अनित्यानि शरीराणी विभवो नैव शाश्वताः
नित्यम सन्निहितो मृत्यू कर्तव्यो धर्म संग्रह:

The physical body and the material possessions are inconstant,impermanent and ephemeral; while the death is a constant and close companion; so (let us) practice DHARMA (i.e. practice the innate conscience; with topmost priority).

न तु अहं कामयेत राज्याम् न स्वर्गम न पुनर्भवम
कामयेत दुक्खतप्तानाम प्राणीनां आर्तिनाशनम

I don't desire heaven, kingdom or liberation. I want to eradicate the pain of suffering living beings.
A Treating Healer......OR.....A Teaching Healer......!!!

योगेन चित्तस्य पदेन वाचा
मलम शरीरस्य च औषधेना
योपाकारोती प्रवरम मुनिनाम
पतंजलीम्प्राजलीरानतोस्मी

I prostrate in front of the great Patanjali at whose behest YOGA purifies our subconscious and unconscious, grammar purifies our speech (our interactions) and Ayurveda purifies physical being.

The human brain is a biological pattern making machine. At birth, a baby�s brain contains 100 billion neurons, roughly as many nerve cells as there are stars in the Milky Way. These billions of neurons in human brain have extraordinary capacity to construct and weave strings of useful information patterns which gets ever more complex as cognitive thought process increases. These neural patterns help the brain to recognize, organize, store and retrieve information patterns when needed. It has been noticed that leaders engage in activities which provide the time, space and structure to facilitate the construction of such neural patterns. People who are open minded to experience new concepts or procedures and who are exposed to more rich information sources such as print, television, news media, internet, seminars and interactive conferences � are able to build more rich and dense neural networks and hence reveal themselves as natural leaders. On the other hand, people who are averse to new models, metaphors, information, concepts or interactive discussions, remain as followers.

Human intelligence is reflective in nature. Reflection is the ability of the brain to consciously manipulate the given information and rehearse options prior to action. When guessing well is the game and pressure is on the brain, people who display reflective intelligence and foresight in thought and action, have distinct advantage as leaders. Such people have higher survival instinct and more mindful disposition. The brain of such people spontaneously responds to problems and obstacles by retrieving and contemplating information which is relevant to action options. Journal writing, meditation, case study analysis and investigative learning enhance reflective intelligence by many folds. People with leadership qualities have been found to be doing these activities more often than others who remain followers.

Reflective intelligence of human brain has also been found to increase by provoking deliberate critical and creative thinking. Provoking critical analysis and creative thinking engages natural ability of the human brain to detect relationships between seemingly unrelated objects, link seemingly unrelated information into useful revelation, and create innovative products with new information. While people with leadership tendencies have been extensively found to be in indulging in lateral & critical thinking, innovative inventions, and analyzing errors in positions by interactive discussions, followers have often been found to tread the beaten path and avoiding social interacting on controversial positions.

A capacity for reflective intelligence does not translate into intelligent behavior and thought automatically. The constructive and reflective dimensions of human intelligence need to be consciously cultivated and continuously exercised if its true potential is to be realized. The constructive and reflective intelligence have to developed and refined to a degree where the person is naturally inclined to use it every time, in his every action and thought. Leaders have a natural disposition to cultivate and maximize such constructive and reflective intelligence by indulging in meta-cognition, reflection on specific thinking strategies, seeking social opportunities for sharing of challenging ideas and optimizing physiological intelligence by choosing to exercise, eat only healthy food, and live in conducive environment which allows adequate light, fresh air and no distractions.

Followers don�t care what their thinking strategies or general disposition is. They do not feel the need to acquire the knowledge about nurturing intelligence. They react to situations in their environment by spontaneous reaction, without applying critical thinking and without analyzing their position. They would more often indulge in gossip, rather than meaningful exchange of ideas on challenging topics. They have less tolerance for views of others which are divergent from their own. They give a damn to what they eat or space where they live, they live only for sensory pleasures which provide immediate gratification.

Emotion involves the processing of sensory information through neural and glandular systems that alter mind and body states while arousing the prefrontal cortex to what is worth thinking about. Emotion is closely connected to arousal and operation of physiological, social and reflective capacity of the human brain. The brain of humans with leadership qualities are conscious of their emotions and are able to control and mediate their responses to their own emotions. This is an essential quality which differentiates leaders from followers. This is also called Emotional Intelligence.

The brain of leaders is able to harness the power of emotion which helps the leaders to make judgments after receiving stimuli from environment and get motivated by challenges. The leader�s brain is continuously screening sensory information, guided by emotions, to understand which task is worthy of attention and commitment of its infinite resources. In other words, when the human brain of people with leadership qualities gets emotionally excited about some task, it helps the leader to efficiently engage in accumulation of knowledge about that task, to engage in meaningful social interaction to find other human brains with common goals, and to engage in reflective reasoning to solve problems encountered in accomplishing that task � all this leads to enhanced physiological growth and refinement of neural networks in human brain. Thus, it can be inferred that brain of humans with leadership traits have more refined neural networks.

Morbid Obesity�A killer disease

Obesity today is recognized as a health problem of epidemic proportions. Overweight is detrimental for a person's, physical, social, psychological and emotional health. Obesity is responsible for Diabetes, Hypertension, Pulmonary problems, Obstructive sleep apnea, knee pains, Cancer of ovary, breast, uterus, prostate and many more problems. Obese people suffer from depression, lack of confidence, marital problems which are more agonizing but less visible.

An Obese Person Is.........

6 times more likely to develop gallbladder disease
5.6 times more likely to develop high blood pressure
3.8 times more likely to develop diabetes
2 times more likely to develop osteoarthritis
Higher rates of cancer have also been linked to obesity including prostate, breast, cervix, and ovarian cancers.

Losing weight will significantly reduce the many health risks that accompany obesity;

Now even growing children are getting obesity disorder due to excess indulgence of indoor games and watching T.V plus avoidance of outdoor games and exercise and premature obesity in later years can also become a cause of early death.

Why Surgery?
Although diet, exercise, behavior therapy and anti-obesity drugs are first-line treatment, but these medical solutions are only temporarily successful with the patient invariably regaining even more weight than the amount lost.

In this condition, Obesity Surgery (bariatric surgery) generally results in greater weight loss than conventional treatment, and leads to improvements in the quality of life and almost complete resolution of obesity related diseases like hypertension and diabetes. That is why obesity surgery is now being termed as Metabolic Surgery.

Am I Candidate
In order to determine if you are a candidate for weight-loss surgery, it is helpful to know your Body Mass Index or BMI. It is equal to your weight (in kilograms) divided by the square of your height (in meters). If your BMI is over 40 or BMI over 35 with comorbidities (Diabetes, hypertension, sleep apnea etc) and have been unsuccessful at dietary / behavioral approaches to weight loss, you may be a candidate for laparoscopic weight-loss surgery.

Surgery for morbid obesity

First of all, it must be clear that this is not a cosmetic procedure but an �fight for existence�. Main obesity surgery procedures are Laparoscopic Gastric Bypass surgery, Lap Band surgery, Laparoscopic Sleeve Gastrectomy surgery.


Laparoscopic Adjustable Gastric Banding
A silicon band is placed around the upper part of stomach, creating a small pouch that can hold only a small amount of food. The narrowed opening between the stomach pouch and the rest of the stomach controls how quickly food passes from the pouch to the lower part of the stomach. Connected to the band is tubing which is attached to a port, this part is placed under the skin in a muscle in the chest wall. The band can be tightened or loosened to meet your needs, on OPD basis.

Laparoscopic Roux-en-y Gastric Bypass:
Gastric bypass involves creating a small pouch by dividing the stomach. The small intestine is divided and brought up to join the new stomach pouch. This allows food to go straight from the stomach pouch into the small intestine, which causes it to bypass the lower stomach and the duodenum (the first segment of the small intestine). This reduces the amount of calories that the body absorbs.

Laparoscopic Sleeve Gastrectomy

The sleeve gastrectomy works by limiting the amount of food you�re able to eat. The surgeon will remove about 70-85% of your stomach. Your new stomach then takes on the shape of a banana thereby



reducing the storage capacity of stomach.

All these operations can be done laparoscopically so that the patient spends only one to two days in the hospital and can return to their daily routine in 1-2 weeks. Patients can lose 50-80% of their excess weight over 1-2 years


How does obesity surgery change your life?

Laparoscopic Bariatric / Metabolic surgery leads to definite & sustained loss of weight and reversal of

most of medical problems like diabetes and hypertension etc.

1 Lifestyle adjustments: Patient must learn to eat food in small amounts and to chew it well and slowly.
2 Weight loss starts soon after surgery and continues for atleast 2 years.
3 There is enhanced quality of life, with improved stamina, mood, self esteem and body image.
4 Almost complete resolution of DM, HPT, Sleep apnea, dyslipidemia etc.
5 Obesity surgery is not a cosmetic surgery




If you need any further information please contact:

Dr Puneet Gupta
MBBS, MS, DNB, FNB (MAS), FIAGES, MNAMS, DHA
Consultant�Minimal Access & Bariatric Surgery
SAHARA HOSPITAL
Viraj Khand, Gomti nagar, Lucknow
Email: drpgmas@yahoo.co.in
Mobile: 09919314819