Monday, October 22, 2018

The 25th Perfect Health Mela opens tomorrow

The 25th MTNL Perfect Health Mela, the annual flagship event of Heart Care Foundation of India (HCFI) opens tomorrow at the Talkatora Indoor Stadium, New Delhi. The theme for theMela this year is“Affordable Healthcare”.

The Mela will be inaugurated by Shri Satyendra Jain, Health Minister, Delhi Govt.

A National Campaign on Hands-only CPR 10 in collaboration with Ministry of Youth Affairs, Govt. of India will also be launched on the inaugural day.

Students from schools and colleges are participating in large numbers in the Mela. There will be the usual lifestyle exhibitions, free health check-ups, lectures, workshops and competitions ‘Harmony and EcoFest’ (inter-school competitions), National Youth Fest (inter-college competitions) and Anmol (for specially-abled children).

The highlight of the Mela this year is the “Evening Conclave” – panel discussions with celebrity guests. These conclaves will be held every day followed by cultural evening. Among the various topics to be discussed at the conclaves include AMR, indoor pollution, harm reduction, safe water and air, CSR, infertility.

The valedictory ceremony will be held on Saturday, 27thOctober.

The Mela timings are 8 am to 10 pm. Entry to theMelais free for all.

I welcome you all to the silver jubilee celebrations of thePerfect Health Mela. There is something in it for everybody.

Come enjoy the Mela …

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Immediate Past National President IMA

Sunday, October 21, 2018

Noise pollution: Keep noise levels less than dB during Diwali

Diwali, the festival of lights is just around the corner. It’s the most widely celebrated festival in the country. Along with all the festivities, unfortunately Diwali is now associated with public health issues like air pollution and noise pollution due to bursting of fire crackers.

Noise is now well-recognized as a health hazard. Noise is an environmental stressor, which has both physiological and psychological effects.

Environmental noise is among the top environmental risks to physical and mental health and well-being, according to the WHO’s “Environmental Noise Guidelines for the European Region 2018”.

In its Guidelines for Community Noise published in 1997, the WHO has defined environmental noise or community noise as “noise emitted from all sources except for noise at the industrial workplace”. The guidelines also differentiate between sound and noise “Sound is a sensory perception and the complex pattern of sound waves is termed noise, music etc. Noise is thus defined as unwanted sound.”

Everyday exposure to noise over time has an impact upon our ability to hear and on the degree of hearing loss that develops. Noise pollution also has other associated health problems such as stress, anxiety, high blood pressure, increased heart rate, heart disease. It may manifest as disturbed sleep/ insomnia, headache, fatigue, irritability, loss of concentration and decreased work efficiency. Loud noise can trigger an acute cardiovascular event.

Continuous exposure to sounds above 85 db can cause progressive hearing loss.  Anyone exposed to sounds above 85 db of noise requires hearing protection.

Firecrackers are an integral part of Diwali celebration, which affect noise quality. Fire crackers generate a noise level as high as 140 dB. A short blast of loud noise can cause severe to profound sensorineural hearing loss, pain, or hyperacusis (pain associated with loud noise). This usually involves exposure to noise greater than 120 to 155 dB.

As per the Central pollution control board Fire crackers noise rules, “the manufacture, sale or use of fire-crackers generating noise level exceeding 125 dB(AI) or 145 dB(C)pk at 4 meters distance from the point of bursting shall be prohibited”.

Loud noise during Diwali can have tragic consequences as happened in Amritsar on the day of Dussehra, where reportedly people could not hear the incoming train due to fireworks and burning of Ravana.

Controlling noise pollution is the need of the hour. It’s a cause for concern. There is a need for sensitization to the adverse health impact of noise pollution.

It’s not just the government, as citizens, we too have a responsibility to keep our environment healthy.

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Immediate Past National President IMA

Saturday, October 20, 2018

The science of addiction

Addiction is commonly associated with substance abuse such as alcohol, tobacco and drugs. National Institute on Drug Abuse has listed different reasons (as below) for why people take drugs.

lTo feel good: Feeling of pleasure, “high”
lTo feel better: To relieve stress
lTo do better: Improve performance
lPeer pressure

Not just drugs, some behaviors too can be categorized as addictive. Addiction to video games is one such addictive behavior. Mounting evidence shows that the effects of video games simulate those of drugs of substance abuse and that video game addictions also alter the brain neurochemistry unlike the previously held belief that a person addicted to games lacked willpower.

The limbic system of the brain also known as the “brain reward system” is the part involved in addiction. When activated it releases neurochemicals such as dopamine, “the feel good” neurotransmitter.

Unlike activities like food, drinking, reading, music, which produce the optimum levels of dopamine, addictive substances or behaviors can release up to 10 times more dopamine leading to the “high” associated with use of drugs.Recurring activation of the “reward system” due to repeated use of addictive drugs leads to addiction.

Dopamine surges in the reward circuit cause the reinforcement of pleasurable but unhealthy activities, leading people to repeat the behavior again and again. Over time, the brain adjusts to the excess dopamine, which reduces the high that theperson feels compared to the high they felt when first taking the drug—an effect known as tolerance. Theymight take more of the drug, trying to achieve the same dopamine high” (National Institute on Drug Abuse).

Recent studies also implicate serotonin, besides dopamine, in the development of addiction. Serotonin is responsible for feelings of well-being and contentment. Low serotonin levels can also increase the risk of drug addiction.

A study from the Victoria University of Wellington showed that serotonin levels during initial drug use affect the chances of a person becoming drug dependent. Higher the serotonin levels, lesser are the chances of somebody becoming addicted. The study suggests that “once drug use escalates and becomes frequent, the anti-addiction effect of serotonin is decreased. Another brain chemical, dopamine, seems to be the critical determinant of drug addiction during this phase”.

Drugs that modify dopamine affect motivation, motor functioning, sense of pleasure and important events a person experiences. While, drugs that affect serotonin affect the ways how a person learns, remembers, sleeps and feels emotions.

A person addicted to gaming can spend anywhere between 10 and 14 hours a day playing. Most of these people have some underlying social and psychological conditions as well. They are either suppressed, depressed, need appreciation or need compliments.

Addiction may worsen an underlying mental disorder or trigger a mental disorder such as attention-deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), anxiety, depression etc. Such persons are more at risk of addictions.

The World Health Organization (WHO) has now included video game addictions as “Internet Gaming Disorder” in its latest revision of the International Classification of Diseases (ICD-11). It described the addiction as a ‘pattern of persistent or recurrent gaming behavior’ that becomes so extensive it ‘takes precedence over other life interests’.

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Immediate Past National President IMA

Friday, October 19, 2018

From Navratri to Diwali: A one-month long spiritual Yagna

Any festival in India consists of rituals which directly or indirectly teach the society how to remain happy and healthy.

The process of the spiritual yagna in Hinduism begins from the first day of Navratri on Amavasya and ends up on Diwali, again on Amavasya.

The first 10 days of this yagna involve intense spiritual practice and the remaining 20 days entail receiving its benefits.

The first nine days, called Navratri, are devoted to a process of purification and detoxification of mind, body and soul.

During this period a person is required to lead a Satvik spiritual life devoting first three days into activities, which reduce negativity in the mind and the body. Thinking differently, thinking positively and thinking opposite is how the negativity in the mind can be reduced.

In the next three days, he should practice positive behavior and in the last three days he should read and learn about spiritual positive things in life.

The spiritual purification process involves eating only Satvik food, one which is offered to God, and following the principles of Satwik lifestyle, which are Satvik Ahaar, Satvik Vichar, Satvik Vyavahaar and Satvik Achaar. There is a custom of worshiping wheat and barley grass during this period. They are detoxifying grasses when consumed in the form of juices. The Satvik fast observed during this period helps in internal cleansing of the body.

Upon completion of this 9-day purification process, the person starts getting the benefits on the tenth day symbolized as Vijayadashmi or dusshera, when one gains victory over Tamas (Kumbhakaran), Rajas (Meghnad) and Ego (Ravana). Victory over the ego entails the ruling of Satwa (Vibhishan) and reunion of Mind (Lakshamana), Body (Sita) and Soul (Rama).

As per the Yoga Sutras of Patanjali, when one attains an ego-free mind, then one is likely to get benefits over a period of time.

The first benefit is seen on the fourth day after Vijayadashmi, on Sharad Purnima. Kheer is traditionally prepared on this day and is kept under the moonlight because moon rays have healing properties. Moon is closest to the earth on Sharad Purnima

Four days later, on the day of karva chauth when married women pray for long life of their husbands, one gets the benefit of the longevity of the spouse, which gives safety to the family.

Four days later on “hoi ashtami”, one prays for the longevity of their children. This ensures protection for the family in their old age.

Then, four days later on “dhanteras”, one gets the benefit of wealth. On this days people worship silver items. On this day, no dealings are done and people spend only to invest in silver and gold items for the future needs of the family.

By this time the person, who has undergone the process of purification, learns the true purpose of his or her existence. The inner ignorance and darkness goes away and one learns the true meaning of wealth and that is inner happiness (spiritual knowledge). The day this happens is called Diwali, when on the day of Amavasya (darkness) one gets internal lighting (Diwali).

These three phases of purification are symbolized as worshiping the Goddess Kali, Laxmi and Saraswati, respectively.

Diwali, therefore, is a one-month long spiritual Yagna, from Amavasya to Amavasya, with 9 days of purification and 21 days of acquiring spiritual benefits out of it.

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Immediate Past National President IMA


Thursday, October 18, 2018

What is Corporate Social Responsibility?

 Every corporate is responsible for some social or environmental cause.

The term Corporate Social Responsibility or CSR, as it is commonly known as, has been derived from the Vedas.

We all are aware of the commonly spoken maxim “Neki kar dariya me daal”. This means do your karma, forget about results. Do good and expect nothing. This is called “Nishkam Karma”.

It is now mandatory for all companies above a given defined size to spend 2% of their net profits of the last three financial years to charity (CSR activities) under Section 135 of the Indian Companies Act.

In Islam, all Muslims who meet the necessary criteria of wealth are required to give 2.5% of their total wealth to the needy as ‘Zakat’. Sikhism also requires Sikhs to donate one-tenth of their earnings as "Daan" towards the common resources of the community. 

The Gandhian principle of “Sarvodaya” or welfare of all advocates that the aim in life therefore should be to work not for oneself but for the welfare of the others. The basic fundamental teaching of the Vedic science is also based on sarvodaya. It talks about “bahujan hitay-bahujan sukhay” i.e. “the good of the masses, the benefit of the masses”.

“Vasudhaiva kutumbakam” i.e. the whole world is one family is derived from the Rig Veda and forms one of the fundamentals of Vedic philosophy.

It has been an IMA Policy that doctors should give 10% of their time to charity in the form of free OPDs or camps. Real charity is 100% free, but when corporates entered, this changed to “camps with conversion”. Charity has to be unconditional. Consultation alone should not be free. The entire treatment should be free and it should be transparent. Even the MCI Code of Ethics Regulations has said, “The prime object of the medical profession is to render service to humanity; reward or financial gain is a subordinate consideration (1.1.2).” 

A Devta is someone who gives and shares. Anybody who gives can be said to be a devta. Doctors can be likened to devtas, as they help the patient to heal.

All doctors do CSR. Every doctor is a “Trust” as he is a trustee of his patient.

This is why the medical profession is called a noble profession.

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Immediate Past National President IMA

Wednesday, October 17, 2018

Unless an adolescent learns coping skills, there is a high risk of depression in this age group

In conversation with Dr Swati Bhave

As per WHO estimates, globally 10-20% of children and adolescents experience mental disorders. Half of all mental illnesses begin by the age of 14 and three-quarters by mid-20s. But most cases are undetected and untreated. If not tackled early, their impact extends to adulthood, impairing both physical and mental health and adversely affect the adolescent’s development, education and consequently their potential to live fulfilling and productive lives.

The World Mental Health Day, observed on 10th October has also focused on adolescent mental health with its theme as “Young people and mental health in a changing world”.

I spoke to Dr Swati Bhave, who is a renowned expert in adolescent health, for her views on mental health issues in adolescence.

Dr Swati Bhave is Executive Director AACCI, Adjunct Prof in Dr DY Patil Medical College and Dr DY Patil Vidyapeeth in Pune and Head of Adolescent Clinic, Jehangir Hospital Pune. She is also the Editor of our Asian Journal of Paediatric Practice.

Here are the 10 salient points on adolescent mental health.

1.    In the past, it was thought that at 18 years the brain is fully mature and hence driving, voting etc. were permitted at this age.

2.    Now it is known by MRI and functional MRI, PET etc. adolescent brain is under development right up to 25 years.

3.    The “emotional brain” or the limbic system is normally under control of the “thinking brain” i.e. the prefrontal cortex and the impulsive behavior is controlled in adults.

4.    In adolescents, the limbic system is well-developed, while prefrontal cortex matures much later. This is the reason adolescents are prone to high risk behavior and experimentations like drinking, smoking, substance abuse, driving under alcohol influence.

5.    They are also very prone to labile emotions and need help to stabilize and handle failures or rejections.

6.    This is done by proper parental, teacher or other adult guidance.

7.    WHO has a program called the Life Skill Education (LSE). This is also under UNFPA and UNICEF. The ten life skills empower adolescents to deal with all problems, they can face during normal adolescent development.

The ten core life skills are: Self-awareness, empathy, communication skills – interpersonal relationships, decision making, problem solving, critical and creative thinking, coping with stress and emotions and negotiating skills.

8.    Unless an adolescent learns the coping skills, there is a high risk of depression in this age group. Severe depression leads to high rates of suicides in this age group on very trivial triggers. We need to empower adolescents to prevent suicides by becoming resilient.

9.    The dopamine reward pathway is also very highly developed in adolescents, which makes their brain very vulnerable to substance abuse, tobacco and alcohol. Children who start smoking and drinking below age 12 years are more likely to be adult-addicts.

10. NCDs or noncommunicable diseases are increasing globally. WHO has identified four behavioral risk factors in adolescent age group: Consumption of junk food, increased sedentary lifestyle, tobacco and alcohol. If these behaviors are checked in adolescence, we will prevent adult-onset NCDs.

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Immediate Past National President IMA

Tuesday, October 16, 2018

Swine Flu: Messages of public health importance for the public

·         Fever with cough and cold is flu, unless proved otherwise.
·         No fever, no flu
·         In low risk patients (no pregnancy, not a newborn/elderly or no comorbidity), with no breathlessness, no testing, hospital admission and/or Tamiflu is required.
·         People with co-morbid conditions, pregnant women and the elderly should not ignore flu
·         No breathlessness, then only digital consultation to avoid crossinfection.
·         For the general public, simple surgical mask; for doctors, N95 mask
·         Wearing a mask is a must in registration counters
·         There should be separate line for labs/x-ray, with people wearing a mask.
·         Children suffering from flu should be allowed leave from school.
·         Office workers suffering from flu should be given paid holiday.
·         Flu patients should enter the doctor’s chamber wearing a mask.
·         In low risk patients, it does not matter, if it is swine flu or the common flu. Cough hygiene is same for both. Keep distance of 3 feet; hand wash with soap and water after coughing or sneezing, cover your nose or mouth with a tissue when coughing, promptly dispose used tissues; throw the used tissue in a waste basket and if you don't have a tissue, cough or sneeze into your upper sleeve, not your hands
·         Tamiflu is effective only if given in the first 48 hours unless you are a high risk patient. Even then, it only shortens the duration by one day.
·         Tamiflu is not given without testing, which costs around Rs. 4000/-. So if you are a low risk patient, why spend this amount?

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Immediate Past National President IMA