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Dr K K Aggarwal

Even children can have acidity

By Dr K K Aggarwal
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Children who have continuing recurrence of cough and croup could be suffering from stomach 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 thought to be caused by a virus, but reflux acidity has been suggested as a possible trigger. In GERD, or gastroesophageal reflux disease, stomach acid causes swelling and inflammation of the larynx, which narrows the airway. It can trigger more swelling with any kind of viral or respiratory infection. Identifying children with GERD could help treat and improve recurring croup. It is unusual for a child to 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.

Even children can have acidity

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , , | | Comments Off on Even children can have acidity

Children who have continuing recurrence of cough and croup could be suffering from stomach 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 thought to be caused by a virus, but reflux acidity has been suggested as a possible trigger. In GERD, or gastroesophageal reflux disease, stomach acid causes swelling and inflammation of the larynx, which narrows the airway. It can trigger more swelling with any kind of viral or respiratory infection. Identifying children with GERD could help treat and improve recurring croup. It is unusual for a child to 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.

Fever in children

By Dr K K Aggarwal
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  • Do not ignore fever in children.
  • Fever with cough and cold means viral sore throat.
  • Fever with chills and rigor may be due to malaria.
  • Fever with severe headache and pain behind the eyes may be dengue.
  • If a child has fever with urinary symptoms, the child needs further investigations.
  • Do not ignore fever with jaundice.
  • Do not give aspirin to children for fever.
  • Immediately lower the temperature if the fever is more than 104°F.
  • If fever is associated with altered behavior, then immediately contact the doctor.
  • Tepid water sponging is better than sponging with cold and ice water.
  • In heat stroke, cold water sponging can lower the temperature if anti-fever medication is not working.
  • Do not ignore if body temperature is low.
  • If body temperature is less than 95°F, immediately warm the child using blankets and other measures.
  • Paracetamol is the safest medicine for children in fever.

Some HCFI health tips for children

By Dr K K Aggarwal
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  1. Prevent exposure to dust mites. These are tiny insects and one of the most common asthma triggers. They tend to live in beds, carpeting, upholstered furniture and soft toys. It is important to keep all these things dust free.
  2. Restrict the child’s contact with pets, especially if he/she is allergic.
  3. Maintain a healthy weight and encourage good eating habits. Include plenty of fruits, vegetables and whole grains in their diet.
  4. Avoid exposure to smoke. Expectant mothers should quit smoking altogether as this is one of the major risk factors for development of asthma in children.
  5. Breastfeed your infant. This will increase immunity and help ward off potential complications.

Children with the following risk factors should be referred for early dental evaluation

By Dr K K Aggarwal
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  • 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 health care needs
  • Insufficient fluoride exposure
  • Visible plaque on upper front teeth
  • Enamel pits or defects

 

Cigarettes should be regulated

By Dr K K Aggarwal
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Electronic cigarettes are a new fad in the society. Not only adults, children too are getting hooked to them. They are easily available through Internet and can be ordered and purchased in Indian rupees. In its policy statement on e-cigarettes, published in the journal Circulation, the American Heart Association has asked the federal government to ban the sale of e-cigarettes to minors on the lines of the ban of cigarettes and smokeless tobacco products. The report has shown concern about the industries marketing and advertising e–cigarettes to children. In the US alone, there are 466 brands and 7764 unique flavors of e–cigarette products available. These flavors have been specifically designed to attract the youth. For the youth, an e-cigarette is high–tech, interesting and cool. In the US and in the west, an alarming number of middle and high school children are experimenting with e–cigarettes. It has also been seen that in experimental e–cigarette users, converting to regular smoking is very high. The efficacy of e–cigarettes as a primary smoking cessation therapy has not been established. A recent study published in the March 2017 of the journal JAMA Cardiology has shown an association of habitual e-cigarette use with increased cardiovascular risk.

Tackling obesity in children

By Dr K K Aggarwal
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More than 30% people of the society including children have potbelly abdominal obesity. India is witnessing an epidemic of metabolic syndrome, which is characterized by abdominal obesity, high triglyceride, low good cholesterol, high blood pressure and high sugar.

Abdominal girth of more than 90 cm in men and 80 cm in women indicates that the person is vulnerable to future heart attack.

Normal weight obesity is the new epidemic of the society. A person could be obese even if his/her body weight was within the normal range. An extra inch of fat around the abdomen increases the chances of heart disease by 1.5 times.

Normally once the height stops growing, most organs will also stop growing. The weight of the heart, liver of kidney cannot increase after that. Only muscles can build up to some extent. The only thing, after that stage, which can increase the weight of the body, is deposition of fat. Therefore any weight gain after puberty is invariably due to fat. Though the overall weight can be in the acceptable normal range but any weight gain within that range will be abnormal for that person. One should not gain weight of more than 5 kg after the age of 20 years in males and 18 years in females. After the age of 50, the weight should reduce and not increase.

Potbelly obesity is linked to eating refined carbohydrates and not animal fats. General obesity is linked to eating animal fats.

Refined carbohydrate includes white rice, white maida and white sugar. Brown sugar is better than white sugar. Refined carbohydrates are called bad carbohydrates and animal fat is called bad fat.

Trans fat or vanaspati is bad for health. Trans fats increase the levels of bad cholesterol and reduce good cholesterol in the body.

Reduction in weight can reduce snoring, pain of arthritis, blood pressure and control uncontrolled diabetes.

Some key points

• Skip carbohydrates once in a week.

• Combine a sweet food with bitter food (prefer aloo methi over aloo matar).

• Consume green bitter items in foods such as karela, methi, palak, bhindi etc.

• Do not eat trans fats (vanaspati).

• Do not consume more than 80 ml of soft drink in a day.

• Do not consume sweets with more than 30% sugar.

• Avoid maida, rice and white sugar.

• Walk, walk and walk…


Children and adolescents with congenital heart disease should avoid body piercing

By Dr K K Aggarwal
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Children and teenagers with congenital heart disease should be strongly discouraged from getting a tattoo or piercing their ears or other body parts, because it could lead to a potentially deadly infection of the heart called endocarditis.

Infective endocarditis occurs when bacteria or fungi attach and begin to grow on the valves of the heart. If left untreated, it can lead to a fatal destruction of heart muscle.

Body art in the form of tattoos and piercing has become increasingly popular among children and teenagers. But, most people remain unaware that they should talk to their doctor before tattooing or piercing their body.

Most experts today strongly discourage all forms of body art. For those who cannot be dissuaded, the recommendation is to give antibiotics prior to tattooing or piercing, “with strong advice for prompt treatment of any signs of subsequent infection”.

Flu in children

By Dr K K Aggarwal
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  • The classical features of uncomplicated flu in children include abrupt onset of fever, headache, muscle pain and malaise affected by manifestation of respiratory tract illness – sore throat, sough and nasal discharge.
  • All the above features may not be present in children.
  • Flu sometimes may last for more than a week in children.
  • Ear discharge, development into asthma and pneumonia are common complications in children.
  • Complicated pneumonia may be severe and rapidly fatal, especially if the bacterium is Staph.
  • During winter, flu should be considered in all children with fever; children with fever and acute onset of respiratory illness; children with fever and exhilaration of underlying chest condition; children with pneumonia and children with fever of more than 100, with severe cough or sore throat.
  • Fever is present in over 95% of cases, often more than 39°C.
  • Cough is present in over 77% patients.
  • Nasal discharge is present in more than 78% patients.
  • Headache is present in more than 26% patients.
  • Muscle pain is present in more than 71 % patients.
  • Incubation period is 1–4 days with high transmissibility.
  • The treatment is often symptomatic.
  • Cough hygiene should be practiced.

Children and adolescents with congenital heart disease should avoid body piercing

By Dr K K Aggarwal
Filed Under Health Care - Ask Dr KK, Wellness | Tagged With: , , , | | Comments Off on Children and adolescents with congenital heart disease should avoid body piercing

Children and teenagers with congenital heart disease should be strongly discouraged from getting a tattoo or piercing their ears or other body parts, because it could lead to a potentially deadly infection of the heart called endocarditis.

Infective endocarditis occurs when bacteria or fungi attaches and begins to grow on the valves of the heart. If left untreated, it can lead to a fatal destruction of heart muscle.

Most people are not aware that they should talk to their doctor before tattooing or piercing their body.

Body art in the form of tattoos and piercing has become increasingly popular among children and teenagers.

Most experts today strongly discourage all forms of body art. For those who cannot be dissuaded, the recommendation is to give antibiotics prior to tattooing or piercing, “with strong advice for prompt treatment of any signs of subsequent infection”.

Children should be screened for the heart before playing any sports

By Dr K K Aggarwal
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Sudden cardiac death amongst athletes is a rare but a devastating event. Most victims are usually young and, apparently, healthy but many have underlying undiagnosed heart disease.

As per American Heart Association Guidelines, children and adolescents undergoing athletic training need medical clearance. Majority of sudden deaths amongst athletes are due to malignant irregularities in the heart rhythm such as ventricular tachycardia and ventricular fibrillation. The precipitating factors can be prolonged physical training or unaccustomed athletic activities.

In athletes under the age of 35, the most common cause of death is underlying congenital heart disease and for those above the age of 35, it is the presence of blockages of the coronary arteries.

As per Heart Care Foundation of India, in every school/college, the attached doctor should evaluate all students with a 12 step history and examination to rule out high risk cases that need further evaluation.

The Foundation, along the lines of European Society of Cardiology, also recommends an additional standard 12–lead ECG before a medical clearance is given for both competitive as well as recreational athletic activities.

Master athletes who are above the age of 35 will need an additional exercise testing before they can be given a clearance for athletic activity.

Diagnostic echocardiography is indicated when clinical, historical and physical findings suggest possibility of structural heart diseases. Athletes on pacemakers should not engage in sports as bodily collision may damage the pacemaker system.

The 12–element AHA recommendations for pre participation cardiovascular screening of competitive athletes are as follows:

  1. Exertional chest pain/discomfort
  2. Unexplained syncope/near–syncope
  3. Excessive exertional and unexplained dyspnea/fatigue, associated with exercise
  4. Prior recognition of a heart murmur
  5. Elevated systemic blood pressure
  6. Premature death (sudden and unexpected, or otherwise) before age 50 years due to heart disease, in one relative
  7. Disability from heart disease in a close relative <50 years of age
  8. Specific knowledge of certain cardiac conditions in family members: hypertrophic or dilated cardiomyopathy, long–QT syndrome or other ion channelopathies, Marfan syndrome, or clinically important arrhythmias
  9. Heart murmur
  10. Femoral pulses examination to exclude aortic coarctation
  11. Physical features of Marfan syndrome
  12. Brachial artery blood pressure (sitting position, both arms)

Even Children Can Have Acidity

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , , | | Comments Off on Even Children Can Have Acidity

Children who have continuing recurrence of cough and croup could 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 thought to be caused by a virus, but reflux acidity has been suggested as a possible trigger.

In gastroesophageal reflux disease, stomach acid causes swelling and inflammation of the larynx, which narrows the airway. It can trigger more swelling with any kind of viral or respiratory infection.

Identifying children with gastroesophageal reflux disease could help treat and improve recurring croup. It is unusual for a child to 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.

Before sports, children need to be screened for the heart

By
Filed Under Wellness | Tagged With: , , , | | Comments Off on Before sports, children need to be screened for the heart

Sudden cardiac death amongst athletes is a rare but a devastating event. Most victims are usually young and, apparently, healthy but many have underlying undiagnosed heart disease.

As per American Heart Association Guidelines, children and adolescents undergoing athletic training need medical clearance. Majority of sudden deaths amongst athletes are due to malignant irregularities in the heart rhythm such as ventricular tachycardia and ventricular fibrillation. The precipitating factors can be prolonged physical training or unaccustomed athletic activities.

In athletes under the age of 35, the most common cause of death is underlying congenital heart disease and for those above the age of 35, it is the presence of blockages of the coronary arteries.

As per Heart Care Foundation of India, in every school/college, the attached doctor should evaluate all students with a 12 step history and examination to rule out high risk cases that need further evaluation.

The Foundation, along the lines of European Society of Cardiology, also recommends an additional standard 12-lead ECG before a medical clearance is given for both competitive as well as recreational athletic activities.

For those master athletes who are above the age of 35, they will need an additional exercise testing before they can be given a clearance for athletic activity.

Diagnostic echocardiography is indicated with clinical, historical and physical findings suggest possibility of structural heart diseases. Athletes on pacemaker should not engage in sports as bodily collision may damage the pacemaker system.

The 12-element AHA recommendations for pre participation cardiovascular screening of competitive athletes are as follows:

1. Exertional chest pain/discomfort

2. Unexplained syncope/near-syncope

3. Excessive exertional and unexplained dyspnea/fatigue, associated with exercise

4. Prior recognition of a heart murmur

5. Elevated systemic blood pressure

6. Premature death (sudden and unexpected, or otherwise) before age 50 years due to heart disease, in one relative

7. Disability from heart disease in a close relative <50 years of age

8. Specific knowledge of certain cardiac conditions in family members: hypertrophic or dilated cardiomyopathy, long-QT syndrome or other ion channelopathies, Marfan syndrome, or clinically important arrhythmias

9. Heart murmur

10. Femoral pulses examination to exclude aortic coarctation

11. Physical features of Marfan syndrome

12. Brachial artery blood pressure (sitting position, both arms)

 

Even Children Can Have Acidity

By
Filed Under Wellness | Tagged With: , , | | Comments Off on Even Children Can Have Acidity

Children who have continuing recurrence of cough and croup could 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 thought to be caused by a virus, but reflux acidity has been suggested as a possible trigger.

In gastroesophageal reflux disease, stomach acid causes swelling and inflammation of the larynx, which narrows the airway. It can trigger more swelling with any kind of viral or respiratory infection.

Identifying children with gastroesophageal reflux disease could help treat and improve recurring croup. It is unusual for a child to 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.

Children & adolescents with congenital heart disease should avoid body piercing

By
Filed Under Wellness | Tagged With: , , , | | Comments Off on Children & adolescents with congenital heart disease should avoid body piercing

Children and teenagers with congenital heart disease should be strongly discouraged from getting a tattoo or piercing their ears or other body parts, because it could lead to a potentially deadly infection of the heart called endocarditis.

Infective endocarditis occurs when bacteria or fungi attach and begin to grow on the valves of the heart. If left untreated, it can lead to a fatal destruction of heart muscle.

Most people are not aware that they should talk to their doctor before tattooing or piercing their body.

Body art in the form of tattoos and piercing has become increasingly popular among children and teenagers.

Most experts today strongly discourage all forms of body art. For those who cannot be dissuaded, the recommendation is to give antibiotics prior to tattooing or piercing, “with strong advice for prompt treatment of any signs of subsequent infection”.