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Dr K K Aggarwal

CT not required in appendicitis

By Dr K K Aggarwal
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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.

Values, Morals and Ethics

By Dr K K Aggarwal
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Values

  • Values are our fundamental beliefs. They are the principles we use to define that which is right, good and just.
  • Values provide guidance to determine the right versus the wrong, the good versus the bad.
  • They are our standards.
  • When we evaluate anything we compare it to a standard.
  • Typical values include: honesty, integrity, compassion, courage, honor, responsibility, patriotism, respect and fairness.
  • Ethics are universal

Morals

  • 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.
  • These values get their authority from outside the individual– a higher being or higher authority (e.g. society).
  • By this definition, one could categorize the values like honesty, integrity, compassion as “moral values” – values derived from a higher authority.

Ethics

  • Ethics is about our actions and decisions.
  • When one acts in ways that are consistent with our beliefs (whether secular or derived from a moral authority) we characterize that as acting ethically.
  • When one’s actions are not congruent with our values – our sense of right, good and just – we view that as acting unethically.
  • The ethics of our decisions and actions is defined socially, not individually.

Is caffeine good for the health?

By Dr K K Aggarwal
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  •  Caffeine is the most consumed stimulant in the world. It is consumed in the form of coffee and tea.
  • At present there is no scientific data for promoting or discouraging coffee and/or tea consumption in the daily diet.
  • Short term benefits include mental alertness and improved athletic performance.
  • Short–term adverse effects including headache, anxiety, tremors and insomnia.
  • Long–term adverse affects include generalized anxiety disorder and substance abuse disorders.
  • Long–term benefits are dose–dependent. Caffeine is associated with a reduced risk of Parkinson’s disease, Alzheimer’s disease, alcoholic cirrhosis and gout. Coffee, both caffeinated and decaffeinated, is also associated with a lower risk of type 2 diabetes.
  • Heavy coffee intake may trigger coronary and arrhythmic events in susceptible individuals, although coffee intake is not considered a long–term risk factor for myocardial disease.
  • Most studies show a modest inverse relationship between coffee consumption and all–cause mortality.
  • Caffeine withdrawal is a well–documented clinical syndrome with headache being the most common symptom. (Source: Uptodate)

Spiritual Prescriptions – Controlling the Inner Noise

By Dr K K Aggarwal
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Yoga Sutras of Patanjali define yoga as restraint of the mental states (Chapter 1.2). In the state of total restraint, the mind is devoid of any external object and is in its true self or the consciousness. Many Vedic scholars have given their own formulae to control the mind.


Being in touch with one’s own consciousness requires restraining of the mind, intellect and ego on one hand and the triad of rajas, tamas and satwa on the other hand. Every action leads to a memory, which in turn leads to a desire and with this a vicious cycle starts.

The mental turmoil of thoughts can be equated to the internal noise and the external desires and objects to an external noise.

The process of withdrawing from the external noise with an aim to start a journey inwards the silent field of awareness bypassing the internal noise is called pratihara by Yoga Sutras of Patanjali. It involves living in a satwik atmosphere based on the dos and don’ts learnt over a period of time or as told by the scriptures. To control inner noise-based thoughts, we either need to neutralize negative thoughts by cultivating opposite thoughts or kill the origin of negative thoughts.

Not allowing thoughts to occur has been one of the strategies mentioned by the scholars. One of them has been neti–neti by Yagnayakya.

The other method is to pass through these inner thoughts and not get disturbed by it and that is what the process of meditation is. This can be equated to a situation where two people are talking in an atmosphere of loud external noise. For proper communication one will have to concentrate on each other’s voice for long till the external noise ceases to disturb. In meditation, one concentrates on the object of concentration to such an extent that the noisy thoughts cease to bother or exist.

One of the ways mentioned by Adi Shankaracharya in Bhaja Govindam and by Yoga Sutras of Patanjali (Chapter 2.35) is that whenever one is surrounded by evil or negative thoughts one should meditate open the contrary thoughts. For example, if one is feeling greedy, one can think of donating something to somebody. Deepak Chopra in his book Seven Laws of Spiritual Success talks in detail about the importance of giving and sharing. He says you should never visit friends or relations empty handed. You should always carry some gift of nature, which if nothing is available can be a simple smile, compliment or a flower. By repeatedly indulging into positive behavior and thoughts, you can reduce the internal noise, which helps in making the process of meditation or conscious living a simpler one.

Washing out negative thoughts is another way mentioned by many Vedic scholars. Writing for 3 min is one such exercise which anybody can do. Just before sleeping, take 3 min and write down all your emotions and then discard the paper. Another exercise is to reward or punish oneself at bed time for the activities done during the day by either patting or slapping yourself.

50% of adverse drug reactions can be prevented

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.

Shiksha and Sabhyata

By Dr K K Aggarwal
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Suno, Samjho, Jaano and Karo is the mantra for education and involves not only hearing but listening and understanding and converting understanding into wisdom by doing it practically.

One of the components of education is etiquettes or manners, which can be at every level of education. In older era, Rajkumars or princes were sent to Gurukuls for formal education including that of warriorship. They were also sent to Gharanas/Kothas to learn tehzeeb the Lucknawi way where they were taught how to talk to each other and respect others. Their language in typically Lucknawi style used to be ‘we’ oriented and not ‘I’ oriented. Today’s education is more oriented towards ‘I–ness’ or ego and not towards the soul or respect.

When we were students, we were taught that a senior is a senior and needs to be respected. Even today, when we meet our teachers, we take their blessings by touching their feet but today’s students believe in shaking hands or saying ‘hi’. There is more and more commercial touch in the teacher–student relationship of today.

Ego makes one rude and arrogant with a mentality full of Rajas and Tamas. Road rage, gang rapes, murders, violence, terrorism are all examples of not learning etiquettes at the right time.

ABO Blood Type is a Risk Factor for Coronary Heart Disease

By Dr K K Aggarwal
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Collective Consciousness

By Dr K K Aggarwal
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Consciousness is an energized field of information with powers to do everything in the universe. Collective consciousness is the internet of the collective souls of many people in a group.

Collective consciousness is the strongest superpower ever available in the universe. As per the Vedic texts whatever is the intent of collective consciousness will become a reality. Scientifically collective consciousness is based on the principle of critical mass. The Vedic literature has shown it to be the 1% of the defined population under study.

The origin of the critical mass comes from 100th monkey phenomenon. The story goes as under: long ago in Japan a monkey called Emo used to eat dirty apples everyday picked up from the ground. One day by accident the apple fell down in a river, the dirt got washed off and he ate the washed apple. Obviously it tasted delicious. The monkey started washing the apple thereafter every day before eating. His fellow monkey started following the same. The process of following went on. A time came when the 100th monkey washed the apple and ate. A strange phenomenon was noticed. All monkeys in and around that state started washing the apple before eating. The number 100 was the critical mass.

Once this mass is crossed, information spreads like wild fire and the intent becomes a universal reality. Vedic literature has also shown if 1% of the public of any area meditates together the crime rate of that area goes down. It also talks about the role of critical mass in prayers in achieving miracles.

The principle of critical mass is often used in designing and organizing an event. In a movie hall of 1000 people if 10 people sitting in different areas clap, then everybody will clap. The same applies to hooting. Most politicians use this principle when they organize election rallies. For a gathering of 10000 they need 100 and for a gathering of 1000 people they only need 10 supporters who are supposed to sit in different areas and shout or clap on given directions. The Mexican way of hooting or clapping in cricket grounds also follow the same principle. Most successful leaders used this technology to lead.

Three simple ways for a restful sleep

By Dr K K Aggarwal
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  •  Cut down on caffeine: Caffeine drinkers may find it harder to fall asleep. Even a single cup of coffee in the morning may lead to a sleepless night. Caffeine blocks the effects of adenosine, a neurotransmitter thought to promote sleep. Caffeine can also interrupt sleep by increasing the need to urinate during the night. Because caffeine withdrawal can cause headaches, irritability, and extreme fatigue, it may be easier to cut back gradually rather than to go cold turkey. Those who can’t or don’t want to give up caffeine should avoid it after 2 p.m., or noon if they are especially caffeine–sensitive.
  • Stop smoking or chewing tobacco: Nicotine is a central nervous system stimulant that can cause insomnia. If you continue to use tobacco, avoid smoking or chewing it for at least 1 to 2 hours before bedtime.
  • Limit alcohol intake: Alcohol depresses the nervous system, so a nightcap may seem to help some people fall asleep. Alcohol suppresses REM sleep, and the soporific effects disappear after a few hours. Alcohol also worsens and other sleep breathing problems.

Spiritual Prescription: Who am I? Know Your Soul Profile

By Dr K K Aggarwal
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These can also be equated to the eight limbs of Yoga Sutras of Patanjali, where the “choices I make” represents Yama and Niyama, “what do I want” represents Dharma and the “entering into discontinuity” represents Dhyana and Samadhi.“I am not my physical body, as I know, once my body dies, nobody wants to touch it.” (Adi Shankaracharya in the Bhaja Govindam)

“I am not my mind as I know whenever I am in trouble; the mind asks the heart for help” (Deepak Chopra in the Seven Spiritual Laws of Success).

“I am my consciousness which is residing in the core of my heart” (Svetasvatara Upanisad 5.8).

“This consciousness is nothing but a web of energized information situated in the void” (Chandogya Upanishad Chapter XII — the Birth of the Gross from the Subtle)

“the consciousness is timeless, has no beginning, no end, weapons cannot cut it, air cannot dry it, water cannot wet it and fire cannot burn it” (Bhagavad Gita 2.23, 24).

Each one of us has a physical profile (as defined by our height, complexion, collar number, waist size, etc.) and has a mental or ego profile. A few examples of ego profile: my bank balance, car, job designation, locality of residence, size of house, contacts, power, clothes’, etc.

Similarly each one of us also has a soul profile. We should give sometime to ourselves for knowing our soul profile and revisit it at least once in a week.

According to Deepak Chopra, to know the soul profile one should ask seven questions to his or her consciousness while sitting in a meditative poise or in state of relaxation. The answer to each question should be either in three words or three phrases.

  1. What is my purpose of life?
  2. What is my contribution going to be for my friends and family?
  3. Three instances in my life when I had my peak experiences.
  4. Names of three people who inspire me the most.
  5. Three qualities which I admire in others the most.
  6. Three of my unique talents.
  7. Three qualities I best express in my relationship.

These twenty one answers will characterize your soul profile or will be your passport for every action you perform in your life.

In day–to–day’s life, one should act from the soul profile and not from the ego profile. Soul profile cannot be manipulated while the ego profile can be.

There are only three ways of improving one’s soul profile and these are:

  1. The choices one makes should be soul–profile oriented and not ego–profile oriented. Whenever there is an opportunity for an action, ask the head for choices, then ask the heart to choose one, and finally order the hand to take action. A soul–based action is the one which is based on the truth, is necessary, and which makes the person and the people around him or her, both happy.
  2. Total clarity of vision of “What do I want” and also “What I don’t want”.
  3. Learn to enter into discontinuity of thought processes using “beej mantra” or doing primordial sound meditation 20 minutes in the morning and 20 minutes in the evening.

These can also be equated to the eight limbs of Yoga Sutras of Patanjali, where the “choices I make” represents Yama and Niyama, “what do I want” represents Dharma and the “entering into discontinuity” represents Dhyana and Samadhi.

Triphala can help in reducing bronchial hyperreactivity

By Dr K K Aggarwal
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Triphala (TRP), a herbal extract, has been shown to affect lymphocytes and natural killer T (NKT) cell function. It has been shown to ameliorate bronchial hyperreactivity through immune–cell modulations.

In a study carried out at the Division of Allergy, Immunology and Pulmonary Medicine, Washington University in Saint Louis, Saint Louis, MO, asthma mouse models were generated through intraperitoneal (IP) injections of ovalbumin (OVA)/2 weeks followed by repeated intranasal OVA challenges.

Mice were then treated with normal saline (OVA/NS) or Triphala (OVA/TRP). Data were compared with mice treated with inhaled budesonide.

Both TRP and budesonide significantly ameliorated functional and histological OVA–induced bronchial hyperreactivity. Triphala causes a significant decrease in bronchial reactivity. It alters immune–cell distributions and show antioxidative properties. Immune–cell modulation with triphala can ameliorate lung injury.

(Ref: Horani A, Shoseyov D, Ginsburg I, et al. Triphala (PADMA) extract alleviates bronchial hyperreactivity in a mouse model through liver and spleen immune modulation and increased anti-oxidative effects. Ther Adv Respir Dis 2012 Aug;6(4):199–210).

Why do We Worship the Tulsi Plant?

By Dr K K Aggarwal
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Yanmule sarvatirhaani
Yannagre sarvadevataa
Yanmadhye sarvavedaascha
Tulasi taam namaamyaham

“I bow to the Tulsi, At whose base are all the holy places, At whose top reside all the deities and In whose middle are all the Vedas.”

The Tulsi or Sacred Basil is one of the most sacred plants. There is a saying in Sanskrit: “Tulanaa naasti athaiva tulsi” that which is incomparable in its qualities is the tulsi. It is the only pooja samagri, which can be washed and reused.

Satyabhama once weighed Lord Krishna against all her legendary wealth. The scales did not balance until a last single tulsi leaf was placed along with the wealth on the scale by Rukmini with devotion. Thus, tulsi played the vital role of demonstrating that even a small object offered with devotion is of greater value than all the wealth in the world.

The Tulsi leaf has great medicinal value and is used to cure various ailments, including the common cold. Tulsi seeds are good for male infertility and increase the viscosity of semen and sperm counts. It has detoxifying properties and is used in fasts including the Satynarayana Katha where a thousand tulsi leaves are added to the water for pooja, which is consumed later by everybody.

Tulsi also symbolizes Goddess Lakshmi. Those who wish to be righteous and have a happy family life worship the tulsi. Tulsi is ‘married’ to Lord Vishnu with pomp and show like any other wedding. This ‘marriage’ is solemnised because according to a legend, the Lord blessed her to be His consort. Tulsi is worshipped in the months of Magh and Kartik. Tulsi vivah is observed in the month of Kartik and is the symbolic marriage of Lord Vishnu in the form of a shaligram (sacred stone) and Tulsi. It indicates the importance of Tulsi for fertility. Tulsi pooja is an important component of any marriage.

Pacing Without Leads

By Dr K K Aggarwal
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The first leadless pacemaker, less than one-tenth the size of a conventional pacemaker, has been approved for use in Europe. It can be delivered via a catheter into the heart.

There will be elimination of the visible lump and scar at a conventional pacemaker’s implant site. Also there is removal of patient activity restrictions that may prevent the dislodgement or damage to a conventional lead.

Initial results from the first–in–man LEADLESS study showed successful implantation in 32 of 33 patients and performance comparable with traditional pacemakers with leads.

Why do we Ring the Bell in a Temple?

By Dr K K Aggarwal
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The vibrations of the ringing bell also produce the auspicious primordial sound ‘Om’, thus creating a connection between the deity and the mind. As we start the daily ritualistic worship (pooja), we ring the bell, chanting:

Aagamaarthamtu devaanaam
gamanaarthamtu rakshasaam
Kurve ghantaaravam tatra
devataahvaahna lakshanam

“I ring this bell indicating the invocation of divinity, So that virtuous and noble forces enter (my home and heart); And the demonic and evil forces from within and without, depart.”

Fever

By Dr K K Aggarwal
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Fever does not mean presence of infection. There are many situations where there is fever without infection and hence needs no antibiotics.

  • Sepsis is a clinical syndrome, which results from the dysregulation of inflammatory response to an infection. The temperature is between 36oC to 38.3oC. Heart rate is often more than 90 per minute.
  • Symptomatic inflammatory response syndrome means a clinical syndrome, which results from dysregulated inflammatory response to any infections such as inflammation of the pancreas, inflammation of the vessels, clot formations in the veins.
  • Many antibiotics can cause fever; unless they are discontinued, fever will not subside.
  • Hyperthermia is a condition with elevated body temperature but it is not called fever. Examples are exposure to heat or heat stroke and in response to anesthetic drugs and anti–psychotic drugs.
  • Hyperthermia may not respond to anti–fever drugs.
  • When fever is more than 41.5oC, it is acute hyperpyrexia.
  • Hyperpyrexia is usually seen in patients with severe infections but it may also occur in brain hemorrhage. It responds to anti–fever drugs.
  • High temperature without infection is found in condition of hyperfunctioning of the thyroid gland.
  • Recreational drugs such as Ecstasy can also cause fever without any infection.
  • Mild fever can also occur after exertion.