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Dr K K Aggarwal

Nail Hygiene

By Dr K K Aggarwal
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  • Nails can harbor dirt and germs and contribute to the spread of many infections.
  • Keep nails short.
  • Trim nails often.
  • Scrub the underside of nails with soap or water each time you wash your hands.
  • Clean any nail grooming tools before use.
  • Nail grooming tools should be sterilized before use in saloon.
  • Avoid biting and chewing nails.
  • Avoid cutting cuticles as they act as barriers to prevent infection.
  • Never rip or bite a hang nail, instead clip it with a clear sterilized nail trimmer (a hang nail is small torn piece of skin next to finger nail or toe nail).
  • Infections of the finger nails or toe nails are often characterized by swelling of the skin or thickening of the nail. In some cases these infections may be serious and need to be treated by a doctor.

Warning signs of worsening heart failure

By Dr K K Aggarwal
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If you have heart failure, call your doctor if you notice any of these signs:

  1. Sudden weight gain (2–3 pounds in one day or 5 or more pounds in one week)
  2. Extra swelling in the feet or ankles
  3. Swelling or pain in the abdomen
  4. Shortness of breath not related to exercise
  5. Discomfort or trouble breathing when lying flat
  6. Waking up feeling short of breath
  7. Coughing or wheezing
  8. Increased fatigue
  9. Mental confusion
  10. Loss of appetite

Even children can have acidity

By Dr K K Aggarwal
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Children who have continuing recurrence of cough and croup could be suffering from stomach acid reflux problems. Croup or ‘Kali Khansi’, as it is called in local parlance, is recognized by a loud cough that often sounds like the barking of a seal. It can cause rapid or difficult breathing, and sometimes wheezing. Croup is thought to be caused by a virus, but reflux acidity has been suggested as a possible trigger. In gastroesophageal reflux disease (GERD), stomach acid causes swelling and inflammation of the larynx, which narrows the airway. It can trigger more swelling with any kind of viral or respiratory infection. Identifying children with GERD could help treat and improve recurring croup. It is unusual for a child to have three or more bouts of croup over a short period of time. These children need to be evaluated. The same is true for adults also. Patients with non responding asthma should be investigated for underlying acidity as the cause of acute asthma.

New form of heart failure on the rise

By Dr K K Aggarwal
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New form of heart failure on the rise

Heart failure is routinely described as the progressive loss of ability of the heart to pump blood. But, there is another form of heart failure where the blood–pumping ability of the heart remains near normal. This second form of heart failure is too often overlooked and is just as lethal.

In this condition the heart muscle becomes thickened. The chamber inside gets smaller and the heart is unable to relax to accommodate the blood it needs to pump out. As there is no room for the heart to relax, the blood backs up into the lungs. This kind of anomaly is not picked up by standard measurements of “ejection fraction” – the percentage of blood in the heart that goes out with every beat.

This form of the disease is called “diastolic heart failure” because the problem occurs during the diastole portion of heart activity, as the heart relaxes after a beat. Nearly one–third of these patients have an ejection fraction greater than 50 percent, which is very near normal. However, the death rate for this kind of heart failure matches that of patients with the more common form of heart failure, with more than 20% of all the patients dying within a year. There is a steady increase over 15 years of heart failure with normal or near–normal ejection fraction.

For patients, the symptoms of both types of heart failure are the same: Shortness of breath, difficulty exercising and fluid retention in the body. Physicians cannot make a diagnosis on the basis of symptoms or routine examinations. One has to have an echocardiogram and see the heart pumping and see if the ejection fraction is normal or reduced. Until now, relatively little attention has been paid to diastolic heart failure. Advances have been made against systolic heart failure, in which the ejection fraction falls below normal but not much has been done about diastolic heart failure.

Pacing for heart failure

For patients with advanced heart failure waiting for cardiac transplant, biventricular pacing not only improves the quality of life but also prolongs life. If the ejection fraction is low the combo device also gives an electric shock when the heart stops. It is said that all patients with low ejection fraction should ask their doctors for possible implantation of these devices.

Signals of heart failure

One of the commonest presentations is breathlessness on exertion, which is often confused as a part of aging or being obese. Not being able to climb stairs may be the earliest sign of hypertensive diastolic heart failure. Other signals are:

  1. Feeling extra tired even after a good night’s sleep. People with heart failure may limit activities they like to do or take naps to avoid feeling tired.
  2. Weight gain: Call your doctor if you gain weight for more than 2 days in a row or if you gain 2 or more pounds.
  3. Shortness of breath: Heart failure makes breathing harder, especially during exercise. Lying position may make it worse.
  4. Swollen ankles, legs, belly, and/or lower back, the swelling is often worse at the end of the day.
  5. Going to the bathroom more at night.