Sunday, October 8, 2017

One in four people leave work a year after a heart attack



Dr KK Aggarwal

Most people leave their job within a year of returning to work after having a heart attack, says a study reported in the Journal of the American Heart Association. Patients aged between 30 and 39 years and those between 60 and 65 years reported the highest rate of work dropout after return to work.

About 91% of the 22,394 heart attack patients who were employed before hospitalization for a first-time heart attack, returned to work within a year of the episode. But, within a year of resuming work, 24.2% of them left their jobs and were supported by social benefits.

Comorbid heart failure, arrhythmia, and depression, diabetes were found to be the clinical risk factors for unemployment. Patients with high income and high education level were more likely to remain employed, compared with those with lower educational and income levels.

Several factors – medical, economic, psychosocial – influence return to work following a heart attack. As doctors we take care of the medical factors, drug therapy, managing complications and secondary prevention. But, being part of the multidisciplinary cardiac rehabilitation team, it is equally important to take care of psychosocial factors that may affect recovery of a patient.

This study brings into focus the rehabilitation of post-MI patients and shows that return to work may not be a valid measure of successful recovery of working capacity.

Besides improving functional capacity, cardiac rehabilitation also supports a patient in returning to work following a heart attack. Hence, the rehabilitation of each patient should take into consideration the individual physical, psychological and social challenges of the patient. Post-MI patients, particularly the young patients and those with comorbidities and poorer socioeconomic status should receive increased focus on cardiac rehabilitation so that they continue with their jobs even after a heart attack.

(Source: AHA News Release, October 4, 2017)

The 24th HCFI MTNL Perfect Health Mela concludes with stellar performances and successful mass health awareness initiatives


New Delhi,08 October 2017: Heart Care Foundation of India (HCFI), a leading national non-profit organization committed to making India a healthier and disease-free nation concluded its annual flagship event – the 24th MTNL Perfect Health Mela today.The five-day event was organized jointly with the Health and Family Welfare Dept. NCT Delhi, MTNL, NDMC, and other central and Delhi state government departments. The IMA was the knowledge partner for the event. The theme for this year’s event was ‘Digital Health’, a concept which talks about how technology can help in preventive health and creating mass health awareness. Experts at the Mela deliberated and debated on strategies for preventive health and health management.

The Health Mela is a confluence of tradition and modernity and has successfully since the past two and a half decades been working towards creating mass awareness on all aspects of health; using a consumer-driven model as the medium. It began with much fanfare and a grand inauguration by the Hon’ble Chief Minister of Delhi, Shri Arvind Kejriwal on the 4th of October 2017

Speaking at the valedictory, Padma Shri Awardee Dr KK Aggarwal, President HCFI & National President IMA, said, “I am extremely happy at the successful conclusion of the event and the huge participation. It is time to focus on preventing lifestyle diseases by making certain changes to our diet and lifestyles. I also urge everyone to have a healthy Diwali and take necessary precautions to protect oneself and others from injury and harm. Avoid bursting crackers as they can contribute to increasing pollution levels in the city and thereby hamper health.”

The five-day event served as a podium for over 40 on-the-spot competitions in which over 8200 children from various schools and colleges took part with great enthusiasm. Among the competitions were Indian and western dance, fashion show, rock band, Mehendi art, collage making, painting, and slogan writing.There were also special performances by the Punjabi Academy, the Urdu Academy, and the National School of Drama, which added value to the event. The purpose behind these competitions and performances was to use infotainment as a way of imparting health education to the masses.

With lifestyle diseases on the rise, the Mela focused on various aspects of preventive health.The message conveyed was that a healthy diet, physical activity, and stress-free life can go a long way in preventing many lifestyle conditions.Experts also shortlisted some people with heart diseases for support and treatment under the Sameer Malik Heart Care Foundation Fund.
Adding further, Dr R N Tandon, Honorary Secretary General IMA, said, “This is another one of IMA’s efforts in sensitizing the masses on health and connected issues. The IMA has always worked towards preventive health and creating awareness and this year was no different. I am happy to see the youth participate in large numbers and takeaway some valuable lessons from this Mela.”

A one-of-its-kind All Religious Conference titled Asto Ma JyotirGamaya and an All Pathy Conference with the theme Rog EkIlajAnek were also organized on the last day of the Mela. In both the conferences, the panels constituted eminent medical practitioners and Dharma gurus, respectively. They shared valuable insights and enlightened the audience with their rich experience and knowledge. A performance by the Rajasthan Academy added fun and fervor to the last day of the Mela.
Speaking at the valedictory,Dr P K Sharma, Medical Health Officer, NDMC and; the civic partner of the year’s Perfect Health Mela, said "We all thank everyone who came and attended the 24th Perfect Health Melaand made it such a success. We are happy to be supporting this event every year and will ensure to extend the same support in the years to come.”

Among other things, the Mela focused on generating oxygen through indoor plants, promoting fast food (easy to eat and quick items like fruits and vegetables) as opposed to traditional fried fast food items, learning to create noise and pollution free environments, importance of doctor-patient relationship, eliminating refined carbs, and misuse of antibiotics. The 24th edition of the Mela being held this year will be a precursor leading up to its silver jubilee celebrations starting the next year.

Saturday, October 7, 2017

Three-day workshop focusing on food for heart health at the 24th Perfect Health Mela


·         Events and competitions such as 100-m racing and youth court scene competition mark the 4th day of the Mela
·         Focus on preventive health and tips for a healthy heart
New Delhi, 07 October 2017: Amidst the plethora of events and competitions being held as part of the 24th MTNL Perfect Health Mela, there was also a three-day workshop by food expert Ms Geeta Anand on Healthy Food for a Healthy Heart. The workshop provided interesting insights into how our eating patterns can affect our heart and what a heart healthy diet is composed of. It was an eye-opener in many respects as many things that we consume as part of our daily lives may not be so good for the heart. The PHM, on till the 8th of October 2017 at Talkatora Stadium, New Delhi, is a one-of-its-kind event combining knowledge and fun.

The 4th day of the Mela continued with newer themes in National Harmony and Eco-Festival competitions, Divya Jyoti and Medico Masti youth competitions, and Heritage – Classical Dance competitions. There were events such inter-school poetry recitation, sports competitions (kho-kho, skipping, and 100-m racing), and youth western dance competition. For the youth court scene competition, the theme was ‘justice delayed is justice denied’. The youth fashion show competition was interesting with youngsters sporting fashion from the 1990s.

Speaking on the day, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) said, “Of the many lifestyle issues today, the incidence of heart disease is perhaps showing the highest trend. Men, women, and children are affected by this condition alike and the only way to prevent heart conditions is to take precautions right at the outset. This Mela is a medium to convey this message to thousands of people, particularly youngsters, who are vulnerable to many factors such as peer pressure, junk food, work stress, and substance addiction. This workshop on heart healthy diet was very insightful and we hope people have taken away learnings from it. Apart from this, one can follow the Formula of 80 for a heathy heart, which entails, maintaining fasting blood sugar (FBS) (mg%), fasting low-density lipoprotein (LDL) bad cholesterol (mg/dL), diastolic lower blood pressure (mm Hg), resting heart rate, and abdominal girth (cm) all below 80. “

Other important attractions during the event include free diagnostic checkups (blood checkups) for all, free exhibitions by government departments and OPDs, and live webcast with prominent doctors.
Adding further, Dr Aggarwal, said, “Preventive health also encompasses sanitation. Children should be taught to keep the surroundings environment clean, keep a check on the collection of stagnant water in and outside our houses to prevent mosquito breeding and promote the consumption of safe water to prevent illness. Mass awareness platforms such as the PHM play an important role in encouraging people to adopt a preventive approach.”

Giving his views, Dr Marthanda Pillai Past President IMA & Dr S S Agarwal Past President IMA , said, “This Mela is not only about workshops, lectures, and demonstrations but also engaging youngsters through activities that are interesting for them. The huge participation here is proof that people want to learn more about prevention and health and are willing to go that extra mile for it. I wish the Mela all success in future as well.”
PHM is being organized by Heart Care Foundation of India (HCFI), a leading national non-profit organization committed to making India a healthier and disease-free nation. The 24th edition of the Mela being held this year will be a precursor leading up to its silver jubilee celebrations starting the next year.

HIV Self-Testing: Comments and suggestions invited



Dr KK Aggarwal

As per HIV estimation 2015, India is estimated to have 21 lakh people infected with HIV and only 15.2 lakh PLHIV know their HIV status (Press Information Bureau, August 4, 2017). This means that around 6-7 lakh are still unaware of their HIV status.

To end AIDS by 2030, the United Nations has set global targets as part of its ‘90-90-90’ strategy – to diagnose 90% of all people living with HIV by 2020, to treating 90% of all people with diagnosed HIV infection with sustained antiretroviral therapy and to maintain viral suppression in 90% of all people receiving ART. Lack of diagnosis has been a major obstacle in achieving these targets. Hence, there is a need for ways to increase access to and use of HIV testing services.

HIV Self-Testing (HIVST) is an innovative way, which can complement the efforts put by NACO in achieving the global target of diagnosing 90% of all people living with HIV by 2020.

Also, HIVST can help in reaching first-time testers, undiagnosed PLHIV and population groups who need frequent retesting and can help countries meet the above targets.

The first global recommendations and Guidelines for HIV Self-testing were released by WHO in December last year.

It is proposed to explore inclusion of HIV self-testing (HIVST) for adoption in the country.

To discuss further on the development of National policy on HIV self -testing, NACO has constituted a Technical Advisory Group, convened by DDG BSD NACO.

The Indian Medical Association (IMA) has been included in the Technical Advisory Group on HIV Self-Testing.

Kindly give your suggestions to finalize IMA Stand on this issue.


Friday, October 6, 2017

Eat slowly for good health and well-being



Dr KK Aggarwal

Most of us lead very busy lives today; we are either working, driving, looking into our smart phone, ipad/tablet etc. In a nutshell, we are too busy to pay attention to what we are eating because we are thinking of the work ahead of us and planning for it and not concentrating on the food.

Eating without awareness or eating while distracted by various activities can be harmful to health. It may cause weight gain, a forerunner to lifestyle diseases such as obesity, type 2 diabetes, heart disease, hypertension etc. Hence, it is important to be aware of the food we are eating. This is called mindful eating.

Mindful eating means being aware of the hunger and satiety signals. It also means using all the five senses while eating: colors (eye), smells (nose), flavors (taste), textures (touch) and sound while chewing (ear) of the food. Mindful eating also relieves stress

In Chapter 6 Shloka 17 of the Bhagwad Gita Krishna says to Arjuna “Yukaharaviharasya yuktachestasya karmasu. Yuktasvapnavabodhasya yoga bhavati duhkhaha”. It means "the one, whose diet and movements are balanced, whose actions are proper, whose hours of sleeping and waking up are regular, and who follows the path of meditation, is the destroyer of pain or unhappiness."

The Bhagwad Gita also says, “While eating, one should concentrate only on eating as the food is served to one's consciousness”.

Eat slowly. The process of digestion begins in the mouth itself. So, you should chew your food at least 15 times. If you chew the food well, you will eat less. You will not only enjoy every bite and savor the food, but also maximally gain the nutritional benefits of the food that you are eating.

Some healthy eating habits

·         Eat only when you are hungry.
·         Do not eat for pleasure, social obligations or emotional satisfaction.
·         Eat at a slow pace. It improves satiety.
·         Eat less; dinner less than lunch.
·         Take small bites of food, chew well, swallow it and only then take the next bite.
·         Do not eat while watching TV, driving a car or watching sports events. The mind is absorbed in these activities and one does not know what and how much one has eaten.
·         Do not talk while eating and never enter into heated arguments. The stomach has ears and can listen to the conversation. It will send signals accordingly to the mind and heart.
·         Plan and decide in advance what and how much you are going to eat.


(Disclaimer: The views expressed in this write up are my own).

Music, dance, and language as a means to good health at the 24th MTNL Perfect Health Mela


Ancient wisdom on health should be revisited and the 3rd day of the Mela focused on this and more

New Delhi, 06 October 2017: The 3rd day of the MTNL Perfect Health Mela (PHM) saw continuation of various events and competitions for schools and colleges. The participation did not seem to lessen with enthusiastic youth pouring in for the event. The PHM is a flagship event organized by the Heart Care Foundation of India (HCFI), a leading national non-profit organization committed to making India a healthier and disease-free nation. The Mela is on till 8th of October at the Talkatora Stadium in New Delhi. Apart from these activities, there is something for everyone such as health checkup camps, live webcasts and consultations with eminent doctors, and even Diwali shopping.

The National Harmony and Eco-Festival, Divya Jyoti and Medico Masti Youth Competitions, and Heritage – a series of National Classical Dance Competitions continued today, although the themes changed. Themes today included language and health, dance as a way to fitness and health, combating water pollution, and leveraging the right to freedom of speech.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) said, “We need to turn to old-age wisdom for good health and the Mela this year will focus on this aspect too. Our ancient systems of medicine have a lot to offer. Natural healing through music, dance, and language therapy needs to be reintroduced. While medication, surgery, and other modern techniques of healthcare have their own place, the beneficiary effects of natural healing cannot be underestimated. Many competitions being held this year are centered around this theme and will help the youth research more about ancient healing techniques. A healthy body houses a healthy mind and this is the basis for long life. The need of the hour is to eat healthy, live a good life, include sufficient physical activity, and do away with dangerous habits such as smoking and drinking.”

Some of the main attractions on this day were the youth skit competition on Puran (way of health awareness), Youth Kavita Path competition with a special performance by the Urdu Academy, and a health debate on the freedom of speech. The health checkup camps being organized on the sidelines saw attendance by 1500 people.

Adding further, Dr Aggarwal, said, “Digital health is one of the ways to bring about complete access to preventive healthcare. Digitization of health will help in bringing the power of health to the hands of people through timely diagnosis of even future health risks due to heredity and lifestyle. Technology can enable people in tracking, managing, and improving their own health and that of their near and dear ones. This will lead to improvement of societal health at large.”

The HCFI released some health sutras also ahead of the PHM which are pointers to good health and lifestyle. The Mela will also have experts shortlisting heart disease patients for free consultation and surgery under the Sameer Malik Heart Care Foundation Fund.

Expressing their opinion, Dr D R Rai and Dr Vinod Khetrapal, said, “This is a one-of-a-kind event which not only educates the masses but also brings in the fun element in good health. The HCFI should be lauded for this initiative as there is no other event that covers everything under one umbrella. There is music, dance, poster making, slogans, debates, health checkups, consultations, workshops, seminars, and what not; and all are connected to health in some way or the other. I am extremely happy to be a part of this event and I am sure I will take away a lot from it too.”

Adding their views, Dr Ramesh Data and Anita Sharma (vedic approach to maths), said, “The vedas and puranas indicate many paths to wellness and good health. We are happy that even such an approach is being taken at the PHM. Not only will this educate the younger generation about the rich tradition of ancient medicine but also make them aware that there is more to health than what meets the eye. We wish the event all the best.”

The 24th edition of the PHM being held this year will be a precursor leading up to its silver jubilee celebrations starting the next year. The first Mela was held in 1993 and was earmarked with the release of a National Commemorative Postal Stamp by the Government of India.

Meditation is a useful adjunct to heart-healthy lifestyle and medical treatment


Dr KK Aggarwal

In a new scientific statement, the American Heart Association (AHA) has included meditation as an adjunct to recommended heart-healthy lifestyle and medical treatment.

The statement published September 28, 2017 in the Journal of the American Heart Association reviewed studies of sitting meditation, including a variety of common forms such as: Samatha; Vipassana (Insight Meditation); Mindful Meditation; Zen Meditation (Zazen); Raja Yoga; Loving-Kindness (Metta); Transcendental Meditation; and Relaxation Response. Combination mind-body practices, such as yoga and Tai Chi, as the physical activity in these practices has an established positive impact on the risk of heart disease.

Overall, the studies included in the review indicated a possible benefit on cardiovascular risk. It was found that meditation may be associated with decreased levels of stress, anxiety and depression, and improved quality of sleep and overall well-being; may help lower blood pressure; may help individuals stop smoking and may lower risk of heart attack (AHA News Release, Sept 28, 2017).

Stress increases the risk for heart disease as it may encourage behaviors that increase their risk for heart disease such as smoking, drinking too much alcohol, physical inactivity and overeating ‘comfort foods’. It’s very important therefore to manage stress.

Meditation has always been recommended as a technique to relax the mind and the body and thereby reduce stress.

Meditation shifts one from the sympathetic (disturbed) to parasympathetic (relaxed) mode.

In the sympathetic state, the heart rate and blood pressure increase, which prevent a person from taking correct and decisive decision. Sympathetic mode releases stress hormones and may trigger panic or nervousness, the “flight or fight” response. On the other hand, the parasympathetic mode is the relaxed state of the body. It is a healing state, evident by reduction in heart rate, blood pressure. It is a relaxed state of mind and enables rational and correct conscious–based decisions. 

Meditation is not synonymous to concentration. Concentration is holding the mind to something within or outside the body. While, meditation is an unbroken flow of thoughts towards the object of concentration. It can be called prolonged concentration. Samadhi or absorption is when the object of concentration and the mind of the perceiver becomes one. When Concentration, Meditation and Samadhi are brought to bear upon one subject it is called Samyam.

According to Yoga Sutras of Patanjali, (3.1–3.6), meditation needs to be learnt and applied step by step. The practice starts by sitting straight with erect spine, preferably in Padmasana (one can also sit on the chair) and concentrate on breathing or a primordial sound given by the teacher.
·         When the mind can be made to flow uninterruptedly towards the same object for 12 seconds, one is said to have learnt the process of concentration.
·         When the mind can continue in that concentration for 12 times (12 seconds × 12 i.e. 2 minutes 24 seconds), one is said to be practicing meditation.
·         When the mind can continue in that meditation for 12 times (12 minutes 24 seconds × 12 i.e. 28 minutes 48 seconds), one is said to be in Samadhi.
·         If this lower Samadhi can be maintained for 12 times, i.e., for 5 hours 45 minutes and 36 seconds, one is said to be in Nirvikalpa Samadhi.

The mind becomes one-pointed when similar thought waves arise in succession without any gap between them. Remember that during meditation, the object of concentration may change in form, time and rhythm. The whole process of meditation, therefore, varies from person to person and day to day. During meditation some may only concentrate, some may actually meditate and some may go into Samadhi. Most of us wander from concentration to meditation.

A change in lifestyle is essential to control the increase in non-communicable diseases (NCDs). A balance between the sympathetic and the parasympathetic modes is required for optimum health and well-being.

(Disclaimer: The views on meditation expressed in this write up are my own).