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Dr K K Aggarwal

The classical description of ‘who we are comes’ from Adi Shankaracharya’s Bhaja Govindam, where he says that even the wife refuses to touch the same physical body after death, with which she has been fondling all these years and if she touches it, a ritual bath has to be taken. This means physical body is not what we are.

If we weigh physical body before and after death there will be no difference. The life force also called consciousness or atman has no weight, shape or dimensions.

In Bhagavad Gita,Krishnain Chapter 2 describes its characteristics as “fire cannot burn it, air cannot dry it, weapons cannot cut it, and water cannot wet it. It is omnipotent, omnipresence and omniscient”.

Though modern medicine may not talk about soul but it does differentiate life and death based on certain parameters.

Vedic description describes five different movement forces in the body: apana vayu expulses urine, stool, baby and menses; samana vayu controls the intestinal movements; vyana vayu controls the circulatory system; udana vayu controls the neurological impulses and the connection between soul and spirit; and prana vayu controls the brain stem reflexes.

Soul or consciousness is linked to udana vayu and prana vayu. The best description of these five forces apart from Ayurveda text comes from prasannopanishad.

A patient with brain stem death can be kept on ventilator for months together, as the body has normal vyana vayu, sana vayu and apana vayus. The patient will therefore, maintain blood pressure, GI functions, urinary functions and reproductive functions. These three vayus are controlled by the atmospheric oxygen and not by the life force.

Can anyone remember the weight, height, abdominal circumference or size of collar, waist or shoes of Lord Krishna? He is only known only from his actions and the soul profile.

All of us have physical, mental, intellectual, ego and soul characteristics. Soul characteristics in all are same & are positive. The examples are love, compassion, care, humility, etc. These soul characteristics are influenced by the subtle mind, intellect and ego characteristics.

While introducing ourselves, most of the times we talk about define our intellectual or ego profile and not the soul profile. When we describe our status, house, car or money, we are describing our ego profile and not the soul profile. Our aim in life should be to understand our soul profile, as without the soul nobody will come near us. The same very people will dispose off our body at the earliest opportunity they get.

Most of us co-relate life span with the life span of the physical body, which has to perish sooner or later. When we ask people how long they want to live their usual  answers are 60 yrs, 70 yrs, 80 yrs or 90 yrs. Nobody thinks beyond physical death. People like Mahatma Gandhi, Indira Gandhi, Mother Teresa are not dead. Though their physical body does not exist, their good karmas, work, memories and the soul profiles are still alive.

The purpose of life should be to create an atmosphere or an aura in such a way that the society remembers us after the death of our physical body. This is only possible when we shift our thinking from the ego profile to the soul profile.

Soul is nothing but an energized field of information and can be equated to the live information fed in any computer or mobile phone. Both computer and mobile phones with and without information weigh the same. Similarly, weight of radio does not change weather the radio is on or off. The live data information in the TV, radio or mobile phone can be termed as their soul. A computer without this soul is useless, so are the mobile and radio sets.

The information is always static and still without any movements. This information in a computer requires a software to run. The static soul in our body also requires a software called life force.

Soul, thus van be described as a combination of the life force and the static information. In Hindu mythology this is called shiva and shakti. Some people describe them as prana and chitta. In vedic philosophy by controlling prana one can control chitta and vice versa.

For a computer to operate one requires two softwares: operational software and application software. Operational software makes the computer do basic work and application software helps one to manipulate the data the way one wants.

All of us our born with the operational software or the life force. We develop and create our own application software over a period of time by using the triad of action, memory and desires.

To understand oneself, therefore, one needs to control our own application software and do not let them go beyond its desired scope of work.

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Women who eat a lot of meat are apt to weigh more than those who do not. Previous studies have consistently shown that vegetarians are lighter and have a lower body mass index than their omnivorous counterparts.

A study from Brigham Young, evaluated 284 premenopausal women, an average of 40 years old and did not smoke. The researchers separated the women into groups classified by low, moderate, and high meat intake per 1,000 calories consumed per day.

Over the 7-day study, the investigators found that the low-intake group ate less than 1.9 three-ounce servings of meat per day, as opposed to more than 3.18 servings for the high-intake group.

More than half (52.8%) of the women classified as having a high meat intake were obese, defined in this study as having greater than 35 % body fat. Conversely, 37.3% of women in the moderate meat intake group were obese and only 15.6% of those in the low meat intake group were obese.

This was a cross-sectional study, so the findings do not show that meat causes obesity, while that could be the case, it could also be that obesity caused women to eat more meat – like more obese women following the Atkins diet, which is rich in meat.

There are a number of physiological mechanisms by which meat could fuel weight gain. Meat proteins, may elevate insulin levels, and thereby growth factors, that could influence weight and percent body fat. It has also been shown that consumption of saturated fat – most of which comes from animal products – is associated with obesity.

To sum up, it may be worth recognizing that eating less meat may be beneficial in a weight management program. It is possible to eat a healthy diet that is limited in meat. Alternative protein sources such as, lentils, nuts and legumes can provide sufficient protein and actually be beneficial in dieting.

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Health is not mere absence of disease; it is a state of physical, mental, social, spiritual, environmental and financial well being. All aspects of health are not defined in allopathy.

During MBBS, medical students are taught more about the physical health. Social and mental healthcare covered only in few lectures. Community health is a separate subject but never given its due importance. Spiritual health is not defined at all and financial health is hardly covered.

Yet, in day today practice it is the social, financial, spiritual and community health which is the most important during patient-doctor communication. It is incorporated in the four basic purposes: dharma, artha,kamaand moksha.

Dharma and artha together forms the basis of karma which righteous earning. You are what your deep rooted desires are. Most of the diseases today can be traced to a particular emotion, positive or negative. Anger and jealously are related with heart attack, fear with blood pressure, greed & possessiveness with heart failure. Unless the mind is healthy, one cannot be free of diseases.

The best description of health comes from Ayurveda. In Sanskrit health means swasthya, which means establishment in the self. One is established in the self when there is a union of mind, body and soul. Most symbols of health are established around a shaft with two snakes and two wings. The shaft represents the body, two snakes represent the duality of mind and the two wings represent the freedom of soul.

Sushrut Samhita in Chapter 15 shloka 10 defines the ayurvedic person as under:

Samadosha, samagnischa, Samadhatumalkriyah,Prasannatmendriyamanah, Swastha iti abhidhiyate.

From ayurvedic point of view for a person to be healthy must have balanced doshas, balanced agni, balanced dhatus, normal functioning of malkriyas and mind, body, spirit and indriyas full of bliss and happiness.

Human body is made up of structures (Kapha) which have two basic functions to perform; firstly, metabolism (pitta) and movement (vata). Vata, pitta and kapha are called doshas in ayurveda. Samana dosha means balance of structures, metabolism and movement functions in the body. Agni in Ayurveda is said to be in balance when a person has normal tejas and a good appetite.

Ayurveda describes seven dhatus: rasa, rakta, mamsa, medha, asthi,majja, shukra and they are required to be in balance. They are equivalent to various tissues in the human body.

Ayurveda necessitates proper functioning of natural urges like urination, stool, sweating and breathing and that is what balances in malakriya means.

Ayurveda says for a person to be healthy he has to be mentally and spiritually healthy which will only happen when his or her indriyas are cheerful, full of bliss and devoid of any negativities. For indriyas to be in balance one has to learn to control over the lust cum desires, greed and ego. This can be done by learning regular pranayama, learning the do’s and don’ts in life, living in a disciplined atmosphere and learn to live in the present.

Regular pranayama shifts one from sympathetic to para sympathetic mode, balances the mind and thoughts and helps in removing negative thoughts from the mind. For living a disabled life one can follow the yama and niyama of yoga sutras of patanjali or do’s and don’ts taught by various religious gurus, leaders and principles of naturopathy. Living in the present means conscious or meditative living. This involves either learning meditation 20 minutes twice a day or learning subtle mental exercises like mind-body relaxation, yogic shavasana, self-hypnotic exercises, etc.

According to Yoga Sutras of Patanjali a person who eats thrice a day is a rogi, twice a day is a bhogi and once a day is yogi. The take home message is: to live more one has to eat less.

Swar yoga defines the importance of respiration and longevity. According to this yoga shastra, everybody has a fixed number of breaths to be taken during the life span. Lesser the number a person takes in a minute more is the life. It also forms the basis of pranayama which is nothing but longer and deeper breathing with reduced respiratory rate. To be healthy one can remember to follow the principle of moderation and variety in diet & exercise, regular pranayama & meditation and positive thinking.

 

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Olfactory dysfunction presenting as odor detection, discrimination, and identification is a common finding in patients with early non vascular Parkinson’s disease..

 As per a study of 2,267 men published in the Annals of Neurology, an impaired sense of smell could be an early indicator of Parkinson’s disease, occurring up to four years before motor skill problems appear.

In the study decreased odor identification was associated with older age, smoking, more coffee consumption, less frequent bowel movements, lower cognitive function and excessive daytime sleepiness, but even after adjusting for these factors, those with the lowest odor identification scores had a five time greater risk of developing Parkinson’s disease than those with the highest scores.

Nerve loss and the formation of Lewy bodies — abnormal clumps of proteins inside nerve cells that are thought to be a marker of the disease — are known to take place in the olfactory structures of patients with the disease.

An impaired sense of smell could also be caused by impaired sniffing, which may be another motor symptom of Parkinson’s.

Early indicators of Parkinson’s disease are olfactory abnormality, constipation and sleep disturbances.

Besides Parkinson’s disease, obesity, diabetes, hypertension, malnutrition, Alzheimer’s disease, multiple sclerosis and Korsakoff’s psychosis are all accompanied or signaled by smell disorders.

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1. Values are our fundamental beliefs.

a. They are the principles we use to define that which is right, good and just.

b. Values provide guidance to determine the right versus the wrong, the good versus the bad.

c. They are our standards.

d. When we evaluate anything we compare it to a standard.

e. Typical values include: honesty, integrity, compassion, courage, honor, responsibility, patriotism, respect and fairness.

f. Ethics are universal

2. Morals

a. Morals are values which we attribute to a system of beliefs, typically a religious system, but it could be a political system of some other set of beliefs.

b. These values get their authority from outside the individual- a higher being or higher authority (e.g. society).

c. Right as defined by a higher authority.

d. By that definition one could categorize the values listed above (honesty, integrity, compassion …) as “moral values” – values derived from a higher authority.

3. Ethics

a. Ethics is about our actions and decisions.

b. When one acts in ways which are consistent with our beliefs (whether secular or derived from a moral authority) we will characterize that as acting ethically.

c. When one’s actions are not congruent with our values – our sense of right, good and just – we will view that as acting unethically.

d. The ethics of our decisions and actions is defined socially, not individually.

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CT not required in appendicitis

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When a patient has all the signs of acute appendicitis, waiting to get a CT scan to confirm the diagnosis is not required.

Compared with a straight-to-surgery approach, the CT strategy is linked to delayed surgery and increased risk of a burst appendix.

Pre-operative CT is not necessary in cases with straightforward signs and symptoms of appendicitis. If, after a thorough physical examination, the diagnosis is still in question, then patients should be scanned. These patients tend to be older, female and have symptoms that are not typical for acute appendicitis.

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In dealing with patients the traditional Patient-Doctor relationship model has been that doctor should remain cool, calm and collected at all times.

Doctor’s approach needs to be strictly scientific, logical, objective, methodical precise and dispassionate.  This model has been since the era of William Osler, the father of modern medicine.  The term used is imperturbability which means coolness and presence of mind under all circumstances.

Osler said a rare and precious gift to doctor is right of detachment.  The right of detachment insulates the doctors and protects them from the powerful emotions that patients display in their presence like anger, frustration, grief, rage and bewilderment.  It also insulates patients from the rolling emotions that doctors may at times feel towards them.

However, a detached attitude also insulates doctors from empathizing with patients.  A detached doctor may talk in a language that is over patient’s head.

Detachment is not like a light switch that you can turn on and off to suit the situation.  Detachment as a practice cannot be in isolation if it becomes your personal style of distracting from the world, it may not be just for the patients but also from your colleague, family friends and even yourself.

I recall when I joined by hospital the first lesson given to me by my boss was not to get unduly attached with patients.  As etiquette, we were taught not to socialize with patients.  Even today the new American Guidelines talk that doctors should not socialize with their patients on social media including Facebook.  Even doctors are human beings and their personal life should not be known to the patients.  As far as law suits are concerned, it is equally true that known close patient’s file a law suit much more than unknown people because over a period of time they know your weakness.  One should learn to empathize with the patients and yet be detached from its results.  Doctors who follow Bhagwat Geeta understand this concept very well.

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Honey excellent for Cough

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A spoonful of honey can quieten children’s’ night time cough and help them — and their parents — sleep better.

When compared to the cough syrup ingredient dextromethorphan or no treatment, honey came out on top. As per a study from Archives of Paediatrics and Adolescent Medicine, the results are so strong that one is able to say that honey is better than no treatment and dextromethorphan was not. There is currently no proven effective treatment for cough due to an upper respiratory infection like the common cold. While dextromethorphan is widely used, there is no evidence that it works, and it carries risks.

Honey is used around the world as a home remedy for cough, and might provide a safe, effective alternative to cough medicine. To investigate, the researchers compared buckwheat honey, a honey-flavoured dextromethorphan preparation, and no treatment in 105 children who had sought treatment for night time coughs due to colds. Among the three groups, children given honey had the greatest reduction in cough frequency and severity, and the most improved sleep, as did their parents. Its sweet, syrupy quality may be soothing to the throat, while its high antioxidant content could also be a factor. Honey also has antimicrobial effects. Honey is not recommended for infants younger below one year of age because of the risk of botulism spores.

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