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Dr K K Aggarwal

The best description of the causes and treatment of insomnia comes from Vidura Niti a dialogue between Vidura and Dhritarashtra.

In the text, King Dhritarashtra said: “O Vidura, Sanjaya has come back. He has gone away after rebuking me. Tomorrow he will deliver, in the midst of the court, Ajatashatru’s message. I have not been able today to ascertain what the message is of the Kuru hero. Therefore, my body is burning, and that has produced sleeplessness. Tell us what may be good for a person that is sleepless and burning.

“My body is burning, and that has produced sleeplessness” is a typical description of anxiety and related sleeplessness, true even today.

Vidura said: “Sleeplessness overtakes thief, a lustful person, him that has lost all his wealth, him that has failed to achieve success, and him also that is weak and has been attacked by a strong person”.

He therefore described five basic reasons for insomnia and even in today’s science they are true. No new cause has been added in this list of stress induced insomnia.

The situations are:

  1. A thief
  2. A lustful person
  3. A person who has lost all his wealth
  4. A person who has failed to achieve success
  5. A person who is weak and has been attacked by a strong person.

Ayurveda describes sleep as an aggravation of Vata and Pitta dosha. The number one cause of the same is mental tension; suppressed feelings and acute bitterness. The above five situations again hold true to this effect.

Apart in Allopathy other causes of insomnia mentioned are constipation; dyspepsia; excessive intake of tea, coffee and alcohol and environment Factors-excessive cold, heat or change of environment. They are in most of the situations the effect and not the cause of insomnia.

The treatment of insomnia involves either suppressing the emotions with drugs or root level eradication of stress with proper counseling. Bhagavad Gita, Chanakya Niti and Vidur Niti are high level counseling books of ancient era and provide texts and sutras even true today.

Bhagavad Gita was a counseling when Arjuna went in an acute anxiety state and was not being able to decide whether or not he should fight with his near ones. He said: my legs are trembling, my bows are leaving me, by body is shaking, what should I do”. The principles of Gita today are incorporated as the principles of any counseling.

Chanakya gave principles of how to manage conflicts and win over others. One of his main teachings was that money earned by unfair means can only last for eight years.

Another answer to insomnia is learning meditation as described in Patanjali Yoga Sutra or Yoga Vashistha. It is based on the principle of concentrating on the present, which shifts the inner environment from sympathetic to para sympathetic mode. 20 minutes of meditation morning and evening provides the same biochemical benefit as gathered from 7 hours of deep sleep.

Here are some other sutras of Vidura Niti:

  1. Do not inhabit a country where you are not respected, cannot earn your livelihood, have no friends, or cannot acquire knowledge. (1.8)
  2. Do not reveal what you have thought upon doing, but by wise counsel keep it secret, being determined to carry it into execution. (2.7)
  3. Consider again and again the following: the right time, the right friends, the right place, the right means of income, the right ways of spending, and from whom you derive your power. (4.18)
  4. A wise man should not reveal his loss of wealth, the vexation of his mind, the misconduct of his own wife, base words spoken by others, and disgrace that has befallen him. (7.1)

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

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  1. Low functioning thyroid is a new epidemic of the society affecting more than 3% of people. If thyroid function is low, it causes weight gain, loss of energy, cold intolerance and menstrual irregularities in women.
  2. All people who are aged 50 and above should have their thyroid profile (TSH test) done to look for thyroid deficiency.
  3. In younger people, or in cases of infertility, menstrual irregularity, pregnancy, weight gain, one should check for thyroid deficiency.
  4. Iodized salt should be used to prevent thyroid deficiency.
  5. Non–iodized salt is only used in two conditions: firstly in patient with thyroid inflammation and secondly, while doing Jalneti in naturopathy, a yoga–related nasal wash technique.
  6. Even mild thyroid deficiency in pregnancy can affect the growth of fetus; hence, dose requirement of thyroid medicine is much higher in pregnancy than in non–pregnancy.
  7. In the elderly, the dose of thyroid medicine to be started is always low as compared to one in the adults.
  8. If thyroid deficiency is untreated, osteoporosis (thickening of bone) and/or atrial fibrillation (irregular and fast heart rate) may result. Osteoporosis can cause recurrent fractures and atrial fibrillation may cause brain paralysis.
  9. In Allopathic medicine, thyroid deficiency is treated by synthetic T4 hormone replacement. In TFSP, thyroid extracts are available, which contain both T4 and T3 potential drugs.
  10. In Ayurveda, thyroid stimulant drugs are available but they are effective only if some amount of thyroid gland is available.
  11. As per Ayurveda, eating soya and drinking water from copper vessel is good for thyroid.
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Honest people regard everybody as honest and dishonest people regard everybody as dishonest. It all depends on the type of people you interact with. If you do not take bribe, nobody will come and offer bribe to you and you will feel everybody is honest. If you take bribe then everybody will come to you to offer bribe and you will feel that everybody in the society is dishonest.

Never judge people with your personal experience. I recall a doctor saying that every doctor takes and gives bribe because he was running an imaging center and every doctor who approached him asked for a bribe. But he did not take into consideration the doctors who did not approach him.

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

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Typhoid fever

By Dr K K Aggarwal
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Typhoid fever is caused by a bacteria Salmonella typhi and is transmitted through the ingestion of food or drink contaminated by the feces or urine of infected people.

Flying insects feeding on feces may occasionally transfer the bacteria through poor hygiene habits and public sanitation conditions. Though the cases occur all through the year, the number is higher during the summer and rainy seasons. Symptoms usually develop 1 to 3 weeks after exposure, and may be mild or severe. They include high fever, malaise, headache, constipation or diarrhea and enlarged spleen and liver. A healthy carrier state may follow acute illness. Typhoid fever can be treated with antibiotics. However, resistance to common antimicrobials is widespread. Healthy carriers should be excluded from handling food. Sanitation and hygiene are the critical measures that can be taken to prevent typhoid.

  1. Typhoid does not affect animals and therefore transmission occurs only from human to human.
  2. Typhoid can only spread in environments where human feces or urine are able to come into contact with food or drinking water.
  3. Careful food preparation and washing of hands are crucial to preventing typhoid.
  4. Typhoid fever in most cases is not fatal.
  5. Prompt treatment of the disease with antibiotics reduces the case-fatality rate to approximately 1%.
  6. When untreated, typhoid fever may persist for three weeks to a month.
  7. Resistance to common antibiotics is now common.
  8. Typhoid that is resistant to common antibiotics is known as multidrug-resistant typhoid (MDR typhoid).
  9. Ciprofloxacin resistance is an increasing problem, especially in the Indian subcontinent and Southeast Asia.
  10. Typhoid vaccine taken every three years is the best preventive approach.
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The Tilak is a mark of auspiciousness and invokes a feeling of respect in the wearer and others. It is recognized as a religious mark. Its form and color vary according to one’s caste, religious sect or the form of worship of the person in question. Tilak is applied on the forehead with sandal paste, sacred ash or kumkum, a red turmeric powder. In a wedding, a Kumkum tilak is applied on the forehead of both the bride and groom.

In earlier times, the four castes (based on varna or color) – Brahmana, Kshatriya, Vaishya and Shudra – applied marks differently. The Brahmin applied a white chandan mark signifying purity, as his profession was of a priestly or academic nature. The Kshatriya applied a red kumkum mark signifying valor as he belonged to the warrior race. The Vaishya wore a yellow kesar or turmeric mark signifying prosperity as he was a businessman or trader devoted to creation of wealth. The Shudra applied a black bhasma, kasturi or charcoal mark signifying service as he supported the work of the other three castes.

The devotees of Shiva apply sacred ash (Bhasma) on the forehead as a Tripundra (three parallel horizontal lines); the devotees of Vishnu apply sandal paste (Chandan) in the shape of “U” and the worshippers of Devi or Shakti apply Kumkum. The tilak is applied in the spot between the eyebrows, which is the seat of memory and thought. It is known as the Aajna Chakra in the language of Yoga. The Tilak is applied with the prayer – “May I remember the Lord. May this pious feeling pervade all my activities. May I be righteous in my deeds.” Even when we temporarily forget this prayerful attitude, the mark on another reminds us of our resolve. The tilak is thus a blessing of the Lord and a protection against wrong tendencies and forces. The entire body emanates energy in the form of electromagnetic waves – the forehead and the spot between the eyebrows especially so. That is why worry generates heat and causes a headache. The tilak cools the forehead, protects the wearer and prevents energy loss. Sometimes the entire forehead is covered with chandan or bhasma.

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

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Sugar, not salt contributes to the majority of the hypertension risk associated with processed food and a reduction in the consumption of added sugars and, in particular, processed foods may translate into decreased rates of hypertension as well as decreased cardiometabolic disease.

James J. DiNicolantanio, PharmD, from Saint Lukes Mid America Heart Institute in Kansas City, Missouri, and Sean C. Lucan, MD, MPH, from Albert Einstein College of Medicine in Bronx, New York, published their review of epidemiological and experimental studies in the journal Open Heart. They concluded that high-sugar diets may make a significant contribution to cardiometabolic risk.

Highly refined processed foods should be replaced by natural whole foods.

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Exercise impact on the knee

By Dr K K Aggarwal
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Different exercises produce different impact on the knee joints. The best and safest exercises causing minimum impact on the knee for patients post knee replacement or knee arthritis are walking, biking, hiking, riding an exercise bike, riding an elliptical trainer and walking on the treadmill. In sports one can play doubles tennis and not singles. One can also participate in downhill or cross–country skiing. The maximum stress–producing exercises are jogging and golf swings.

Impact

  1. Biking generates the least force, producing impact of about 1.3 times the person’s body weight.
  2. Treadmill walking was next best, producing forces of 2.05 times the body weight.
  3. Walking on level ground generated forces of 2.6 times the body weight.
  4. A game of tennis produces forces of 3.1 to 3.8 times the body weight; serving produces the highest impact.
  5. Jogging produced forces of 4.3 times body weight.
  6. Golf swings produces forces of 4.5 times body weight on the forward knee and 3.2 times body weight in the opposite knee.
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