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Dr K K Aggarwal

World Earth Day 2012 – Every Day is Earth Day

World Earth Day organized by Heart Care Foundation of India jointly with Delhi Public School, Mathura Road and Ministry of Earth Sciences

World Earth Day organized at DPS Mathura Road

Flagging the World Earth Day Walk organized by Heart Care Foundation of India jointly with Delhi Public School, Mathura Road and Ministry of Earth Sciences, Military Secretary to the President of India- Lt. Gen. A.K. Bakshi, SM, VSM said that every school child should plant a tree to reduce the problem of global warming in the society.

Talking to a gathering of over one thousand children, Padmashri & Dr. B.C. Roy National Awardee, Dr. K K Aggarwal, President, Heart Care Foundation of India, said that one should not use mercury based thermometer and blood pressure instruments. They can be risky to life. Two thermometers are broken each year for every bed in a hospital. For 40,000 beds in Delhi alone, 80,000 thermometers get broken every year and the mercury of these thermometers enters the environment. Each thermometer contains ½ g of mercury meaning 4 kg of mercury is released in the environment every year only from breaking of thermometers in various hospitals in the city of Delhi.

Mercury is toxic and with active and chronic exposure, affects brain and kidney. Acute exposure can cause nausea, blurred vision, painful breathing, and excessive salivation. Chronic exposure can lead to high blood pressure, memory disturbance, vision disturbance, tremors and personality changes. Mercury can cross the blood brain barrier and affect the brain development in the child in the pregnant or lactating women.

Lt. Gen. Bakshi showed concern that in past few years, Delhi is experiencing differentiable shift in the climate like winters are squeezing with each passing year and temperatures staying over 45 degrees C for most part of the year. This scientists world over are attributing to increase in global temperatures. Unless the general public is sensitized and convinced to take measures/adopt environment friendly actions at their work places, in their homes; this trend of global warming cannot be arrested.

Mr. M.I. Hussain, Principal, DPS Mathura Road, said that unless preventive strategies are taken in this area, situation may worsen in the coming years.

Members of Management Committee of DPS Society and Parent Reps: from Nursery to Class XII were also present to celebrate the World Earth Day.

Over 500 school children participated in the walk and on-the-spot competition which included:

Children displayed the following placards and slogans:

1. Do not burn leaves and let them decompose.

2. Walking is the best medicine

3. The least amount of electricity one uses the better it is.

4. Plant trees to save the mother earth.

In addition inter school competitions (Painting, Poetry recitation, AD Mad) were also held.

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The circadian variation in frequency of heart attack, sudden cardiac death, and heart pain is characterized by a morning peak.

Maximum heart attacks and sudden heart death occur between the hours of 6 am and noon compared to the rest of the day.

Cardiac events are triggered stimulation of sympathetic nervous system.

Fibrinolytic or the clot dissolving capacity is also low in the morning. Among patients with stable heart blockages plasminogen activator inhibitor-1 activity peaks in the early morning while tissue plasminogen activator activity is at its nadir.

Lessons

1.    If you are a heart patient do not smoke after getting up. It can increase the sympathetic activity

2.    If you are a heart patient do not take a cup of tea or coffee immediately after getting up. It can increase the sympathetic activity

3.    Heart patients should take their drugs in the night so that the drug is available in the blood in the morning hours

4.    Heart patients should not exercise early in the morning if they have not taken their morning drug or the previous night drugs

5.    Heart patients should not do kapal bhati or bhastrika pranayama without medical supervision

6.     Early morning anger can be harmful.

7.    Early morning is more harmful in winter and near full moon.

8.    Early morning is more harmful in diabetic patients

9.    Early morning is more harmful in uncontrolled blood pressure patients

10.  Beta blockers and aspirin can prevent early morning heart attack and sudden heart death

About the author: Dr K K Aggarwal is Padmashri and Dr B C Roy National Awardee, President Heart Care Foundation of India, Dean Board of Medical Education Moolchand Medcity, Sr. Physician & Cardiologist, Chairman Ethics Committee Delhi Medical Council, Visiting professor Clinical Research DIPSAR, Past President Delhi Medical Association and Past Academic and Research Wing Heads IMA.

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Xanthelasma are soft, cholesterol–filled plaques that develop under the skin, usually on or around the eyelids and most often near the nose. They occur mainly in middle–aged and older adults and in women more often than in men. They are always benign and rarely impair vision. But they can be a sign of hyperlipidemia—elevated blood–fat levels in 50% of the people.

The presence of xanthelasma on the eyelids is an independent predictor of future heart blockages. In a large prospective study By Dr Anne Tybjærg–Hansen, of Rigshospitalet in Copenhagen published in BMJ during a mean follow–up of 22 years, adults participating in a long–term Danish heart study who had xanthelasmata at baseline had an adjusted hazard ratio for acute heart attack of 1.48. In the study those with the eyelid lesions had lower levels of apolipoprotein A1 and HDL cholesterol as against those who had arcus corneae they had higher levels of lipoprotein (a).

The plaques are especially common in people with inherited disorders of low–density lipoprotein (LDL) metabolism. They occur in 75% of older people with familial hypercholesterolemia (very high cholesterol levels) and in 10% of people with high levels of apolipoprotein B.

Treating any underlying lipid condition may reduce the size of xanthelasma. If no lipid abnormality is present then xanthelasma is largely a cosmetic problem.

There are several ways to remove xanthelasma. These include cryotherapy (freezing the lesions with liquid nitrogen), laser ablation, surgical excision, electrodesiccation (destruction of the lesion with an electric needle), and chemical cauterization (application of a topical agent such as trichloroacetic acid to dissolve the plaques).

Take home message

  • All patients with xanthelasmas should get lipid profile done.
  • Look for low HDL and low Apo A1 levels.
  • Look of high Apo B levels.
  • Get LP(a) levels it will usually be normal.

 

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Ondansetron can trigger dangerous and possibly lethal changes in heart rhythms as per FDA warning. It can cause prolongation of the QT interval in ECG which can lead to an abnormal and potentially fatal heart rhythm, including Torsade de Pointes,” the FDA said.

Patients at greatest risk include those with “underlying heart conditions, such as congenital long QT syndrome, [and] those who are predisposed to low levels of potassium and magnesium in the blood” as well as patients who are taking other medications also associated with QT prolongation.

Ondansetron is a 5-HT3 serotonin receptor antagonist, commonly prescribed to prevent nausea and vomiting caused by cancer chemotherapy, radiation therapy, and surgery.

The FDA label recommend ECG monitoring in certain patients including those with hypokalemia or hypomagnesemia, congestive heart failure, bradyarrhythmias, and in patients who are taking other medications that increase the risk of QT.

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