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Dr K K Aggarwal

Winter Asthma

By Dr K K Aggarwal
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Any breathlessness after the age of 40, appearing for the first time in winter, is cardiac asthma unless proved otherwise. Such patients should immediately have their blood pressure check-up done and if high needs immediate medical attention. First-onset breathlessness can also be an indication of angina or heart attack. However, the more common is winter asthma or acute exacerbation of winter COPD (chronic bronchitis). Asthma is reversible airway obstruction and COPD is irreversible airway obstruction. Sudden exposure to cold, humidity, pollution at lower levels in atmosphere can precipitate asthma in susceptible individuals. Winter is the time to increase the dose of asthma medicines.

If a person can speak a full sentence, the asthma attack is mild; if a person speaks broken sentences the asthma attack is moderate and if the person is able to speak only words then the asthma attack is severe. Severe attack of asthma needs immediate hospitalization.

The Vedic meaning of Mahamritunjaya Mantra and the Gayatri Mantra

By Dr K K Aggarwal
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Any activity should always engage the 3 H model of Heart, the Head and the Hand. The same has been advocated by the western scholars of today. This means that when doing any work, ask the head for choices, then refer these choices to the heart to choose one and finally order the hands to carry out that action.

In his book ‘The Seven Spiritual Laws of Success’, Deepak Chopra also 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 carry out that action.

All the above concepts come from our ancient Vedic knowledge. The two main mantras of our times are the Mahamritunjaya Mantra and the Gayatri Mantra.

The Mahamritunjaya Mantra is from the Rig Veda and needs initiation for attaining any Siddhi. This is the greatest reliever from all evils and reads as under: Aum Trayambakam Yajamahe, Sugandham 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 (bandhanan) 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 meaning of the mantra is the importance of the third eye and the benefits of its opening. The two eyes are at the level of the physical body. The third eye means the eyes of the mind and the eyes of the soul. It also indicates that in difficulty one should look inward from the eyes of the mind and ask for the choices. Like the cucumber, one should chose the good ones and drop the bad choices.

The mantra for the conscious–based decision comes from Gayatri mantra: Om Bhur Bhuvaha Suvaha Thath Savithur Varenyam Bhargo Devasya Dheemahi Dhiyo Yonaha Prachodayath. 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. The Gayatri mantra 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 as Vedasara –– “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 this Gayatri mantra.

Choosing 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 question is no, not to indulge in that actions. These four questions are: Is it the truth, is it necessary, will the actions bring happiness to you and to the others.

Diet is linked to the diabetes epidemic

By Dr K K Aggarwal
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A study published in the journal Diabetes Care, has highlighted the importance of the whole diet rather than focusing on certain foods or food groups that might be beneficial. A diet rich in whole grains, fruits and vegetables (leafy green), nuts and low-fat dairy may help people lower their risk of type 2 diabetes by 15% over 5 years than those who ate the lowest amounts of these foods. Also, a diet which contains high amounts of red meat, high-fat dairy and refined grains like white bread may boost the odds of diabetes development by 18%.

Type 2 diabetes is closely linked to obesity and it is well-known that maintaining a healthy weight through diet and exercise reduces the risk of developing the disease. Diet affects diabetes risk independent of a person’s weight.

Dealing with Stress

By Dr K K Aggarwal
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Stress may be broadly defined as comprising of three components, namely a “known situation, interpretation of a situation and the physical and mental reaction to that interpretation of the situation”.

Stress is a situation: There cannot be a stress without a situation. One cannot be stressed about some event occurring in USA without knowing the person or the situation. The situation requires familiarity with the particular sensory object (known situation).

Stress is an interpretation of a situation: Without interpretation, stress is not possible. The same situation can be interpreted differently by different people. A stimulus may be stressful to one but not to the other.

Stress is a physical and mental response to the interpretation of the situation: Stress manifests because of a chemical imbalance resulting due to sympathetic over-activity, which manifests as mental and or physical symptoms.

Stress is the body’s physical and mental response to the interpretation of a situation. Management of stress, therefore, involves either changing the situation, changing the interpretation of the situation or making the body resistant to physical and mental changes in the situation.

Practicing Patanjali’s eight limbs of yoga via living a yogic lifestyle, adhering to the various Dos and Don’ts in life as taught in various religious teachings, and learning to meditate helps our body to resist these sympathetic–activating changes and handle the stressful situation. These involve proper diet, exercise, meditation and relaxation exercises. Changing the interpretation of a situation involves counseling. Cognitive behavior therapy used in counseling is one such example. Change in interpretation requires deeper understanding of the problem and removal of the obstacles. This can be done by using Ganesha’s principles of stress management, Rosenburg’s Principle of Non–Violent Communication, or the principles of counseling from Bhagwad Gita. Change of the situation is the final resort for solving the problem, even though this may not be always possible. For example, in a dispute between husband and wife, divorce should be the last choice, after all counseling efforts have failed to resolve the issue.

How safe are anti-obesity drugs?

By Dr K K Aggarwal
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Obesity is a major health problem. The long–term success rate is low of diet and physical activity. Therefore, antiobesity drugs are of great interest, especially when lifestyle modification has failed. As obesity is not an immediate life–threatening disease, these drugs are required to be safe.

Drugs developed so far have limited efficacies and considerable adverse effects affecting tolerability and safety. Therefore, most antiobesity drugs have been withdrawn

. • Fenfluramine and dexfenfluramine were withdrawn because of the potential damage to heart valves.

• Sibutramine was associated with an increase in major adverse cardiovascular events in the Sibutramine Cardiovascular Outcomes (SCOUT) trial and it was withdrawn from the market in 2010.

• Rimonabant was withdrawn because of significant psychiatric adverse effects.

• Orlistat was approved for long–term treatment of obesity, but many patients cannot tolerate its gastrointestinal side effects.

• Phentermine and diethylpropion can only be used for less than 12 weeks because the long–term safety of these drugs is unknown.

• Ephedrine and caffeine are natural substances but the effects on weight reduction are modest.

• Recently lorcaserin and topiramate plus phentermine have been approved for the treatment of obesity but long–term safety data are lacking. (Ther Adv in Drug Safe 2013;4(4):171–181)

Is the origin of ISO Certification from the Vedas?

By Dr K K Aggarwal
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Whatever you say or do means you are ISO certified.

In mythology, truthfulness means that you do what you think or say. ISO therefore is a Vedic stamp for truthfulness. You need ISO certification in Kalyug as majority being Kalyugis will not be doing what they say or think.

In traditional old business times, transactions were done on verbal assurances but today every one works on written agreements. The saying was “Prana Jaye per vachan na jaye”.

Obesity reduces life expectancy

By Dr K K Aggarwal
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Obesity in adulthood is associated with a striking reduction in life expectancy for both men and women. Among 3457 subjects in the Framingham Study, done in the United States, those who were obese (Body Mass Index or BMI ≥30 kg/m2 at age 40 years lived 6 to 7 years less than those who were not (BMI ≤24.9 kg/m2). Those who were overweight (BMI 25 to 29.9 km/m2) at age 40 years lived about 3 years less, and those who were both obese and smoked lived 13 to 14 years less than normal–weight nonsmokers. The steady rise in life expectancy during the past two centuries may come to an end because of the increasing prevalence of obesity. Being overweight during adolescence also increase the risk of premature death as an adult. The analysis of Nurses’ Health Study has shown the risk of premature death increases with higher BMIs at age 18 years. For a BMI at age 18 of 18.5 to 21.9, 22 to 24.9, 25 to 29.9, and ≥30 kg/m2, the hazard ratio for premature death were 0.98, 1.18, 1.66, and 2.79, respectively.

A prospective study from the United States, at National Cancer Institute, National Institutes of Health, Bethesda, valuated the relationship between BMI and risk of death over a maximum follow–up period of 10 years among over 500,000 men and women aged 50 to 71 years. Among the subset of individuals 50 years of age (when prevalence of chronic disease is low) who had never smoked, an increased risk of death was associated with being either overweight (20 to 50 percent increase in those between 26.5 to 29.9 kg/m2) or obese (two– to over threefold increase in those ≥30 kg/m2).

Overweight and obesity, when analyzed together, is associated with increased mortality from diabetes and kidney disease. Obesity, when analyzed alone, is associated with increased cardiac mortality and cancers considered to be obesity–related (colon, breast, esophageal, uterine, ovarian, kidney, and pancreatic cancer), but not with mortality from other cancers or non–cardiac mortality.

There are some recent studies which showed that obese people live longer. Overweight was shown to be associated with reduced mortality from non cancer, non–cardiovascular causes, but not with cancer or cardiovascular mortality. In them being underweight was associated with increased mortality from non cancer and non–cardiac causes, but not cancer and cardiac CVD causes. Obesity and increased central fat are associated with increased morbidity in addition to mortality. Overweight and obese individuals have a higher relative risk of hypertension, hypercholesterolemia, and diabetes mellitus compared with normal weight individuals. The risk of hypertension and diabetes increases with increasing BMI.

In the Nurses’ Health and the Health Professionals studies, the risk of developing a chronic disease (gallstones, hypertension, heart disease, colon cancer and stroke (in men only)) increased with increasing BMI, even in those in the upper half of the healthy weight range (BMI 22.0 to 24.9 kg/m2). Obesity is measured by using a measurement called BMI, which is calculated by dividing a person’s weight in kilograms by the square of their height in meters.

A BMI of 18.5 to 23 is considered normal (Asians). One below 18.5 is considered underweight and 25 or above is considered obese.

The Allopathic Ramayana

By Dr K K Aggarwal
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Navratras to Diwali is the season of revisiting the messages from Ramayana, the largest epic of our country which was once classified as one of the Puranas.

One can understand the story of Ramayana as the story of mind, body and soul and the story of causation and prevention of a disease, where the soul is represented as Rama and the physical body as Sita. Body is made up of five elements with earth being the predominant. Sita was the daughter of earth (prithvi).

Soul and body can only unite in presence of a determined mind holding them together. Determination means “aim” and in Hindi it is called “lakshya”. The mind with a defined aim, therefore, represents “Lakshmana”.

Rama, Lakshmana and Sita, therefore, represent the union of mind, body and soul. The three will stay together as long as one has his/her 10 senses (five motor and five sensory) under control. Senses are Chanchal like horses. Chariot of two horses is called Rath and chariot of the 10 horses is called “Dasharatha”. Therefore, mind, body and soul will be together with the resultant health only if the body is ruled by “Dasharatha” by controlling all the ten senses.

The next part of Ramayana talks about the causation of disease and worries. The causative factors are “kama, lobha and ahankar”. In Ramayana kama is depicted by Kaikeyi, lobha by Mareech and ahankaara by Ravana. Ramayana would not have happened with any one of them not being there. The sum total of the three is responsible for any disease or miseries in life.

When kama (Kaikeyi) predominates, senses (Dasharatha) have to die. When moha (Mareech) dominates, the mind (Lakshman) gets diverted and when Ahankar (Ravana) takes over, it controls the body (Sita) and makes the mind (Lakshman) and soul (Rama) wander.

The next part of Ramayana is how to win over ego or Ravana. The first step is to win over the mind by controlling the prana Vayu component of the body by indulging in Pranayama. In Ramayana context it means winning over Hanumana, the son of Vayu. Once he is controlled, all the thoughts representing as the Vanar Sena (Chanchal natures) get controlled.

The next step is to control the intellect (King Sugriva). He can only be influenced by killing lust (Bali), who is living with Sugriv’s wife. Lust cannot be killed from front and has to be killed from behind and that is what Rama does to Bali. Killing of the lust from behind is depicted as Pratyahara in Yoga and means living a disciplined satvik lifestyle.

The next step is to follow “one point contemplation” or living in the present. In the context of Ramayana, it represents one point determination or “the war over Lanka”. Once that happens firstly the tamas (Kumbkaran), than the rajas (Meghnad) and finally the ahankar (Ravana) dies. Both tamas and ego dies automatically by the consciousness (Rama) but for killing the rajas one has to conquer it with the mind (Lakshmana).

Once this happen the Satwa or Vibhishana takes over and the mind, body and soul are reunited leading to inner happiness again.

Lastly when Rama, Lakshman and Sita go back to their journey of life, back to Ayodhya, Hanuman goes with them as in Ayodhya, Dasharatha is no more.

If you cannot control your 10 senses by yourself you need to continue Pranayama or carry Hanuman with you for life. These are what the spiritual message from Ramayana.

Older people ‘should exercise to build muscle even into their 80s’

By Dr K K Aggarwal
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Older people should exercise to build their muscles even into their eighties, according to a review which suggests it will help them with everyday tasks.

Climbing the stairs, housework, walking and even washing was made easier if elderly people worked out 2 or 3 times a week, said Chiung–ju Liu of the Department of Occupational Therapy at Indiana University.

People lose muscle as they age, which can make daily chores more difficult. Working out by using small weights or elastic bands can help to rebuild these muscles.

By “walking well”, however, you power yourself around all day using muscles in your bottom, midriff and the backs of your thighs. This brings dramatic, sustainable results.

9th Chaitra Navratri: Siddhidatri

By Dr K K Aggarwal
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Siddhidatri is worshipped on the 9th day of Navratri. SHE gives all the eight siddhis – Anima, Mahima, Garima, Laghima, Prapti, Prakamya, Iishitva and Vashitva. SHE rides on a lion or on a lotus. SHE has four hands and looks pleased.

Spiritual message on the 9th Navratri: By the 9th day of spiritual detoxification, one gets all spiritual powers.

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.

8th Chaitra Navratri: Maha Gauri

By Dr K K Aggarwal
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Maha Gauri is worshipped on the 8th day of Navratri. SHE looks as white as moon and jasmine. White means purity of mind. SHE is dressed in a white sari. SHE has three Eyes and four hands and holds a drum and a trident and is often depicted riding a bull (control over the desires).

Her upper left hand is in a fearless pose and she holds a ‘Trishul’ in her lower left hand. Her upper right hand has a tambourine and the lower right hand is in a blessing Mudra.

Spiritual message on the 8th Navratri

By the 8th day of spiritual detoxification, purity of mind is attained.

How can you explain coronary artery disease to your patients?

By Dr K K Aggarwal
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The following is how I communicate with my patients and explain to them about coronary artery disease.

• There are three coronary arteries, which can be equated to three main roads of the city.

• Any road has shops on each side. The coronary artery has the endothelium on the sides.

• There are pavements in front of the shops. The pavements in coronary arteries are called intima-media.

• When the local municipal corporation does not maintain discipline, shopkeepers start encroaching the pavement. In terms of coronary arteries, this is equivalent to intima media thickness.

• The next to follow are temporary encroachments of the road, which is equivalent to several plaques in the coronary arteries.

• Then comes permanent encroachment, which is equivalent to heart plaques.

• With encroachment, the traffic slows down and heavy honking of horns starts. This denotes angina or chest pain.

• When the traffic congestion is heavy, motorists often blow their horn continuously. This can be equated to unstable angina.

• When the traffic stops, but the car engine is still working, this can be likened to a heart attack.

• When the car stops and the engine also stops, this is a cardiac arrest.

On the 7th Navratri, Enjoy a mind devoid of inner darkness

By Dr K K Aggarwal
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Kalaratri is worshipped on the 7th day of Navratri. She is dark and black like night. Her hairs are unlocked. SHE has three eyes and four hands.

She holds a sharp Sword in her right hand and blesses her devotees with her lower hand. HER vahana is a donkey, destroyer of darkness and ignorance (or shava). She spills out fire from her nostrils. She has put on necklaces shining like lightening. In Yoga Shastra, she represents the Sasahara Chakra

Spiritual mantra on the 7th Navratri

On the 7th day, control your aggression (lion), take right decisions (mudras) by controlling your ignorance (donkey) using your sharp intelligence (sword).

Weight gain precedes the onset of diabetes

By Dr K K Aggarwal
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Weight gain after age 18 years in women and after age 20 years in men also increases the risk of type 2 diabetes.

The Nurses’ Health Study, compared women with stable weight (those who gained or lost <5 kg) after the age of 18 years to women who gained weight. Those who had gained 5–8 kg had a relative risk of diabetes of 1.9; this risk increased to 2.7 for women who gained 8–11 kg.
Similar findings were noted in men in the Health Professionals Study.

Thus, the excess risk for diabetes with even modest weight gain is substantial.

Weight gain precedes the onset of diabetes. Among Pima Indians (a group with a particularly high incidence of type 2 Diabetes), body weight gradually increased 30 kg (from 60 kg to 90 kg) in the years preceding the diagnosis of diabetes.