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Dr K K Aggarwal

Explaining cardiac interventions

By Dr K K Aggarwal
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For any traffic management, following are the options:

  • Placing traffic signals can be equated to dos and don’ts of lifestyle management.
  • Posting a traffic inspector on the crossing – This can be equated with clinical cardiologist.
  • Diverting the traffic from main road to side roads – This can be equated to opening collaterals by drugs, exercise.
  • Hiring an architect to make maps – This can be equated to an angiographer doing angiography.
  • Looking for the possibility of widening the roads – This can be equated to balloon angioplasty.
  • To prevent encroachment of widened roads to place railing around the widened roads can be equated to placement of metallic stent.
  • To prevent mishandling of railing, safety grills are put. This can be equated to drug eluting stents.
  • When the roads cannot be widened, flyovers are made, which can be equated to bypass surgery.
  • Flyovers can be made by stopping the traffic. This can be equated to open bypass surgery.
  • Flyovers can be made without disturbing the traffic, this can be equated to heart bypass surgery.

Spiritual Prescription: Yoga, the Greatest Healer

By Dr K K Aggarwal
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The Sanskrit word for ‘healthy’ is ‘Svastha’ – Sav-Stha – means being established in one’s own true self. This is only possible when the body is in union with the mind and the consciousness.

The Bhagavad Gita (Ch. IV shloka 36), says Api chedasi papebhya sarvebhya pap kritama or in other words “even if thou are the sinner of all sinners, you shall cross over all sin by the raft of knowledge”. Here sin can be equated with physical or mental sickness.

Again, in shloka 37, Krishna says “Gyanagni sarva karmani bhasmasat kurute tatha”. In other words, “as fire reduces fuel to ashes, the fire of knowledge reduces all karma to ashes”.

In shloka 38, Krishna said “Na hi gyanena sa drisham pavitram ih vidyate” or in other words “there is no greater purifier than knowledge. One realizes it in his own heart in time, as he practices yoga”.

The medical interpretation of these are that to acquire mind-body union, one needs to practice yoga which helps to establish pure consciousness. Once that is established, only then one can be called as healthy. This is further clarified in Ch II verse 65, where Krishna said “prasade sarva dukhanam hanirasya upjayte” or in other words “in peace all the troubles are destroyed”. Here ‘peace’ can be equated with one with pure consciousness and troubles with ‘sickness’.

Yoga sutras of Patanjali also describe the first sutras as “yoga chitta uritti nirodhe” or in other words “yoga is the cessation of fluctuations in the mind”.

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

Eating refined sugar can cause diabetes

By Dr K K Aggarwal
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Eating too much refined white sugar can cause insulin resistance and future diabetes.

Diabetes does not mean that one cannot have desserts forever. While eating too many sugary foods should be avoided, one can have an occasional dessert, especially if one exercises and otherwise eats healthy. It’s better to substitute brown sugar or Jaggery in that case. Artificial sweeteners including stevia are the other options.

Fruits are healthy for diabetics but cannot be consumed in huge amounts, as they contain carbohydrates.

As per Ayurveda, diabetes is a Kapha disorder and diabetics should limit the intake of sweet, salt and sour taste in the diet. Any fruit or vegetable, which is bitter and dark green, has anti-diabetic properties.

One should combine a bitter taste with a sweet taste when choosing a vegetable or a fruit. For example, one should not combine peas with potatoes but one can combine potatoes with fenugreek (methi) leaves or spinach (palak).

Diabetics are not more susceptible to colds and other illnesses but may have more complications of flu.

Taking insulin does not cause hardening of the arteries or high blood pressure.

Diabetes is not contagious and one cannot catch diabetes from someone else.

Why do we not touch papers, books and people with our feet?

By Dr K K Aggarwal
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In every traditional Gurukul, no studies start without chanting the following

Saraswati namasthubhyam

Varade kaama roopini

Vidyaarambham karishyaami

Sidhirbhavatu me sadaa

“O Goddess Saraswati, the giver of Boons and fulfiller of wishes, I prostrate to You before starting my studies. May you always fulfil me”

Indian Vedas consider knowledge about self as the supreme knowledge and all tools for the same are considered sacred and divine and must be given respect. The traditional custom is not to step on any sacred educational tool.

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

Debts in Mythology

By Dr K K Aggarwal
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It is said that there are three debts, which everybody has to pay in his or her lifetime. In Vedic language, they are called Dev Rin, Pitra Rin and Rishi Rin.

In medical language, the body consists of soul, physical body, mind, intellect and ego. The soul is given to us by God or Devtas (Dev Rin), the physical body by our parents (Pitra Rin) and the mind, intellect and ego by our Gurus (Rishi Rin).

In terms of computer language, if I see my body as a computer, then my body as a computer is made by my parents; operating software and my inner internet represent the soul or consciousness given by the Devtas and the application softwares, i.e. Word, Excel and Power point, which we learn over a period of time are given to us by our Gurus. Therefore, we have to pay all these three debts while we are still alive.

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

How to keep your memory sharp?

By Dr K K Aggarwal
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  • Manage your stress, especially deadline pressure and petty arguments.
  • The biggest stress is an ongoing sense of extreme anxiety. This can be managed by deep breathing, meditation, yoga and by mindful approach to living.
  • Get a good night’s sleep. The most common reason for poor sleep is difficulty in falling asleep and staying asleep. Many drugs used to treat insomnia can also impair memory.
  • If you need a sleeping medicine, it should be used in the lowest dose and for the shortest period of time.
  • Get up at the same time in the morning.
  • If you smoke, quit.
  • If you do not drink, do not start.
  • Alcohol makes it difficult to perform short-term memory tasks such as memorizing a list. It also induces vitamin B1 deficiency, which can cause dementia.
  • Protect your brain from injury as repeated minor head trauma can cause brain damage.
  • Wear seat belt when riding in a motor vehicle.
  • Wear helmet while driving or riding a motorcycle.

What is the importance of silence?

By Dr K K Aggarwal
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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. On all such days, he used to communicate with others only by writing on paper.

Hindu principles also talk about a correlation between mauna (silence) and shanti (harmony). Mauna Ekadashi is a ritual followed traditionally in our country. On this day, the person is not supposed to speak at all and observe complete silence throughout day and 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 “The Seven Spiritual Laws of Success” talks in great detail about the importance of observing silence in day-to-day life. He recommends everyone should observe silence for 20 minutes every day. Silence helps redirecting our imagination towards self from the outer atmosphere. Even Swami Sivananda, in his teachings, recommended observing mauna daily for 2 hours for Ekadashi. Take milk and fruits every day, study one chapter of Bhagwad Gita every day, 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 a great sage of our country who is known for the bhoodaan movement. He was a great advocator and practical preacher of mauna vrata.

Mauna means “silence” and vrata means “vow”. Mauna vrata, therefore, means vow 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 conscience dwells. There is no religious tradition which does not talk about silence. It removes worldly communication and forces a dialogue towards inner communication. That is 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 benefit 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 my own).

Tips on Water Hygiene

By Dr K K Aggarwal
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  • Travelers should avoid consuming tap water.
  • Avoid ice made from tap water.
  • Avoid any food rinsed in tap water.
  • Chlorination kills most bacterial and viral pathogens.
  • Chlorination does not kill Giardia and Entamoeba cysts or Cryptosporidium.
  • Boiled/treated water is safe.
  • Carbonated drinks, wine and drinks made with boiled water are safe.
  • Freezing does not kill the organisms known to cause diarrhea. Ice in drinks is not safe unless it has been made from adequately boiled or filtered water.
  • Alcohol does not sterilize water or ice. Mixed drinks may still be contaminated.
  • Hot tea and coffee are the best alternates to boiled water.
  • Bottled drinks should be requested without ice and should be drunk from the bottle with a straw rather than with a glass.
  • Boiling water for 3 minutes followed by cooling to room temperature will kill bacteria.
  • Adding two drops of 5% sodium hydrochloride (bleach) to quarter of water (1 liter) will kill most bacteria in 30 minutes.
  • Adding 5 drops of tincture of iodine to 1 liter of water will kill bacteria within 30 minutes.

Clinicians should aggressively treat unhealthy lifestyles

By Dr K K Aggarwal
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Unhealthy behaviors should be managed as aggressively as hypertension, high cholesterol, and other heart disease risk factors, according to an American Heart Association policy statement published in the journal Circulation.

Doctors should create “interprofessional practices” to connect patients with behavior-change specialists. They must implement five A’s when caring for patients –

  1. Assess a patient’s risk behaviors for heart disease
  2. Advise change, such as weight loss or exercise
  3. Agree on an action plan
  4. Assist with treatment
  5. Arrange for follow-up care.

Why do We Burn Camphor in Any Pooja?

By Dr K K Aggarwal
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No Aarti is performed without camphor. Camphor, when lit, burns itself out completely without leaving a trace.

Camphor represents our inherent tendencies or vasanas. When lit by the fire of knowledge about the self, the vasanas burn themselves out completely, not leaving a trace of ego.

Ego is responsible for a sense of individuality that keeps us separate from the Lord or consciousness.

Camphor, when burns, emits a pleasant perfume. This signifies that as we burn our ego, we can only spread love and nothing else.

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

Cough Hygiene

By Dr K K Aggarwal
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  • When you cough or sneeze, you tend to expel out respiratory waste, which can be droplets (larger than 5 micron) or airborne droplets less than 5 micron; both have different clinical implications.
  • Droplets remain suspended in the air for a limited period only and exposure of less than 3 feet is usually required for human-to-human transmission of droplet-borne respiratory organisms. In flu, this can be up to 6 feet. The examples of droplet infections are meningitis, influenza, rubella (German measles), etc.
  • No precaution needs to be taken by a person who is 6-10 feet away from the patient but if a person is sitting or working at even 3-6 feet distance, the non-coughing person should wear a simple mask.
  • Airborne droplet nuclei that carry respiratory secretions smaller than 5 microns can remain suspended in the air for extended period and can cause infections to people who are standing even more than 10 feet away. The examples of airborne droplet nuclei infections are TB, measles, chickenpox and SARS.
  • Patients with these diseases should be placed in an isolation room and all healthcare personnel who are looking after these patients must use a safe N95 mask.
  • In normal house with windows opened, there is a constant exchange of air, which prevents spread of infections but in AC setups with no air exchange, the infections can spread from one person to another.
  • When sitting in an air-conditioned atmosphere, the setting of the AC should be such that the same air is not circulated and fresh air is allowed to exchange. Split ACs, therefore, are more dangerous than the window ACs.
  • In an office with split AC, if one employee is suffering from any of the droplet nuclei disease, he/she can transmit infection to others. Therefore, patients with confirmed TB, measles, chickenpox and SARS should not be allowed to work in split AC atmosphere.

Am I a spiritual seeker?

By Dr K K Aggarwal
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Every one cannot be a spiritual seeker. In fact, majority is not interested in seeking spiritual knowledge and they keep themselves busy in the worldly desires. To become a good seeker, one needs to acquire many qualities.

In Bhagavad Gita, Arjuna, in a state of disturbed mind, sought guidance from Lord Krishna. In Katha Upanishad, Nachiketa, as a healthy seeker, learned the knowledge of life after death from Yama.

Katha Upanishad described in detail the qualities of a seeker in Nachiketa.

The story goes as under: Vajashrava sage performed a sacrifice in which he was required to give away all his worldly possessions. His son Nachiketa saw that the cows given in the donations were all old. Such charity was not going to give his father any merits. Feeling disturbed by the inappropriateness of his fathers observance of the sacrifice, Nachiketa asked to whom was he given. The sage ignored him twice, but on third asking, the irritated sage said in anger, “Unto Yama, I give thee.” Whereupon Nachiketa went to the abode of Yama, and, finding him absent, waited there for three days and nights. Yama on his return offered to grant him three wishes.

Nachiketa wished the following:

  1. To be allowed to return to his father alive, and that his father not be angry with him
  2. To be instructed about fire sacrifice
  3. To be given knowledge about life after death.

Yama granted the first wish immediately. In answer to Nachiketas second question, Yama named performance of a special fire-sacrifice after Nachiketa. Before answering the third question, Yama tested Nachiketa, offering him all sorts of worldly pleasures instead, but Nachiketa insisted. And then Yama taught him about life after death.

The properties of true seeker therefore are:

  1. Righteousness and truthfulness: Nachiketa did not agree with his father as his (father’s) act was not based on Dharma.
  2. Persistence: He waited for three days to meet Yama.
  3. Compassion and forgiveness: The first boon he asked was to have his father forgiven.
  4. Intellectual understanding: The fire of knowledge means intellectual understanding.
  5. Let go of the desires: He let go all his desires and did not get attracted to the worldly offers given by the Yama.

Only after that he qualified to receive the knowledge of soul and become a true seeker.

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

The science behind observing Shradhs

By Dr K K Aggarwal
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Shradhs are observed every year in Dakshinayana during Chaturmas in the Krishna Paksha of Ashwin month. Many rituals are performed to satisfy the unfulfilled desires of three generations of our ancestors.

According to the Vedas, every individual has three debts to be paid off, firstly, of the Devtas (Dev Rin), secondly of Guru and teachers (Rishi Rin) and, thirdly, of Ancestors (Pitra Rin). From a scientific point of view, devtas represent people with Daivik qualities; teachers are the ones who have taught us and Pitra, three generations of our ancestors. Rin, from scientific point of view, would mean unfinished desires or tasks.

The rituals scientifically would mean detaching oneself from the guilt of unfinished tasks of our ancestors by detoxifying our mind.

Debt means desires of our ancestors that had not been fulfilled during their lifetime. The responsibility to fulfil them automatically falls onto the eldest son in the family and they need to be carried out. If not, it is a sign of guilt disorder in the family and may present with loss of wealth, loss of direction and courage and health. The resultant problems faced were called Pitra Dosh in mythology.

The ritual of performing Shradhs originated to remove this guilt and the resultant illnesses. Shradh has many components:

  • Tarpan (offering water to the ancestors while reciting Mantras).
  • Arpan (preparing food what the ancestors used to like on the day of Shradh)
  • Brahmin bhoj (offering Satvik food to Brahmins)
  • Pind Daan (offering black sesame, Kusha Grass, Jwar and boiled or baked rice); observed by some.
  • Observing a spiritual holiday or incubation period (taking a break from the routine worldly desires and going to a distant place like Gaya).
  • Remembrance: Once the unfulfilled desires of the ancestors are over, remembering our ancestors every year on the day of their death anniversary.

Scientifically, Dakshinayana is the period of negative state of mind (nights are longer than days) and starts from 14th July and ends on 13th January. Chaturmas period (first four months) during Dakshinayana has the maximum negativity in the mind. Chaturmas includes the months of Sawan, Bhado, Ashwin and Kartik.

The negative state of mind in Sawan is related to anger and disturbed mind; in Bhado to non-fulfilment of desires and uncontrolled ego and in the month of Ashwin to guilt because of non-fulfilment of desires of others (ancestors), especially during Amavasya.

In the rituals, Tarpan of Jal (water) is offered to ancestors. Jal in mythology means flow of thoughts and offering Jal in mythology equates to confession and getting connected. Tarpan is always done with an aim to purify the mind and wash off the guilt.

Tarpan is always done after the desires of our ancestors have been fulfilled by the person performing the Shradh. This ritual is Arpan. Tarpan and Arpan on the day of Shradh mean getting connected to our consciousness and informing that all the unfinished tasks are over so that we can get rid of the long persisting guilt from our mind. Offering and making food which was liked by our ancestors on that day is just to remember and pay respect to them.

Confession is only possible in a Satwik state of mind, which requires eating of Satwik food for a few days. The ritual of offering Satwik food to Brahmins during the Shradh means making only Satwik food on that day so that everyone in the family is forced to eat Satwik food during Shradhs.

Pind Daan denotes medicinal ways of detaching oneself from the guilt. All the four offerings (black sesame, Kusha grass, Jwar and boiled or roasted rice) in Ayurveda have been described to detoxify the mind and making it Satwik by removing Rajas and Tamas.

If the guilt does not go by repeated Shradhs then one is required to go for a spiritual vacation during Shradh period so that he is away from the worldly desires for a few days before the Shradh and this is what going to Gaya means. This spiritual retreat works like an incubation period to the disturbed mind and gets rid of the disturbed mind and allows the undisturbed state of mind to confess and purify.

The Pitra ceremonies are usually performed either on Amavasya every month (period of most negativity in a month) or on the death anniversary or the Hindu Tithi (day) of the death of the ancestors coinciding with the day during Shradh days. If the date of death is not known then the Shradh is observed on Amavasya.

Some people perform Shradh for full 15 days and others perform it from the first day till the day of their ancestors’ Shradh.

It is said that once a Shradh is successfully performed or Gaya Shradh is performed, there is no need to perform Shradh rituals thereafter. Once the guilt is over, there is no need for further detoxification of the mind. After that the only ritual that needs to be performed is remembrance, which is usually performed on the death anniversary of the deceased ancestor usually by doing some charity on their names.

One is not supposed to do auspicious things during Shradh as during this period, the mind is in a process of detoxification.

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

Tips to relieve heartburn

By Dr K K Aggarwal
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  • Avoid foods that seem to trigger your symptoms.
  • Eat small portions and dont overeat; chew food slowly and completely.
  • Avoid smoking, eating quickly, chewing gum, and drinking carbonated beverages as they lead to swallowing excess air.
  • Reduce stress.
  • Get enough rest.
  • Dont lie down within 2 hours of having a meal.
  • Maintain a healthy body weight.

(Source: Harvard Healthbeat)

Hand, foot and mouth disease: Salient facts

By Dr K K Aggarwal
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  • Hand, foot and mouth disease is a viral illness most commonly caused by the Coxsackie virus A6.
  • Enteroviruses 71 (EV71) can also cause hand, foot and mouth disease.
  • Both adults and children can develop this infection. But young children below 5 years old are more susceptible.
  • It is a moderately contagious illness.
  • The incubation period is 5 days.
  • The illness begins with fever, which lasts for 24-48 hours.
  • Fever is followed by appearance of painful sores in mouth. They begin as small red spots that blister and then often become ulcers. Tongue is involved.
  • There is peripherally distributed, small, tender, non itchy rash with blisters on palms of the hands, and soles of feet and buttocks.
  • The sores hurt on touch and swallowing is difficult.
  • There is proximal separation of nail from the nail bed.
  • The virus is present in mucus from nose, saliva, fluid from sores and traces of bowel movements.
  • The virus spreads in the first week of infection.
  • The infection spreads from person to person by direct contact with nasal discharge, saliva or blister fluid or from stool of infected persons.
  • The virus can persist in the stool for weeks.
  • The illness is not transmitted to or from pets or other animals.
  • The illness stays for 2-3 days. It is usually mild and self-limited.
  • Enterovirus 71 is associated with brain involvement (meningitis and encephalitis), lungs and the heart.
  • The patient remains infectious after the symptoms have gone.
  • Test is not necessary.
  • There is no specific treatment.
  • Paracetamol tablet can be taken to relieve pain and fever.
  • Aspirin is to be avoided in children.
  • Avoid dehydration.
  • Eat ice cream to numb the pain.
  • Use mouthwashes or sprays that numb the mouth.
  • Regularly wash your hands with soap and water.
  • Avoid exposure to infected person.
  • Maintain touch hygiene to reduce your risk of acquiring the infection.
  • During first week of illness, the child should be kept in isolation.
  • Schools should be closed.
  • There is no vaccine currently available.