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Dr K K Aggarwal

Why is My Nose Bleeding?

By Dr K K Aggarwal
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Nosebleed is a common problem, occurring in up to 60% of the general population and is often because of a respiratory illness or dry conditions. Nasal drying is common in the hot summer months because of the extreme temperature and dry air due to use of air conditioners. Here are some typical reasons for nosebleeds: • Nasal allergies • Blowing your nose too hard or trying to remove something from inside the nose • A result of “popping” the ear • Nasal exposure to chemicals • Frequent sneezing or having an upper respiratory infection • Use of nasal spray or a blood-thinning drug, such as aspirin • Inhaling air that is extremely dry or cold • Having recent surgery on the nose or elsewhere on the face • Breaking the nose or a similar injury • Uncontrolled blood pressure Bleeding can be controlled by direct pressure i.e. compression of the nostrils rasping the alae distally so all mucosal surfaces are opposed. Direct pressure should be applied continuously for at least five minutes, and for up to 20 minutes. The patient should be encouraged not to check for active bleeding. Patients who are properly instructed may control their bleeding while the evaluation gets underway. Other maneuvers include bending forward at the waist while sitting up (to avoid swallowing blood), placing a plug of cotton wool or gauze into the bleeding nostril (sometimes coated with antibiotic ointment), expectorating out blood that accumulates in the pharynx and a cold compress applied to the bridge of the nose. These maneuvers also should be taught to high-risk patients for use at home. Many ENT specialists recommend initial treatment with two puffs of oxymetazoline to hasten hemostasis.

Heart Patients Beware of summer

By Dr K K Aggarwal
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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 during summer period.

Not passing urine in eight hours, dry armpits, feeling exhausted or feeling weak 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.

Winter blood pressure 5 mm Hg higher than summer blood pressure

By Dr K K Aggarwal
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Winter blood pressure 5 mm Hg higher than summer blood pressure

The systolic (top number) and diastolic (bottom number) blood pressures rise and fall with change of season.

In a study by the Institute National de la Sante et de la Recherche Medicale of Paris and published in the journal Archives of Internal Medicine involving 8801 people aged 65 or older, average systolic blood pressure was five points higher during the winter than in summer.

Instances of high blood pressure (systolic blood pressure higher than 159, or diastolic higher than 94 mmHg) in the study were found in 33.4 percent of participants during winter but just 23.8 percent during summer.

The reason could be related to the baroreflex, a mechanism of blood pressure regulation that is modified in elderly subjects or a function of the sympathetic nervous system, which helps control involuntary actions such as stress response. A 5 mm change in blood pressure can explain why more heart patients die in winter.

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.