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Dr K K Aggarwal

Expressive writing can relieve stress

By Dr K K Aggarwal
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One can significantly boost mental and physical health by spending 30 minutes each day for four days to write out the innermost thoughts and feelings.

This so-called expressive writing requires only pen and a paper.

In expressive writing therapy, patients are encouraged to express whatever is on their mind, letting their hopes and fears flow out in a natural, unrestrained way. It is like keeping a journal, but more focused on the things that might be bothering one or triggering stress.

Four of the best exercises you can do

By Dr K K Aggarwal
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  • Swimming. It is the perfect exercise. Swimming is good for those who have arthritis as it is less weight-bearing.
  • Strength training. Lifting light weights will help keep your muscles strong. Our muscles tend to lose their strength over time if we don’t use them.
  • Walking. Walking is a simple exercise. It can help one stay fit, improves cholesterol levels, strengthens bones, keeps blood pressure under control, elevates the mood and decreases the risk of diseases like diabetes and heart disease.
  • Kegel exercises. These exercises strengthen the pelvic floor muscles that support the bladder. Strong pelvic floor muscles and vital for preventing incontinence. These exercisescan benefit both men and women.

What is the correct way of doing a Kegel exercise? Squeeze and release the muscles that you would use to stop urination or prevent yourself from passing gas. Alternate quick squeezes and releases with longer contractions that can be held for 10 seconds, and then released for 10 seconds. Do about three sets of 10-15 Kegel exercises every day.

(Source: Harvard HealthBeat)

In Paralysis, Act Fast

By Dr K K Aggarwal
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Brain attack should be tackled like a heart attack. As time is brain, a patient with suspected paralysis/stroke or brain attack should be shifted to hospital at the earliest and given a clot dissolving therapy if the CT scan is negative for brain hemorrhage. Prevention for paralysis is the same as prevention for heart attack. All patients with paralysis should be investigated for underlying heart disease and all patients with heart diseases should undergo testing to detect blockages in the neck artery, which can cause future paralysis.

Facts

  • One should rule out brain hemorrhage as soon as possible.
  • Obtain emergent brain imaging (with CT or MRI) and other important laboratory studies, including cardiac monitoring during the first 24 hours after the onset of ischemic stroke.
  • Check glucose and correct high or low sugar. If the blood sugar is over 180 mg/dL, start insulin.
  • Maintain normothermia for at least the first several days after an acute stroke.
  • For patients with acute ischemic stroke who are not treated with thrombolytic therapy, treat high blood pressure only if the hypertension is extreme (systolic blood pressure >220 mmHg or diastolic blood pressure >120 mmHg), or if there is another clear indication, such as active ischemic coronary disease, heart failure, aortic dissection, hypertensive encephalopathy, acute renal failure, or pre–eclampsia/eclampsia.
  • For patients with acute ischemic stroke who will receive thrombolytic therapy, antihypertensive treatment should be given so that systolic blood pressure is ≤185 mmHg and diastolic blood pressure is ≤110 mmHg.
  • Antithrombotic therapy should be initiated within 48 hours of stroke onset.
  • For patients receiving statin therapy prior to stroke onset, it should be continued.

Cough Hygiene

By Dr K K Aggarwal
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  • When you cough or sneeze, you tend to expel out respiratory waste, which can be droplets (larger than 5 microns) or airborne droplet nuclei less than 5 microns; both have different implications.
  • Droplets remain suspended in the air only for a limited period and exposure of less than 3 feet is usually required for human to human transmission of droplet-borne respiratory organisms. In flu, this can be up to 6 feet. The examples of droplet infections are meningitis, influenza, rubella (German measles), etc.
  • No precautions need to be taken by a person, who is at a distance of 6-10 feet away from the patient. But, if a person is sitting or working even at a distance of 3-6 feet, the non-coughing person should wear a simple mask.
  • Airborne droplet nuclei, which carry respiratory secretions smaller than 5 microns can remain suspended in the air for extended period and can cause infections to people who are standing even more than 10 feet away. The example of airborne droplet nuclei infections are TB, measles, chickenpox and SARS.
  • Patients with these diseases need to be placed in an isolation room. And, all those people who are looking after these patients must use a safe N95 mask.
  • In normal house with open windows, there is a constant exchange of air, which prevents spread of infections, but in rooms with air conditioners (ACs) with no air exchange, infections can spread from one person to another.
  • When sitting in an air conditioned atmosphere, the setting of the AC should be such that the same air is not circulated and fresh air is allowed to exchange. Split ACs, therefore, are more dangerous than the window ACs.
  • In an office with split AC, if one employee is suffering from any of the droplet nuclei disease, he/she can transmit infection to others. Therefore, patients with confirmed TB, measles, chickenpox and SARS should not be allowed to work in offices with split ACs.

Walking Tips

By Dr K K Aggarwal
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  • Walking requires no special clothes or equipment, and it’s free.
  • Make walking fun by going to places you enjoy.
  • Walk with someone else to enjoy a chat, or listen to your favorite music, but also listen to the sounds around you.
  • Keep safety in mind as you plan when and where to walk.
  • Carry a phone and ID with you.
  • Inform someone about your walking time and route.
  • If it’s dark outside when you go for a walk, wear a reflective vest or brightly colored clothing.
  • Always be aware of your surroundings.

Ten Golden Rules for preventing CKD

By Dr K K Aggarwal
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Kidney diseases are silent killers. There are several easy ways to reduce the risk of developing kidney disease.

  1. Keep active: Keeping fit helps to reduce the blood pressure and therefore reduces the risk of chronic kidney Disease.
  2. Keep fasting sugar < 80 mg%: Nearly half of people who have diabetes develop kidney damage. Kidney damage due to diabetes can be reduced or prevented if detected early.
  3. Keep lower BP < 80 mm Hg: High blood pressure is a common cause of kidney damage. High blood pressure can cause kidney damage when associated with other factors such as diabetes, high cholesterol and cardiovascular diseases.
  4. Keep your abdominal circumference < 80 cm: Eat healthy and keep your weight in check. This can help prevent diabetes, heart disease and other conditions associated with chronic kidney disease. Reduce your salt intake. The recommended sodium intake is 5-6 grams of salt per day (about a teaspoon). Limit the intake of processed and restaurant food and avoid adding salt to your food.
  5. Drink adequate fluids: Drink 1.5 to 2 litres (3 to 4 pints) of water per day. Intake of adequate amount of fluid helps the kidneys clear sodium, urea and toxins from the body which leads to a significantly lower risk of developing chronic kidney disease. One should not advocate aggressive fluid loading, as it can have side effects. People who have already suffered a kidney stone must drink 2 to 3 litres of water a day to decrease the risk of forming a new stone.
  6. Do not smoke: It slows the flow of blood to the kidneys. Smoking tends to increase the risk of kidney cancer by about 50%.
  7. Do not take over-the-counter pain killers: Common drugs such non-steroidal anti-inflammatory drugs are known to cause kidney damage if taken regularly.
  8. If you have a kidney disease, ask your doctor for ACE inhibitors.
  9. Know your eGFR = 140 – age x body weight (in kg)/72 × serum creatinine (x 0.85 if female)
  10. Keep your LDL levels < 80 mg%.

OTC does not mean that these drugs can be taken without a doctors advice

By Dr K K Aggarwal
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An over-the-counter antacid is often used to relieve mild cases of heartburn or acid reflux. Though they are available without a doctor’s prescription, they should be taken only under a doctor’s advice. As per American Academy of Family Physicians:

  • There are different types of antacids, which work in different ways.
  • Always consult your doctor before taking an antacid.
  • To manage an ulcer, an antacid may need to be taken along with an antibiotic.
  • If one needs more calcium to help strengthen bones, one should take an antacid that contains calcium carbonate.
  • Antacids may have minor side effects such as nausea, headache, diarrhea or constipation in some patients.
  • Read the label carefully to make sure that one is not allergic to any of the ingredients.
  • People with kidney disease may not be able to take all sorts of antacids.
  • An antacid may interact with other medications.

Keeping blood pressure in the safe zone

By Dr K K Aggarwal
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By keeping your BP below 120/80, you can avoid a number of diseases, such as heart disease, kidney failure and erectile dysfunction. When lifestyle changes fail to provide benefit, doctors can provide medication.

  • Limit sodium intake. DASH diet keeps sodium to 2,300 mg per day (about one teaspoon of salt). Cutting it down to 1,500 is even better. The DASH diet can decrease your systolic blood pressure by 10 points or more.
  • Monitor your blood pressure at home. This can give you an instant idea on the benefits of diet and exercise and yield a more accurate picture of your blood pressure levels. This is important, in the sense that some people experience white coat hypertension, wherein the blood pressure rises higher than normal when measured at the doctor’s office.
  • Limit alcohol intake. Men can take 1 to 2 alcoholic drinks per day, defined as 1.5 ounces (1 shot glass) of 80–proof spirits, a 5–ounce serving of wine, or a 12–ounce serving of beer. Women may take no more than one drink a day.
  • Take more meds if required—but take the right ones.

(Healthbeat)

Drinking coffee prevents Parkinson’s disease

By Dr K K Aggarwal
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Nicotine present in tobacco has been used for its medicinal value for quite some time for diseases like Parkinson’s disease and ulcerative colitis. A study from University of Miami School of Medicine, USA revealed that people from families prone to Parkinson’s disease are less likely to develop the disease if they drink coffee on a regular basis.

Both coffee and nicotine have a link with dopamine in the brain. Dopamine is a chemical that decreases in patients with Parkinson’s disease.

It is possible that people who are going to have Parkinsons disease have lower levels of dopamine. Those with low levels of dopamine may be more likely to enjoy caffeine.

Parkinsons disease occurs when brain cells that produce dopamine die. This is a progressive disease and affects about 1% of people above 65 years of age. Symptoms include tremors, muscular rigidity and slow movements and can progress to paralysis. While there is no cure, some drugs may make symptoms better for a period of time.

Predicting sudden cardiac death

By Dr K K Aggarwal
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  • Normally people can walk a distance of 400-700 meters in 6 minutes.
  • A 6-minute walking distance of less than 300 meter is a simple and useful predictor of sudden cardiac death in a patient with mild to moderate heart failure.
  • Patients with interstitial lung disease who can cover less than 200 meters during 6 minute walk test are 4 times more likely to die than those who can walk greater distance.
  • People who can cover a distance of 200-300 meters need further evaluation.
  • A fall of SpO2 of more than 4% ending below 93% suggests significant desaturation.
  • An improvement of more than 70 meters or 10% in distance walked can make all the difference.
  • An improvement of 30 meters in any distance walked is the minimally important difference in any treatment.
  • Sudden cardiac death is linked to 15% of total urban mortality.
  • Risk factors for sudden cardiac death include abnormal lipid level, high blood pressure, cigarette smoking, physical inactivity, diabetes, obesity and family history of premature heart disease or heart attack.
  • Binge alcoholism can cause sudden cardiac death (6 or more drinks per day or five drinks in one session).
  • Risk of sudden cardiac arrest is transiently increased for up to 30 minutes after strenuous exercise.
  • If you are at low risk for having a heart problem, you do not need a regular treadmill test.

Even Children Can Have Acidity

By Dr K K Aggarwal
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Children with continuing recurrence of cough and croup could probably 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 believed 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, thus narrowing the airway. It can incite more swelling with any viral or respiratory infection.

It is important to identify children with GERD in order to help treat and improve recurring croup. It is unusual that a child would 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.

Tips to prevent diabetes

By Dr K K Aggarwal
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  • Do not eat white refined carbohydrates.
  • Eat less at a time.
  • Work out at least 30 minutes a day.
  • Eat plenty of green bitter vegetables.
  • Eat a high fiber diet.
  • Do not consume trans fats.

Winter smoking may be dangerous

By Dr K K Aggarwal
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Winter smoking can precipitate heart attack, paralysis and acute rise in blood pressure.

Smoking in winter can also increase the risk of erectile dysfunction in men. Men who smoke 20 cigarettes a day are 40% more likely to struggle with erectile dysfunction than men who do not smoke. Nicotine present in smoke can constrict the blood supply to the male organ.

As per a study published in the journal Tobacco Control, in men aged 16-59, the risk of erectile dysfunction was almost double in smokers than in non-smokers.

In winter, blood pressure and diabetes may also be uncontrolled adding to the problem of erectile dysfunction.

Obese people and people who consume more alcohol are more at risk.

Depression is also common in winter adding to the agony.

10 surprising benefits of walking

By Dr K K Aggarwal
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  1. It helps maintain a healthy weight.
  2. Regular walking is linked with longevity.
  3. It strengthens bones and muscles.
  4. It relieves joint pain.
  5. It boosts your mood.
  6. It can reduce the risk of breast cancer.
  7. Walking can help you sleep better.
  8. It can reduce your risk of diabetes.
  9. It helps your heart.
  10. It protects your brain.

All diabetics must get an eye check-up done

By Dr K K Aggarwal
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The vast majority of diabetes patients who develop diabetic retinopathy (eye involvement) have no symptoms until the very late stages (by which time it may be too late for effective treatment). Since the rate of progression may be rapid, therapy can be beneficial for both symptom amelioration as well as reduction in the rate of disease progression. It is important to screen patients with diabetes for the development of retinal disease. The eyes carry important early clues to heart disease, signaling damage to tiny blood vessels long before symptoms start to show elsewhere. Diabetic people with retinopathy are more likely to die of heart disease over the next 12 years than those without it. As per a study from the University of Sydney and the University of Melbourne in Australia and the National University of Singapore, people with retinopathy have nearly twice the odds of dying of heart disease compared to people without it.

People with these changes in the eyes may be getting a first warning that damage has started in their arteries, and that work is needed to lower cholesterol levels and blood pressure. Patients with retinopathy have a greater risk of incident cardiovascular disease (CVD) events, including heart attack, stroke, revascularization, and CVD death, compared with those without retinopathy.