Showing posts with label Dr B C Roy National Awardee. Show all posts
Showing posts with label Dr B C Roy National Awardee. Show all posts

Saturday, July 23, 2011

Emedinews: Inspiration: Dads Blessings

Dads Blessings :  young man was getting ready to graduate from college. For many months he had admired a beautiful sports car in a dealer's showroom, and knowing his father could well afford it, he told him that was all he wanted.

As Graduation Day approached, the young man awaited signs that his father had purchased the car.  Finally, on the morning of his graduation, his father called him into his private study. His father told him how proud he was to have such a fine son, and told him how much he loved him. He handed his son a beautifully wrapped gift box.  Curious, but somewhat disappointed, the young man opened the box and found a lovely, leather-bound Bible, with the young man's name embossed in gold. Angry, he raised his voice to his father and said "With all your money, you give me a Bible?" and stormed out of the house, leaving the Bible.

Many years passed and the young man was very successful in business. He had a beautiful home and wonderful family, but realized his father was very old, and thought perhaps he should go to him.  He had not seen him since that graduation day.  Before he could make arrangements, he received a telegram telling him his father had passed away, and willed all of his possessions to his son. He needed to come home immediately and take care of things.

When he arrived at his father's house, sudden sadness and regret filled his heart.  He began to search through his father's important papers and saw the still new Bible, just as he had left it years ago.  With tears, he opened the Bible and began to turn the pages.  And as he did, a car key dropped from the back of the Bible.  It had a tag with the dealer's name, the same dealer who had the sports car he had desired. On the tag was the date of his graduation, and the words PAID IN FULL.

How many times do we Miss Spirit's blessings and answers to our prayers because they do not arrive exactly as we have expected?
TODAY'S's affirmation:  "Today I look beyond the obvious and allow miracles to be created in my life."

Contributed by Dr G M Singh

Monday, July 18, 2011

Dr KK Answers : For patients with atrial fibrillation which is the drug of choice?

Many patients with atrial fibrillation (irregular heart rhythms of the smaller atrial chamber) who are started on long-term anticoagulation (blood thinners) with warfarin or acitrom are unable to continue due to difficulty with regular monitoring. Dabigatran is an approved alternative anticoagulant for these patients.

[ N Engl J Med 2011; 364:806]

Sunday, July 17, 2011

Dr KK’s formula of 20 for identifying at risk dengue patients


Dengue fever is now prevalent all over the world and has significant but preventable mortality. Knowing simple formulas can reduce the mortality.
The treatment of dengue is, that once the fever is over, give the patient enough fluids that he or she passes urine every 4 hours. Intravascular dehydration is the reason for mortality and not platelet deficiency. Do platelets only for diagnosis and not for follow ups.  Only monitor the pulse pressure and keep it > 20.

There is no need for platelet transfusion unless platelet count is less than 2% of the baseline value
AND there is presence of ACTIVE spontaneous bleeding.
.
 The period of maximum risk for shock is between the third and seventh day of illness. This tends to coincide with resolution of fever. Plasma leakage generally first becomes evident between 24 hours before and 24 hours after fever is over.  Often people insist on a discharge from the hospital when the fever is over or do not want to get admitted once the fever is over.

 Physicians should remember the Dr KK’s formula of 20 for identifying high risk patients.
1.      Rise in pulse by more than 20.
2.      Fall in upper BP by more than 20.
3.      Difference between lower and upper BP of less than 20.
4.      Platelet count less than 20 thousand.
5.      Presence of more than 20 hemorrhagic spots on the arm after tourniquet test.
6.      Rise in hematiocrit by more than 20%.
7.      Treat such patients with 20 ml/kg body weight per hour of fluid replacement till the patient passes urine and the BP is stabilized.

Tuesday, July 12, 2011

Banned drugs still available: whom to blame?

Yesterday I was called by AajTak News to comment on the continuing availability of three banned drugs Gatifloxacin, Tegaserod and Rosiglitazone in the markets in India.

The response of the chemist to this issue was that once a drug has been banned it’s the duty of the pharmaceutical company to immediately recall its stocks. If they do not do so and the doctors keep on prescribing the said drug then how could they not dispense it.

When we talked to many doctors they said they have no means to know when a drug has been banned or a new drug is introduced in the market. The pharma representatives come and inform whenever a new drug
has been introduced but not when a drug is banned.

The banned drug list on the website of DCI has not updated since 2008. New drugs introduced list is updated only twice a year. Banned drugs circulars are only for a brief period. If a drug is banned, it becomes the duty of the DCI to inform all registered doctors within a week. MCI and the State Medical Councils have the list, then what is the difficulty in communication.

Gatifloxacin was banned in March 2011. As per the circular, Gatifloxacin ban was for manufacture, sale and distribution of Gatifloxacin formulation for systemic use in human by any route including oral and injectable.
Its surprising that after Gatifloxacin was banned its ophthalmic formulation was approved. As per the DCI site, on 19.5.11,  Gatifloxacin 0.3% + Loteprednol Etabonate 0.5% + Benzalkonium Chloride 0.01% w/v  Ophthalmic suspension was approved for post operative steroid repulsive inflammatory ocular conditions when ocular bacterial infections or a risk of bacterial infection exists.  Such discrepancy is sufficient to confuse the treating doctors.

Following are the drugs that have been recently banned.

1.        Gatifloxacin, Tegaserod were withdrawn from the market on 16th March 2011.
2.        Rosiglitazone, the diabetic drug was banned on October 7 2010 with immediate effect.
3.        Following drugs were banned on 10th Feb 2011
           a. Nimesulide formulations for human use in children below 12 years of age
           b. Cisapride and its formulations for human use.
           c. Phenylpropanolamine and its formulations for human use.
           d. Human placental extract and its formulations for human use.
           e. Sibutramine and its formulations for human use.
           f. R-Sibutramine and its formulations for human use.

 When ever a drug is banned its the duty of the state drug controller to ensure that the ban is immediately effective and the formulations called from the market on top priority. The chemists and druggists are directed to stop the sale of these drugs and return the unused stocks to the manufacturers.

Issues

1. The DCI site is  http://www.cdsco.nic.in/

2. The section Drugs Banned in India http://cdsco.nic.in/html/Drugsbanned.html mentions since 2003 only about the following drugs

i. Fixed-dose combination of Cyproheptadine with Lysine or Peptone banned on Jan 1, 2003 GSR 170(E) dated dt.12.3.01

ii. Astemizole banned on Apr.1, 2003 vide GSR 191(E) dt.5.3.03

iii. Terfinadine banned on Apr.1, 2003 vide GSR 191(E) dt.5.3.03

iv. Phenformin banned on Oct.1, 2003 vide GSR 780(E) dt.1.10.03

v.  Rofecoxib banned on Dec 13, 2004 vide GSR 810(E) dt. 13.12.04

vi. Valdecoxib and its formulations banned on July 25, 2005 vide GSR 510(E) dt. 25.07.05

vii.Diclofenac and its formulations for animal use banned on  July 4, 2008 vide GSR 499(E) dt.4.07.08

No drug has been added to the list after 2008. The list needs to be updates every week if not every day. If a drug is banned and is still available, the license of the pharma company should be cancelled.

Friday, July 8, 2011

Insight into medicolegal issues - a conference

 A first ever National Conference on “Insight on Medicolegal Issues” will be organized in New Delhi at Chinmaya Mission Auditorium, Lodhi Road on Sunday, 10th July, 2011. Over 300 doctors from across the country will be participating. The faculty will include eminent doctors and advocates. Senior advocates who will be participating in the conference are Mr. Mukul Rohtagi, Mr. Ajay Agrawal, Ms Priya, Ms Meenakshi Lekhi, Mr. M C Gupta, Mr. Sidhartha Luthra and Ms Indu Malhotra. The Medical Faculty will include Dr. Ranjit Roy Chaudhury, Dr. H S Risam, Dr. Naveen Dang, Dr. Neelam Mohan, Dr. N P Singh, Dr. Sanjiv Malik, Dr. Anupam Sibal, Dr. Ajay Gambhir, Dr. Vijay Aggarwal, Dr. Girish Tyagi and Dr. Sudhir Gupta and others. 
 The conference will be inaugurated by Justice A K Sikri, Hon’ble Judge Delhi High Court. Justice Vipin Sanghi, Hon’ble Judge Delhi High Court will be the Guest of Honour. Justice Sikri will also deliver a keynote address on the subject.
 Among the important subjects to be discussed include: Ethical issues concerning clinical trials, ethical issues for organ transplantation, Understanding court procedures, Medical negligence versus medical accidents, Doctor-Pharma relationship, handling medicolegal cases etc.
 Addressing a press conference, Padma Shri & Dr. B.C. Roy National Awardee Dr. KK Aggarwal, President Heart Care Foundation of India, said that to err is human. The Supreme Court of India has also observed that ‘Mere accident is not evidence of negligence’. It has also clarified that difference of opinion or error of judgment cannot be termed negligence and likewise, adverse reactions and medical accidents cannot be put under medical negligence. Negligence cannot be attributed to a doctor as long as he performs his duties with reasonable skill and competence.
 But, there are certain errors which are preventable but still occur. An example is wrong surgical site surgery, a sentinel event, and involves operation of a wrong site, wrong side, wrong patient and wrong surgery. In one of the recent studies of 8 hospitals, 44 such events were reported every week in the US alone. These events come under ‘never events’. The number will be much larger in our country. Never events are medical negligence unless proved otherwise, he further added.
 A doctor must always maintain the highest standards of professional conduct. He should be careful that he does not violate any rule laid down under the Code of Ethics that define uniform standards of practice.  He also has several legal responsibilities and is often required to deal with issues like consent, insanity, consent, fitness to stand trial etc. So, he needs to be aware of the law.
Dr. Girish Tyagi, Registrar Delhi Medical Council said that every effort is being made by Delhi Medical Council to reduce the gap between patients and doctors.
 Dr Vinod Khetarpal, President Delhi Medical Association said that no doctor should practice without an indemnity insurance as any medical error will require a compensation to be paid to the patient.
 The conference proceedings will be converted in the form of white paper and will be sent to Medical Council of India, Delhi Medical Council and the Government for implementation.

Thursday, July 7, 2011

How to Attain Spiritual Health

For spiritual health one needs to follow the basic principles of Vedic texts. The main if the Vedic Expression  described in ‘Satchithananda’ where ‘Sat’ means ‘truth', ‘Chitha’ means ‘conscious based’ and ‘Ananda’ means ‘inner happiness’. People in touch with their soul speak the truth, take consciousness-based decisions and experience inner happiness.

The great sages of India described ‘Satchithananda as the main formula for how to be in touch with one’s soul and get inner happiness. This formula is based on three questions to be asked to oneself before performing any action. If the answer to all three is ‘yes’, go ahead. In other words, if the answer to any of the three is “no”, do not perform that action.

  1. Is it the truth?
  2. Is it consciousness based?
  3. Will it give happiness?

Later on, many texts have modified this formula as per the need of the society.

1. Buddha’s Law of Action summarized these questions as:
a.       Is it the truth?
b.      Is it necessary?
c.       Will it bring happiness to me?
d.      And will it bring happiness to others?
If the answer to any of the questions is, no do not do that action.

2. Buddha’s Law of Speech summarized the questions as:
a.       Is it the truth?
b.      Is it necessary?
c.       And is it kind?
If the answer to any of the question is ‘no’, do not speak.

3.  The Rotary four-way test comprises of:
a.       Is it the truth?
b.      Is it fair to all concerned?
c.       Will it build goodwill and better friendship?
d.      Will it be beneficial to all concerned?
If the answer to any of the answer is ‘no’ do not perform that deed.

4. Formula of three H: Head, Heart and Hand: Before doing any action ask your head for the choices. Then listen to the heart to give you the best consciousness-based advice and finally order the hand to do the action.

5. The formula Satyam Shivam Sundram is based again on three questions:
a.       Is it the truth;
b.      is it God (consciousness based);
c.       And is it going to build my inner beauty (happiness).

6. ‘May I help you?’ is another formula given in Srimad Bhagwad where you offer help in day to day practice and once you agree to help, you end up with all the four requirement of being a satyugi and they are 'Satya' (truthful); 'tapas' (hard work) ; 'pavitrata' (purity of mind) and "daya and daan" (charity and compassion).

7. “I AM” Before doing any action ask yourself who you are (who I am).  Say to yourself I Am the expression of pure love born to help others. And I AM the same soul as in you and everybody.

8. Formula of “I want peace”. Remember these three words and to get peace just remove ‘I’ (ego) and ‘Want’ (desires) and you will get peace.

9. Whenever in trouble recall the Maha Mrityunjaya Mantra which starts with aum tryambaka yajāmahe  (We worship the third eye Shiva). It means to open the third eye or think differently and look for multiple options. When you get multiple options to choose one of them recall Gayatri Mantra which gives us the meassge to have the lord direct the intellect to take the right decision or in other words to take soul or conscious based decisions.

10.  According to Deepak Chopra, to know your soul profile one should ask seven questions to his or her consciousness while sitting in a meditative poise or in state of relaxation and focussing the awareness on the heart. The answer to each question should be either in three words or three phrases.
  1. What is my purpose of life?
  2. What is my contribution going to be for my friends and family?
  3. Three instances in my life when I had my peak experiences.
  4. Names of three people who inspire me the most.
  5. Three qualities which I admire in others the most.
  6. Three of my unique talents.
  7. Three qualities I best express in my relationship.

These twenty one answers will characterize your soul profile or will be your passport for every action you perform in your life. In day-to-day’s life, one should act from the soul profile and not from the ego profile. Soul profile cannot be manipulated while the ego profile can be.

Wednesday, July 6, 2011

Non fulfillment of desires is the main cause of anger

Cynicism is one of the recognized major risk factor for causation of coronary heart disease (blockages in the channels supplying blood to the heart) and anger, jealousy and irritability form the triad responsible for this.

Anger is the enemy of peace, knowledge and devotion. According to Ayurveda, anger is a manifestation of Pitta (metabolism) imbalance and is a pre-disposing risk factor for causation of heart attack, paralysis, gall bladder stone, kidney stone, acidity, ulcer, asthma and cancer.

In Bhagavad Gita, Lord Krishna described the pathway of anger leading to destruction in Chapter 2 Sloka 62-63. According to him when a persons desires are not fulfilled or expectations are not met one becomes angry and under the effect of anger one does all types of sinful activities. During anger one loses the distinction between good and bad, loses one’s memory, the understanding becomes clouded, and the intellect gets perverted. Loss of intellect leads to animal-like behavior, and ultimately to destruction of self.

The repercussions of anger can be injustice, rashness, persecution, jealousy, taking possession of others property, killing, speaking harsh words and cruelty. The degree of anger may vary from irritation, frowning, resentment, indignation, rage, fury and wrath.

Anger is not always bad. It is only when the anger is an outcome of greed or selfish motives, it is bad. Righteous or spiritual anger is a type of anger caused with good intentions. This anger passes off the next moment as a wave subsides in the sea.

The root cause of anger is ignorance, egoism, and passion (strong desires) with passion being the most important. To control anger, therefore, passion should be controlled first. In Vedic language, both anger and passion are Rajo-Vriti disorders and get exaggerated with any Rajas-increasing lifestyle. Living a life with less of Rajas characteristics will reduce the chances of getting into passion and anger.

Rajas-increasing foods are eggs, fish, onion, garlic, fermented foods, etc. Indulging into modern fashion, night clubs, reading novels with stories of violence, living in the company of bad people, indulging in sexual talks, use of tobacco, alcohol and drugs are all Rajas-increasing life styles. A typical Rajasic person is the one indulging in eating, drinking and procreating.

Controlling anger and passion is a procedure involving effort. As a fish swims upstream against the current in a river to breathe, a person has to work against the disturbed thoughts. To balance and stabilize the mind, consuming ‘satvik’ foods like fresh food, vegetables, milk, and barley bread will help. Many exercises can/help also to control anger.

A few suggested ones are observing silence for 20 to 30 minutes in a day, walking regularly, practicing speaking kind words; doing regular meditation, practicing non violent communication daily and learning to think differently.

During an episode of anger one can try left nostril pranayama, a short deep breathing exercise, taking a walk, drinking cold or simple water or chanting 'AUM' or "I AM". With inspiration one chants “I” and with expiration “AM” reminding one who I AM. That I am the expression of pure spirit and my purpose of life is not to become angry. Remember the person who gets angry will have high blood pressure. On whom you are angry may have no change in blood pressure.


One should realise that during anger, one loses the power of discrimination and suffers from intellectual impairment. Therefore, anger has to be controlled much before it becomes full blown. The initial stage of anger is irritability, and therefore, with the onset of irritability, one should try to control it at the earliest.

One should never judge an individual with his own level of perception. One should realise that if a servant starts working with your level of expectations, he or she will not be working with you as a servant.

One should also make sure that one is not hungry at the time of feeling angry or irritable. Regular meals prevent development of anger.

Anger can be expressive or suppressive. Expressive anger presents with aggressive behavior and the outbursts of anger can cause social unhealthiness. It can cause sudden rise in upper blood pressure or cause rupture of a plaque in the artery supplying blood to the heart precipitating a heart attack.

Suppressive anger can lead to acidity, asthma, formation of plaques in the heart arteries etc. In long run suppressed anger if not expressed may end up with depression, despondency, guilt etc.

Therefore anger should neither be passed on to others (expressive) nor taken within (suppressed or repressed). Anger, therefore, should be altered, neutralized, or modified. This can be done by temporarily holding it for some time and than taking timely action. Temporary holding can be achieved by using the above exercises. Remember both passion and anger are energies which should be conserved and not wasted.

The mythological explanation of Shiva the Neelkanth is also the same. One should neither throw the poison (anger), nor drink it but keep it in the throat for some time and take the right action after the anger manifestations are over.

From Vedic text point of view every thought arises from the silent potential web of energized information or consciousness. This thought from the mind is then analysed by the intellect and the modified by the ego. At this stage it leads to an action. An action lead so memory and memory leads to desire for the action again,.

If this desire if fulfilled it leads to action again and then desire again. Repeated fulfillment of desires leads to habits formation, addictions and development of a particular personality. If the desire is not fulfilled it leads to irritability and irritability leads to anger which then can be expressive or suppressive. The answer therefore lies in changing the perception at the level of the thought or controlling the desires and or the expectation.




Tuesday, July 5, 2011

Smokers can also get moksha


Quit Smoking Now if you want Moksha as per Garuda Purana

Smokers end up with untimely premature death is a medical fact. When we read Hindu shastras the description of untimely death comes in Garuda Purana a dialogue between Garuda (the king of birds) and Lord Vishnu. The latter half of this Purana deals with life after death. In Hindus rituals this Pura.... more

http://www.itimes.com/users/iti475269/blogs

Monday, July 4, 2011

Chanakya Neti and non-righteous earning

Eight year cycle of corruption: Chanakya Neti Sastra (Political Ethics ) described that the cycle of corruption and any earning by unfair means cannot last for more than eight years. Chanakya  said that people who acquire money by unrighteous means will have to pay back to the society within next eight years. Right or wrong, whether one believes in Chanakya Neti or not, this rule provides youngsters a message to follow the right path of truthfulness. Eight years mentioned by Chanakya is an arbitrary number and can vary plus-minus a few years.
In Bhagwad Gita also Lord Krishna wrote that everybody has to pay the price of one’s good or bad deeds (Karma) sooner or later. As per Krishna, it is a sum total of bad and good deeds which decides the ultimate fate of a person.
This law is also true for unfair practices. Public cannot be befooled for more than eight years in succession. The classical examples can be seen in different health waves India has seen over the last three decades. In early 80s, Sherry Lewis Weight Management Programme came like a storm, stayed in the market for few years and then vanished altogether. At that time, everyone was crazy for getting their weight management done the Sherry Lewis way. Obesity is a disease and weight management is a medical program and advertising it is not allowed and therefore is an unfair practice.
Then came the era of Personal Point with a chain of weight management centres opened all over the country. This chain also remained in limelight only for a few years. This wave was followed by the chain of Vandana Luthra. She is persisting in the market to some extent as she keeps on diversifying into other fields.
Weight management era was followed by an era of Reiki. During this period, newspapers were full of Reiki advertisements and every second person in the family wanted to become a Reiki master. This era also lasted only for a few years.
In the field of Yoga also, we saw similar waves. In Indira Gandhi’s time, Dhirender Brahmachari created a wave through the media. His wave also lasted only for a few years and now a similar wave seems to have been created by Yoga Teacher Baba Ram Dev. How long will it last only the time will tell but in the current scenario where he could not sustain fasting for more than six days has created doubt amongst the public about his way of teaching yoga. Ram Dev bought commercial time in television, advertised his products, charge fee from each fellow in the camp. These principles of advertisement marketing used by him can only add a few years to his campaign but cannot last longer. His campaign of drinking ghiya juice is already on the decline.
In the field of spirituality, we also saw a wave of transcendental meditation by Maharshi Mahesh Yogi but the movement did not last long. Probably, selling spirituality in India is not easy and the time for the same is still not ripe. But, who knows tomorrow?
In terms of public behavior also, we have seen eras of cycling, exercising, jogging, aerobics, western dancing and now back to walking.

Friday, July 1, 2011

Spiritual Significance of Jagannath Yatra

Why Subhadra is worshipped along with Lord Krishna in Jagannath Yatra
In 2011 Jagannath Rath Yatra starts July 2nd and has a special significance when it comes to the relationship between brother s and sisters.
 The value of relation between brother and sister has been shown in many festivals and rituals in our country.
 Raksha Bandhan and Bhai Dooj are two major festivals devoted to this sacred relationship. In Raksha Bandhan, the brother vows for the safety of his sister and sister prays for the long life of the brother. The Raksha Bandhan rakhi or the red thread ‘moli’ works as a reminder and is removed on the date of Janmashtami falling after Raksha Bandhan. When Bahadur Shah of Gujarat attacked Chittor, Rani Karnavati sent a Rakhi to Emperor Humayun, calling him a brother and requested for his help. Humayun did come to his Rakhi sister's help.
 In the ritual of Bhai Duj, the sister anoints her brother’s forehead with vermilion and performs aarti. This festival is similar to that of Raksha Bandhan. Only the ritual of tying Rakhi has been replaced with tikka (vermilion spot on forehead).
In terms of symbolism, the brother-sister relationship is depicted in Jagannath Mandir in Puri and is one of the temples in the country where Gods and Goddesses are not worshiped in the form of husband and wife.
The other example is Ganesha and Lakshmi worshipped together as brother and sister. Goddess Lakshmi is symbolic of good fortune and wealth and Lord Ganesh is symbolic of the intelligence required to utilize the wealth that we have.
At the Jagannath temple, Subhadra, the sister, is depicted in the center and Krishna and Balram (Lord Balabhadra) are shown on the left and right side of Subhadra. Here, Krishna is worshipped along with his brother and sister. Subhadra was married to Arjuna and a brave boy Abhimanyu was born to them.

A synonym of Purushottam is Jagannath and his abode. Puri is known as Purushottam Kshetra, which is one of the four most sacred places in India for the Hindus. The famous festival related to the Jagannath temple is the Ratha Yatra, or chariot festival, which occurs yearly in June or July. During this festival, the three deities are taken from the temple and placed in large chariots which are then drawn along Grand Road to the Gundecha temple, a few kilometers away. After they have stayed in that temple for seven days, the deities again ride the chariots back to their home temple. Then three idols are made of margosa (neem) wood.
Brother-sister relationship is always a sacred relationship in Indian law. Marriages or illicit relationship between brothers and sisters are prohibited. Consanguineous marriages are also known to end up with diseases. While in some religions, a marriage of the daughter with maternal uncle is allowed, but in no religion, a marriage between a brother and sister is allowed.  
Devaki and Kansa depict the extreme opposite of brother-sister relationship. Kansa was the maternal uncle of Lord Krishna and brother of Devaki. There was a prediction that the eighth child of Devaki would kill him. When Kansa came to know about that prediction he decided to kill all children born to his sister.
 All three festivals Jagannath Yatra, Raksha Bandhan and Bhai Dooj are observed in the last six months of a year in the period of dakshinayana, which is the period with darker or the negative side of the mind. In Chaturmas the mind is more negative, violent, irritable and with more non fulfillment of desires. All festivals which relates to purity of relationship are thus observed in this period.

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

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. 

Wednesday, June 22, 2011

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]