HCFI Update: When not to ignore constipation

While most instances of constipation may not be serious, some cases of infrequent or difficult bowel movements need evaluation by a doctor said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India, and MTNL Perfect Health Mela.

Constipation is one of the most common gastrointestinal complaints. Those reporting constipation most often are women and adults ages 65 and older. Pregnant women may have constipation, and it is a common problem following childbirth or surgery.

Constipation occurs when the large colon absorbs too much water or if the colon's muscle contractions are slow or sluggish, causing the stool to move through the colon too slowly. As a result, stools can become hard and dry.

Common causes of constipation are:

1. Not enough fiber in the diet
2. Lack of physical activity
3. Some drugs
4. Pregnancy
5. Elderly
6. Abuse of laxative
7. Ignoring the urge to have a bowel movement
8. Dehydration
9. Underlying cancer
10. Depression

Heart Care Foundation of India offers this list of warning signs:

a. You’re constipated for the first time
b. You’ have been treating with house hold remedies for constipation for three weeks with no improvement.
c. You have associated abdominal pain.
d. You have associated bloody stools.
e. You have associated unexplained weight loss.

HCFI Update: Risk of heart attack triples with pre-hypertension

A person with pre–hypertension, upper systolic blood pressure between 120–140 mmHg and lower diastolic pressure between 80–90 mmHg, is more than three times likely to have a heart attack and 1.7 times more likely to have heart disease than a person whose blood pressure is lower than 120/80 mmHg, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

Normal blood pressure is lower than 120/80 mmHg and hypertension is a blood pressure more than 140/90 mmHg or higher.

If pre–hypertension is aggressively treated, 47% of all heart attacks can be prevented. Lifestyle modifications such as weight control, regular physical activity and changes in diet are recommended for people with pre–hypertension. The importance of pre–hypertension has been listed as one of the top 10 recent advances in cardiology. Every effort should be made to lower the blood pressure below 120/80 mmHg.

HCFI Update: Do not ignore 2nd attack of dengue

If you have suffered from dengue in the past be more careful as the second attack of dengue may be more dangerous than the first attack, said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

There are four different strains of dengue and one can, suffer with dengue four times during lifetime. Subsequent dengue infections are more likely to end up with deadly complications.

A person with dengue can also simultaneously suffer from malaria. Malaria and dengue together can lower platelet counts to a dangerous level leading to complications.

In a dengue season nobody should take aspirin for fever as it can precipitate bleeding, he added.

In dengue most complications occur within two days of subsiding of fever and most people are careless during this period. Any abdominal pain, giddiness or weakness after the fever has subsided should be attended to, by a doctor. Dengue complications during this period are due to shift of blood volume and patient requires rapid infusion of oral or intravenous fluids in large quantity.

There is no need for giving platelets unless the counts have fallen lower than 2% of original platelet counts.

HCFI Update: Walk at a pace of 4mph for 90 minutes a week

Physical activity involving moderate-intensity exercise for 15 minutes a day or 90 minutes a week can reduce deaths from any cause by 14% and increase life expectancy by three years said Padmashri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

Quoting a study published in the August 16 in The Lancet, Dr Aggarwal said that beyond the minimal amount of 15 minutes of daily exercise, each additional 15 minutes was associated with a further reduction in all-cause mortality risk by 4% and in all-cancer mortality risk by 1%.

These benefits of exercise are seen in all age groups, in both sexes, and in persons at risk for cardiovascular disease.

The current guideline is to do 150 minutes of exercise per week.

Moderate intensity exercise refers to a level of exertion during exercise that raises your heart rate to a point where you sweat and feel you're working, yet you're able to carry on a conversation. You can talk, but you can't sing.

Example is walking at a pace of 4mph.

HCFI Update: NCR to benefit from MTNL Perfect Health Mela in October

The country’s popular “18th Perfect Health Mela 2011” will be held from 14th to 23rd October 2011 at NDMC Grounds Laxmi Bai Nagar, New Delhi.

The Mela is being organised by Heart Care Foundation of India jointly with Health Department, Govt. of Delhi, MTNL, NDMC, MCD, LIC, Dept. Of Science & Technology, Govt. of India, Coca Cola India Ltd., World Fellowship of Religions, etc.

18th in a row, the brainchild of Heart Care Foundation of India, the Mela attracts 3-5 lakh members of the public over a duration of 10 days.

The Mela is organised every year between Dusshehra and Diwali and creates health awareness about all aspects of health among people from all walks of life and all ages, incorporating all pathies under one roof through the medium of infotainment. The Mela is the right mix of health picnic, exhibition, competition and infotainment.

Addressing a press conference and releasing Mela Poster, Dr. K K Aggarwal, Padma Shri & Dr. B.C. Roy Awardee, President of Heart Care Foundation of India and MTNL Perfect Health Mela and Mr. Sandeep Marwah Director, Asian Academy of Film and Television said that the event will provide a unique opportunity for the NCR people to have their heart and general health check up done and know all about prevention.

Dr. P K Sharma, MHO, NDMC, Dr. N K Yadav, MHO, MCD , Dr K S Bhagotia CMO, DHS, Mr. Sunil Kumar PGM, MTNL, Dr Sadhna Ji Maharaj from World Fellowship of Religions in a joint statement said that the Mela will be a right place to know everything that is happening in medicine.

The Mela will be a mix of exhibitions, checkups, competitions, and infotainment under one roof and will be a perfect health picnic spot for the schools and families.

HCFI Update: Do not eat curd in Bhadon month?

One should not take green leafy vegetables in the month of Shravan and curd (yogurt, dahi) in the month of Bhadon said Padma Shri and Dr B C Roy National Awardee Dr K K Aggarwal President heart Care Foundation of India and MTNL Perfect Health Mela.

One should also avoid milk in the month of Ashwin and butter milk (mahi, matha), pulses and oil in the month of Kartik.

Ayurveda defines the concepts of Vata, Pitta and Kapha. In terms of modern medicine, Vata represents movement; Pitta metabolism and Kapha structure and water.

As per Ritucharya (seasonal routine), Vata or movement functions in the body are aggravated in Varsha Ritu (rainy season) which coincides with Shravan and Bhado months. During these months, pitta starts accumulating.

Pitta or metabolism is aggravated in Sharad Ritu (Ashwin and Kartik months) and Kapha in the Vasant Ritu (Chaitra and Vaisakha). In Sharad Ritu when Pitta gets aggravated the Kapha is accumulating.

In the month of Shravan, as Vata or movement function is aggravated, any food item which aggravates Vata or movement will cause harm to the body. Ground leafy vegetables increase Vata, and therefore, are prohibited in the month of Shravan. According to modern medicine, during rainy season, most of the ground worms will also come to the surface and infect the leafy vegetables. This is another reason why leafy vegetables are harmful to the body in the month of Shravan.

In Varsha Ritu (Rainy season), Vata is aggravated but Pita has stated accumulating which gets aggravated in Sharad Ritu. Therefore in the month of Bhadon, it is advised to eat less yogurt (dahi) as anything fermented aggravates Pitta. Though Ayurveda says that curd should not be eaten in the month of Bhadon season, from allopathic point of view, it should be true for all fermented foods including alcohol, dosa, idli or dhokla etc.

Kapha producing substances like milk and butter milk are avoided in Sharad Ritu as at that time Kapha is accumulating and Pitta is aggravated.

As per the Ayurveda in the month of Shravan and Bhadon, the digestive fire is weak and, therefore, any substance which can obstruct the digestive channels should be avoided and curd is one of them.

Ayurveda also prohibits eating curd in the night throughout the year as after 6 pm the digestive fire in the body is weak, Kapha is predominant and any curd food taken at that time will block the digestive channels.

Naturopathy is in agreement with Ayurveda but Allopathy is silent on this issue. Without going into the details of the subject the conclusion is to avoid eating curd in the month of bhadon.

HCFI Update: Opt for medical treatment for heart blockages with low left heart functions

For most patients with systolic left heart pumping function (LVEF) of 35 percent or less and coronary heart blockages amenable to bypass surgery one should first initiate optimal medical therapy alone rather than medical therapy plus bypass surgery, said Padmashri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

Earlier view had been that compared with medical therapy, surgical bypass of viable heart muscle improves both survival and left heart function. This view was based on the fact that up to 50 percent of patients with left heart pumping dysfunction due to coronary heart blockages have a significant amount of viable heart muscles.

The results of Surgical Treatment for Ischemic Heart Failure (STICH), a randomized trial have shown that compared with optimal medical therapy alone, optimal medical therapy plus bypass surgery resulted in no significant improvement in the primary outcome of all-cause mortality at a median follow-up of 56.

The current recommendation that one should initiate optimal medical therapy alone rather than optimal medical therapy plus bypass surgery is based upon the significant morbidity associated with bypass surgery. Bypass surgery, however, is preferred by patients with ongoing anginal symptoms despite optimal medical therapy.

HCFI Update: Acetone in the urine means fat is used as a source of energy

Anna Hazare’s urine shown presence of acetone which means that his fat is now becoming the source of energy, said Padmashri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India and MTNL Perfect Health mela. As long as fat content in the body remains more than 10% the body can tolerate fasting. Anna being 70 kg can afford to lose 10 kg weight.

The fall of upper BP by 30 and rise of pulse by 10 means dehydration and need for more fluids.

1. Ketonuria is a medical condition in which ketone bodies are present in the urine. Medically it is presence of acetone in the urine.

2. It is seen in conditions in which the body produces excess ketones as an alternative source of energy. It is seen during starvation or in diabetes. Higher levels of ketones in the urine indicate that the body is using fat as the major source of energy.

3. Production of ketone bodies is a normal response to a shortage of glucose, meant to provide an alternate source of fuel from fatty acids.

4. In prolonged fasting insulin deficiency increases fat lysis and increased free fatty acid delivery to the liver. Glucagon excess promotes conversion of free fatty acids into ketoacids in the liver.

5. Ketone bodies that appear in the urine when fats are burned for energy are acetoacetate and beta-hydroxybutyric acid. Acetone is also produced. Normally, the urine should not contain a noticeable concentration of ketones to give a positive reading.

6. The body continues to use fat for as long as there is fat to consume. The body will generally indicate to the faster when fat levels are running extremely low (less than 7% and 10% of body weight for males and females, respectively) with an increased urge for food. Fasts are usually broken long before this point. If the fast is not broken, starvation begins to occur, as the body begins to use protein for fuel. Health complications associated with fast-induced starvation include electrolyte imbalances, thinning hair, lanugo, cardiac arrhythmia and renal failure. Death can occur if fasting is pursued to the point of complete starvation.

7. While fasting one should not take paracetamol as it can case fatal liver damage.

8. Acetone can be tested by a dipstick or by a lab. The results are reported as small, moderate, or large amounts of acetone. A small amount of acetone is a value under 20 mg/dl; a moderate amount is a value of 30–40 mg/dl, and a finding of 80 mg/dl or greater is reported as a large amount. In prolonged fasting the Ketoacid levels do not exceed 10meq/L and plasma bicarbonate concentration is typically above 14meq/L. The limitation in the degree of ketone formation with fasting in part reflects the ability of ketonemia to promote insulin secretion, thereby limiting the availability of free fatty acids. There is also increased ketoacid uptake by the brain as it switches from glucose to ketones as a source of fuel.

9. Fasting ketoacidosis is treated by administration of dextrose and saline solutions. The dextrose will increase insulin and reduce glucagon secretion, while the saline will repair any fluid deficit.

10. The plasma phosphate concentration may fall to low levels with therapy as insulin drives phosphate into the cells. When present, severe hypophosphatemia may be associated with marked and possibly life-threatening complications in these patients, including heart attack.

HCFI Update: Precautions while fasting on Janmashtami

Fasting is generally good for health, but if you are a patient, consult your doctor before you fast on Janmashtami, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

A Fast or Vrata purifies the mind, body and soul. It facilitates restraining of the senses. It advocates a satvik lifestyle. The three wise monkeys of Mahatma Gandhi symbolize inner purification by the three principles of See no evil, Hear no evil, Speak no evil. Similarly, fasting also means fasting from negative thoughts and not simply abstaining from food and water.

The Heart Care Foundation of India released guidelines for taking food while fasting.

Fast without water: The ardent followers of Lord Krishna celebrate Janmashtami by observing Nirjal fasts, which literally means starvation with no food and water intake. The fast is broken only at midnight, when aarti is performed and prasad are offered to the deity. Patients with kidney disease should not do this type of fast. Those who take medicinal drugs should take it with minimal water.

Phalahar Fast: This is another type of fast observed on Krishna Janmashtami. It is relatively lenient than the nirjal fast, because the person can consume milk and fruits. No cereals are taken. The fast is broken at midnight, after Janmashtami Puja. This fast if done once a week is good for patients with diabetes and heart disease and those who are obese. But, on the day of fast diabetics will need to reduce their intake of insulin and other anti diabetic drugs.

Food for Janmashtami Fast: A variety of dishes using milk, milk products are made like Peda, Shrikhand, Kalakand, Vella Seedai, Neyyappam, kheer are made. Some prepare 56 dishes (Chappan Bhog) on this day. People should be cautious as refined carbohydrates (white sugar, white flour and white rice), chocolates and food cooked in trans fats rich in hydrogenated vanaspati oils are harmful for the health. Instead, singhara, kuttu (buckwheat) flour, cholai laddo and samak rice are made from fruits and not cereals and can be eaten.

HCFI Update:The Science behind Anna Hazare Movement, Satyagraha & Gandhigiri

Gandhigiri always works, whether it was Mahatma Gandhi, the movie “Lage Raho Munnabhai” or the Gandhian Anna. The Gandhian principles were so framed that it always united the common man, said Padmashri and Dr B C Roy National Awardee Dr K K Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

Dr Aggarwal said that four basic principles Gandhi taught are of Satya (truthfulness); Ahimsa (non violence); Sarvodaya (welfare for all) and Satyagraha. The word Dharma means to hold together. All the above four principles can hold people together and hence forms the backbone of dharma.

Yoga-shastras as well as the Yoga Sutras of Patanjali propagate truthfulness as one of the main components for living a disciplined life or to start yoga. Satya means oneness in your thoughts, speech and actions. Bapuji’s three monkeys also had truthfulness represented in one of the monkeys who talked about ‘bura mat bolo’. In fact, Gandhi believed that “there is no religion higher than truth”

Gandhi preached the concept of “experimenting with truth” — a phrase that formed the subtitle to his autobiography. He taught how to learn through trial and error, often admitting to mistakes and changing one’s behaviour accordingly. Non observance of truthfulness is the root cause of any corruption in the society.

Ahimsa is the next principle and teaches us the path of non violence. Again it has to be practiced not only in actions but in thoughts and speech also. It also forms the basis of Jainism and Hinduism as a religion.

Sarvodaya or welfare for all is the third Gandhian teaching. Vedic philosophy also emphasizes on the welfare for all. It talks about “bahujan hitay-bahujan sukhay” (‘the good of the masses, the benefit of the masses). Gandhi found in it a composite concept of social welfare & economic justice. Any action which is aimed and seems to be aimed at the welfare of the people will e accepted by every one in the society.

Satyagraha is the protest based on satya (path of truthfulness) and non violence and includes peaceful demonstrations, prolonged fasts etc. It’s a non violence based civil resistance. Satyagraha is formed by two Sanskrit words Satya (truth) and Agraha (holding firmly to or firmness). Gandhi said “Satyagraha is a weapon of the strong; it admits of no violence under any circumstance whatsoever; and it ever insists upon truth”. Gandhi said if you are firm in the truth in the long run you are going to win. It is base on the law of persistence.

The current Satyagraha by Anna Hazare is using all the principles of Gandhigiri and is already in its way to success.

HCFI Update: Travel more than doubles risk of blood clots

Long distance travelers should periodically move around and stretch their legs, and drink plenty of water to stay hydrated, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

Long–distance travel can lead to fatal blood clots in the lungs. Cancer patients, people who have recently had major surgery such as a joint replacement, and women on birth control pills are especially at higher risk.

In general, travel is associated with a nearly three-fold increase in the risk of vein clots. If such a clot dislodges and travels to the lungs, it can cause a potentially fatal condition called pulmonary embolism or a lung attack.

A combination of factors including dehydration and hours of sitting in cramped conditions explains why some people develop blood clots.

A review, published in the Annals of Internal Medicine, analyzed 14 studies involving more than 4,000 cases of venous thromboembolism and found that travelers had a nearly three-fold higher risk of blood clots than non–travelers. The risk climbed along with the duration of the trip, rising 18 percent for every two hours of any type of travel, and by 26 percent for every two hours of air travel.

Symptoms of a blood clot in the leg include pain, warmth, swelling and redness in the limb. If the clot travels to the lungs, it may cause sudden shortness of breath, chest pain or a cough that produces blood.

Some medical conditions and medications increase a person's risk of developing a blood clot. These conditions are pregnancy, obesity, smoking, heart failure, previous vein clots or clots in the lungs, advanced age, some cancers, nephrotic syndrome and drugs like birth control pills, hormone replacement therapy, erythropoietin, tamoxifen, thalidomide. The risk of a blood clot is further increased in people who use one of these drugs and smoke or are overweight.

Tips to prevent development of leg clots while on board with flights longer than 6 to 8 hours

1. Stand up and walk around every 1 to 2 hours.

2. Do not smoke prior to travel.

3. Wear loose-fitting, comfortable clothing.

4. Prefer bulkhead or emergency row seating.

5. Periodically flex and extend the ankles and knees.

6. Do not cross the legs.

7. While seated change positions frequently.

8. Avoid dehydration by drinking plenty of non-alcoholic beverages.

9. Wear knee-high compression stockings.

10. Avoid sedatives and sleeping pills and alcohol, which could impair the ability to get up and move around.

HCFI Update:Hospital-acquired anemia can increase mortality in acute heart attack

For patients hospitalized with an acute heart attack an increasing volume of blood drawn for diagnostic tests is associated with a greater risk of developing anemia. For every 50 mL of blood drawn, the risk of developing moderate-to-severe anemia in the hospital rises by 18%, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and MTNL Perfect Health Mela.

It is possible to reduce this risk by

1. Reviewing the necessity for routine vein puncture
2. Reducing the volume of blood obtained during a hospitalization.
3. Enlisting the minimum amount of blood required for each test
4. Limiting scheduled phlebotomy
5. Using pediatric blood tubes for blood collection
6. Using 2 or 5 ml syringes instead of 10 ml syringes
7. Using stored serum specimens or storing the first sample of the patient till the day of hospitalization.
8. Rationalization of the routine testing

According to Dr Mikhail Kosiborod, of Saint Luke's Mid America Heart and Vascular Institute in Kansas who published their data in the Archives of Internal Medicine, hospital-acquired anemia in patients with acute heart attack is associated with poorer outcomes including higher mortality. He evaluated 17,676 patients with acute heart attack from 57 U.S. hospitals. The patients had normal hemoglobin levels at admission. Overall, 20.1% of the patients developed moderate-to-severe anemia (a decline in hemoglobin from normal values to less than 11 g/dL) during their hospital stay. The mean volume of blood drawn was significantly higher in patients who developed moderate-to-severe anemia (173.8 versus 83.5 mL). Those who developed the condition were also more likely to have more than 300 mL drawn (12.5%) and more than 500 mL drawn (3.8%).

HCFI Update:Heart Disease is every woman’s concern

Heart disease kills more women than all cancers combined in women including breast cancer. Normally, women are not supposed to get heart attack before menopause but now a days, ratio is 40:60 indicating a faulty lifestyle amongst women, said Padmashri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

Being an Indian woman, is a risk factor for heart attack. A study from UK had shown that Indian women are 17% more prone to get heart attack than a local UK women. Indian women are more prone to get obesity, fatty liver, diabetes and insulin resistance.

Earlier women used to prevent heart attack by indulging into regular walks, skipping, dancing and games like Kikli at ceremonies but now, most women are living a faulty lifestyle indulging into both active and passive smoking, having late nights with faulty diet heavy in white sugar, white maida and white rice.

It has been observed that heart attack in women is more serious, more fatal and less attended to. Chances of women undergoing angioplasty or bypass surgery are less than that of any man.

With simple changes and a better understanding of the condition, many people live full and active lives. The time to take charge of your health is today.

 Changing lifestyle, stress and a poor metabolic profile are making young and middle-aged women more susceptible to heart diseases.

 Facts about women and heart

Although the traditional risk factors for coronary artery disease such as high cholesterol, high blood pressure and obesity affect women and men, other factors may play a bigger role in the development of heart disease in women. For example:

1.   Metabolic syndrome  a combination of fat around the abdomen, high blood pressure, high blood sugar and high triglycerides  has a greater impact on women than on men.

2.  Mental stress and depression affect women's hearts more than men's.

3.    Smoking is a greater risk factor for heart disease in women than in men.

4.    Low levels of estrogen after menopause pose a significant risk factor for developing cardiovascular disease in the smaller blood vessels (small vessel heart disease).

5.   While heart disease is the leading cause of death for women 65 and older, it's the third-leading cause of death for women 25 to 44 and the second-leading cause of death for women 45 to 64. Women under the age of 65 who have a family history of heart disease should pay particularly close attention to the heart disease risk factors. Still, all women, of all ages, should take heart disease seriously.

6.   The most common symptom of a heart attack in both men and women is some type of pain, pressure or discomfort in the chest. But it's not always severe or even the most prominent symptom, particularly in women. Women are more likely than men to have signs and symptoms unrelated to chest pain, such as:  Neck, shoulder, upper back or abdominal discomfort; Shortness of breath; Nausea or vomiting; Sweating; Light-headedness or dizziness; Unusual fatigue. These signs and symptoms are more subtle than the obvious crushing chest pain often associated with heart attacks. This may be because women tend to have blockages not only in their main arteries, but also in the smaller arteries that supply blood to the heart a condition called small vessel heart disease.

7.   In some women, plaques build up as an evenly spread layer along artery walls, which isn't treatable using procedures such as angioplasty and stenting designed to flatten the bulky, irregular plaques in some men's arteries. For some women, drug treatment rather than angioplasty or stenting may be a better   option.

8. Certain heart medications, such as clot-busting drugs thrombolytics) tend to be more effective in women than in men. Aspirin therapy benefits both men and women, but there's also a difference between men and women in the effects of aspirin therapy. In women, aspirin therapy seems to reduce the risk of stroke more than in men, while in men it reduces the risk of heart attack more than it reduces stroke.

9.    There are several lifestyle changes women can make to reduce your risk of heart disease:  Exercise 30 to 60 minutes a day on most days of the week; Maintain a healthy weight; Quit or don't start smoking and eat a diet that's low in saturated fat, cholesterol and salt.  10. Some women at high risk of heart disease may also benefit from the use of supplements, such as omega-3  fatty acids.

11. Today 1 in 2 women die of heart disease or stroke, compared with 1 in 25 women who die of breast cancer. 42% of women who have heart attacks die within 1 year compared with 24 percent of men.

12. Smoking by women causes almost as many deaths from heart disease as from lung cancer.

13. Women with heart disease are more likely to die (5.6% of the women versus 4.3% of the men).

14. One of every three deaths for women is from heart disease, only one in every thirty death is from breast cancer. Over 60% of women believe their biggest health threat is breast cancer but heart disease kills 6 times as many women as breast cancer. Most women do not
realize heart disease is a health threat.

15. Women who smoke are two to six times more likely to suffer a heart attack than a non smoking woman and the risk increases with the number of cigarettes you smoke each day. Smoking also boosts the risk of stroke. Women who smoke risk having a heart attack 19 years earlier than non smoking women.

16. Women with diabetes are two to three times more likely to have heart attacks.

 The survival rate following a heart attack is lower among women than men. Reasons for high mortality in women include differences in diagnosis, treatment, symptoms, reaction to drugs and age at the onset of the disease.

HCFI Update: British are out and now get azadi from life style disorders

Forget the past as a history and live in the present. Celebrate 15th August every year as day of independence from eradicable diseases said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India & MTNL Perfect Health Mela.

Every year on 15th August the Prime Minister should announce a 'Quit' India Movement for a particular disease.

The International Task Force for Disease Eradication in 1992 identified six "eradicable" or "potentially eradicable" infectious diseases. These are dracunculiasis, poliomyelitis, mumps, rubella, lymphatic filariasis, and cysticercosis. In 2002, measles was added to this list. Of this only guinea worm disease or dracunculiasis has already been eradicated from India so far. Polio is on the verge or eradication.

Malaria, yellow fever, and yaws eradication programmes of earlier years were unsuccessful but they contributed greatly to a better understanding of the biological, social, political, and economic complexities of achieving the ultimate goal in disease control. In early 1997, WHO listed leprosy, onchocerciasis (River blindness), and Chaga’s disease as being candidates for elimination "as public health problems within ten years".

Life style disorders are other eradicable diseases as they are man made. No wild animals suffer from a heart attack but a lion in the zoo, rabbit in the lab and a dog at home gets it. One can prevent a heart attack by observing the laws of nature.

A study of 641 patients in Aug. 8 issue of the Archives of Internal Medicine, has shown that the risk of developing diabetes over next three years can go down by fifty percent by simple lifestyle interventions. The risk can further drop in the subgroup that also has impaired glucose tolerance at baseline. The interventions involve a healthy diet and regular exercise. A classical diet is low calories, high fiber, zero trans fat and low in refined carbohydrates. Even in full blown diabetics the requirement of drugs can be reduced by 50% over three months by life style interventions. The same is true in hypertension and heart blockages.

HCFI Update: Beware of lead in paints

Seventy three  percent of consumer paint brands from 12 countries in one study tested positive for lead higher than the U.S. standard of 600 parts per million (ppm) said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

Paints can be a source of lead poisoning. Enamel paints have higher lead concentration.  Painters who scrap paints may end up with acute lead poisoning with abdominal pain.

Some paints have Volatile Organic Compounds (VOCs) that may cause asthma and cough.  VOCs are organic chemical compounds that vaporize and enter the atmosphere.  VOCs include aldehydes, ketones, and hydrocarbons and may be either organic compounds or mixtures of varied composition. Conventional household paints release VOCs in the air. VOCs contain many chemicals considered carcinogens.

‘Chuna’(limestone) used to whitewash their houses is safer to use than the high end paints available in the market.

Exposure to lead can lead to weakness in fingers, abnormal blood pressure, anaemia and severe damage to brain and kidneys.  Dry hacking cough can occur due to exposure to toluene diisocyanate (TDI), a well-known sensitizing agent, and one of the chemical components in the car paint sprays.

Many of the toxic effects of lead are reversible if identified early.

Asthmatics should avoid entering a freshly painted room.  Instead of using paints that can be harmful opt for organic paint or environmentally friendly paint such as real milk paint or other natural paint made from natural ingredients.

Long-term exposure to household paints has led to the medical diagnosis of “Painter’s’ syndrome” to describe the effects that solvents used in synthetic paints can have on those exposed to them in the medium and longer terms.

HCFI Update: Living alone after heart attack risky

Living alone after a heart attack increases the chances of death in the next four years, said Padmashri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

Citing a recent study published in the American Journal of Cardiology, he further added that the chances of death at one year after a heart attack was roughly the same for individuals living alone

compared to those living with someone else. But, patients who lived alone had 35% greater risk of death at four years after the heart attack.

Social support greatly influences the outcome of an illness. It enhances not only physical health but also mental health. Family support, including those of their friends, helps these patients to recover and have a good quality of life. Lack of social support in people who live alone hampers their recovery. They do not have the assistance they need to take their medicines, the motivation to follow the prescribed exercise regime and keep up with follow up visits to their doctor.

HCFI Update: Low BP may be normal

There is nothing like low blood pressure. If it is low keep it low and is good for the heart said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

Low blood pressure, medically called hypotension, however can be a medical problem if there is an acute or chronic fall of blood pressure from a baseline blood pressure value.

Any fall of upper blood pressure of more than 30 mm Hg will be called as an acute low blood pressure and cause symptoms and reduced flow to vital organs.

An acute fall in blood pressure can occur in heart failure, acute heart attack, and reactions to some drugs, acute allergic reaction, dehydration, blood infection or irregular heart rhythms.

Blood pressure may become permanently low in heart valve stenosis, chronic heart failure, some cardiac drugs Some individuals routinely may have blood pressures of 90/50 with no symptoms and therefore do not have low blood pressure. However, others who normally have higher blood pressures may develop symptoms of low blood pressure if their blood pressure drops to 80/60 or a fall of 30 in the above reading.

The arbitrary criteria for low blood pressure is upper BP lower than 90 or lower BP lower than 60 or a fall of more than 30 mm Hg in upper blood pressure acutely.

If there is an acute fall in blood pressure, kidney shutdown is at risk. If the patient does not pass urine in the next 8 hours the patient can end up with acute kidney failure.

HCFI Update: Eating refined sugar can cause diabetes

Eating too much refined white sugar can cause insulin resistance and future diabetes said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

Diabetes does not mean that one can never have desserts. While eating too many sugary foods is to be avoided, an occasional dessert can be had, especially if one exercises and otherwise eats healthy. It’s better to substitute brown sugar or Jaggery in that case. Artificial sweeteners including stevia are the other options.

Fruits are healthy for diabetics but cannot be consumed in huge amounts, as they contain carbohydrates. According to Ayurveda, diabetes is a Kapha disorder and diabetics should limit the intake of sweet, salt and sour taste in diet.

·         Any fruit or vegetable, which is bitter and dark green has anti diabetic properties.

 ·         One should combine a bitter taste with a sweet taste when choosing a vegetable of a fruit. For example  one should not combine peas with potatoes but one can combine potatoes with leafy vegetables like fenugreek (methi) or spinach (palak).

 ·         Diabetics are not more susceptible to colds and other illnesses but may have more complications of flu.

 ·         Taking insulin does not cause hardening of the arteries or high blood pressure.

 ·         Diabetes is not contagious and one cannot get diabetes from someone else.

HCFI Update: Bloated and Gassy Feeling in the abdomen is related to faulty lifestyle

  If you constantly feel bloated or gassy, then you can cut down on foods  and food habits that worsen symptoms of gas in the abdomen said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

As per traditional Ayurveda, foods that split equally into two parts produce gas. The examples are pulses, Rajma (Red Kidney Beans), Chole (Chickpeas) etc. One should cook them after soaking them in water for few hours or cook them with asafoetida.

Foods that grown on the ground surface such as cauliflower, broccoli, cabbage etc. if eaten raw produce gas. Similarly, foods that grow under the ground e.g.  onion, radish, carrot etc produce gas if eaten raw or without soaking them in water.

What can be done?

1.                Cut down on gas-producing foods such as beans, dairy products, bran and whole wheat foods.

2.                Limit gas-forming vegetables such as onions, broccoli, cabbage and brussel sprouts.

3.                Limit gas causing fruits such as peaches, apples and pears.

4.                Some people are fructose-intolerant and do not tolerate fruits.

5.                Those who are fructose-intolerant may find that many sodas contain fructose and produce the same problems.

6.                Limit sugary fruit drinks and carbonated soft drinks.

7.                Limit artificial sweeteners such as maltitol, mannitol, sorbitol, xylitol and other sugar alcohols, as they can increase bloating.

8.                Several habits can increase the amount of air you take in. These include: Eating too quickly, gulping beverages, loose or poorly-fitted dentures, drinking though a straw, excessive swallowing due to nervous tension, excessive swallowing due to postnasal drip and chewing gum or sucking on candy.

9.                Avoid swallowing excessive air by eating slowly and chewing thoroughly.  If you gulp food, or eat too quickly, you may swallow excess air, leading to gas and bloating. Normally, about half of passed gas comes from swallowed air.

10.           Too much stress can cause your stomach and colon to go into spasms, leading to uncomfortable gas and bloating. When under stress, one also eats more.

11.           Exercising helps the body to absorb gases in the colon. Aerobic exercise for at least 30 minutes every day can help to counter constipation.

12.           Lactose-intolerance is a relatively common food allergy. Milk, dairy products, and medications that contain lactose can produce gas.  Lactose that is not completely digested will pass to the colon where gas is produced by the bacteria trying to break it down.

13.           Certain vegetables produce more gas.  Baked beans, Broccoli, Brussels sprouts, Cabbage, Cauliflower, Lentils and Lima beans and Fatty foods (they slow digestion, giving food more time to ferment).

14.           Starches that produce gas are wheat, corn and potatoes

15.           Some drugs such as those that inhibit digestive enzymes or contain indigestible sugars like lactulose or sorbitol, can cause gas-related symptoms. Antibiotics are known to cause excess gas because they kill the beneficial bacteria in the colon that normally aids in digestion.

16.           Most people tilt their head forward when they use a straw to drink. This puts the air in your mouth above the liquid when you swallow and leads to more gas in your system.

HCFI Update:20 minutes of sunlight and a glass of milk can keep osteoporosis at bay

Osteoporosis and vitamin D deficiencies are the two new epidemics of the society said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India and MTNL Perfect Health Mela.

Drinking less milk, quitting sunlight exposure and omitting the traditional aerobic indoor games are few reasons for the new epidemic. Younger professionals also stay indoors with practically no sunlight exposure. This is especially true for medical residents.

Here are few tips to prevent osteoporosis and strengthen the bones:

1. One should stop smoking as it increases bone loss.
2. Eat a calcium-rich diet: The aim should be to get 1,500 milligrams of calcium a day in postmenopausal woman or a man over age 65. Good dietary sources of calcium include dairy products, tofu and other soy products; orange juice fortified with calcium, canned salmon with the bones, and cooked spinach. The alternative is to take calcium supplements.
3. Get enough vitamin D: Vitamin D levels are influenced by how much sunlight one gets.  Levels tend to decrease in older adults, especially in winter and in people who are unable to leave their home. One should consider taking a supplement to make sure one gets the recommended daily amount. 
4. Get exposure to sunlight of at least 20 minutes per day. The exposure should at least be of 20 minutes every day for a month in a year.
5. Get enough protein in diet: An adequate intake of protein in diet, combined with an adequate intake of Ca helps increase bone density. One should aim for about 12% of calories to come from proteins such as legumes, poultry, seafood, meat, dairy products, nuts and seeds. However, too much protein with too little Ca can be harmful.
6. Weight-bearing exercises: These are activities such as walking, jogging and stair climbing that one should do on the feet, with your bones supporting your weight. They work directly on the bones of the legs, hips and lower spine to slow mineral loss.
7. Weightlifting exercises: These exercises are also called resistance training or strength training. They strengthen muscles and bones in the arms, chest and upper spine. They can work directly on the bones to slow minerals loss.
8. Get adequate vitamin K: This vitamin may be helpful in enhancing bone strength. Green leafy vegetables are the best sources of vitamin K. If one is taking a blood thinner he or she should check with the doctor. 
9. Avoid excessive alcohol: Women should limit alcohol consumption to less than one ounce a day and men should limit it to less than two ounces.
10. Limit cola drinks: People who have high cola intake often have lower bone density.