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Dr K K Aggarwal

Even children can have acidity

By Dr K K Aggarwal
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Children who have continuing recurrence of cough and croup could be suffering from stomach Reflux problems.

Croup or ‘Kali Khansi’ as it is called in local parlance is recognized by a loud cough that often sounds like the barking of a seal. It can cause rapid or difficult breathing, and sometimes wheezing. Croup is thought to be caused by a virus, but reflux acidity has been suggested as a possible trigger.

In GERD, or gastroesophageal reflux disease, stomach acid causes swelling and inflammation of the larynx, which narrows the airway. It can trigger more swelling with any kind of viral or respiratory infection.

Identifying children with GERD could help treat and improve recurring croup. It is unusual for a child to have 3 or more bouts of croup over a short period of time. These children need to be evaluated.

The same is true for adults also. Patients with non responding asthma should be investigated for underlying acidity as the cause of acute asthma.

Low Self Esteem

By Dr K K Aggarwal
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Low self-esteem is the opposite of ego. Supportive psychotherapy is often used to treat depression by improving self-esteem.

Low self–esteem always develops when you compare your skill or knowledge with somebody else. We often forget that for passing marks, we only need 50%. One who passes with 50% is a good student. But the same person, when compares himself or herself with a student who has scored 90% or higher, feels that his education was inferior as he was not as competent as others.

Remember that one is required to possess average degree of knowledge and skill and not the maximum degree of skill and knowledge. In the society, one needs to possess only average degree of skill and knowledge.

For example, if a person has passed MBBS with 50% marks, he or she is allowed to practice medicine with full powers and respect. There may be chances when a person who is in the 90th percentile may be able to take some better decisions but the same does not make him a superior doctor.

The fundamental principle in self–esteem is to make a person proud of his personal knowledge and skills and also to bring out his or her uniqueness.

Passion and profession are two different things. We should judge an individual from is passion and not profession.

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

Harvard 8 tips for buying shoes that are good to your feet

By Dr K K Aggarwal
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  1. Wait until the afternoon to shop for shoes — your feet naturally expand with use during the day and may swell in hot weather.
  2. Wear the same type of socks that you intend to wear with the shoes.
  3. Have the salesperson measure both of your feet. If one foot is larger or wider than the other, buy a size that fits the larger foot.
  4. Stand in the shoes. Make sure you have at least a quarter– to a half–inch of space between your longest toe and the end of the shoe.
  5. Walk around in the shoes to determine how they feel. Is there enough room at the balls of the feet? Do the heels fit snugly, or do they pinch or slip off? Don’t rationalize that the shoes just need to be “broken in” or that they’ll stretch with time. Find shoes that fit from the start.
  6. Trust your own comfort level rather than a shoe’s size or description. Sizes vary from one manufacturer to another. You’re the real judge.
  7. Feel the inside of the shoes to see if they have any tags, seams, or other material that might irritate your feet or cause blisters.
  8. Turn the shoes over and examine the soles. Are they sturdy enough to provide protection from sharp objects? Do they provide any cushioning? Also, take the sole test as you walk around the shoe store: do the soles cushion against impact? Try to walk on hard surfaces as well as carpet to see how the shoes feel.

Four Types of Insults

By Dr K K Aggarwal
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Insulting someone invariably means hurting somebody’s ego. In politics, as per Chanakya Niti, a person never forgets three types of insults. The first two are attacking someone with character assassination or financial irregularities.

In politics, we have seen that whenever a person is charged with immorality or financial corruption, he/she had to step down from the political post. Similarly, successful movies show the hero in the role of an angry man. An honest police officer is charged with either immorality or financial corruption so that he can be made to step down. In politics, the opponents always look to manipulate these two charges against any person so as to gain sometime and immediate benefits.

As a spiritual man, if you want to be healthy and happy, you should never talk loose against someone, which may amount to character assassination or corruption charges. Ego in mythology is symbolized with snake (Naag) and it is said that if a Naag is killed, the Naagin captures the photo of the person who has killed the Naag and will take revenge in future. The mythological meaning is that if you hurt someone’s ego, that person’s Shakti (ego) will keep it in her mind till she takes action against the person, who has hurt the ego.

The third type of insult is insulting somebody’s caste or religion. We have seen chaos, massacre and public outrage whenever anyone has tried to insult somebody’s race, religion or caste.

All other insults are easily forgotten by the people and are short lasting e.g. ignoring somebody, abusing somebody, shouting or hitting at somebody.

By definition, an insult is expression or statement or behavior which is considered degrading offending. Insults may be intentional or accidental. For example, accidentally ignoring somebody or not answering somebody’s phone calls or emails.

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

Relieve stress by changing the interpretation

By Dr K K Aggarwal
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Stress is the reaction of the body or the mind to the interpretation of a known situation. Stress management, therefore, involves either changing the situation, changing the interpretation or taming the body the yogic way in such a way that stress does not affect the body.

Every situation has two sides. Change of interpretation means looking at the other side of the situation. It is something like half glass of water, which can be interpreted as half empty or half full.

Studies have shown that anger, hostility and aggression are the new risk factors for heart disease. Even recall of anger has been reported to precipitate a heart attack.

Many studies have shown that when doctors talk positive in front of unconscious patients in ICU, their outcome is better than those in whose presence doctors talk negative.

The best way to practice spiritual medicine is to experience silence in the thoughts, speech and action. Simply walking in the nature with silence in the mind and experiencing the sounds of nature can be as effective as 20 minutes of meditation. He said that 20 minutes of meditation provides the same physiological parameters as that of seven hours of deep sleep.

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

Lassa fever: Some tips from HCFI

By Dr K K Aggarwal
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  1. Avoiding rodents (multimammate rats).
  2. Consider all patients as infectious even if signs and symptoms are mild.
  3. All standard, contact, and droplet precautions as well as correct use of appropriate personal protective equipment should be strictly adhered to.
  4. Blood and body fluid specimens from patients with suspected Lassa fever infection should be considered highly infectious. Caution should be exercised when handling such material.
  5. Postexposure prophylaxis with oral ribavirin for contacts with known or suspected Lassa fever infection with risk factors for transmission such as penetrating needle stick injury, exposure of mucous membranes or broken skin to blood or body fluids, and participation in procedures involving exposure to bodily fluids or respiratory secretions without use of personal protective equipment.

You are the Temple of God and the Spirit of the God Dwells in You

By Dr K K Aggarwal
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This sutra from the Bible reflects the union between the spirit and the soul. The ‘Spirit’ represents the Parmatama or the Brahman and ‘You’ represents the individualized spirit or the Soul (Jivatama).

A temple is a place of worship and also the place where the God resides. Every human being represents a temple (place of worship) where God exists (one’s soul) and this soul is nothing but the essence of God (the spirit).

One should treat every individual in the same manner as the same spirit dwells in every human being. The soul is also the reflection of individual’s past and present karmic expressions. Most people are in the habit of looking and searching for God in artificial temples, gurudwaras and churches, not realizing that the same God is present within us, provided we undertake the internal journey to look for Him.

He is present in between thoughts in the silent zone and can be approached by adopting any of the three pathways: Karma Yoga, Bhakti Yoga and Gyana (Gnana) Yoga.

Doing selfless work with detachment to its results; working with the principles of duty, devotion and discipline and/or regularly doing Primordial Sound Meditation or other types of meditations can help one reach the stage of self–realization or meeting one’s true self. Once there, one can have all the happiness in life.

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

UIP Vaccination Schedule

By Dr K K Aggarwal
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  1. BCG (Bacillus Calmette Guerin) 1 dose at Birth (up to 1 year if not given earlier)
  2. DPT (Diphtheria, Pertussis and Tetanus Toxoid) 5 doses; Three primary doses at 6weeks,10weeks and 14 weeks and two booster doses at 16-24 months and 5 Years of age
  3. OPV (Oral Polio Vaccine) 5 doses; 0 dose at birth, three primary doses at 6,10 and 14 weeks and one booster dose at 16-24 months of age
  4. Hepatitis B vaccine 4 doses; 0 dose within 24 hours of birth and three doses at 6, 10 and 14 weeks of age.
  5. Measles 2 doses; first dose at 9-12 months and second dose at 16-24 months of age
  6. TT (Tetanus Toxoid) 2 doses at 10 years and 16 years of age
  7. TT – for pregnant woman two doses or one dose if previously vaccinated within 3 Years
  8. Japanese Encephalitis (JE vaccine) vaccine was introduced in 112 endemic districts in campaign mode in phased manner from 2006-10 and has now been incorporated under the Routine Immunisation Programme.

Should there be a mourning room in the hospital?

By Dr K K Aggarwal
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In a survey conducted by Heart Care Foundation of India of 400 people from all walks of life, 90% of the people wanted that wishes of the dying person and dead body should be respected in the hospital setting. They said that doctors should be more compassionate and emphatic at the time of declaring a patient dead.

Unless people are expecting a death, death usually comes as a shock to the family members. It is expected that the relations may be in agony, pain and even anger. Every hospital should have a mourning room where the relatives should be made to sit, counselled and death declared.

After the death is declared, the treating doctors, nurses and hospital staff must sit with the patient’s relatives, counsel them, tell them about the sequence of events before death and also counsel them about how to handle the dead body. People also want to know the cause of death so that similar thing may not happen to another person in the family.

They also want to know if the body is infectious or not and what rituals to be avoided if the body is infectious. They also like to know about how to preserve the dead body till cremation.

They may also like to know whether a postmortem is required to know exact cause of death, which can help future family members of the family.

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

Some tips from HCFI

By Dr K K Aggarwal
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  1. Exercises and stretches can help maintain strength and stop joints becoming stiff in children with spinal muscular atrophy. Although the amount of exercise will depend on the condition, its best to try and stay as active as possible.
  2. There are activities/exercises that can be done to strengthen the breathing muscles and make coughing easier.
  3. It is important for people with spinal muscular atrophy, especially children, to get the right nutrients. This will help with healthy growth and development. A dietitian can offer advice about feeding and diet.

Science behind regrets

By Dr K K Aggarwal
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In a US–based study, dying people were asked about their regrets, if any. The top five regrets were:

  1. I wish I had the courage to live a life I wanted to live and not what others expected me to live.
  2. I wish I had worked harder.
  3. I wish I had the courage to express my feelings.
  4. I wish I had stayed in touch with my friends.
  5. I wish I had let myself to be happier.

Regrets are always based on suppression of emotions or non–fulfillment of desires and needs. These need-based desires can be at the level of physical body, mind, intellect, ego or the soul. Therefore, regrets can be at any of these levels.

I did a survey of 15 of my patients and asked them a simple question that if they come to know that they are going to die in next 24 hours, what would be their biggest regret.

Only one of them, a doctor said that she would have no regrets.

Only one person expressed a physical regret and that was from a Yoga expert who said that her regret was not getting married till that day.

Mental regrets were two.

  1. A state trading businessman said, “I wish I could have taken care of my parents.”
  2. A homeopathic doctor said, “I wish I could have given more time to my family.”

Intellectual regrets were three.

  1. A lawyer said, “I wish I could have become something in life.”
  2. A businessman said, “I wish I could have helped more people.”
  3. A retired revenue inspector said, “I wish I had married off my younger child.”

Egoistic regrets were two.

  1. One fashion designer said, “I wish I could have become a singer.”
  2. A housewife said, “I wish I could have become a dietician.”

Spiritual regrets were six.

  1. A Consultant Government Liaison officer said, “I wish I could have made my family members happy.”
  2. A businessman said, “I wish I could have meditated more.”
  3. A Homeopathic doctor said, “I wish I could have spent more time with my family.”
  4. A reception executive said, “I wish I could have spent more time with my parents.”
  5. An entertainment CEO said, “I wish I could have taken my parents for a pilgrimage.”
  6. A fashion designer said, “I wish I could have worked more for the animals.”

In a very popular and successful movie, Kal Ho Na Ho, the hero was to die in the next 40 days. When asked to remember the days of his life, he could not remember 20 ecstatic instances in life.

This is what happens with each one of us where we waste all our days and cannot remember more than 50 or even 20 of such instances. If we are given 40 days to live and if we live every day ecstatically, we can get inner happiness. Therefore, we should learn to live in the present instead of having a habit of postponing everything we do.

We should learn to prioritize our work and do difficult work first or else we would be in a state of constant worry till that work is over.

I teach my patients that they should practice confession exercise and one confession is to talk about your regrets and take them as challenge and finish before the next Tuesday. When working, there are three things which are to be remembered – passion, profession and fashion. Profession is at the level of mind, ego and spirit.

We should convert our profession in such a manner that it is fashionable and passionate. Passion means working from the heart and profession means working from mind and intellect and fashion means working the same at the level of ego which is based on show–off.(Disclaimer: The views expressed in this write up are my own).

Some health tips from HCFI

By Dr K K Aggarwal
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  1. Be aware of the products you use in your home and on your skin. For example, cleaning products with harsh chemicals.
  2. Eat healthy and include lots of fresh fruits and vegetables in your diet. They contain fibre and substances that can help in flushing toxins out of your system.
  3. Take steps to combat stress as this lowers your immune system function. Exercise, sleep well, and meditate. You can also opt for yoga to get rid of stress.
  4. Sleep well as it reduces cortisol produced by the body during stress. It also balances leptin, which determines how much food we eat. If our leptin is off balance, most likely the body will feel that it never gets enough food, which leads to overeating.
  5. Reduce or quit smoking and drinking.

Who is a Good Teacher?

By Dr K K Aggarwal
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A good teacher is the one who follows the principles of listening first, teaching in detail till confusion arises and then teaching with reasoning while going into the minutest details and finally summarizing the ‘take-home’ messages.

This is what Lord Krishna taught to Arjuna in Bhagavad Gita. In the first chapter, he only listens, in the second, he gives detailed counseling, from 2 to 17 chapter, he gives reasoning and in 18th chapter, he revises.

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

Some tips on thyroid disorders from HCFI

By Dr K K Aggarwal
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  1. Hypothyroidism is linked to weight gain. Thus, a person with this condition can find it difficult to lose weight. Consume a diet rich in fibre and low in fat to maintain a healthy weight.
  2. Although it may be difficult to get moving in those with a sluggish thyroid, it is a good idea to push yourself to do some physical activity.
  3. Stress is known to exacerbate thyroid disorders. Do something to reduce those stress levels. It could be yoga, meditation, dance, or anything.
  4. Know the symptoms. Understand what the common symptoms of thyroid cancer are.
  5. Get Tested. Have your GP check for nodules and test TSH levels every few years if you have risk factors for cancer.

Guidelines about Eating

By Dr K K Aggarwal
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  • Eat only when you are hungry.

  • Do not eat for pleasure, social obligations or emotional satisfaction.

  • Eat at a slow pace

  • Eat less; dinner less than lunch.

  • Take small mouthfuls each time, chew each morsel well, swallow it and only then take the next morsel.

  • Do not eat while watching television, driving a car or watching sports events. The mind is absorbed in these activities and one does not know what and how much one has eaten.

  • Do not talk while eating and never enter into heated arguments. The stomach has ears and can listen to your conversation. It will accordingly send signals to the mind and heart.

  • Plan and decide in advance what and how much food you will be eating.

  • Use low fat or skimmed mild dairy products. For cooking, use oils which are liquid at room temperature.

  • Do not take red meat and if you are a non–vegetarian, you may take poultry meat or fish.