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Dr K K Aggarwal

Some tips to cope with high pollution levels

By Dr K K Aggarwal
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  1. Patients with asthma and chronic bronchitis should get the dose of their medicine increased during smog days.
  2. Avoid exertion in conditions of smog. It is better to avoid walking during smog hours.
  3. Drive slowly during smog hours.
  4. Heart patients should stop their early morning walk during smog hours.
  5. Remember to take the flu pneumonia vaccine.
  6. Keep doors and windows shut particularly during the early morning hours.
  7. It is better to wear protective masks if you must venture out.

Heart Patients Beware of Eating Cakes

By Dr K K Aggarwal
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Food of animal in origin and saturated foods contain cholesterol. 1% rise in cholesterol raises the chances of heart attack by 2. Heart patients should therefore avoid eating cakes during the Christmas and New Year Season. They should distribute fruits & dry fruits instead of cakes. Beware of the term Low or High Cholesterol on the labels

  1. Cholesterol Free means less than 2 mg cholesterol and 2 grams or less fat.
  2. “Low Cholesterol” means 20 mgs or less cholesterol and 2 grams or less saturated fat.
  3. “Fat Free” means less than ½ gram fat;
  4. “Low Fat” means 3 grams or less fat;
  5. “Reduced Fat” means at least 25% less fat than other brands of same food.

High fat diet is prostate cancer prone

By Dr K K Aggarwal
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Diets high in saturated fat increases the risk of prostate cancer, according to a report from University of Texas M. D. Anderson Cancer Center in Houston published in the International Journal of Cancer. Men who consume high saturated animal fat diet are two times more likely to experience disease progression after prostate cancer surgery than men with lower saturated fat intake. There is also shorter “disease–free” survival time among obese men who eat high saturated fat diet compared with non–obese men consuming diets low in saturated fat. Men with a high saturated fat intake had the shortest survival time free of prostate cancer (19 months). Non–obese men with low fat intake survived the longest time free of the disease (46 months). Non–obese men with high intake and obese men with low intake had “disease–free” survival of 29 and 42 months, respectively.

Take home messages

• High saturated fat diet has been linked to cancer of the prostate

• Reducing saturated fat in the diet after prostate cancer surgery can help reduce the cancer progression.

• Cancer prostate has the same risk factors as that of heart blockages and both are linked to high saturated fat intake.

• With the increase of heart patients, a corresponding increase in prostate cancer patients is also seen in the society.

 

Stress management programs for heart patients a must

By Dr K K Aggarwal
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Drugs such as beta–blockers and psychosocial interventions can reduce the physiologic response to some forms of stress. In patients with known coronary disease, the cardioprotective effect of beta blockers with regard to heart attack and sudden cardiac death are partly due to a diminution of catecholamine and hemodynamic–induced endothelial damage and a rising of the threshold for ventricular fibrillation. In patients at risk for cardiovascular events who are under increased psychosocial stress, a stress management program can be considered as part of an overall preventive strategy. The goals of a stress management program are to reduce the impact in the individual of stressful environmental events and to better regulate the stress response. Interventions may be considered at several levels: • Removal or alteration of the stressor • Change in perception of the stressful event • Reduction in the physiologic sequelae of stress • Use of alternative coping strategies Stress management techniques typically include components of muscular relaxation, a quiet environment, passive attitude and deep breathing with the repetition of a word or phrase. The physiologic changes produced include a decrease in oxygen consumption, reduced heart rate and respiratory rate and passive attitude and muscular relaxation. Such changes are consistent with a decrease in sympathetic nervous system activity. Other measures, such as relaxation techniques and biofeedback, can produce a small reduction in blood pressure of 5 to 10 mmHg. Behavior modification programs are also an important adjunct to smoking cessation and have been associated with a reduction in cigarette consumption. Improvements in compliance with medication regimens may be an additional benefit from stress reduction program.

Heart Patients Beware of Eating Cakes

By Dr K K Aggarwal
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Food of animal in origin and saturated foods contain cholesterol. 1% rise in cholesterol raises the chances of heart attack by 2%. Heart Patients should therefore avoid eating cakes during the Christmas and New Year Season. They should distribute fruits & dry fruits instead of cakes.

Beware of the term Low or High Cholesterol on the labels

  • Cholesterol Free means less than 2 mg cholesterol and 2 grams or less fat.
  • “Low Cholesterol” means 20 mgs or less cholesterol and 2 grams or less saturated fat.
  • “Fat Free” means less than ½ gram fat;
  • “Low Fat” means 3 grams or less fat;
  • “Reduced Fat” means at least 25% less fat than other brands of same food.

Pneumonia more risky to heart patients

By Dr K K Aggarwal
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People who are hospitalized with bacterial pneumonia are eight times more likely to suffer heart attack or other “acute coronary syndrome” within 15 days of admission than are their peers hospitalized for other conditions.

Even the patients with bacterial pneumonia are at greater risk for acute heart–related “events” in the days following admission than they are one year before or after hospitalization.

As per a research at Baylor College of Medicine in Houston, from a study which focused on 206 patients with pneumonia and 395 non–pneumonia patients, compared to control patients, pneumonia patients had 7.75–fold higher risk of suffering an acute heart–related event within 15 days of being admitted to the hospital. Overall, 10.7 percent of pneumonia patients suffered an acute coronary heart event within 15 days of hospital admission, compared with only 1.5 percent of control patients. Further analysis showed that pneumonia patients were roughly 45–times more likely to experience an acute coronary heart syndrome in the days following their admission than either one year before or after their hospital stay.

Heart Patients Beware of Summer

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Dehydration can precipitate heart attack in susceptible individuals. Dehydration can be dangerous in patients with uncontrolled blood pressure or diabetes. In these patients, dehydration can make the blood thicker and precipitate heart attack.

Dehydration is common in summer, and with the rising temperatures, chances of a person developing dehydration increase. A person, therefore, needs to increase fluid intake during summer.

The normal fluid requirement is 30 ml per kg weight, but the same needs to be increased in the summer because of the loss of fluid from sweating. Apart from water, sodium (Na) or salt is also lost.

Walking is a necessity for heart patients and it should be continued even during peak summer but the peak heat periods should be avoided. One can walk early in the morning or late in the evening.

Heart Patients Beware of Summer

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Dehydration can precipitate heart attack in susceptible individuals. The normal fluid requirement is 30 ml per kg weight, but the same needs to be increased in the summer because of the loss of fluid from sweating. Apart from water, Sodium or salt is also lost. A person, therefore, needs to take more fruits intake during summer period.

Not passing urine in eight hours, dry armpits, feeling exhausted or feeling week are suggestive of underlying dehydration. Dehydration can make the blood thick and precipitate heart attack in patients with uncontrolled blood pressure or diabetes.

Walking is a necessity for heart patients and the same should be continued even during peak summer but the timing should be so chosen that peak heat periods are avoided. One can walk early in the morning or late in the evening. People taking anti-allergic pills should take special precautions as they are more likely to get heat stroke.

Heat stroke is a medical emergency leading to charring of organs because of extreme internal heat. A person’s temperature may be more than 105°F.

Preventing Summer Disorders

The most common summer disorders are dehydration, heat cramps, heat exhaustion and heat stroke on one hand and acidity, infections, diarrhea, cholera, typhoid and jaundice on the other hand.

Heat cramps, exhaustion and stroke all result from prolonged exposure to heat but differ in the severity of the illness. Heat cramp is a milder form of illness where a person ends up with weakness, dehydration, and salt deficiency. The treatment, is replacing fluid and salt orally.

Heat exhaustion, on the other hand, is a relatively serious condition with fever, dehydration, weakness but presence of sweating. If not diagnosed and treated in time with rapid fluid replacement, heat exhaustion can end–up into heat stroke where the body’s thermoregulatory mechanisms fail leading to a sudden rise in internal temperature and charring of organs and ultimate death.

Heat stroke, therefore, is a medical emergency and requires bringing down of temperature within minutes. Absence of sweating, dry armpit, non-passing of urine for eight hours or presence of high grade fever in summer season should not be ignored and medical attention taken immediately.

Diarrhea, Cholera, Typhoid and Jaundice are all food and water-born diseases due to poor hygiene and shortage of water supply in the community. All of them can become serious if not attended in time. Of these diarrhea and cholera are infections of the small intestine and require replacing with lemon water mixed with sugar and salt. The deficiency of fluid may be upto 6 to 8 liters. A person needs to be hospitalized only if the loose motions are more than 12 in number. For prevention of these diseases, one needs to follow the principle – Heat it, Boil it, Cook it, Peel it or Forget it.

Heart patients beware of bhang

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Heart patients to avoid bhang or consult cardiologist. Indiscriminate use can increase heart rate and BP. Pretreatment with beta-blocker can help.

Heart patients should not take bhang as it can precipitate an increase in heart rate and sudden rise in blood pressure, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President Elect IMA.

Those who are socially committed should consult their doctor. Pre-treatment with propranolol a beta blocker can block the cardiovascular effects of marijuana. It can prevent the learning impairment and, to a lesser degree, the characteristic subjective experience.

Marijuana is known to induce typical subjective state (“high”) with marked increases in HR, BP and conjunctival infection. It impairs performance on a learning test without significantly affecting attention.

 

About Bhang

 

  • Bhang is a traditional Indian beverage made of cannabis mixed with various herbs and spices, which has been popular inIndiafor ages.
  • Bhang is a less powerful preparation than Ganja, which is prepared from flowering plants for smoking and eating.
  • Charas, more potent than either Bhang or Ganja, consists of cannabis flower tops harvested at full bloom.
  • Dense with sticky resin, Charas is nearly as potent as the concentrated cannabis resin preparations called hashish.

 

Heart Patients Beware of Eating Cakes

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Food of animal in origin and saturated foods contain cholesterol. 1% rise in cholesterol raises the chances of heart attack by 2%. Heart Patients should therefore avoid eating cakes during the Christmas and New Year Season. They should distribute fruits & dry fruits instead of cakes.

Beware of the term Low or High Cholesterol on the labels

1.  Cholesterol Free means less than 2 mg cholesterol and 2 grams or less fat.

2. “Low Cholesterol” means 20 mgs or less cholesterol and 2 grams or less saturated fat.

3.  “Fat Free” means less than ½ gram fat;

4.  “Low Fat” means 3 grams or less fat;

5.  “Reduced Fat” means at least 25% less fat than other brands of same food.

Heart Patients Should Be More Cautious During Xmas Time

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In the emergency room, heart attacks can be both over and under diagnosed. About 10% of heart attacks are over diagnosed and an equivalent number can be missed as the ECG can be normal in the first six hours after a heart attack.

Most heart attacks occur during winter all over the world includingIndia. Missing heart attacks during this period in the early hours of the morning can lead to spurts in number of cases of sudden cardiac death.

Moreover, most senior doctors maybe on vacation during Xmas further worsening the situation for the common man.

Every effort should be taken to reduce the number of false positive or false negative diagnosis of heart attack.

In a study published in JAMA, Henry and coauthors studied the medical records of 1,345 people treated for suspected heart attacks in a regional system between 2003 and 2006, looking at emergency room decisions. All patients had classical heart attack called STEMI, a heart attack characterized by a specific ECG pattern. About 14 % of heart attacks were overdiagnosed.

Men and women have about the same adjusted in-hospital death rate for heart attack — but women are more likely to die if hospitalized for a more severe type of heart attack

All heart patients should have their cardiac and mental stress levels check up done in winter. A heart attack can come with irregular meals, late nights, missing of regular dose of medicines and indulgence in smoking and drinking.

Acute stress-related events are common during winters, especially close to full moon in the early morning hours.   The circadian variation in event frequency suggests that cardiac events may be triggered by external activities, particularly those activating the sympathetic nervous system.

Data from the Multicenter Investigation of the Limitation of Infarct Size (MILIS) indicated that among 849 patients with acute heart attack, 48 percent described one or more possible triggers, the most common of which was emotional upset (14 percent).

There are several mechanisms by which emotional stress might trigger an acute heart attack.

The physiologic changes that have been described in the morning period of enhanced cardiovascular risk — increase in blood pressure, heart rate, vascular tone, and platelet agreeability — also may result from mental stress. These factors may all be related to abnormalities in autonomic tone and activation of sympathetic nervous system activity, which may enhance platelet aggregation and increase the susceptibility to serious ventricular arrhythmias.

A Guide for heart patients

  • Keep BP < 120/80 mm hg
  • Maintain blood sugar levels < 90 mg%
  • Not to miss their regular dose of cardiac drugs, if prescribed. The morning pulse and BP should be normal.
  • Ask your doctor for a beta-blocker, if not contraindicated, to keep the stress under control
  • Say no to smoking
  • Say no to alcohol
  • Get a flu vaccine.
  • Avoid heavy eating.
  • Not to ignore any suicidal thoughts.
  • Have a complete medical check up done including a treadmill.

Meditation May Reduce Death, Heart Attack And Stroke In Heart Patients

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1. Twice-a-day Transcendental Meditation helped African Americans with heart disease reduce risk of death, heart attack and stroke.

2. Meditation helped patients lower their blood pressure, stress and anger compared with patients who attended a health education class.

3. Regular Transcendental Meditation may improve long-term heart health.

African Americans with heart disease who practiced Transcendental Meditation regularly were 48 percent less likely to have a heart attack and stroke or die from all causes compared with African Americans who attended a health education class over more than five years, according to new research published in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.

Those practicing meditation also lowered their blood pressure and reported less stress and anger. And the more regularly patients meditated, the greater their survival, said researchers who conducted the study at the Medical College of Wisconsin in Milwaukee.

The National Heart, Lung and Blood Institute funded the study. [Medline]

Stress Management Programs For Heart Patients A Must

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Drugs such as beta-blockers and psychosocial interventions can reduce the physiologic response to some forms of stress.

In patients with known coronary disease, the cardioprotective effect of beta blockers with regard to heart attack and sudden cardiac death are partly due to a diminution of catecholamine and hemodynamic-induced endothelial damage and a rising of the threshold for ventricular fibrillation.

In patients at risk for cardiovascular events who are under increased psychosocial stress, a stress management program can be considered as part of an overall preventive strategy. In premature heart attack, the mean age is 53-54 yrs.

In general, the goal of a stress management program is to reduce the impact in the individual of stressful environmental events and to better regulate the stress response.

Interventions may be considered at several levels:

  • Removal or alteration of the stressor
  • Change in perception of the stressful event
  • Reduction in the physiologic sequelae of stress
  • Use of alternative coping strategies

Stress management techniques typically include components of muscular relaxation, a quiet environment, passive attitude and deep breathing with the repetition of a word or phrase.

The physiologic changes produced include a decrease in oxygen consumption, reduced heart rate and respiratory rate and passive attitude and muscular relaxation. Such changes are consistent with a decrease in sympathetic nervous system activity.

Other measures, such as relaxation techniques and biofeedback, can produce a small reduction in blood pressure of 5 to 10 mmHg.

Behavior modification programs are also an important adjunct to smoking cessation and have been associated with a reduction in cigarette consumption. Improvements in compliance with medication regimens may be an additional benefit from stress reduction program.

Ten percent of the heart attacks in the emergency room are over diagnosed. Heart attacks which are common near Xmas can also be missed as the ECG can be normal in the first 6 hours.

Every effort should be taken to reduce the number of false positive or Read more