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Dr K K Aggarwal

Padma Shri and Dr B C Roy National Awardee

FODMAPS free diet

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Symptoms of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) may be partly related to impaired absorption of carbohydrates. Fermentable oligo–, di– and monosaccharides and polyols (FODMAPs) in patients with IBS or IBD may reach the distal small bowel and colon where they are fermented, giving way to symptoms and increased intestinal permeability (and possibly inflammation).

Examples of FODMAPs include:

  • Fructans or inulins (wheat, onions, garlic, and artichokes)
  • Galactans (beans, lentils, legumes, cabbage, and Brussels’ sprouts)
  • Lactose (dairy)
  • Fructose (fruits, honey, high fructose corn syrup)
  • Sorbitol
  • Xylitol
  • Mannitol
  • Polyols (sweeteners containing sorbitol, mannitol, xylitol, maltitol, stone fruits such as avocado, apricots, cherries, nectarines, peaches, plums)

Avoidance of carbohydrates has been a popularized non-pharmacologic approach to reduce symptoms in IBS (and possibly modifying disease in IBD).

Ganesha, the Stress Management Guru

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If Lord Krishna was the first counselor who taught the principles of counseling, Lord Ganesha taught us the principles of stress management.

We should worship Lord Ganesha and become like him in the face of any difficulty or are stressed out.

The elephant head of Lord Ganesha signifies that in the face of a difficulty, we must use our wisdom, intelligence and think differently. We can think of it as the Third Eye of Lord Shiva. Elephant is considered the most intelligent animal. Wisdom, here, signifies thinking before speaking. Lord Buddha also said that we must not speak unless it is necessary and is truthful and kind.

The big elephant ears of Lord Ganesha signify that we must listen to everybody when in difficulty. Elephant’s ears can hear long distances. Elephant’s eye can see a long distance.In mythological terms, it symbolizes that we must acquire the quality of foreseeing when in difficulty. The mouth of Lord Ganesha represents speaking less (and listening more).

The huge tummy of Lord Ganesha symbolizes digesting all information gathered by listening to people in difficulty. The trunk is a symbol of using the power of discrimination to decide from the retained information. It is also a symbol of doing both small and big things by yourself. The elephant’s trunk is capable of picking up a needle as well as a tree.

The teeth, broken and unbroken, signify that we must be in a state of balance, both in loss and in gain. One should not get upset if a task is not accomplished and also not get excited if the task is accomplished. Ganesha also teaches us that we must not lose strength and control our attachments, desires and greed.

The four arms of Lord Ganesha are a symbol of strength. Ropes in two hands symbolize attachment; Laddoo or Sweet in one hand symbolizes desires while the mouse represents greed. Riding over the mouse signifies controlling one’s greed.

Lord Ganesha is worshipped when we are about to start a new work or when we are finding it difficult to complete a task. In both the situations, these principles of Lord Ganesha need to be inculcated in one’s habits.

Food poisoning with rice dishes

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  • Staphylococcus aureus and Bacillus cereus can cause acute food poisoning within 6 hours of ingestion of food. B. cereus is the likely cause when rice is the reason behind it.
  • B. cereus is able to persist in food processing environments on account of its ability to survive at extreme temperatures as well as its ability to form biofilms and spores.
  • B. cereus has been recovered from a wide range of foods, including rice, dairy products, spices, bean sprouts and other vegetables.
  • Fried rice is an important cause of emetic-type food poisoning linked with B. cereus.
  • The pathogen is found in uncooked rice, and heat-resistant spores have the potential to survive cooking.
  • Cooked rice subsequently at room temperature can allow vegetative forms to multiply, and the heat-stable toxin that is produced can survive brief heating.
  • B. cereus causes two types of toxin-mediated food poisoning -marked by either diarrhea or vomiting, based on the toxin involved. Vegetative cells produce the diarrheal toxin in the small intestine following the ingestion of either bacilli or spores. The emetic toxin is ingested directly from contaminated food. Both toxins can lead to disease within 24 hours of ingestion.
  • Heating can reduce the number of viable spores and vegetative bacteria that produce diarrheal toxin; however, spores associated with emetic toxin can survive heat.
  • The toxin cereulide has thermal stability and resists gastric conditions.
  • The ingested toxin can cause disease despite heating.
  • The emetic syndrome manifests as abdominal cramps, nausea, and vomiting. Diarrhea may also occur in about one-third of patients. Symptomsdevelop within 1 to 5 hours of ingestion, but can also develop within half an hour and up to six hours after ingestion of contaminated food.
  • Symptoms usually resolve in 6 to 24 hours.
  • Rice-based dishes are associated with emetic toxin-mediated disease. This could be attributed to cooling fried rice dishes overnight at room temperature and reheating them the next day.
  • Cereulide can cause symptoms at a dose of 8 to 10 micrograms per kilogram of body weight.

The lips of truth shall be recognized forever

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This is a sutra from Bible which has a deep significance in day-to-day life. Truth lasts forever and always ends up in internal happiness and self-realization. In the long-term, it provides happiness. A lie, on the other hand, provides momentary pleasure but will eventually lead to some difficulty later in life.

Spoken words cannot come back, just likean arrow released from the bow. One cannot get back his youth or respect, once lost. Likewise, spoken words cannot be taken back and bad words, once spoken, will continue to create negative waves in the other person, to whom they were spoken.They will persist as repressed thoughts or memory in the other person’s mind forever. Such bad memories keep on coming back in the person’s mind causing damage to the personal relationships.

A spoken word is a karmic expression. For every karmic action there is an opposite and equal reaction. For every negative karmic action, one has to pay the debt, either now or in future. According to the law of karma, every debt has to be paid.

One must avoid using negative language, both in spoken words as well as in the mind. The yoga sutras of Patanjali describe thinking, speaking or doing anything wrong as having the same karmic significance. We should not only purify ourselves in actions and spoken words but also in the mind. If a person has negative thoughts in the mind, the same will be reflected to the outside world.

The momentary pleasure which one gets by lying has no spiritual significance; it only satisfies the person’s ego or makes him attached to any of the five senses. The transient pleasure that the body experiences stimulates a cascade of reactions, including action, memory and desire, resulting in action again, which will eventually heighten greed and attachments. In the Mahabharata, Lord Krishna gave two examples, which work as an exception to such a situation. Any truth, which may be harmful to others, may not be spoken and any lie which does not harm anyone but benefits a few may be spoken.

Truth is the opposite of doubt. It is always better to clear all the doubts from the mind as any repressed doubts can lead to heart attack, paralysis and cancer.

Truth also signifies taking consciousness-based decisions as the consciousness never lies. While taking any decision one should always ask oneself— Is it the truth? Is it necessary? And will it bring happiness to me and the people around?

Lord Krishna has also been described as “Satchitanand”, which indicates qualities of truthfulness, consciousness-based decisions and internal happiness. Truthfulness has to be practiced over a period of time and made a part of one’s daily life.

10 ways to keep the kidneys healthy

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  1. Monitor blood pressure and cholesterol.
  2. Control weight.
  3. Dont overuse over-the-counter painkillers.
  4. Monitor blood glucose.
  5. Get an annual physical examination.
  6. Know if you have a family history of chronic kidney disease (CKD), diabetes or heart disease. If so, you may be at risk.
  7. Dont smoke.
  8. Exercise regularly.
  9. Follow a healthy diet.
  10. Get tested for chronic kidney disease if youre at risk.

Panchamrit body wash

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Panchamrit is taken as a Prasadam and is also used to wash the deity. In Vedic language, anything which is offered to God can also be taken by the human body. Panchamrit bath is the original and traditionally full bath prescribed in Vedic literature. It consists of the following:

  • Washing the body with milk and water.Milk acts as a soothing agent.
  • Washing the body with curd, which acts as a substitute for soap and washes away the dirt from the skin.
  • Then, washing the body with desi ghee, which is akin to oil massage.
  • This is followed by washing the body with honey, which acts like a moisturizer.
  • Last step is to rub the skin with sugar or khand. Sugar works as a scrub.

Panchamrit bath is much more scientific, cheaper and health friendly.

HCFI tips to reduce your risk of NAFLD

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  • Consume a healthy plant-based diet which is rich in fruits, vegetables, whole grains and healthy fats.
  • Overweight or obese individuals should limit the number of calories consumed in a day and exercise more. Those who have a healthy weight should work to maintain it by opting for a healthy diet and exercising.
  • Exercise most days of the week. One should try to get at least 30 minutes of physical activity every day.

Express gratitude

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  • Gratitude is a thankful appreciation for what we have.
  • Appreciate the roof over your head, the good health you have, people you have in your life who care about you.
  • Set aside a few minutes every day and think about five things you’re grateful for, whether big or small. Write them down.
  • Be specific and remember what each thing means to you.

Honey excellent for cough

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A spoonful of honey can relieve night time cough in children and help them sleep better. In comparison with the cough syrup ingredient dextromethorphan or no treatment, honey seems better. According to a study published in the Archives of Paediatrics and Adolescent Medicine, the results are so strong that we can easily say that honey is better than no treatment and dextromethorphan is not.

There is no proven treatment effective for cough due to an upper respiratory infection like the common cold. Dextromethorphan is commonly used for cough but there is no evidence that it works and moreover, it carries some risks.

Honey is used across the globe as a home remedy for cough, and might provide a safe, effective alternative to cough medicine.

Investigators compared buckwheat honey, a honey-flavored dextromethorphan preparation, and no treatment in 105 children seeking treatment for night time cough due to cold. Children who received honey exhibited the greatest reduction in cough frequency and severity, and the most improved sleep, as did their parents. Its sweet, syrupy quality seems to soothe the throat. Its high antioxidant content could also be a beneficial factor. Honey also has antimicrobial properties.

Honey is; however, not recommended for infants below one year of age due to the risk of botulism spores.

Should doctors be detached in dealing with their patients?

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When dealing with patients, the traditional Patient-Doctor relationship model states that the doctor should remain cool, calm and collected at all times.

The doctor’s approach must be strictly scientific, logical, objective, methodical, precise and dispassionate. This has been the model since the times of William Osler, the father of modern medicine. Imperturbability is the term used, which means coolness and presence of mind under all circumstances.

According to Osler, a rare and precious gift to doctor is the right of detachment. This right protects the doctors from powerful emotions that patients display in their presence, such as anger, frustration, grief, and rage. Additionally, it protects patients from the rolling emotions that doctors may feel towards them.

A detached attitude also shields doctors from empathizing with patients. A detached doctor may talk in a language that goes over the patient’s head.

Detachment is not like a light switch being turned on and off to suit the situation. Detachment as a practice cannot be in isolation if it becomes one’s personal style of distracting from the world.

One must  learn to empathize with the patients and yet be detached from its results. Doctors who follow Bhagawad Gita can understand the concept well.

Fever

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Fever does not mean presence of infection. There are many situations where there may be fever without infection. Such fevers do not need antibiotics. 

  • Sepsis, a clinical syndrome, occurs due to the dysregulation of inflammatory response to an infection. The temperature is between 36°C to 38.30°C. Heart rate is often above 90 per minute.
  • Symptomatic inflammatory response syndrome (SIRS)is a clinical syndrome, which occurs as a result of 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, a condition with elevated body temperature, is not called fever. Examples – 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 41.5°C, it is called acute hyperpyrexia.
  • Hyperpyrexia is often seen in patients with severe infections but it may also occur in brain hemorrhage. It responds to anti-fever drugs.
  • High temperature without infection can be seen in case of a hyperfunctioning thyroid gland.
  • Recreational drugs such as Ecstasy may cause fever without any infection.
  • Mild fever can also occur following exertion.

There is a ritual of offering food to God before eating

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This is a Vedic reminder to oneself that one should eat only those foods that are offered to God. Each time you offer food to God, it is a reminder to you to change your decision and choices. For example, alcohol, tobacco, onion, garlic, radish, etc., are not offered to God. If they are part of your food, there are chances that you will not consume these food items, if you observe this ritual.

Cheating is permitted one day out of the 21 meals in a week. Over a period of time, people have stopped following this ritual and now eat some foods which cannot be offered to God in all their 21 meals. This is the reason why the incidence of lifestyle diseases is increasing in the community.

Diagnosis of hypertension in childhood requires repeated BP

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It is needed to confirm the presence of hypertension on the basis of three blood pressure measurements at separate clinical visits.

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

A study published in the journal Pediatrics in 2013 noted that 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% of children.

At follow–up, subsequent hypertensive measurements were noted in just 4% of the 10,848 children who had shown initial hypertensive values. The overall prevalence of hypertension in the cohort was 0.3%.

Forgetfulness and Age

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As we cross the age of 40, most of us develop minimal cognitive impairment and a memory loss of very recent events or objects. This is age-related and should not be considered as dementia.

This can also be seen in patients who are vegetarians and have vitamin B12 deficiency. People often experience difficulty in naming objects and remember names of the people.

Just as a computer hangs when multi-tasking, so can the human mind. While handling multiple projects at the same time, one may experience thought blocks, which is natural. It is 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. Unless full information is given to us by patient on phone, mistakes may occur, especially, if it is a phone consultation.

Diet is linked to the diabetes epidemic

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A study published in the journal Diabetes Care highlights 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.

In contrast, adults whose diets were high in red meat, high-fat dairy, refined grains like white bread plus beans and tomatoes, saw their diabetes risk go up by 18% as a group.

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.