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Dr K K Aggarwal

Swine Flu is back but no panic

By Dr K K Aggarwal
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• Swine flu presents with fever of more than 1000 F with cough or sore throat in the absence of any other main cause. • The diagnosis is confirmed with a lab test using rRT/PCR technique. • Mild or uncomplicated flu is characterized by fever, cough, sore throat, nasal discharge, muscle pain, headache, chills, malaise and sometimes diarrhea and vomiting. In mild cases, there is no shortness of breath. • Progressive swine flu is characterized by the above symptoms along with chest pain, increased respiratory rate, decreased oxygen in the blood, labored breathing in children, low blood pressure, confusion, altered mental status, severe dehydration and exacerbation of underlying asthma, renal failure, diabetes, heart failure, angina or COPD. • Severe or complicated swine flu is characterized by respiratory failure, requirement of oxygen or ventilator, abnormal chest x-ray, inflammation of the brain, lowering of blood pressure to less than 60 and involvement of the heart muscle. These patients will have persistent high fever and other symptoms lasting more than three days. • Most patients will remain asthmatic with illness lasting 3-7 days. • The characteristic features are presence of chills, muscle pain and joint pain. • In the pregnant women, flu can cause more serious complications including death of fetus. • Mild cases do not require admission but progressive cases need to be admitted. • Underlying, organ disease and requirement of mechanical ventilation is the indication for admission. • Oseltamivir phosphate is the treatment of choice but it should be taken under medical supervision. It has to be given in the first 48 hours. It is given in severely low patients, pregnant women, underlying organ disease or age less than 5 years. • Flu vaccine can be given to all. It should be given to all high-risk patients. • The virus spreads through droplet infection and spreads with a person coughs, sneezes, sings or speaks. The virus can cover only a distance of 3 to 6 feet. • Stay 3 feet away from the person who is coughing. • The standard prevention is respiratory hygiene, cough etiquette and hand hygiene. • Hand washing should be performed before and after every patient contact or infectious material and before putting and after removing gloves. • Hand hygiene can be performed by washing with soap and water or with alcohol based hand drops. • If hands are visibly soiled, they should be washed with soap and water. • Patients should be placed in a private room or area. The health care staff should wear a face mask while entering the patient’s room. When leaving the room, the health care workers should remove the face mask, dispose it off and then perform hand hygiene. • Patients should wear a surgical mask and should be aware of respiratory hygiene, cough etiquette and hand hygiene. • Droplet precaution should be taken for seven days after illness onset or 24 hours after resolutions of fever and respiratory syndrome. • One should not cough in the hands, handkerchief but instead cough either in the tissue paper and dispose it off or in the side of the arm. • Swine flu causes fewer deaths than normal seasonal flu. • Hong Kong Study of H1N1 (Between April and December 2009]: Overall attack rate was 10.7 percent, case-hospitalization rate was 0.47 to 0.87 % among people aged 5 to 59 years, case-ICU rate was 7.9 cases per 100,000 infections in children aged 5 to 14 years, case-ICU rate was 75 cases per 100,000 infections in adults aged 50 and 59 years, case-fatality rate was 0.4 cases per 100,000 in children aged 5 to 14 years and case-fatality rate 26.5 cases per 100,000 in adults aged 50 to 59 years. • Case fatality is 0.4 – 26.5 cases per 100,000. That means 10 deaths would occur if one lac people gets fly. For getting 95 deaths we need almost one crore people getting infected with flu. This again means 10% of the society suffering from flu or two patients per family. Either the figure 95 is wrong or the figure number of positives deaths is wrong. • Two third of deaths occur in people with underlying chronic illness. • In seasonal flu more deaths are in people above 65 years of age and in H1N1 flu more deaths are in 50-64 years old age group.

Reduce liquids to reduce weight

By Dr K K Aggarwal
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When it comes to losing weight, cut down on liquid calories rather than food.

Body is able to self-regulate its intake of solid food. If you eat too much solid food at lunch, you’ll tend to eat less at dinner. But the same self-regulation is not in place for what you drink. The body does not adjust to liquid calories, so over time, you gain more weight.

Cutting back on calories from sugary drinks – by only one serving per day – can account for nearly two-and-a-half pounds of lost weight over 18 months.

Beverages are categorized into eight categories

1. Sugar-sweetened beverages (including soft drinks, fruit drinks, fruit punch, or high-calorie beverages sweetened with sugar)

2. Diet drinks such as diet soda and other diet drinks that were artificially sweetened

3. Milk (including whole milk, 2 percent milk, and 1 percent skim)

4. 100 percent fruit and vegetable juice

5. Coffee and tea with sugar

6. Coffee and tea without sugar

7. Alcoholic beverages

8. Water with no calories The best drinks are water, plain soda and tea/coffee with no sugar.

 

What is the significance of a Tilak?

By Dr K K Aggarwal
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The Tilak is not merely a beauty–enhancing mark, or a sign of religiosity. Hindu cultural traditions have given a significant place to wisdom in life. Life’s journey is guided by wisdom, which leads us through evolution of life towards salvation. If a man loses everything in his life but has his wisdom, he can recreate everything he has lost.

In Gayatri Mantra we chant, “May my Wisdom be enlightened and purified”. The worship that has been revered in the Vedas is symbolized in the Tilak. The seat of wisdom is the head and since the forehead is its front part, we worship wisdom by placing the Tilak on the forehead.

A Tilak is the ‘third eye’ in a manner of speaking. It is a divine eye which when ‘opened’ by divine knowledge shows the way to self–realization. Lord Shiva destroyed Kamadeva with his third eye, so too, we may destroy our desires and evil elements by striving for knowledge. Disclaimer: The views expressed in this write up are entirely my own

What Is The Importance Of Silence?

By Dr K K Aggarwal
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The 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. The process of achieving silence is what meditation is. Observing silence is another way of getting benefits of meditation. Many yogis in the past have recommended and observed silence now and then. Mahatma Gandhi used to spend one day of each week in silence. He believed that abstaining from speaking brought him inner peace and happiness. All such days he used to communicated with others only by writing on paper. Hindu principles also talks about a correlation between mauna (silence) and shanty (harmony). Mauna Ekadashi is a ritual followed traditionally in our country. On this day the person is not supposed to speak at all and keep complete silence throughout day & night. It gives immense peace to the mind and strength to the body. In Jainism this ritual has a lot of importance. Nimith was a great saint in Jainism who long ago asked all Jains to observe this vrata. Some people recommend that on every ekadashi one should observe silence if not the whole day but for few hours in a day. Deepak Chopra in his book 7 Laws of Spiritual Success talks in great detail about the importance of observing silence in day today life. He recommends everyone should observe silence for 20 minutes everyday. Silence helps redirecting our imagination towards self from the outer atmosphere. Even Swami Sivananda in his teaches recommend to observe mauna daily for 2 hours for ekadashi, take milk and fruits everyday, study daily one chapter of Bhagwad Gita, do regular charity and donate one-tenth of the income in the welfare of the society. Ekadashi is the 11th day of Hindu lunar fortnight. Ekadashi is the day of celebration occurring twice a month, meant for meditation and increasing soul consciousness. Vinoba Bhave was the great sage of our country who is known for this bhoodaan movement. He was a great advocator and practical preacher of mauna vrata. Mauna means silence and vrata means bow hence mauna vrata means bow of silence. Mauna was practiced by saints to end enmity and recoup their enmity. Prolonged silence as the form of silence is observed by the rishi munis involved for prolonged periods of silence. Silence is a source of all that exists. Silence is where conscious dwells. There is no religious tradition which does not talk about silence. It removes worldly communication and forces a dialogue towards inner communication that one reason why all prayer, meditation and worship or any other practice whether we attune our mains to the spiritual consciousness within are done in silence. After the death of a person it is a practice to observe silence for two minutes. The immediate benefits is that it saves a tremendous amount of energy. 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 the combination of observing silence and the art of observation. Disclaimer: The views expressed in this write up are entirely my own

Energy Drinks May Put Heart at Risk for Sudden Death

By Dr K K Aggarwal
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Energy drinks may raise blood pressure and prolong QT interval increasing the risk of sudden cardiac death. In a meta-analysis by Sachin A. Shah at University of the Pacific in Stockton, Calif, with a pooled analysis of 93 people who consumed energy drinks, the QT interval on an ECG was significantly prolonged by 10 ms. The threshold level of regulatory concern is around 5 ms. In another pooled analysis of 132 people by the same group, researchers found a significant increase in systolic blood pressure by 3.5 mmHg that was associated with the consumption of energy drinks. Doctors are generally concerned if patients experience an additional 30 ms in their QT interval from baseline. QT prolongation is associated with life-threatening arrhythmias. Most energy drinks have caffeine. Drinks such as Monster, Red Bull, Rockstar, Full Throttle and AMP have three times the amount of caffeine as colas. A 16-oz. can of Monster Energy, for example, contains 160 mg of caffeine, which is almost as much as 5 cans of soda.

Spiritual Prescriptions – Controlling the Inner Noise

By Dr K K Aggarwal
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Yoga Sutras of Patanjali define yoga as restraint of the mental states (Chapter 1.2). In the state of total restraint, the mind is devoid of any external object and is in its true self or the consciousness. To control the mind many Vedic scholars have given their own formulas. Being in touch with one’s own consciousness requires restraining of the mind, intellect and ego on one hand and the triad of rajas, tamas and satwa on the other hand. Every action leads to a memory, which in turn leads to a desire and with this a vicious cycle starts. The mental turmoil of thoughts can be equated to the internal noise and the external desires and objects to an external noise. The process of withdrawing from the external noise with an aim to start a journey inwards the silent field of awareness bypassing the internal noise is called pratihara by Yoga Sutras of Patanjali. It involves living in a satwik atmosphere based on the dos and don’ts learnt over a period of time or as told by the scriptures. To control inner noise based thoughts we either need to neutralize negative thoughts by cultivating opposite thoughts or kill the origin of negative thoughts. Not allowing thoughts to occur has been one of the strategies mentioned by the scholars. One of them has been neti–neti by Yagnayakya. The other method is to pass through these inner thoughts and not get disturbed by it and that is what the process of meditation is. This can be equated to a situation where two people are talking in an atmosphere of loud external noise. For proper communication one will have to concentrate on each other’s voice for long till the external noise ceases to disturb. In meditation, one concentrates on the object of concentration to such an extent that the noisy thoughts cease to bother or exist. One of the ways mentioned by Adi Shankaracharya in Bhaja Govindam and by Yoga Sutras of Patanjali (Chapter 2.35) is that whenever one is surrounded by evil or negative thoughts one should meditate open the contrary thoughts. For example, if one is feeling greedy, one can think of donating something to somebody. Deepak Chopra in his book Seven Laws of Spiritual Success talks in detail about the importance of giving and sharing. He says you should never visit friends or relations empty handed. You should always carry some gift of nature, which if nothing is available can be a simple smile, compliment or a flower. By repeatedly indulging into positive behavior and thoughts, you can reduce the internal noise, which helps in making the process of meditation or conscious living a simpler one. Washing out negative thoughts is another way mentioned by many Vedic scholars. Three minutes writing is one such exercise which anybody can do. Just before sleep anybody can do three minutes writing where you can write down all your emotions and then discard the paper. Another exercise is to reward or punish oneself at bed time for the activities done during the day by either patting or slapping yourself. Disclaimer: The views expressed in this write up are entirely my own.

Tips to prevent eye infections from contact lenses

By Dr K K Aggarwal
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• Replace your contact lens case regularly. • Do not sleep or nap while wearing contact lenses. • Don’t swim or shower while wearing contact lenses. (Source: CDC)

Collective Consciousness

By Dr K K Aggarwal
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Consciousness is an energized field of information with powers to do everything in the universe. Collective consciousness is the internet of the collective souls of many people in a group. Collective consciousness is the strongest super power ever available in the universe. As per the Vedic texts whatever is the intent of collective consciousness will become a reality. Scientifically collective consciousness is based on the principle of critical mass. The Vedic literature has shown it to be the 1% of the defined population under study. The origin of the critical mass comes from 100th monkey phenomenon. The story goes as under: long ago in Japan a monkey called Emo used to eat dirty apples everyday picked up from the ground. One day by accident the apple fell down in a river, the dirt got washed off and he ate the washed apple. Obviously it tasted delicious. The monkey started washing the apple thereafter everyday before eating. His fellow monkey started following the same. The process of following went on. A time came when the 100th monkey washed the apple and ate. A strange phenomenon was noticed. All monkeys in and around that state started washing the apple before eating. The no. 100th was the critical mass. Once this mass is crossed the information well spread like a wild fire and the intent becomes a universal reality. Vedic literature has also shown if 1% of the public of any area meditates together the crime rate of that area goes down. It also talks about the role of critical mass in prayers in achieving miracles. Thus principle of critical mass is often used in designing and organizing an event. In a movie hall of 1000 people if 10 people clap sitting in different areas everybody will clap. The same is true for hooting of a particular scene. Most politicians use this principle when they organize election rallies. For a gathering of 10000 they need 100 and for a gathering of 1000 people they only need 10 supporters who are supposed to sit in different areas and shout or clap on given directions. Mexican way of hooting or clapping in cricket grounds also follow the same principle. Most successful leaders used this technology to lead. Disclaimer: The views expressed in this write up are entirely my own

Smoking leads to cardiovascular aging

By Dr K K Aggarwal
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Consuming tobacco can increase the cardiovascular age of a person, which can be much higher than the biological age. Cardiovascular aging in chronic smokers can be 10 years more than the biological age. This can be calculated by measuring the wall thickness of the carotid neck artery supplying blood to the brain. Apart from that, one can also measure the endothelial functions of the brachial artery supplying blood to the hand. Cardiac age of a person is calculated by measuring the relaxation functions of the heart. With advancing age the heart fails to relax properly. This relaxation abnormality usually comes after the age of 60. If the same is seen at the age of 40, one knows what the biological age and cardiac age is. The good news is that cardiovascular age of a person can be regressed by quitting smoking and tobacco along with adoption of a healthy lifestyle including diet and exercise. Graying of the hair may not be sufficient to know the age of a person. Today, it is the cardiovascular age which is important.

As per Ayurveda physiology, food is Brahman and contains the same consciousness as in us and this consciousness is the essence of any food. Any food digested is converted into three portions, the gross undigested food is converted into waste (feces); the middle one is converted in one of the Dhatus and the subtlest form gets converted into ojas or the immunity. As per standard Ayurveda, food once eaten is converted into the first Dhatu i.e. Rasa. Once the formation of Rasa is complete, the remaining is converted into Rakta (blood).The left over essence of food makes Mamsa (muscles), left over of which makes (Medha (adipose tissue) and so on to form Asthi (Bone), Majja (bone marrow) and Shukra (sperm/ova). As per this physiology, the second Dhatu will only form once the first Dhatu is of good quality and so on and at any step in Dhatu, if not formed properly, subsequent Dhatu will also show defective formation. For example, defective Dhatu at the stage of Asthi (bone) will have normal plasma (blood), muscle and adipose tissue but may have an impaired immunity/sperm/bone marrow. Similarly, defective Dhatu at the level of bone marrow may have only impaired immunity with no impairment of other Dhatus. On the other hand, impairment of Dhatus at the level of plasma or blood will involve all other Dhatus in sickness. Isolated disorders of Shukra may have no involvement of other Dhatus at all. This Ayurveda principle can help us in answering many unanswered questions in modern allopathy. Like – why in typhoid fever all the organs are involved and why in azoospermia no other organ is involved. Upanishads talk about formation of Dhatus in much more detail. According to them, different types of food make different types of Dhatus. The fiery foods like oil and ghee are responsible for formation of Karamendriyan (part of shukra), bone and bone marrow (Dhatu). The earthy foods are responsible for formation of Gnanandriyan and Manas (shukra) and muscle (flesh) and water in food is responsible for formation of Rasa and Rakta (plasma and blood) and Pran (Shukra). That means every different type of food would make different types of Dhatus and a balanced food with a combination of fire, water and earth will only be responsible for formation of shukra, immunity or the essence. Disclaimer: The views expressed in this write up are entirely my own

4 ways to put off joint replacement

By Dr K K Aggarwal
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Lose weight: For every extra pound you carry, you put about three pounds of additional pressure on your knees and multiply the pressure on your hips by six. If you have arthritis, losing just 15 pounds can cut your knee pain in half. If you do eventually need a joint replaced, losing weight beforehand can reduce your risk of having complications from surgery. Swimming, walking, or riding a stationary bike are the way to go. • Take care when using your joints: By standing up straight instead of slouching you can protect the joints in your neck, hips, and knees. Also use the proper technique when lifting or carrying anything heavy. If any activity hurts, stop doing it right away. • Try nonsurgical approaches before turning to surgery: Treatment with steroid injections is one approach. Benefits can last anywhere from 4 to 6 months. However, it doesn’t work for everyone. Viscosupplementation involves injecting a lubricating fluid into damaged knee joints to treat osteoarthritis. • Get pain relief: Use NSAIDs. There is also some evidence that the dietary supplement glucosamine chondroitin can lead to subtle improvements in arthritis pain. “It doesn’t rebuild joints, but it does seem to help with the pain. • If you can’t escape from joint pain even while at rest, your pain is only relieved by narcotic medications, or your function is severely compromised, it’s time to consider a joint replacement.

Why is Ganesha worshipped in every puja?

By Dr K K Aggarwal
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Every Hindu ritual traditionally begins with a prayer to Lord Ganesh. The wedding ceremony too begins with a puja of Lord Ganesha invoking him to bless the couple and to ensure that the ceremony goes off well. Ganesha, the son of Shiva and Parvati, is the harmonious Aacharan or characteristic disposition of man. Remembered and ritually worshipped before starting a new venture, the entity of Ganesha has in store the facets of a complete man. Ganesha’s head that of an elephant, represents wisdom, intelligence and a healthy mind capable of making sound decisions. Think before you speak, implies Ganesha’s head. The big ears of this elephant deity signify the lending of a patient ear to the echo produced by others’ deeds and speech. It is said that half the dispute is resolved by patiently lending an ear to the words of the other. It also denotes that one must patiently listen to all sides before reaching a decision. Ganesha’s extremely small mouth characteristically represents the need for a limited dialogue and the vanity of talking too much. Over-expression through words causes unsought-for problems which could have been avoided. Ganesha’s small eyes, highlights the need for a focused outlook in life. Such an outlook not only re-defines and foresees the right goals, but also relieves one from the stress-manifested episodes in life. The long trunk identifies with the power of discrimination. Ganesha’s long nose has the strength to uproot a tree and the competency of picking up a pin from the ground. Such should be the approach of an individual who should be capable of perceiving the good and bad for himself, and then have the strength to overcome these against all odds. The tusks and the small teeth of Ganesha tell us to maintain a balance between loss (broken tooth) and gains (whole tooth) in the life. Man ought to maintain his mental state so that ups and downs do not deter him from his honest endeavors. The ample stomach of Ganapati Deva advocates the need for retaining information. Acquiring knowledge, utilizing it and retaining it for years to come, is the crux of ‘big-belly commandment’. The Char-Bhuja Dhari Ganesha, further represents strength by virtue of his four hands in which the Lord entraps his attachments, desires and greed. Two of the arms of Ganesha, which hold a rope, symbolize control over the attachments. The laddoo or sweet in one shows command over desires and earthly delusions. The mouse sitting near the feet of Ganesha represents greed and gluttony upon which the Almighty rides, exhibiting control over evils. Ganesha’s physical traits are an assembly of the characteristics most desired in an individual of substance.

Warning signs of worsening heart failure

By Dr K K Aggarwal
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If you have heart failure, call your doctor if you notice any of these signs: • Sudden weight gain (2–3 pounds in one day or 5 or more pounds in one week) • Extra swelling in the feet or ankles • Swelling or pain in the abdomen • Shortness of breath not related to exercise • Discomfort or trouble breathing when lying flat • Waking up feeling short of breath • Coughing or wheezing • Increased fatigue • Mental confusion • Loss of appetite

Positive Attitudes

By Dr K K Aggarwal
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All those out there who feel you are at your wits’ end wondering how things don’t ever work out for you, can now relax and dwell on all those failures that life has taken you through and turn failure into success. 1. Failure doesn’t mean you are a failure. But it does mean you haven’t succeeded yet. 2. Failure doesn’t mean you have accomplished nothing. It does mean you have learned something. 3. Failure doesn’t mean you have been a foolish. It does mean you had a lot of faith. 4. Failure doesn’t mean you’ve been discouraged. It does mean you were willing to try. 5. Failure doesn’t mean you don’t know what to do. It does mean you have to do it in a different way. 6. Failure doesn’t mean you are inferior. It does mean you are not perfect. 7. Failure doesn’t mean you have wasted your life. It does mean you have a reason to start afresh. 8. Failure doesn’t mean you should give up. It does mean you must try harder. 9. Failure doesn’t mean you’ll never make it. It does mean it will take a little longer. 10. Failure doesn’t mean God has abandoned you. It does mean God has a better idea. Disclaimer: The views expressed in this write up are entirely my own.

Premature heart disease is when heart disease occurs before 55 years in men and 65 years in women. In premature heart disease, the prevalence of dyslipidemia (high cholesterol levels without symptoms) is 75-85%. Fifty-four percent of all patients with premature heart disease and 70% of those with a lipid abnormality have a familial disorder. Hence, a screening test for lipids is recommended for first-degree relatives of patients with myocardial infarction, particularly if premature. Screening should begin with a standard lipid profile and if normal, further testing should be done for Lp(a) and apolipoproteins B and A-I. About 25% patients with premature heart disease and a normal standard lipid profile will have an abnormality in Lp(a) or apo B. Elevated apo A-1 and HDL are likewise associated with reduced CHD risk. First-degree relatives are brothers, sisters, father, mother; second-degree relatives refer to aunts, uncles, grandparents, nieces, or nephews and third-degree relatives refer to first cousins, siblings, or siblings of grandparents. Familial hypercholesterolemia (FH) is a genetic disorder, characterized by high cholesterol, specifically very high LDL (“bad cholesterol”) levels and premature heart disease. Patients may develop premature cardiovascular disease at the age of 30 to 40. Heterozygous FH is a common genetic disorder, occurring in 1:500 people in most countries. Homozygous FH is much rarer, occurring in 1 in a million births. Heterozygous FH is normally treated with drugs. Homozygous FH often does not respond to medical therapy and may require apheresis or liver transplant. To detect familial high cholesterol levels, a universal screening must be done at age 16. The cholesterol levels in heterozygous patients are between 350 to 500 mg/dL, and in homozygous, the levels are between 700 to 1,200 mg/dL.