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Dr K K Aggarwal

Adverse drug reactions are preventable

By Dr K K Aggarwal
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Over 50% of all adverse drug reactions treated in hospitals and emergency care are preventable. Many preventable drug reactions like drug overdoses and internal bleeding associated with the improper use of blood thinners and painkillers are life–threatening, especially in the elderly. There are many reasons for these reactions and may include poor coordination of care, lack of time and knowledge among health professionals, and lack of patient education, according to Swedish researchers, who conducted a meta–analysis of 22 studies. Human error is inevitable, and therefore systems must be made to reduce the error. The study concluded that:

  • In outpatient setting, the frequency of preventable adverse drug reactions resulting in hospitalization or emergency treatment is 2%; of these, 51% are preventable.
  • In the elderly, 71% of drug reactions are preventable.
  • In admitted patients the frequency of harmful drug reactions is 1.6% and 45% of them are preventable.
  • A third of preventable adverse drug reactions are life–threatening.

On 6th Navratri chant AUM

By Dr K K Aggarwal
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Mata Katyayani is worshipped on the sixth day of Navratri. SHE has three eyes and four hands and rides on a Lion.

The top right hand is positioned in a gesture of providing courage and the other hand is positioned in a gesture of rendering a boon. The top left hand is holding a sword and the other holding a lotus.

In Yoga Shastra she represents the Ajna Chakra and AUM bija mantra. AUM chanting helps attaining success in religion, wealth, passion and salvation and removing fear and sorrows.

Spiritual mantra on the 6th Navratri

AUM chanting is one of the most powerful chakra and should be done concentrating on the Ajna chakra.

B12 deficiency can present with recent memory loss

By Dr K K Aggarwal
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If you are forgetting things instead of worrying that you are going towards dementia, get your vitamin B 12 levels done.

Animal products (meat and dairy products) provide the only dietary source of B12 (Cbl) for humans. Strict vegans avoid all animal products, and are at risk of developing nutritional Cbl deficiency. The usual western diet contains 5 to 7 micrograms of cobalamin per day, while the minimum daily requirement is 6 to 9 micrograms per day. Total body stores of Cbl are 2 to 5 milligrams and one-half of this is in the liver. It takes years to develop vitamin B12 deficiency after absorption of dietary B12 ceases.

There is a link between infection with Helicobacter pylori (as seen in peptic ulcer) and low serum B12 levels. Mild and usually subclinical cobalamin deficiency can also occur in 24% of the elderly. About 10 to 30 percent of patients taking metform inj (diabetics, obesity, and polycystic ovarian disease) have impaired Cbl absorption and lower B12 levels, which can be reversed with supplemental oral calcium. Prolonged use of omeprazole (given for acidity) can result in Cbl deficiency. Women who are only moderate vegetarians may become Cbl deficient during pregnancy and lactation; their infants may also be Cbl deficient.

We give up leisure in order that we may have leisure, just as we go to war in order that we may have peace. Aristotle

On 5th Navratri Learn Detached Attachment and to Control One’s Ego

By Dr K K Aggarwal
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Skanda Mata is worshipped on the fifth Day of Navratri. SHE is holding her son ‘Skandaa or Kartikaya’ on her lap.

SHE has three eyes and four hands. Two hands hold lotuses while the other two hands respectively display defending and granting gestures.

She is the ocean of knowledge. She rides on a lion.

In Yoga Shastra, she represents the Vishuddha chakra and HAM bija mantra. She also dignifies motherhood, fertility and mother child relationship.

Skandaa means the one with six heads corresponding to the five senses and the mind or the one who has a control over the six demonic vices: kaama (sex), krodha (anger), lobha (greed), moha (passion), mada (ego) and matsarya (jealousy).

Kartikeya carries a spear in one hand and his other hand is always blessing devotees. His vehicle is a peacock, a pious bird that grips with its feet a serpent, which symbolizes the ego and desires of people. The peacock represents the destroyer of harmful habits and the conqueror of sensual desires.

Spiritual mantra on the 5th Navratri One should learn detached attachment as the main principle of spirituality.

Psoriasis patients may be at an increased risk for type 2 diabetes, and the risk appears to be greatest among patients with severe psoriasis.

By Dr K K Aggarwal
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Compared with the general population, patients with mild psoriasis had a 49% increased risk of developing diabetes, and individuals with severe psoriasis had a 2.13-fold increased relative risk when compared with the general population, said Dr Ole Ahlehoff, post-doctoral fellow in cardiology at Copenhagen University Hospital Gentofte at the European Society of Cardiology meeting.

Kushmanda is worshipped on the fourth day of Navratri. SHE shines brightly with a laughing face.

By Dr K K Aggarwal
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Out of eight hands (Ashtabhuja) in her four arms, she carries weapons like bow, arrow, discus and mace. In other three hands, she holds a lotus, a beaded rosary and a Kamandalu. In the remaining hand, she carries a jar of nectar.

SHE rides on Lion. Rosary represents her power to bless her devotees with Ashtasiddhi (eight types of studies or wisdom sources) and Navanidhi (nine types of wealth). In Ayurveda, SHE represents the control over the air element.

In Yoga Shastra, SHE represents the heart or Anhata Chakra with the Bija sound YAM.

Spiritual mantra on the 4th Navratri

One should continuously (beaded rosary) control the air (anahata plexus) within us by using our sharp intelligence (sword) and balancing the mind (Trishul) by focusing on one point (arrow and bow), practicing detached attachment (lotus), accepting things as they are (Kamandalu), keep smiling in both acceptable and difficult situations (smiling face) and killing the negative energies by using discus (power) when needed.

Give BP Drugs at Night

By Dr K K Aggarwal
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Blood pressure drugs should be taken at night.

Uncontrolled blood pressure can lead to heart attacks, paralysis and heart failure. Most such attacks occur in the early morning hours. Pulse, blood pressure and thickening of platelets are all higher in the early morning hours.

Controlling early morning blood pressure can reduce cardiovascular mortality.

According to a study published in the Journal of the American Society of Nephrology, among patients with chronic kidney disease and high blood pressure, taking at least one antihypertensive drug at bedtime significantly improves blood pressure control, with an associated decrease in risk for cardiovascular events.

The study included 661 patients with chronic kidney disease who were randomly assigned either to take all prescribed anti BP drugs on awakening or to take at least one of them at bedtime. Patients were followed for a median of 5.4 years; during that time, patients who took at least one BP-lowering drug at bedtime had approximately one third of the cardiac risk compared with those who took all medications on awakening.

A similar significant reduction in cardiac deaths, heart attacks and paralysis was noted with bedtime dosing. Patients taking their medications at bedtime also had a significantly lower mean BP while sleeping.

For each 5 mmHg decrease in mean sleep-time systolic upper BP, there was a 14% reduction in the risk for cardiovascular events during follow-up.

Potential explanation for the benefit of night time treatment may be associated with the effect of night time treatment on urinary albumin excretion levels. Urinary albumin excretion is significantly reduced after bedtime, but not morning, treatment.

On 3rd Navratri control your fire and negative energies

By Dr K K Aggarwal
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Chadraghanta is worshipped on the third day of Navratri. SHE is shown with golden skin and riding a tiger. She is depicted with ten hands and 3 eyes with a crescent moon on the head. Eight of HER hands display weapons. The rest two are in the mudras or gestures of boon giving and stopping harm (Varada and abhay mudra) indicating protection.

Out of her eight hands, five hold:

1&2. Bow and arrow (to bend, focus, one point determination. The bow and arrow also represent energy. Holding both the bow and arrow in one hand indicates control over both potential and kinetic energies)

Trishul (balance)

Sword (sharp intelligence)

Mace (power to destroy the evil).

Rest three hands fold:

Rosary (tapas)

Lotus (detached attachment)

Kamandalu (acceptance).

In Ayurveda, SHE represents the control over the fire element. In Yogashastra SHE represents the solar or Manipura Chakra with the Bija sound RAM.

Sound of her bell terrifies demons as well as all enemies. SHE represents protector and bravery.

Spiritual mantra on the 3rd Navratri

One should continuously (beaded rosary) control the fire (solar plexus) within by using our sharp intelligence (sword) and balancing the mind (Trishul) by focusing on one point (arrow and bow), practicing detached attachment (lotus), accepting things as they are (Kamandalu) and killing the negative energies by using gada (power) when needed.

Singhara flour – a favorite Navratre diet

By Dr K K Aggarwal
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During Navratra fasts, wheat flour should be omitted from diet and be substituted with water chestnut (Singhara) or buckwheat (kuttu) flour, said Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President Elect IMA. Singhara is not a cereal but a fruit and hence a good substitute for a Navratra fast where cereals are not to be eaten.

  • Singhara flour is prepared from Singhara or Water Chestnut.
  • Singharas are floating aquatic plants, growing in slow–moving water up to 5 meters deep. The plant bears ornately shaped fruits containing a single very large starchy seed.
  • The seeds or nuts are boiled and sold as snacks or eaten raw.
  • The flour is made from dried, ground water chestnuts. The nuts are boiled, peeled, dried then ground into flour. The flour is bright white fine powder; it is actually a starch rather than flour.
  • The flour is primarily used as a thickener.
  • The flour is used as food in Navratra and consumed as phalahar (fruit) diet.
  • It is an excellent source of energy and provides 115 kcals per 100g.
  • The glycemic index for chestnut is 60. Low GI foods have a GI value less than 55; medium GI foods have a GI value between 55 and 69 and high GI foods have GI value greater than 70.
  • Chestnuts are relatively low in net carbs (total carbohydrate minus dietary fiber) and so are included in many low carb diets.
  • Being a gluten–free product, chestnut flour is a cooking option for people with celiac disease or other gluten intolerances or allergies.
  • Chestnuts do not contain the fat that regular nuts have.
  • It contains less carbohydrate than white flour.
  • People with tree nut allergies should avoid chestnut flour as it may cause an allergic reaction.
  • Flour made from chestnuts is typically more difficult to locate in many areas as well as more expensive than white flour.
  • Avoid eating deep fried chestnut flour pooris or paranthas.
  • Do not use trans fats containing vegetables oils to cook bread from chestnut flour.
  • Buy only branded flour as flour left over from the previous year can lead to food poisoning.
  • As per Ayurveda, chestnut flour has cool and buckwheat flour has hot properties.
  • Both chestnut flour and buckwheat flours can be combined.
  • One should eat phalahar once a week and at least 80 days in a year.

On 2nd Navratri Let Go of Your Impure Thoughts

By Dr K K Aggarwal
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Brahmacharini (Uma or Tapacharini) is worshipped on 2nd day of Navratri as the goddess who performed ‘Tapa’ (penance or continuous efforts) (Brahma – Tapa, Charini – Performer).d

SHE personifies love and loyalty and provides knowledge and wisdom. Those who worship her, attain, Tap (Religious Austerity), Tyagi (Sacrifice), and Vairagya (Asceticism).She is shown to hold Japa mala (rosary beads) in her right hand and Kamandalu in left hand.

This form of Shakti as per Yoga Shastras is present in second gonad chakra (in Allopathy gonad plexus) called Svadhisthana Chakra. The bija sound for the chakra is VAM, which removes attachments. In Ayurveda, the 2nd chakra represents the water element. In mythology ‘white’ represents purity of mind; beaded rosary or japa mala represents continuous efforts (meditation and concentration) and Kamandalu represents acceptance and water in it represents pure thoughts.

Kamandalu also means living an egoless state of mind. Kamandalu is a water pot made from dry pumpkin; it contains nectar and is shown on the ground next to Shiva. The process of making Kamandalu has deep spiritual significance. A ripe pumpkin is plucked from a plant, its fruit is removed and the shell is cleaned to hold the nectar. In the same way, an individual must break away from attachment to the physical world and clean his inner self of egoistic desires in order to experience the bliss of the Self, symbolized by the nectar in the Kamandalu.

Spiritual mantra on the 2nd Navratri

“Purify the mind (white cloths) with continuous efforts (japa mala) by accepting the things and situations as they are (kamandalu) and building humility in the mind (egoless state)”

Navratra: Time to eat buckwheat flour

By Dr K K Aggarwal
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Navratra is the time when wheat flour is omitted from the diet and substituted it with buckwheat flour or kuttu ka aata. Buckwheat is not a cereal grain; it is a fruit and hence is a good substitute for Navratra fasts where cereals are prohibited.

  1. The flour is extremely high in protein and is a wonderful substitute for those who are allergic to gluten (found in wheat).
  2. It is good for patients with celiac disease as it is gluten-free.
  3. It contains phytonutrient rutin, which lowers cholesterol and blood pressure.
  4. It is rich in magnesium, vitamin B, iron, calcium, folate, zinc, copper, manganese and phosphorus.
  5. As the buckwheat hulls are hard to chew, traditionally they are soaked for about six hours and then cooked to make them softer and easily digestible.
  6. It also contains alpha linolenic acid, which increases HDL cholesterol (“good” cholesterol) and controls LDL cholesterol (“bad” cholesterol).
  7. It is a good source of insoluble fiber and prevents occurrences of gallbladder stones. According to the American Journal of Gastroenterology, a 5 % increase in the insoluble fiber intake results in a 10% reduced risk of gall-bladder stones.
  8. Kuttu is 75% of complex carbohydrates and 25% of high quality protein, which makes it an ideal food for weight loss.
  9. As the flour is gluten-free, a potato is used to bind the flour together.
  10. The flour tastes different.
  11. Pooris made from kuttu flour are crunchier than the normal wheat flour pooris.
  12. One should not make pooris with hydrogenated oils or vanaspati as it will take away all the medical benefits of buckwheat flour.
  13. Buckwheat flour however is subjected to adulteration.
  14. Mixtures of rye flour, Indian corn flour, wheat flour, and other ground cereals are often used as a substitute for buckwheat.
  15. Being high in fiber and low glycemic index it is good substitute for diabetic patients. The glycemic index for buck wheat is 47 (Low GI foods have a GI value less than 55; medium GI foods have a GI value between 55 and 69 and high GI foods have GI value greater than 70).
  16. The chiro-inositol present in buckwheat has been identified as the diabetes preventing component.
  17. Asthma symptoms can occur in sensitized children when food allergens such as buckwheat are cooked in a confined area. Both acute and late-phase respiratory symptoms are seen.
  18. Eat kuttu ki roti instead of poori or pakodas (fried items) made from kuttu atta (buckwheat flour).
  19. One can also prepare idlis from kuttu atta (buckwheat flour) and dosa from the samak rice (non grain seed)
  20. Food poisoning may occur if flour left over from the previous year is reused.

On 1st Navratri Let Go Your Desires

By Dr K K Aggarwal
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Navratri is the detoxification of body, mind and soul. Body detoxification means:

  1. Eating less.
  2. No cereals. You can take wheat grass juice.
  3. Eating once if possible.
  4. Satvik lifestyle.

In Navratri diet

  1. Wheat flour is replaced with Kuttu or Singhara flour.
  2. Pulses are replaced with amaranth or Rajgiri.
  3. Rice with Samak rice.

Mental and soul detoxification can be done by practicing Yoga Sadhna as described in nine forms of Durga. As per mythology, Mata Shailputri is daughter of the mountain king, Himalaya. She is the first among nine avatars of Durga and worshipped on the 1st day of Navratri. In Yogashastra, she represents the lowest Muladhara chakra. The bija sound to chant is LAM in the sacral root area. In Allopathy, she represents activation of sacral autonomic plexus.

The Goddess has a half moon on her forehead and is depicted holding a trident (trishul) in her right hand and a lotus flower in her left hand. She rides on Nandi, a bull. Shailputri represents the shakti or power of the root chakra, who, upon awakening, begins Her journey upwards in search for the last crown chakra (Shiva). Bull in mythology represents ‘desires’. On the first day we must let go our desires. Trishul represents balancing Tamas, Rajas and Satwa. Lotus represents practicing detached attachment. We are required to donate all Rajsik and Tamsik foods and items so that we are not attracted during Navratra. Moon symbolizes thinking with a cool mind.

In Navratri pooja on the first day, yogis keep their mind concentrated on Muladhara chakra as the starting point of spiritual discipline or Yoga Sadhna.

What to do on first day

  1. Let go your desires
  2. Keep the mind cool
  3. Practice detached attachment
  4. Balance Tamas and Rajas guna with Satwa or to stay in balance.
  5. Concentrate on Muladhara chakra (sacral root)
  6. Chant LAM reducing the respiratory rate to 2-4 per minute.
  7. In Ayurveda, muladhara chakra represents the earth element (attachments).

Mantra

On the first day control (riding), your desires (bull) by balancing (Trishul) the mind with cool thoughts (moon) and practicing detachment (lotus). This can be assisted by chanting LAM focusing on sacral chakra.”

Heart attack symptoms in women and elderly are different

By Dr K K Aggarwal
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Winter is the month for heart attacks and the symptoms in women and the elderly may be different

  • Chest pain is still the most common sign of a heart attack for most women but women are more likely than men to have symptoms other than chest pain or discomfort when experiencing a heart pain. In a study published in the Archives of Internal Medicine, researchers examined 35 years of research that yielded 69 studies and found that, between 30 and 37 percent of women did not have chest discomfort during a heart attack. In contrast, 17 to 27 percent of men did not experience chest discomfort.
  • Older people are also more likely to have heart attack without chest discomfort. Absence of chest discomfort is a strong predictor for missed diagnosis and treatment delays.
  • Women are also more likely than men to experience other forms of cardiac chest pain syndromes, such as unstable angina, and they appear to report a wider range of symptoms associated with acute coronary syndrome (ACS). They are more likely to report pain in the middle or upper back, neck, or jaw; shortness of breath; nausea or vomiting; indigestion; loss of appetite; weakness or fatigue; cough; dizziness; and palpitations.
  • Women are, on an average, nearly a decade older than men at the time of their initial heart attack. Coronary heart disease is the leading cause of death among U.S. women, and affects one in 10 women over the age of 18

Why Spirituality is wellbeing-friendly

By Dr K K Aggarwal
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  1. What you believe in can have a big impact on health and longevity. People with high levels of religious beliefs or spirituality have lower cortisol responses. Cortisol is a hormone the body releases in response to stress.
  2. Positive thinking produces nearly a 30 percent drop in perception of pain.
  3. Spirituality and the practice of religion are associated with a slower progression of Alzheimer’s disease.
  4. Those who regularly attend organized religious activities may live longer than those who don’t. Regular participation lowers mortality rate by about 12 percent a year.
  5. People who undergo cardiac rehabilitation feel more confident and perceive greater improvements in their physical abilities if they have a strong faith.
  6. Increased levels of spirituality and religious faith may help substance abusers kick their habit.
  7. Spirituality stimulates the relaxation response. When the body is relaxed, your heart rate, blood pressure and breathing rate all go down, which decreases the body’s stress response.
  8. Spirituality can affect immune-system function. Spirituality, faith, church attendance improves immune function in ways that can be measured, like an increase in white blood cells.
  9. Prayer heals the heart. Positive talking and thinking in the ICU produces better results.
  10. Spirituality is what brings you peace and safety. It can be achieved through God or Goddess, nature, a beautiful sunset, a meditation, Pranayama, religious meeting, chanting, mind body relaxation, etc. Spirituality is something that can help all the way from promoting wellness to helping with recovery.

Four of the best exercises you can ever do

By Dr K K Aggarwal
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  • Swimming. It is a perfect exercise. Swimming is good for individuals with arthritis because it’s less weight–bearing.
  • Strength training. Lifting light weights won’t bulk up your muscles, but it will keep them strong. If you don’t use muscles, they will lose their strength over time.
  • Walking. Walking is simple yet powerful. It can help you stay trim, improve cholesterol levels, strengthen bones, keep blood pressure in check, lift your mood, and lower your risk for a number of diseases (diabetes and heart disease, for example).
  • Kegel exercises. These exercises won’t help you look better, but they do something just as important — strengthen the pelvic floor muscles that support the bladder. Strong pelvic floor muscles can go a long way toward preventing incontinence. While many women are familiar with Kegels, these exercises can benefit men too.

To do a Kegel exercise correctly, squeeze and release the muscles you would use to stop urination or prevent you from passing gas. Alternate quick squeezes and releases with longer contractions that you hold for 10 seconds, and then release for 10 seconds. Work up to three sets of 10–15 Kegel exercises each day.