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Dr K K Aggarwal

Identify the triggers. For some individuals, the triggers could be dairy products. It is important to identify the foods that trigger the symptoms and avoid them.

Opt for less gassy foods. It is advisable to avoid beans, cabbage, and cauliflower; these can cause gas. Consume more of foods which have high omega-3 fatty acid content.

Eat smaller meals. This will help the digestive system adjust better to the condition.

Keep yourself hydrated. Drink plenty of water and other fluids. However, limit the consumption of caffeine and alcohol.

Guidelines on Health

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  • Keep your blood cholesterol less than 160 mg%. Even 1% reduction in cholesterol reduces the chances of heart attack by 2%.
  • Uncontrolled diabetes and blood pressure can precipitate a heart attack. Keep these under check.
  • Eat less, walk more.
  • Regular exercise is good for health. The best exercise is walking, which is brisker than brisk walking.
  • Soya products are good for health. These should form an essential ingredient of the diet.
  • Fruits are better than juices.
  • Brown rice is better than polished rice and jaggery is better than white sugar.
  • Eat high fiber diet.
  • Driving and drinking do not go together.
  • Pregnant women must not drink. It harms the baby in the womb.
  • Get your health check-up done at least once in a year.
  • Salt intake should be restricted.
  • Avoid APC where A stands for achar, P for papad and C for chutney.

Expressive writing can relieve stress

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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 a 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.

Guidelines about Eating

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  • Eat only when you are hungry.
  • Do not eat for pleasure, social obligations or emotional satisfaction.
  • Eat at a slow pace.
  • Eat less; dinner less than lunch.
  • Take small mouthfuls each time; chew each morsel well, swallow it and only then take the next morsel.
  • Do not eat while watching television, driving a car or watching sports events. The mind is absorbed in these activities and one does not know what and how much one has eaten.
  • Do not talk while eating and never enter into heated arguments. The stomach has ears and can listen to your conversation. It will accordingly send signals to the mind and heart.
  • Plan and decide in advance what and how much food you will be eating.
  • Use low fat or skimmed mild dairy products. Use oils which are liquid at room temperature for cooking.
  • Do not take red meat and if you are a non-vegetarian, you may take poultry meat or fish.

Younger women with acute coronary syndromes may not have classic chest pain

By Dr K K Aggarwal
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Younger women with an acute coronary syndrome have slightly lesser likelihood than men to present with the classic symptom of chest pain, reported a study published in JAMA Internal Medicine. As a result, they often fail to receive a correct diagnosis in the emergency department.

Khan and colleagues prospectively evaluated data from over 1,000 ACS patients aged 55 or younger (30% women), participating in the GENESIS PRAXY study.

In these younger patients women had lesser odds of having chest pain, compared to men (19% of women versus 13.7% for men, p = 0.03). Additionally, women were more likely than men to have a non-ST-segment elevation myocardial infarction (37.5% vs 30.7%; p = 0.03).

Multivariate analysis revealed that women and patients with tachycardia had a lesser likelihood of having chest pain. The absence of chest pain did not indicate any change in the type or severity of the ACS.

Diagnosis of any disease with a lower prevalence but higher mortality, such as coronary artery disease in younger women, is more challenging.

Public health messages should focus on both men and women regarding ACS symptom presentation with or without chest pain in order to encourage earlier and more widespread access to lifesaving care.

OTC drug does not mean it should be taken without a doctor’s advice

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An over-the-counter (OTC) 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 the American Academy of Family Physicians –

  • Different types of antacids have different mechanisms of action.
  • To manage an ulcer, an antacid may need to be taken along with an antibiotic.
  • If one needs more calcium to help strengthen bones, an antacid that contains calcium carbonate is preferred.
  • Antacids may cause minor side effects in some, such as nausea, headache, diarrhea or constipation.
  • One must read the label carefully to ensure that he/she is not allergic to any of the ingredients.
  • It may not be feasible for those with kidney disease to take all types of antacids.
  • An antacid may interact with other medications.Talk to the doctor before taking an antacid.

Talk to the doctor before taking an antacid.

Folic Acid Update

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  • Folic acid (vitamin B9) is a water-soluble B vitamin.
  • It is lost in traditional Indian cooking.
  • Folic acid is essential for DNA repair, cell division and normal cellular growth.
  • Profound deficiency of folic acid during pregnancy is associated with neural tube defects, such as spina bifida, in neonates.
  • Deficiency in adults has been associated with megaloblastic anemia and peripheral neuropathy.
  • In both men and women, low serum folate levels can increase homocysteine levels, which are correlated with elevated cardiovascular risk.
  • Low folic acid levels during pregnancy in women with epilepsy have been associated with fetal malformation and older enzyme-inducing anti-epileptic drugs (AEDs) are known to reduce serum folate levels.
  • The risk of having a pregnancy complicated by a major congenital malformation (e.g., neural tube defect) is doubled in epileptic women taking AEDs compared with those with a history of epilepsy not taking these agents.
  • Risk is tripled with AED polypharmacy, especially when valproic acid is included.
  • Consensus statements recommend 0.4-0.8 mg of folic acid per day in all women planning a pregnancy. Ideally, this should be started at least 1 month prior to pregnancy, if possible.
  • The guidelines recommend higher daily folic acid doses (4 mg/day) in women with a history of neural tube defects.
  • Enzyme-inducing anticonvulsants, such as phenytoin, carbamazepine, primidone and phenobarbital, are known to decrease folate levels, and valproic acid may interfere with folate metabolism.
  • Other AEDs, such as oxcarbazepine, lamotrigine and zonisamide, do not appear to alter folate levels.
  • Because many pregnancies are unplanned, it is recommended that folic acid supplementation be given routinely to all women of childbearing potential at 0.4 mg/day.

Preventing death due to hypothermia

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People can die of hypothermia. Imagine a situation when you come across two people lying in a JJ cluster area with no clothes early in the morning. One of them is shivering and the other one is not. The one who is shivering indicates that his body is trying to compensate with the low core body temperature. The other one, who is not shivering, may be dead, dying or normal.

Recall your naturopathy teaching “Sar Thanda, Pet Naram and Paon Garam”. If the soles of the feet and the feet are cold and the person is not shivering, this is a medical emergency. On the contrary, if the person is not shivering and the feet are warm, it is not medical emergency.

Therefore, hypothermia with no shivering and hyperthermia with no sweating are bad signs.

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 a 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.

Beware of Diwali pollution

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Air pollution during Diwali day can worsen asthma or COPD in susceptible individuals.

Asthmatics are advised to avoid smoky atmosphere and consult their doctor to take increased dose of regular medicines.

Expressive writing can relieve stress

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , | | Comments Off on Expressive writing can relieve stress

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

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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

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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

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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

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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.