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Dr K K Aggarwal

Padma Shri and Dr B C Roy National Awardee

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

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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).

Some healthy alterations that one can make in their lifestyle

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  • Avoid stress: Start taking short breaks at regular intervals whenever working at the office or even at home. Eat foods like brown bread for carbohydrates instead of white bread, oranges and lemons for vitamin C and spinach for magnesium. A healthy diet and sufficient sleep help release chemicals like serotonin, which helps to reduce stress.
  • Quit smoking: More often than not, people think that smoking helps in reducing stress, which is nothing more than a myth. Excessive smoking aggravates blood pressure, increases heart rate and reduces the supply of oxygen to the brain. You should immediately quit smoking for a disease-free life.
  • Avoid alcohol: Alcohol is one of the most dangerous evils prevailing in our society; it is responsible for a plethora of medical ailments. Alcohol can worsen heart problems and cause cirrhosis of the liver. It triggers obesity and depression.
  • Reduce intake of high trans fat, sugar and sodium-laden food: The majority of lifestyle diseases stem from our irregular and unhealthy eating habits. People who indulge in overeating and consume primarily junk food can develop long-term chronic diseases like diabetes, high blood pressure, heart issues due to increased cholesterol and obesity. A balanced diet is the key; consume healthy meals, which have the required nutritional meals your body needs to function efficiently. Consuming small but frequent meals, which contain a sufficient quantity of fruits and vegetables, is key.
  • Exercise daily: Include a 5-minute brisk walk and a 10-minute stretching in your things to do list whenever you get time. Regularly exercising also helps keep a check on hypertension and obesity.

The very purpose of life is to face sufferings

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According to Hinduism, the very fact we are born means that in our last life, we did not get liberation or Moksha. It also means that some sufferings in our last birth still remained. Therefore, the purpose of this birth is to face those sufferings.

When the purpose of our life is to face sufferings, why suffer from them?

This should be considered as ‘sukh’ and not ‘dukh’. As per Vedic literature, every adversity is an opportunity to learn or to do something different. The notable principles of Buddhism also talk about the same. The first is that suffering exists, second that there is a reason for every suffering and third that it is possible to neutralize the suffering by understanding the 8 paths of cessation of suffering.

Also remember that in every ‘dukh’ you think of ‘sukh’ and in every ‘sukh’ you think of a ‘dukh’. Next time you have a problem, think differently and learn to enjoy them.

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

Explaining cardiac interventions

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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, placing 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

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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 is 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.

Five cholesterol-friendly foods

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  1. Oats provide 1 to 2 g of soluble fiber.
  2. Beans are a rich source of soluble fiber. The body takes some time to digest beans.
  3. Nuts: Intake of 2 ounces of nuts a day can reduce your LDL levels by about 5%.
  4. Foods fortified with sterols and stanols: Intake of 2 g of plant sterols or stanols a day can reduce LDL cholesterol by about 10%.
  5. Fatty fish: Eating fish 2 or 3 times a week can decrease your LDL levels.

[Source: Harvard Health Publishing]

Significance of Lighting a Lamp in Any Worship

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Deepajyothi parabrahma

Deepa Jyotir Janaardanah

Deepo harati paapaani

Sandhyaa deepa namostute

“I prostrate to the dawn/dusk lamp, whose light is the Knowledge Principle (the Supreme Lord), which removes the darkness of ignorance and by which all can be achieved in life.”

Light is a symbol of knowledge, and darkness, of ignorance. Knowledge removes ignorance the way light removes darkness. The purpose of any ritual is to remove internal darkness and attain some knowledge.

Vedic literature recommends lighting a lamp daily as a part of puja ritual. Some do it once at dawn, others twice a day – at dawn and dusk ; while some let the lamp light continuously (akhanda deepa). No auspicious functions can commence without lighting of the lamp and the same is to be maintained right through the occasion.

Knowledge is an enduring inner wealth which is a means to accomplish all outer achievement. By lighting the lamp, we bow down to knowledge as the greatest of all forms of wealth. Knowledge about the self is the greatest wealth. It goes around achieving inner happiness by burning the negativity of mind full of lust and ego.

The traditional oil lamp defines this spiritual significance. The oil or ghee symbolizes our vasanas (lust) and negative tendencies (the wick & the ego). Lit by spiritual knowledge, the vasanas slowly exhaust and the ego perishes. The flame of a lamp always burns upwards signifying that only that knowledge should be acquired that takes us towards higher ideals.

Fat but fit no longer good for health

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A study published in the International Journal of Epidemiology challenged the concept that by being physically fit, individuals who are obese can fully compensate mortality risk. The study suggested that physically fit obese men have a higher risk for death compared to men who are of normal weight but are physically unfit. And it also found a graded association between aerobic fitness at the age of 18 years and the risk of early death.

The study by Gabriel Högström, Dept. of Community Medicine and Rehabilitation at Umeå University, Sweden, and colleagues, obtained data from the Swedish Military Conscription Registry and included 1,317,713 Swedish men (mean age, 18 years) conscripted into the Swedish military from 1969 to 1996. At the time of conscription, they were subjected to baseline assessments for aerobic fitness testing, wherein they cycled until fatigue set in. Investigators assessed all-cause and cause-specific deaths, using national registers. Mortality information was obtained from the National Cause of Death Registry.

Over a mean follow-up of 28.8 years, 44,301 of them died. After adjustment for age and conscription year, those with the highest aerobic fitness levels were found to have a 51% lower risk for all-cause death compared to those with the lowest fitness levels. Similar findings were seen from analyses of weight-adjusted fitness.

Alcohol and narcotic abuse were found to have the strongest associations with death (HR, 0.20; 95% CI, 0.15 – 0.26).

Obese men obtained lesser benefit than normal-weight men from being physically fit (P < .001). Additionally, normal-weight men in all levels of aerobic fitness had lower risk for all-cause mortality (30% – 48%; P < .05 for all) in comparison with obese men with the highest levels of aerobic fitness.

The benefits of aerobic fitness appeared to decline with increase in weight. After adjusting for age and year, normal-weight men in the upper half of aerobic fitness had 34% lower risk for death compared to those in the lower half (HR, 0.66; 95% CI, 0.64 – 0.68). The benefit was seen to decrease to 28% among overweight men, and disappeared completely in those with the highest levels of obesity… (Medscape)

The spiritual meaning of the word ‘Artha’

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Dharma, Artha, Kama and Moksha are the four fundamental principles of our very existence which means earning righteously with a desire to fulfil the inner happiness.

Righteous earning is called ‘Artha’ and mistakenly it has been linked to materialistic money. In mythology, Artha is synonymous with Lakshmi, Saraswati and Kali, where Lakshmi represents righteously earned materialistic wealth, Saraswati represents wealth of knowledge and Kali represents wealth of wisdom to fight the bad in you and in the society.

In any country, it is the wealth of knowledge, which is more important. India was ruled initially by warriors (Kali), later by money (Lakshmi) and in future will be ruled by knowledge (Saraswati).

It is the human resources, which today decide the growth of a company and the amount of money invested. If you have good human resources, your company is going to succeed.

Some facts on Malaria

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  • Malaria is transmitted by the bite of a female anopheles mosquito.
  • The mosquito mainly bites between dusk and dawn.
  • Malaria can also be transmitted through blood transfusion, or through sharing of contaminated needles.
  • Bed nets are good against malaria as the major malarial vectors bite during the night.
  • The behavior of the mosquitoes may differ. Some may prefer to rest indoors and feed indoors in the night. Some mosquitoes may rest and feed outdoors earlier in the day.
  • Preventive therapy of malaria can be instituted during pregnancy in high risk areas.
  • The malaria mosquito feeds every third day compared to the dengue mosquito, which feeds three times in a day.
  • Unlike the malaria mosquito, the dengue mosquito bites during the day.
  • Malarial fever presents with chills, especially during afternoon.
  • Spraying of the indoor residential walls and ceiling is effective against mosquitoes.
  • DDT is commonly used as indoor residential spraying.
  • DDT should not be applied more than once or twice in a year on the walls.
  • Mosquito contact with DDT surface would generally save from lethal exposure outside the house.
  • Public must know that spray may require rearrangement of the furniture. Walls may become streaked with chemical treatment and residual odor from DDT.
  • The other alternative is malathion spray.

Managing grief by free expressive writing

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The loss of a loved is often painful. The resultant grief makes it hard to eat, sleep and leads to loss of interest in routine life, affecting behavior and judgment.

Some can feel agitated or exhausted, to sob unexpectedly, or to withdraw from the world and others may find themselves struggling with feelings of sorrow, numbness, anger, guilt, despair, irritability, relief, or anxiety.

It is well known that disclosing deep emotions through writing can boost immune function as well as mood and well-being. Conversely, the stress of holding in strong feelings can increase blood pressure and heart rate and increase muscle tension.

One can write on a piece of paper, in his personal book, on the open website or keep it in the mind. One doesn’t have to preserve the emotions and can throw away the writings.

In absence of deeply troubling situations, such as suicide or a violent death, which are best explored with the help of an experienced therapist, one can choose writing as a way to express the grief.

  • Start writing for 15 to 30 minutes a day for 3 to 4 days.
  • Continue up to a week if it is helping.
  • Continue writing for 15 to 30 minutes once a week for a month.
  • Writing has stronger effects when it extends for more number of days.
  • Remember, writing about grief and loss can trigger strong emotions (one may cry or feel deeply upset).
  • Several people find journal writing valuable and report feeling better afterward.
  • Don’t worry about grammar or sentence structure.
  • Truly let go. Write down how you feel and why you feel that way.

(Source: Harvard News Letter)

You look at people the same way as you are

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Honest people regard everybody as honest and dishonest people regard everybody as dishonest. It all depends on the type of people you interact with. If you do not take bribe, nobody will come and offer bribe to you and you will feel everybody is honest. If you take bribe then everybody will come to you to offer bribe 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 did not take into consideration the doctors who did not approach him.

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

Normal Aging Changes

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  • Heart rate shows less variability.
  • There is altered circadian pattern (24-hour cycle of the body).
  • There is a delayed response of bone marrow to loss of blood or hypoxia (reduced oxygen).
  • The function of the white blood cells is impaired.
  • Advancing age is a procoagulant stage. This means that the blood gets clotted easily.
  • Reflux of the stomach acid in the food pipe is common.
  • Tendency to constipation is common.
  • Painkillers can quite easily cause ulcers in the stomach.
  • Renal functions decline with age.
  • Older kidney is more prone to be damaged with painkillers.
  • Calcification of heart valves may occur.
  • The maximum heart rate may not reach the level as that in the young age in response to exercise.
  • About one-third of the lung volume may be lost.
  • Aging slows the rate of fracture repair.
  • Skin may become atrophic (thin) and elasticity is reduced.
  • A person may not be able to read small print.
  • There may be impaired speech recognition in noisy environment.
  • There may be loss of taste and smell.
  • There may be high frequency hearing loss.
  • Immunity may be reduced.
  • With age, one is more prone to get urinary tract infection.
  • With age, ejaculation may get impaired.

Think differently in mythology

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  • Lord Ganesha’s elephant head depicts that one should use his/her wisdom before taking any decision.
  • Vishnu’s first incarnation, fish, symbolizes the need to learn to swim in the opposite direction.
  • Brahma’s five heads mean to use all five senses before taking any decision.
  • Shiva’s third eye means to think differently in difficulties.
  • Ravana’s 10 heads mean using your ten senses before taking any decision (but he used them for negative forces).
  • Maha Mrityunjaya mantra starts with saying that we worship the three eyed Shiva.
  • Gayatri mantra means that one should ask the heart to direct the intellect to take the right decision.

The 3H philosophy is linked to the same, where first H is ask the head for options, second H is to ask the heart to choose one of the options and the third H means to order the hands to do the action.

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

Social determinants of health

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There are several factors that determine our health, with access to social and economic facilities being the most prominent ones. The conditions in which people are born and the conditions in which they live, work and grow old can greatly affect an individual’s health. These factors have a direct impact on the quality and length of life besides having an influence on the possibilities of disability-free life.

In most of the cases, medical professionals only evaluate the proximate causes of diseases like smoking, obesity, altered lifestyle and alcohol. However, the actual ‘causes of causes’ are most of the times ignored, which constitute the root of all the medical ills. An effective social determinants approach includes far more than just focusing on proximate causes. It has to address what actually exacerbates premature ill health and the contributing factors.

The lower the people are positioned in the socioeconomic ladder, the more they tend to smoke, the more incomplete their diet is, and the less physical activity they engage in. Education seems to dominate all the other factors such as excessive alcohol consumption, taxation, price and availability, bans on advertising, smoking in public places and tobacco consumption.

Some examples of social determinants:

  • Access to and availability of resources to fulfil daily requirements such as shelter, food, clothes, etc.
  • Access to educational institutions, medical establishments, economic opportunities like jobs or any other source of earning
  • Access to quality medical facilities and healthcare services
  • Quality education, learning and knowledge
  • Availability of community-based resources like recreational and leisure-time activities
  • Daily-life facilities such as transportation and public safety options
  • Society’s attitude towards a person; for instance discrimination, racism or any other kind of bias
  • Prevailing conditions such as crime, violence, lack of cooperation in a community and social disorder
  • Socioeconomic conditions like concentrated poverty and other stressful conditions
  • Literacy and culture
  • Access to mass media and emerging technologies like cell phones, the Internet, and social media.

The world is going through a universal movement that seeks to address the inequalities in health and length of life through action on the social determinants of health. This movement has involved the World Health Organization, several national governments, civil society organization, and academics. Solutions are being sought and learnings shared.

WMA insists that doctors should be well-informed participants in this debate. The medical professionals can be advocates for action on the social conditions that affect health. The WMA agrees to add significant value to the necessary actions being taken:

  • By helping doctors, other health professionals and National Medical Associations understand what the emerging evidence shows and what works, in different circumstances
  • By helping doctors to press more effectively within their countries and across international borders, and ensure that medical knowledge and skills are shared
  • Gathering data of examples that are working, and helping engage doctors and other health professionals in trying new and innovative solutions
  • Educating and informing their members and putting pressure on national governments to take the appropriate steps for minimizing the root causes of premature ill health
  • Drawing up new action plans which include general practice that works across sectors to improve the quality of peoples lives and hence reduce health inequalities
  • Gathering examples of good practice from its members and promoting further work in this area.

[Source: WMA Declaration on Social Determinants of Health]