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Dr K K Aggarwal

Cant avoid anger: Take aspirin

By Dr K K Aggarwal
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Emotionally stressful events, and more specifically, anger, immediately precede and appear to trigger the onset of acute heart attack. Episodes of anger are capable of triggering the onset of acute heart attack and aspirin can reduce this risk. People who cannot control their anger should ask their doctors to consider taking aspirin.

The Onset Anger Scale identified 39 patients with episodes of anger in the 2 hours before the onset of heart attack. The relative risk of heart attack in the 2 hours after an episode of anger was 23. Regular users of aspirin had a significantly lower relative risk (1.4) than nonusers (2.9). Anger in response to stress is also of particular importance for the development of premature heart attack in young men. An episode of anger may also trigger an acute heart attack in the next 2 hours.

Cant avoid anger: Take aspirin

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , , | | Comments Off on Cant avoid anger: Take aspirin

Emotionally stressful events, and more specifically, anger, immediately precede and appear to trigger the onset of acute heart attack. Episodes of anger are capable of triggering the onset of acute heart attack and aspirin can reduce this risk. People who cannot control their anger should ask their doctors to consider taking aspirin.

The Onset Anger Scale identified 39 patients with episodes of anger in the 2 hours before the onset of heart attack. The relative risk of heart attack in the 2 hours after an episode of anger was 23. Regular users of aspirin had a significantly lower relative risk (1.4) than nonusers (2.9). Anger in response to stress is also of particular importance for the development of premature heart attack in young men. An episode of anger may also trigger an acute heart attack in the next 2 hours.

Aspirin for the primary prevention of cardiovascular disease and cancer

By Dr K K Aggarwal
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People above the age of 50 without excess bleeding risk should take low-dose daily aspirin (75 to 100 mg) as per the current recommendations. 

Patients who are more concerned about the bleeding risks than the potential benefits (prevention of cardiovascular events and cancer) may reasonably choose to not take aspirin for primary prevention. 

Meta –analyses of randomized trials have shown aspirin to reduce the risk of non-fatal myocardial infarction (Arch Intern Med 2012; 172:209) and long–term aspirin use reduces overall cancer risk (Lancet 2012;379:1602). 

A meta–analysis addressing this combined outcome suggests that aspirin use in 1000 average risk patients at age 60 years would be expected to result, over a 10–year period, in six fewer deaths, 19 fewer non-fatal myocardial infarctions, 14 fewer cancers, and 16 more major bleeding events.

Aspirin for the primary prevention of cardiovascular disease and cancer

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , | | Comments Off on Aspirin for the primary prevention of cardiovascular disease and cancer

People above the age of 50 without excess bleeding risk should take low-dose daily aspirin (75 to 100 mg) as per the current recommendations.

Patients who are more concerned about the bleeding risks than the potential benefits (prevention of cardiovascular events and cancer) may reasonably choose to not take aspirin for primary prevention.

Meta –analyses of randomized trials have shown aspirin to reduce the risk of non-fatal myocardial infarction (Arch Intern Med 2012; 172:209) and long–term aspirin use reduces overall cancer risk (Lancet 2012; 379:1602).

A meta–analysis addressing this combined outcome suggests that aspirin use in 1000 average risk patients at age 60 years would be expected to result, over a 10–year period, in six fewer deaths, 19 fewer non-fatal myocardial infarctions, 14 fewer cancers, and 16 more major bleeding events.

The majority of known risk factors for heart attack disease are modifiable by specific preventive measures.

Nine potentially modifiable factors: include smoking, dyslipidemia, hypertension, diabetes, abdominal obesity, psychosocial factors, regular alcohol consumption, and one should daily consume of fruits and vegetables and do regular physical activity. These account for over 90 percent of the population attributable risk of a first heart attack.

In addition, aspirin is recommended for primary prevention of heart disease for men and women whose 10-year risk of a first heart attack event is 6 percent or greater.

Smoking cessation reduces the risk of both heart attack and stroke. One year after quitting, the risk of heart attack and death from heart disease is reduced by one-half, and after several years begins to approach that of nonsmokers.

A number of observational studies have shown a strong inverse relationship between leisure time activity and decreased risks of CVD. Walking 80 minutes in a day and whenever possible with a speed of 80 steps per minute are the current recommendations.

Tweet of the day @drkkaggarwal

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  1. One can book direct flights to any domestic destination on Spice Jet @ 2013 for travel between 1st February and 30th April 2013.
  2. Erectile dysfunction has 44% increased risk of cardiovascular disease & 25% increased risk of death. [January, Circulation]
  3. Erectile dysfunction is associated with a significant 62% increased risk of heart attack and a 39% increased risk of paralysis. [January, Circulation]
  4. Consuming fructose appears to cause changes in the brain that may lead to overeating, a new study suggests in Jan issue of JAMA.
  5. The newADAguidelines raise the target for systolic upper blood pressure from <130 mmHg to <140 mmHg in diabetics.
  6. FDA has issued another safety communication about QTc prolongation and potentially fatal cardiac arrhythmias in patients treated with ondansetron.
  7. Prolongation of the QT interval and torsades de pointes is associated with macrolide antibiotics, such as erythromycin, clarithromycin and azithromycin
  8. Revisiting 2012: Major change in the previously-issued HIV treatment guidelines; antiretroviral therapy is now recommended in all HIV-infected patients, regardless of CD4 cell counts.
  9. Revisiting 2012: Start ARV in every HIV patient as more potent agents with less toxicity are available
  10. Revisiting 2012: Start ARV in every HIV patient as untreated HIV is associated with increased morbidity & mortality due to heart, kidney & liver disease & malignancy
  11. Aspirin plus clopidogrel is no better than aspirin alone for preventing recurrent stroke.

Learn CPR- Sushil Shinde 

New Delhi: Sunday, 11 November 2012: On the concluding day of MTNL Perfect Health Mela being organised by Heart Care Foundation of India, India’s Home Minister Sh Sushil Shinde released the CPR 10 Mantra “Within 10 Miniutes of Cardiac arrest( earlier the better) for the next atleast 10 miniutes compress the centre of the chest with a speed of 100/min (10×10)”

Mr Shinde to the Mela Delegation led by Padmashri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that CPR should be learned by everybody. He wished the CPR-10 initiative all the success.

The 19th Perfect Health Mela was formally closed on Sunday evening. Thousands of people participated and visited the Mela. Dr. (Prof.) Kiran Walia, Women & Child Department, Social Welfare Department and Languages in her message said that youngsters should not indulge into alcoholism. She said that the drug addiction is becoming a major problem in adolescents. Patient who indulges in substance abuse should be tackled gently and with care. She also said that menstruating women should take a weekly dose of folic acid.

Dr. KK Aggarwal said that the Mela has ended with a good note for the public as dengue is at its decline.
CPR 10 a draw at the Mela Following records were made
•       1050 students were trained in one session of multiple-rescuer CPR.
•       201 people were trained in one session of single-rescuer CPR.
•       Maximum people trained in one day were 2168.
•       96 children with special needs were trained in one session.
•       Total number of people trained more than 8500 people in CPR 10
Heritage Inter Dancing School Competition
Various classical dances like Bharatnatyam, Odissi and Kathak were organized as part of Heritage, the Inter Dance School Festival. The competitions were coordinated by Indian Oil Corporation.
•       Classical dance has effects like meditation.
•       Classical dancing should be part and parcel of school education.
•       People who indulge into classical dance have less lifestyle disorders.
Conference on Zoonoses 2012
Over 100 people participated in a conference on Zoonoses. The messages were:
•       Zoonoses is an animal disease, which can be transmitted to humans.
•       Humans are accidental hosts who acquire disease through close contact with an infected animal who may or may not be having a Zoonosis.
•       Children are at higher risk.
•       Pets can transmit bacterial, fungal and parasitic zoonoses.
•       The different routes of transmission may be saliva, respiratory secretions or through direct contact.
•       Saliva transmission can be through bites or contaminated scratches.
•       The risk of transmission can be reduced by simple precautions.
•       Owners should wash their hands following contact with their pets or cleaning of their cages.
•       Younger pets present a greater risk of diseases than older pets.
•       Pets should not be fed raw meat or eggs.
•       Pets should not be allowed to eat garbage.
•       Pets should not be allowed to drink surface water or toilet water.
•       Pets should be treated timely for diarrhea and dermatoses.
•       All dogs should be vaccinated for rabies.
National Workshop on pre-hospital care in heart attack
A national workshop on pre-hospital care in heart attack was organized in association with National Heart Institute. The faculty included Dr Vinod Sharma, Dr K K Aggarwal, Dr. Tushar Roy, Dr. Lokesh C Gupta, Dr.SK Modi, Dr. KC Goswami and Dr. Sameer Srivastava.

Facts released
In heart attack, at the onset of chest pain, one should chew a tablet of 300 gm of water soluble aspirin. This will reduce chances of death by 22%.
•       Any pain which can pinpointed by a finger is not a heart pain.
•       Any pain of less than 30 seconds duration is not a heart pain.
•       One should reach hospital within 90 minutes of heart attack to receive clot dissolving or clot removing therapy.
•       At the onset of heart attack, one should also be given stat dose of anti cholesterol medicine.
•       Burning in chest for the first time in life after the age of 40 should raise the suspicion of a heart attack.
•       Breathlessness after the age of 40 for the first time in life should not be ignored.
Live discussion on diabetes
A live discussion was held on Dilli Aajtak on diabetes. The faculty included Dr K K Aggarwal and Dr A K Jinghan. The star attraction was cricketer Mr Vijay Dahiya.
Facts about diabetes:
•       Fasting sugar of more than 90 can have cardiovascular involvement.
•       A1c of more than 6.5 is diagnostic of diabetes.
•       A1c testing should be done every three years.
•       Blood sugar along with blood pressure should be kept under control in all patients with diabetes.
•       If uncontrolled, diabetes can damage the heart, eyes, kidney and brain.

Sindhi Academy organized cultural evening
A cultural evening was organized where Sindhi singer Uma Lallo performed.

Symposium on Prayer, Health & Religion A symposium was organized on prayer, health and religion in association with Bharatiya Vidya Bhavan.
The panelists included Prof. Sunil Kumar (Hinduism), Imam Umar Ahmed Iliyasi (Islam), Padri Kanasih G (Christianity), Bhikshu Purnima (Buddhism), Dr. AK Merchant (Bahai Faith), Dr. E A Malekar (Yahudi)
and Acharya Dr. Sadhvi Sadhna Ji Maharaj (Jainism). The session was moderated by Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President of the Mela. Mr. J. Veeraraghavan delivered the
keynote address.
Facts about prayer:
•       Even silent prayers can be effective
•       Prayer has been known to help heal patients.
•       Every hospital should have a prayer room with facilities for prayer for every religion.
•       Patients of some religions may request the doctor to pray with them. Their sentiments should be preserved.
•       In Islam doctors may pray for patients and they are encouraged to do so.
•       Prayer is one of the five pillars in Islam.
•       Prayer is a staple of Jewish spiritual life.

Today (Oct 29) is World Stroke Day and all doctors should revise their ABCs of stroke.

ABC for stroke prevention is

1.     Aspirin for people at risk

2.     Blood Pressure control

3.     Cholesterol management.

Most people are not taking the precautions

a. Less than 50% of those who should be taking daily aspirin take it

b. Less than 50% of those with high blood pressure have it under control.

c. Less than 33% of those with high cholesterol are on effective treatment

d. Less than 25% of those who smoke get help to quit when they see their doctor.

World Stroke Day is part of the Million Hearts campaign. The goal of the campaign is to cut the rate of heart attacks and stroke by one million over the next five years.

Someone in the U.S. alone has a stroke every 40 seconds. Stroke is one of the country’s leading causes of death.