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Category : All ; Cycle : December 2012
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Dec31
HIS DESIRE DR SHRINIWAS KASHALIKAR
Suddenly in the New Year celebrations the noise changed into whispers and loud discussions.
The news had taken everybody by surprise.
Someone had noticed God Himself sitting on a nearby hillock.
All of them agreed that this was a wonderful opportunity and great boon to meet Him personally.
As they were approaching Him; someone said; “We always pray and put forth our demands and desire to God! But won’t it be wiser to ask Him His desire?”
Even though it was unusual; ultimately all agreed on this point.
As they reached God; they prostrated in front of Him and saluted in their different ways!
As God asked them to tell what they wanted; all of them unanimously said; “This time; we have come to fulfill; NOT our desire; but your desire!
God laughed!
He said; “Thinking this way; is a great achievement! You have come closer to me! Actually “my desire” operates through you as “your desire”; even if you are unaware of it!! Your awareness and concern about “my desire” is also my desire! My desire is self sufficient and omnipotent! Instantly it becomes a reality!
In this New Year and the years to come; the practice of remembering me i.e. remembering your true self (called jikra, jaap, jap, sumiran, simaran, NAMASMARAN) would spread in all the continents, nations, provinces, cities, villages, homes, institutions, industries, hospitals, farms and every nook and corner.
Further; this practice would not be aimed at petty gains! It would be selfless and blossom into holistic perspective, policies, plans and programs and their implementation! The spiritualism and materialism, theism and atheism would be culminated in holistic renaissance, superliving or individual and universal blossoming! The profundity and prosperity would go hand in hand!
Individualism and socialism would be culminated in; Self realization and SAMASHTI YOGA; respectively!
The people were thrilled to hear all this!
However; one of them, who was very curious to know; how this could happen; asked; “But how would all this happen?”
God said; “Just as 75 trillion cells unite and live in unity, complementarity and harmony; where; every cell participates in its own well being and also homeostasis i.e. wellbeing of the individual; every individual; from every nook and corner of the world; would participate simultaneously and inseparably; in his own wellbeing as well as that of the universe!


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Dec31
HIS DESIRE: DR SHRINIWAS KASHALIKAR
HIS DESIRE: DR SHRINIWAS KASHALIKAR

Suddenly in the New Year celebrations the noise changed into whispers and loud discussions.
The news had taken everybody by surprise.
Someone had noticed God Himself sitting on a nearby hillock.
All of them agreed that this was a wonderful opportunity and great boon to meet Him personally.
As they were approaching Him; someone said; “We always pray and put forth our demands and desire to God! But won’t it be wiser to ask Him His desire?”
Even though it was unusual; ultimately all agreed on this point.
As they reached God; they prostrated in front of Him and saluted in their different ways!
As God asked them to tell what they wanted; all of them unanimously said; “This time; we have come to fulfill; NOT our desire; but your desire!
God laughed!
He said; “Thinking this way; is a great achievement! You have come closer to me! Actually “my desire” operates through you as “your desire”; even if you are unaware of it!! Your awareness and concern about “my desire” is also my desire! My desire is self sufficient and omnipotent! Instantly it becomes a reality!
In this New Year and the years to come; the practice of remembering me i.e. remembering your true self (called jikra, jaap, jap, sumiran, simaran, NAMASMARAN) would spread in all the continents, nations, provinces, cities, villages, homes, institutions, industries, hospitals, farms and every nook and corner.
Further; this practice would not be aimed at petty gains! It would be selfless and blossom into holistic perspective, policies, plans and programs and their implementation! The spiritualism and materialism, theism and atheism would be culminated in holistic renaissance, superliving or individual and universal blossoming! The profundity and prosperity would go hand in hand!
Individualism and socialism would be culminated in; Self realization and SAMSHTI YOGA; respectively!
The people were thrilled to hear all this!
However; one of them, who was very curious to know; how this could happen; asked; “But how would all this happen?”
God said; “Just as 75 trillion cells unite and live in unity, complementarity and harmony; where; every cell participates in its own well being and also homeostasis i.e. well being of the individual; every individual; from every nook and corner of the world; would participate simultaneously and inseparably; in his own well being as well as that of the universe!


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Dec30
UNITY AND STRESS: DR. SHRINIWAS KASHALIKAR
UNITY AND STRESS: DR. SHRINIWAS KASHALIKAR

Uniting, organizing and working together are natural in young age. In fact; they are important steps in stress management!

Naturally; and usually; we get involved in movements; based on issues; which eventually lead to; building of social and political organizations; such as working class unions and political parties, which could then serve as instruments; to bring about socioeconomic and political revolution.

However; gradually it becomes clear that “the issues” are not “simple”! Sometimes they are of immediate pertinence, such as accidents, disasters, crimes and coercive land acquisition or rehabilitation. But in other instances; they are long standing, wide spread and deep rooted; such as caste system, coercive traditions, and unjust laws.

We then realize that the solutions provided in these movements and organizations; even though honest; are ad hoc, palliative and sometimes even sectarian; and not radical, holistic and hence satisfactory. For example; we do not feel like opposing it or supporting reservation policy; as we feel that the very need of reservations should be abolished!

There have been several movements and organizations; for the welfare of a school, village, region, language, caste, religion; or other issues such as memorials, statues and philanthropic or charity activities. They have been serving a great role. But as we grow; we feel that these ideas and activities need to be buttressed with a holistic and radical solution.

This realization; brings a new and fresh rejuvenation in our life! We realize that our SWADHARMA; is to explore and realize (manifest) the already existing but concealed unity of universe; and complementarity in already existing and excellently functioning organizations and institutions; through the study, practice and propagation of Total Stress Management i.e. superliving i.e. holistic renaissance (the core of which is NAMASMARAN).


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Dec26
Sleep Disorder
SLEEP DISORDERED BREATHING(SDB)


Introduction:

The detrimental effects of sleep disturbance produced by abnormal breathing patterns have been extensively studies in recent times and are called as Sleep disordered breathing(SDB)
SDB constitutes a number of the major part of sleep disorders seen by sleep physicians’ world over.
With growth of Obesity, Hypertension, Diabetes,& use of Medicines, Otolaryngologists & Sleep clinicians are witnessing a large increase in such patients.

IMPACT

SDB and along with its effects is a very significant problem in the society as it can lead to
• Road traffic accidents
• Lower productivity at school and work
• Morbidity-Impaired immune function, HTN, insulin resistance, stroke, pulm HTN, poor asthma control, ventricular arrhythmias and sudden death
• Neuro-cognitive and mood dysfunction
• Impaired quality of life
• Impaired performance in surgical skills, anesthesia administration, intubations and ECG interpretation


EPIDEMIOLOGY
Recent data suggests approximately 5% of population suffer from SDB
12-15 million adult American have SDB. In Indian scenario polyssomnography proven cases of SDB is around 3.57% (Sharma et al)

SEX:
Males> Females
• Severe OSA male to female is 8:1, moderate OSA 3:1
• Sex difference reduces after menopause
The reasons for sex predilection are not clear, possibly due to
• Body fat distribution
• Craniofacial differences
• Female hormone
RISKFACTORS & ASSOCIATED MEDICAL CONDITIONS

• Obesity:

Cardiovascular disease
Increased risk of HTN

Cerebrovascular disease : This has an unclear but growing evidence
Studies reveal that the odds ratio of having a CV stroke are high but this was not significant not after adjusting for age and BMI


Metabolic syndrome :This is a term used for features related to
• Waist circumference
• Triglycerides
• Glucose level
• BP
• Insulin resistance



DEFINATIONS

Snoring: Loud upper airway breathing sounds in sleep without episodes of apnea or hypoventilation
Apnoea :Cessation of airflow at nostrils and mouth for at least 10 seconds regardless of oxygen saturation
Sleep Apnea syndrome
30 or more apnoeic episodes during 7 hrs sleep
Apnea index =/>5
Obstructive sleep apnea
Cessation of airflow in presence of continued respiratory effort
Breath holding spells
Central sleep apnea: Cessation of airflow with cessation of all respiratory effort
Mixed Apnea : Begins as a central type of apnea followed by increasingly forceful respiratory efforts till airflow clears
UARS : Increased inspiratory effort with frequent arousals but no apnea or hypopnea



PATHOPHYSIOLOGY OF SLEEP DISORDERED BREATHING :
The primary cause of SDB is collapse of the upper airway during sleep. The mechanism for this is multi-factorial, which is mainly due to interdependence of anatomical vulnerability with physiologic mechanism of ventilation.


Local Factors:
The size of lumen depends on the dilating and collapsing forces
The dilating forces include
• Dilating muscle activity
• Mechanical force on airway wall
• Intraluminal airway pressure
• Large upper airway

The collapsing forces include
• Mass lesion in nasopharynx
• Negative intraluminal pressure
• Tissue mass
• Surface adhesive forces
• Increased extra luminal pressure

Craniofacial characteristics

Increased distance of hyoid from mandibular plane
Retrognathia
Increased cervical angulations

Neck and jaw posture

Neck flexion close airway, extension opens it
Opening Jaw slightly increase size of airway
Progressive opening-- pharyngeal narrowing
Large tongue
Myxedema
Acromegaly

Oropharynx:
Tonsillar enlargement
Macroglossia
Retrognathia
Hunters/Hurlers
High arched palate
Nasopharynx
Adenoid hypertrophy

Hypopharynx
Mass/growth


Nose:

Nasal obstruction also has a role in causing severity of OSA by :
• Reduced nasal airflow affect muscle tone of upper airway
• Increase mouth opening
o Destabilize pharyngeal airway
 Reduced humidification
Causes:

Nasal polyps
DNS
Rhinitis
Choanal atresia



CLINICAL FEATURES

The patients of OSA has certain characteristic night and day time complaints
Night Time:
• Snoring
• Witnessed breath holds,Choking
• Fragmented sleep
• Restlessness
• Dry mouth mainly due to mouth breathing
• Nocturia due to Increased abd pressure, Atrial natriuretic peptide
• Esophageal reflux due to heartburn
Day time symptoms constitutes of
o Sleepiness
 Afternoon
 Meeting
 Driving
o Headache
o Fatigue, reduced alertness
o Personality changes
 Irritability
 Anxiety
 Depression








APPROACH TO PATIENT WITH SLEEP DISORDERED BREATHIN

History

Detailed history
Underestimate symptoms…leading questions help
RTA/Drifting across lanes/honked by drivers
Assocoated HTN/ DM asked and looked for.

Physical Findings

o Obesity and
 BMI calculation
• >28 kg/sq mt
o Neck circumference
 Superior border of cricothyroid membrane, upright position
Cut off level of 40-43 cms highly specific in OSA




Detailed nasal/ oropharyngeal assessment

o Macroglossia
o Uvula, soft palate – low lying/size/edema/erythema
o Retrognathia
o Tonsillar hypertrophy
o Nose –Contributory factor



INVESTIGATION


o Establish diagnosis…
o PSG, oximetry, multichannel home testing
o Estimate level of obstruction:..
o Pharyngoscopy, Radiology, manometry
o Investigate for Causes / Predisposing factors/Sequelae….
o Hematological Ix for Hypothyroidism, HTN, Diabetes mellitus


To establish Diagnosis

Overnight Polysomnography(PSG)…Gold Standard
Overnight Oximetry
Home multi channel testing

PSG(POLYSOMNOGRAPHY)

Considered gold standard in diagnosis of OSA
Can differentiate central from peripheral apnea
Not ideal but best available
– Breathing disturbance may vary from night to night
– Does not suggest the site of obstruction

o Simultaneous Recording of multiple sleep related events
o Neurophysiolgical
o Cardiopulmonary
o Other physiological parameter over course of several hours

o Parameters specified by AASM
o EEG( frontal, central, occiptal)
o B/L EOG,
o Chin EMG,Leg EMG
o Airflow,Respiratory effort( chest and abdominal)
o SpO2, ECG
o Body position, & Video monitoring
OVERNIGHT OXYMETRY
o It is a gadget sited at the end of digit with a wrist watch like device which measures oxygen saturation and pulse rates

o Standard practice:
o 4% drop in O2 saturation( resting >90%)
o ODI: Oxygen desaturation index
 Number of times O2 saturation falls >4% per hr
 >15 suggests OSA
o Advantage:
o Easily available and cost effecient
o Good specifcity
o Good +Predeictve value
o Very useful if positive

o Disadvantage
o Poor sensitivity
o Poor – pred.value
o Miss subjects OSA who don’t de-saturate

o NOTE:
o If OD!<15, but other cofactors present refer for multi-channel assessment


HOME MULTI-CHANNEL TESTING: (Multi channel: nasal/oral airflow, chest & abdominal movements, Pulse oximeter)


o Disadvantages
– Sensor failure
– Fewer channels
– Underestimate severity as EEG not available

o Advantages
– Better patient comfort
– Cost savings
– No hospital admission
– Speed of analysis


INVESTIGTION TO DETERMINE SITE OF OBSTRUCTION

MULLERS MANUVEUR
Patient performs reverse valsalva
– effort generates negative pressure in upper airway
– Nasopharyngeal sphincter is visualized with endoscope
– Compliant tissue will collapse
– Degree of collapse scored
– Used as criteria for patient selection for Surgery
Not a reliable test as
– Done in awake patient
– And surgery based on this test is unsuccessful

Soft palate Lower pharynx
3 or 4 No ideal
3 or 4 1 or 2 Sub optimal
<3 >2 Not suitable

1=minimal collapse
2=reduced area by 50%
3=reduced area by 75%
4=complete obliteration






Radiological Investigations

Lateral cephalometry
– Very accurately taken lateral head and neck Xray
– Relationship between various soft tissue and bony points measured

No study has shown significant change in normal and OSA
Not sole diagnostic procedure


CT SCAN

– Greater anatomic details
– Awake state so low predictive value for diagnosis of OSA
– 3-D scans
 Easier way to assess the caliber of upper airway
 Statistical correlation with severity of OSA lacking


MRI

– Good anatomic definition of soft tissue
– Multiplanar images
– No radiation exposure
– Dynamic images can also be obtained
– Disadvantage
 Awake patient
 Scanner noise
 Limited studies available


Manometry

Use of catheters in upper airway to measure pressure at various sites
Important for patients suspected of UARS
– No frank apnea, but snoring and arousals in sleep
Advantage:
– Sleep manometry documents obstruction site
Disadvantage
– Precise placement o probe
– Poorly tolerated


DIAGNOSTIC CRITERIA

AHI: Number of apnea and hypopnoea averaged per hour of sleep
RDI: (respiratory disturbance index)
Number of apnea hypopnea and respiratory effort related arousal, diagnosed by EEG

AHI<5: no evidence of OSA
AHI:5-15: mild OSA
AHI:15-30: moderate OSA
AHI:>30: severe OSA
No account of desaturation index nor the length of apnea and hypopnea


TREATMENT

Depends on number of factors
– Severity of disorder
– What does patient want
– Presence of any complication
– Level of obstruction
Treatment options
– Non surgical
– Surgical


NON-SURGICAL


Address co-existent, predisposing conditions
– Obesity
– Tobacco
– Sleep deprivation
– Avoiding agents affecting sleep
– Treat hypothyroidism
– Modification of body position during sleep

Mechanical devices( positive airway pressure)

Pharmacological therapy


MANAGE OBESITY

– Documented reduction in symptom after weight reduction
– Degree of improvement no linear corelation with weight
– Few may not benefit if co-existent craniofacial abnormalities

Life style modification
Dietary modification
Pharmacological
Surgical options

BODY-POSTURE MODIFICATION

– Sleeping with head and trunk elevated to 30-60 degree angle to horizontal reduces OSA
– Lateral decubitus is also effective in reducing episodes (sleep ball)

Pharmacological Therapy

Protriptyline
– Effects not proven


Agents with uncertain limited role
– Serotonin agonists
• Affects the pharyngeal dilators

Busiprone used
Data insufficient
Stimulants
Amphetamines are also used but known to have CVS complication. Insufficient data



CPAP(continous positive airway pressure)

When to use?
– mild OSA with EDS/ Co-morbidities, moderate to severe OSA
Many consider it to be mainstay of OSA treatment

Mechanism:
– Acts as pneumatic splint

Equipment:
– machine provides fixed pressure or vary pressure depending on the presence of apnoeas (Auto CPAP)
– mask is nasal or full face, kept in place by Velcro straps
– port of exhalation
– newer machine small and light so portable
– humidifier also available as an optional mode

SIDE EFFECTS

 Claustrophobia
 Nasal stuffiness
 Skin abrasions, nasal bridge abrasions
 Leaks are uncomfortable or eyes
 Air swallowing if pressure more than esophageal sphincter pressure
 Pulmonary baro trauma ( very rare)
 Treatment Failure


COMPLIANCE WITH CPAP

By 3 years 25-40% stop using CPAP mainly due to one of possible reasons:
Treatment failure
Cost factor
– Regular service and maintenance
– Change of mask
Side effects




SURGICAL TREATMENT


 Uuvuloplatopharyngoplasty(UPPP)
 Laser assisted UP(LAUP)
 Radiofrequency tissue volume reduction(RFTVR)
 Genioglossus advancement
 Other surgeries


UVULOPALATOPLASTY

First described by Ikematsu(1950), Fugita popularized in 1985
The Surgical principle:
– Stiffen the soft palate by scarring
– Increase space behind soft palate
Complications:
– Severe post op pain
– Hemorrhage
– Laryngospasm
– Polmonary edema, hypoxia
– Nasal regurgitation
– Swallowing & voice problems
– Not satisfied post surgery

 FACTS:
– 75-95% short term success
– Long term –45%
– Modification: Preserve uvula


LAUP(LASER ASSISTED UVULOPLASTY)

Described by Kamami in France in 1993
Principle
– Stiffen the soft palate
– Prevent palatal flutter
Surgery
– Local anesthesia on soft palate
– B/L vertical incision in soft palate followed by partial vaporization of uvula with CO2 Laser
– Various modification done
Complications
– Low
– Globus like symptom common
– Post operative pain
RFTVR(RADIO-FREQUENCY TISSUE VOLUME REDUCTION THERAPY


Principle
– Similar to diathermy
– Lower temperature, lower current and voltage
– Thermal injury to specific submucosal sites in soft palate causing fibrosis and contraction

Advantage
– Day care, LA
– Less post operative pain
– Significant improvement reported
– Good for multi level obstruction
– Low relapse rate

OTHER OCCASIONAL SURGICAL PROCEDURE

Palatal: Z-pharyngoplasty, palatal implants
Tongue base
– RFTVR
– Laser midline glossectomy
– Tongue suspension suture
– Hypoglossal nerve stimulation
Epiglottis
– epiglottectomy
Temporary tracheostomy
Hyoid myotomy and suspension
Maxillomandibular osteotomy and advancement


ORAL APPLIANCES
Two basic types of appliances used

Mandibular advancement devices– popular
– Positioning the lower jaw and tongue downward and forward.
– The airway passage is increased
• Comfortable
• More effective,
Tongue repositioners.
– pulling only the tongue forward and not the entire lower jaw.
– teeth, jaw muscles and joints are less affected.
• Less studied
A period of consistent nightly wear is required
Patient motivation and cooperation essential


For treatment and guidance
Dr (major) Prasun Mishra
Pune
09881676449


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Dec25
CRIMES DR SHRINIWAS KASHALIKAR
Crime is a sign of; lack of or loss of control on our passions; of the holistic enlightenment; in our education, art, culture, literature, conventions, traditions, rules, laws, programs, plans, policies and perspective.

The canvas of the problem is global and its root cause is negligence of the way to the source of holistic enlightenment inside us; viz. NAMASMARAN, JAP, JAAP, JIKRA, SIMARAN, SUMIRAN i.e. remembering true self.

We are brilliant but sectarian; hence we cannot "see" anything holistic!

We are sharp but callous; hence we cannot understand even simple poetry!

We are smart but impotent and hence lack the initiative of practicing anything selflessly!

Hence we are still reluctant, inhibited, apprehensive and often staunchly against introducing the practice of NAMASMARAN, JAP, JAAP, JIKRA, SIMARAN, SUMIRAN i.e. remembering true self; in nurseries, schools, colleges, universities, industries, government departments, trade centers and other places.

Instead; we are marketing superstitions and ideological and/or religious phobia, paranoia or mania; in the centers of religious, technological, economic, political and military power!


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Dec25
THE PURSUIT DR SHRINIWAS KASHALIKAR
The pursuit of universalization of NAMASMARAN is actually aiming at realization or manifestation of already existing but unperceived unity and harmony in the world. It is a pursuit towards inviting and including; everybody; in the joyous and melodious universal orchestra of individual and universal blossoming. It is a pursuit of manifesting; the mammoth potential of superliving (holistic renaissance i.e. holistic perspective, holistic policy making, holistic planning, holistic programs and their universal implementation) embodied in NAMASMARAN!
This target may appear to some; as utopian; as it may or may not ensure immediate results; in terms of; all the seven thousand millions of human beings in the world understanding, accepting, internalizing this potential of NAMASMARAN; and practicing it!
But this pursuit even if unfulfilled; in itself; is rejuvenating and empowering. It unites us with the life in the universe! It connects us with the process of universal blossoming. We are no more isolated fragile individuals.
It reinforces and consolidates our own conviction (and in the course of time our own experience); in the practice of NAMASMARAN (jikra, jap, jaap, sumiran, simaran; i.e. remembering true self).
Thus; both; this pursuit (whether accomplished or not); and the practice of NAMASMARAN, are empowering and rejuvenating even in personal life! They ensure; the moment to moment; victorious Total Stress Management! This is a way; as well as the destination; open to all; irrespective of their race, religion, region and theist or atheist ideologies.


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Dec25
SUCCESS FAILURE AND GLORY DR SHRINIWAS KASHALIKAR
The examples of “success”, “failure” and “glory of failure” in Total Stress Management can be described as follows.
The first step of success is; recognizing the stress of mortal life. This very recognition is simultaneously; painful, igniting and motivating. It triggers the expedition of stress management.
This is associated with greater stress or challenge to manage the stress which is universal! The ignorant ones or the callous ones may not suffer from this! Thus we fail to be selfish and careerist. We fail to be rich; if assessed with materialistic yardsticks! Even our simple requirements may not be fulfilled. Moreover; as we are preoccupied in the expedition of understanding the challenge of stress i.e. injustice, sorrow and maladies of life; we fail to be indifferent; and enjoy the celebrations and festivities. This isolates us from family, friends and society also; to a great extent.
But in this failure lies the glory of being more keenly engaged in solving the problem viz. stress; that plagues one and all.
The second step to success is; getting the holistic solutions.
But this is not at all easy. It is inevitably associated with internal devastating turmoil and hence failure to be involved in piecemeal solutions and sectarian curriculums and day to day work; to one’s own satisfaction! But as a result of this failure; we can make glorious contributions in evolving holistic perspective, policies, plans and programs and their implementation.
The third step to success is; crystallizing and applying i.e. treading the path of Total Stress Management and articulating and sharing the details of the sojourn; with others.
This is often associated with failure to match the popular demands of entertainment and failure in commercial and financial gains.
But the glory of this failure is in terms of going successfully through the ordeal of being true to our core.
The glory is that this honesty sharpens our perceptions and keeps us free from commercial considerations and entanglement; and multiplies the accuracy, potentials and scope of our solutions.
The glory is that this accuracy results from commercial failure; which averts; “being bloated with pride”!
The glory is that this commercial failure precludes “being trapped in” deceptive, hollow and vain glamour, glitter and temptations!
The glory is that freedom from the shackles of glamour, glitter and temptations; free us from prejudice in our perspective, thoughts, feelings and actions.
The fourth step to success is in happily accepting the result; as the solutions have their own scope and limitations; even though accepting “not so glamorous result” is difficult.
But even if we succeed in this; it is usually associated with the failure to be overconfident and aggressive on the background of aggressive and imposing behavior of sectarian forces. This leaves us with guilt of being passive and defeatist and ineffective!
But the glory of this failure is that we are out of the rat race and thus; the subjective, inaccurate and dictatorial elements; within us; begin to decline.
We begin to appreciate that increasingly greater accuracy and objectivity is needed! We begin to understand that even the attachment and commitment to “our” ideological perceptions and convictions can throttle our freedom. We begin to appreciate the paramount role of NAMASMARAN in further overcoming the subjectivity/ego.
The fifth step of success is; surrendering the endeavors, which we thought as “ours” to the “source” from where they spring.
This kind of surrender is really painful; like death. But even if we succeed in this; we usually fail to project ourselves with so called style and flamboyance. We fail to carry the facades of greatness. We fail to impose our leadership through self aggrandizement. This is as painful as publicly stripping ourselves! The stripping of ego; makes us feel empty and low.
But this failure has the glory of being free from every burden and bondage! Being free of ego; is a unique experience of being naturally connected with others by a sublime bond of love.
The sixth step to the success; is to return to immortal source of the solutions and be immortal!!!
This is obviously not easy. But as we begin to succeed in this; we begin to get glimpses of immortality and feel like being in holistic convalescence!
This leads to failure in being proficient or brilliant in the activities of “social, political, economic and other materialistic security and growth”!
The glory of this failure however; is “the steady but definite progress in self realization or a globally benevolent state of reunion with NAMA, BRAHMA or SACCHIDANANDA i.e. GURU; through NAMASMARAN (jap, jaap, jikra, sumiran, simaran or remembering one’s true self); at the cost of otherwise worthless mortal life.


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Dec25
HOLISTIC RENAISSANCE DR. SHRINIWAS KASHALIKAR
Holistic renaissance is the development of perspective, policies, plans, programs and implementation; of these for individual and global blossoming.

The body systems, machines, industries, institutions, organizations, state machineries, nations, and universe; would be empowered and channeled in the realization of absolute consciousness i.e. individual and universal blossoming.

The instincts such as physical activity, locomotion, urination, defecation, cleanliness, hunger, thirst, safety, sexual desire, parental care; and emotional needs such as friendship, dialogue, expression of conscience; would be appropriately fulfilled so as to culminate in individual and global blossoming.

Geeta seems to imply emergence of all this (without describing any explicit details); in reiterating the victory of divinity in DHARMYA YUDDHA (life struggle).

God (the true self) enables us to connect with Him through NAMASMARAN (jap, jaap, jikra, sumiran, simaran, remembering true self) and evolve and express the concept of holistic renaissance and/or contribute to it; in myriads of ways in different fields. Our ultimate and singular goal/prayer; therefore; is be to remain continuously and thankfully; in NAMASMARAN.


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Dec25
CELL MANAGEMENT DR SHRINIWAS KASHALIKAR
Insecurity, pain, betrayal, fear, hunger, thirst, sexual desire, anger, lowliness, loneliness, hatred, jealousy, contempt, revengefulness, wants, lassitude, restlessness, cynicism, grief; and such many phenomena; constitute our existence.
They variously cause sadness or happiness; but always a sense of helplessness and incompleteness.
The characteristic of these phenomena is that they are infectious! We knowingly or unknowingly and willingly or unwillingly cast their influence on the others and multiply the sense of helplessness and incompleteness.
How to be free from all these?
We hear life management, self management, mind management, stress management, anger management and so on; besides the perennial preaching of conquering the SHADRIPUS viz. kama (uncontrolled desires or urges), krodha (anger, anguish, rage), lobha (petty often insatiable selfish wants), mada (arrogance, pried or deliriousness), moha (being mesmerized or blind in attachment), matsara(being mad; in intractable jealousy); and living a detached life.
But in general; with very few exceptions (like Shri Gondavlekar Maharaj, Gajanan Maharaj, Swami Samarth); for majority of us; all these phenomena; resulting from the metabolic, paracrine, autocrine, endocrine, neurocrine activities in the CELLS; are unavoidable, inseparable and invincible!
The objective omniscient, omnipresent and omnipotent reality (“God” of the theists and “nature” of the atheists) has provided us with; the holistic perspective, policy making, planning and implementation in fields such health, education etc. to universalize and enhance NAMASMARAN (jap, jaap, jikra, sumiran, simaran i.e. remembering our true self); which acts as a route as well as a vehicle to reach it!
While creating a global ambience conducive to the practice of NAMASMARAN; we automatically begin to experience; the transformation in the metabolic, paracrine, autocrine, endocrine and neurocrine activities in our cells; in terms of freedom from the grip of all the phenomena mentioned above; and experience the glimpses of true self i.e. the immortal objective reality.
We may call this a successful CELL MANAGEMENT!


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Dec25
HOLISTIC RENAISSANCE: DR. SHRINIWAS KASHALIKAR
HOLISTIC RENAISSANCE: DR. SHRINIWAS KASHALIKAR

Holistic renaissance is the development of perspective, policies, plans, programs and implementation; of these for individual and global blossoming.

The body systems, machines, industries, institutions, organizations, state machineries, nations, and universe; would be empowered and channeled in the realization of absolute consciousness i.e. individual and universal blossoming.

The instincts such as physical activity, locomotion, urination, defecation, cleanliness, hunger, thirst, safety, sexual desire, parental care; and emotional needs such as friendship, dialogue, expression of conscience; would be appropriately fulfilled so as to culminate in individual and global blossoming.

Geeta seems to imply emergence of all this (without describing any explicit details); in reiterating the victory of divinity in DHARMYA YUDDHA (life struggle).

God (the true self) enables us to connect with Him through NAMASMARAN (jap, jaap, jikra, sumiran, simaran, remembering true self) and evolve and express the concept of holistic renaissance and/or contribute to it; in myriads of ways in different fields. Our ultimate and singular goal/prayer; therefore; is be to remain continuously and thankfully; in NAMASMARAN.


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