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Dr K K Aggarwal

Blood pressure drugs should be taken at night

By Dr K K Aggarwal
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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 1 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.

The spiritual meaning of the word Artha

By Dr K K Aggarwal
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Dharma, Artha, Kama and Moksha are the four fundamental principles of our very existence which means earning righteously with a desire to fulfill the inner happiness.

Righteous earning is called ‘Artha’ and mistakenly it has been linked to materialistic money.

In mythology, Artha is synonymous with Lakshmi, Saraswati and Kali where Lakshmi represents righteously earned materialistic wealth, Saraswati represents wealth of knowledge and Kali represents wealth of wisdom to fight the bad in you and in the society. In any country, it is the wealth of knowledge, which is more important. India was ruled initially by warriors (Kali), later by money (Lakshmi) and in future will be ruled by knowledge (Saraswati).

It is the human resources, which today decide the growth of a company and the amount of money invested. If you have good human resources, your company is going to succeed.

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

Myths

By Dr K K Aggarwal
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The right skin cream can keep your skin looking young: For reducing wrinkles, the topical treatment with the best evidence behind it is retinoic acid. The best ways to keep wrinkles at bay are using sunscreen and not smoking. Antibacterial soap is best for keeping your skin clean: Many experts are concerned that the use of antibacterial soap could lead to more antibiotic-resistant bacteria. Antibacterial soap is not necessary for everyday use. Regular soap is fine. Thorough and consistent hand-washing, not antibacterial soap, is what helps prevent the spread of infection.

Tips a woman can follow to prevent birth defects in newborns

By Dr K K Aggarwal
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  1. Consume a healthy diet rich in fruits, vegetables, and whole grains. Limit the intake of processed or junk food.
  2. Quit smoking or drinking as both these habits can harm the fetus. Avoid any form of drugs as well.
  3. Some infections that a woman can get during pregnancy can be harmful to the developing baby and can even cause birth defects. Follow a healthy lifestyle to avoid these.
  4. Get all your pregnancy vaccinations on time and take any medications prescribed as per schedule.

Forgetfulness and Age

By Dr K K Aggarwal
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By the time we cross 40, most of us suffer from minimal cognitive impairment and have a memory loss of very recent events or objects. This is age related and should not be confused with dementia. This can also happen in patients who are vegetarians and vitamin B12 deficient. People often have difficulty in naming objects and name of the people. Just as a computer hangs up while doing multiple tasks, so does the human mind. When you handle multiple projects at the same time, you may experience thought blocks, which is natural and not a sign of a disease. When we introduce ourselves to a new person, we often tell our name first. It is possible that by the time you finish your conversation, the person may forget your name. Therefore, one should either introduce themselves last after the conversation is over or introduce oneself at the start and also at the end of the conversation. Some people introduce themselves before the conversation and hand over their visiting card at the end of a conversation. This is also taught in how to market yourself. As medical doctors, we face these difficulties quite often. People send SMSs without their names or call without telling their names. For example, I once got a call “Malhotra Bol Raha Hoon Pehchana Kya?” As a doctor, we may have had hundreds of Malhotras as our patients and it is not expected from us, especially after the age of 40 to recall a person just by his surname. Unless we are given complete information by the patient on phone, mistakes can be made, especially if it is a phone consultation. In any way, phone consultation needs to be avoided. Even Supreme Court in one of its judgments said that giving phone consultation may amount to professional misconduct on the part of the doctor.

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

Positive Attitudes

By Dr K K Aggarwal
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All those out there who feel you are at your wits end wondering how things don’t ever work out for you, can now relax and dwell on all those failures that life has taken you through and turn failure into success.

• Failure doesn’t mean you are a failure. But it does mean you haven’t succeeded yet. • Failure doesn’t mean you have accomplished nothing. It does mean you have learned something. • Failure doesn’t mean you have been foolish. It does mean you had a lot of faith. • Failure doesn’t mean you’ve been discouraged. It does mean you were willing to try. • Failure doesn’t mean you don’t to do. It does mean you have to do it in a different way. • Failure doesn’t mean you are inferior. It does mean you are not perfect. • Failure doesn’t mean you have wasted your life. It does mean you have a reason to start afresh. • Failure doesn’t mean you should give up. It does mean you must try harder. • Failure doesn’t mean you’ll never make it. It does mean it will take a little longer. • Failure doesn’t mean God has abandoned you. It does mean God has a better idea.

 

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

Cycling can cause erectile dysfunction

By Dr K K Aggarwal
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Age, diabetes, hypertension, obesity, high lipids, smoking, drugs, heart disease, upright cycling for more than 3 hours a week can cause erectile dysfunction (ED) in males. Those who ride bicycles for more than 3 hours a week should do so in a reclining position and not upright position. A man is considered to have ED when he cannot acquire or sustain an erection of sufficient rigidity for sexual intercourse. Any man may, at one time or another during his life, experience periodic or isolated sexual failures. The term “impotent” is reserved for those men who experience erectile failure during attempted intercourse more than 75% of the time. Heart disease increases the risk for later ED; ED also may be an early warning sign of future heart disease. Men with erectile dysfunction without an obvious cause (e.g., pelvic trauma), and who have no symptoms of heart disease, should be screened for heart disease prior to treatment since there are potential cardiac risks associated with sexual activity in patients with heart disease. Eight of the 12 most commonly prescribed medications list impotence as a side effect and it is estimated that 25% of cases of ED are due to drugs. Depression, stress, or the drugs used to treat depression can result in ED. Neurologic causes include stroke, spinal cord or back injury, multiple sclerosis, or dementia. In addition, pelvic trauma, prostate. Surgery or priapism may cause ED. A less obvious, but of increasing importance, has been the possible association of ED with bicycling. Anything that places prolonged pressure on the pudendal and cavernosal nerves or compromises blood flow to the penile artery can result in penile numbness and impotence. Cycling-induced impotence, is primarily a problem of serious cyclists and has been reported to occur in Norwegian men competing in a 540 km bicycle race. The penile numbness is attributed to the pressure on the perineal nerves whereas the erectile dysfunction is thought to be due to a decrease in oxygen pressure in the pudendal arteries. Recreational cyclists, those who cycle for less than 3 hours per week and men who cycle in a reclining position avoid the sustained intense pressure on the penile nerve and artery and are less likely to experience sexual side effects. Continued cycling in a seated upright position can reduce the penile oxygen levels lasting 10 minutes.

Mindfulness meditation

By Dr K K Aggarwal
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  1. Sit on a straight–backed chair or cross–legged on the floor.
  2. Focus on an aspect of your breathing, such as the sensation of air flowing into your nostrils and out of your mouth, or your belly rising and falling as you inhale and exhale.
  3. Once youve narrowed your concentration in this way, begin to widen your focus. Become aware of sounds, sensations, and ideas.
  4. Embrace and consider each thought or sensation without judging it good or bad. If your mind starts to race, return your focus to your breathing. Then expand your awareness again

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

Avoid Food Poisoning by thorough washing and proper cooking

By Dr K K Aggarwal
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Thorough washing and proper cooking of fruits and vegetables can eliminate most bacteria that cause food poisoning.

Food-borne illnesses or food poisoning usually occurs due to eating food that is contaminated with bacteria or their toxins. Virus and parasites can also be cause food poisoning. People have known for long that raw meat, poultry and eggs can also harbor diseases causing microbes. But in recent years most outbreaks of food borne illnesses have been due to fresh fruits and vegetables.

Food poisoning can cause abdominal pain, nausea, headache, fatigue, vomiting, diarrhea and dehydration. Symptoms may appear several hours to several days after eating tainted food. For example, Salmonella bacteria will cause illness 12 hours to 3 days after ingestion lasting about 4-7 days.

The most common way to treat food poisoning is to drink plenty of fluids. The sickness usually subsides within a few days.

Understanding Yamraja

By Dr K K Aggarwal
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All these years, like others, I too had a perception of Yamraja as a negative personality whose name has been used for centuries to frighten people. I started analyzing him only recently, after I started searching why Yamraja has a Bhainsa (male buffalo) as his sawari (vehicle).

Yamraja is also known as Dharma Raja, which means the one who is enriched with the power of justice.

The mythological names were so written that they fitted the personality of the person. Dushasan means the one who is Dusht in Shasan, Yudhishthir means one who is sthir in the battle field.

We, as human beings, have negative and positive qualities. Negative qualities are depicted with the need to control and are depicted as the vehicles of GOD.

Yamraja within us means our inner power to do justice. As per mythology, the role of Yamraja is to decide and send us into hell or heaven by calculating the positive and negative karmas. If the balance is positive, the person goes to heaven and if the balance is negative, the person goes to hell.

As per modern science, hell and heaven are within this planet earth. Your Yamraja quality of consciousness is all the time subtracting bad karmas from good karmas. If the sum total result is negative, you end up with a disease or suffering. Suffering can be equated to hell and a period of no suffering and no illness can be equated to heaven.

Instead of fearing Yamraja, we should actually make him our personal friend and everyday in the evening, he (our consciousness) should be asked to give us a score of our Karmas, whether positive or negative. If negative, the next day we should do more positive karmas to negate the bad karma.

To become a good human being we need to control our negative animal like tendencies. Bhainsa (male buffalo) is known for his nature of destroying anything which comes in his way.

Your power of justice can only be successful if you learn to control this quality of yours. Your judgments should always be neutral and non vindictive; always keep anger under control.

In fact, the Yamraja quality in us can be equated to the qualities, which a judge should have in Court; be it District, High or Supreme Court. The better term, therefore, is Dharma Raja as no judge would like to be called as Yamraja.

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

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 your doctor check both your arms for blood pressure and which of the two is higher, use that arm for future blood pressure readings.

Soul does not leave the body immediately after the death

By Dr K K Aggarwal
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According to Prashna Upanishad, at the time of death, the Prana Vayu (life force and respiration) merges with Udana Vayu (brain stem reflexes) and leaves the body. But this does not happen immediately after clinical death, which is defined as stoppage of heart and respiration. Medically the term used for clinically dead patients is sudden cardiac arrest.

As per the modern medicine, in cardiac arrest, the brain does not die for the next 10 minutes and during this period, if the heart can be revived, life can be brought back.

The revival of patient during this period can be remembered by the ‘Formula of 10’: Within 10 minutes of the stoppage of heart (cardiac arrest), if effective chest compressions are given for the next ten minutes with a speed of 100 per minutes (10X10), 80% of the cardiac arrest victims can be revived.

This period can be much longer in hypothermia state. If the temperature of the body is low, the soul does not leave the body till the temperature is brought back to normal. Today, this property of soul is also used as therapeutic measure where patients who cannot be revived in the first 10 minutes of clinical death are put in a freezing chamber and artificial hypothermia is produced and these patients can then be transported to an advance cardiac centre where even after 24 hours, resuscitation measures can be applied after re-warming the body. Many people have been revived even after 24 hours of cardiac arrest with such a technology.

There are instances in literature where a newborn with hypothermia was declared dead but revived in the cremation ground when the environment heat brought the body temperature to normal and the pressure of the wood worked like cardiac massage.

This aspect of “life after death” is a contribution of the modern science to the Vedic science. Though in Vedic literature, it was well known phenomenon as Savitri brought life back into Satyavan even after his clinical death.

Take home message is that one should not declare a patient dead in the first 10 minutes; give cardiac massage and try reviving him with chest compression cardiopulmonary resuscitation (CPR).

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

Tips to prevent type 2 diabetes

By Dr K K Aggarwal
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  1. Exercise more Exercise has various benefits including preventing weight gain, controlling blood sugar levels, and other conditions. A minimum of 30 minutes of physical activity every day is very beneficial.
  2. Eat healthy A diet rich in whole grain, fruits, and vegetables is very good for the body. Fibrous food will ensure that you feel fuller for a longer period and prevent any cravings. Avoid processed and refined food as much as possible.
  3. Limit your alcohol intake and quit smoking Too much alcohol leads to weight gain and can increase your blood pressure and triglyceride levels. Men should limit drinks to two per day and women to one per day. Smokers are twice as likely to develop diabetes as non-smokers and therefore, it is a good idea to quit this habit.
  4. Understand your risk factors Doing so can help you in taking preventive measures at the earliest and avoid complications.

Best time to sign a deal is at 4 pm

By Dr K K Aggarwal
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As per Ayurveda 2–6 pm in the evening and 2–6 am in the morning are the periods of Vata or creativity. Most poets and writers do their creative work during these times of the day, especially 2–6 am in the morning.

Vata period is more creative and you are less likely to make mistakes. Four PM in the evening is considered the best time to make a deal, sign a document or to send a confession note.

Apart from the time of the day Vata age is old age and Vata month is rainy season. This is one reason that we always pay attention to the advice of the elderly.

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

A mix of exercise protocol is better

By Dr K K Aggarwal
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A combination of weight training and aerobic exercise is the best prescription for overweight patients at risk for diabetes and heart disease. Only aerobic exercise is also as good as it reduces weight and takes inches off the waistlines. Just weight lifting alone has very little benefit.

According to a study published in the American Journal of Cardiology, people in the weight–training group gained about 1.5 pounds and those in the aerobic group lost an average of 3 pounds and half an inch from their waists. Those who did both weight and aerobic training dropped about 4 pounds and 1 inch from the waistline. This group also saw a decrease in diastolic lower blood pressure and in a metabolic syndrome score. Both the aerobic–only group and the combined-exercise group also lowered their levels of bad triglycerides.