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Dr K K Aggarwal

In people with type 2 diabetes, intensive drug therapy can significantly lower bad LDL cholesterol and reduce the thickness of the neck carotid arteries supplying oxygen to the brain.

A study published in Journal of the American College of Cardiology has shown that every effort should be made to bring down the bad LDL cholesterol to less than 80mg/dL.

The Stop Atherosclerosis in Native Diabetics Study (SANDS) trial tested the value of aggressively lowering bad LDL cholesterol to 70 mg/dL or lower, and non HDL cholesterol to 100 mg/dL.

The standard treatment group had standard goals (100 mg/dL for LDL and less than 130 mg/dL for non HDL Cholesterol).

The study involved 427 type 2 diabetic Native Americans who were aged 40 or older and who had no history of heart attack or other heart-related event. There were 204 people in the standard treatment group and 223 in the aggressive treatment group. Ultrasound tests showed that neck artery thickness got worse, or progressed, in the standard treatment group and regressed in the aggressive treatment groups.

The test called intima media thickness of the carotids is the only cost-effective test to know whether or not the heart blockages are shrinking or progressing as the thickening in carotids goes hand in hand with the thickening in the heart arteries.

Why do we do Pradakshina?

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We cannot draw a circle without a centre point. The Lord is the centre, source and essence of our lives. We go about doing our daily chores, recognizing Him as the focal point in our lives.  This is the significance of pradakshina, which is a Sanskrit word meaning circumambulation or walking in a circle around the deity.

Pradakshina is done only in a clockwise manner. In India the right side symbolizes auspiciousness. During pradkshina we remind ourselves to lead an auspicious life of righteousness, with the Lord on our right side. Also every point on the circumference of a circle is equidistant from the centre. This means that wherever or whoever we may be, we are equally close to the Lord. His grace flows towards us without partiality.

Indian scriptures enjoin us – Matrudevo Bhava, Pitrudevo Bhava, Acharyadevo Bhava i.e. “May you consider your parents and teachers as you would the Lord. With this in mind we also do pradakshina around our parents and divine personages.”

After the completion of the traditional worship (pooja), we customarily do pradakshina around ourselves. In this way we recognize and remember the supreme divinity within us, which alone is idolized in the form of the Lord that we worship outside.

An apple a day may keep the doctor away, but three kiwis could lower your blood pressure. In a study by Mette Svendsen at Oslo University Hospital in Norway eating kiwi fruit with the tart green flesh three times a day lowered blood pressure more than an apple. Kiwis contain lutein, which has antioxidant properties. After eight weeks, researchers found the kiwi group’s 24-hour systolic blood pressure was 3.6 mmHg lower than that of the apple eaters, on average. The diastolic blood pressure was also lower in the kiwi group.

Any activity should always engage the 3 H model – of Heart, Head, and the Hand. The same has been advocated by the western scholars of today. The concept means that while doing any work one should ask the head for choices and then refer these choices to the heart to choose one and finally order the hands to do the action.

Deepak Chopra also talks about this in great details in his book ‘The Seven Spiritual Laws of Success’. He 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 indulge into that action.

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

The Mahamritunjaya Mantra comes from the Rig Veda. This is the greatest reliever from all evils and reads as under: Aum Trayambakam Yajamahe, Sugandhim 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 (bandhan) 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 manta 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. (Jo acha lage use apna lo; Jo bura lage use jaane do).

The mantra for the conscious-based decision comes from Gayatri Mantra. The same reads as Om Bhur Bhuva Svah Tat Savutur Varenyam Bhargo Devasya Dheemahi Dhiyo Yo Nah Prachodayaat. It means that 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. It 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 or “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 action bring happiness to you?
  • Will the action bring happiness to others?

Swelling around the ankle called oedema feet is a common occurrence amongst the people. Quite often it is considered synonymous with heart failure. Although it is one of the commonest causes for it but there are many other causes, often treatable, causes which should be known.

One of the common causes is immobility due to any reason. Patients recovering from paralysis, leg fractures etc often show presence of this due to diminished flow of the veins (channels carrying impure blood) in the legs, lack of muscle pump action and the effect of gravity. The sweating is often seen in both the lower limbs though it may be more on one side.

Many patients with liver and kidney disorders or with malabsorption / malnutrition may have lower levels of proteins in the blood which can manifest as swelling of both the lower limbs.

Drugs like steroids (often used for asthma), stilbesterol (female hormone) non steroidal anti inflammatory drugs (commonly used for joint pains) etc. can cause fluid retention causing oedema feet.

Patients with high blood pressure on drugs like nifedipine, felodipine, amlodipine etc can often be seen with edema feet. Once the dose of the drug is reduced it often disappears.

Formation of a clot in the blood channels carrying impure blood called deep venous thrombosis occurs far more commonly than is suspected. Though common in patients with underlying cancer, or those who have been immobilized for some time, it can also occur in patients immobilized for as short as 6 hours, which occurs in situations like international flights.

Presence of varicose veins, often seen as tortuous veins on the legs on the surface of the skin can also cause oedema due to the increase in the pressures in the column of blood in the vessels. This is often seen after pregnancy or in Rickshaw pullers.

Sometimes the cause is cancer causing blockage in the lymphatic system. The point to remember is that the constrictive effects of some clots can result in venous stasis and aggravation of the oedema. This may be elasticized legging of ladies underwear or the practice often employed of keeping stoking in position by twisting their tops.

The management lies in treating the underlying condition. The other treatment is simply to elevate the foot of the bed at night to redistribute the flow unless it is contraindicated in situations like heart failure, peripheral arterial disease and hiatus hernia.

Simple advice to raise the legs often leads to them being put on a foot stool, resting on the calves. This may be bad and can worsen the oedema. It impairs the back flow of the blood and also does not help as the leg is still dependent.

Crepe bandages are often used as a supportive treatment. They may be unsatisfactory if not properly put on.

Elastic bandages may suffice as a second best option provided they are worn correctly. And of course exercising ankles and knees will always help.

Addressing the spiritual needs of a person facilitates recovery from any mental stress. Religious involvement and spirituality are associated with better health outcomes.  In prayer we talk to God. In meditation, GOD talks to us. Prayer is like inserting intent in the field of consciousness and meditation is akin to formatting our hard disk.

Most people pray either at home in the prayer room or go to a temple that is often situated far away and usually at a great height.

Most Indian homes have a prayer room or altar where they light a lamp everyday and worship the Lord. The room is also used for japa (reciting the Lord’s name repeatedly), meditation, parayana (reading of the scriptures), prayers or devotional singing.

For those who believe in dualism (Dwaita philosophy) God is present every where and is the true owner of the house. The prayer room is the Master room of the house that belongs to him and we are only the caretakers of His home.  He is always with us in every difficulty and decision making. We invoke His grace and blessings by communing with Him on the day of marriage.

In any house the drawing room is for receiving guests and kitchen for cooking. The furniture, decor and the atmosphere of each room is made favorable to the purpose it serves. So for worship or prayer, we have a conducive atmosphere in the form of a prayer room where sacred thoughts and sound vibrations pervade the place and influence the minds of those who spend time there. Even when we are tired or agitated, by just sitting in the prayer room for a while, we feel calm, rejuvenated and spiritually uplifted.

For believers of non dualism (Adwaita philosophy), God is within us and prayer room is the place to be in silence and to be aware of the God within us. In yoga, it is said that only in silence can one be in touch with all the powers of the spirit. A prayer room is the place to experience that silence.

True silence is the silence between the thoughts and represents the true self, consciousness or the soul. It is a web of energized information ready to take all provided there is a right intent. In his book ‘The Seven Spiritual Laws of Success,’ Deepak Chopra talks in great detail about the importance of observing silence. He recommends that everyone should observe silence for 20 minutes everyday. Silence helps to redirect our imagination towards self from the outer atmosphere.

Silence is cessation of both sensory and mental activity. It is like having a still mind and listening to the inner mind. Behind this screen of our internal dialogue is the silence of spirit. Meditation is this process of achieving silence, which also combines alongside, the art of observation.

Sometimes back Late Shri K. R. Narayanan the Vice President of India went to Chennai to have his wife’s medical check-up and came back with his own bypass surgery. Many at that time were surprised after reading it. But is it not common?

A large number of cases with heart disease for the first time present with heart attack, sudden death or cardiomyopathy – a condition where the heart gets dilated. Many of these situations may need emergency therapeutic procedures including bypass surgery or balloon therapy.

Coronary artery disease (CAD) in which there is deposition of fat in the channels supplying blood to the heart is not a one day process. It takes on an average 10-50 years for the blockage to become significant to cause cardiac symptoms.

The process of fat deposition called atherosclerosis is multi factorial. Active or passive smoking, uncontrolled blood pressure or diabetes, stress, high cholesterol, stress (especially negative), obesity and lack of exercise are a few of the known risk factors. These risk factors must be present for long enough to cause the blockage.

In simple words it is said “you cannot gift, or accept as a gift, a heart attack”. You have to earn it i.e. you cannot get heart attack by smoking 100 cigarettes or not exercising or having you blood pressure or diabetes uncontrolled for a day.

Ten years to produce blockage of coronary arteries is long enough period for a person to get it checked up or for a doctor to detect it by way of investigations. But few are in the habit of getting a regular medical check up. We are very particular about our car, fridge, computer or cooler and will have it checked and serviced at regular intervals but not our body.

One must have a routine ECG done as a baseline at the age of 20. ECG may or may not diagnose underlying blockage and may be abnormal only at a time when the person is actually having cardiac pain. But the comparison with the base line ECG often helps in doubtful cases. In some cases the ECG abnormalities may be present even at rest.

The heart for its nutrition is dependent on oxygen and nutrients from the coronary arteries. The work the heart has to do on DEMAND is related to the oxygen and nutrition it will get on SUPPLY.

If the demand is more i.e. in situations like running, jogging, walking etc. the supply needed is more. And if the arteries are not being able to supply the required nutrition, as they are blocked, the heart will cry at the time of increased demand – called angina.

It takes at least 70% blockage of one or more of the arteries to cause symptoms of chest pain. Therefore the conditions may remain silent for a long period of time.

Before the person becomes symptomatic the evidence of blockage can easily be found by creating a situation of demand vs. supply imbalance – a test called as stress test or treadmill test (TMT). The person is subjected to graded exercise on a machine, while changes in heart rate, BP and the ECG is recorded, and also constantly monitored. The level of exercise when the person becomes symptomatic or the abnormal ECG changes suggestive of lack of blood supply appear indicates the severity of blockage, and further mode of treatment.

Normally a person without blockage should be able to do 12-14 minutes of graded exercises on the machine, achieving an exercise of about 10-12 METS i.e. about 10 times the basal energy expenditure, without causing any symptoms or ECG changes.

The TMT may be positive in the first 3 minutes of exercise, called severely positive, or in the 3-6 minutes of exercise, called moderately positive, or after 6 minutes or exercise called mildly positive TMT test.

Persons with moderately or severely positive TMT are often symptomatic, but the group with mildly positive TMT may be symptomatic or asymptomatic.

Silent heart disease is very common. The persons may have severe blockage of the coronary arteries and may suffer from episodes of damage to the heart muscles without experiencing any symptoms. Painless episodes are common amongst diabetics and patients with thyroid disorders.

Symptoms also depend on the duration of disease, age of the patient and the development of collaterals in the heart. If the person is old, there is enough time for the collaterals to develop and the person may do well on medicines. On the other hand if the person is young, the collaterals may not be adequate and he may end up with a heart attack.

Bypass surgery is necessary when there is failure of adequate medical treatment to provide the desired quality of life. Normally when the patient becomes symptomatic or for the first time he is detected to have underlying coronary disease, he is put on medical treatment first and if he does not respond he is considered for balloon or bypass surgery.

There are occasions when at the first detection of disease the patient may be subjected for surgery, for instance if  the TMT test shows positive test (lack of blood supply)  at 0-3 minutes of exercise or if angina occurs at low levels of heart rate or at rest or recurrent pain (3-4 times/day).

Angiography is often considered if the patient is young, has survived a recent cardiac arrest, has unstable angina or post heart attack angina or TMT is positive in the first stage.

If the angio shows disease of the main channel supplying blood to the heart it becomes an emergency surgery. Presence of 2 or 3 artery blockage in otherwise asymptomatic patient is not an indication for surgery. One has to correlate with the symptoms and response to the treatment.

Also a patient asymptomatic on drug with 2 or 3 vessel disease may not be subjected for surgery. Many a time an angina may temporarily become unstable due to some precipitating factors like blood loss, thyroid disorder, stress, fever etc. In such cases treating the precipitating factor may control the angina.

Indians have more severe heart disease. The blockage is more common, more severe and more diffuse. They also report late to the doctors. It is therefore expected that if we do not change our life style we may have the largest number of bypass surgeries in the world in time to come.

Bypass is not a cure. It only bypasses on already blocked artery. If the defective life style or risk factors continue either new blockage will appear in the non-bypassed vessels or in the grafts. The only answer is early detection of blockage and change in the life style.

Every person should have his TMT done once in 5 years after the age of 30 and annually if he has 1 or 2 risk factors, viz. family history of heart disease, high blood pressure, diabetes, smoking, obesity, stress, high cholesterol or a history of sudden death in the family.

Hindu rituals define five essential signs of married woman which are

  1. Mangalsutra ( beaded yellow thread with a gold pendent)
  2. Red Sindoor of Kumkum
  3. Nose Ring
  4. Toe Ring
  5. Red Bangles.

The two most important amongst them are Mangalsutra and Sindoor.

These essential five items from a distance differentiate an unmarried girl from a married lady.

A traditional Indian Hindu married woman in any function would go with Sindoor and Mangalsutra on.

Mangalsutra: A Mangalsutra is typically made of gold and black beads strung together on one or two yellow threads.

A woman not wearing a Mangalsutra is considered to be either unmarried or widowed.

It represents the basic faith between husband and wife and the lifelong commitment to each other.

From Vedic point of view, the manga sutra is always worn on the neck with the pendent going up to the area of the thymus gland or Anhata chakra which represents unconditional love.

 Sindoor: Red is the colour of power and sindoor represents the female energy of Sati and Parvati. A married woman is considered like a Sati who is known for the sacrifices she made to protect her husband’s honour. She is also regarded as Goddess Parvati who grants “Akhand Soubhagya” (lifelong good fortune) to women. Sindoor thus expresses a woman’s desire for a long life for her husband.

Modern sindoor mainly uses vermilion an orange-red pigment. Vermilion is the purified and powdered form of cinnabar or mercury sulfide. Sindoor is toxic and must be handled carefully.

Sometimes, red lead (lead tetroxide, also known as minium) is added to sindoor. Red lead is toxic and a known carcinogen for laboratory animals, though its carcinogenicity to humans has not been established.

Traditional sindoor was made with turmeric and alum or lime, or from other herbal ingredients. Unlike red lead and vermilion, these are not poisonous.

Lung cancer may be detected at an earlier stage by screening individuals with chronic obstructive pulmonary disease (COPD) early as per a report in Nov 20011 issue of European Respiratory Journal.

COPD is the fourth leading cause of death in the world and lung cancer is the seventh, according to the World Health Organization. These two conditions are associated.

The research has shown that individuals with COPD are more likely to develop lung cancer compared to individuals who currently or previously smoked with normal lung function.

Amongst COPD patients 1% develops lung cancer each year compared to 0.2% of people with normal lung function, a five time increase in the risk of COPD patients developing lung cancer.

The description of horses has been mentioned in Ashwamedha Yagna, Dashrath in Ramayana, Bhagavad Gita with Krishna riding a rath, Kathopnishad describing the meaning of a chariot and in any marriage with the bridegroom riding a female horse.

Horse is a symbol of sacrifice. Horses are known for their speed, dynamism, faithfulness and devotion.  For self-realization, speed, dynamism, faithfulness and devotedness are all necessary. One needs to sacrifice the internal horses. We must meditate on the qualities of the horse and invoke these divine qualities to enter into us.

The Brhadaranyaka Upanishad starts with the description of the sacrificial horse used in the Ashvamedha yagna. A horse represents the senses and controlling or winning over the horse means winning over the 10 senses.

Kathopanishad (1.3.4-7) also talks about the importance of controlling the mind and the senses.  It describes the body as the chariot; the self as its master; intellect as the charioteer, the mind as the reins, the senses as the horses and the sense-objects as the paths.

The number of horses also have different connotations: Five in Kathopanishad (five senses motor or sensory); 10 in Ramayana (Dashrath, who has control over his ten senses), seven in Sun God (Sapta-vaahanah i.e. One who has the vehicle of seven horses). Lord Sun, represents control over the mind all seven days of the week.

The imagery associated with the Bhagavad Gita is that of a chariot with four or five white horses, Arjuna on the chariot and Lord Krishna as the charioteer. The human body represents the chariot, Arjun the individual soul and Krishna the Spirit or the Supreme Soul. The chariot has three wheels (Satwa, Rajas, and Tamas); it has three kinds of motion (upwards or downwards or transverse, implying superior, inferior, and intermediate birth as brought about by acts). The four horses, apart from senses, also represent the time, pre destiny, will of the deities, and one’s own will. It has three naves (white, black, and mixed, implying good acts, evil acts and acts that are of a mixed character, respectively).

Vidur also talked about the same in Vidur Niti. He said to Dhritarashtra, “O king, man’s body is just like a Ratha (chariot), intelligence (buddhi) like a charioteer (Saarathi) and senses are its horses.” One who controls all these three, travels happily in this world, just like the charioteer who has controlled the horses of the chariot)

Horses in Vedic language therefore symbolize the senses (indriyas) in the body. A female horse is much more ‘Chanchal’ than the male one and symbolizes the childish behavior of the person.

Riding over the female horse means controlling the senses and leaving behind childish behavior as one is now entering into a new phase of life full of responsibility. The ceremony involves riding the female horse and tightening of the reins.

The triad of early diagnosis, proper treatment and mass awareness in cancer is essential.

Unless there are good centres in a city which can provide complete treatment if the cancer is detected in time then only the awareness will have an impact. If the general feeling is that what is the use of diagnosis, if there is no cure’ then the programme is going to be a failure.

In awareness, more important is to detect cancer at its early stage. Cancers of head, neck, lung and cervix are preventable. If treated in time a large number of cancers are curable. Most of the childhood tumors are curable, so are a few of the adult cancers like Hodgkin’s disease, non Hodgkin’s lymphomas and breast cancer.

The incidence of cancer is increasing in the West but the mortality is decreasing.

It is unfortunate to note that while in the U.S.A. most of the breast cancers are detected in stage 0 or 1, the same are detected in our country at stage 3 or 4.

Nobody should die of cervical cancer. In the West the mortality has come down to zero. But in India its still one of the major causes of cancer deaths. The only answer seems to be detection of early cancer by periodic PAP smear test but not more than 2% of Indian women get their annual PAP smears done.

Everybody after the age of 40 must be screened for the presence of early cancer but if a family history of cancer (e.g. breast, other organs) is present, the screening must start at the age 25.

There are a few cancers (e.g. blood cancers) which cannot be predicted or detected by annual screening. The emphasis for them has to be on the right and timely treatment.

Most of the stomach cancers in India are misdiagnosed as acidity for atleast 6 months to one year, and this loss of time is many a time responsible for progression of cancer to an incurable stage.

This is the time to create awareness amongst public and to refresh knowledge of doctors. One should remember that first treatment is the best treatment. Never leave the first chance. If at the first instance the diagnosis is missed, or only partial treatment is started, the outcome can never be successful.

All cancers are not identical. They all behave differently and the response to therapy may also be different. Mythical beliefs should be removed only then a uniform level of public awareness can be expected.

“It is said that the husband’s name in the intricate henna motifs is made for the bridegroom who has to find out his name in his bride’s mehendi as an evidence of his sharp eyes and active brain to impress his girl.”

“It is believed that the darker and deeper the henna stains the more the husband and the in-laws will love her bride.”

Mehendi or henna application is one amongst the most important pre-wedding ceremonies. The bridegroom applies it as a token on his hands; the bride applies it on her hands and feet.

Mehendi signifies the strength of love in a marriage. It is believed that the darker the colour of the mehendi, the stronger will be the love and bond between the bride and her bridegroom.The first motif of Mehendi is supposed to be applied by the bride’s mother- in-law in the centre of her palm.

Henna medically is antiseptic, astringent, analgesic, antipyretic, cooling agent and anthelmintic.

It beautifies the parts of bride’s body. It epitomizes the bride changing from a virgin girl to a temptress for her husband. The exotic fragrance of the Mehendi paste and oil add to the ambience. In Indian Mythology, Parvati would decorate herself with mehendi in order to please Shiva.

Shringar is a Hindi word that means beauty of a woman’s creativity’ and mehendi is one of the ways in which an Indian woman expresses this power of beauty beneath the surface.

The ‘Solah Shringar’ lists mehendi amongst the 16 adornments of a woman and the Kama Sutra describes mehendi tattooing as one of the 64 arts of women.

Mehendi celebrations can be performed additive to Ladies Sangeet. As women sing traditional songs and tease the bride with mischievous lyrics targeting her in-laws and husband, the mehendi artist does her job.

The medicinal use of chocolate has a long history in North America dating back to the 16th century. From Mesoamerican Codices and European Treatises scholars have determined that for hundreds of years the beverage called chocolate was administered to the sick and prescribed homeopathically to prevent illness.

Cocoa and particularly dark chocolate are rich in flavonoids and it lowers the blood pressure. Blood pressure lowering effect was shown in a Novel Study by Al-Safi SA and group from Texas Woman’s University, College of Nursing in Jordan in 2011.

The data that plant sterols combined with dark chocolate reduces bad LDL cholesterol was published in 2008 in the journal

A Harvard study published in 2011 in Clinical Nutrition by Diousse L and group from Brigham and Women’s Hospital has shown that dark chocolate consumption is inversely associated with prevalence of coronary heart disease.

Dark chocolate improves endothelial functions and the platelet function was shown by Hermann F and group in 2006 in the Journal Heart.

Franco OH and group from Erasmus MC University Medical Centre Rotterdam, Netherlands in 2004 wrote in British Medical Journal that the polymeal concept is a more natural, safer, and probably tastier than the Polypill strategy to reduce cardiovascular disease by more than 75%. The evidence based recipe included wine, fish, dark chocolate, fruits, vegetables, garlic, and almonds.

Another study published in 2007 in Heart Advis has shown that small dietary changes yield big blood pressure benefits. One should limit sodium, eat more veggies, and add modest amounts of soy nuts and dark chocolate to improve the heart health.

In 2009 Sirtori CR and group from University of Milano, Italy wrote in Nutr Res Rev journal that dark chocolate is gaining much attention as a functional food for its multifunctional activities, useful both for the prevention of dyslipidemia as well as hypertension.

Loffredo L and group from I Clinica Medica, Viale del Policlinico Italy has shown in the journal Heart in 2011 that the acute effects of dark chocolate in smokers are due to NOX2-mediated arterial dysfunction. Cocoa enhances artery dilatation by lowering of NOX2 activation as assessed by blood levels of soluble NOX2 derived peptide.

I recently participated in a seminar on Christian-Jain collaboration organized by World Fellowships of Religions, The pontifical Council for Inter-Religious Dialogue, the Catholic Bishop’s conference of India and Delhi Catholic Archdiocese.  I was asked to speak on common codes of conduct between two dharma.

It was not an easy subject being I said that two dharma can be united and only a doctor can do that as he is the only one who can be a Christiana and a Jain at the same time.

First let us look at the Jainism. The five Great Vows (Mahavratas) of Jainism talks about right knowledge, right faith, and right conduct as the main three essentials for attaining liberation. In order to acquire these, one must observe the five great vows namely Nonviolence (Ahimsa); Truth (Satya); Non Stealing (Achaurya or Asteya); Self Control (Bramhacharya) and Non Attachment/Non Possession (Aparigraha).

A doctor has to be a Jaini in his conduct. While treating and handling patients he has to follow the path of non violence and truthfulness in his actions, speech and thoughts. He has to be a person with extreme self control else he will lose control in emergent conditions. He has to observe Asteya though transparency in his charges. Finally the doctor must believe in aparigraha which means he must learn to practice detached attachment. It also means not keeping things more than required and it applies to both drugs and devises as keeping drugs and devises after expiry date may be harmful to the patients. Another principle of Jainism is ‘Anekant‘ which means multi-sided views.  A doctor cannot be a good doctor unless he believes in this philosophy and respect the views of other colleagues.

When it comes to Christianity the religion gives emphasis on love, service, compassion and confession etc. All are part of medical ethics and characteristics of a good doctor.

If we look at some of the Ten Commandments, they are equally applicable to medical profession under their code or ethics. They are Thou shall not kill (one should not harm the patients); Thou shall not commit adultery ( having sexual relations with patients is ethical); Thou shall not steal (a doctor should not over bill any patient); Thou shall not bear false witness against thy neighbour or Thou shall not covet thy neighbor’s house or Thou shall not covet thy neighbor’s wife, nor his manservant, nor his maidservant, nor his ox, nor his ass, nor any thing that is thy neighbor’s (here neighbour can be equated to patient and also to your professional colleague).

Winter asthma special

Peak expiratory flow meter is asthma meter and is equated to a thermometer. All asthmatics should have it. They should know their personal best value and keep it > 70%. If it is < 50% they need immediate medical attention.

Peak flow measurements take less than one minute to perform, are safe and inexpensive, and, when repeated over time, can be used to monitor a patient’s response to treatment. Normal values differ with gender, height, and age, but a peak flow rate below 200 L/min indicates severe obstruction for all but unusually small adults.