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Dr K K Aggarwal

Even the elderly should exercise

By Dr K K Aggarwal
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Research has found that older runners live longer and suffer fewer disabilities than healthy non–runners. This observation applies to a variety of aerobic exercises, including walking.

A study by authors, from Stanford University School of Medicine, published in the Archives of Internal Medicine has shown that being active reduces disability and increases survival.

There are benefits of vigorous activity late in life. Earlier many experts believed that vigorous exercise would actually harm older individuals. And running, in particular, would result in an epidemic of joint and bone injuries. But this new study proves otherwise.

Two hundred and eighty–four runners and 156 healthy “controls,” or non–runners, in California completed annual questionnaires over a 21–year period. The participants were 50 years old or over at the beginning of the study and ran an average of about four hours a week. By the end of the study period, the participants were in their 70s or 80s or older and ran about 76 minutes a week. At 19 years, just 15 percent of the runners had died, compared with 34 percent of the non–runners.

In the study, running delayed the onset of disability by an average of 16 years. It’s so important to be physically active your whole life, not just in your 20s or 40s, but forever.

Exercise is like the most potent drug. Exercise is by far the best thing you can do.

One should take lessons from Yudhishthir in Mahabharata who walked till his death. However a word of caution, if an elderly person is walking or entering into an exercise program, he or she should have a cardiac evaluation done to rule out underlying heart blockages.

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All about Diabetes

By Dr K K Aggarwal
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• Type 2 diabetes can be delayed or prevented, and both types 1 and 2 diabetes can be managed to prevent complications

• India may soon be the diabetic capital of the world.

• People with diabetes are nearly two times more likely than people without diabetes to die from heart disease, and are also at greater risk for kidney, eye and nerve diseases, among other painful and costly complications. Type 2 diabetes can be delayed or prevented, and both types 1 and 2 diabetes can be managed to prevent complications.

• In type 1 diabetes, the body does not make insulin. In type 2 diabetes the body makes insufficient insulin or does not use insulin well.

• Gestational diabetes occurs in some women during pregnancy. Though it usually goes away after the birth, these women and their children have a greater chances of getting type 2 diabetes later in life.

• Type 2 diabetes has begun to affect young people.

• Losing a modest amount of weight — about 15 pounds — through diet and exercise can actually reduce your risk of getting type 2 diabetes by as much as 58 percent in people at high risk.

• In type 1 diabetes, tight control of blood sugar can prevent diabetes complications.

• Choose healthy foods to share.

• Take a brisk walk every day.

• Talk with your family about your health and your family’s risk of diabetes and heart disease.

• If you smoke, seek help to quit.

• Make changes to reduce your risk for diabetes and its complications — for yourself, your families and for future generations.

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Skin care

By Dr K K Aggarwal
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• Clean with soap and water.

• Moisturizers can make the skin dirty.

• Dryness is better than being dirty.

• No soap is a better soap.

• Glycerin is the safest moisturizer.

• Rub hard but take care to not cause bruises.

• Soap emulsifies, therefore, one should remove 100% of surface part.

• Killing the normal flora of the skin is a bad idea. So, do not use antiseptic soaps.

• Remember, e commonly used antiseptic solutions do not kill pseudomonas infection.

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Snorers at risk of sudden death

By Dr K K Aggarwal
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The interrupted night time breathing of sleep apnea increases the risk of dying. Sleep apnea is a common problem in which one has pauses in breathing or shallow breaths during sleep.

Studies have linked sleep apnea during snoring to increased risk for death. Most studies were done in sleep centers rather than in the general community. A study published in the journal Sleep has suggested that the risk is present among all people with obstructive sleep apnea. The size of the increased mortality risk was found to be surprisingly large.

The study showed a six–fold increase, which means that having significant sleep apnea at age 40 gives you about the same mortality risk as somebody aged 57 who does not have sleep apnea.

For the study, the researchers collected data on 380 men and women, 40 to 65 years old, who participated in the Busselton Health Study. Among these people, three had severe obstructive sleep apnea, 18 had moderate sleep apnea, and 77 had mild sleep apnea. The remaining 285 people did not suffer from the condition. During 14 years of follow–up, about 33 percent of those with moderate to severe sleep apnea died, compared with 6.5 percent of those with mild sleep apnea and 7.7 percent of those without the condition. For patients with mild sleep apnea, the risk of death was not significant and could not be directly tied to the condition.

People who have, or suspect that they have, sleep apnea should consult their physicians about diagnosis and treatment options.

Another study by researchers from the University of Wisconsin has also shown that severe sleep apnea was associated with a three–fold increased risk of dying. In addition, for those with moderate to mild sleep apnea, the risk of death was increased 50 percent compared with people without sleep apnea. Sleep apnea is also linked to future heart attacks and with thickened wall thickness of the neck artery.


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Walking 2000 steps extra lowers cardiovascular risk

By Dr K K Aggarwal
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Walking 20 min at a moderate pace each day is associated with improved cardiovascular outcomes in patients with impaired glucose tolerance, according to a study in The Lancet. People who walked 2,000 steps more per day at baseline had a 10% lower risk of cardiovascular death, paralysis or heart attack during an average follow–up of 6 years according to Thomas Yates, PhD, of the University of Leicester in England, and colleagues. And those who increased the amount they walked by 2,000 steps per day from baseline to 1 year had a similar reduction in risk of cardiovascular events.

The findings from NAVIGATOR trial support both the promotion of increased ambulatory activity, and the avoidance of decreased ambulatory activity irrespective of the starting level, as important targets in the prevention of chronic disease.

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Tips to prevent Dengue and Malaria

By Dr K K Aggarwal
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• Both malaria and dengue mosquitoes bite during day time. • It is the female mosquito which bites.

• Dengue mosquito takes three meals in a day while malaria mosquito takes one meal in three days.

• Malaria may infect only one person in the family but dengue will invariably infect multiple members in the family in the same day.

• Malaria fever often presents with chills and rigors. Suspect Chikungunya if the fever presents together with joint and muscle pains.

• Both dengue and malaria mosquitoes grow in fresh water collected in the house.

• The filaria mosquito grows in dirty water.

• There should be no collections of water inside the house for more than a week.

• Mosquito cycle takes 7-12 days to complete. So, if any utensil or container that stores water is scrubbed cleaned properly once in a week, there are no chances of mosquito breeding.

• Mosquitoes can lay eggs in flower pots or in water tanks on the terrace if they are not properly covered.

• If the water pots for birds kept on terraces are not cleaned every week, then mosquitoes can lay eggs in them.

• Some mosquitoes can lay eggs in broken tires, broken glasses or any container where water can stay for a week.

• Using mosquito nets/repellents in the night may not prevent malaria and dengue because these mosquitoes bite during the day time.

• Wearing full sleeves shirt and trousers can prevent mosquito bites.

• Mosquito repellent can be of help.

• If you suspect that you have a fever, which can be malaria or dengue, immediately report to the doctor.

• There are no vaccines for malaria and dengue.

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Treatment of Fatty Liver

By Dr K K Aggarwal
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• A 10% weight loss can improve fatty liver and possibly inflammation.

• Metformin and ursodeoxycholic acid (UDCA) are not recommended.

• Statins are safe in patients with fatty liver but whether they can reduce fatty liver is not known.

• Omega–3 fatty acids have been tried

• Pioglitazone is useful in the treatment of biopsy–proven fatty liver with inflammation

• Vitamin E at a dose of 800 IU/day improves liver inflammation

• Use of bariatric surgery for treatment of fatty liver is premature and should be avoided in patients with cirrhosis.

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Tips for safe driving

By Dr K K Aggarwal
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• All through the year, especially during the holiday season, take steps to make sure that you and everyone you celebrate with avoids driving under the influence of alcohol or other drugs.

• Always designate a non–drinking driver before any holiday party or celebration begins.

• Arrange for someone to pick you up

• Do not let a friend drive if you think that they are impaired. Take the car keys.

• Stay overnight at your friend’s place, if possible and drive back home in the morning.

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