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Dr K K Aggarwal

Keep your kidneys healthy

By Dr K K Aggarwal
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We all want our kidneys to last for a lifetime. We all should show our love for kidneys by adopting a 10-step program for protecting kidney health. One should begin with monitoring blood pressure and controlling weight and then move on to the rest of the kidney-healthy tips. • Monitor blood pressure and cholesterol.

• Control weight.

• Don’t overuse over-the-counter painkillers.

• Monitor blood glucose.

• Get an annual physical exam.

• Know if chronic kidney disease (CKD), diabetes or heart disease runs in your family. If so, you may be at risk.

• Don’t smoke.

• Exercise regularly.

• Follow a healthy diet.

• Get tested for chronic kidney disease if you’re at risk.

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Any activity should always engage the 3H model – of heart, the head, and the hand. The same has been advocated by the western scholars. The concept means that while doing any work one should ask the head for choices, then refer these choices to the heart to choose one and finally order the hands to do the action. Deepak Chopra also talks about this in great detail in his book The Seven Spiritual Laws of Success. He writes that conscious-based decisions are the best decisions. Before taking any decision he recommends asking the body for the signals of comfort or discomfort and if the signals of discomfort are perceived, then one should not indulge in that action. All these concepts come from ancient Vedic knowledge. The two main mantras are the Mahamrityunjaya Mantra and the Gayatri Mantra. The Mahamritunjaya Mantra comes from the Rig Veda. This is the greatest reliever from all evils: ‘Aum Trayambakam Yajamahe, Sugandhim Pushtivardhanam, Urva Rukamiva Bandhanan, Mrityor Mokshiye Mamritat’. It means ‘we worship Shiva – The Three-Eyed Lord; who is fragrant and nourishes all beings; May he protect us (bandhan) from all big (urva) diseases (aarookam). May he liberate us (mokshiye) from death (mrityor), For the sake of immortality (mamritat, amrit); as the cucumber is automatically liberated, from its bondage from the creeper when it fully ripens.’ The manta speaks of the importance of the third eye and its benefits. The two eyes are at the level of the physical body. The third eye means the eyes of the mind and the soul. It also indicates that in difficulty one should look inward with the eyes of the mind and ask for choices. Like the cucumber, one should choose the good ones and drop the bad choices. (‘Jo acha lage use apna lo; Jo bura lage use jaane do’). The mantra for conscious-based decisions comes from Gayatri Mantra. ‘OmBhur Bhuva Svah Tat Savutur Varenyam Bhargo Devasya Dheemahi Dhiyo Yo Nah Prachodayaat’. It means:‘we meditate on the glory of the Creator; who has created the Universe; who is worthy of Worship; who is the embodiment of Knowledge and Light; who is the remover of all Sin and Ignorance; may He enlighten our Intellect.’ It talks about the importance of conscious-based decisions and its directions to the intellect to choose the right and not the convenient actions. The Gayatri Mantra is the Vedic prayer to illuminate the intellect. Gayatri is considered Vedasara or “the essence of the Vedas”. Veda means knowledge, and this prayer fosters and sharpens the knowledge-yielding faculty. As a matter of fact, the four mahavakyas or ‘core-declarations’ enshrined in the four Vedas are implied in the Gayatri Mantra. Making the right decision from the consciousness was later defined by Buddha. He taught that before any action ask yourself the following four questions and if the answer to any of the questions is ‘no’, then that action should be avoided. These four questions are:

• Is it the truth?

• Is it necessary?

• Will the action bring happiness to you?

• Will the action bring happiness to others?

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Tips for Boosting Memory

By Dr K K Aggarwal
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1. Follow routines, such as leaving your car keys, glasses, and cell phone in the same place every day so that finding them becomes a “no brainer.”

2. Slow down and pay attention to what you are doing to give your brain’s memory systems enough time to create an enduring memory.

3. Avoid distracting or noisy environments and multitasking, the major memory busters in today’s fast–paced society.

4. Get enough sleep, reduce stress, and check with your doctor to see if any of your medications affect memory — all potential memory spoilers. (Harvard Medical School)

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A physical body becomes useless once the life force is gone. The same body, which was lovable to everyone, becomes a liability after death. Everyone wants to dispose it as early as possible as keeping a dead body at home is considered a bad omen.

To transfer of dead body from one place to another, nobody wants to keep the body in a vehicle other than a hearse van, meant to transport dead bodies. No family would be willing to carry the dead body of a person in a car in which the deceased person had been traveling or driving for years.

Once you touch a dead body you are required to take a bath, for any reason, health or ritual, before you commence your daily routine.

Within a matter of hours in absence of life force, the physical body starts disintegrating and in a matter of days, it shows signs of self-destruction and putrefaction.

This vital force is nothing but the soul, atma, brahma, spirit or consciousness described in different Vedic texts.

Adi Shankaracharya in his book Bhaja Govindam shloka 6 says:

Yávat-pavano nivasati dehe

Távat-pøcchati kuùalam gehe,

Gatavati váyau dehápáye

Bháryá bibhyati tasmin káye.(6)

“Till the life force remains in the body, people come and enquire about your welfare. But, the moment the life force goes out, even your wife is afraid of coming anywhere near your body”.

Life force can be equated to the network of information in computer, radio, television or mobile phone. All these gadgets without data are useless and are thrown away. This silent data retrievable by operational and application software represent the life force or soul of these electronic gadgets.

Just as one does not give importance to a computer without data, one should not give importance to the physical body. It is the life force within the body which is respected and cared for and that is what real “I” or “We” are. All glories of the body are only until the life force remains in it. In Bhagavad-Gita, Lord Krishna in Chapter 2 (2.23) says about this life force or ataman “fire cannot burn it, weapon cannot cut it, water cannot wet it, air cannot dry it, it is immortal”.

The life force has no dimensions: height, weight, color or image. It is immortal, omnipotent, omniscient and omnipresent. The weight of a live and a dead body immediately after the death is the same.

It is the same life force, which dwells in everybody and during life is modified by actions, memory and desire cycle. If one gets attached to any of the three, then one starts getting detached from the soul or the life force. People who are in touch with their life force all the time attain peace and happiness and die young in old age.

Most Vedic mahavakyas talk about, that it is the same spirit, which dwells in everybody and hence every person in the society should be welcomed and treated with equal importance. Aham brahmasami, tatwam asi, vasudeva kutumbakam, etc. are a few of the examples.

According to Adi Shankaracharya, one can achieve non-duality only by seeing God in everyone. Athithi-devo-bhava is also based on the same principle.

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Longer chest pain equals bigger MI risk

By Dr K K Aggarwal
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Patients with acute myocardial infarction (MI) have longer duration of chest pain than those without an MI. Patients with chest pain of short duration, less than 5 minutes, are unlikely to have an acute infarction and have a good prognosis at 30 days. A single–center study showed that only 8.9% of the patients received a final diagnosis of acute MI, and these patients had a significantly longer duration of chest pain compared with the rest of the cohort (120 versus 40 minutes) according to Carlos Calle–Muller, MD, of Henry Ford Hospital in Detroit, and colleagues. Those who had chest pain lasting less than 5 minutes always had a good outcome, with no acute MIs or deaths within 30 days, as reported in the journal Critical Pathways in Cardiology. If the clinical assessment and ECG are benign, such patients might be able to be discharged directly from the emergency department without stress testing for outpatient follow-up. The median chest pain duration was 180 minutes among the 10 patients who died and only 40 minutes for the others. Among the patients with acute MI, longer chest pain duration was not associated with higher 30–day mortality, but it was associated with a higher initial level of cardiac troponin-I.

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Express gratitude

By Dr K K Aggarwal
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• Gratitude is a thankful appreciation for what you have.

• Appreciate from a roof over your head to good health to people who care about you.

• Set aside a few minutes every day and think about five large or small things you’re grateful for. Write them down if you like.

• Be specific and remember what each thing means to you.

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Diabetes Update

By Dr K K Aggarwal
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• Morbidity from diabetes involves both macrovascular (atherosclerosis) and microvascular disease (retinopathy, nephropathy and neuropathy).

• Smoking cessation is essential for patients who smoke.

• Cardiovascular morbidity can also be significantly reduced with aggressive management of hypertension, cholesterol (goal LDL less than 80 mg/dL and use of aspirin (8o mg/day) in patients with or at high risk for cardiovascular disease.

• Glycemic control can minimize risks for retinopathy, nephropathy and neuropathy in both type 1 and type 2 diabetes, and has been shown to decrease the risk for cardiovascular disease for type 1 diabetes.

• A1c goal is <7% for most patients.

• More stringent control (A1c <6%) may be indicated for individual patients with type 1 diabetes and during pregnancy.

• A higher target A1c (i.e., <8%) may be preferable for some type 2 patients with comorbidities or with an anticipated lifespan, owing to advanced age or other factors, that is too brief to benefit from the effects of intensive therapy on long–term complications.

• The appropriate target for A1c in fit elderly patients who have a life expectancy of over 10 years should be similar to those developed for younger adults (<7.0%).

• The risk of hypoglycemia, which may lead to impaired cognition and function, is substantially increased in the elderly. Thus, avoidance of hypoglycemia is an important consideration in establishing goals and choosing therapeutic agents in elderly adults.

• In the absence of specific contraindications, start with metformin as initial therapy for all patients with diabetes including the elderly. Start with metformin at the time of diabetes diagnosis, along with consultation for lifestyle intervention. Titrate metformin to its maximally effective dose (usually 2000–2500 mg/day in divided doses) over 1 to 2 months, as tolerated. Metformin should not be administered when conditions predisposing to lactic acidosis are present.

• In patients with contraindications and/or intolerance to metformin, a short–acting sulfonylurea (e.g., glipizide) is an alternative option.

• In patients who are intolerant of or are not candidates for metformin or sulfonylureas, repaglinide is a reasonable alternative, particularly in a patient with chronic kidney disease (CKD) at risk for hypoglycemia. • Start lifestyle intervention first, at the time of diagnosis. The weight gain that accompanies a sulfonylurea will presumably be less if lifestyle efforts are underway. However, if lifestyle intervention has not produced a significant reduction in symptoms of hyperglycemia or in glucose values after one or two weeks, then the sulfonylurea should be added.

• DPP4–inhibitors can be given as monotherapy in elderly patients who are intolerant of or have contraindications to metformin, sulfonylureas, or repaglinide. They are weak agents and only lower A1c by 0.6%. They are given when the A1c level is relatively close to the goal level. DPP–4 inhibitors have no risk of hypoglycemia and are weight-neutral, when used as monotherapy. Sitagliptin or saxagliptin are the choices but more expensive and less potent in lowering glycemia than repaglinide.

• Insulin can also be considered a first–line therapy for all patients with type 2 diabetes, particularly patients presenting with A1c >10%, fasting plasma glucose >250 mg/dL, random glucose consistently >300 mg/dL, or ketonuria.

• Another alternative is a thiazolidinedione, which may be considered in patients with lower initial A1c values or if there are specific contraindications to sulfonylureas.

• Patients who are initially thought to have type 2 diabetes may actually have type 1 diabetes, and therefore require insulin as initial therapy. In patients in whom it is difficult to distinguish type 1 from type 2 diabetes, initial treatment with insulin is required.

• Further adjustments of therapy, which should usually be made no less frequently than every three months, are based upon the A1c result (and the results of home glucose monitoring).

• If inadequate control is achieved (A1c remains >7.0%), another medication should be added within 2 to 3 months of initiation of the lifestyle intervention and metformin.

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as I understand it

By Dr K K Aggarwal
Filed Under Spirituality - Science Behind Rituals | Tagged With: , , , | | Comments Off

Sometimes back, I regarded a ‘will’ to simply mean as to how my finances would be controlled by my wife and children after my death. But, as I started acquiring Vedic knowledge, my interpretation changed. Following is the gist for writing a Will, as I understand it the Vedic way. Of course, writing a will requires a sound state of mind, two witnesses, signed registered paper with accompanying, if possible audio-visual link.

1. The first step is to calculate your life earnings. The earning is not only your finances earned but also your respect, dignity and image earned in the society.

2. Now the next step is to pay off your unpaid debts (Hrins). Apart from actual loans we have taken from banks, friends and others, there are three more debts (Hrins) that we need to pay before we die and define in our Will to be paid from our earning if we die unexpectedly. These as per mythology are Pitra Hrin, Dev Hrin and Rishi Hrin. They means not been able to fulfill the committed desires of our ancestors and commitments made to our God and teachers respectively. All these debts, if unpaid, need to be paid out of the finances you are leaving at the time of death. A percentage of your finances, therefore, should be kept to pay these debts. These commitments are usually fulfilled by the eldest son and eldest daughter if there is no son or wife till she is alive.

3. Rest of my finances need to be divided to fulfill your Dharma, Artha, Kama and Moksha or purpose for which you were born.

a. Artha, a percentage of your finances should go and be equally divided within your immediate family. A percentage of this amount should be converted into a family trust account to be used for the minus 18 years of age children in future.

b. Dharma: Dharma literally means ‘to hold’. A percentage of your finances should be kept into a reserve account and this account interest can be used by the family only if they stick to the code of family conduct (includes rituals, religious activities etc) you have created in your life and mentioned in the will or this amount may be given for charity as defined in your will.

c. Kama and Moksha: Kama means unfulfilled desires at the level of intellect and ego and Moksha the same at the level of our soul. We must enlist both our desires at the level of mind and at the level of soul and a percentage of our finances should be converted into a trust or defined to fulfill these desires. The examples of desires at the level of soul are to do some charitable work without any publicity. The same at the level of ego are to open some dispensary, Dharamshala etc. on our own name. In your desires you also need to fulfill and document your desired rituals at the time of death. These rituals must answer the following questions

i. Should my death be celebrated (band, lunch) as I completed all my purposes of life?

ii. How should my death anniversary be celebrated or observed?

iii. What should be my last rites? Final Note: If my children and wife are not willing to take care of the finances other than Artha, I nominate the following persons to manage my finance to look after my other desires

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