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Dr K K Aggarwal

  • Manage your stress, particularly the pressures of deadlines and petty arguments.
  • An ongoing sense of extreme anxiety can be a reason for stress. Manage this with the help of deep breathing, meditation, yoga and a mindful approach to living.
  • Get a good night’s sleep.
  • If you need a sleeping medicine, it should be used in the lowest dose for the shortest period of time.
  • Get up at the same time every morning.
  • If you smoke, you must quit.
  • If you do not drink, do not start.
  • Alcohol makes it difficult to perform short term memory tasks such as memorizing a list. Alcohol induces vitamin B1 deficiency, which can also cause dementia.
  • Protect your brain from injury; repeated minor head trauma can cause brain damage. It is advisable to wear seat belt when riding in a motor vehicle. Wear a helmet while driving or riding a motorcycle.

Patients with an acute leg cramp should forcefully stretch the affected muscle, for example, by active dorsiflexion of the foot with the knee extended, for a cramp in the calf.

Some patients may find relief from passive stretching by getting out of bed and standing with the foot flat on the floor and pressing downward firmly. However, active dorsiflexion of the foot may be more effective.

Other measures that may bring relief from the acute cramp include:

  • Walking or leg jiggling followed by leg elevation
  • A hot shower with the stream directed at the cramp area, for about five minutes, or a warm tub bath
  • Ice massage.
  • Brushing helps prevent plaque formation and build-up of bacteria which can cause tooth decay and periodontal diseases.
  • Floss every day as it can help clean the crevices where the brush is not able to reach.
  • Avoid sugary and starchy foods; sugar reacts with the bacteria in saliva to form an acid that erodes tooth enamel causing tooth decay.
  • The tongue can also harbor bacteria. Use a tongue scraper and clean your tongue every time you brush your teeth.
  • Consult a dentist if your gums are inflamed or there is bleeding. Do not ignore any pain in the teeth or gums.
  • Get a dental check-updone every six months. Dental cleaning and check-up twice a year is imperative.
  • Mother/primary caregiver with active cavities
  • Parent/caregiver with low socioeconomic status
  • Prolonged breastfeeding or bottle-feeding (>12 months)
  • Frequent consumption of sugary beverages and snacks
  • Use of a bottle at bed time, especially with sweetened beverages
  • Use of liquid medication for longer than three weeks
  • Exposure to passive tobacco smoke
  • Children with special healthcare needs
  • Insufficient fluoride exposure
  • Visible plaque on upper front teeth
  • Enamel pits or defects

Tips to avoid Smartphone addiction in children.

By Dr K K Aggarwal
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  • Interact with your children: Instead of trying to keep them busy by giving them a phone, try spending some time interacting with them.
  • Keep computers or TVs in shared spaces: This will help you keep track of their usage and limit screen time.
  • Have a tech-free time: Make sure that a few hours in a day are devoted to zero screen time for the entire household.
  • Be wary of your habits: If parents devote too much time to mobiles and computers, children will follow the same. Set an example for your children.
  • Eat together: Meal times should not include screens; they are a time for the family to sit together and eat.
  • Indulge in physical activity: Make sure that your children spend sufficient time in outdoor activities. This will minimize the use of a Smartphone.

Human body needs servicing too!

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While automobiles need preventive servicing every three months, the human body also needs it every two months.

According to Ayurveda, seasons change every two months, approximately in the middle of the month.

Ayurveda describes these changes as well as the precautions that need to be taken. Lohri marks the sun’s entry into the ‘Makar Rashi’. The sun changes its direction northwards, leading to lengthening of day and shortening of night. This period calls for several lifestyle changes to balance health and prevent diseases. Vata gets aggravated, kapha gets accumulated and pitta gets depleted during this season.

In allopathic language, pitta represents metabolic functions, vata signifies movement functions and kapha stands for secretory functions.

Lohri, Makar Sankranti and Pongal are celebrated with khichdi, milk, gur, bhaat, sesame (Til) laddu, light hot food and beverages, etc. All of these point to measures to limit vata and kapha and increase pitta in the body.

Postmenopausal women should get their insulin levels done

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Postmenopausal women must try to keep their insulin levels normal by means of weight loss, regular exercise and other methods. Postmenopausal women with high insulin levels have an increased risk of developing breast cancer.

A report published in the International Journal of Cancer from Researchers at Albert Einstein College of Medicine of Yeshiva University in New York City noted a strong link between elevated insulin levels in the blood and increased risk of breast cancer. Evaluating data on 5,450 women who were a part of the Women’s Health Initiative, they noted that women with insulin levels in the highest third had double the likelihood of developing breast cancer compared to women in the bottom third.

The link between raised insulin levels and breast cancer was found to be more robust among thin women compared to obese women, who tend to have higher insulin levels. This is an important finding as it suggests that, in postmenopausal women, insulin may serve as a risk factor for breast cancer independent of obesity.

Dentists can diagnose

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  • Early mouth cancer
  • Scurvy: In the mouth, scurvy can cause gums to swell, bleed and soften, resulting in tooth loss.
  • Eating disorder: Regular episodes of vomiting can cover the teeth in gastric acid that can remove the tooths enamel. As a result, teeth can become discolored, cracked and sensitive.
  • Anemia: Ulcers at the corner of the mouth,a change in color of the gums and tongue.
  • Sinus infection: Infected sinuses can cause pain in the jaw and around the teeth, which can be mistaken for a toothache.
  • Poor vitamin intake: Vitamin D is needed for calcium absorption, which helps to prevent tooth decay and gum disease. Lack of zinc predisposes to gum disease, dry mouth and loss of sensation in tongue.Low vitamin B3 levels can cause the tip of the tongue to become red and swollen. Deficiency of vitamin B2 can cause the tongue to become sore and lips red and shiny. Vitamin B12 levels can prevent bad breath, loss of taste and fissured tongue.
  • Patients with diabetes have a higher risk of early gingivitis and periodontitis.
  • Biting the nails: Biting nails puts undue stress on the teeth, causing them to crack, chip and wear down.Jaw pain, receding gums and headaches are other side effects of grinding and clenching associated with nail biting.

Ways to boost your energy

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  1. Pace yourself: Keep going, but don’t overdo it. Instead of burning all your energy in two hours, spread out the work as morning tasks, afternoon tasks, and evening tasks; take rest and meals in between.
  2. A walk or a nap: If you have trouble sleeping at night, taking a nap during the day can worsen insomnia. In such a case, get moving. Walk around the neighborhood, or just move around the house. If you do not have insomnia, you can enjoy a 20- to 30-minute nap.
  3. Skip supplements: There is a lack of evidence that they work.
  • DHEA: There is a lack of convincing evidence that DHEA is actually beneficial.
  • Iron: Iron improves energy only when one is clearly deficient.
  • B vitamins: B vitamins can help the body convert food into the form of energy that cells can burn, but taking more B vitamins has no role in supercharging the cells.

4. Eat wisely: A sugary roll is loaded with calories, but your body metabolizes them faster, and eventually you have decreasing blood sugar and fatigue. A steady energy level can be maintained by eating lean protein and unrefined carbohydrates. You can go for low–fat yogurt with nuts, raisins, and honey. (Harvard)

Some tips from HCFI

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  • Eat light food as the GI system cannot digest heavy food.
  • Do not eat leafy vegetables without washing or boiling as they may be contaminated with eggs of round worms. Beware of eating snacks at some outside stall.
  • Beware of electrical shock in this season as the coolers without earthing can leak electricity.
  • Do not walk barefoot as most worms can come out and cause infection.
  • Do not keep wet clothes and leather without drying them properly as they may attract fungus.
  • With each shower of rain, the BP may fluctuate so medications must be revisited.
  • Do not play in stagnant water as rat urine mixed with rain water may lead to leptospirosis (fever with jaundice).
  • Do not let water accumulate in the house or surrounding areas to avoid breeding of mosquitoes.
  • Drink only boiled or safe water as there are more chances of diarrhea, jaundice, and typhoid in this season.

Poor hygiene habits may lead to typhoid

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Typhoid fever is caused by the bacterium Salmonella typhi and is transmitted through the ingestion of food or drink contaminated by the feces or urine of infected people.

Insects feeding on feces might transfer the bacteria to humans owing to poor hygiene habits and public sanitation conditions. Though the cases occur all through the year, the number is higher during the summer and rainy seasons.

Symptoms often develop 1 to 3 weeks following exposure, and may be mild or severe, including high fever, malaise, headache, constipation or diarrhea and enlarged spleen and liver. A healthy carrier state may follow acute illness.

Typhoid fever can be treated with antibiotics. However, resistance to common antibiotics is widespread. Healthy carriers should be excluded from handling food.

Good sanitation and hygiene are critical measures to prevent typhoid.

  • Typhoid does not affect animals and therefore transmission occurs only from human to human.
  • Typhoid can only spread in conditions where human feces or urine can come into contact with food or drinking water.
  • Hygienic food preparation practices and hand washing are the cornerstones of typhoid prevention.
  • In most cases, typhoid fever is not fatal.
  • Prompt treatment with antibiotics limits the case fatality rate to about 1%.
  • If left untreated, typhoid fever may persist for three weeks to a month.
  • Resistance to common antibiotics is widespread.
  • Typhoid resistant to common antibiotics is known as multidrug-resistant typhoid (MDR typhoid).
  • Ciprofloxacin resistance is a common problem, especially in the Indian subcontinent and Southeast Asia.
  • Azithromycin is a new drug for drug-resistant typhoid.
  • Typhoid vaccine taken every three years is the best preventive approach.

Bystander CPR better when more people help

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Patients experiencing a cardiac arrest are more likely to receive good quality bystander-initiated cardiopulmonary resuscitation if several people assist.

Among cases of out-of-hospital cardiac arrest, CPR quality has been linked with multiple rescuers initiating bystander CPR, being in a central or urban setting, and receiving bystander-initiated CPR and longer duration of resuscitation, as per researchers in the journal Resuscitation.

Good quality bystander CPR is less commonly performed by a family member, by older bystanders and in home environments.

The survival and positive neurological outcomes for people experiencing an out-of-hospital cardiac arrest is based on the initiation of bystander CPR. This should involve chest compressions only, without mouth-to-mouth resuscitation.

Good quality means: Appropriate hand positions or finger positions in case of infants, compression rate of at least 100 per minute, compression depth of at least 2 inches or at least one-third of the anterior-posterior diameter of the chest.

Time to arrest or recognition of arrest to initiation of CPR is significantly shorter among those who provide good quality CPR (median 3 minutes versus 4 minutes).

Poor hygiene habits may lead to typhoid

By Dr K K Aggarwal
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Typhoid fever is caused by the bacterium Salmonella typhi and is transmitted through the ingestion of food or drink contaminated by the feces or urine of infected people.

Insects feeding on feces might transfer the bacteria to humans owing to poor hygiene habits and public sanitation conditions. Though the cases occur all through the year, the number is higher during the summer and rainy seasons.

Symptoms often develop 1 to 3 weeks following exposure, and may be mild or severe, including high fever, malaise, headache, constipation or diarrhea and enlarged spleen and liver. A healthy carrier state may follow acute illness.

Typhoid fever can be treated with antibiotics. However, resistance to common antibiotics is widespread. Healthy carriers should be excluded from handling food.

Good sanitation and hygiene are critical measures to prevent typhoid.

  • Typhoid does not affect animals and therefore transmission occurs only from human to human.
  • Typhoid can only spread in conditions where human feces or urine can come into contact with food or drinking water.
  • Hygienic food preparation practices and hand washing are the cornerstones of typhoid prevention.
  • In most cases, typhoid fever is not fatal.
  • Prompt treatment with antibiotics limits the case fatality rate to about 1%.
  • If left untreated, typhoid fever may persist for three weeks to a month.
  • Resistance to common antibiotics is widespread.
  • Typhoid resistant to common antibiotics is known as multidrug-resistant typhoid (MDR typhoid).
  • Ciprofloxacin resistance is a common problem, especially in the Indian subcontinent and Southeast Asia.
  • Azithromycin is a new drug for drug-resistant typhoid.
  • Typhoid vaccine taken every three years is the best preventive approach.

The Science of Hygiene

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We all know about hygienic living and this subject should be included as a chapter in the curriculum of every school. There are several types of hygiene.

Respiratory hygiene: This is important to prevent cross infection, specifically, from flu and related respiratory illnesses. One should maintain a distance of minimum 3 ft. from a person who is coughing, sneezing or singing. Most respiratory particles are more than 5 microns in size and do not travel a distance of more than 3 ft. This respiratory hygiene; however, will not prevent transmission of the tuberculosis bacteria, which are less than 5 microns and keep circulating in the area.

Hand hygiene: This is the fundamental principle for any disease prevention and the important point here is “before and after”, i.e. one should wash hands before and after eating food, touching any infected material, seeing a patient or after normal evacuation of stool.

Food hygiene: This means maintaining hygiene at home while cutting, serving and eating food. While cutting a vegetable, it involves clean hygienic surface, knife, hands, water, utensils, etc. If this is not possible, follow the formula of ‘boil it, heat it, peel it, cook it or forget it’. This means that any food which has been boiled, heated or peeled is safe for eating. Peeling means removing the skin of a fruit such as banana or oranges.

Water hygiene: This involves drinking safe water, safe drinking glass, proper washing of glass, not washing multiple glasses in the same utensil and picking up glasses properly. People often pick up four glasses of water at the same time with one finger in each glass.

Body hygiene: This involves 16 upchars, as mentioned in mythology. Out of these 16 basic steps, some are related to body hygiene and they involve washing feet first and then hands, followed by mouth and finally the body. Washing of the feet is the most important as they are the ones which carry infections into one’s house.

Cleaning of mouth is cleaning the teeth with one finger, gums with two fingers, tongue with three fingers and palate with thumb.

Abhishekam or the snana of the body involves multiple steps. Ancient steps have been washing the body with milk water (rose water, etc.) followed by rubbing with curd (soap), honey (moisturizers), ghee (oil), sugar (the drying agent) and finally with milk water again. This facilitates natural bathing and is not dependent on soap.

Nail hygiene: This is also a very important hygiene, especially for food handlers, because they are responsible for causation of water and food disease. It is important that they receive typhoid vaccines and de-worming tablets every three months.

Another important hygiene that must be observed at our homes is that of the servants or the house helps. They are often provided soap at the start of the month and they are supposed to use that bar of soap for a month. If by any chance, they lose that soap in 2-3 weeks’ time, they are apprehensive in asking the owners for another soap. As a result, they may wash their hands without soap for the next 2-3 weeks.

Lifestyle counseling can reduce heart disease

By Dr K K Aggarwal
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An intensive effort to change the lifestyle among individuals at high risk of heart disease can help them reduce risk factors, such as high blood pressure, cholesterol and smoking.

The Euroaction study, published in The Lancet, compared the results of added counseling on lifestyle issues including diet, physical activity and smoking, to usual care. The study included over 3,000 people with coronary heart disease and over 2,000 who were at high risk of developing the disease. Half of the group were counseled by a team of nurses, dietitians, physiotherapists and the treating doctors. The counseling was given to families as well as individuals.

Two groups of patients were studied. One group included patients who already had developed coronary heart disease. The second group included those who were asymptomatic but at high risk on account of a combination of risk factors that increase the chances of developing heart disease over 10 years.

About 55% of those receiving the counseling reduced their intake of saturated fat compared to 40% of those not getting counseling. Consumption of fruits and vegetables increased in 72% of the counseled patients, and 17% of them also increased their consumption of heart-friendly oily fish, compared to 35% and 8% in the group not receiving counseling. Similar results were seen for blood pressure, cholesterol and physical activity; however, it appeared to be difficult to have people seen in general practice quit smoking.