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Dr K K Aggarwal

Cycling can cause erectile dysfunction

By Dr K K Aggarwal
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Age, diabetes, hypertension, obesity, high lipids, smoking, drugs, heart disease, upright cycling for more than 3 hours a week can cause erectile dysfunction in males. For those who ride bicycles for more than 3 hours a week should do so in a reclining position and not upright position.

A man is considered to have erectile dysfunction when he cannot acquire or sustain an erection of sufficient rigidity for sexual intercourse. Any man may, at one time or another during his life, experience periodic or isolated sexual failures.

The term “impotent” is reserved for those men who experience erectile failure during attempted intercourse more than 75 percent of the time. Heart disease increases the risk for later erectile dysfunction. Erectile dysfunction may be an early warning sign of future heart disease. Men with erectile dysfunction without an obvious cause (e.g., pelvic trauma), and who have no symptoms of heart disease, should be screened for heart disease prior to treatment since there are potential cardiac risks associated with sexual activity in patients with heart disease.

Eight of the 12 most commonly prescribed medications list impotence as a side effect and it is estimated that 25 percent of cases of erectile dysfunction are due to drugs.

Depression, stress, or the drugs used to treat depression can result in erectile dysfunction.

Neurologic causes of erectile dysfunction include stroke, spinal cord or back injury, multiple sclerosis, or dementia. In addition, pelvic trauma, prostate. Surgery or priapism may cause erectile dysfunction.

Bicycling, less obvious, but of increasing importance, has been the possible association of erectile dysfunction with bicycling. Anything that places prolonged pressure on the pudendal and cavernosal nerves or compromises blood flow to the penile artery can result in penile numbness and impotence.

Cycling-induced impotence is primarily a problem of serious cyclists and has been reported to occur in Norwegian men competing in a 540 km bicycle race.

The penile numbness is attributed to the pressure on the perineal nerves whereas the erectile dysfunction is thought to be due to a decrease in oxygen pressure in the pudendal arteries.

Recreational cyclists, those who cycle for less than 3 hours per week and men who cycle in a reclining position avoid the sustained intense pressure on the penile nerve and artery and are less likely to experience sexual side effects. Continued cycling in a seated upright position can reduce the penile oxygen levels lasting 10 minutes.

HCFI tips for fasting

By Dr K K Aggarwal
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  1. Plan your diet especially if you have medical conditions such as diabetes and hypertension. Do not skip your medication schedule. Keep a healthy snack handy for those cravings.
  2. Keep yourself hydrated by drinking water, coconut water, green tea, buttermilk, and lime juice. Avoid aerated drinks.
  3. Avoid gorging on salty ‘vrat snacks’. Eat something that is boiled or roasted instead.
  4. Use rock salt in your food instead of usual salt as it helps in better mineral absorption. It is also beneficial for those who have high or low blood pressure.
  5. Eat lighter meals as these can aid digestion.
  6. For dessert, you can try eating dates or fruit yogurt. Also, add honey instead of sugar.
  7. Eat lots of fresh fruits and vegetables.

Spirituality, The Key To Health

By Dr K K Aggarwal
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To stay healthy, one needs to eat right, get plenty of exercise and rest and avoid bad habits such as smoking. But, now it is said that “what you believe in” can have a big impact on health and longevity. Many studies show that patients with strong spirituality can improve their health from a variety of chronic conditions, like hypertension, heart disease, recovery from surgery and more.

Research indicates there are real health benefits from spirituality:

  1. People with high levels of religious beliefs or spirituality have lower cortisol responses. Cortisol is a hormone the body releases in response to stress.

  2. Positive thinking produces nearly a 30% drop in perception of pain.
  3. Spirituality and the practice of religion have recently been associated with a slower progression of Alzheimer’s disease.

  4. Those who regularly attend organized religious activities may live longer than those who don’t. Regular participation lowers mortality rate by about 12% a year.
  5. People undergoing cardiac rehabilitation feel more confident and perceive greater improvements in their physical abilities if they have a strong faith.

  6. Increased levels of spirituality and religious faith may help substance abusers kick their habit.

  7. Spirituality stimulates the relaxation response. When the body is relaxed, your heart rate, blood pressure and breathing rate all go down, which decreases the body’s stress response.

  8. Spirituality can affect immune-system function. Spirituality, faith, church attendance improves immune function in ways that can be measured, like an increase in white blood cells.

  9. Prayer heals the heart.

  10. Positive talking and thinking in the ICU produces better results.

Spirituality is what brings you peace and safety. It can be achieved through God or Goddess, nature, a beautiful sunset, a meditation, Pranayama, religious meeting, chanting, mind-body relaxation, etc. Spirituality is something that can help all the way from promoting wellness to helping with recovery.

(Disclaimer: The views expressed in this write up are my own).

Sugar, not salt, may be at fault for high BP

By Dr K K Aggarwal
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Sugar, not salt contributes to the majority of the hypertension risk associated with processed food and a reduction in the consumption of added sugars and, in particular, processed foods may translate into decreased rates of hypertension as well as decreased cardiometabolic disease.

James J. DiNicolantanio, PharmD, from Saint Lukes Mid America Heart Institute in Kansas City, Missouri, and Sean C. Lucan, MD, MPH, from Albert Einstein College of Medicine in Bronx, New York, published their review of epidemiological and experimental studies in the journal Open Heart. They concluded that high-sugar diets may make a significant contribution to cardiometabolic risk.

Highly refined processed foods should be replaced by natural whole foods.

Cycling can cause erectile dysfunction

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , , , , , , | | Comments Off on Cycling can cause erectile dysfunction

Age, diabetes, hypertension, obesity, high lipids, smoking, drugs, heart disease, upright cycling for more than 3 hours a week can cause erectile dysfunction (ED) in males. Those who ride bicycles for more than 3 hours a week should do so in a reclining position and not upright position. A man is considered to have ED when he cannot acquire or sustain an erection of sufficient rigidity for sexual intercourse. Any man may, at one time or another during his life, experience periodic or isolated sexual failures. The term “impotent” is reserved for those men who experience erectile failure during attempted intercourse more than 75% of the time. Heart disease increases the risk for later ED; ED also may be an early warning sign of future heart disease. Men with erectile dysfunction without an obvious cause (e.g., pelvic trauma), and who have no symptoms of heart disease, should be screened for heart disease prior to treatment since there are potential cardiac risks associated with sexual activity in patients with heart disease. Eight of the 12 most commonly prescribed medications list impotence as a side effect and it is estimated that 25% of cases of ED are due to drugs. Depression, stress, or the drugs used to treat depression can result in ED. Neurologic causes include stroke, spinal cord or back injury, multiple sclerosis, or dementia. In addition, pelvic trauma, prostate. Surgery or priapism may cause ED. A less obvious, but of increasing importance, has been the possible association of ED with bicycling. Anything that places prolonged pressure on the pudendal and cavernosal nerves or compromises blood flow to the penile artery can result in penile numbness and impotence. Cycling-induced impotence, is primarily a problem of serious cyclists and has been reported to occur in Norwegian men competing in a 540 km bicycle race. The penile numbness is attributed to the pressure on the perineal nerves whereas the erectile dysfunction is thought to be due to a decrease in oxygen pressure in the pudendal arteries. Recreational cyclists, those who cycle for less than 3 hours per week and men who cycle in a reclining position avoid the sustained intense pressure on the penile nerve and artery and are less likely to experience sexual side effects. Continued cycling in a seated upright position can reduce the penile oxygen levels lasting 10 minutes.

Diagnosis of hypertension in childhood requires repeated BP measurements

By Dr K K Aggarwal
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The diagnosis of hypertension in children should be based on three blood pressure measurements at separate clinical visits. Normative BP percentiles are based upon data on gender age height and blood pressure measurements from the National Health and Nutrition Examination Survey and other population based studies. In a study initial BP measurement was normal below the 90th percentile pre hypertensive systolic or diastolic BP between the 90th or 95th percentile and hypertensive systolic or diastolic BP 8805 95th percentile in 82 13 and 5 percent of children. At follow up subsequent hypertensive measurements were observed in only 4 percent of the 10 848 children who had initial hypertensive values. In the cohort the overall prevalence of hypertension was 0.3 percent. Source Lo JC Sinaiko A Chandra M et al. Prehypertension and hypertension in community based pediatric practice. Pediatrics 2013 131 e415.

A slight move is all that matters

By Dr K K Aggarwal
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Middle-aged women who move around more in their daily life have lower levels of intra-abdominal fat, a risk factor for heart disease.
A minor modification in daily routine: Reducing the time watching TV or increasing the walk time to work can make a difference in the long-term health.
Visceral fat is a hot topic because of metabolic syndrome, which predisposes people to diseases.
Intra-abdominal fat, or the fat that wraps around the organs in the abdomen and chest, tends to accumulate at midlife and can contribute to developing diabetes, hypertension and heart disease. The fat around the organs is known to be more related to heart disease and diabetes. A woman does not need to appear outwardly heavy to have a potentially troublesome extra “tire” around her organs.
Exercise for long has been known to reduce the amount of intra-abdominal fat.

Clinicians should aggressively treat unhealthy lifestyles

By Dr K K Aggarwal
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Unhealthy behaviors should be managed as aggressively as hypertension, high cholesterol, and other heart disease risk factors, according to an American Heart Association policy statement published in the journal Circulation. Doctors should create “interprofessional practices” to connect patients with behavior-change specialists. They must implement five A’s when caring for patients 1. Assess a patient’s risk behaviors for heart disease 2. Advise change, such as weight loss or exercise 3. Agree on an action plan 4. Assist with treatment 5. Arrange for follow–up care.

Sugar, not salt, may be at fault for hypertension

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , | | Comments Off on Sugar, not salt, may be at fault for hypertension

Sugar, not salt contributes to the majority of the hypertension risk associated with processed food and a reduction in the consumption of added sugars and, in particular, processed foods may translate into decreased rates of hypertension as well as decreased cardiometabolic disease. James J. DiNicolantanio, PharmD, from Saint Luke’s Mid America Heart Institute in Kansas City, Missouri, and Sean C. Lucan, MD, MPH, from Albert Einstein College of Medicine in Bronx, New York, published their review of epidemiological and experimental studies in Open Heart. The authors conclude that high-sugar diets may make a significant contribution to cardiometabolic risk. Highly refined processed foods should be replaced by natural whole foods.

Restricting salt in diet can lower heart disease risk

By Dr K K Aggarwal
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Restricting salt in the diet can lower the risk of developing heart disease by 25 percent and the risk of dying from heart disease by 20 percent.

Dietary intake of sodium among Indians is excessively high. Among hypertensive individuals, lowering sodium is quite well established to lower blood pressure, but now it has been shown that reducing salt also has an effect on cardiovascular disease as shown in a Harvard Medical School study published in British Medical Journal.

When people with pre hypertension (blood pressure more than 120/80 and lower than 140/90), reduced their salt intake by about 25 to 35%, they were 25% less likely to develop cardiovascular disease 10 to 15 years after the trial ended. There was also a 20 percent lower death rate from cardiovascular disease among those who cut their salt consumption.

Salt restriction is best achieved by avoiding salted, salt cured and salt smoked foods such as lunch meat, hot dogs, ham, olives, pickles and regular salted canned foods, and other prepared foods, which often use more salt than homemade equivalents. Foods we would never think of as salty, such as breakfast cereals, cookies, and even some soft drinks, often contain copious additions of sodium.

Check your BMI to know your risk of future heart attack

By Dr K K Aggarwal
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If you are less than 40 years of age, male, with a strong family history of diabetes, blood pressure or heart disease, have a normal weight as judged by body mass index (BMI) but have a pot belly, or have gained more than 10 kg since the age 18, do not ignore this and go to your cardiologist to reduce your chances of a future heart attack.

A BMI of 20 to 23 kg/m2 is associated with little or no increased risk unless visceral fat is high, or the subject has gained more than 10 kg since 18 years.

1. Subjects with a BMI of 23 to 30 kg/m2 may be described as having low risk, while those with a BMI of 30 to 35 kg/m2 are at moderate risk. 2. Subjects with a BMI of 35 to 40 kg/m2 are at high risk, and those with a BMI above 40 kg/m2 are at very high risk from their obesity. 3. At any given level of BMI, the risk to health is increased by more abdominal fat (increased weight to hip ratio, WHR), hyperlipidemia, hypertension, age less than 40 years, male sex, and a strong family history of diabetes, hypertension, or heart disease.

The body mass index (BMI) is the most practical way to evaluate the degree of obesity. It is calculated from the height and weight as follows:

BMI = body weight (in kg) ÷ square of stature (height, in meters)

Overweight is defined as a BMI between 23 and 30 kg/m2 and obesity as a BMI greater than 30 kg/m2.

Diagnosis of hypertension in childhood requires repeated BP measurements

By Dr K K Aggarwal
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Hypertension should be confirmed based on three blood pressure measurements at separate clinical visits.

Normative BP percentiles are based upon data on gender, age, height, and blood pressure measurements from the National Health and Nutrition Examination Survey and other population–based studies.

In a study initial BP measurement was normal (below the 90th percentile), pre–hypertensive (systolic or diastolic BP between the 90th or 95th percentile) and hypertensive (systolic or diastolic BP =95th percentile) in 82, 13, and 5 percent of children.

At follow–up, subsequent hypertensive measurements were observed in only 4 percent of the 10,848 children who had initial hypertensive values. In the cohort, the overall prevalence of hypertension was 0.3 percent.

Source: Lo JC, Sinaiko A, Chandra M, et al. Prehypertension and hypertension in community–based pediatric practice. Pediatrics 2013;131:e415.

Cycling can cause erectile dysfunction

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , , , | | Comments Off on Cycling can cause erectile dysfunction

Age, diabetes, hypertension, obesity, high lipids, smoking, drugs, heart disease, upright cycling for more than 3 hours a week can cause erectile dysfunction in males. Those who ride bicycles for more than 3 hours a week should do so in a reclining position and not upright position.

A man is considered to have erectile dysfunction when he cannot acquire or sustain an erection of sufficient rigidity for sexual intercourse. Any man may, at one time or another during his life, experience periodic or isolated sexual failures.

The term “impotent” is reserved for those men who experience erectile failure during attempted intercourse more than 75 percent of the time. Heart disease increases the risk for later erectile dysfunction. Erectile dysfunction may be an early warning sign of future heart disease. Men with erectile dysfunction without an obvious cause (e.g., pelvic trauma), and who have no symptoms of heart disease, should be screened for heart disease prior to treatment since there are potential cardiac risks associated with sexual activity in patients with heart disease.
Eight of the 12 most commonly prescribed medications list impotence as a side effect and it is estimated that 25 percent of cases of erectile dysfunction are due to drugs.
Depression, stress, or the drugs used to treat depression can result in erectile dysfunction.
Neurologic causes of erectile dysfunction include stroke, spinal cord or back injury, multiple sclerosis, or dementia. In addition, pelvic trauma, prostate. Surgery or priapism may cause erectile dysfunction.
Bicycling: Less obvious, but of increasing importance, has been the possible association of erectile dysfunction with bicycling. Anything that places prolonged pressure on the pudendal and cavernosal nerves or compromises blood flow to the penile artery can result in penile numbness and impotence.
Cycling-induced impotence is primarily a problem of serious cyclists and has been reported to occur in Norwegian men competing in a 540 km bicycle race.
The penile numbness is attributed to the pressure on the perineal nerves whereas the erectile dysfunction is thought to be due to a decrease in oxygen pressure in the pudendal arteries.
Recreational cyclists, those who cycle for less than 3 hours per week and men who cycle in a reclining position avoid the sustained intense pressure on the penile nerve and artery and are less likely to experience sexual side effects. Continued cycling in a seated upright position can reduce the penile oxygen levels lasting ten minutes.

Smell check, scratch and sniff, a new test for Parkinson’s disease

By Dr K K Aggarwal
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Olfactory dysfunction presenting as odor detection, discrimination, and identification is a common finding in patients with early non vascular Parkinson’s disease.

As per a study of 2,267 men published in the Annals of Neurology, an impaired sense of smell could be an early indicator of Parkinson’s disease, occurring up to four years before motor skill problems appear.

In the study decreased odor identification was associated with older age, smoking, more coffee consumption, less frequent bowel movements, lower cognitive function and excessive daytime sleepiness, but even after adjusting for these factors, those with the lowest odor identification scores had a five time greater risk of developing Parkinson’s disease than those with the highest scores.

Nerve loss and the formation of Lewy bodies –– abnormal clumps of proteins inside nerve cells that are thought to be a marker of the disease –– are known to take place in the olfactory structures of patients with the disease.

An impaired sense of smell could also be caused by impaired sniffing, which may be another motor symptom of Parkinson’s.

Early indicators of Parkinson’s disease are olfactory abnormality, constipation and sleep disturbances.

Besides Parkinson’s disease, obesity, diabetes, hypertension, malnutrition, Alzheimer’s disease, multiple sclerosis and Korsakoff’s psychosis are all accompanied or signaled by smell disorders.

Diagnosis of hypertension in childhood requires repeated BP measurements

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , | | Comments Off on Diagnosis of hypertension in childhood requires repeated BP measurements

One needs to confirm presence of hypertension based on three blood pressure measurements at separate clinical visits.

Normative BP percentiles are based upon data on gender, age, height, and blood pressure measurements from the National Health and Nutrition Examination Survey and other population–based studies.

In a study initial BP measurement was normal (below the 90th percentile), pre–hypertensive (systolic or diastolic BP between the 90th or 95th percentile) and hypertensive (systolic or diastolic BP ≥95th percentile) in 82, 13, and 5 percent of children.

At follow–up, subsequent hypertensive measurements were observed in only 4 percent of the 10,848 children who had initial hypertensive values. In the cohort, the overall prevalence of hypertension was 0.3 percent.

Source: Lo JC, Sinaiko A, Chandra M, et al. Prehypertension and hypertension in community–based pediatric practice. Pediatrics 2013;131:e415.