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Dr K K Aggarwal

Depression Should Be Treated In Patients with Diabetes

By Dr K K Aggarwal
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Presence of depression in diabetic patients is the most important factor leading to erectile dysfunction in such patients.

An India cum US study published in the Journal of Urology, depression and erectile dysfunction are related to each other in the form of a vicious cycle. Depression instigates erectile dysfunction and erectile dysfunction perpetuates the symptoms of depression.

  1. India is the diabetic capital of the world and both the incidence and prevalence of diabetes are increasing day by day.
  2. It is, therefore, important for the family physician to look for presence of depression in patients with diabetes.
  3. Diabetic patients who complain of erectile dysfunction in the study also have higher prevalence of high blood pressure and cholesterol abnormalities. These patients were also of older age with uncontrolled diabetes, history of smoking and longer duration of diabetes.

It was also shown that patients who develop erectile dysfunction also had diabetes, eye disorders, neuropathy and peripheral vascular disease.

Effective control of diabetes may reduce both depressive symptoms and erectile dysfunctions in such cases.

The Concept of Second Opinion

By Dr K K Aggarwal
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In legal system when you are not satisfied with a judge, you re–appeal in the same court and if you are still not satisfied, you go to double bench before going to higher court.

Practice the same when you take a second opinion about your health.

Never go to a different doctor. First go to the same doctor and ask him to give his opinion again and, if you are not satisfied, then go to a team of two doctors and finally go to a doctor with qualification higher than the initial doctor. If your second opinion is from another doctor, it may invariably be wrong or partial.

Can blood pressure be higher in one arm?

By Dr K K Aggarwal
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A small difference in blood pressure readings between arms is normal. However, a difference of more than 20 mm Hg for systolic pressure (top number) or more than 10 mm Hg for diastolic pressure (bottom number) can be a sign of an underlying narrowing of the main arteries to that arm.

A difference of 10 to 15 mm Hg for upper systolic pressure that shows up repeatedly is a risk marker for vascular disease and future heart attacks.

Always have the doctor check both your arms for blood pressure and whichever is higher, use that arm for future blood pressure readings.

My answer is yes; now tell me your problem

By Dr K K Aggarwal
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This was the best statement I have ever come across in my life. One of the medical superintendents at Moolchand Hospital when he joined had this statement on the wall behind him. It clearly indicates that he was sitting to solve the problem and not to create problems.

If all the service provider agencies follow this statement, the scenario of the country can change. Our job should be to solve problems and not find mistakes. None of us is 100% truthful, honest or hardworking. Each one of us will have some positive points and some negative points. Our job should be to remove our negative points and convert them into positive.

Remember, the SWOT analysis taught in marketing i.e. “Strength, Weakness, Opportunity and Threat”. Our job should be to convert our weakness into strength and threat into opportunities.

Choose to become a father before you are 40

By Dr K K Aggarwal
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Men should think about becoming fathers much before 40 years in order to minimize the effects of age on fertility and outcomes of pregnancy. The ideal age to become a father is between 25–35 years.

The age of sperm donors as per recommendations should be less than 40 years of age. Beyond this age, the sperm quality is reduced considerably and this may adversely affect fertility and pregnancy outcomes.

Researchers from the French National Institute for Medical Research has reported that miscarriages rates were higher in women whose partners were older than 40 years when compared to women whose partners are young men. This risk doubled when their partners were 45 years of age.

Older fathers are more likely to have a child with schizophrenia, heart defects, cleft lip, Down syndrome or a child being born autistic are higher if the age of the father is more than 40.

In women, pregnancy after 35 years of age is generally regarded as high risk with greater chances of birth defects and miscarriages. But, according to the researchers, the age of the male should also be taken into consideration by gynecologists.

Negative Thoughts Are Absence Of Positive Thoughts

By Dr K K Aggarwal
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Darkness cannot be removed physically; it can only be removed by switching light or going into sunlight or lighting fire. Similarly negative thoughts are absence of positive thoughts.
In Bhagavad Gita also it has been said that the period of Uttarayana with longer days, the first half at full moon, in the presence of light or agni, one acquires more positive thoughts as compared in Dakshinayana before Amavasya or no moon or in absence of light.
Bhagavad Gita also says that whatever you think the whole life, you think at the time of death and if the time at the time of death you have positive thoughts, you are likely to get Moksha. That may be the reason why in Hindu mythology it is said that just before the death, we should light a diya or chant in front of agni (fire) so that dying person’s thoughts become positive.
In computer language, it is explained that when you open a file repeatedly, it becomes a priority file and comes in search engine on priority as compared to other files.

Blood pressure measurement may detect proneness to heart attack

By Dr K K Aggarwal
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The ankle–brachial index (ABI), a simple, non–invasive 10–minute test should be incorporated into a routine physical exam for diagnosing peripheral arterial disease in the middle aged and the elderly, especially those with heart attack risk factors like smokers, diabetics and the ones with high BP or cholesterol levels.

With the patient in a supine position, the doctor takes blood pressure readings from both arms; he then takes blood pressure readings from both ankles with a sphygmomanometer and Doppler device. ABI value is calculated by dividing the higher systolic pressure in each leg by the higher systolic brachial pressure.

ABI scores should be interpreted as follows:

  • Greater than 0.90: Normal
  • 0.71 – 0.90: Mild obstruction
  • 0.41 – 0.70: Moderate obstruction
  • Less than 0.40: Severe obstruction
  • More than 1.30: Calcification of the vessels

Presence of peripheral arterial disease may indicate associated blockages in the heart and proneness to heart attack or paralysis.

Why is Ganesha worshipped in every pooja?

By Dr K K Aggarwal
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Every Hindu ritual traditionally begins with a prayer to Lord Ganesh. The wedding ceremony too begins with a pooja of Lord Ganesha invoking him to bless the couple and to ensure that the ceremony goes off well.

Ganesha, the son of Shiva and Parvati, is the harmonious Aacharan or characteristic disposition of man. Remembered and ritually worshipped before starting a new venture, the entity of Ganesha has in store the facets of a complete man.

Ganesha’s head that of an elephant, represents wisdom, intelligence and a healthy mind capable of making sound decisions. Think before you speak, implies Ganesha’s head.

The big ears of this elephant deity signify the lending of a patient ear to the echo produced by others’ deeds and speech. It is said that half the dispute is resolved by patiently lending an ear to the words of the other. It also denotes that one must patiently listen to all sides before reaching a decision.

Ganesha’s extremely small mouth characteristically represents the need for a limited dialogue and the vanity of talking too much.

Overexpression through words results in unsought–for problems which could have been avoided.

Ganesha’s small eyes highlight the need for a focused outlook in life. Such an outlook not only re–defines and foresees the right goals, but also relieves one from the stress–manifested episodes in life.

The long trunk identifies with the power of discrimination. Ganesha’s long nose has the strength to uproot a tree and the competency of picking up a pin from the ground. Such should be the approach of an individual who should be capable of perceiving the good and bad for one’s own self, and then have the strength to overcome these against all odds.

The tusks and the small teeth of Ganesha tell us to maintain a balance between loss (broken tooth) and gains (whole tooth) in the life. Man ought to maintain his mental state so that ups and downs do not deter him from his honest endeavors.

The ample stomach of Ganapati Deva advocates the need for retaining information. Acquiring knowledge, utilizing it and retaining it for years to come, is the crux of ‘big–belly commandment’.

The Char–Bhuja Dhari Ganesha, further represents strength by virtue of his four hands in which the Lord entraps his attachments, desires and greed. Two of the arms of Ganesha, which hold a rope, symbolize control over the attachments. The laddoo or sweet in one shows command over desires and earthly delusions.

The mouse sitting near the feet of Ganesha represents greed and gluttony upon which the Almighty rides, exhibiting control over evils.

Ganesha’s physical traits are an assembly of the characteristics most desired in an individual of substance.

Work-related Stress can kill

By Dr K K Aggarwal
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Job stress raises the risk of heart disease by disrupting the body’s internal systems.

The findings from a long–running study involving more than 10,000 British civil servants also suggest stress–induced biological changes may play a more direct role than previously thought.

The researchers measured stress among the civil servants by asking questions about their job demands such as how much control they had at work, how often they took breaks, and how pressed for time they were during the day.

The team conducted seven surveys over a 12–year period and found chronically stressed workers – people determined to be under severe pressure in the first two of the surveys – had a 68 percent higher risk of developing heart disease. The link was strongest among people under 50.

Stressed workers also eat unhealthy food, smoke, drink and skip exercise – all behaviors linked to heart disease.

In the study, stressed workers also had lowered heart rate variability – a sign of a poorly–functioning weak heart – and higher–than–normal levels of cortisol, a “stress” hormone that provides a burst of energy for a fight–or–flight response.

Too much cortisol circulating in the blood stream can damage blood vessels and the heart.

Why spiritual gurus do not suffer?

By Dr K K Aggarwal
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Most spiritual gurus do acquire disease but they do not suffer from them. This means that they have learnt the art of facing or fighting a disease without mental suffering. They face any adversity as an opportunity to do something different in their life.

Classical examples are Lord Krishna who suffered from a nonhealing wound and Jesus Christ who at the time of his crucifixion was calm yet positive in his approach.

MR–Guided Focused Ultrasound for Knee Osteoarthritis

By Dr K K Aggarwal
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Local bone denervation by MR–guided focused ultrasound has been demonstrated as a promising tool for pain palliation of bone metastases. A study in BMC Musculoskelet Disord 2013;14(267) has shown the safety and efficacy of MR–guided focused ultrasound treatment in osteoarthritis. Significant increase of pressure pain thresholds on treated area showed successful denervation effect on the nociceptive nerve terminals. MR–guided focused ultrasound is a promising and innovative procedure for noninvasive pain management of knee OA.

Did all Gods suffer before death?

By Dr K K Aggarwal
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Most Gods and spiritual gurus had suffered in their last days. Lord Krishna had a nonhealing wound, Jesus Christ was crucified, Bhagwan Rajneesh had an infectious disease, Swami Chinmayanand had low functioning heart, Maharshi Mahesh Yogi had heart and pancreatic disease, Satya Sai Baba was put on a ventilator etc. When they were God–like personalities, why did they suffer in their last days?

The answer to this comes from Vedic knowledge within the concept of rebirth. Vedanta says that the very fact that we are born means that in the last birth we did not attain moksha or liberation. In other words, this means that there were some sufferings yet to be faced. You are born to face those sufferings. When you face the last suffering, there are high chances that this suffering might be your last suffering before liberation.

Most Gods or saints who died in a phase of suffering may mean that they did not attain liberation. A person who dies suddenly or unnaturally would mean that he would have to take rebirth to face more sufferings.

According to me, terminal sufferings are good from spiritual point of view.

Clinicians should aggressively treat unhealthy lifestyles

By Dr K K Aggarwal
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Health care providers should treat unhealthy behaviors as aggressively as they treat hypertension, high cholesterol, and other heart disease risk factors, according to an American Heart Association policy statement published in the journal Circulation.

Doctors should create “interprofessional practices” to connect patients with behavior–change specialists.

They must implement five As when caring for patients

  • Assess a patient’s risk behaviors for heart disease
  • Advise change, such as weight loss or exercise
  • Agree on an action plan
  • Assist with treatment
  • Arrange for follow–up care.

Curses in Mythology

By Dr K K Aggarwal
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There were no judges in mythological era. The role of judges was performed either by Rishi Munis or by the kings. We have heard lot of examples of curses (shraps) being given by Rishi Munis. In all probability, these were the sentences uttered by them to the guilty or the culprit person. Following are a few examples.

  • The curse (shrap) of Bhasama can be equated to today’s ‘death sentence’ by electrocution.
  • Rishi Gautam giving a Shrap to Lord Indra and made him impotent for some time can be equated to chemical castration. He was later relieved by Lord Ganesha, which can be equated to acquittal from the higher court.
  • Rishi Gautam giving a Shrap to Ahilya of becoming a ‘stone’ can be equated to imprisonment for a number of years in isolation where movements are not possible (solitary confinement). Lord Rama relieving her from imprisonment (converting back to a woman) may mean a Presidential pardon and reducing the imprisonment time.

There are several similar cases of curses (shraps) in mythology that can be equated to today’s judicial system. If you have any, please forward the same to me.

High fat diet, prostate cancer prone

By Dr K K Aggarwal
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Diets high in saturated fat increase the risk of prostate cancer. As per a report from University of Texas M. D. Anderson Cancer Center in Houston published in the International Journal of Cancer:

  • Men who consume high saturated animal fat diet are two times more likely to experience disease progression after prostate cancer surgery than men with lower saturated fat intake.
  • There is also shorter “disease–free” survival time among obese men who eat high saturated fat diet compared with non–obese men consuming diets low in saturated fat.
  • Men with a high saturated fat intake had the shortest survival time free of prostate cancer (19 months)
  • Non–obese men with low fat intake survived the longest time free of the disease (46 months).
  • Non–obese men with high intake and obese men with low intake had “disease–free” survival of 29 and 42 months, respectively.

Take home messages

  • High saturated fat diet has been linked to cancer of the prostate
  • Reducing saturated fat in the diet after prostate cancer surgery can help reduce the cancer progression.
  • Cancer prostate has the same risk factors as that of heart blockages and both are linked to high saturated fat intake.
  • With an increase in number of heart patients, a corresponding increase in prostate cancer patients is also seen in the society.