Thursday, June 30, 2011

Doctors too should respect the prefix ‘Dr.’ before their name

Go and wish your doctor “Happy Doctor’s Day”
July 1 is Doctor’s Day.  Call your doctor or your doctor friends and wish them a Happy Doctor’s Day.  Medicine is a noble profession. Among all professions, medicine is the only profession which can be regarded as next to God.
 “Doctors treat, but God heals” is a well-known saying. Doctors thus serve as the messengers of God. A doctor cannot refuse treatment. It is a doctor’s duty to attend to a patient in emergency regardless of caste, creed, race or the financial status of the person.
This principle has been very well-personified in our mythology too. Ramayana cites the story of Vaidya Sushen, who treated Lakshmana with the famed Sanjivani booti. He was called to see the unconscious Lakshmana during the war between Lord Rama and Ravana. Despite the fact that he was a royal physician in the kingdom of Ravana, Sushen made the decision of treating Lakshmana. This illustrates the ethical duties of a physician.  Likewise, if a person sentenced to death by hanging falls ill, it is the duty of a physician to treat him until the day of his hanging.
 The concept of Family Physician or the General Practitioner of the olden times is fast vanishing in this age of super specialization. Every day new specialties are coming up. What was once the domain of a family physician has been now divided among different specialties. This has created a gap in communication between patient and doctor often leading to litigations. To avoid this, look for a Family Physician, who will be your guide in all health matters and also coordinate your care when specialists are involved.
Doctors too should respect the prefix ‘Dr.’ before their name
Very few professions have the privilege of prefixing an honor before their name and medical profession is one of them. We, as doctors, are allowed to prefix ‘Dr.’ before our names and we must respect this honor.
Diwan, Rai Bahadur, Rotaries, Lion, Justice etc. are other sets of prefixes given by the society to distinguished people.  Even the Prime Minister of India, President of India, Member of Parliaments, MLAs, Councillors have no such privilege. Likewise, Padma Awardees too have no such privilege. They cannot write Padma Shri Dr. XYZ but can only write Padma Shri Awardee Dr. XYZ.
There is no law in India, which allows doctors to write prefix ‘Dr.’ before their names. It is a precedence which has been accepted and honored by the society. The prefixes Dr., Diwan, Rai Bahadur etc. distinguish the privileged persons from the rest of the population. These prefixes indicate that the main duty of these people is towards the welfare of the society. For example, people are aware as to whom to contact when in trouble. It can be any one with a ‘prefix’.
It is the Vedantic principle of “welfare of the society” which makes doctors special and different in the society. The day this aspect of welfare is lost, society may not accord us the same respect as they have been doing so till now.
The principles involved in acting towards the welfare of the society includes giving 10% of our time to charity; not charging any fee from those who cannot afford;  charging less from the middle class and charging normal from people who can afford and where reimbursements are available. Probably, this is the reason that in every hospital even today we have multiple systems of patients and policies starting from Free Wards, General Wards, Concessional Semi Paying Wards and Fully Paid Wards. Many hospitals have even come out with another category of Deluxe where one can charge more from people where money is not a problem. It is the rich who has to pay for the poor in the welfare system.
Let us ( we the doctors) resolve on Doctor’s Day, July 1, 2011 to commit some portion of our time for the welfare of the society.

Wednesday, June 29, 2011

Can i go to mountains?

In summer most people like to travel to mountains either for holidays or for a spiritual retreat.  In both situations it works like a detoxifier for the mind providing an atmosphere devoid of routine stresses of life. 
Most spiritual destinations are situated at high altitude and require a 7-10 days to complete the retreat.  This 7-10 days visit with frequent halts provides inner happiness through sequential mental detoxification (let go of desires); intellectual and ego detoxification (let go of expectations and of ego) and physical detoxification (let go of attachments).
Many precautions needs to be taken so that this spiritual journey does not end into a sickness as at high altitudes one can end up with high altitude related sicknesses.
 Amarnath Yatra is one such spiritual destination. The snow- build Amarnath Shiva Lingam is situated at an altitude of 13700 ft (5486 m) and is regarded as one of the most sacred places in India. An altitude over 3,000 meters (9,843 feet) is usually defined as high altitude.
 The Yatra tour demands good health and physical fitness. People with problems of hypertension, diabetes, heart ailments, epilepsy and asthma should consult their doctor before planning for the Yatra. One should start the physical fitness program several weeks before starting the journey. Walking regularly is the best way to prepare. One should take appropriate quantities of the right medicines for a wide variety of ailments.
Preventing mountain sickness
Acute Mountain Sickness depends on the elevation, the rate of ascent and individual susceptibility. Most visitors suffer from some symptoms that will generally disappear through acclimatization in several hours to several days.
Symptoms are worse at night and include headache, dizziness, lethargy, loss of appetite, nausea, breathlessness and irritability. Difficulty sleeping is another common symptom, and many travelers have trouble sleeping for the first few days.
Acute mountain sickness (AMS) can be very serious, with the most serious symptoms being High altitude pulmonary edema (HAPE) and High altitude cerebral edema (HACE), which can be fatal. Symptoms of HAPE include weakness, shortness of breath, even at rest, impending suffocation at night, and a persistent productive cough with white, watery, or frothy fluid. Symptoms of HPCE may include headache, ataxia, weakness, hallucinations, psychotic behavior, coma and loss of memory. Both approach and strike at night and can be fatal! Immediate descent is the surest treatment.
A gradual ascent allows the body to acclimatize to higher altitudes and the decreased oxygen supply. The formula is to give a night halt between 7000 to 10,000 feet, night halt for every 1500 feet climb and full day halt for every 3000 feet climb thereafter.
One should avoid exercise in the first few days. One should attempt to do half of the activities on the first day while the body is working to acclimate to higher altitude oxygen conditions.
No alcohol should be consumed especially in the first few days and no smoking should be done on the journey.  This is tru for those going for holidays. For those going for spiritual retreats bot in anyway are prohibited.

One should drink enough water each day so that the urine runs clear.
One should eat enough calories. Low cal diets at high altitudes can sabotage health. A well-nourished body can adjust to changes better than an under nourished one can. One should take high carbohydrate diet.
One should avoid taking tranquilizers and sleeping pills. These will depress the respiratory drive and limit oxygen intake. Some medication also helps to prevent AMS, like acetazolamide and nifedipine.  Pregnant ladies should avoid high altitude visits. Patients with chronic diseases should take a medical clearance.

Tuesday, June 28, 2011

Vedic evidence that the fetus in the womb is listening

Amaranth Yatra Special, the Yatra starts from: 29th June to 13th August.
There is a lot of research in modern medicine, which suggests that we should name our child before he or she is born, talk to the baby and make the baby listen to the music. It is said that between 12-16 weeks the baby is ready to listen and respond to the external stimuli.  This has led to the concept of ‘conscious pregnancy’ based on Abhimanyu concept. The west today is trying to prove that the fetus inside responds to the loudness of music and to the emotions of the mother.  
It may be true in the west to look for western evidences and try to prove whether it is true or not, but as Indians we have enough Vedic evidence in the form of stories that it is true. There are three instances in the Vedic literature I know of, that prove this. Vedic proof not only relates to the fact that the fetus is listening but even provides evidence that the fertilized egg too can hear.
As per the Vedic literature, the first evidence is the incidence of pigeon ova listening to Shiva in Amarnath cave, second is the birth of Sage Ashtavakra and the third is the birth of Abhimanyu in Mahabharata.
The birth of immortal pigeons: In the tale of Amarnath Cave, the cave was chosen by Shiva for narrating the secrets of immortality and creation of Universe to Parvati. To ensure that no living being could hear the Immortal Tale, he created Rudra named Kalagni and ordered him to spread fire to eliminate every living thing in and around the Holy Cave. Then, He started narrating the secret of immortality to Parvati. But as a matter of chance, one egg which was lying beneath the Deer skin remained protected. It is believed to be non living and more over it was protected by Shiva-Parvati Asana. The pair of pigeons which were born out of this egg became immortal having heard the secret of immortality (Amar Katha). 
Birth of Sage Ashtavakra (Stories from Mahabharata): Long ago, there was a learned Rishi Uddalaka. One of his disciples Kahoda, pleased his Guru exceedingly with his devotion. So impressed was Uddalaka, that when Kahoda finished his studies, he married his daughter Sujata to him. Sujata became pregnant. She was in the habit of sitting near her father and husband while they were teaching. Her unborn child attained mastery over the Vedas by listening to his grandfather. Kahoda was not equally skilled as his Guru and made a number of mistakes while reciting the scriptures. Unable to bear these errors, the child started correcting them from his mother's womb! Humiliated before his disciples, Kahoda cursed his son, saying, "As you insulted your father, may you be born with eight bends in your body!" Accordingly, the child was born with his body crooked in eight places, and was named Ashtavakra (one with eight deformations).
The birth of Abhimanyu: As an unborn child in his mother's womb, Abhimanyu learned the knowledge of entering the deadly and virtually impenetrable Chakravyuha from Arjuna, his father. He overheard Arjuna talking about this with his wife Subhadra. Arjuna explains to Subhadra in detail, the technique of attacking and escaping from various vyuhas (an array of army formation) such as Makaravyuha, Kurmavyuha, Sarpavyuha etc. After explaining all the vyuhas, he explains about the technique of cracking Chakravyuha. Arjuna explains to her how to enter the Chakravyuha. When he was about to explain how to exit from the Chakravyuha, he realizes that Subhadra is asleep and stops expounding on the Chakravyuha further. As a result, the baby Abhimanyu in the womb did not get a chance to learn how to come out of it.

Monday, June 27, 2011

The science behind Amarnath Yatra and Katha

Amarnath cave was chosen by Lord Shiva for narrating the secrets of immortality and creation of Universe to Parvati. In 2011 the Yatra starts from starts from29th June to 13th August.
Most of us have heard of Rishi Munis doing deep meditation (tap) and getting spiritual realizations. What about a common man who does not want to become Muni or Rishi. For him the only way is doing a daily 20 minutes meditation and undertaking off and on spiritual journeys for self purification. Amarnath Yatra is one of them. Others are Viashno Devi Yatra,  Mini Char Dhaam Yatra, Chaar Dham Yatra etc.
Each spiritual retreat or journey requires a spiritual frame of mind and a commitment of 7-10 days for self purification. Most spiritual destinations are located at up into mountains firstly to provide a pollution free environment and secondly a difficult travel so that nobody can reach the destination before 7-10 days. This 7-10 days travel helps in controlling the mind, intellect and ego and getting rid of the desires, attachments, greed, tamas and rajas. On the way as one is travelling alone without carrying his worldly attachments he or she invariably reaches the destination in a positive state of mind and when one meditates at the place of final destination one experience spiritual insights which inspire one to come out of worldly worries and provides one the path for future living and answers the unanswered questions.     
The Amarnath Story
Once Parvati asked Shiva to let her know why and when he started wearing the beads of heads (Mund Mala). Shiva said whenever you are born I add one more head in my beads. Parvati said,” My Lord, my body is destroyed every time and I die again and again, but you are Immortal. Please let me know the secret of this." Shiva replied that it is due to Amar Katha."
Spiritual Significance
The spiritual significance of the above is, that here Shiva represents the Soul and Parvati the Body. The soul never dies and is immortal. The soul is the energized filed of information and in computer language is like the web of energized information. Every time any work is done (sanskara) a copy of the same is kept in the memory in both the soul and the spirit.
The further part of the story is the katha or the process of doing meditation and its benefits
The story
 “Parvati insisted that she may be told that secret.  For long Shiva continued postponing.  Finally on consistent demand He made up his mind to tell the immortal secret. He started for lonely place where no living being could listen it. He chose Amarnath Cave.”
Spiritual Significance
For learning to meditate the first principle is dedication and persistence.  Second is silence or a place with no internal and external disturbance. In asthanga yoga it is called Pratyahara ( the withdrawal of senses).
The story
“Shiva left His Nandi (The Bull)  at Pahalgam or Bail Gaon; his moon from his hairs (jatha) at Chandanwari; his snake at the banks of Lake Sheshnag; his Son Ganesha at Mahagunas Parvat (Mahaganesh Hill ) and his five elements at  Panjtarni. As a symbol of sacrificing the earthly world. Shiva and Parvati  had Tandav Dance . After leaving behind all these, Shiva enters the Holy Amarnath Cave along with Parvati. Lord Shiva takes his Samadhi on the Deer Skin and concentrate.

Spiritual Significance
In process of meditation one first gets rid of desires (Nandi or the mind), discriminating or analyzing the thoughts power (moon or the intellect) and ego (snake). Once that is done one is away from the worldly desires totally (Ganesh and the five elements). Now the body is in symphony with the soul (Tandava dance)
The story
To ensure that no living being is able to hear the Immortal Tale, Shiva created Rudra named Kalagni and ordered him to spread fire to eliminate every living thing in and around the Holy Cave. After this He started narrating the secret of immortality to Parvati. But as a matter of chance one egg which was lying beneath the Deer skin remained protected. It is believed to be non living and more over it was protected by Shiva -Parvati Asan (Bed). The pair of pigeons which were born out of this egg became immortal  having listened the secret  of immortality (Amar Katha). 
Spiritual Significance
It again signifies the importance of undisturbed state of mind at the time of meditation. Fire indicates the internally meditation generated spiritual fire or agni which burns all the negative thoughts and negative energies. The egg of the pigeon indicates that spiritual knowledge can transform at the level DNA. It also tells us that those who are sitting near the meditating persons also get benefitted.
About the author: Dr Aggarwal is Padmashri and Dr C Roy National Awardee and writes science behind spirituality. He is a senior consultant physician and cardiologist at Moolchnad Medcity Delhi ( He also writes in facebook or twitter.com/DrKKAggarwal or www.kkaggarwal.com/www.emedinews.in)

Sunday, June 26, 2011

The Health Significance of Ashad Month

Ashad (Ashada) Maas ki mahima
Ashad (Ashada) month, mausam, maas or mahina is the fourth month in traditional lunar Hindu calendar and consists of continuing summer with added humidity due to rain. It’s a part of dakshinayana with the start of longer nights compared to days.
From Ayurveda context it is a period of Pitta or metabolism predominance with Vata or movement accumulation. Chaturmas starts in Ashad month (14th July). The Chaturmas months are savan, bhado, ashwin and kartik. The start of savan and bhado months falls in rainy season with air or Vata aggravation in the environment and in the body especially in the mind.
In Ashad month with continuing Pitta aggravation (though reducing) diseases like typhoid, jaundice, and diarrhea continue to occur but due to start of rainy season rainy disease like malaria, dengue, chikungunya and electrical accidents gets added. Also with falling heat but with increase in humidity the heat index rises and hence the cases of heat cramps, heat exhaustion and heat stroke continue.
In terms of diet Vata or movement gets aggravated by bitter, astringent and pungent foods and Pitta or metabolism gets aggravated by pungent, sour and salty foods,  Pungent food being in common should be eaten less in this month of Ashad.
With the start of savan month one will need to avoid bitter, astringent and pungent foods especially the leafy vegetables.
The festivals of Ashad month are Devshyani ekadashi or the start of Chaturmas; Gupta Navratre, Jagannath yatra, Guru Purnima etc.
There are two Gupt (hidden) Navratre in a year. One is observed in the month of Magh (January – February) and the other is observed in the month of Ashad (June – July). Ashad Navratre is also known as Shakambari Navratre and Gayatri Navratre. In July 2011, Ashad Navratre starts from 2nd July to 9th July. It is observed during the Shukla paksha (waxing moon phase) of the month.  The main two famous Navratre fall in the months of Chaitra and Ashwin. There is another Navratre festival known as “Poushya Navigate.” It is celebrated in the months of December and January. Navratre means a nine days detoxification or purification period of the mind body and soul and is observed whenever there is a season change. The two main are observed at the start of the summer and the winter. Ashad Navratre is observed to prepare the body to bear the negativity observed in the Chaturmas rainy period.

Saturday, June 25, 2011

zSHARE - Dr K K Aggarwal on Ashad Month.MP3

zSHARE - Dr K K Aggarwal on Ashad Month.MP3

Will I be allowed to marry in Chaturmas?

Dakshinayana is the start of negative state of mind
The uttarayana and dakshinayana are not only time periods mentioned in the Vedic literature but also the state of minds. Uttarayana means a period for a positive state of mind and Dakshinayana a period for relatively negative state of mind.
Dakshinayana is the southern transit of the Sun. The Uttarayana and Dakshinayana period is calculated differently in South and North India. In North Indian calendars, Dakshinayana in 2011 begins on June 21. In South Indian calendars, it begins on July 17, 2011. In South India, Uttarayana period starts with Makar Sankranti on January 14 or 15 and ends on July 14 or 15. Dakshinayana is from July 14 or 15 to Makar Sankranti. In North India, Uttarayana period starts on December 21 and ends on June 21. Dakshinayana is from June 21 to December 21.
Bhagwad Geeta talks about Moksha and liberation. Those who believe in the philosophy of rebirth know that once a soul is liberated at death, a person is not reborn. Those who believe that hell and heaven are in this birth only for them liberation means dying peacefully and without sufferings.
The theory of rebirth is well described in Bhagwad Geeta in Chapter 8.

The gist of Lord Krishna’s teaching is:
1.       Whatever you think throughout your life will be your thought at the time of death.
2.       Whatever is the state of mind at the time of death will be the atmosphere you will get in the rebirth. For example if your state of mind is in cruelty at the time of death, you will be born in a cruel family. If you are relaxed, thinking of God or Chanting AUM at the time of death, there are chances your soul will be liberated.
4.       Fire, illumination, daytime, fortnight before the full moon and uttarayana are the paths for liberation. It means these are the periods / ways for spontaneous positive thinking. And the reverse is for dakshinayana
From mental health point of view, this knowledge can be converted into medical prescription. Uttarayana means satwa, healthy state of mind and dakshinayana means a depressed negative state of mind. Performing and attending to Yagna, sitting in well illuminated lights or exposing oneself to the day sunlight can be an adjunct to depression treatment. During the first fortnight of full moon and during uttarayana, the psychotherapy and counseling invariable will work better and the requirement of drugs may get reduced. The reverse will happen in dakshinayana.
In chakra language , from mooladhara chakra to anahata chakra is the dakshinayana path and from anahata chakra to ajna chakra is the uttarayana path. Those who travel on the uttarayana path travel from anahata chakra. Those who travel on the dakshinayana path start from mooladhara.
The Chatur Mas or Four holy months in Hinduism falls during the period of Dakshinayana. Chaturmas begins on July 11 and ends on November 6. It begins on the Ekadasi day in Shukla Paksha in the month of Ashada and ends on the Ekadasi in the Shukla Paksha in the month of Kartik. It occurs during monsoon season and most important festivals take place during this period. It’s a four month period for observing fast, rituals, pujas and festivals.
 Chaturmas has folowwing months 
1st Shravan month is dedicated to Lord Shiva, especially the Mondays. Is a month or Vata or air imbalance. The classical song " Savan ka mahina Pavan kare shor" explains the air imbalance in this month. The vata function in the mind is related to emmotional imbalance.
2nd Bhadrapad is the month of festivals including the Ganesh Chaturthi and Janmaasthmi. The month is again related to Vata or air imbalance. The classical Bollywoodsong " tete naina savan bhado phir bhi mera man payasa" explains the state of the mind in savan and bhado months. The state of the mind is negative with chances of more non fulfillment of desires.
3rd Ashwin month include, Durga Puja, Navratri, Diwali etc.
4th Kartik and Diwali celebrations end in this month.
It’s a saying to avoid green leafy vegetables in Shravan month, Curd in Bhadrapad, milk in Ashwin and pulses, the split variety in Kartik month.
No marriages or important functions take place in chaturmas for many reasons
1.         Firstly it is a period of negative state of mind and hence more chances of divorce
2.         For the same reason more chances of infertility
3.         Due to rainy seasons more chances of worms on the surface and infesting the leafy vegetables
4.         Due to Vata ( movement) predominance, leafy vegetables will not be health friendly
5.         Due to pitaa ( metabolism) suppression the digestive fire will be weak
6.         Many people avoid garlic and onion as it can stimulate unnecessary excitements, cause indigestion and distract devotee from pujas and prayers. 

Thursday, June 23, 2011

zSHARE - Emedinews news of the day 23rd June.MP3

zSHARE - Emedinews news of the day 23rd June.MP3

Aishwarya Rai is pregnant - time to celebrate and yet be careful.

The pitfalls and precautions in an elderly pregnancy
Aishwarya Rai was born on 1st November 1973 and is about 38 years old now. As reported, she is pregnant. Everyone wants to know about her pregnancy outcome. We wish her well and pray that the outcome is a healthy mother and child.
Now more and more working women are choosing to become pregnant at a later age. This comes with its own set of medical challenges and we take this opportunity to address specific issues related to the older gravid or women ≥35 years of age at the estimated date of delivery.
There is higher risk of fetal aneuploidy (trisomy 21, 13, 18). Aneuploidy is the condition of having less than or more than the normal diploid number of chromosomes. To diagnose aneuploidy, one may be advised to undergo invasive amniocentesis or chorionic villus test. The other alternative is to screen using maternal serum testing and ultrasound evaluation of fetal nuchal translucency to adjust the mother's age-related risk.
There is higher prevalence of Down syndrome in offspring of older women. One may ask for the screening for Down syndrome.
Age and obesity are risk factors for development of type 2 diabetes mellitus, as well as gestational diabetes.
There is an increased risk of congenital anomalies in older women and hence, a detailed second trimester ultrasound examination may be required to look for significant structural anomalies, especially cardiac anomalies.
Many pregnancy complications occur with increased frequency in older gravidae and they are spontaneous abortion, low lying placenta, pregnancy-induced diabetes, pre eclampsia, pre term birth and cesarean delivery.
There are also more chances of preterm delivery, low birth weight, intrauterine growth restriction, and stillbirths.
Most pregnancies at age 37 will need to be delivered at 39 weeks of gestation on medical grounds.
Chances of IVF pregnancy at this age are higher and hence a twin or a triplet delivery is likely.

Wednesday, June 22, 2011

zSHARE - Bhagvad Gita Chapter 2 Shloka 20-30.MP3

zSHARE - Bhagvad Gita Chapter 2 Shloka 20-30.MP3

zSHARE - Dr K K Aggaral on Bhagwad Gita Chapter 2_ 20-30 on Consciousness.MP3

Bhagwad Gita Chapter 2 consciousness
zSHARE - Dr K K Aggaral on Bhagwad Gita Chapter 2_ 20-30 on Consciousness.MP3

zSHARE - Dr K K Aggarwal why In Hindu Dharma So Many Gods.MP3

zSHARE - Dr K K Aggarwal why In Hindu Dharma So Many Gods.MP3

zSHARE - DR K K Aggarwal on What is Gift.MP3

zSHARE - DR K K Aggarwal on What is Gift.MP3

Dr KK's Formula of Eighty For Living Upto Eighty


To live above the age of eighty one needs to have ideal health parameters and ideal lifet style and the same can be remembered by the formula of "eighty". One should keep fasting blood sugar (mg%), fasting LDL bad cholesterol (mg/dL), lower blood pressure (mm Hg) and abdominal circumference (cm) all below 80. Most people will cross hundred if they reach eighty without an illness.

Abdominal (Waist) circumference
Increasing central adiposity is associated with an increased risk of morbidity and mortality. Therefore, in addition to measuring body mass index, waist circumference should be measured to assess abdominal obesity. Patients with abdominal obesity (also called central adiposity, visceral, android, or male-type obesity) are at increased risk for heart disease, diabetes, hypertension, and dyslipidemia.
Although computed tomography (CT) and magnetic resonance imaging (MRI) are more accurate than waist circumference for assessing the distribution of body fat, they are too expensive to be performed for this purpose alone. Measurement of the waist-to-hip ratio provides no advantage over waist circumference alone. The waist circumference is measured with a flexible tape placed on a horizontal plane at the level of the iliac crest as seen from the anterior view. In adults with a BMI of above 23 kg/m2, a waist circumference greater than 80 cm is associated with a greater risk of hypertension, type 2 diabetes, and dyslipidemia, and heart disease.

Blood pressure

Lower blood pressure should be kept lower than 800 mm Hg. If the lower blood pressure is between 80-90 mm hg it is called pre hypertension and if above 90 mm Hg is called hypertension. A person with pre-hypertension, is more than three times likely to have a heart attack and 1.7 times more likely to have heart disease than a person whose lower blood pressure is lower than 80 mmHg. Diastolic or lower blood pressure is the pressure when the heart is at rest between the heart beats. If pre-hypertension is aggressively treated 45% of all heart attacks can be prevented.

The 2007 United States Preventive Services Task Force (USPSTF) guidelines recommend screening every two years for persons with lower pressures below 80 mmHg, and yearly for persons with a lower blood pressure of 80 to 89 mmHg. Patients with pre hypertension have a greater prevalence of traditional cardiovascular risk factors than those with normal blood pressures. Presence of at least one adverse risk factor (above-normal cholesterol levels, overweight/obesity, and diabetes mellitus) is significantly more likely among pre hypertensive than normotensive individuals.
There is an association between pre hypertension and microalbuminuria, a risk factor for cardiovascular disease and early cardiovascular mortality.

Blood Sugar

Normal fasting blood sugar is 60-90 mg%. Any fasting sugar of over 126  mg% increases the risk for both macrovascular and microvascular disease and above 90 mg% increases the risk of macrovascular disease (myocardial infarction, stroke, peripheral vascular disease), but not for microvascular disease (retinopathy, neuropathy and nephropathy). For cardiovascular protection the blood sugar should be lower 80 mg% or lower. 

Diabetes risk factors are age ≥45 years, overweight (body mass index ≥23 kg/m2), family history diabetes mellitus in a first-degree relative, habitual physical inactivity, history of delivering a baby weighing >4.1 kg (9 lb) or of gestational diabetes mellitus, hypertension (blood pressure ≥140/90 mmHg), dyslipidemia defined as a serum high-density lipoprotein cholesterol concentration ≤35 mg/dL (0.9 mmol/L) and/or a serum triglyceride concentration ≥250 mg/dL (2.8 mmol/L), previously identified impaired glucose tolerance or impaired fasting glucose, polycystic ovary syndrome and history of vascular disease.

Cholesterol (LDL Bad)
The optimal value for LDL bad cholesterol in both men and women is <100 mg/dL in normal population but lower than 80 mg% in patients with heart disease or at risk of heart disease ( being an Indian is a risk factor). A one standard deviation (38.5 mg/dL) LDL increase is associated with an age adjusted relative risk for heart disease of 1.42 for men and 1.37 for women. Being an India is a risk factor for heart disease.

Heart disease equivalents, that is, risk factors that place the patient at similar risk for heart disease as a history of heart disease itself, are identified as diabetes mellitus, symptomatic carotid artery disease, peripheral arterial disease, abdominal aortic aneurysm, multiple risk factors that confer a 10-year risk of heart disease >20 percent and chronic renal insufficiency (defined by a plasma creatinine concentration that exceeds 1.5 mg/dL or an estimated glomerular filtration rate that is less than 60 mL/min per 1.73 m2).

Patients at very high risk for heart disease might also be expected to benefit from more intensive lipid lowering therapy. Such patients should be treated with the lowest dose of a statin that reduces their LDL-C below 80 mg/dL.


Diet

Eating fewer calories has been shown to reduce chances of heart attack. One gram of food contains 6 calories on an average. One should not eat more than 80 grams of food in any meal.

Exercise

·     Cardiovascular training exercise involves walking 80 steps a minute.
·     Cardiovascular exercise involves attaining 80% of target heart rate (220- age is 100 % target heart rate).
·     Adequate walking cum exercise duration per day is 80 minutes a day.
·     80 km running per week is associated with an elevation in serum HDL-cholesterol levels and significant reductions in adiposity and serum triglycerides [Arch Intern Med 1997; 157:191].
·     The recommended recreational (non sporting) activity duration is 80 minutes thrice a week.
·     The recommended regular walking duration is 80 minutes in 2 days.

Pranayama

One should do 80 alternate nostril pranayama a day.
Or one should do 80 UMMMMM chanting a day.

Alcohol

·     For health reasons, for those who consume social drinks: social drinking when not contraindicated in males is taking 80 grams in one week (10 grams is 30 ml 80 proof whisky). In women it is 80 grams in two weeks.
·      One should not take more than 80 ml of whisky in one day.

About the author: Padmashri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal is a Senior Consultant, Physician, Cardiologist at Delhi based Moolchand Medcity; President Heart Care Foundation of India; Chairman Ethical Committee Delhi Medical Council and has served as the Research and Academic Wing Heads of National Indian Medical Association.  [emedinews@gmail.com, www.heartcarefoundation.org, www.emedinews.in]

Tuesday, June 21, 2011

zSHARE - Dr K K Aggarwal In Rainbow FM 102.6 21st June Live .MP3

zSHARE - Dr K K Aggarwal In Rainbow FM 102.6 21st June Live .MP3

On Heart Care
Radio

zSHARE - Dr K K Aggarwal on Confession.MP3

zSHARE - Dr K K Aggarwal on Confession.MP3

zSHARE - Dr K K Aggarwal on Should we Shave Hairs with Razor Before Surgery Hindi.MP3

zSHARE - Dr K K Aggarwal on Should we Shave Hairs with Razor Before Surgery Hindi.MP3

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zSHARE - Dr K K Aggarwal on Should we Shave Hairs with Razor Before Surgery English.MP3

zSHARE - Dr K K Aggarwal on Can Insurance Companies Refuse Reimbursement English.MP3

zSHARE - Dr K K Aggarwal on Can Insurance Companies Refuse Reimbursement English.MP3

zSHARE - Dr K K Aggarwal on Can Insuranc Companies Refuse Reimbursements Hindi.MP3

zSHARE - Dr K K Aggarwal on Can Insuranc Companies Refuse Reimbursements Hindi.MP3

Don’t discard diabetic drug Pioglitazone even after the FDA’s Safety Announcement

The U.S. Food and Drug Administration has announced that the use of the popular diabetic drug pioglitazone for more than one year may be associated with an increased risk of bladder cancer.
According to the FDA’s Safety Announcement, information about this risk will be added to the Warnings and Precautions section of the label for pioglitazone-containing medicines.
However the Endocrine Society, American Association of Clinical Endocrinologists and American Diabetes Association inspite of the FDA announcement have urged diabetes patients not to panic and stop the drug without their doctor’s advice.  Stopping diabetic drug can result in higher levels of blood glucose that may cause serious short term health problems and could increase the risk of diabetes-related complications in the long term.
As per the advice all diabetics should adhere to the following guidance provided by the FDA:
1.       All diabetics should be told that there may be an increased chance of having bladder cancer when taking pioglitazone
2.        One should not take pioglitazone if receiving treatment for bladder cancer;
3.        One should consult right away if one has any of the symptoms of bladder cancer including blood or red color in urine; urgent need to urinate or pain while urinating; pain in back or lower abdomen;
According to the FDA Safety Announcement, the five-year interim analysis of an ongoing ten-year study showed that although there was no overall increased risk of bladder cancer with pioglitazone use, an increased risk of bladder cancer was noted among patients who had been on pioglitazone the longest and had been on higher doses over time.
Large number of diabetics are on pioglitazone which reduces insulin resistance and is useful in metabolic syndrome. The drug is already in criticism for gaining weight and possible heart failure.
About the author: Padmashri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal is a Senior Consultant, Physician, Cardiologist at Delhi based Moolchand Medcity; President Heart Care Foundation of India; Chairman Ethical Committee Delhi Medical Council and has served as the Research and Academic Wing Heads of National Indian Medical Association.

Monday, June 20, 2011

zSHARE - Dr K K Aggarwal on Yogavashishta vs Gita.MP3

zSHARE - Dr K K Aggarwal on Yogavashishta vs Gita.MP3

zSHARE - Dr K K Aggarwal on Dualism Vs Non Dualism Vs Qualified Non Dualism.MP3

zSHARE - Dr K K Aggarwal on Dualism Vs Non Dualism Vs Qualified Non Dualism.MP3

zSHARE - Dr K K Aggrwal on Which Vedic Text to Read.MP3

zSHARE - Dr K K Aggrwal on Which Vedic Text to Read.MP3

Do not get body parts shaved to get the hairs removed before surgery

Hair removal is commonly performed before any surgery to provide the surgeon with a clean field and to prevent hair from falling into the surgical site. Many reports have however indicated an increased risk for surgical site infections in patients undergoing preoperative hair removal.
Scanning electron micrographs show that razors cause gross skin cuts while clippers cause less injury, and depilatory agents cause no injury to the skin surface. The rates of surgical site infections are higher when shaving is performed (6%) compared with clipping (1.7%) the hair or use of depilatory creams (0.6%).
The lowest rates of surgical site infections are reported when hair is removed just prior to the surgical incision.
Neurosurgeons question the need for hair shaving in brain surgery. Those who do not remove the hair follow the following
1.      Patients have their hair washed with shampoo and 4 %  chlorhexidine within 24 hours of their operation.
2.      In the operating room, the surgical site is scrubbed for 8 to 10 minutes with 4 % chlorhexidine diluted with water, and then cleansed with 10 % povidone-iodine solution.
3.      Prophylactic antibiotics are administered for three days.
The current view is that there is no difference in rate of surgical site infections among patients who have their hair removed prior to surgery and those who have not. If hair needs to be removed, it should be clipped rather than shaved, as patients who are shaved are more likely to develop surgical site infections.

zSHARE - Dr K K Aggarwal on Science Behind Rituals FLO Jaipur Lecture.MP3

zSHARE - Dr K K Aggarwal on Science Behind Rituals FLO Jaipur Lecture.MP3

Sunday, June 19, 2011

One can get allergy by eating, touching, and inhaling food allergens?

  1. One can normally get food allergy only after eating a food.
  2. Touching or inhaling or smelling the food can only lead to localized hives in children but not systemic reactions.
  3.  However, inhaling tiny food particles from steaming, boiling, frying, grating, shedding, or grinding can trigger an allergic reaction in sensitive people. People who are very sensitive should avoid situations in which aerosolized food could be inhaled.
  4.  Peanut protein cannot become airborne from peanut butter but it may from peanut flour or dusty roasted peanuts.
  5.  The smell of peanut butter is from volatile organic compounds that evaporate easily and is not related to particles of peanut butter in the air, so it is not likely to trigger an allergic reaction.
  6.  Touching an allergenic food and then touching the eyes, nose, or mouth can cause an allergic reaction.

Dry powdered inhalers may contain food derivative lactose which can cause food allergy

If one is allergic to food he can still get allergy from certain non food items which may contain food ingredients.  Here is a list


1. Gelatin, egg, and chicken products is used in the production of certain vaccines.

2. Gelatin is included in measles, mumps, rubella (MMR), varicella, diphtheria, tetanus, acellular pertussis (DTaP), and Japanese encephalitis vaccines.

3. Egg protein is present in yellow fever and influenza vaccines.

4. Some people with egg allergies can be given the influenza vaccine safely.

5. Chicken proteins may be present in the yellow fever vaccine.

6. Lactose is a sugar derived from milk. Highly allergic patients should avoid using products that contain lactose (e.g., use metered dose inhalers rather than dry powder inhalers that contain lactose).

7. Soy lecithin is the fatty derivative of soy, and it contains trace amounts of soy proteins.  Certain asthma inhalers contain small amounts of soy lecithin, which could potentially cause an allergic reaction in a person who was highly allergic to soybeans or peanuts. You should discuss the risks and benefits of these inhalers with your healthcare provider.

8. Casein is a cow’s milk protein used as an anti–stick agent on latex gloves.

9. Cosmetics may contain a variety of food–derived ingredients, including milk, nut oils, wheat, and soy.

10. Craft item like modeling dough may contain wheat.

11. Egg white is sometimes used to smooth finger–paints.

Saturday, June 18, 2011

zSHARE - Dr K K Aggarwal and Dr S B Sharma on Home Remedies on Erectile Dysfunction.MP3

zSHARE - Dr K K Aggarwal and Dr S B Sharma on Home Remedies on Erectile Dysfunction.MP3

zSHARE - Dr K K Aggarwal on Ayurvedic Body Typing and type of food.MP3

zSHARE - Dr K K Aggarwal on Ayurvedic Body Typing and type of food.MP3

zSHARE - DR K K Agarwal on charity and Daan .MP3

zSHARE - DR K K Agarwal on charity and Daan .MP3

zSHARE - Dr K K Aggarwal on science behind rituals Gymkhana Club.MP3

zSHARE - Dr K K Aggarwal on science behind rituals Gymkhana Club.MP3

Can a doctor disclose his patient’s information to the relations?

As per Medical Council of India Code of Ethics Section Clause 7.14, "The registered medical practitioner shall not disclose the secrets of a patient that have been learnt in the exercise of his/her profession except – i) in a court of law under orders of the Presiding Judge; ii) in circumstances where there is a serious and identified risk to a specific person and/or community; and iii) notifiable diseases." It is his duty that he should inform public health authorities immediately about any communicable or notifiable disease. However, the MCI Act does not define all secretes of patient."

As per American Medical Association Code of Ethics (Opinion 5.05), the information disclosed to the patient, "The information disclosed to a physician by a patient should be held in confidence. The patient should feel free to make a full disclosure of information to the physician in order that the physician may most effectively provide needed services. The patient should be able to make this disclosure with the knowledge that the physician will respect the confidential nature of the communication. The physician should not reveal confidential information without the express consent of the patient, subject to certain exceptions which are ethically justified because of overriding considerations.

When a patient threatens to inflict serious physical harm to another person or to him or herself and there is a reasonable probability that the patient may carry out the threat, the physician should take reasonable precautions for the protection of the intended victim, which may include notification of law enforcement authorities." When the disclosure of the confidential information is required by the law or the court, it is the duty of the doctor to inform the patient about the same.

When a doctor is summoned by the court, he or she should disclose the minimal information required by the law and not voluntary additional information.

The AMA Code of Ethics Opinion 5.051 also talks about confidentiality of medical information after death. As per their ethics, the law does change about confidential information where the person is alive or death. Even the post mortem report is confidential information and should not be leaked to any unauthorized relation of the patient. It is the duty of the doctor who is treating a patient to ask the patient about possible names to whom he can disclose about his sickness and to what extent. In the Prabha Manchanda case, Supreme Court of India has clearly decided that even a mother has no right to give extended consent for her daughter who happens to be under anesthesia. In America, confidentiality is defined under the HIPAA Privacy Act.

The privacy rules required a doctor to make reasonable efforts to limit the amount of protected health information of the doctor used or disclosed to the minimum amount that is necessary to accomplish purpose of use or disclosure. Under the HIPAA Private Rules, a hospital is not supposed to announce the name of a patient in the OT list containing the name of a person in open or accessible to the public or disclose any information by which a third person may be able to know that a particular person is undergoing surgery or a medical treatment in the hospital. In no way the diagnosis or reasons of the disease should be disclosed to an unauthorized relation or a person. A doctor should not share the patient information with the patient’s family or friends if the patient has asked the doctor not to or if the treating doctor believes, in his or her professional judgment, the disclosure would be inappropriate.

The privacy rules, however, allow the doctor to share patient’s information with the patient’s family members or friends so long the information is limited, the information directly relevant to that person’s involvement in patient’s care. For example, a doctor may tell a person living with the patient that the patient needs plenty of rest and lots of fluids or that the patient need to be checked twice daily. A doctor is not supposed to share more information than the person needs to assist with the patient’s care.

HIPAA also prohibits doctor providing patient’s list to any representative or a device provider as this would automatically leak the patient’s disease condition to an unwanted person.

Friday, June 17, 2011

zSHARE - Dr K K Aggarwal n Ayurvedic Body Typing.MP3

zSHARE - Dr K K Aggarwal n Ayurvedic Body Typing.MP3

Consult if you are above the age of 40 and planning to become a father

19th June is Father’s Day: Medically, both men and women should complete their child bearing commitment before the age of 40 to minimize the effects of age on fertility and pregnancy outcome.
Age of sperm donors as per recommendations should be less than 40 years of age. This age is 45years in UK.
 With advancing age of the father, chances of having a child with schizophrenia are also increased. Chances of mutation occurring in the gene are also higher if the age of the father is more than 40.
 The risk of producing a child with mongolism is also higher if the age of the father is more than 40 and age of the mother is more than 35.
  Some studies have shown that if the age of the father is more than 40, chances of child having autism are also higher.
 Advance parental age is also associated with many autosomal dominant mutations including short stature of child and marfan syndrome.
  A study which included over 55 million births observed that 1.5% of them had a birth defect when the age of the father was more than 40.
 An advance parental age is also associated with more risks of abortions. 
About the author: Padmashri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal is a Senior Consultant, Physician, Cardiologist at Delhi based Moolchand Medcity; President Heart Care Foundation of India; Chairman Ethical Committee Delhi Medical Council and has served as the Research and Academic Wing Heads of National Indian Medical Association.

 

zSHARE - Dr K K Aggarwal on right age to become father English.MP3

zSHARE - Dr K K Aggarwal on right age to become father English.MP3

zSHARE - Dr K K Aggarwal on weather doctors can take gift from patients HINDI.MP3

zSHARE - Dr K K Aggarwal on weather doctors can take gift from patients HINDI.MP3

zSHARE - Dr K K Aggarwal on weather doctors can take gift from patients English.MP3

zSHARE - Dr K K Aggarwal on weather doctors can take gift from patients English.MP3

zSHARE - Dr K K Aggarwal on right age to become father Hindi.MP3

zSHARE - Dr K K Aggarwal on right age to become father Hindi.MP3

zSHARE - Dr K K Aggarwal on right age to become father English.MP3

zSHARE - Dr K K Aggarwal on right age to become father English.MP3

Thursday, June 16, 2011

zSHARE - Dr K K Aggarwal on right age to become father Hindi.MP3

zSHARE - Dr K K Aggarwal on right age to become father Hindi.MP3

zSHARE - Dr K K Aggarwal on insomnia.MP3

zSHARE - Dr K K Aggarwal on insomnia.MP3

zSHARE - Dr K K Aggarwal on Thinking DifferentlyHindi.MP3

zSHARE - Dr K K Aggarwal on Thinking DifferentlyHindi.MP3

Lessons from Vaidya Sushena in Epic Ramayana

Doctors’ Day Special

A medical doctor is accorded a status next to God as he or she has a duty to heal the sick irrespective of their caste, creed, race or financial status. The classical description of the duty of a doctor was depicted in the Hindi film ‘Achanak’ by Gulzar in 1973.

In the movie, Vinod Khanna plays the character of an army man who loves his wife intensely. He returns home after the 1971 war to find his wife, actress Lily Chakravarti, involved with his close friend. In a fit of emotion, he kills his wife and her lover. He is sentenced to death but is wounded in an attempt to escape the police. At the hospital he is looked after by a team of doctors (Om Shivpuri, Asrani) and a nurse (Farida Jalal). They work hard day in and day out to save him from the lethal injury only to hand him over to the police chief (Iftikhar) for the due capital punishment. The story ends with the message that the duty of the doctor is to save the dying man and the duty of the policeman is to award the due deserved capital punishment.

Historically, the first known example of medical ethics comes from the story of Ramayana. During the war between Lord Rama and Ravana, Meghnath shot a Brahmastra shakti baan (arrow) that hit Laxmana and he became unconscious.

Vibhishana informed Sri Rama about a physician, Sushena, who lived in Lanka. Hanumana was asked to bring him. He brought Vaidya Sushena, together with his house. Vaidya Sushena, well aware that he was a physician attached to the kingdom of Ravana, and that treating Lakshmana could end up annoying Ravana, took a conscious ethical decision of treating the wounded Lakshmana. He said that only the ‘Sanjivani Booti’ (an herb found only on Sumeru Hill) could save Laxmana. But that herb grew on Himalayas at a great height and needed to be brought before day break. Then Jambavanta reminded Hanumana that only he could bring back the ‘booti’ before sunrise. He said, “Fly across the ocean to Himalaya Mountains and bring back herbs Mritha Sanjivani, Vishalya karani, Savamakarani and Sandhanakarani.”

Hanuman went to Sumeru Hill, which was far, far away from the battlefield. There he found several herbs that looked similar to the ‘Sanjivani Booti’. Confused, Hanumana immediately lifted Sumeru Hill in his right hand and flew back to the battlefield in Lanka. Thus, Laxmana was saved by Vaidya Sushena who waited by Lakshaman’s side till Hanuman returned with the remedy.

Both the above depictions relate to the true message later described in the classical Hippocratic Oath, traditionally taken by physicians pertaining to the ethical practice of medicine. But today many doctors are ruining the image of the medical profession. They indulge in indiscriminate sex determination, carry out illegal abortions, making people beggars by cutting their hands, making males eunuchs by castrating their private parts, illegal organ trade or getting involved with the criminals and helping them in torturing their captive persons. The classical example is what happened in Iraq.

We should take lessons from the movie ‘Achanak’ and from Vaidya Sushena who stood by his professional duty and acted according to what was right and ethical.

About the author : Padmashri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal is a Senior Consultant, Physician, Cardiologist at Delhi based Moolchand Medcity; President Heart Care Foundation of India; Chairman Ethical Committee Delhi Medical Council and has served as the Research and Academic Wing Heads of National Indian Medical Association.



It’s safe to watch lunar eclipse
It’s safe to watch total lunar eclipse. Unlike solar eclipse watching total lunar eclipse does not damage the eyes. It’s safe for pregnancy as per alllopathy but Ayurveda restricts it to be watched by pregnant ladies.
On lunar eclipse day there is “full moon” present in an atmosphere of “new moon”. The full moon effect on the environment also reflects on the mood and mind of a person. The high tides in the ocean reflect in the mind as mood disturbance.  These mood changes may occur in every full moon and that is the reason why in India mythology it is advised to control the mind by observing fast either on ekadashi ( 3 days before full moon) or on the day of full moon.

The ‘sutak’ (nine hours period before the lunar eclipse starts) is also observed in Indian mythology as a period of physical and mental fast so as to avoid the effect of eclipse on the mind. During this period one is required not to eat cereals, if possible nothing by mouth and do pranayama and meditation.

Ten percent of the society at any given time is affected with anxiety or depression. The full moon as per Ayurveda is said to effect and exacerbate symptoms of anxiety or depression. The fluctuations in the mind can also be associated with fluctuations in upper systolic blood pressure.
In an Institute of Psychiatry & Human Behavior, Goa study a significant trend was observed for greater numbers of patients with non-affective psychoses on full moon days and on days of visible lunar eclipse, but no pattern was observed for mania or depression. [Indian J Psychiatry. 1999 Jan; 41(1):60-5.
If one believes in Indian mythology then one should observe the rituals as the fear of harmful effects of the mind for example in a pregnant lady can harm the fetus based on a common Vedic saying and principle “ you are what you think”