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Dr K K Aggarwal

Diagnosis of hypertension in childhood requires repeated BP measurements

By Dr K K Aggarwal
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One needs to confirm presence of hypertension based on three blood pressure measurements at separate clinical visits.

Normative BP percentiles are based upon data on gender, age, height, and blood pressure measurements from the National Health and Nutrition Examination Survey and other population–based studies.

In a study published in the journal Pediatrics in 2013, the initial BP measurement was normal (below the 90th percentile), pre–hypertensive (systolic or diastolic BP between the 90th or 95th percentile) and hypertensive (systolic or diastolic BP ≥95th percentile) in 82, 13, and 5 percent of children.

At follow–up, subsequent hypertensive measurements were observed in only 4 percent of the 10,848 children who had initial hypertensive values. In the cohort, the overall prevalence of hypertension was 0.3%.

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 when multi-tasking, so can the human mind. When you are handling multiple projects at the same time, you may experience thought blocks, which are natural and not a sign of a disease.

When we introduce ourselves to a new person, we often tell them our name first. It is possible by the time you finish your conversation, the person may forget your name. Therefore, one should either introduce himself at the end of the conversation or introduce oneself both times i.e. at the start and 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 a medical doctor, quite often we face these difficulties. 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 be handling hundreds of Malhotras and it is not expected from us, especially, after the age of 40 to recall a person just by his surname. Unless full information is given to us by patient on phone, mistakes may occur, especially, if it is a phone consultation. Phone consultation anyway needs to be avoided. Even the Supreme Court in one of its judgments has 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).

Beware of fatty liver

By Dr K K Aggarwal
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  1. Nonalcoholic fatty liver disease (NAFLD) means presence of hepatic steatosis (fatty liver), when no other causes for secondary hepatic fat accumulation (heavy alcohol consumption) are present.
  2. NAFLD, if not treated, may progress to cirrhosis and is likely an important cause of cryptogenic cirrhosis.
  3. NAFLD is subdivided into: Nonalcoholic fatty liver (NAFL) or simple fatty liver with no liver inflammation and nonalcoholic steatohepatitis (NASH) or fatty liver with liver inflammation
  4. Patients with NAFLD may have mild or moderate elevations in SGOT and SGPT levels (liver enzymes).
  5. Normal SGOT and SGPT levels, however, do not exclude NAFLD.
  6. When elevated, the SGOT and SGPT levels are typically 2 to 5 times the upper limit of normal.
  7. In acute viral hepatitis, the SGOT/SGPT ratio is less than 1 (unlike alcoholic fatty liver disease, which typically has a ratio greater than 2)
  8. The degree of SGOT and SGPT elevation does not predict the degree of liver inflammation or fibrosis, and a normal SGOT, SGPT levels does not exclude clinically important histologic injury.
  9. The alkaline phosphatase may be elevated to 2 to 3 times the upper limit of normal.
  10. Serum albumin and bilirubin levels are typically within the normal range, but may be abnormal in patients who have developed cirrhosis. When cirrhosis sets in, one may have prolonged prothrombin time and cytopenias.
  11. A serum ferritin greater than 1.5 times the upper limit of normal in patients with NAFLD may mean presence of inflammation

Vedic Science behind Post- traumatic Stress Disorder

By Dr K K Aggarwal
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PTSD is a type of stress that lasts for up to 13 days if handled properly and for months or years if not handled after an acute stress. This can be a serious disorder.The reference to mourning a death can be found in the Vedic literature. There is a custom that the grieved partner is made to weep till she or he is overwhelmed with emotions. In fact, all relatives and friends participate in the exercise, depending upon their respective closeness to the deceased.In the antim yatra most relatives join and after that the grieved person is made to sit for 90 minutes every day as a part of the ceremony which either ends on chautha or tervi where again everybody known gather together to end the ceremony. Thereafter, normal activities of life are resumed.In some sections of the society there is also a custom of shaving the head or doing ‘daan’ of hairs and or wearing white clothes.Is there a scientific explanation for these customs? The plausible explanation are many and are based on the observation that a grieved person may go into depression, which if not treated properly may last for months together, or even forever. For example the acute stress after the death of somebody very close will be called acute traumatic stress and the condition Post–Traumatic Stress Disorder (PTSD).

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

Plate Your Food Now

By Dr K K Aggarwal
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A ‘Food Plate’ symbol has replaced the traditionally recommended ‘Food Pyramid’ of the USDA. These guidelines break down a healthy diet into 4 main quadrants on a plate: red for fruits, green for vegetables, orange for grains and purple for protein. A small blue circle attached to the plate signifies dairy products.

Fruits and vegetables occupy half of the plate space, with the vegetable portion being a little bigger than the fruit section. Eating more fruits and vegetables means consumption of fewer calories on the whole, which helps to maintain a healthy body weight. Fruits and vegetables are also a rich source of fiber along with vitamins and minerals.

The other half is divided between grains and proteins. Grains, with emphasis on whole grains make up one quarter of the plate. Protein is a smaller quarter of the plate. The recommendation is to aim to eat different kinds of protein in every meal.

In a major shift from the food pyramid, the Plate does not mention the number of servings for any food group or portion size. Nor does it mention fats and oils.

Remember the following tips for a healthy meal:

  1. Eat less and enjoy your food by eating slowly
  2. Fill half your plate with fruit and vegetables.
  3. Avoid oversized portions, which can cause weight gain.
  4. At least half of your grains should be whole grains.
  5. Reduce intake of foods high in solid fats and/or added sugar.
  6. Use fat–free or low fat milk and/or dairy products.
  7. Drink plenty of water. Avoid sugary drinks.
  8. Avoid foods that have high sodium levels such as snacks, processed foods.
  9. Above all, balance your food choices with your activity level.

Top Characters of Mahabharata

By Dr K K Aggarwal
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To be in harmony with the body (five elements represented by Draupadi), one must acquire five qualities or in other terms live a focused life, full of strength and not being disturbed with loss or gain and finally working for the welfare of the society without having any partiality towards anyone.

  1. Balanced mind: Yudhishthir (“sthir” or balanced in “yudh” or disturbed state of mind)
  2. Focused vision (Arjuna)
  3. Using internal power or strength (Bhima)
  4. Not being partial or remaining neutral (Nakul)
  5. Working for the welfare of the society (Sahdev)

With this, one can kill 100 negative qualities that a person can have (the 100 Kauravs). The hundred negative qualities are acquired because of cunningness (Shakuni), not working with the eyes of the soul (Dhritarashtra) and keeping a blind eye to any wrong happening (Gandhari).

The main negative qualities are taking decisions in day–to–day life situations (Duryodhana: dusht in yudha or war) and choosing wrong choices as a ruler (dushasana: dusht and shasan).

The positive qualities once acquired will also win over other negative qualities like blind faith or undue attachments (Bhishma pitamaha); unrighteous loyalty (Dronacharya) and unrighteous ego (Karna).

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

Is microwave safe for cooking and nutrition?

By Dr K K Aggarwal
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Some people believe that microwave cooking removes nutrients and makes food less healthy.

Microwave ovens cook food using waves of energy that are similar to radio waves but shorter. These waves are remarkably selective, primarily affecting water and other molecules that are electrically asymmetrical — one end positively charged and the other negatively charged. Microwaves cause these molecules to vibrate and quickly build up thermal (heat) energy.

Some nutrients break down when they are exposed to heat, whether it is from a microwave or a regular oven. Vitamin C is perhaps the clearest example. But because microwave cooking times are shorter, cooking with a microwave does a better job of preserving vitamin C and other nutrients that break down when heated.

Cooking vegetables in water robs them of some of their nutritional value because the nutrients leach out into the cooking water. For example, boiled broccoli loses glucosinolate, the sulfur-containing compound that may give the vegetable its cancer-fighting properties (as well as the taste that many find distinctive and some find disgusting). Is steaming vegetables better? In some respects, yes. For example, steamed broccoli holds on to more glucosinolate than boiled or fried broccoli.

The cooking method that best retains nutrients is one that cooks quickly, heats food for the shortest amount of time, and uses as little liquid as possible. Microwaving meets those criteria. Using the microwave with a small amount of water essentially steams food from the inside out. That keeps more vitamins and minerals than almost any other cooking method. (Harvard News Letter)

Wahans (Vehicles) in Mythology

By Dr K K Aggarwal
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In mythology, the negative tendency of a man is symbolized with the animal nature. Gods in Indian mythology are symbolized as living a positive behavior. Every God has been given a vehicle or Wahan. Both God and the Wahan symbolized how to live a positive life and how to control the animal tendencies. Following are a few examples.

  1. Lord Ganesha rides a Mouse. Mouse in mythology is symbolized with greed and Ganesha as the one who removes obstacles. The spiritual meaning behind both is – one should learn to control greed to tackle obstacles in life.
  2. Lord Shiva rides Nandi. The bull symbolizes uncontrolled sexual desires and the duo signifies that to learn meditation, one needs to control sexual desires first.
  3. Saraswati (the Goddess of knowledge) sitting on a swan symbolizes that to acquire knowledge one must learn to control the power of discrimination or vivek. A swan can drink milk and leave water from a mixture of milk and water.
  4. Indra (the one who has a complete control over the intellect) riding on the elephant Airavat symbolizes that for its development the intellect (Indra) requires control over masti and madness (elephant).
  5. Durga (the perfect woman) riding a lion symbolizes that to become a perfect woman, she must learn to control agitation or aggression (lion).
  6. Lakshmi (wealth) riding an owl symbolizes that to earn righteously, one must learn to control owl-like properties within us, which is not to get befooled.
  7. Lord Vishnu (the doer) riding the eagle or Garuda (Eagles are opportunistic predators which means they eat almost anything they can find) means controlling your desires to eat an unbalanced diet.
  8. Krishna riding five horses means one need to control our five senses.
  9. Kartikeya riding a peacock symbolizes that one should learn to control one’s pride (vanity) or ego.
  10. The vehicle of Goddess Kali is a black goat. Agni rides Mesha, a ram. Kubera, the god of wealth, also has a ram as his vehicle. A ram is an uncastrated adult male sheep. Goat also signifies uncontrolled sexual desires but lesser than the bull.
  11. Yamraj rides a buffalo, which is known for its rampant destruction. Lord Yama or Yamraja is referred to as the God of death, twin brother, lord of justice, Dharma Raja. One can do justice only if one has a control over anger and aggressive behavior.

In mythology, apart from Wahans, animals are also shown to be sacrificed, which means to kill the animal tendency within ourselves. In Kali Pooja, a buffalo is sacrificed, which again means that in extreme situations, you may need to kill your ego or anger.

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

Is microwave safe for cooking and nutrition?

By Dr K K Aggarwal
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Some people believe that microwave cooking removes nutrients and makes food less healthy.

Microwave ovens cook food using waves of energy that are similar to radio waves but shorter. These waves are remarkably selective, primarily affecting water and other molecules that are electrically asymmetrical — one end positively charged and the other negatively charged. Microwaves cause these molecules to vibrate and quickly build up thermal (heat) energy.

Some nutrients break down when they are exposed to heat, whether it is from a microwave or a regular oven. Vitamin C is perhaps the clearest example. But because microwave cooking times are shorter, cooking with a microwave does a better job of preserving vitamin C and other nutrients that break down when heated.

Cooking vegetables in water robs them of some of their nutritional value because the nutrients leach out into the cooking water. For example, boiled broccoli loses glucosinolate, the sulfur-containing compound that may give the vegetable its cancer-fighting properties (as well as the taste that many find distinctive and some find disgusting). Is steaming vegetables better? In some respects, yes. For example, steamed broccoli holds on to more glucosinolate than boiled or fried broccoli.

The cooking method that best retains nutrients is one that cooks quickly, heats food for the shortest amount of time, and uses as little liquid as possible. Microwaving meets those criteria. Using the microwave with a small amount of water essentially steams food from the inside out. That keeps more vitamins and minerals than almost any other cooking method. (Harvard News Letter)

Wahans (Vehicles) in Mythology

By Dr K K Aggarwal
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In mythology, the negative tendency of a man is symbolized with the animal nature. Gods in Indian mythology are symbolized as living a positive behavior. Every God has been given a vehicle or Wahan. Both God and the Wahan symbolized how to live a positive life and how to control the animal tendencies. Following are a few examples.

  1. Lord Ganesha rides a Mouse. Mouse in mythology is symbolized with greed and Ganesha as the one who removes obstacles. The spiritual meaning behind both is – one should learn to control greed to tackle obstacles in life.
  2. Lord Shiva rides Nandi. The bull symbolizes uncontrolled sexual desires and the duo signifies that to learn meditation, one needs to control sexual desires first.
  3. Saraswati (the Goddess of knowledge) sitting on a swan symbolizes that to acquire knowledge one must learn to control the power of discrimination or vivek. A swan can drink milk and leave water from a mixture of milk and water.
  4. Indra (the one who has a complete control over the intellect) riding on the elephant Airavat symbolizes that for its development the intellect (Indra) requires control over masti and madness (elephant).
  5. Durga (the perfect woman) riding a lion symbolizes that to become a perfect woman, she must learn to control agitation or aggression (lion).
  6. Lakshmi (wealth) riding an owl symbolizes that to earn righteously, one must learn to control owl-like properties within us, which is not to get befooled.
  7. Lord Vishnu (the doer) riding the eagle or Garuda (Eagles are opportunistic predators which means they eat almost anything they can find) means controlling your desires to eat an unbalanced diet.
  8. Krishna riding five horses means one need to control our five senses.
  9. Kartikeya riding a peacock symbolizes that one should learn to control one’s pride (vanity) or ego.
  10. The vehicle of Goddess Kali is a black goat. Agni rides Mesha, a ram. Kubera, the god of wealth, also has a ram as his vehicle. A ram is an uncastrated adult male sheep. Goat also signifies uncontrolled sexual desires but lesser than the bull.
  11. Yamraj rides a buffalo, which is known for its rampant destruction. Lord Yama or Yamraja is referred to as the God of death, twin brother, lord of justice, Dharma Raja. One can do justice only if one has a control over anger and aggressive behavior.

In mythology, apart from Wahans, animals are also shown to be sacrificed, which means to kill the animal tendency within ourselves. In Kali Pooja, a buffalo is sacrificed, which again means that in extreme situations, you may need to kill your ego or anger.

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

Some tips to prevent cervical cancer

By Dr K K Aggarwal
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  1. Reduce your chances of getting infected with the human papillomavirus (HPV) by avoiding sexual contact with multiple partners without adequate protection.
  2. Get a Pap test done every 3 years as timely detection can help in curing this condition.
  3. Quit smoking right away. Nicotine and other components found in cigarettes may pass through the blood stream and get deposited in the cervix where they can alter the growth of cervical cells. Smoking can also suppress your immune system making it more susceptible to HPV infections.
  4. Eat a healthy diet rich in fruits, vegetables, and whole grains.
  5. Maintain a healthy weight as being overweight or obese increases the risk of insulin resistance, which may lead to type 2 diabetes and increase the risk of developing cancer

Sewa the best dharma

By Dr K K Aggarwal
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Offering help is the best service to the humanity. As per Sikhism, Sewa (unconditional service), Simran (meditation) and Satsang (company of good people) constitute the trio to acquire happiness and spiritual health. In Sikhism, Sewa is the main path for acquiring spiritualism. In Gurudwara, one even offers sewa by cleaning the shoes of others or by cleaning the entry paths to any Gurudwara.

Offering help covers all the paths of being a Satyugi i.e. truthfulness, unconditional hard work, purity of mind and finally, Daya and Daan. When you offer help, you always do it in a positive state of mind and it involves hard work, mercy and charity.

The five pillars of Jainism are Ahimsa (non-violence in action, speech and thoughts), satya (being synonymous in action, speech and thought), Brahmacharya (disciplined life), Asteya (non-stealing) and Aparigriha (not storing more than required).

Any offering therefore should be without any reward; the same applies to actions, thoughts and speech.

Jainism also prescribes not storing things which are not required and therefore anything more than required can be donated or offered to people in the form of sewa.

All professions which primarily do sewa are given special status in the society. for example, doctors are allowed to prefix ‘Dr.’ in front of their names and eminent people who offered help to the society are allowed to prefix names like Raja, Deewan, Rai Bahadur, Rotarian, Lion etc.

As per Government policy every PSU has to spend a 2% budget for charity in corporate social responsibility. Similarly, each one of us should spend 2% of our time, money or assets for charity or community service.

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

Some facts about polio vaccine

By Dr K K Aggarwal
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  1. Polio vaccine should be given immediately after the neonate is born.
  2. Some people believe that one dose of the polio vaccine is enough to prevent the attack from the virus, which is not true.
  3. Children should get all the doses of the oral polio drops.
  4. It is a virus that resides in the throat or the intestinal tract.
  5. A common myth associated with polio vaccine is that it causes impotency. The polio vaccine is the safest vaccine available in India

The inseparable pairs in Vedanta

By Dr K K Aggarwal
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Luv-Kush, Shubha-Labha, Riddhi-Siddhi are inseparable pairs of Vedanta. They signify that you cannot get one without the help of the other.

In Luv-Kush, Kush is a symbol of purity and Luv symbolize the spiritual love. To achieve love one has to be pure in consciousness. To acquire love and inner happiness in life, one may have to use kush, a herb, in daily life. No traditional Hindu ritual is complete without the use of kush grasses.

Kush is a benevolent satvik detoxifying grass, a symbol of progress and alertness. The word “kushal buddhi” originates from the word kush. In Bhagavad Gita (shloka 6.10) Krishna said that for meditation one should sit on a seat covered with kush grass. The Garuda Purana also described the importance of kush grass in rituals of Panchak death and in cremation of a person whose body has not been found as in natural calamities, by making an effigy of kush grass and completing the rituals. Kush grass is often held in the hands before taking a sankalp.

Kush grass is called Imperata cylindrica Beauv. It is a clean, pure, brittle grass with acrid, cooling, oleaginous, aphrodisiac and diuretic properties. Kush sharbat is a drink routinely used by traditional healers of Chattisgarh.

In Riddhi-Siddhi, Riddhi is knowledge and Siddhi is perfection. An obstacle-free life (represented by Ganesha) can be attained only when one masters or tames both knowledge and perfection.

Riddhi and Siddhi are the two inseparable wives of Lord Ganesha.

Some symbolize Siddhi as success and Riddhi as prosperity or Riddhi as material abundance and Siddhi as the intellectual and spiritual prowess or Riddhi as prosperity and Siddhi as progress. All are dependent on each other.

Ganesha is said to have two sons, Shubha-Labha. Again the two terms are inseparable from each other. Both the words are written during Diwali on each account book. Shubha is auspiciousness and Labha, profit.

Ram Lakshman are often spoken of as Ram-Lakhan, which signifies that to be in touch with consciousness (Rama) one has to control the mind with an aim (Mana with a Lakshya).

Other pairs, which are inseparable, are Rama and Sita, Radha and Krishna, Shiva and Parvati, Brahma and Saraswati and Vishnu and Lakshmi.

In Rama-Sita, Rama signifies soul consciousness and Sita, the body. It is true for the Krishna and Radha combination. They also signify the dual character of the nature, feminine and masculine natures.

In Brahma and Saraswati, Brahma represents creativity or innovations and Saraswati the art of acquiring pure knowledge. Again both are dependent on each other.

Lakshmi and Vishnu are again inseparable. Vishnu or Krishna is the doer and performer. They signify action in the present. Lakshmi signifies material and spiritual benefits. One can only get the benefits by action in dharma.

Shiva-Parvati is other inseparable word used in Vedic literature. The other is Shiva and Shakti. They represent the true nature of the consciousness, the male and the female energies; the purusha and the prakriti. In terms of computer language, they represent the operational and the application software. No computer can run without both. One is knowledge or the information and the other is energy.

Other uncommon pairs are Bharata and Shatrughana of Ramayana. Bharata represents bhakti, devotion and discipline and Shatrughana, victory over the enemy. To win over the Shatru, one has to become Bharata.

In Mahabharata, there is the pair of Nakul (being neutral) and Sahdeva (helping every one). Again they are inseparable. You cannot help unless you are neutral.

The pairs of modern post Vedic era are Heer-Ranjha, Laila-Majnu, Sheeri-Farhad, Banti and Babli and Veer-Zara. They all symbolize human love relationship

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

Vitamin A-rich diet

By Dr K K Aggarwal
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Vitamin A–rich foods include the following:

  1. Liver
  2. Beef
  3. Chicken
  4. Eggs
  5. Whole milk
  6. Fortified milk
  7. Carrots
  8. Mangoes
  9. Orange fruits
  10. Sweet potatoes
  11. Spinach, kale, and other green vegetables

Eating at least 5 servings of fruits and vegetables per day is recommended in order to provide a comprehensive distribution of carotenoids.

A variety of foods, such as breakfast cereals, pastries, breads, crackers, and cereal grain bars, are often fortified with 10–15% of the RDA of vitamin A.