence cases we get at the Medical Council of India and the Delhi Medical Council are increasing by the year. With the increasing work pressure and competition, doctors often ignore some of the basic steps that they must take when dealing with any patient. It is extremely important that all doctors not just follow the line of treatment which has been decided in consultation with the patient or his family, but they must also document what they do and save that incase any dispute arises in the future. Following these three simple steps can help the doctor safeguard himself and his practice”.

Dr. KK Aggarwal is the recipient of three National Awards, namely the Padma Shri for brilliance in medicine and the Dr. BC Roy award for excellence in socio-medical awareness and DST National Award for Outstanding Efforts in Science & Technology Communication. Dr. KK Aggarwal has also served as a Director at IMA AKN Sinha Institute, Finance Secretary at IMA and Chairman at IMAAMS in the past.

In a joint statement, Dr. R.D. Dubey, Chairman of the organizing committee of National AMSCON 2014 along with Dr. S.K. Raj, Chairman IMA AMS HQ Hyd and Dr E. Prabhavati, Hony. Secretary IMA AMS HQ Hyderabad said, “ It gives us immense happiness to present this award to someone as deserving as Dr. KK Aggarwal. His vision and outlook towards creating health awareness and streamlining the medical practice is commendable. We congratulate him on another achievement and hope that he continues to serve the society the way he does in the future as well”.”

A pioneer of leading health initiatives, Dr. KK Aggarwal has been instrumental in bringing treatments such as clot dissolving therapy for acute heart attacks and Colour Doppler Echocardiography in the country.  In addition to this, he has also conceptualized and organized unique consumer driven health awareness platforms such as The Perfect Health Mela and the Run for your Heart as a part of his role as the President of The Heart Care Foundation of India. His most recent project within the NGO called the Sameer Malik Heart Care Foundation Fund is playing an instrumental role in providing heart care for all patients in need of treatment but do not have the financial or technical means to fund it.

Dr. KK Aggarwal’s other roles also include Dean of the Board of Medical Education Moolchand Medcity, Member Ethics Committee Medical Council of India, Chairman Ethics Committee Delhi Medical Council, Editor in Chief IJCP Group of Publications and eMedinewS and Chairman Legal Cell Indian Academy of Echocardiography.

- Ends-

About Heart Care Foundation of India

Heart Care Foundation of India is a National NGO working in the field of creating health awareness for people from all walks of life about all aspects of health incorporating all pathies under one roof using low cost infotainment modules.

For further information please contact:

Talking Point Communications

Naina Aggarwal/ Shriya Mishra

9582363695/ 9650785276

naina.a@talkingpointcommunicaitons.com/ Shriya.m@talkingpointcommunications.com

HCFI Media Coordinator:

Sanjeev – 9871079105

Hcfi.1986@gmail.com

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Fever

By Dr K K Aggarwal
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Fever does not mean presence of infection. There are many situations where there is fever without infection and hence needs no antibiotics.

  • Sepsis is a clinical syndrome, which results from the dysregulation of inflammatory response to an infection. The temperature is between 36°C to 38.30°C. Heart rate is often more than 90 per minute.
  • Symptomatic inflammatory response syndrome means a clinical syndrome, which results from dysregulated inflammatory response to any infections such as inflammation of the pancreas, inflammation of the vessels, clot formations in the veins.
  • Many antibiotics can cause fever; unless they are discontinued, fever will not subside.
  • Hyperthermia is a condition with elevated body temperature but it is not called fever. Examples are exposure to heat or heat stroke and in response to anesthetic drugs and anti–psychotic drugs.
  • Hyperthermia may not respond to anti–fever drugs.
  • When fever is more than 41.5°C, it is acute hyperpyrexia.
  • Hyperpyrexia is usually seen in patients with severe infections but it may also occur in brain hemorrhage. It responds to anti–fever drugs.
  • High temperature without infection is found in condition of hyperfunctioning of the thyroid gland.
  • Recreational drugs such as Ecstasy can also cause fever without any infection.
  • Mild fever can also occur after exertion.
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All about depression

By Dr K K Aggarwal
Filed Under Spirituality - Science Behind Rituals  | | Comments Off

  • Depression is a major public health problem as a leading predictor of functional disability and mortality.
  • Optimal depression treatment improves outcome for most patients.
  • Most adults with clinical significant depression never see a mental health professional but they often see a primary care physician.
  • A non–psychiatrist physician misses the diagnosis of the depression 50% of times.
  • All depressed patients must be enquired specifically about suicidal ideations.
  • Suicidal ideation is a medical emergency
  • Risk factors for suicide are psychiatric known disorders, medical illness, prior history of suicidal attempts, or family history of attempted suicide.
  • Demographic reasons include older age, male gender, marital status (widowed or separated) and living alone.
  • World over about 1 million people commit suicide every year.
  • Seventy–nine percent of patients who commit suicide contact their primary care provider in the last one year before their death and only one–third contact their mental health service provider.
  • Twice as many suicidal victims had contacted with their primary care provider as against the mental health provider in the last month before suicide.
  • Suicide is the 10th leading cause of death worldwide and account for 1.2% of all deaths.
  • In US suicidal rate is 10.5 per 100,000 people.
  • In America suicide is increasing in middle aged adults.
  • There are 10–40 non–fatal suicide attempts for every one completed suicide.
  • The majority of suicides completed in US are accomplished with fire arm (57%); the second leading method of suicide in US is hanging for men and poisoning in women.
  • Patients with prior history of attempted suicide are 5–6 times more likely to make another attempt.
  • Fifty percent of successful victims have made prior attempts.
  • One of every 100 suicidal attempt survivors will die by committing suicide within one year of the first attempt.
  • The risk of suicide increases with increase in age; however, younger and adolescents attempt suicide more than the older.
  • Females attempt suicide more frequently than males but males are successful three times more often.
  • The highest suicidal rate is amongst those individuals who are unmarried followed by widowed, separated, divorced, married without children and married with children in descending order.
  • Living alone increases the risk of suicide.
  • Unemployed and unskilled patients are at higher risk of suicide than those who are employed.
  • A recent sense of failure may lead to higher risk.
  • Clinicians are at higher risk of suicide.
  • The suicidal rate in male clinicians is 1.41 and in female clinicians it is 2.27.
  • Adverse childhood abuse and adverse childhood experiences increase the risk of suicidal attempts.
  • The first step in evaluating suicidal risk is to determine presence of suicidal thoughts including their concerns and duration.
  • Management of suicidal individual includes reducing mortality risk, underlying factors and monitoring and follow up.
  • Major risk for suicidal attempts is in psychiatric disorders, hopelessness and prior suicidal attempts or threats.
  • High impulsivity or alcohol or other substance abuse increase the risk.
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Heart disease starts in youth

By Dr K K Aggarwal
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Autopsy studies of young people who died in accidents have shown that by the late teens, the heart blockages, the kind of lesions that cause heart attacks and strokes are in the process of developing The best opportunity to prevent heart disease is to look at children and adolescents and start the preventive process early. More than a third of children and adolescents are overweight or obese.

The first signs that men are at higher risk of heart disease than women appear during the adolescent years despite the fact that boys lose fat and gain muscle in adolescence, while girls add body fat.

Between the ages of 11 and 19, levels of triglycerides, a type of blood fat associated with cardiovascular disease, increases in the boys and drops in the girls. Levels of HDL cholesterol, the “good” kind that helps keep arteries clear, go down in boys but rise in girls.

Blood pressure increases in both, but significantly more in boys. Insulin resistance, a marker of cardiovascular risk, which is lower in boys at age 11, rises until the age of 19 years.

Any protection that the young women have for cardiovascular protection can be wiped out by obesity and hence obesity in girls at any cost should be handled on priority.

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Anything which cannot be taken as a full meal is not good for health and either should not be taken or taken in a small amount. For example, we never eat a breakfast of onion or garlic or radish. These are the items, which either should not be taken or eaten only in small quantity only as an accompaniment to the main meal. Onion is good for health and has anti–cholesterol and also blood thinning properties, yet it is consumed only in small quantity. In Vedic language, onion has both rajasik and tamasik promoting properties, which make a person more aggressive and dull.

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Defining Acute MI

By Dr K K Aggarwal
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  • In 1979: The diagnosis of acute MI was based on WHO criteria based on epidemiology
  • In 2000: A Joint committee of European Society of Cardiology (ESC) and American College of Cardiology (ACC) proposed a clinically based definition of an acute, evolving, or recent MI.
  • In 2007: Joint Task Force of the European Society of Cardiology, American College of Cardiology Foundation, the American Heart Association, and the World Health Federation (ESC/ACCF/AHA/WHF) refined the 2000 criteria and defined acute MI as a clinical event consequent to the death of cardiac myocytes (myocardial necrosis) that is caused by ischemia (as opposed to other etiologies such as myocarditis or trauma)
  • 2012: This definition was not fundamentally changed in the third universal definition of MI released in 2012 by the ESC/ACCF/AHA/WHF.

Third universal definition

Any one of the following criteria meets the diagnosis of MI:

  1. Detection of a rise and/or fall of cardiac biomarker values (cTn with at least one value above the 99th percentile upper reference limit (URL)) and with at least one of the following:
    • Symptoms of ischemia
    • Development of pathologic Q waves in the ECG
    • New or presumed new significant ST–segment–T wave (ST–T) changes
    • New LBBB
    • Identification of an intracoronary thrombus by angiography or autopsy
    • Imaging evidence of new loss of viable myocardium or a new regional wall motion abnormality.
  2. Cardiac death with symptoms suggestive of myocardial ischemia and presumed new ischemia ECG changes or new LBBB, but death occurred before cardiac biomarkers were obtained, or before cardiac biomarker values would be increased.
  3. PCI- related MI: elevation of cTn >5 × 99th percentile upper reference limit in patients with normal baseline values or a rise of values >20 percent if the baseline values are elevated and are stable or falling. In addition, either (i) symptoms suggestive of myocardial ischemia, or (ii) new ischemic ECG changes or new LBBB, or (iii) angiographic loss of patency of a major coronary artery or a side branch or persistent slow– or no–flow or embolization, or (iv) imaging demonstration of new loss of viable myocardium or new regional wall motion abnormality are required.
  4. Stent thrombosis associated with MI: Detected by coronary angiography or autopsy in the setting of myocardial ischemia and with a rise and/or fall of cardiac biomarkers with at least one value above the 99th percentile
  5. CABG–associated MI: Elevation of cardiac biomarker values >10 × 99th percentile URL in patients with normal baseline cTn values. In addition, either (i) new pathologic Q waves or new LBBB, or (ii) angiographic documented new graft of native coronary artery occlusion, or (iii) imaging evidence of new loss of viable myocardium or new regional wall motion abnormality.

The joint task force further refined the definition of MI

  • Type 1 (spontaneous MI): MI consequent to a pathologic process in the wall of the coronary artery (e.g., plaque erosion/rupture, fissuring, or dissection), resulting in intra luminal thrombus
  • Type 2 (MI secondary to an ischemic imbalance): MI consequent to increased oxygen demand or decreased supply (e.g., coronary endothelial dysfunction, coronary artery spasm, coronary artery embolus, anemia, tachy–/bradyarrhythmias, anemia, respiratory failure, hypertension or hypotension)
  • Type 3 (MI resulting in death when biomarker values are unavailable): Sudden unexpected cardiac death before blood samples for biomarkers could be drawn or before their appearance in the blood
  • Type 4a (MI related to PCI)
  • Type 4b (MI related to stent thrombosis)
  • Type 5 (MI related to CABG)

Thygesen K, Alpert JS, Jaffe AS, et al. Third universal definition of myocardial infarction. Circulation 2012;126(16):2020–35.

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