Diastolic Heart Failure - Dr Vivek Baliga, Baliga Diagnostics

In this brief presentation, Dr Vivek Baliga discusses the basics of diastolic dysfunction seen in clinical practice.

Dr Vivek Baliga - Diastolic heart failure - A complete overview from Dr Vivek Baliga

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For patient health articles, visit HeartSense Website

 

Alkaline Foods to Prevent Cancer, Obesity & Heart Disease by Dr Vivek Baliga

With time, we all get older and as we get older, we need to take care of our health more often. As children, we used to keep our bodies active by playing most of the time. But as we grow old, a lot of responsibilities take a toll on our activeness which leads to a lot of diseases such as obesity and other chronic heart diseases. This will be very problematic in the long run and as older adults, chances are that we will have severe diseases that began with bad diet and no activity. You can prevent this, yes that is possible. You must eat food items that are rich in alkaline. Alkaline is known to prevent diseases like cancer, obesity and heart diseases. Dr Vivek Baliga lists different foods that are alkaline in nature and that will help you in maintaining your health well:

1. Spinach

Spinach is something that our mothers have asked us to eat ever since we were kids and most of us disliked it. But did you know that spinach can abolish free radicals? Yes! Not only that, spinach can also improve your memory and keep your heart strong. This is because spinach is rich in antioxidants that can stimulate your brain functions. It is extremely healthy and has a lot of benefits in the long run.

2. Lemons

Rich in Vitamins E, A, C, B6, lemons have a lot of important minerals like zinc, calcium, potassium etc. The lemon juice is known to minimize the risk of a stroke. It is also a cure for kidney stones and helps you fight cancer. This is why most people prefer drinking lemon juice or lemonade during the summers. It not only helps you in freshening up, but it also helps you in a lot of ways by boosting your health.

3. Quinoa

Quinoa is the one food dish that is known to control cholesterol and blood sugar level. Experts have suggested that quinoa is right is proteins and when it is compared to other grains, it has a lot more fiber. Today, a lot of nutritionists and dieticians will suggest you to switch to quinoa to maintain your health and to avoid problems in the long run. This is mainly because, quinoa is rich in manganese, magnesium, riboflavin, lysine and iron.

4. Buckwheat

Ordinary wheat may not be fattening but it still does not help you improve your health. Buckwheat on the other hand, can help you in fighting diseases like diabetes and other chronic diseases related to heart. It also happens to be the single most essential food to eat to get the right amount of nutrients such as vitamins, iron and proteins.
 
5. Bananas

Bananas are not only most people’s comfort food, but they should also be something that you incorporate in your regular meals. They help you lose weight. Of course, the weight loss will not be a dramatic transformation but it is sure to happen steadily. Additionally, they are rich in nutrients like potassium, manganese, B vitamins and fiber.

Dr Vivek Baliga reviews that consumption of alkaline foods can be highly beneficial for your health. So, you must incorporate these foods into your daily diets.

Dr Vivek Baliga Guide - Here Is A Guide On Plantar Fasciitis

For those of you with painful feet, here is a guide for you on plantar fasciitis.

Plantar fasciitis - A Simple Patient Guide by Dr Vivek Baliga, Bangalore from Dr Vivek Baliga

The Basics About Diabetes - Dr Vivek Baliga Article

Weight loss in diabetes is an important aspect of getting your blood sugar levels under control. Obesity is a well recognised aspect of diabetes management.

If you are thinking as to why your blood sugar levels are elevated, then one thing you must think about is your body weight.

In an article written by Dr Vivek Baliga, weight loss is regarded as one of the most important aspects in the management of diabetes.

You can read this article here.

Dr Vivek Baliga Video - Diuretics

In this presentation, Dr Vivek Baliga discusses the use of diuretics in clinical practice and their side effects.

Dr Vivek Baliga Presenation on Diuretics - What... by drvivbaliga

Patient articles - http://heartsense.in/author/dr-vivek-baliga-b/

Organ Donation - Be A Part Of The FORT Program - Dr Vivek Baliga article

In this presentation, Dr Vivek Baliga discusses the reasons why you should list yourself for organ donation, and why you need to be a part of the FORT program.

Dr Vivek Baliga - Organ Donation And The FORT Program from Dr Vivek Baliga

You can read this article online by visiting  http://heartsense.in/organ-donation-fort-program/

Connect with Dr Vivek Baliga on LinkedIn -  https://www.linkedin.com/in/dr-vivek-baliga-7b59b0125

For more articles on health by Dr Vivek Baliga, click here

Association of 3 Different Antihypertensive Medications With Hip and Pelvic Fracture Risk in Older Adults - Review Dr Vivek Baliga

Dr Vivek Baliga, Consultant at Baliga Diagnostics discusses a recent paper.

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OBJECTIVE : To examine whether the use of thiazide diuretics for the treatment of hypertension is associated with reduced fracture risk compared with ACEI and CCB.

Methods:

• The study examined hip and pelvic fracture hospitalizations in ALLHAT participants (> 65 years & from USA only) randomized to chlorthalidone (CH), amlodipine besylate, or lisinopril from 1994 to 1998;
  
• The mean study follow-up was 4.9 years.
  
• Post-trial extended follow-up was conducted till 2006, using passive surveillance via national databases.
  
• MAIN OUTCOMES AND MEASURES Hip and pelvic fracture hospitalizations

 RESULTS:

• Total 22 180 participants (mean age, 70.4  years) were followed for up to 8 years (mean: 4.9  years) during masked therapy.
  
• After trial completion, 16 622 participants  were available were followed for up to 5 additional years (mean total follow-up: 7.8 years). 
  
• Participants in CH group had significantly lower risk of fracture by 21%  vs (amlodipine/lisinopril) on adjusted analyses [0.82 Vs 1.17 per 100 Person years ([HR], 0.79; P = 0.04).
  
• Risk of fracture was significantly lower by 25% in CH group vs lisinopril group (HR, 0.75; P = .04)
  
• No significantly difference in risk of fracture in CH Vs amlodipine group (HR, 0.82; ; P = .17).
• In extended follow-up, cumulative incidence of fractures was nonsignificantly lower in CH group vs (lisinopril or amlodipine) (HR, 0.87; P = .10) and vs each medication separately. 

CONCLUSION:

Elderly hypertensive patients on chlorthalidone (CH) therapy has lower risk of pelvic/hip fracture than those on ACE inhibitors in ALLHAT trial.   

Dr Vivek Baliga - PRECISION: Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis

Dr Vivek Baliga, Consultant at Baliga Diagnostics discusses a recent paper.

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OBJECTIVE: To assess cardiovascular, gastrointestinal, renal, and other outcomes with moderate dose celecoxib Vs ibuprofen and Naproxen in arthritis patients with high CV risk

METHODS:

• Patients who required NSAIDs for osteoarthritis or rheumatoid arthritis and were at increased CV risk were randomised to receive celecoxib, ibuprofen, or naproxen.
  
• Patients initially received celecoxib (100 mg BD), ibuprofen (600 mg TDS), or naproxen (375 mg BD) with matching placebo.
  
• Dosage can be increased upto: celecoxib -200 mg BD,  Ibuprofen 800 mg TDS, or  naproxen 500 mg BD for the treatment of symptoms
• Esomeprazole (20 to 40 mg) was provided to all patients for gastric protection.
• Low-dose aspirin (≤325 mg daily) was permitted to patients if required.
  
• Primary Composite Outcome :  Cardiovascular death (including hemorrhagic death), nonfatal myocardial infarction, or nonfatal stroke
• Analysis was done on both ITT (intention to treat) and on treatment population
  

Results

• Total 24081 patients were initially randomized,
  
• Baseline Characters:Mean Age 63 years, 23% patients had established CVD, 90% had osteoarthritis, 10% had rheumatoid arthritis
• Mean treatment duration: 20.3 months; Mean followup period of 34.1 months.
• During the trial, 68.8% of the patients stopped taking the study drug, and 27.4% of the patients discontinued follow-up
  
• No difference in primary end point between 3 drugs. Celecoxib was non-inferior to naproxen and ibuprofen in both ITT and on treatment analysis  (as shown in figure)

Conclusion:
At moderate doses, celecoxib was found to be noninferior to ibuprofen or naproxen with regard to cardiovascular safety

Link to the article
http://www.nejm.org/doi/full/10.1056/NEJMoa1611593

Dr Vivek Baliga - First Aid For Toothache

Tooth ache can be a nuisance. Here are some first aid tips from Dr Vivek Baliga to manage tooth ache at home.

Our oral cavity is a breeding ground for bacteria. Bacteria can increase the production of acid within the mouth, causing damage to the teeth and tooth decay. Tooth decay is a common cause of tooth ache.

Tooth ache usually starts slowly and can get worse over time. Patients describe it as a ‘throbbing’ or ‘aching’ pain or discomfort that is often worse at night. It may be a constant pain or one that comes and goes. The teeth become sensitive to hot and cold, meaning that eating or drinking hot or cold foods and fluids can make the pain worse.

Here are some simple tips to manage toothache.

1. Rinse the mouth with clean warm water. This can get rid of any large food particles that are stuck in between the teeth.

2. Clean the teeth and gums with dental floss to remove any small pieces of food stuck in the teeth.

3. Apply a numbing gel that contains a local anaesthetic to the area that is painful. Always seek medical advice before using any medication. Some local anaesthetic agents are harmful for children below the ages of 2 years.

4. Take painkillers if required. Simple paracetamol and ibuprofen can be sufficient.

Despite the above, tooth ache can continue sometimes. This could indicate more severe tooth damage than you thought or could be due to an underlying infection. In such situations, seeing a dentist as soon as possible is advised.

When to see a dentist  Persistent pain despite painkillers. Difficulty chewing and swallowing food. A high fever accompanies the toothache (could indicate a dental abscess). ·         The gums are swollen and red and there is pus formation. ·         If the patient develops difficulty breathing.

After-care

Once treated, make sure you maintain proper dental hygiene by flossing the teeth before brushing. Brush teeth twice a day with a good quality fluoridated toothpaste. Avoid smoking and chewing tobacco.

A word of caution

In older patients who have risk factors for heart disease, a toothache can sometimes be an indication of angina or a heart attack. Often patients have accompanying symptoms such as chest pain as well, and the pain is no worse on chewing and swallowing. If you have any concerns, talk to your doctor. 

Dr Vivek Baliga Presentation - Pulmonary Embolism

Dr Vivek Baliga, Consultant at Baliga Diagnostics discusses pulmonary embolism and how it should be managed in clinical practice.

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Pulmonary embolism - Diagnosis and management from Dr Vivek Baliga

Dr Vivek Baliga Health Check Before Taking Up Running

We recently conducted a blood pressure camp at a nearby gym, where all members who walked through the door had their blood pressure checked.

Of the 25 members we screened in 2 hours, we detected high blood pressure in 3 of them! One had a blood pressure of 220/130 mmHg (normal is around 120/80 mmHg), and he was just 37 years old! He had been working out without knowing he had high blood pressure, and it is likely that if you continued without treatment that he would be at risk of a heart attack, stroke or kidney disease.

Why get a medical check up?

The problem with illnesses such as high blood pressure and heart disease is that it can be ‘silent’. People are unaware they have a problem until they have undergone a health check-up. 

You may have heard of cases where young people have died suddenly when out for a walk or even when sitting at home. Many a time, these tragedies are due to undiagnosed heart disease which could have been detected if the person had undergone a medical check up.

What to get done

The important tests that must be done in all people looking to take up running as a hobby (or professionally) must include a blood test, electrocardiogram, echocardiogram and an exercise treadmill test.

Blood tests can help determine if an individual has low haemoglobin, high blood sugar and/or high lipids. All these can be risk factors for heart disease and can be easily treated though lifestyle modification and medicines.

An electrocardiogram (or ECG) is a test that looks at the electrical activity of the heart. An abnormality in the conduction of electricity is clearly seen on the ECG and this may need treatment. Rare cases that need immediate treatment have been picked up on an ECG and the information put together with other tests has helped reach a diagnosis. In some cases, the ECG can be normal even there is an underlying problem, though this is rare.

An echocardiogram is a specialised test where ultrasound waves are used to visualise the heart on a machine. The test will provide information on the structure of the heart muscle, the state of the valve and how strong the heart is pumping (called ejection fraction). Causes of sudden cardiac death such as hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy (ARVC) can be detected through this scan. Narrowing of the heart valves and abnormalities in their function such as leaks can also be detected easily. 

You can read about these conditions on the website www.heartsense.in.

An exercise treadmill test is a very useful test that can help determine how the heart performs when the person is exercising. The normal response is for the heart rate and blood pressure to go up and for the ECG to remain in normal limits. Exercise tests are doctor supervised and the patients are pushed till the heart rate reaches a particular value (called target heart rate, which is 220-age of the individual). Some tests are continued beyond the target heart rate, but this is rarely necessary.

The treadmill test can help determine the following – 

1. Is there any abnormality in the way the heart conducts electricity? This can be seen with the way the waves look, the regularity of the heart beating and the presence of extra beats or abnormal rhythms.

2. Is there any problem with the circulation of blood to the heart? This can be determined if there are changes in particular segments of the ECG on exercise or at rest.

If any abnormality is found, your doctor will let you know if you need any further investigations. Some patients may be advised not to exercise until all additional tests have been done.

While most patients who undergo these tests have normal results, it is not uncommon to pick up the odd case where the tests are positive. These patients have gone on to have either angioplasty, bypass surgery or have commenced medication. Lifestyle changes form part and parcel of these treatments as well, and must be followed strictly.

‘It is better to be safe than sorry’

 

You may have heard this before. It cannot be any further from the truth when it comes to running and your heart. These tests are simple to perform and take no more than a couple hours of your time. Numerous centres now offer these tests at a good price, with only a handful running specialist packages. 

Now that you have read this tip, make time to see your doctor and talk to them about getting the tests arranged. 

For more articles by Dr Vivek Baliga, click here.

Dr Vivek Baliga Presenation - Diastolic heart failure

In this presentation, Dr Vivek Baliga discusses a common cardiac problem encountered in clinical practice - Diastolic heart failure, a term now replaced by Heart Failure with Preserved ejection fraction.

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Dr Vivek Baliga - Diastolic heart failure - A complete overview from Dr Vivek Baliga

Dr Vivek Baliga - Getting Inspired For Running

Dr Vivek Baliga - How To Get Inspired For Running

Ask people who do not exercise every day what they think about running, and chances are they will retaliate with a comment ‘isn’t running boring?’

As a runner, it is possible to get easily offended by this comment; some may just sweep it under the rug and move on.

The fact of the matter is this – running is one of the most enjoyable sports there is. Furthermore, those who think that there is no fun in running may not realise that running forms the ‘building block’ of most sports. Cricketers run in between wickets and to bowl, footballers run, tennis players run; almost every ground sport has some form of running in it.

We have already talked about the ‘runner’s high’ in a previous section. This high aside, many runners find that running clears their head of stress and worries they may have had in the day. In the west, it is not uncommon to find people with busy jobs getting a run in even late in the night just to clear their head. 

At times, when running, it is not unusual to hit a ‘plateau’ – a phase where you just don’t feel like going for a run. This plateau can put a big dent in your running routine; many have even given up running due to this.

 

There is no shame in hitting a plateau – it is not a testament in any sense to being lazy or short of motivation. Every one hits it at some point in their running routine. It’s all about trying to come out of that phase and move on to the next level of running.

How can you achieve this? Well, get inspired! Here are some simple ways.

1

1. Remember why you took up running in the first place. It might have been to become fit because you were breathless when walking up stairs or because you looked at yourself in the mirror one day and did not like what you saw. 
2. Read an inspiring story – There are many runners who have been on a long and tedious journey to be a successful runner. Along the way, they have encountered many problems which most runners would anyway. Read about these and use their recommended strategies to restore your focus on your goals.
3. Set easy goals – Setting too many can confuse things for you. Decide on your goal and work towards it every day.
4. Play your favourite tunes before you run – If you love music, then playing tunes that inspire you are great before you head out for your run. Music can pump you up and get you prepared for your run.
5. Talk to a friend – There are friends who motivate, and these friends are invaluable when it comes to running. If you feel a lack of motivation, ask your friend or running buddy to give you a pep talk. All it takes sometimes is a little push to get you going again.
6. Attend local fun runs – If you are bored on a weekend and seek inspiration to run, just head out to any running events that may be going on in your neighborhood and cheer the runners. You don’t even have to run – just watching them can sometimes be inspiration enough. You will see people of different ages running, and these are an invaluable source of inspiration.
7. Reward yourself – If you have completed a run that you thought you could not do, then most certainly reward yourself once in a while. This could be in the form of eating a small portion of your favourite food, or enjoying a healthy dinner out with friends. We don’t recommend you buy yourself a Ferrari though. 
8. Have a blog – Having a running blog can be a great way to inspire yourself. When you don’t feel like going out for a run, just go through your own blog or the blog of others. Your mood reflects in your blog posts, and you will likely be reminded of how you felt when you ran and then came home to blog about it. 

Creating a blog is simple – you can do so on Blogger or Tumblr. Comments and congratulations from friends and even complete strangers can be a wonderful source of inspiration.

Dr Vivek Baliga's 3 Tips For Extreme Obese Women Or Men

The vast majority of our population is overweight, at least a little.  To determine 'how overweight' someone is, we commonly use a body mass index, or BMI.  Anyone who has a BMI of over 39% is considered morbidly, or extremely, obese.  Everyone knows that having excess body fat can cause a myriad of health problems, and the more overweight you are the more severe and frequent your health problems will be.  But don't give up, even extreme obese women can find the help they need to get their weight under control, once and for all.

Before you decide which type of weight loss plan is best for you, don't overlook your emotions.  Many people will 'emotionally eat' or eat when they are upset or depressed.  Recognizing your bad habits is the first step to changing them and adopting new, healthier, habits.

Here are some steps that can help you get back in shape:

1. The first step anyone who is obese needs to take is a trip to their doctor.  You are far more susceptible to heart problems so you need to find out if you are healthy enough for exercise.  Exercise and diet is the best way for anyone to lose weight.  No, it's not quick or easy, but it's a lifestyle change that can help you keep the weight off permanently.

Start off easy by taking short walks.  Other great ideas are non-impact activities such as swimming or biking.  You will have to start slow and that is fine, but as long as your doctor says it's ok, you need to start.  Hiring a trainer to help you modify exercises for your specific limitations is another good idea (they can also help you stay motivated).

2.  While not as highly recommended as step 1, medication can help some people who are extremely overweight.  It's still not a quick fix and the medications will need to be prescribed, and monitored, by your doctor; but using medications for a short time might be a good way to kick start your weight loss.  It's not recommended that you use these medications for extended periods of time due to the number of side effects, so if you decide to go this route think of it as only a temporary thing to get you started.

3. There are now some surgical remedies to obesity.  Bariatric weight loss surgery has helped many morbidly obese patients lose all of their unwanted weight and by doing so has allowed many of them to completely reverse some negative health issues that they were dealing with.  This surgery is expensive though and as with any surgery, there can be complications.

All in all, it's best if you can make lifestyle changes with your diet and by adding exercise to your daily routine if you need to lose weight, but if you need extra help their are other things that you can do.  The most important thing that extreme obese women need to remember is that it's not so important which method you choose, just choose one and stick with it.  You deserve a long, happy, healthy life, and only you can make that happen.

For more articles by Dr Vivek on weight loss, click here.

Emergency Weight Loss Plan That Works: Vivek Baliga

 Have you left it a little late to lose those pounds? Try this 2 day slim down but please remember that this is an emergency weight loss plan and not one that should be continued for any length of time. Your health is far too important and you should respect it. Long term weight loss is a great plan but gradual and slow should be the name of the game. However for those last minute panics, these tricks will work.

The first day of your plan should be a juice only day. This means either pure water with a squeeze of lemon or some home made unsweetened fruit or vegetable juices. The latter will help to give you some key nutrients to keep you going. A day drinking just juices will not cause most people any health issues but it is definitely not suitable for those who are pregnant, already underweight or have any existing health problems such as diabetes, heart disease or kidney problems.

When making vegetable and fruit juices, try to use organic produce where possible. Always wash the items carefully before preparation. This is particularly important if you cannot afford organic as you want to get rid of as much of the preservatives as possible. When using celery and other root vegetables include the stalks and leaves in the juice as a lot of the nutrients are contained here. If not using organic, it is best to remove the roots, stalks and leaves and dispose of them.

Try combining carrots and apples or raspberry and peach. Just juice enough for one serving and drink immediately as the nutrients start to disappear very quickly. You can drink as much as you would like but aim to consume at least 1.5 liters of water so you do not dehydrate. Water should be filtered and not carbonated or flavored.

On day two you can add some fruit to your diet. Fruit has a laxative effect so will help you to continue to lose weight by making your bowels move. It will stimulate your colon and so will increase the amount of waste eliminated by your system. Watermelon is a diuretic so will speed the passage of fluids through your system. Pineapple and Mango will help to stimulate the growth of good bacteria in your gut while grapes will help to counter the production of mucus which can clog your tissues.

Be sure to get plenty of rest and relaxation following this plan and you will probably want to stay close to home in case the laxative effect comes on rather suddenly. Following this 2 day slim down diet will help you to lose water weight and bloating, both of which will make you look slimmer.

The next stage it to cheat on the day in question. Dress for success and use whatever tricks you can find to make yourself look slimmer. This includes standing straight as correct posture makes us all look less weighty. Wear the right size clothes in colors that flatter your shape and draw attention to the good bits rather than the bad. Like our page for more updates on health https://www.facebook.com/Drvivekbaliga