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Dr K K Aggarwal

First aid for poisonous bites and stings

By Dr K K Aggarwal
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People often panic if they have been bitten or stung. You should tell the patient that many snakes, spiders, insects and sea creatures are harmless and that even the bites and stings of dangerous animals often do not cause poisoning.

Keep the patient calm and still. Moving the bitten or stung limb speeds up the spread of venom to the rest of the body. Fear and excitement also make the patient worse. The patient should be told not to use the limb and to keep it still and below the level of the heart. The limb may swell after a while, so take off the patient’s rings, watch, bracelets, anklets and shoes as soon as possible. A splint and a sling may help to keep the limb still. Consider the following:

  • Do not cut into the wound or cut it out.
  • Do not suck venom out of the wound.
  • Do not use a tourniquet or tight bandage.
  • Do not put chemicals or medicines in the wound or inject them into the wound (for e.g., potassium permanganate crystals).
  • Do not put ice packs on the wound.
  • Do not use proprietary snake bite kits.
  • The patient should lie on one side in the recovery position so that the airway is clear, in case of vomiting or fainting.
  • Do not give the patient anything by mouth – no food, alcohol, medicines or drinks. However, if it is likely to be a long time before the patient gets medical care, give the patient water to drink to stop dehydration.
  • Try to identify the animal, but do not try to catch it or keep it if this will put you, the patient or others at risk. If the animal is dead, take it to hospital with the patient, but handle it very carefully, because even dead animals can sometimes inject venom.
  • As soon as possible, take the patient to a hospital, medical dispensary, or clinic where medical care can be given. The patient should not walk but should keep as still as possible. If there is no ambulance or car, carry the patient on a stretcher or trestle, or on the crossbar of a bicycle.
  • Antivenom should only be given in a hospital or medical center where resuscitation can be given, because the patient may have an allergic reaction. If available, antivenom should be used if there is evidence of severe poisoning. It should not be used when there are no signs of poisoning.

Why do we apply holy ash?

By Dr K K Aggarwal
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Bhasma is the holy ash produced from the Homa, the sacrificial fire, wherein special wood along with ghee and other herbs are offered as a part of pooja. By the time a bhasma is formed, no trace of original matter remains in the ash. Ash obtained from any burnt object is not bhasma.

The ritual involves worshipping the deity by pouring ash as abhishek and then distributing it as bhasma, which is then applied on the forehead (usually), upper arms, chest, or rubbed all over the body. Some consume a pinch of Bhasma when they receive it.

The word bhasma is derived from “bha” or “bhartsanam” (“to destroy”) and “sma” or “smaranam” (“to remember”). It denotes “that by which our sins are destroyed and the Lord is remembered”. Bhasma is also called vibhuti, which means glory. Bhasma is associated with Lord Shiva who applies it all over His body.

Spiritually, the Homa is the offering of oblations into the fire with sacred chants and signifies offering or surrender of the ego and egocentric desires into the fire of knowledge. The resultant ash signifies the purity of the mind. The fire of knowledge burns the oblation and wood signifying ignorance and inertia, respectively. The application of ash implies that one should burn false identification with the body.

Bhasma has medicinal values in Ayurveda. It is supposed to be the strongest of all Ayurveda preparations. According to Ayurveda, a Bhasma is formed when the matter is converted into non matter by the process of homa. The non matter is the spirit or the energy of the matter being processed with strong healing powers. It has the same significance as any ‘potentized’ medicine in Homoeopathy.

It absorbs excess moisture from the body and prevents colds and headaches.

When applied with a red spot at the centre, the mark symbolizes Shiva–Shakti (the unity of energy and matter that creates the entire seen and unseen universe).

The Upanishads say that the famous Mrityunjaya Mantra should be chanted whilst applying ash on the forehead.

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

Blood pressure drugs should be taken at night

By Dr K K Aggarwal
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Uncontrolled blood pressure can lead to heart attacks, paralysis and heart failure. Most such attacks occur in the early morning hours. Pulse, blood pressure and thickening of platelets are all higher in the early morning hours.

Controlling early morning blood pressure can reduce cardiovascular mortality. According to a study published in the Journal of the American Society of Nephrology, among patients with chronic kidney disease and high blood pressure, taking at least one antihypertensive drug at bedtime significantly improves blood pressure control, with an associated decrease in risk for cardiovascular events.

The study included 661 patients with chronic kidney disease who were randomly assigned either to take all prescribed anti-BP drugs on awakening or to take at least one of them at bedtime. Patients were followed for a median of 5.4 years; during that time, patients who took at least 1 BP-lowering drug at bedtime had approximately one third of the cardiac risk compared with those who took all medications on awakening. A similar significant reduction in cardiac deaths, heart attacks and paralysis was noted with bedtime dosing. Patients taking their medications at bedtime also had a significantly lower mean BP while sleeping. For each 5 mmHg decrease in mean sleep-time systolic upper BP, there was a 14% reduction in the risk for cardiovascular events during follow-up. Potential explanation for the benefit of night time treatment may be associated with the effect of night time treatment on urinary albumin excretion levels. Urinary albumin excretion is significantly reduced after bedtime, but not morning, treatment.

The vast power of the Spirit

By Dr K K Aggarwal
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Om Poornamadah Poornamidam, Poornaat Poornamudachyate

Poornasya Poornamaadaaya, Poornameva Avasihyate”

The whole is whole; if you take away the whole away from the whole, the whole will still remain (That is infinite, this is infinite, from the infinite, the infinite has come out. Having taken the infinite out of the infinite, the infinite alone remains).

(In Vedanta “That” represents super consciousness, God or the Brahman and “This” the visible universe)

Atman, which makes up our body, is 99.99% space and if we look at the rest, it is also nothing but space or void. This void or ‘akasha’ is what is called Brahman, God or consciousness and is a web of energized information. This web of information of inner space, called inner consciousness, is the Atman or the Soul. This is connected with the outer space in the universe having a similar web of energized information called the Spirit or Brahmand.

This spirit has been given many names by different religions. Allah (Islam), Buddha (Buddhism), Brahman (Hinduism), Christ (Christianity) or Wahe Guru (Sikhism), all signify the same. This spirit, the energized field of information, is a powerful expression of live energy which can move faster than the speed of light. Soul is nothing but an individualized expression of the spirit.

This energy containing information in the spirit cannot be seen, felt, touched, tasted or smelt. It is beyond the perception of five senses. One cannot destroy it with a weapon, fire, water or air. This consciousness is embedded in the space of each and every cell of the body. It is like sugar added to the milk. Once added, you cannot find it as it gets embedded with each and every drop of milk.

Soul originates from the spirit. Each soul differs from the other by way of the subtle layer of consciousness called the ‘sukshma sharira’ which is controlled by the triad of actions, memories and desires. Spirit is like light, which is always positive and only removes darkness. The basic nature of the consciousness is “truth and bliss”. The soul and the spirit are devoid of hatred, anger or jealousy and are full of unconditional love. They are nothing but a treasury of information about everything. This infinite information is capable of doing anything, including miracles. It is like the flame of a candle, which can light an infinite number of candles, while still retaining its illumination to the same degree.

Dr Deepak Chopra once said that the soul is like the voice of Lata Mangeshkar coming out of a radio, and even if you break the radio, you will not find Lata Mangeshkar in it. Similarly, even if you cut the body into pieces, you cannot find the physical presence of the spirit.

Spirit is present all over, be it the universe or the living beings. Any amount of spirit taken out from it will not make any difference to the spirit. In religious terms, the infinite or the vastness is equated and described by the blue color, and that is one reason why most of the gods are represented by the blue color, or are shown in the background of blue sky. This only represents the vastness and infinite character of the consciousness. One of the Gurus explained to his disciple the description of the spirit by the following equation: 1×1=1, 1/1=1 or, in other words everything is one. One can also explain it by the equation that infinity when added, subtracted, multiplied or divided by infinity will result in infinity only.

This infinite potential in our mind is present in between the thoughts and can be experienced by enabling oneself to go in between the thoughts by a process called mediation. One can experience the silent gap between the thoughts either with the use of primordial sound mantra as a vehicle or by way of yoga. People who have learnt meditation and have achieved the ability to go into the silent gaps can accomplish everything in their life using the principles of intention and attention. After any intention is introduced in the silent gap, a new reality can be created.

“That which is born of the flash is a flash; that which is born of the spirit is spirit” (John)

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

Wet vs Dry winter

By Dr K K Aggarwal
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The whole universe is made up of five elements, i.e. Air, Space, Fire, Water and Earth. These five elements are also responsible for formation of the human body as per Vedic principles. In our body, Air and Space components are responsible for different types of movement functions, Fire and Water elements for metabolism and Water and Earth components for formation of secretions and structures. Ayurveda calls them as Vata, Pitta and Kapha humors.

People with Vata humor personality have more of Air and Space elements and, therefore, have more dry and cold extremities. On the other hand, people with Kapha humor personality have more of structure and water, therefore have wet and cold extremities. In terms of atmosphere, Vata period will be cold and dry and Kapha period will be cold and wet.

According to the Vedic concept, early winter is cold and wet with more humidity and late winter is dry and cold with less humidity and more of windy movements. The chances of fog and smog are higher in early winter as compared to late winter. Hypothermic deaths are much more in late winter because of cold winds.

As per Ayurveda, in Kapha period, prone persons will experience fluctuations in blood sugar and will have more frequent attacks of bronchitis, expectoration and joints pains with effusion. The lower blood pressure will rise more than upper blood pressure and if a patient ends up with a heart attack there are more chances of heart muscle dysfunction.

Whereas in the cold and dry winter, due to Vata aggravation, there will be acceleration of upper blood pressure and more chances of brain hemorrhage, nose bleeding, joints pain and heart attacks presenting with abnormal accelerated rhythm disorders.

In the early Kapha wet winter, there are more chances of water retention, depression, movement disorders, seasonal affective disorder and craving for sweets and salts.

Win Relationships and Not Arguments

By Dr K K Aggarwal
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It is a well-known saying that when you are arguing with a wrong boss, you may win the argument but you may invariably lose the relationship and not argument. Lord Krishna was born after Lord Rama and Krishna taught us when to say ‘sorry’ even if you are not at fault. Never hurt the ego of a person who is under influence of alcohol or boss when he is angry.

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

A mix of exercise protocol is better

By Dr K K Aggarwal
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A combination of weight training and aerobic exercise is the best prescription for overweight patients at risk for diabetes and heart disease.

Only aerobic exercise is also good as it reduces weight and inches off the waistlines. Just weight lifting alone has very little benefit.

According to a study published in the American Journal of Cardiology, people in the weight-training group gained about 1.5 pounds and those in the aerobic group lost an average of 3 pounds and half an inch from their waists. Those who did both weight and aerobic training dropped about 4 pounds and 1 waistline inch. This group also had lower diastolic blood pressure as well as a decline in metabolic syndrome score. Both the aerobic-only group and the combined-exercise group also lowered their levels of bad triglycerides.

Spiritual Prescription: You are born with a quota, use it judiciously

By Dr K K Aggarwal
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Everyone is born with a passport with a defined battery life to live up to 100 years after which one has to go back to renew or recharge the batteries.

If the battery is overused or misused and is depleted early, one may have to go back prematurely for recharging, but this time when one comes back, he or she may come back with a different body which may not be the human one. There are 84 lakh Yonis as described in the Vedic Literature.

According to the Vedic description, if one dies prematurely, there are chances that the rebirth will not be in the same species.

To live up to the time period defined at the time of birth by Dharamaraja, one has to follow the principles as described in Yogashastra.

The main principle is the principle of moderation and variety. It says that everything has to be used; if not used, will get rusted and if overused will undergo wear and tear.

When using the principles of moderation and variety, it is important to remember that each one of us is born with a fixed quota of everything – a quota of diet, respiration, heart rate and thoughts.

According to swara yoga, one is born with predefined number of respirations to be taken during life. If one consumes them early, he will depart for refueling early from the life. To reduce respiratory rate is therefore the basis of postponing aging and prolonging life. Stimulating the parasympathetic nervous system by learning and practicing pranayama, which is slow and deep breathing, does the same.

One breathes 15 times a minute or 21600 breaths in a day, or 7884000 (78.84 lakh) a year or 788400000 (78.84 crores) during life (assuming it to be 100 years). Some yoga books say that a person is born with 33 crore breaths, the same if taken at the rate or 15 per minute would last for 42 years.

In fact Pranayama originated on the concept that the breaths of each one of us are numbered, that our life-span is dependent on how many times we shall breathe in a given life, and that, as a consequence of this fact, we must reduce the number of breaths so as to live longer.

In Gorakshapaddhati (I.93), it is written that “Due to fear of death, even Brahma, the Lord of creation, keeps on practicing pranayama, and so do many yogis and munis. It is recommended that a student of yoga must always control his breath.”

Hathayoga-pradipika (II.39) also writes: “All the Gods including Lord Brahma became devoted to the practice of pranayama because they were afraid of death. We the mortals should follow the same path and control the breath.”

Similarly, one is born with a quota of heartbeats with an average of 70 per minute. Many studies have shown that people who have a higher resting heart rate have more chances of sudden death. The aim therefore is to keep their heart rate slow. This can be achieved either by regular exercise, meditation, or AUM Pranayama. In people who run marathons or participate in other athletic activities, the temporary increase in the heart rate during exercise is compensated by the body by adapting the cardiovascular system in such a way that the basal heart rate reduces. The marathon runners may have a heart rate of only 50 per minute.

The less one eats, the more he lives is a Yogic saying. It is said that people who eat once a day are Yogis, twice a day are Bhogis and thrice a day are Rogis. There are enough studies now, which say that 25% reduction in the calorie content can increase the life span. Many studies in rodents have also shown the same effect.

The moderation in exercise is to walk 10000 steps a day. No exercise will end up with obesity and over use with osteoarthritis.

Stress is the excess of thoughts in the mind. Controlling the mind forms the basis of meditation. Samadhi is the state of no thoughts. Practicing meditation 20 minutes twice daily helps to restrain the mind with resultant state of Turiya where the mind has controlled limited positive thoughts.

Pain management

By Dr K K Aggarwal
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  • Pain is a common occurrence in day-to-day life and should be managed well.
  • Remember the word ‘ICE’, where ‘I’ means putting ice pack on the injured painful area, ‘C’ stands for compression and ‘E’ stands for elevation.
  • The mantra, therefore, is to use cold compression and elevation for any injury.
  • Alternate hot and cold packs are used for chronic pain.
  • Painkillers should not be taken without a doctor’s advice.
  • If a painkiller has to be taken, it should be one tablet of paracetamol.
  • People who take alcohol should not consume paracetamol without asking their doctor.
  • In patients with kidney disease, even one tablet of painkiller can precipitate kidney failure.
  • In patients with acid peptic disease, one tablet of painkiller can precipitate gastric bleeding.
  • Instead of taking a painkiller, look for alternative methods to relieve pain.
  • Pain relieving ointments are better than oral painkillers.
  • Intravenous and intramuscular injectable painkillers are available in hospital setting.
  • Always tell your doctor that you are taking painkillers.
  • Always contact your doctor if the pain makes you uneasy, is unexplainable or appears for the first time in life.

Understanding helping others

By Dr K K Aggarwal
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When you help others, your action should not end up in harming or hurting somebody else even though your help has been unconditional. If you have promoted a junior by superseding another who deserves the senior position, this is not regarded as helping, as the person whom you are helping will give you one blessing but the person whom you have harmed may give you 10 curses. Ultimately, you end up with minus points. Helping others also means that it should give you happiness as also to the person/s you have helped and also to those whom you have not helped.

Very low-calorie diet mimics benefits of bariatric surgery

By Dr K K Aggarwal
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Marked improvement in blood sugar control occurs in patients with type 2 diabetes mellitus shortly after Roux–en–Y gastric bypass surgery (RYGB) and before there is major weight loss.

A study determined whether the magnitude of this change is primarily due to caloric restriction or is unique to the surgical procedure. Eleven hospitalized subjects who underwent RYGB and 14 subjects mean-matched for BMI, HbA1c, and diabetes duration were given a very low-calorie diet of 500 kcal/day with a macronutrient content similar to that consumed by patients after RYGB.

Frequently sampled intravenous glucose tolerance tests were performed before and after interventions.

Both groups lost an equivalent amount of weight over a mean study period of 21 days. Insulin sensitivity, acute insulin secretion after intravenous glucose administration, and β-cell function as determined by disposition index improved to a similar extent in both groups.

Likewise, changes in fasting glucose and fructosamine levels were similar. Based on these data, VLCD improves insulin sensitivity and β-cell function just as well as RYGB in the short-term.

Consciousness

By Dr K K Aggarwal
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  • Energy is the raw material of the universe.
  • Information is the organization of energy into reproducible patterns.
  • Consciousness is living information and energy (living energized information).
  • Consciousness is, therefore, intelligence.
  • Intelligence is information and energy that has self-referral or the ability to learn through experiences and the ability to re-interpret and influence one’s own information and energy states.
  • Consciousness is live, advanced, software-driven energized information. A close example: Advanced computer software which can type, correct, interpret, edit and store spoken or read information.

Non obstructive heart blockages not benign

By Dr K K Aggarwal
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In a retrospective study of patients undergoing elective coronary angiography, non-obstructive coronary artery disease (heart blockages), compared with no apparent coronary artery disease (no blockages), was associated with a significantly greater 1-year risk of heart attack and all-cause mortality.

After risk adjustment, there was no significant association between 1- or 2-vessel non-obstructive coronary artery disease (blockages in one or two arteries) and mortality, but there were significant associations with mortality for 3-vessel non-obstructive coronary artery disease (blockages in all three arteries).

Veterans with evidence of non-obstructive CAD on elective coronary angiography had a 2- to 4.5-fold greater risk for heart attack compared with those with no evidence of blockages and 1-year heart attack risk was found to increase progressively by the extent of blockages, rather than increasing abruptly when blockages became obstructive. The results of this study were published in JAMA.

Never tell your patients “that your coronaries are fine and they have nothing to worry about.” Instead, one should say “There is evidence of atherosclerosis and while there is no need to panic, we need to address it.”

Remember there is nothing like “mild coronary artery disease.” Up to 1 in 4 angiograms show minimal plaque or blockages.

Non-obstructive blockages mean presence of atherosclerotic plaque revealed during coronary angioplasty or angiography that does not appear to obstruct blood flow or result in angina symptoms.

These non-obstructive lesions occur in about 10-25% of patients undergoing elective angiography, and their presence has historically been characterized as “insignificant” or “no significant blockages in the medical literature even though multiple studies have shown plaque ruptures leading to heart attack commonly come from non-obstructive plaques.

You look at people the same way as you are

By Dr K K Aggarwal
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Honest people see everybody as honest and dishonest people see everybody as dishonest. It all depends on the type of people you interact with. If you do not take bribe, nobody will offer a bribe to you and you will feel that everybody is honest. If you take bribes, then you will be offered bribes and you will feel that everybody in the society is dishonest. Never judge people with your personal experience.

I recall a doctor saying that every doctor takes and gives bribe because he was running an imaging center and every doctor who approached him asked for a bribe. But he had not taken into consideration the doctors who did not approach him.

Passive smoking can cause dementia

By Dr K K Aggarwal
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People exposed to secondhand smoke may face as much as a 44 percent increased risk of developing dementia. Smoking is already known to increase the risk for dementia and Alzheimer’s disease.

A study from Peninsula Medical School in Exeter, England published in the British Medical Journal has shown an association between cognitive function and exposure to passive smoking. The risk increases with the amount of exposure to secondhand smoke. For people at the highest levels of exposure, the risk is probably higher.

The study collected data on more than 4,800 nonsmokers who were over 50 years old and tested saliva samples from these people for levels of cotinine, a product of nicotine that can be found in saliva for about 25 hours after exposure to smoke. The researchers found that people with the highest cotinine levels had a 44 percent increased risk of cognitive impairment, compared with people with the lowest cotinine levels. And, while the risk of impairment was lower in people with lower cotinine levels, the risk was still significant.

Passive smoking is also associated with an increased risk of stroke and heart disease.