Whenever we ask our friends �how are you?� they usually respond by saying �fine�! This is because our asking and their answering is casual and does not mean the words we speak! In fact; usually we speak and communicate from a very superficial and casual stratum of mind. We are not aware enough to think of the deeper meaning or purport of what we speak!

Often we say; that we are fine, when in fact we are not; because we don�t know whether we are happy or not and what could be the causes of happiness or sadness of a person.

It is often said by the spiritual masters (who appear to know and experience �true happiness�) that we should conquer the six enemies; desire, anger, attachment, jealousy, arrogance, craving (KAMA, KRODHA, LOBHA, MOHA, MADA, MATSARA); to be happy!

But our usual experience is that we can not conquer these and we come to terms with life and keep declaring that we are happy; even amidst conflicts, problems and misery!

In fact we begin to explain ourselves and convince that even the great spiritual masters suffer; and hence drawbacks and suffering are inevitable parts of life. We accept our defeat and call the �defeat� itself �success�; and �misery� itself �happiness!!

Being happy is actually a product of our growth, development and blossoming! It is like getting a prize; after studying and passing each test! But just as for passing in each test; the bare minimum prerequisite is to appear for the test; similarly for getting the gift of happiness we have to be; during after every ordeal; in connection with our inner self; through NAMASMARAN (or whatever means, endeavors, techniques we trained and convinced to be in).

Being happy is like blossoming of flowers and ripening of fruits. �Being happy� declares itself undeniably and unequivocally! Further more; �being happy� showers benevolence on others in various forms; but especially global perspective, policies, plans and programs!

�Being happy� is being one with every bit of growth and blossoming of everything and every being; such as the rivers, mountains, gardens, animals, plants and people; in any and every part of the world; and every victorious action; to conquer every bit of disease, distress, degeneration, decay, decomposition and destruction in the world!

The causes of stress are called stressors. These are inside as well as outside.

The outer stressors can usually be easily identified and described in many books on stress management.

But the inner stressors, which often create unbearable conflicts; are not easy to recognize. These stressors are like hidden or invisible enemies! They are located so deep within our thoughts, emotions and our instincts and hence often in our subconscious mind, that they not accessible to our thoughts and reasoning. They elude even our spouse, family members, counselors, guides, friends, teachers, close relatives and so on!

In view of the stressors and the stress (and subsequent degeneration, deterioration, degradation, downfall and destruction) they cause; the traditional wisdom emphasizes on being in satsang i.e. being in good company.

The real meaning of satsang is being in selective company of the truth outside as well as inside; even amidst the presence of falsity.

In other words we have to shield ourselves from (or overcome) the destructive influence of people opposed to individual and global blossoming; at physical, instinctual, emotional and intellectual levels.

This can be done by
1. Avoiding or overcoming the influence of physical presence by not attending certain social events or leaving certain places as early as possible
2. Avoiding or overcoming the influence of certain seductive exhibitions, movies, which are designed to trap our instincts; especially sexual passions
3. Avoiding or overcoming the influence of plays, movies, speeches, literature etc, which ignite prejudice, hatred, division, disruption by trapping our emotions
4. Avoiding or overcoming the influence of intellectual sarcasm, cynicism, skepticism and other arguments which trap our intelligence into bigotry, fanaticism, pettiness and meanness
5. Sublimating our own physical, instinctual, emotional and intellectual sensations; producing urges, cravings, feelings, desires and compulsions, which time and again weaken us and drag us into situations for which we have repent later.
6. While choosing the company of truth outside is very difficult; choosing the company of truth inside is even more difficult.
7. The tradition has provided us with the powerful gadget (the practice of NAMASMARAN) that empowers us to select and cling to the truth outside and inside; amidst the harrowing and stupefying falsehood; i.e. be in satsang!

Non-surgical treatment for Uterine Fibroid & Adenomyosis by Uterine Artery Embolization

Uterine fibroids are the most frequent tumors of the female genital tract: Almost 77% women of childbearing age have a fibroid. And about 30% of uterine fibroids are associated with Adenomyosis (bulky / enlargement of uterus) an estimated 40% need treatment, many of whom are forced to go through emotional, physical and financial trauma of hysterectomy i.e. removal of uterus. Others survive on pain medications.

Adenomyosis are commonly misdiagnosed as fibroids, because the symptoms are similar. In India most of the patients still depend on their family doctors & consulting gynecologist for their complete medical information. While in USA & Europe, people now go through internet for getting best information & hence can chose the best possible treatment options.

Fibroids and Adenomyosis, they may cause:
1. Heavy, prolonged painful menstrual periods with clots lead to anemia.
2. Lower abdomen, back or leg pain.
3. Lower abdomen pressure or heaviness.
4. Bladder pressure leading to a constant urge to urinate.
5. Pressure on bowel, leading to constipation and bloating
6. Abnormally enlarged abdomen
For Fibroid and Adenomyosis (enlarged uterus / bulky uterus) many women unfortunately have to undergo hysterectomy (surgical removal of uterus) thinking that no other treatment is available for this.

Now a very effective & very patient-friendly non-surgical treatment is available for treatment of fibroids & adenomyosis called�Uterine Artery Embolization� is available that requires only 24 hrs hospitalization, no surgical scar on abdomen, short recovery than from hysterectomy or even laparoscopic surgery, all fibroids & adenomyosis are treated at one sitting, no blood loss or risk of blood transfusion, resolution of heavy bleeding in majority, within 24 hours. Emotionally, financially and physically � embolization has an overall advantage over major surgeries.

Dr. Pradeep Muley M.D. a Head & Senior Consultant Interventional Radiologist at Fortis Hospital, Vasant Kunj, New Delhi has made the India�s first UTERINE FIBROID CLUB for women who are suffering from uterine fibroids

Falling In Love Is The Best Arthritis Medicine Of All

Here's the good news: People with arthritis who go ahead and have sex, despite the pain in their joints, often report that their joints are pain-free for more than 6 hours afterward. Sexual arousal touches off a cascade of blissful hormonal changes, boosting the production of corticosteriod, a hormone that reduces pain and inflammation in the joints, as well as endorphins, the body's natural opiates. (By some lights, falling in love is the best arthritis medicine of all. Heart surgeon Christiaan Barnard, for instance, suffered from rheumatoid arthritis for years before he married a ravishing young woman named Barbara. "For several years after the wedding," he reported later in a book, "I virtually ceased to be a sufferer.")

Okay, now here's the bad news: About half of the Indians who suffer from some form of arthritis also complain that it interferes with their sex lives. In fact, people with rheumatoid arthritis, a severe form of the disease much more likely to affect women than men, have a higher divorce rate than people with most other kinds of chronic disease.

Some women with rheumatoid arthritis sail through menopause without a care while others experience a full menu of menopause symptoms: hot flashes, insomnia, mood swings, weight gain. Menopause can also increase symptoms of rheumatoid arthritis, such as joint pain and fatigue.

There is actually a slight rise in new diagnoses of rheumatoid arthritis in women around the onset of menopause. The fact that menopause can aggravate rheumatoid arthritis symptoms are probably related to the body�s drop in estrogen, which is believed to affect rheumatoid arthritis. That may also be why pregnant women who have higher levels of estrogen while they're expecting may see their rheumatoid arthritis symptoms get better for a while.

Whether you've lived with rheumatoid arthritis for a while or just been diagnosed, menopause can pose new challenges to sex, intimacy, and overall well-being. You may feel that because menopause signals the end of fertility, it also means the end of sex. But women with rheumatoid arthritis can have a thriving sex life well past menopause. Work closely with your doctor, talk honestly with your partner, and try these strategies to help you move smoothly through this life passage.

Rheumatoid Arthritis, Menopause, and Vaginal Dryness
One of the first symptoms of menopause that many women experience is vaginal dryness. And it can be a special problem if you have Sj�gren�s syndrome, a condition often seen with rheumatoid arthritis that includes eye, mouth, and vaginal dryness as well as fatigue and achiness. Vaginal dryness can make sex uncomfortable or even painful.

Lowered Sex Drive
Some women feel less interest in sex during or after menopause. That's true for some women even without rheumatoid arthritis. But living with rheumatoid arthritis can also stifle your libido. For example, if you take high doses of steroids to control inflammation, it may cause you to gain weight which in turn could make you feel less interested in sex.

Worrying about pain during sex can kill desire too. And your partner may hold back from sex out of fear of hurting you.

Not Tonight, Honey. I�ve Got Joint Pain.
Swollen and painful joints can put a damper on having sex, and menopause and aging can increase joint pain and stiffness in some women. For women who have relatively severe disease, finding a comfortable position for intercourse may be challenging. In some instances, when pain is especially severe, a woman may not even feel like having intercourse.

Talking to a doctor can also open up discussion between you and your partner. Discussing sex openly is critical. It gives you both a chance to air your fears and feelings, and can make your relationship stronger.

You Can Enjoy Sex

Here are some other ways to make sex more painless and pleasurable.
Get ready. An hour beforehand, take whatever pain-relieving medication you're using. Avoid painkilling narcotics or other drugs that have sex-inhibiting side effects. Corticosteroids, for instance, may relieve pain in men, but they also suppress erection.

Loosen up. While you relax and get in the mood, try doing a few gentle range-of-motion exercises to limber up your joints.

Warm up. Take a warm bath or shower in preparation- or better yet, invite your partner to join you. Turn it into a slow, soapy, delicious form of foreplay.

Stay toasty. Try an electric blanket- it may keep your limber while it keeps you warm. Or what about a heated waterbed? Some arthritis sufferers say it makes all the difference.

Don�t' forget to touch. Don't forget that physical love doesn't only mean intercourse- there's always kissing, hugging, caressing, stroking, massaging and a thousand other variations on the ecstasy of touch.

Lubricate. Some times women who have arthritis also suffer from Sjogren's syndrome, an unpleasant side effect that causes dryness of the mucous membranes around the eyes, mouth and vagina. It may help to use a germ-free, water-soluble suppository lubricant like K-Y Jelly, Lubrin or Steri-lube, which are available without a prescription in drugstores. (Petroleum jelly products and other oily substances should not be used, because they may harbor germs and cause infection.)

Experiment with times. Most people with rheumatoid arthritis have their most severe symptoms in the morning when they awaken. Symptoms are often lowest in midafternoon and tend to worsen later in the day. Try adjusting your timetable for lovemaking to coincide with the periods during which symptoms are less severe.

Experiment with positions. The usual missionary position may be very uncomfortable if the woman has arthritis in her hip or the man has it in his knee, leg or arm. The Arthritis Foundation puts out a nice little booklet about sex and arthritis called Living and Loving, which (among other things) describes seven positions likely to be more comfortable.

Reducing Fatigue
Menopause can increase fatigue, which you may already be feeling thanks to your rheumatoid arthritis. If that�s the case, the only thing you may want to do in bed is sleep. Menopause can also lead to insomnia, another problem for some women with rheumatoid arthritis.

Other tips: I suggests trying yoga, which may help with sleep, or talking to your doctor about a mild prescription sedative.

Intimacy and Depression
Depression is about twice as common in people who have rheumatoid arthritis as in people who don�t. It�s not uncommon to feel depressed by rheumatoid arthritis pain or by not being able to do some things that you used to do.

Menopause can also bring on or increase depression. Some women, with or without rheumatoid arthritis, find that it takes a toll on their self-image, making them feel old, less attractive sexually, and insecure. Often those feelings pass. But if you�re worried about depression or you're having severe menopause symptoms, you may want to talk to your doctor about antidepressants.

The benefits of antidepressants go beyond relieving sadness and anxiety: They may reduce menopausal symptoms such as hot flashes as well the pain of rheumatoid arthritis. However some antidepressants may reduce your libido, so talk to your doctor if this is a concern.

Get Moving to Get Through Menopause
One of the keys to having a healthy sex life during menopause and beyond is taking care of your overall health. Eating well, keeping your rheumatoid arthritis symptoms under control with medication, and getting enough vitamins and minerals are essential.

Menopause may be a good time to try yoga, if you haven�t before. It has shown promise in promoting joint health and emotional well-being, as well as reducing hot flashes.

The many benefits of exercise can also enhance self-image and that�s good for anyone�s sex life.

Sexual communication- letting your partner know what feels good and what doesn't- is so important. Good communication is important in any sexual relationship, of course, but when you've got arthritis hanging over the bed, there's a great potential for hurt feelings.

INTRODUCTION
Coronary bypass surgery without cutting sternal bone sound like description of a cardiac surgery of future but at Ahmedabad this ground breaking advances in surgical treatment of heart disease
is now reality. Fracture created on the sternum hurts patient and worries them the most most of the patient can be discharged from the hospital within 48 to 72 hrs, and return to full activity within a week or two.

Recommendations for Keyhole(MIDCAB) bypass
surgery should be perform if any of the below
criteria are met.

� Patient with very old age particularly female because of
osteoporotic bone.
Patient who is engaged in manual labors.
� Patient with failed angioplasty with CTO lesions.
� Patient with double vessel disease.
� Patient with triple vessel disease.
� Patient with LMCA with triple vessel disease.
� Patient with compromise LV with triple vessel disease.
� Patient with very bad LV function with Tripple vessel disease in
whom CABG+stem cell therapy is indicated.
� Patient with very bad LV function with triple vessel disease in
whomCABG+TMR is indicated.
� Patients with CABG+AVR.
� Patient with CABG+MVR.
� Following are NOT contraindication to Keyhole surgery.
� Very obese patient.
� Very old patient.
SYNONYMS:
Keyhole surgery, Minimally invasive cardiac surgery, sternal sparing
heart surgery, Video assisted cardiac surgery, port access heart
surgery.