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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 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 (GERD), 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.

Sleep deprivation and sleep apnea both bad for the heart

By Dr K K Aggarwal
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Both sleep deprivation and sleep apnea have been linked to a higher risk of heart disease.

Short–term sleep deprivation is linked with high cholesterol, high triglycerides, and high blood pressure. Sleep apnea makes people temporarily stop breathing many times during the night. Up to 83% of people with heart disease also have sleep apnea.

In sleep apnea oxygen levels dip and the brain sends an urgent “Breathe now!” signal. That signal briefly wakes the sleeper and makes him or her gasp for air. That signal also jolts the same stress hormone and nerve pathways that are stimulated when you are angry or frightened. As a result, the heart beats faster and blood pressure rises — along with other things that can threaten heart health such as inflammation and an increase in blood clotting ability. (Source Harvard)

Every arthritis is not the same

By Dr K K Aggarwal
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Every arthritis is not the same. While osteoarthritis, also called as green arthritis, may require only painkillers and rehabilitation exercises, the red inflammatory arthritis called rheumatoid arthritis can end up with serious deforming complications if not treated early and aggressively.

Any arthritis in young women of child-bearing age should not be ignored, especially if it is worse in the morning and improves by movement. Most of them will have high platelet count on blood examination. These patients require aggressive treatment with disease–modifying drugs within days of the onset of symptoms and diagnosis. Approximately 1–2% of population may have this type of disease.

Osteoarthritis, on the other hand, is a disease of 50+ age group and is due to wear and tear of various joints in the body and break down of the cartilage cushion in the joints. It mainly affects the weight–bearing joints like the knees, hips, neck and lower back joints. Inflammation is not a major feature of osteoarthritis. The experts said that another form of joint disorder is due to gout which is never seen in people below 40 years of age and is almost never seen in young women before the onset of menopause unless there is a known underlying kidney disease and never seen in children.

The progression of osteoarthritis can be arrested with appropriate exercises, weight reduction and preventing posture and movement that worsen the disease.

Typical wear and tear of osteoarthritis is caused by sitting cross legged, doing Padmasana, squatting, other non physiological postures, sitting on low level surface like floor and low chairs, doing push ups, going up and down on stairs, etc.

Most yoga postures should be done under medical supervision and should follow with a counter yoga exercise.

Most patients of serious arthritis end up with treatment with other systems of medicines or with quacks.

Treatment of Fatty Liver

By Dr K K Aggarwal
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  • A 10% weight loss can improve fatty liver and possibly inflammation.
  • Metformin and ursodeoxycholic acid (UDCA) are not recommended.
  • Statins are safe in patients with fatty liver but whether they can reduce fatty liver is not known.
  • Omega–3 fatty acids have been tried
  • Pioglitazone is useful in the treatment of biopsy–proven fatty liver with inflammation
  • Vitamin E at a dose of 800 IU/day improves liver inflammation
  • Use of bariatric surgery for treatment of fatty liver is premature and should be avoided in patients with cirrhosis.

Winter Asthma

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Any breathlessness after the age of 40, appearing for the first time in winter, is cardiac asthma unless proved otherwise. Such patients should immediately have their blood pressure check-up done and if high needs immediate medical attention. First-onset breathlessness can also be an indication of angina or heart attack. However, the more common is winter asthma or acute exacerbation of winter COPD (chronic bronchitis).

Asthma is reversible airway obstruction and COPD is irreversible airway obstruction. Sudden exposure to cold, humidity, pollution at lower levels in atmosphere can precipitate asthma in susceptible individuals. Winter is the time to increase the dose of asthma medicines.

If a person can speak a full sentence, the asthma attack is mild; if a person speaks broken sentences the asthma attack is moderate and if the person is able to speak only words then the asthma attack is severe. Severe attack of asthma needs immediate hospitalization.

An attack of asthma is due to inflammation, narrowing and collection of fluid in the wind pipe and needs medicines to widen the wind pipe and reduce the inflammation.

The need of asthma medicines can be intermittent and/or permanent. The ‘Formula of ‘2’t becomes handy in such situations. A person who consumes more than two canisters of inhalers in a year or consumes asthma medicines more than twice in the night time in a month or more than twice in a day in a week, then he or she needs continuous asthma and anti inflammatory medicines. Inhalers are the best choices.