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Dr K K Aggarwal

Malaria Revisited

By Dr K K Aggarwal
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• Malaria is transmitted by the bite of a female anopheles mosquito. • The mosquito bite occurs mainly between dusk and dawn. • Malaria can also be transmitted through blood transfusion, or via sharing of contaminated needles. • Bed nets are good against malaria as the major malarial vectors bite during the night. • The behavior of the mosquitoes may differ. Some may prefer to rest indoors and feed indoors in the night. Some may prefer to rest and feed outdoors earlier in the day. • Preventive therapy of malaria can be instituted during pregnancy in high risk areas. • The malarial mosquito feeds every third day compared to the dengue mosquito, which feeds three times in a day. • Unlike the malarial mosquito, the dengue mosquito bites during the day. • Malarial fever presents with chills, especially during afternoon. • Spraying of the indoor residential walls and ceiling is effective against mosquitos. • DDT is widely used as indoor residential spraying. • DDT should not be applied more than once or twice in a year on the walls. • Mosquito contact with DDT surface would generally save from lethal exposure outside the house. • Public must know that spray may require rearrangement of the furniture. Walls may become streaked with chemical treatment and residual odor from DDT. • The other alternative is malathion spray.

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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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Turmeric can prevent heart failure

By Dr K K Aggarwal
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Traditional Indian turmeric prevents heart failure, lowers cholesterol, prevents cancers and gall stones and augments scar formation in a wound. Studies from the University of Toronto’s Cardiology Division and published in The Journal of Clinical Investigation have shown that Curcumin, an ingredient in the curry spice turmeric, when given orally to a variety of mouse models with enlarged hearts (hypertrophy), could prevent and reverse hypertrophy, prevent heart failure, restore heart function and reduce scar formation. In the studies, curcumin was given to rats, who then underwent surgery or received drugs designed to put them at risk of heart failure. The rats that received curcumin showed more resistance to heart failure and inflammation than comparison groups of rats that did not get curcumin. Curcumin treatment also reversed heart enlargement. Curcumin short–circuited the heart enlargement process, though it’s not clear how it did that. The healing properties of turmeric have been well–known. The herb has been used in traditional Indian medicine to reduce scar formation. For example, when there is a cut or a bruise, the home remedy is to reach for turmeric powder because it can help to heal without leaving a bad scar. Curcumin has come under the scientific spotlight in recent years, with studies investigating its potential benefits for reducing cholesterol levels, improving cardiovascular health and fighting cancer. As an herb, turmeric should to be taken 300 mg thrice–daily with meals. It has useful actions like antioxidant, anti–inflammatory, anti rheumatic; cholesterol–lowering, anti cancer and prevention of gall stones. It is also found to be useful in situations like dysmenorrhea, dyspepsia, HIV, muscle soreness, peptic ulcer disease, scabies and uveitis. Curcuminoids, act as free radical scavengers. They also inhibit leukotrienes and synthesis of prostaglandins. The anti–inflammatory activity has been claimed to be comparable to NSAIDs (such as indomethacin). Curcuminoids lower blood lipid peroxides, decrease total cholesterol and LDL cholesterol, and increase HDL cholesterol. Turmeric has also been claimed to inhibit platelet aggregation.

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Sugar, not salt, may be at fault for hypertension

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 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.

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1. Cut down on caffeine: Caffeine drinkers may find it harder to fall asleep. Even a single cup of coffee in the morning may lead to a sleepless night. Caffeine blocks the effects of adenosine, a neurotransmitter thought to promote sleep. Caffeine can also interrupt sleep by increasing the need to urinate during the night. Because caffeine withdrawal can cause headaches, irritability, and extreme fatigue, it may be easier to cut back gradually rather than to go cold turkey. Those who can’t or don’t want to give up caffeine should avoid it after 2 p.m., or noon if they are especially caffeine–sensitive. 2. Stop smoking or chewing tobacco: Nicotine is a central nervous system stimulant that can cause insomnia. If you continue to use tobacco, avoid smoking or chewing it for at least one to two hours before bedtime. 3. Limit alcohol intake: Alcohol depresses the nervous system, so a nightcap may seem to help some people fall asleep. Alcohol suppresses REM sleep, and the soporific effects disappear after a few hours. Alcohol also worsens snoring and other sleep breathing problems.

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Eating high fiber diet

By Dr K K Aggarwal
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• There are two types of fibers. One is soluble and the other is insoluble. • Soluble fiber includes those that are made up of carbohydrates and absorb water. Examples are oats, barley and legumes.

• Insoluble fiber comes from plant cells and does not dissolve in water. Examples are wheat, ragi and other grains.

• Traditionally, fiber is insoluble fiber.

• Dietary fiber is a combination of soluble and insoluble fiber.

• The recommended intake of dietary fiber is 20–35 gm in a day.

• Eating a high–fiber diet both can prevent constipation, reduce cholesterol, and help in reversing obesity and heart diseases in children and adults.

• A high–fiber diet should be a balanced diet with food from all food groups.

• The common sources of fiber are whole grain produce and cereals, legumes, fruits and vegetables.

• Raw vegetables such as carrot, garlic or cherry tomatoes are rich in fiber.

• Salads with dark green lettuce provide high fiber content.

• Eating whole wheat bread or with added fiber is a rich source of fiber.

• Prefer brown rice over white rice.

• You can eat whole wheat carbohydrates, bran muffins, bran cereals or oat meals.

• Avoid eating refined white flour, cereals and other starches.

• If juices are to be taken, one should take 4–6 ozs.

• Fruits are better than juices

• Try to develop a taste for bran by starting with 2–4 tablespoons every day.

• Mix a high fiber cereal with a regular cereal.

• Isabgol is a fiber supplement.

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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 nails.

• Avoid 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.

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Exercise impact on the knee

By Dr K K Aggarwal
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Different exercises produce different impact on the knee joints. The best and safest exercises causing minimum impact on the knee for patients post knee replacement or knee arthritis are walking, biking, hiking, riding an exercise bike, riding an elliptical trainer and walking on the treadmill. In sports one can play doubles tennis and not singles. One can also participate in downhill or cross–country skiing. The maximum stress–producing exercises are jogging and golf swings.

Impact

• Biking generates the least force, producing impact of about 1.3 times the person’s body weight.

• Treadmill walking was next best, producing forces of 2.05 times the body weight.

• Walking on level ground generated forces of 2.6 times the body weight.

• A game of tennis produces forces of 3.1 to 3.8 times the body weight; serving produces the highest impact.

• Jogging produced forces of 4.3 times body weight.

• Golf swings produces forces of 4.5 times body weight on the forward knee and 3.2 times body weight in the opposite knee.


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