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Dr K K Aggarwal

  • Extended exposure to sounds above 85 db can lead to progressive hearing loss. Anyone exposed to sounds above 85 db of noise requires hearing protection.
  • The special limit for people who are exposed to noise above 90 db is 8 hours, for 95 db is 4 hours and 2 hours for 100 db.
  • A brief blast of loud sound also can result in severe to profound sensorineural hearing loss and pain. This usually involves exposure to noise above 120-155 db. Hearing protection in the form of muffins or ear plugs is recommended whenever a person is exposed to loud noise.

Preventing malaria

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

The majority of known risk factors for heart attack are modifiable by specific preventive measures.

The nine potentially modifiable factors include smoking, dyslipidemia, hypertension, diabetes, abdominal obesity, psychosocial factors, regular alcohol consumption, daily consumption of fruits and vegetables and regular physical activity. These account for over 90 percent of the population attributable risk of a first heart attack.

In addition, aspirin is recommended for primary prevention of heart disease for men and women whose 10-year risk of a first heart attack event is 6 percent or greater.

Smoking cessation reduces the risk of both heart attack and stroke. One year after quitting, the risk of heart attack and death from heart disease is reduced by one-half, and after several years begins to approach that of nonsmokers.

A number of observational studies have shown a strong inverse relationship between leisure time activity and decreased risks of CVD. Walking 80 minutes in a day and whenever possible with a speed of 80 steps per minute are the current recommendations.

Tips to prevent pneumonia

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  • Get vaccinated with the flu and pneumococcal vaccines
  • Practice respiratory and cough hygiene to protect yourself against respiratory infections that may lead to pneumonia.
  • Respiratory hygiene: Keep a distance of minimum 3-6 ft, from a person who is coughing, sneezing or singing to prevent cross infection, specifically, from flu. Most respiratory particles are more than 5 microns in size (except tuberculosis droplet nuclei) and do not travel a distance of more than 3 ft.
  • Cough hygiene: Cough on your sleeves or tissue paper (and discard it immediately) and not in hands and handkerchief. Wash hands with soap and water after coughing or sneezing or use an alcohol-based hand rub.
  • Dont smoke as it can damage the natural defence of the lungs against respiratory infections.
  • Keep the immune system strong by getting enough sleep, exercising regularly, and eating a healthy diet.
  • Your diet should be low in sodium and no person should consume more than 6 gm of sodium chloride in a day.
  • Consumption of trans fats, which is found in hydrogenated oils or vanaspati ghee, should be minimal as they are bad for the heart and reduce the HDL cholesterol and increase the LDL cholesterol.
  • Avoid eating out as much as possible since the food in most restaurants and hotels has high amounts of trans fats and is generally bad for the heart
  • Refined carbohydrates like white bread, white flour, white rice and refined sweetened cereals and white sugar should be avoided and replaced with options like whole grain flour, healthy green cereals and oat meal.
  • Any sweet item containing more than 10% sugar should be limited. On an average, the sugar content in soft drinks is 10%, Indian sweets contain 30-50% sugar.

Do not heat leafy vegetables twice

By Dr K K Aggarwal
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Nitrates in foods such as spinach, beet root and lettuce stimulate the production of nitric oxide in the body. Nitric oxide relaxes blood vessels. Ingested nitrate is reduced by oral, commensal bacteria to nitrite, which can further be reduced to nitric oxide.

Vegetables are a major source of dietary nitrate. Green leafy and root vegetables, such as spinach and carrots, provide more than 85% of dietary nitrate. Foods in which nitrate is present are bacon, fermented sausage, hot dogs, bologna, salami, corned beef, ham and other products such as smoked or cured meat, fish and poultry. The conversion of dietary nitrate to nitrite has antimicrobial benefits in the mouth and stomach. Certain epidemiological studies have shown a reduced rate of gastric and intestinal cancer in people with a high vegetable-based nitrate intake.

While nitrate is harmless, it can be converted to nitrite and some portion of nitrite to nitrosamines, some of which are known to be carcinogenic. Heating can potentially increase the conversion rate. The longer the heat treatment, the more nitrosamines will be formed. Hence, it is recommended not to heat leafy vegetables twice.

Adding lemon juice to vegetables can reduce the formation of nitrosamines. It contains vitamin C, which also reacts with nitrite, thereby preventing the nitrosamine formation.

Childhood obesity increasing at an alarming rate around the world

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The prevalence of obesity among children is increasing at an alarming rate. Overweight four-year-old children have a doubled risk of high blood pressure by age six, raising the hazard of future heart attack and stroke. The World Health Organization (WHO) has listed childhood obesity as one of the most serious public health challenges of the 21st century.

Obesity is a multifactorial disorder; unhealthy diet – eating foods high in fats, sugar and salt (junk food, processed food) and a sedentary lifestyle (TV, internet, computer and mobile games have taken precedence over outdoor sports) contribute significantly to this escalating epidemic. Women should lose those extra pounds before conceiving, avoid gaining excess weight during pregnancy, and quit smoking, as these are known risk factors for childhood obesity.

Most obese children grow up to be obese adults. Overweight and obese children are at risk of other lifestyle disorders such as type 2 diabetes, hypertension, dyslipidemia, metabolic syndrome later in life. They are more prone to joint problems, sleep apnea and social and psychological problems such as stigmatization and poor self-esteem.

Healthy habits in childhood lay a foundation for a healthier adulthood. Here are some tips that parents can follow at home to tackle obesity and unhealthy habits in children:

  • Encourage healthy eating habits right at the onset.
  • Try making their favorite dishes healthier. Few changes can make even snacks healthier.
  • Avoid tempting children with calorie-rich food. It is okay to treat them but in moderation and by limiting high-fat and high-sugar or salty snacks.
  • Make kids understand the importance of being physically active.
  • Lead by example. Indulge in at least 60 minutes of moderate to intense physical activity every day.
  • Reduce sedentary time. While reading is a good option, too much of screen time is not.
  • Replace screen time with the outdoors and fun activities to keep children engaged.

Prevention strategy relies on lifestyle

By Dr K K Aggarwal
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Stenting may not be the answer every time for treating heart disease with stable coronary artery disease (CAD). A German study has shown that patients with stable CAD who were subjected to an exercise regimen had significantly higher rates of event-free survival compared to those who had undergone percutaneous coronary intervention (PCI). In the study, 70% of patients in the exercise program had event-free survival (no stroke, heart attack, or death), compared with 50% of stented patients after a four year period. Exercise is an important part of any type of prevention, and it should be introduced for anyone with stable coronary heart disease.

The study on stenting versus exercise was a continuation of a pilot study first reported in 2004 in the journal Circulation. That study included 101 male patients and noted that after one year, 88% of patients who exercised had an event-free survival compared to 70% of stented patients. The updated data reflect an additional 100 patients, who performed moderate intensity exercise for two weeks under hospital supervision, followed by use of an exercise bike to continue their regimen at home. Patients with stable angina exercised at 80% of their threshold, and after four weeks of exercising, their angina threshold increased.

The clear message for patients is to get 30 to 60 min of moderate-intensity aerobic activity every day. About 30% of heart disease could be prevented by 2.5 hours of walking per week.

Treatment of acute leg cramps

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

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

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

  • Walking or leg jiggling followed by leg elevation
  • A warm tub bath or a hot shower with the stream directed at the cramp area, usually for five minutes
  • Ice massage

Facts about exercise

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  • Exercise for 80 minutes a day and brisk exercise 80 minutes a week.
  • The speed of walking should be at least 80 steps per minute.
  • Do resistance or weight-bearing exercises twice in a week.
  • Avoid doing strenuous exercises for the first time in life after the age of 40.
  • Ayurveda says that one should exercise according to his or her body type.
  • Patients with diabetes should not exercise if blood sugar is lower than 90.
  • In conditions of smog, avoid walking early in the morning till sunlight appears.

Types of smokers

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  • Light: < 10 cigarettes per day
  • Heavy: > 25 cigarettes a day
  • Chippers: Very light smokers (< 5 cigarettes a day) who regularly use tobacco without developing dependence
  • Light and intermittent smokers: 1-39 cigarettes per week, or 10 cigarettes per day on average or 1-4 grams of tobacco per day and have never smoked daily
  • Low-level smokers: < 20 cigarettes per day and < 1 pack per week
  • Low-rate smokers: < 5 cigarettes per day and never >10 cigarettes per day
  • Non-daily smokers: < 7 days per week; may smoke < 3 packs per week
  • Occasional smokers: < 5 cigarettes per day and < 3 times per week, usually dependent on circumstances such as partying or drinking or after meals
  • Social smokers: < 5 cigarettes per day and < 7 days per week over last two years; have never exceeded that limit.

Exercise impact on the knee

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Different exercises produce different impacts 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 is next best, producing forces of 2.05 times the body weight.
  • Walking on level ground generate 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 produces forces of 4.3 times body weight.
  • Golf swings produce forces of 4.5 times body weight on the forward knee and 3.2 times body weight in the opposite knee.

Top 10 ways to keep the kidneys healthy

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  1. Monitor blood pressure and cholesterol.
  2. Control weight.
  3. Dont overuse over-the-counter painkillers.
  4. Monitor blood glucose.
  5. Get an annual physical exam.
  6. Know if chronic kidney disease (CKD), diabetes or heart disease runs in your family. If so, you may be at risk.
  7. Dont smoke.
  8. Exercise regularly.
  9. Follow a healthy diet.
  10. Get tested for chronic kidney disease if youre at risk.

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 may occasionally transfer the bacteria to humans due 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.
  • Careful food preparation 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.

Tips to relieve heartburn

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  • Avoid foods that trigger your symptoms.
  • Eat small portions and dont overeat; chew food slowly and completely.
  • Avoid smoking, eating quickly, chewing gum, and drinking carbonated beverages as they lead to swallowing excess air.
  • Reduce stress.
  • Get enough rest.
  • Dont lie down within 2 hours of eating.
  • Maintain a healthy body weight.