2006 Program for AAPI, American Association of Physicians of Indian Origin

24TH
AN
N
UAL CONV
ENTION
•AT
LANTA, GEORG
IA•

Leadership COMMITTEE CHAIRS, COORDINATORS, OFFICERS, BOARD, DIRECTORS . . . 6–11
Editorial . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Messages . . . . . . . . . . . . . . . . . . . . . . . . 14–25
Welcome to Atlanta . . . . . . . . . . . . . . . . . . . . . 26
u Developments and News . . . . . . . . . . . . . . . . 39–52
u Reflections and Perspectives . . . . . . . . . . . . . . 53–88
u Medical and Health . . . . . . . . . . . . . . . . . . 89–138
u Our Universe: MOTIVATION, PRACTICE, FINANCE, COMMUNITY, ESSAYS . . 139–207
Author Biographies . . . . . . . . . . . . . . . . . . . 210–213
Article References . . . . . . . . . . . . . . . . . . . 214–216
Final Essays . . . . . . . . . . . . . . . . . . . . . . . . 218
Leadership COMMITTEE CHAIRS, COORDINATORS, OFFICERS, BOARD, DIRECTORS . . . 6–11
Editorial . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Messages . . . . . . . . . . . . . . . . . . . . . . . . 14–25
Welcome to Atlanta . . . . . . . . . . . . . . . . . . . . . 26
u Developments and News . . . . . . . . . . . . . . . . 39–52
u Reflections and Perspectives . . . . . . . . . . . . . . 53–88
u Medical and Health . . . . . . . . . . . . . . . . . . 89–138
u Our Universe: MOTIVATION, PRACTICE, FINANCE, COMMUNITY, ESSAYS . . 139–207
Author Biographies . . . . . . . . . . . . . . . . . . . 210–213
Article References . . . . . . . . . . . . . . . . . . . 214–216
Final Essays . . . . . . . . . . . . . . . . . . . . . . . . 218
C O N T E N T S
PHOTOGRAPHY:©2006JOHNELLIOTT

VENUGOPAL VARADHACHARY
2 0 0 6 C O N V E N T I O N S TAT E
C O O R D I N AT O R S
FLORIDA
ALABAMA
TENNESSEE
NORTH CAROLINA
SOUTH CAROLINA
KIRAN PATEL
SHARAD PATEL
NAVIN NANDA AMIT CHAKRABARTHY
RITA FRENCHMAN
VIJAYALAKSHMI APPAREDDY
PRAFUL MEHTA SUNIL DESAI
AMIT SHAH VIJAY KRISHAN
VENUGOPAL VARADHACHARY
2 0 0 6 C O N V E N T I O N C O M M I T T E E
NARESH PARIKH B.P. RAO
MANOJ SHAH BIPIN CHUDGAR
NAVIN NANDA
SHAILESH GANDHI ASHA PARIKH P.K. NATARAJAN
VINAYAK KAMATH SAVITHA SHAMA BEENA PATEL
SUDHAKAR JONNALAGADDA
PRAKASH DESAI ARVIND GUPTA SONAL GANDHI MUKESH PATEL
MADHU PURUSHOTAM
PUJA MEHTA YOGI PATEL
YOGESH JOSHI
KRISHNA NARAYANI
FEROZE YOUSEFI SMITA ATRE
6 AAPI 2006 7
PHOTOGRAPHY(BACKGROUND):©2006JOHNELLIOTT

2 0 0 6 C O N V E N T I O N B O O K
EDITORS
Savitha Shama, MD
John Elliott
S.G. (Nik) Nikam, MD
PUBLISHER
Millennium Communications, Inc.
Duluth, Georgia
www.mcicom.com
CREATIVE DIRECTOR
John Elliott
COURTESIES: Sree Shama (cover model);
Raj Pandya, MD; Beena Patel, MD; Somesh Karanjee;
Sujit Basu (physician models), Abha Karanjee; Deepti Basu;
Danielle Williams, Brooke Rankin (patient models)
Views and opinions expressed by authors are their
own and do not necessarily reflect the opinions of the
editors or of AAPI. Information in this publication is
not necessarily endorsed by AAPI, nor any industry
standard, nor as a recommendation to be adopted by
or applied to any member of this association. All efforts
have been made to reflect accuracy of contents and any
errors or omissions are unintentional.
2006 11
R E G I O N A L D I R E C T O R S
Ram Trehan
Region 9–South Atlantic
Jagannath Surpure
Region 2–Mountain
Gopal Reddy Gade
Region 1–Pacific
10 AAPI
Anil Khosla
Region 3–NW Central
Kiran H. Shah
Region 4–SW Central
2 0 0 6 - 7 C O N V E N T I O N C O M M I T T E E
Executive Committee
President~~ S. Balasubramaniam
President-Elect~~ Hemant Patel, MD
Vice President~~ Sanku Rao, MD
Secretary~~ Vinod Shah, MD
Treasurer~~ Ajeet Singhvi, MD
Regional Directors
Pacific~ ~ Manish Mehta, MD
Mountain~ ~ J. S. Srao, MD
NW Central~ ~ Anil Khosla, MD
SW Central~ ~ Jayesh Shah, MD
NE Central~ ~ Narendra Kumar, MD
SE Central~ ~ Jyotin Chandarana, MD
New England~~ Prasad Srinivasan, MD
Mid Atlantic~~ Satish Anand, MD
South Atlantic~~ Suresh K. Gupta, MD
South~ ~ Gogi Ramappa, MD
Board of Trustees
Chair:
Ram Upadhyay, MD
Members:
Rita Ahuja, MD
Rita Frenchman, MD
Sunita Kanumury, MD
Sudeep Kukreja, MD
Arun K. Pramanik, MD
Dayan Naik, MD
Jayesh Kanuga, MD
Rajendra Gupta, MD
10 AAPI 2006 11
Amit Chakrabarty
Region 6-SE Central
Ashok M. Fulambarker
Region 5–NE Central
Kirit R. Vaidya
Region 7–New England
Jagan N. Pahuja
Region 8–Mid Atlantic
Pulipaka B. Rao
Region 10–South
E X E C U T I V E
D I R E C T O R
Brian Maddox
PHOTOGRAPHY(COVERANDTHISPAGE):©2006JOHNELLIOTT

Insights and Reflections
Your Convention Book Holds a Significant Message
EDITORIAL
My heartiest wel-
come to all of you
attending the 24th
AAPI Annual Con-
vention! By taking
time out of your
busy lives, you are
showing your pas-
sion and fellowship
for AAPI, while fur-
thering your learning. On behalf of AAPI,
I’d also like to thank all the dignitaries for
their messages of support and encour-
agement. And, as you have just read, our
distinguished AAPI leaders have shared
valuable information and updates of in-
terest to all.
The purpose of this souvenir book is to
capture the essence of the convention and
offer insights into the mission and mem-
bership of AAPI. The response for our call
for articles was overwhelming and authors
of varying breadth and depth of experience
have graciously contributed to this effort.
As the cover photo implies, when you
look into this book, you’ll see not only
your reflections, but a glimpse into the
future for our group and profession.
You’ll also find a few details about our
host city, Atlanta–including its humorous
side. We’ve organized all of the materials
into four major sections. After you read
some of the important news in our
Developments section, you’ll enjoy our
Reflections section–by and about you,
our members and supporters. The articles
in this area are about achievements,
brotherhood across borders, adapting
to changes, inspirations from our role
models, dilemmas of medical ethics and
the tragedy of an illnesses when it hits
close to home. If you think that you are
ready to slow down from your non-stop
practice, read the authors’ fascinating
perspectives on staying healthy and
active. And let us not forget to have some
fun with what we love–food! Rather, I
mean cooking.
In the Medical section, you’ll read about
the dual challenges of diabetes and heart
disease that we of Indian origin are fac-
ing. The projected statistics is alarming
and calls for a concerted, aggressive, and
relentless effort to change this trend. Fur-
ther on in the section, authors have rightly
keyed in on other major global health is-
sues such as cancers that affect women
worldwide, the clinical studies on women’s
health issues that has influenced our prac-
tice of medicine, the worldwide challenges
of malaria and tuberculosis and advances
in cancer and genetics.
We all realize health is not just the ab-
sence of illness but the holistic scope of
body, mind, and
spirit. We are
fortunate to have
our roots in a cul-
ture that has a trove of knowledge about
ancient healing methods, so read on as our
authors give great insight into how we can
incorporate our traditional ways of healing
into modern medicine and expand health
to its greater meaning.
In the Universe section our authors have
touched upon genuine happiness, leader-
ship roles, career, business, money mat-
ters, community service and even the light-
er side of you. Read about public service
through political involvement and future
mission for our organization. Learn some
valuable tips to get rid of your techno-pho-
bia and discover how technology can be a
key for your business success.
Often there is a longing to just practice
medicine. In this Universe section, you’ll ex-
plore outsourcing business operations and
even your very job! This section also tackles
money matters and gives good insight into
some important risk management strategies
When you look into this book, you’ll see not only
your reflections, but a glimpse into the future....
like proactive asset protection, alternative
disability insurance plans, cutting costs of
your health insurance premiums and estate
planning. Still have cash left? The last thing
you want to experience is investment errors,
so you’ll profit from some helpful hints from
a nationally acclaimed columnist.
We are proud of all the volunteer orga-
nizations and the individuals for their great
spirit of giving. Their services epitomize
the saying,“When people share their fears
with you, share your courage with them.”
Rounding out the Universe section, you’ll
hear from community-minded authors
who share their touching experiences, and
also a bit of the lighter side.
My sincere thanks to all the AAPI leaders,
dignitaries, authors, sponsors, supportive
committee members, staff, and assistant
editors for their kindness and support.
A special thanks to our publishing team
members for their creativity, dedication,
and for a job well done! And, as always,
I’m thankful for the love of my children and
husband, who take pride in my work.
Putting together this souvenir book was
far more than challenging for me! I quickly
realized how much discipline and time it
required. I had to polish my organizational
capabilities, email skills, and communica-
tion style. I learned to work at hours that
were separate from patient care and fam-
ily time, burning the midnight oil. The part
that kept me going was the sheer satisfac-
tion and fun in accomplishing this. When
we were inundated with things to do, our
motivation was the old adage, “The best
preparation for tomorrow is to do today’s
work superbly well.
In the end, if nothing else, my typ-
ing speed has tripled…now I type with
three fingers.
Sincerely,
Savitha Shama, MD
Internal Medicine
13 AAPI
PHOTOGRAPHY(ATLANTA):©2006JOHNELLIOTT

Atlanta Botanical Garden features
several distinct exhibit areas. The
Fuqua Conservatory is a giant
greenhouse enclosing different
climate-controlled ecosystems. The
steamy Tropical Rotunda features
colossal-leafed plant life and towering
rubber trees. Visitors feels like they
are in a real rainforest. Outdoors,
there are numerous paths to guide
guests through planned nature walks.
The influence of Japanese architecture
is evident throughout, and quiet spots
to sit and absorb the beauty of the
landscape are abundant. Children
are special guests at the Botanical
Gardens. An interactive “kid’s space”
is scheduled to be completed in 1999.
Atlanta Cyclorama & Civil War
Museum. In the 1880s, before there
were epic motion pictures, there
were Cycloramas. This 42-foot-high
cylindrical oil painting depicts the
Battle of Atlanta in 1864. Viewed from
a 360-degree rotating platform, the
vivid details of this historic Civil War
battle are now restored and enhanced
with music, narration and sound
effects. Accompanying the Cyclorama
is the Civil War Museum, highlighted
by a steam locomotive from 1862.
Atlanta History Center Museum. Life in
Atlanta, the South, and the military are
the focus of this museum, which also
highlights materials native to Georgia,
with a floor of heart pine and polished
Stone Mountain granite. Displays are
provocative, juxtaposing Gone With
the Wind romanticism with the grim
reality of Ku Klux Klan racism.
APEX Museum, located in the Sweet
Auburn area of downtown Atlanta, the
APEX (African-American Panoramic
Experience) Museum serves as a
gateway to the Martin Luther King,
Jr. National Historic District. The small
but growing museum, housed in a
beautifully restored 1910 building,
chronicles the history of Sweet Auburn
and offers changing exhibits on
African Americans.
Auburn Avenue Research Library, an
amazing $10 million facility dedicated
to African-American research. Be sure
to check out the free lecture series,
exhibits, and cultural events.
Big Bethel African Methodist Episcopal
Church, home to one of the oldest
Black congregations in the United
States. The original church, built in
the 1890s, was destroyed by fire in
1920. Today’s building, constructed in
1924, has recently undergone a $1.8
million renovation.
Callaway Gardens, a stunning 13,000-
acre resort and gardens, offers the
perfect setting for a memorable
summer family vacation, quick
getaway, social or corporate event, or
day trip. A variety of special events
fills the calendar all year long so
there’s always plenty to do, especially
in the summer. You can have a
splashing good time in and out of the
water at Robin Lake Beach.
Centennial Olympic Park, a clean
and well-maintained space, featuring
a decorative mosaic of grass-green
patches and various geometric shapes
composed in red brick. The Quilt of
Remembrance, a memorial to those
killed by the bomb planted here
during the 1996 Olympics, is the most
notable of the park’s many artistic
adornments. Every day at noon sharp
jets of water suddenly burst from
the six rings of an Olympic logo in a
beautiful water display that includes
programmed music.
Center for Puppetry Arts, a 22-year-
old center which prides itself on
being the largest organization in
the US devoted to puppetry. The
center offers puppetry classes, daily
performances by center puppeteers
and various companies, along with a
great interactive museum that includes
figures like the Muppets.
Château Élan Winery, within the
sweeping panorama of the north
Georgia foothills, just 40 minutes
north of Atlanta but a world away
from the bustling city is Château Élan.
On 3,500 acres, French provincial
and southern hospitality combine to
produce a superb leisure destination.
– Continued next page >
2006 27
Hot lanta!
Atlanta has been dubbed everything from the “capital of the new South” and “the
next international city” to “the best place to do business,” and of course, “Hotlanta”.
It’s a great place to visit for even a short time. Fueled by the prosperity of local mega
companies like Coca-Cola and Holiday Inn, the prestige of hosting the 1996 Summer
Olympic Games and the energy of young upwardly mobile types who have migrated
to the city in droves, Atlanta is on fire. (Not something to say a hundred years ago,
however, given its Civil War trauma). This time the heat’s a good thing: from world-
class restaurants and a myriad of cultural attractions to a hip nightlife and sporting
events galore, the city is cosmopolitan in every sense of the word.
But Atlanta has also managed to maintain its historic character. Stop by the Atlanta
History Center or visit the Martin Luther King Jr. Historical Site, a moving tribute to an
American icon. Browse through the former home of famous author Margaret Mitchell or
pop into the Jimmy Carter Library and Museum for details on the life and times of one
of the most popular former presidents. Whether you choose modern urban endeavors or
old southern pleasures, Atlanta will not disappoint. Here is just a sampling of some of
the diverse and unique attractions you you’ll enjoy in the area.
26 AAPI
WELCOME TO…
PHOTOGRAPHY: JOHN ELLIOTT (3,4); GEORGIA ECONDEV AGENCY (BACKGROUND,1,6,8); CHATEAU ELAN (7)

28 AAPI 2006 29
The only way to get out of downtown Atlanta is to turn around and
start over when you reach Greenville, South Carolina.
All directions start with, “Go down Peachtree” and include the phrase,
“When you see the Waffle House.” Except, that in Cobb County,
where all directions begin with, “Go to the Big Chicken.”
If you ask anyone for directions, they will always send you down
Peachtree. Peachtree Street has no beginning and no end
and is not to be confused with: Peachtree Circle, Peachtree
Battle, Peachtree Place, Peachtree Corners, Peachtree
Lane, New Peachtree, Peachtree Road, Old Peachtree,
Peachtree Parkway, West Peachtree, Peachtree Run,
Peachtree-Dunwoody, Peachtree Terrace, Peachtree-Chamblee,
Peachtree Avenue, Peachtree Industrial Boulevard, Peachtree
Commons, or any other of the 55 streets that start with Peachtree.
Also, once the road you’re on crosses another road, the name of
the road you’re on changes. Some roads names change every
half mile or so.
Atlantans only know their way to work and their way home.
Atlanta is the home of Coca-Cola. Coke’s all they drink there, so
don’t ask for any other soft drink unless it’s made by Coca-Cola.
The gates at Atlanta’s Hartsfield-Jackson International Airport are
about 32 miles away from the Main Concourse, so wear sneakers and
pack a lunch.
The 8 a.m. rush hour is from 6:30 to 10:30 AM. The 5 PM rush hour is
from 3:00 to 7:30 PM. Friday’s rush hour starts Thursday afternoon and
lasts through 2 AM Saturday.
Only a native can pronounce Ponce De Leon Avenue, so do not
attempt the Spanish pronunciation. People will simply tilt their
heads to the right and stare at you. The Atlanta pronunciation is
“pawntz duh LEE-awn.”
And yes, they have a street named simply,
“Boulevard.”
The falling of one raindrop causes all drivers
to immediately forget all traffic rules. If a single
snowflake falls, the city is paralyzed for three
DON’TYOU
ATLANTA?
LOVE
days and it’s on all the channels as a news flash every 15
minutes for a week. Overnight, all grocery stores will be sold out of
milk, bread, bottled water, toilet paper, and beer.
I-285, the loop that encircles Atlanta, which has a posted speed
limit of 55 mph (but you have to maintain 80 mph just to
keep from getting run over), is known to truckers as “The
Watermelon 500.”
Don’t believe the directional markers on highways. I-285
is marked “East” and “West” but you may be going North
or South. The locals identify the direction by referring to
the “Inner Loop” and the “Outer Loop.” If you travel on Hwy 92
North, you will actually be going southeast.
Never buy a ladder or mattress in Atlanta. Just go to one of the
interstates and you will soon find one in the middle of the road.
The last thing you want to do is give another driver the finger, unless
your car is armored, your trigger finger is itchy and your AK-47 has a
full clip.
Possums sleep in the middle of the road with their feet in the air.
There are 5,000 types of snakes and 4,998 live in Georgia.
There are 10,000 types of spiders. All 10,000 live in Georgia, plus a
couple no one has seen before.
If it grows, it sticks. If it crawls, it bites. If you notice a vine trying to
wrap itself around your leg, you have about 20 seconds to escape,
before you are completely captured and covered with Kudzu,
another ill-advised “import,” like the carp, starling,
English sparrow, and other “exotic wonders.”
It’s not a shopping cart, it’s a buggy. “Fixinto” is one
word (I’m fixinto go to the store).
Sweet Tea is appropriate for all meals and you start
drinking it when you’re 2 years old.
“Jeet?” is actually a phrase meaning “Did you eat?”
Culled from various sources
Cartoons by Fitzroy James
Hotlanta!
CNN Center, the global headquar-
ters of the CNN News and also an
entertainment-shopping-dining-ho-
tel extravaganza. The crown jewel
of the Center is the CNN Studios
tour, a must-see for an impressive
behind-the-scenes look at global
news in the making.
Fox Theatre, known as The “Fabu-
lous Fox,” has had many close
encounters during its lifetime. It
originated as a mosque and movie
house in the 1920s, but fell into
financial difficulty during the Great
Depression, and thrived again until
the early 70s, when it struggled
and was threatened by destruction
until Atlanta Landmarks took over
in 1976. Today, it is a majestic
performance and special event
venue, as well as a movie house in
the summer.
Georgia Aquarium, one of the ar-
ea’s newest attractions, this facility
houses hundreds of species of
fish, taken from waters around the
world. The exterior of the building
was designed to look like a giant
ship breaking through a wave. As
guests enter the huge atrium in-
side the building, they will be led
into the facility by “a wall of fish”
guiding them inside. They then
have the choice of entering five
galleries. Located near Centennial
Park, near downtown.
Hammonds House, Georgia’s only
independent fine art museum dedi-
cated to presenting art by peoples
of African descent. The museum
houses an extraordinary collection
of Haitian and African tribal art
and serves as a resource center for
Black artists worldwide.
High Museum of Art, Atlanta, a
stunning, porcelain-enameled build-
ing was designed by famed archi-
tect Richard Meier and is rivaled
only by the art inside. Featuring
American, European and African
art, as well as decorative art and
photography, the High Museum
boasts a permanent collection of
over 11,000 pieces, many of which
can be viewed from different levels
of the four-story, glass atrium.
Features a permanent gallery that
you can visit anytime, as well as
acclaimed feature exhibits such
as Norman Rockwell, Picasso, and
Pop Art.
Jimmy Carter Library and Museum,
the only presidential library in the
southeast United States, honors
the early life, political career, and
presidency of Jimmy Carter. Mu-
seum open to the public 7 days;
designed for a relaxed, leisurely
visit. Enjoy a 30 minute historical
film on the Presidency, visit the
Oval Office and enjoy an exact rep-
lica of the beautiful Crown of St.
Stephen, a gift from the people of
Hungary. Ongoing and temporary
exhibits are offered.
Kennesaw Mountain National Park
commemorates the 1864 Civil War
battle for Atlanta. Union forces un-
der General Sherman assaulted the
heavily fortified Confederate posi-
tions on Kennesaw, losing more
than 5,000 men. Eventually, Con-
federate forces retreated in defeat.
Today, the park encloses 2,882
acres of protected land and boasts
16 miles of hiking trails.
Lake Lanier Islands, a resort and
waterpark spread across 1,200
acres, with numerous hotels, golf
courses, boat rentals. The biggest
attraction is the waterpark, featur-
ing water-slide rides, a king-size
wave pool, a mile and a half of
white sandy beach, volleyball, live
music and DJs.
Martin Luther King Jr. Center for
Nonviolent Social Change continues
King’s work, holding workshops on
famine and illiteracy, providing day
care for needy families, and teach-
ing nonviolent leadership skills.
The Exhibition Hall houses King’s
Bible and clerical robe, the Grammy
Award he won for his “Why I Op-
pose the War in Vietnam” speech,
and a replica of the Nobel Peace
Prize he won in 1964. The key to
his Memphis motel room where he
was assassinated in April 4, 1968,
is also on display here. One of
the Center’s most moving sites is
King’s white marble crypt, which
rests on a five-tiered reflecting
pool in Freedom Plaza. The tomb
is inscribed with his words: “Free
at Last. Free at Last. Thank God
Almighty I’m Free at Last.” An
eternal flame, symbolizing the
continuing efforts to realize King’s
dream, burns nearby. Start at the
visitor center and then work your
way around the three main sites
in this historic park: the home in
which the leader of the Civil Rights
movement in America was born,
the church where he preached and
the memorial site where he is bur-
ied. A major Atlanta attraction, the
park draws some 500,000 visitors
each year.
Piedmont Park, now the center of
outdoor and recreational activi-
ties in Atlanta, where virtually any
game or activity imaginable can be
found here. Piedmont also hosts
various statuary and memorials that
bear witness to the city’s history.
Shrine of the Black Madonna Book-
store and Cultural Center, with a
mission to transform the spiritual
emptiness, economic powerlessness
and social disorganization that the
church believes has plagued the
Black community.
Six Flags Over Georgia, located a
half-hour from downton, Six Flags
offers hours of breathtaking fun.
You can ride any of the eight roller
coasters, catch a show at one of
the performance venues, play
games for prizes, or enjoy a meal in
the shade.
Sports venues. With so many win-
ning sports teams in Atlanta, it’s
hard to choose, but you’ll always
find a game worth watching! The
Atlanta Braves play at Turner
Field, while the Falcons inhabit the
80,000-seat Georgia Dome, and the
Thrashers hockey team and Hawks
baseball team play in the newly
built Phillips Arena.
Stone Mountain Park, located 20
minutes outside of Atlanta, and
features a three-acre sculpture of
Confederate leaders etched into the
mountainside. Stone Mountain also
has a restored Antebellum Planta-
tion, featuring 18th and 19th cen-
tury colonial mansions, slave cabins
(the area was a haven for racism
until recently), coach houses, and
barns. The Park’s 3,200 acres con-
tain numerous lakes, hiking trails,
paved recreational paths, and a
1.3 mile climb to the top of Stone
Mountain. From the top one can
see Atlanta’s modern skyline and
the nearby Appalachians. There are
also a wildlife preserve and petting
zoo operates year round. Finally,
there is a nightly laser show that
recreates historical events.
Sweet Auburn district. A walk down
Auburn Avenue is one of the best
history lessons Atlanta has to of-
fer. The opportunities available in
this Black residential and business
district, even in the face of Atlanta’s
segregation laws, inspired political
leader John Wesley Dobbs to nick-
name the area “Sweet Auburn.”
Underground Atlanta, a favorite
attraction throughout the southern
USA, Underground is known for
its specialty shops, eateries, and
special events such as the Midday
Jazz Excursion and the annual Open
Air Market.
World of Coca-Cola, a popular At-
lanta attraction, this tribute to the
world-famous sugar drink, born
a century ago in a local Atlanta
pharmacy, fills three stories with
everything you ever wanted to
know about Coca-Cola, including
its origins and connection with
cocaine. A spectacular collection of
memorabilia, entertaining, hands-on
exhibits and video presentations as
well as unlimited samples in many
flavors await you.
< Continued from previous page
PHOTOGRAPHY:GEORGIADEPARTMENTOFECONOMICDEVELOPMENT(1);JOHNELLIOTT(2,3,4)

38 AAPI 2006 39
Developments
R E P O R T S • N E W S • E V E N T S
A good Financial Advisor never clocks out. Markets close but the process of watching, evaluating and discerning never
ceases. For us at Smith Barney, helping build your wealth is an unending process. The goal is not a number. The goal
is a tireless work ethic that doesn’t wax and wane with market conditions. These are the reasons I work at Smith
Barney. To discuss how I can work with you, please call me at (800) 825-5334 Ext. 2246 or (585) 389-2246.
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the Umbrella Device are trademarks and service marks of Citigroup Inc. or its afﬁliates and are used and registered throughout the world.

40 AAPI
AAPI–Where Next?
Sarala A. Rao, MD
Chair, AAPI Board of Trustees.
REPORTS
It is possible to fail in many ways…while
to succeed is possible only in one way.
Aristotle, Nichomachean Ethics
Our Greetings to all
AAPI members and po-
tential members from
the team on the AAPI
Board of Trustees. We
are delighted to have
you all here to attend
the most eagerly antici-
pated event of the year,
our annual convention.
You have all made an
excellent and wise decision to come with your
family and friends. There is no better opportunity
to meet fellow physicians, get acquainted with
new members, reëstablish contact with our for-
mer colleagues and partners in AAPI and at the
same time enjoy the wide variety of services and
entertainment offered here. The hard work and
dedication of our superb convention committee–
so ably captained by Dr. Naresh Parikh and his
dedicated team of physicians, their families and
friends from the Atlanta region–have made this
possible. I am sure you will agree with me that
they deserve a big round of applause for their un-
relenting effort, the results of which are all here
for us to view and enjoy.
How do you think all this came about? It sure
did not happen overnight by magic! Our past
leaders have played a prominent and important
role in laying the foundation. Each year since
its inception a team has been formed, consist-
ing mostly of local physician leaders, ably sup-
ported by the AAPI main office and the President
and Executive Committee of AAPI. They planned
events–each one more elaborate and innovative
than the previous one–improved on the process,
considered what the membership desired in such
a meeting to make it unique to our Indian culture
and values; that is how the establishment of a
family friendly meeting and convention evolved.
Since in many of our other professional ac-
tivities we leave our families behind, this is one
occasion where we have attempted to combine
our professional activities during the day with
entertainment and extra curricular activities for
the spouses and children in the evenings. Very
important governance issues and Continuing
Medical Education activities are the mainstay
during the morning hours. In all of this we have
partnered with our industry partners to provide
useful information on a wide variety of topics
such as financial planning, women’s issues–both
health related as well as career-life-balance issues–
a fashion show which is of interest to everyone,
and separate children’s and young adult activities.
We are grateful to our industry partners for
their support and encouragement in formulat-
ing these plans and making it a big part of AAPI,
to help make it a grand success. I urge all of you
to go around the exhibit halls, visit the various
booths, ask questions of the staff manning the
booths and express your appreciation to them
for their enthusiastic participation in these AAPI
events. The evenings of course are for dining,
dancing, singing, relaxation and having fun with
friends and family. This is the most eagerly antici-
pated segment of the event.
What does all this have to do with the board
of trustees, you may ask? It is not an obscure
group, segregated in a corner, agonizing over
how to cross the t’s and dot the i’s and make life
difficult and intolerable for everyone else despite
what you may have heard and/or imagined! It is
a dynamic group of AAPI members elected to a
staggered term of three years and they form one
of four pillars of AAPI responsible for governance
issues. If everything is going along merrily ac-
cording to the rules and regulations that are laid
out in our bylaws, their existence is not indeed
very noticeable.
Human nature being what it is, however, ques-
tions of conflicts of interest or conformity with
the written bylaws or questions of commission or
omission seem to be always lurking behind the
scenes. As part of the system of checks and bal-
ances promulgated in the AAPI Constitution, the
Board of Trustees is charged with an oversight
function to ensure the system of checks and bal-
ances are functioning as they are supposed to.
They are also charged with the responsibility of
management and oversight of the Patron Fund,
an endowment fund created about 15 years ago
to safeguard the funds collected from all the pa-
tron members of AAPI. They are responsible to
ensure appropriate use of funds, investment
strategy and ongoing growth of AAPI. They may
also be called upon to mediate conflicts or differ-
ences of opinion among AAPI members.
It is my pleasant duty at this time to inform all
of you that all nine members of our team worked
together to formulate a prudent, mild-to-moder-
ate risk category of investment, with a profile of
growth and income. In this we were ably sup-
ported and helped by our financial advisor and
planner, Mathew Lapides of Merrill Lynch. The
other very happy news I have the privilege of pre-
senting to all of you is the purchase of an office
condominium in Oakbrook, Illinois. This was ac-
complished via the use of funds from the Patron
Fund. We are extremely thankful to the members
of the task force created for this purpose by our
President, Dr.Vijay Koli, Dr. Jagan Ailinani, who
headed the force, and some prominent physi-
cian leaders from the local chapter. They worked
very hard and fast to identify the location of an
appropriate piece of property which met our
needs and helped complete the deal. In late Feb-
ruary we were able to move in and had a well at-
tended “Open House” function to inaugurate our
new home on March 11. All of us on the Board
of Trustees are extremely thankful to the entire
membership of AAPI for their outpouring of sup-
port and encouragement in this endeavor.
I want to leave you with a few thoughts and
reflections on the role of AAPI members in the
day-to -day affairs of our organization which we
all love so dearly. All of us need to remember and
remind ourselves and our fellow members that
this is not an easy job and it does not run itself on
auto pilot. It is highly complex, needs tremendous
participation and input from all quarters, working
in collaboration with each other in a manner that
our future membership and leaders are proud
of us. It is serious business and we are a profes-
sional organization facing our share of highs and
lows. We are only as good as our membership is
and only as strong as our numbers are.
If you see someone sitting on the sidelines and
Monday morning quarterbacking, do prod them
into getting involved. It is the responsibility of
the entire membership to stay informed about
the rules of governance. How else can you be
aware of things going alright or not? It is wishful
thinking to assume that everything is going fine
always and there is harmony and progress unim-
peded by controversies. If this ever truly comes
about, you can bet that someone or no one is
thinking at all about what is going on.
Differences of opinion do crop up on occasion.
This is when the role of membership is crucial.
All of us have to be alert. Express your opinion.
Get involved in constructive engagement. Be vo-
cal and advocate on behalf of the entire member-
ship. Use E-mail productively by addressing your
concerns to the appropriate AAPI leadership.
Write letters to the editor of the AAPI Journal.
Ask questions on the AAPIGRAM. Avoid going
directly to the media before you even let anyone
in AAPI know what your grievances are. You risk
being trivialized your self as well as the organiza-
tion when that happens–hardly a useful choice for
members of a professional organization like ours!
Lastly, if you had a good time, enjoyed the
events and want to return for these and other
AAPI events, go out and tell your fellow physi-
cian friends and colleagues; be our ambassadors,
sign up hoards of new members and be an active
participant in AAPI Governance and AAPI Affairs.
Rome wasn’t built in a day nor is any organization
that is strong, benevolent and long lasting.
So go out and have fun but don’t forget to
come back next year for our Grand Silver Jubi-
lee Celebrations! Join us in double the numbers!
After all, with 42,000 members of physicians of
Indian Origin out there by last count, we have
lots of room to grow! With your help we’ll make
it happen!
“Coming together is a beginning.
Keeping together is progress. Working
together is success.” –Henry Ford
2006 41
Developments
BACKGROUNDILLUSTRATION:©2006JOHNELLIOTT

42 AAPI 2006 43
Developments
AAPI Charitable Foundation
REPORTS
“This is the gist of all worship: to be pure
and to do good to others. He who sees
the Lord in the poor, in the weak, and
in the diseased really worships Shiva.
Great work requires great and persistent
effort for a long time.”
– Swami Vivekananda
This is what AAPI Charitable
Foundation has been doing for the
last fifteen years. AAPI Charitable
Foundation has provided continu-
ous and necessary care for the
sick and destitute through its
fifteen clinics in rural and deprived
areas throughout India. We also
provide preventative immuniza-
tions, eye camps, fixtures for the
disabled, and other services to
almost a million people. This year,
we have inaugurated two more
clinics in Andhra Pradesh: Jagtial
at Karimnagar and Kaali AAPI
Rural Clinic. They continue to hold
camps and provide HIV care.
AAPI Charitable has partici-
pated whenever and wherever
calamity has struck, whether in
India or the United States. We
have raised more than fifty thou-
sand dollars for Katrina
and given fifty-five thou-
sand dollars for tsunami
reconstruction. We have
also built five hospitals:
a trauma hospital in
Latur, Maharashtra and
four hospitals in Gujarat
in collaboration with
other NGOs. We have
not only contributed
financially, but have also
conducted fieldwork for
administering care in
these disasters.
The following is a list of the
clinics throughout India:
Durganagar, Jammu
Gurgaon, Haryana
Jagtial, Andhra Pradesh
Proddatur, Andhra Pradesh
Jigni, Karnataka
Sambalpur, Orissa
Ammanpettai, Tamil Nadu
Visnagar, Gujarat
Mandi, Himachal Pradesh
Worli, Bombay
Indore, Madhya Pradesh
Kaali, Andhra Pradesh
Kartarpur, Punjab
Rozda, Rajasthan
Hospet, Karnataka
We would like to open one
clinic in each state in India. As it
is, our annual budget is $180,000
and requires constant attention
for collection. We also want to
engage in other preventative
programs in India, but our efforts
are hampered due to lack of
funds.
You may laugh or wonder what
we are trying to achieve in a
country of over a billion people
with over five lakhs of villages.
To this, I would respond with a
tale from the Ramayana.
When the great bridge was be-
ing built across the sea to Lanka,
a host of animals came. Monkeys,
bears, and other large beasts lifted
huge stones for construction. One
little squirrel was also in their
midst, transferring dirt within the
stones to hold the bridge together.
The other animals laughed at what
they perceived to be its insignifi-
cance. Lord Rama picked up the
squirrel and admonished them
saying that this squirrel does more
than its share, a remarkable lesson
for all to learn.
If we can all join together to
give back to our people in India,
we too can be like the squirrel. A
hundred dollars per person can
go a long way. Please contact
any of the following for further
information:
Dr. Krishan K. Aggarwal 304.723.2825
Dr. Shashi S. Shah 516.365.4853
Dr. H.N. Ramaprakash 260.432.1973
Dr. Brahma N. Sharma 412.682.2100
2005 Katrina flooding in New Orleans, USA (St. Bernard Parish)
2005 tsunami flooding in India (Andra Pradesh)
Best Wishes From
Drs. Prakash & Usha Desai
Are you an Indian or of Indian origin living in the United States and
are older than 18 years of age? You are invited to participate in an
research study being conducted at Emory University named Sleep and
Heart in Asian Indians(SAHAI). This study seeks to explore the potential
relation between obstructive sleep apnea and cardiovascular illness in
Asian Indians. Your particpation takes about 15 minutes of your time
filling an online survey instrument from the comfort of your home.
The information you give will be stored in a HIPA-compliant database at
Emory University.
For details:
Please contact Srinivas Bhadriraju, MD (PI)
sbhadr2@emory.edu

52 AAPI
Reflections
I N S I G H T S • C O M M E N T A R Y • O P I N I O N
52 AAPI

60 AAPI 2006 61
Reflections
“Aathi Sarvathra
Varjayathe”
Denounce Things That
Are Extreme
By Raghuveer Halkar, MD
A gentleman in his late seventies
was sitting next to me in one of my
recent airline travels.
It turned out that he is a retired
radiologist who had started a
group practice which is now being
managed by his son. I just could
not resist and asked him, “Tell me
what you think has changed in the
practice of medicine that bothers
you”. He said, “These days there is
no incentive for group fidelity!”
Seeking clarification, I asked him,
“What does that mean?” He said
“Young man” (probably to flatter
me), “when I ran the group every
one had to work five to ten years to
be a partner, started at a low salary,
and only reached a senior salary
after ten years. Now, in two or
three years, they are full partners
and there is hardly any difference
in pay between senior and junior.”
Now I saw what he was driving
at. The partners are not very much
committed to the group and they
can move to any other group and
quickly receive the same pay and
benefits. We hear about this in
the business world often, as high
rate of employee turnover. Lack
of fidelity is one major cause of
employee turnover.
But this lack of fidelity has also
become pervasive in our greater
society as well. In “olden days,” a
person worked all his or her life for
one company and the company in
turn promised lifetime employment.
The life of a company or an
institution was certainly longer than
the work life of an individual. The
worker became a stake holder in the
company, his future and wellbeing
depended on that of the company.
Presently, the life of companies has
become shorter than the life of a
worker. The take over phenomenon
continually changes the company’s
mission and vision. Workers are no
longer stake holders in a company;
they are at best share holders.
Few have allegiance to the same
company and companies also do
not offer nor promise life time
employment. Fidelity is treated as
weakness.
What is fidelity or lack of it?
Basically it amounts to change.
Change is the only constant in life.
Most of us do not like changes
and we often resist them.
–Continued next page
BestWishes
from
THE
ADMINISTRATION
AT
SMITH NORTHVIEW HOSPITAL
VALDOSTA, GEORGIA
ILLUSTRATION:BROOKERANKEN,©2006MILLENNIUMCOMMUNICATIONS,INC.

62 AAPI
Changes are inevitable in life. An
MBA friend of mine has a different
outlook toward employee turnover.
He thinks it has some positive
aspects: it brings new ideas and
new way of things. Changes bring
challenges, but they also bring new
opportunities and people who are
able to use these opportunities
to their advantage are often the
successful ones. We–the Indian
community that has migrated to
USA–have adopted well. Practice
of medicine was physician-centric
30–50 years ago, when physicians
were on the top of the pyramid.
Now physicians are just middle-level
blocks in the pyramid and healthcare
is becoming managed care or group/
institution-centric. I hope eventually
it will turn into patient-centric.
We have accepted most changes
quite well. I am not talking about
the changes in how we dress,
eat or drink. That is often easy.
The changes we have to make in
attitudes and personal philosophies
are the most difficult ones.
“End does not justify means” and
“It is the path you tread and not the
heights you reach”; growing up in
India I was fed and raised on these
lines. But I knew better. I had heard
what Kenneth Galbraith (considered
one of 20th century America’s most
famous economists) had said:
“Everything is fiscal and in the long
run all of us are dead.”
Iknewveryearlyinlifethat,onlyfor
thewinner,winningdidnotmatter.
Growing up in India had taught me
that history is written by the victor.
My mentor in Kuwait often
reminded me, “Life is complex
and the purpose of all learning is
to make it simple”. I worked there
for a nationalized health program.
There was a turf battle too–a
different one. Everyone wanted to
keep their turf as small as possible.
Now I am here in USA and I am told
to make things complex and make
them not too profitable lest some
one may take it away from us. We
want as large a turf as possible.
“Don’t give a fish to a hungry
person, but teach him how to fish,”
we were told. Now I know that if I
give him a fish he will come back
again and I am in control. Teach
him how to fish and soon he will
be my competition. After all there
are only so many fishes in the sea.
These are the few examples
of difference in attitudes and
philosophies, which I had to adapt
to in my new life in USA. Have I
changed? Yes. But I often think I have
created a blend of old and new values.
I have no problems with changes.
The issue often is the rate of
change and amount of change. Too
rapid and too much of a change
amount to revolution. Probably
what we all wish for is an evolution
and not a revolution. The Sanskrit
quote “Aathi Sarvathra Varjayathe”
comes to my mind. It is better to
shun anything that is extreme.
–About the author, page 215
The Challenge To
Stay Challenged
By M. Vinayak Kamath MD
Not since the ancient Huguenots
has the world seen as successful
a migration as that of Indians to
the United States in the last half
century. More impressively, all
indications are that the second
generation is going to reach
even greater heights and be a
force to reckon with in terms of
their intellectual, financial and
geopolitical clout. We can take a
bow!
But what is the future?
As we learn to counter, treat
and prevent cardiovascular
and metabolic diseases,
the kaleidoscope shifts to
looming problems of dementia,
Alzheimer’s and arthritis.
Numerous studies have
concluded that a simple and
Aathi Sarvathra
– Continued from previous page.
active lifestyle is conducive
to a long, functional life span.
Observational data suggests that
benefits are maximized if one
can gradually move into less
stressful avocation and hobbies
by age sixty. The transition can be
difficult. So we need to plan early.
It is clear that if we stay
physically and mentally active,
most of us can expect to live well
into our 80s. How can we stay
physically and mentally active?
As we gain more control of our
worldly lives, we are offered a
smorgasbord of options. We
can pursue leisure activities,
attain spiritual goals or nurture
grandchildren, just to name a few.
Certainly, after decades of hard
and stressful work, after playing
musical chairs all our lives, we
are entitled to do whatever we
can afford to do. We need to take
time to enjoy life.
The fact remains, however, that
unless we are challenged, we
do not achieve
–a fact as true at age seven as
it is at age seventy. It is not in
our own best interest not to
be challenged. The goal is find
activities that are stimulating and
satisfying but not stressful.
But wait. Is it all about us only?
Is it all about a mechanical,
pleasure filled existence? Is it
all about bagichay ki seva and
afternoon chai?
Our success, in large parts,
is due to our education in
India (practically free) and the
opportunities that were offered
to us in the United States
(opportunities not available
anywhere else in the world).
We need to consider our larger
obligations to society as well
when we plan our future. We
have much to offer, even in areas
outside our chosen profession.
So look around, opportunities
abound. I can think of no nobler
way of staying physically and
intellectually fit and yet helping
others at the same time. Done
right, it is a lot of fun too.
Most of us have altruistic links
to our motherland. But history
tells us that we will be richly
rewarded if we pay particular
attention to our responsibilities
towards our adopted land,
especially since our future lies
here within these Unites States.
History also tells us, repeatedly,
of the dangers of not doing so.
So plan early, enjoy a long
life and leave a mark. Future
generations will thank you.
–About the author, pages 210-213
Reflections
©PHOTODISC

2006 81
Reflections
CARTOONS BY FITZROY JAMES © 2006
1. Patient has chest pain if she lies on her left side for over a year.
2. On the 2nd day the knee was better and on the 3rd day it disappeared
completely.
3. The patient has been depressed ever since she
began seeing me in 1993.
4. The patient is tearful and crying constantly. She also ap-
pears to be depressed.
5. Patient’s past medical history has been remarkably in-
significant with only a 40 pound weight gain in the past
three days.
6. Discharge status: Alive but without permission.
7. Healthy appearing decrepit 69 year-old
male mentally alert but forgetful.
8. I saw your patient today, who is still
under our car for physical therapy.
9. The patient has no past history of suicides.
10. She is numb from her toes down.
11. Patient had waffles for breakfast and anorexia for lunch.
12. Between you and me, we ought to be able to get this lady pregnant.
13. Patient has left his white blood cells at another hospital.
14. The skin was moist and dry.
15. Occasional, constant, infrequent headaches.
16. Patient was alert and unresponsive.
17. She stated that she had been constipated for most of her adult
life, until she got a divorce.
18. The patient refused an autopsy.
19. The patient was to have a bowel resection. However, he took a
job as a stockbroker instead.
20. Skin: Somewhat pale but present.
21. Patient was seen in consultation by Dr. Blank, who felt we
should sit on the abdomen and I agree.
22. Large brown stool ambulating in the hall.
UNEDITED
HUMOR
We’ve collected some interesting diagnoses from
various medical records. The following are actual
doctors’ notes written on patients’ charts.
UNEDITED
POETRY
The First Dance
By Monita Soni
It was a very snowy weekend
The children were tumbling in the soft blanket
Making angel wings with there arms
Eyes sparkling with glee
Snowflakes clinging avidly
I called her indoors, to drape the saree
It was her first dance performance
The rich navy and pink kanchipuram
Her long deep auburn hair
Braided with jasmine flowers
The lipstick was easy but licked away
In a moment, the eye make-up
Took some time, the result
Was stunning, but not to
Her taste, tears welled, ready to flow
After some deft corrections and a
Lot of reassurance, the maiden was
Ready for her first dance
I looked at her, and looked away
My heart about to burst
The teacher recited as the children came on stage
Yato Hasta Stato Drushti
Yato Drushti Stato Manha
Yato Manha Stato Bhava
Yato Bhava Stato Rasaha
Keep the song in your throat
Let your hands tell the story
Your glance follow the gestures
Let your mind be in sync with your eyes
This will create the right expression............
For the audience to experience the rasaha
I do not know if it was the loving teacher
Or the devout innocent students
But the effect of the first dance
Was tremendous
The little girls with black kohled eyes
Danced their way into our hearts
The angels in the snow made magic........
You carry her on swaying hips;
Heaving ox carts, cane and sticks.
Burden raised, saree caught,
Nostrils flared, choli taut;
Fruits arranged for blessings bought.
Standing tall from your chore,
Breath emerged from hidden store;
Sweat upon hammer, brick upon stone;
Mighty nation, yet so alone;
One lakh of years your children shone.
Dark strands of Ganges braided tight,
Mysterious eyes of Kashmir’s light;
Soft lips are the temples below;
Our trembling torches barely show,
The majesty of forgotten glow.
Through samsara you emerge;
Looking back, ahead you surge.
Yes, Hind, you could have been,
What you were in Bharat’s din:
Yet ahimsa’s victory led a planet’s kin.
Hands of India
By John Elliott
From the haze, some can discern,
Vestige of outrage parched throat burn:
Ignore dacoit of baksheesh passed!
Hawala severing veins outclassed:
Bapuji’s karma nearly slashed.
But early morn sounds the bell,
Clears the mind, so gods can smell,
The scent of ninety crore garlands,
Each so sweet, yet grains of sands,
Impassioned prayers a goldenbird lands.
We saw an India with outstretched hands;
Proud soldiers marching, magnificent bands;
Heroes welcomed from tortured roads;
Sharing hosts, gourmets’loads;
Sonorous tabla; millennias’odes.
And to this land we will return;
Its clasping hands shall we not spurn;
The songs of India not denied;
This brother, this sister have now replied:
Memory of you we shall not hide.

88 AAPI 2006 89
Medical
2006 89
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114 AAPI 2006 115
Medical
TUBERCULOSIS: A TIME BOMB.
Tuberculosis (TB) claims one per-
son every fifteen seconds worldwide
and one person every minute in India.
Someone in the world is newly infected
with TB bacilli every second. One third
of the world’s population is already in-
fected with TB bacillus. About 5-10%
of these TB infected people not infect-
ed with human immunodeficiency vi-
rus (HIV), becomes sick or infectious at
some point during their lifetime. Left
untreated, each person with active TB
disease will infect on average between
10 and 15 people every year. This grave
scenario is complicated by the emer-
gence of multi-drug resistant (MDR)
strains of the bacillus and its synergy
with HIV.
TB is a contagious disease spread
through air, caused by bacteria called
mycobacterium tuberculosis. . The bac-
teria usually attack lungs but can attack
any part of the body such as kidney,
spine, brain, etc. TB disease is curable
and the most common medicines used
to treat TB include first-line (isoniazid,
rifampicin, ethambutol, pyrazinamide)
and second-line (kanamycin, ofloxacin,
ethionamide) drugs.
Even with the availability of all these
drugs, TB disease is far from under
control, let alone eradicated. Numer-
ous factors are attributed to this, with
one of the most concerning ones be-
ing non-adherence of the patient to the
drug regimen. TB treatment usually
lasts around 6-9 months. It is highly es-
sential for the patient to adhere to the
regimen until completion. Non-adher-
ence can lead to disease progression
in the patient and can have drastic im-
plications in terms of development of
drug resistant strains and their subse-
quent transmission in the community.
The World Health Organization, in or-
der to enhance patients’ adherence to
drugs, recommends what is referred
to as DOTS (Directly Observed Treat-
ment, Short-course) as part of TB con-
trol programs in various nations. This
is a mechanism in which someone ac-
countable would help patients take the
drug at the required time in their pres-
ence. DOTS has five components:
• Government commitment,
• Case detection using sputum microscopy,
• Standardized short-course chemotherapy ,
• Regular drug supply, and
• Standardized monitoring and reporting sys-
tem that allows assessment of individual pa-
tients as well as of overall program perfor-
mance.
The goal of TB control in India is to
reduce the chain of transmission by de-
tecting at least 70% of all infectious TB
cases in the community and curing at
least 85% of these cases. The Revised
National TB Control Program (RNTCP)
in India, based on the principle of DOTS
and on the strengths of a national TB
program, was implemented in pilot ar-
eas in 1993. After initial testing, rapid
scale-up of the RNTCP began in late
1998. Though RNTCP has had impres-
sive achievements so far, sustaining
and expanding the program in the con-
text of a less developed socioeconomic
environment is a major challenge. In
addition, other detrimental factors with
relevance to the Indian scenario in-
clude: sub-optimal primary health care
system, a large and unregulated pri-
vate health care system, and the dual
threats of HIV and MDR-TB.
Considering the operational con-
straints in achieving the goals of TB
control in India and also the existing
lacunae in knowledge, the focus of re-
search in India has shifted to priority
areas such as:
• Involving the private health sector in the
DOTS program
• Implementing patient-oriented treatment
services
• Reducing delays in diagnosis
• Increasing the access to and utilization of TB
services
• Preventing and treating
TB among HIV-infected
persons
• Preventing and treating
MDR-TB
• Increasing and sustaining political commit-
ment to DOTS expansion
• Developmental research in terms of newer
diagnostic tools, drugs and vaccines, etc.
The government of India has taken
laudable steps in strengthening the
TB control program by involving vari-
ous segments of the society. Innovative
schemes like Public-Private Mix (PPM)
DOTS projects are being implemented
throughout the country. Over 80 corpo-
rate sector units are involved in RNTCP.
By the time one would have gone through this
article in about four minutes, the world has
witnessed 16 deaths due to TB
The essential role of non-governmental
organizations (NGOs) in health promo-
tion of the community has also been
recognized. The Indian government
has come out with five schemes for
collaboration with NGOs and, to date,
around 800 NGOs are officially provid-
ing RNTCP services. The other impor-
tant area identified was an information,
education and communication (IEC)
campaign. IEC involves awareness
generation among general population
including self-reporting by symptom-
atic cases. IEC is a very important tool
and the Central TB Division has already
made considerable amount of IEC ma-
terial available under RNTCP.
India is a diverse and large country.
Implementing, sustaining and widen-
ing DOTS in such a varied background
to reach all sections of the society is a
major challenge for India today. On the
other hand, it should be noted that TB
is a global disease, a disease without
borders. To reiterate the fact that we are
all sitting on a TB time bomb, it must
be realized that by the time one would
have gone through this article in about
four minutes, the world has witnessed
16 deaths due to TB. Out of these, four
deaths are from India alone.
By Mani Cheruvu, PhD and Satish Bhadriraju, M.D
–About the authors, page 210-213

extensive materia medica describing
the therapeutic use of medicinal plants.
Ayurveda has as a goal the creation of
perfect health for the individual rather
than simply the absence of disease.
The main contribution of Ayurveda
is the reminder that the mind and con-
sciousness exert a deep influence on
our physiology. If priority is given to
the development of consciousness,
the physiology will have the greatest
capability to resist disease by keeping
Ayurvedic Nutrition
Recommendations from Cooking
Expert Dr. Sunanda Ranade
Food, sleep, and sex have sometimes been
considered in India as the three pillars of
humanity, with the most important being
food. Good nutrition necessitates that the
food be properly cooked, taken at a proper
time, in a proper quantity that nourishes
the body and mind. Prepared thus, the food
enhances the
growth of the
tissues, deals
well with the
wear and tear
of the tissues
caused by our
daily movements, and eliminates waste
properly.
According to traditional ayurveda,
health requires an equilibrium of three en-
ergies, and well maintained Agni (digestive
fire). This leads to happiness of soul, mind
and maintenance of sensory organs.
Fresh food grown organically contain
more Prana (vital force), which provides
even more energy. A variety of grains, veg-
etables, roots and beverages like pure wa-
ter openly exposed to air and sun are the
best, natural nutrition for humans.
Many other foods are unnatural and may
even act like foreign bodies if not properly
assimilated in the stomach, quickly ac-
cumulating partially digested in excretory
and other organs. When they cannot find
their way out, they reside in the tissue
crevices by law of gravitation (Ama) and,
– Continued on page 121 sidebar
– Continued on following page
Ayurveda is said to be as old
as humanity. It is knowledge that is
inherent in the laws that govern life
throughout the universe and a branch
of a complete body of knowledge
known as Veda. This science of health
was founded by the great seers of
ancient India. Through their deep
insight into the depths of nature s
functioning, they came to know the
laws that govern our health and life.
Thus the word Ayurveda means the
science of life.
Ayurveda is a holistic system of
health care that deals with the whole
range of life, from its origin in the
deepest level of human consciousness–
pure consciousness–to its expressions
in mind, body, behavior, and the
environment. Ayurveda has an
uninterrupted oral tradition of clinical
knowledge predating the written
texts. There is also a theoretical
framework that provides valuable
insights into psychological and
physiological functioning, and an
AYURVEDAThe Science Of Life
By Hari Sharma, MD, FRCPC
118 AAPI 2006 119
Medical

mediating the influence of consciousness on the body.
When present in abundance, ojas gives strength, immune
strength, contentment, and good digestion. Inefficient
digestion and metabolism, on the other hand, result in
production of toxic material in the body called ama, the
buildup of which results in disease.
Proper dietary measures strengthen the digestive and
metabolic fires known as Agni and eliminate impurities
from the physiology. Agni is created by the three doshas
and functions in different areas of the body to carry
on metabolic activities. Agni converts the food in the
body to help form the bodily tissues. It is well known
that without the proper heat, food cannot be cooked.
Similarly, inside the body, Agni or heat is generated in
various tissues to give rise to the necessary chemical se-
cretions, metabolic reactions, and functional processes
associated with optimal digestion.
Some aspects of diet emphasized in Ayurveda are taste
and food qualities. The six tastes are sweet, sour, salty,
pungent, bitter, and astringent. The taste of food is re-
lated to the properties of food. Food contains packets
of intelligence analyzed by taste. Ayurveda recommends
that all six tastes be represented in each meal.
Ayurveda categorizes food according to six major
food qualities: heavy, light, oily, dry, hot, and cold.
Food qualities and taste also affect the doshas, so the
proper combination is needed to maintain balance in
the physiology. Which tastes and food qualities should
predominate in the diet depends on the dosha status
of the individual.
Ayurveda includes detailed discussions of lifestyle and
behavior and their impact on health. Behavior, speech,
and emotions are important aspects of the human
psyche that affect health. Emotions can be understood
as fine fluctuations of consciousness; as such, their im-
pact on the more expressed physical levels of the body
is understood to be immense. Interestingly, traditional
virtues such as respect for elders, teachers, loved ones,
and family members; pardoning those who wrong you;
practicing nonviolence; not speaking ill of others behind
their back and so on, are understood to promote health
for the individual s mind and body, as well as for the
community and society as a whole.
The input from the five senses–hearing, sight, touch,
taste, and smell–creates changes in the physiology, and
each experience is metabolized in its own way. When
food is digested, assimilated, absorbed, and metabo-
lized, the byproduct of metabolism affects our physiol-
ogy. Similarly, the information from the different senses
is metabolized and affects our behavior. Therefore, it is
important to experience health-promoting input through
becoming fermented, produce diseases affecting
body and mind. This cycle leads to premature aging
or even death.
Natural food brings calmness to mind, clear un-
derstanding as well as a proper way of thinking. It
helps you to find your healthy way. It also enhances
the sattva guna of mind.
Ayurveda has given emphasis on vegetarian food
but same time explains properties of various types
of meat and fish for treating diseases. This food
being heavy in nature brings dullness to the mind;
therefore one should not consider having the non-
vegetarian food, especially who are accustomed to
vegetarian food.
The entire gastro-intestinal canal of the human,
various digestive secretions that are poured for di-
gestion, the length of the intestines, as well as
structure of his oral cavity and the teeth are ideal for
vegetarian food. Experiments also prove that non-ir-
ritant vegetarian food is admirably suitable for devel-
opment of children physically and mentally.
Food should be prepared in clean kitchen, ide-
ally after the cook has recently bathed and is wear-
ing fresh clothes. One should cook on low fire and
steamed cooking is always best. Often, however, in
this world the majority of the people are engaged
with hectic activities and they may not have enough
time to prepare proper food for themselves.
Regarding the quantity (Rashi) of consumption,
ayurveda says it depends upon one’s age,
constitution, agni, country and the time of intake.
You have to consider seasons also. Warm or cold food
in summer and hot, slightly spicy foods in winter
is beneficial.
For proper digestion (Samyak Pachan) of food,
breathing should be at ease and one should strive
to feel light and happy. One should eat the food in a
clean, calm place with cheerful surroundings. If ap-
propriate, pray to the god and visualize that the food
is going to nourish your body. Avoid too cold or too
hot food, as it affects digestive capacity and lowers
the digestive fire.
Currently, many people prefer to take break-
fast while driving the car, perhaps biting piece of
baked goods or sipping coffee. But this also affects
– Continued from sidebar, page 119
– Continued on following page
Ayurvedic Nutrition
AYURVEDAaligned with the invincible forces of nature that cre-
ated it. The technology for evolution of consciousness
is meditation.
Ayurveda sees problems of health as being an imbalance
in a person s individual physiological constitution. One
s constitution is called one s Prakriti. If the Prakriti is
out of balance, it creates Vikriti, the basis of disease.
Ayurvedic physicians (Vaidyas) first look at their patients
as whole human beings who are unique in their Prakriti.
They then look at the Vikriti, or imbalance, that has
occurred. Vaidyas then make recommendations for
restoring balance in the physiology, including dietary
recommendations, nutritional supplements, and
behavioral adjustments.
In the Vedic texts, the five fundamental categories
of matter and energy responsible for material creation
are called panchamahabhutas. They are
known as Akasha (space), Vayu (air),
Tejas (fire), Apas (water), and Prithivi
(earth). They are created as a result of
the self-interacting dynamics of pure
consciousness. The combination of
panchamahabhutas results in formation
of the three doshas, which are known
as Vata (combination of space and
air), Pitta (combination of fire and water), and Kapha
(combination of water and earth). The doshas are fun-
damental, irreducible metabolic principles that govern
the functioning of the entire body as well as the entire
universe. These doshas are the connection between the
human body and the universe on the material level.
Vata represents motion and flow. It is at the basis of
all activity. Pitta represents bodily functions concerned
with heat and metabolism. It directs all metabolic and
catabolic activities, biochemical reactions, and the
process of energy exchange. Kapha represents structure
and cohesion of the organism. It is responsible for bio-
logical strength, natural tissue resistance, and proper
body structure.
The human constitution is made up of the combination
of consciousness and matter. Matter is represented by
Vata, Pitta, and Kapha. When the relationship of con-
sciousness and Vata, Pitta, and Kapha is in balance, a
state of total balance and perfect health is created.
In Ayurveda, this state of health is known as Swastha,
which means established in the Self, established in the
wholeness of life.
Vata predisposes toward diseases of the nervous sys-
tem, pain syndrome, cardiovascular illness, rheumatic
disorders, constipation, anxiety, worries, and fear. Pit-
ta predisposes toward ulcers of the alimentary tract and
chronic inflammatory skin diseases, and is also respon-
sible for anger, envy, and jealousy. Kapha predisposes
toward diseases of the respiratory system, diseases of
the kidneys, diabetes mellitus, obesity, hardening of
the arteries, and tumors. It is also responsible for feel-
ings of attachment and grief. The doshas are affected
differently by the food eaten, the season of the year,
the time of day, and so on.
Ayurveda maintains that all approaches to health can
be maximally effective only if appropriate dietary mea-
sures are instituted simultaneously to support the res-
toration of physiological balance. Ayurveda has no single
diet that is purported to be suitable for all individuals
and all situations. The prescription of diet is individu-
alized, being based on the diagnosis of the individual s
current dosha status and taking into account seasonal
influences, the individual s age and digestive capacity,
any disease or imbalance present, sources and purity of
food, and other factors.
Digestion is also of prime importance in maintaining
health. The end product of truly healthy diet and diges-
tion is said to produce significant amounts of ojas. Ojas
is said to be the most important biochemical substance
The Science Of Life
–Continued from Previous Page
Food contains packets of
intelligence analyzed by
taste. Ayurveda recommends
that all six tastes be
represented in each meal.
–Continued on following page
120 AAPI 2006 121
Medical

AYURVEDAeach of the five senses to maintain balance in the physiology.
Daily rhythms and seasonal rhythms also affect our psyche
and physiology. The changes in the seasons are understood to
create fundamental shifts in our biochemistry and metabolic
style. Variations in sunlight, heat, cold, wind, and moisture
are metabolized by the body. These variations in nature are
mirrored by variations in the human physiology. The seasons
and time of day are classified according to the doshas. Thus,
changes in the weather and the time of day affect the physi-
ology of the body. This is seen in the predominance and mani-
festation of diseases due to Vata, Pitta, and Kapha during
their respective seasons. For example, colds and respiratory
problems are predominant in the springtime. This is Kapha
season, and Kapha predisposes toward diseases of the respi-
ratory system. Also, when one season changes into another
season, there is an accumulation of doshas. At this time, the
likelihood of aggravation of the doshas, resulting in disease,
is more likely.
Ayurveda recommends daily and seasonal routines to main-
tain balance in the physiology. Adjusting one s behavior to
health-promoting daily and seasonal routines puts the mind
and body in tune with the functioning of the laws of nature.
By promoting behavior in accord with natural law, these rou-
tines maintain the integrity of key biological rhythms.
Ayurvedic pharmacology (called Dravyaguna) utilizes the
synergistic cooperation of substances as they co-exist in
natural sources. It uses either single plants, or more often,
mixtures of plants whose effects are complementary. In
terms of Ayurveda, the effectiveness of herbal mixtures may
ultimately be explained by the idea that plants, especially
herbs, are concentrated repositories of
nature s intelligence which, when used
properly, can increase the expression
of that intelligence in the body. Special
preparations known as Rasayanas pro-
mote longevity, stamina, immunity, and
overall well-being.
Integrating Ayurveda into the current
medical system holds great promise for
the future of healthcare in the U.S.
the digestion, leading to diseases like hyper acidity. At
a minimum you have to carve out 15 minutes for break-
fast and 30 minutes for lunch & dinner each, to eat food
peacefully which ultimately going to nourish your body.
Never eat food sitting in front of TV, watching hor-
ror movies or while working on computer. These expe-
rience have a bad impact on digestive secretions. The
mantra of this century seems to eat ready-to-cook, in-
stant or fast food, all of which is full of preservatives,
chemicals and artificial colors and result in diseases
such as cancer.
Enormous use of Teflon-coated utensils and disin-
fectants in the kitchen also leads to different diseases.
Frozen, canned food having less life force in it is not
useful at all. Our younger generation is victim of all this
things. Hence we see many more diseases cropping up
in our society.
For well being of the human race, and for the main-
tenance of good health, it is better to follow the ay-
urvedic principles of food, its proper preparations and
its effect on bodily energies. Charaka, wise and ancient
sage, has said that those following all these principles
live healthy, enjoyable and long life.
The Science Of Life
–Continued from page 121
Adjusting one’s behavior to
health-promoting daily and
seasonal routines puts the
mind and body in tune with the
laws of nature.
– Continued from sidebar, page 121
Ayurvedic Nutrition
122 AAPI
Indian culture’s current attraction stems
from many sources. It is one of the world’s
fastest growing economies. Many people who
were once unfamiliar with all that India has to
offer are now acquiring new knowledge of our
beautiful motherland. The global marketplace
is replete with images of Bollywood and fashion
trends like bindis and kurtis. The IT industry and out-
sourcing are readily identified with locations such as
Bangalore or High Tech City. There’s no question that
India is at center stage in the present era of globalization.
Even before this trend started, however, the influence
of Indian culture was felt around the world. Marco Polo
carried Indian spices back to Italy. Some of these spices
included the same exotic flavors (e.g., cardamom) that
go into making chai–now a household word and a top
seller at Starbucks.
Indeed, the saying that “everything old is new again”
can also be seen in healthcare. Many people are opting for
a simpler way of life, taking guidance from wisdom tradi-
tions such as those of the East. More and more people are
becoming aware of Ayurveda, the world’s oldest system
of healing. Ayurveda is a comprehensive system of health
and lifestyle management that places great emphasis on
self-care and harmonizing the interactions among the vari-
ous systems that make up a person’s unique environment.
A Google search of “Ayurveda” revealed 14,500,000 hits.
Ayurveda’suseofnaturalremediessuchasherbshasmade
it popular among both the lay and scientific communities.
India’s native neem tree is making headlines for its antimi-
crobial powers. The benefits of haldi (turmeric) are being
studied through NIH funding. In fact, the National Center
for Complementary and Alternative Medicine has funded
several studies on Ayurveda. In Arizona, for example, re-
searchers are investigating the effects of ginger, turmeric,
and boswellia on the treatment of inflammatory disorders
such as arthritis. The Cleveland Clinic Foundation is study-
ing a compound called cowhage to determine its potential
to reduce or even prevent the often disabling side effects of
treatment with conventional drugs for Parkinson’s disease.
In addition to herbs, many Westerners’ palettes are also
being influenced by Ayurveda. Much of traditional Indian
cuisine is prepared according to the principles of this an-
cient science of life. Two examples of Ayurveda’s influence
on our eating habits include 1) an emphasis on eating a
variety of foods, particularly their taste and color and 2)
vegetarianism. Ayurveda places importance on having all
six tastes in a given meal. This combination benefits not
only optimal physiological functioning by stimulating the
taste buds and promoting digestion, but it also contributes
to an optimal psycho-spiritual state of being that empow-
ers the individual to make healthy choices
in other areas of his or her life.
India is over 80% vegetarian. Many
cooking techniques date back to ancient
times. The Atharva Veda, which is largely
a treatise on Ayurvedic principles, classi-
fied foods according to sattvic, rajasic and
tamasic qualities. In this system, meat was
noted to be deplete energy, similar to overeating
or consuming over-ripe foods; these foods were
discouraged as they were not beneficial to the whole
being which included mind, body and soul.
Today, many people from around the world are choos-
ing to become vegetarian. Reasons for this change include
the health benefits of a plant-based diet over one that in-
volves animal proteins (consumption of animal products
have been linked to cancer and heart disease), spiritual and
religious beliefs–such as the morality of killing animals, and
economic and environmental considerations. In fact, the In-
ternationalVegetarianUnionwillholditsannualconvention
in Goa this year to highlight India’s role in vegetarianism.
Our knowledge of vegetarianism and healthful nutri-
tion can be incorporated into our medical practices. For
example, we can counsel patients to not only do certain
Yoga asanas, but we can also provide a list of beneficial
herbs and spices as well as healthful recipes. In this man-
ner, we can assist patients to make informed–and very
practical–decisions on lifestyle modifications.
As both the population and the economy of India con-
tinue to grow, its contributions to the world will become
increasingly more visible through continued exports of
not only tangible products, but also of cultural insights.
Those of us who have been in the US for many years
have already witnessed the wave of change.
Let us, as physicians of Indian origin practicing in the
US, take advantage of our unique opportunity to serve
not only as medical guides to our patients but also as
cultural health ambassadors. We are at a momentous
time in history. We are in a position to facilitate the ush-
ering in of true integrative medicine by blending our
roots in the East with our modern training and delivery
methods of the West. We can serve as role models for
both our patients and our families by exemplifying this
integrated lifestyle approach in our own daily routines
as well as in communications with others.
As Mahatma Gandhi once said, “Be the change that
you want to see in the world”. We have much to be
proud of. Let us embrace our ancient traditions as they
take us into the future.
Ayurveda Into The Future
122 AAPI 2006 123
Medical
About the Author, page 210–213.
By Aparna Sundaram, MD

126 AAPI 2006 127
Medical
Vegetarian Diets
in Prevention and Treatment of Chronic Disease
By Reed Mangels, PhD, RD, LDN and Sudha Raj, PhD, RD
A number of factors in vegetarian diets positively
affect cardiovascular disease risk.
The position of the American Dietetic Associa-
tion and the Dietitians of Canada on vegetarian di-
ets states, “Appropriately planned vegetarian diets
are healthful, nutritionally adequate, and provide
health benefits in the prevention and treatment
of certain diseases.”1
This article will review the
evidence for health benefits of vegetarian diets in
disease prevention and treatment.
A vegetarian does not eat meat, fish, or fowl or
products containing these foods.1
Within the gen-
eral category of vegetarianism, there are several
sub-categories. Lacto-ovo vegetarians include
dairy products and eggs while lacto vegetarians
exclude eggs but include dairy products. Vegans
exclude all animal products. Practitioners may
also encounter individuals who describe them-
selves as “vegetarian” but who occasionally do
include fish, poultry, and even meat in their diets.
In most countries, vegetarians are only a small
proportion of the population. For example, 2.5%
of the US adult population consistently follows a
vegetarian diet.2
India is exceptional in that per-
haps as many as 35% of the population follows
a traditional lacto or lacto-ovo vegetarian diet;
vegan diets are very rarely practiced.3
However,
vegetarian diets may not be maintained by some
Asian Indians due to acculturative changes when
they move to the United States.4
Studies of Vegetarians
Studies of Seventh-day Adventists (SDA) have
provided insights into the health effects of vege-
tarian diets. Close to half of the SDAs in the United
States either follow a vegetarian diet or eat very
limited amounts of meat. About one-fourth of
SDAs consistently follow a lacto-ovo vegetarian
diet; about 3% are vegan.5
Other large studies in
the United Kingdom 6,7
and in other countries 8–10
have increased our knowledge of health effects of
vegetarian diets.
Cardiovascular Disease
Vegetarians have been consistently shown to have
lower rates of cardiovascular disease. For example,
an analysis of five prospective studies involving
more than 76,000 subjects found that vegetarian
men had a 31% lower risk of mortality from ischemic
heart disease than non-vegetarian men while veg-
etarian women had a 20% lower risk than non-vege-
tarian women.11
Vegetarians in Bangalore, India had
a 20% lower risk of for myocardial infarction com-
pared with non-vegetarians.10
Vegetarian SDA men
have half the rate of fatal myocardial infarctions as
do non-vegetarian SDA men and also have a lower
risk of developing cardiovascular disease.12
Vegetarians’lowerserumcholesterolconcentrations
can explain some of the differences in cardiovascular
disease risk between vegetarians and non-
vegetarians. A review of nine studies found that, in
comparisontonon-vegetarians,lacto-ovovegetarians
had 14% lower total cholesterol concentrations while
vegans averaged 35% lower.13
Vegetarians also tend
to have lower concentrations of LDL cholesterol,
similar triglyceride concentrations, and may have
lower HDL concentrations than non-vegetarians.1, 14
Elevated triglyceride concentrations reportedly seen
in some vegetarians may be improved by partial
substitution of carbohydrate with either protein or
monounsaturated fat.15
The lower HDL levels seen
in some vegetarians may be due to low intakes of
dietary fat or
alcohol.1
A number of
factors in vege-
tarian diets pos-
itively affect car-
diovascular dis-
ease risk. These
include typically
lower intakes
of saturated fat
and dietary cho-
lesterol, higher
intakes of fiber,
soy products,
vitamin C, vita-
min E, and phy-
tochemicals.1
Possible negative effects of vegetarian diets include
lower intakes of omega-3 fatty acids and higher ho-
mocysteine concentrations. Blood homocysteine
levels have sometimes 16, 17
but not always predicted
an increased risk of coronary heart disease.18
In veg-
etarians, elevated homocysteine levels appear to be
due to poor vitamin B12 status 19–21
since both folate
and pyridoxine levels are typically adequate in veg-
etarians.19,22
In addition, Asian Indians are more likely
to have polymorphisms in the genes responsible for
homocysteine metabolism21
, thus further increasing
risk of hyperhomocysteinemia. Vegetarians can be
encouraged to seek out plant-based sources of ome-
ga-3 fatty acids and to use reliable sources of vitamin
B12 in order to reduce these potential risk factors for
cardiovascular disease.
Vegetarian diets particularly the lacto and lacto-
ovo patterns can have high levels of saturated fats
making them very similar
to non-vegetarian dietary
patterns.23
Sources of satu-
rated fats in vegetarian di-
ets include cheese, milk, ice
cream, baked goods, butter, and eggs. Dietary coun-
seling may be required to enable clients to reduce
the saturated fat in their diets.
Vegetarian diets have been successfully used as in-
terventions for cardiovascular disease. For example,
Dean Ornish, MD, placed patients with moderate to
severe coronary heart disease on a regimen that in-
cluded a very-low-fat vegetarian diet, moderate aer-
obic exercise, smoking cessation, and stress reduc-
tion. Participants who followed the vegetarian diet
and other lifestyle changes demonstrated a regres-
sion of coronary
atherosclerosis
while the con-
trol group had
a progression
of atheroscle-
rosis and more
than twice as
many cardiac
events.24,25
A
near-vegan diet
high in phytos-
terols, soluble
fiber, and soy
protein has
been seen to
be as effective
as a lacto-ovo
vegetarian diet and a statin drug in reducing risk of
coronary heart disease.26
An Indo-Mediterranean diet rich in whole grains,
fruits, vegetables, and nuts was used in subjects
who were at high risk for coronary artery disease.
Some subjects were vegetarian while about a third
ate meat once or twice a week. The subjects were
compared to a control group consuming a diet simi-
lar to that recommended by the National Cholesterol
Education Program (NCEP). The intervention group
had fewer sudden cardiac deaths and heart attacks
as well as lower blood pressure, and reduced blood
cholesterol and LDL cholesterol levels.27
Cancer
Consumption of meat, especially red meat and pro-
cessed meat (ham, bacon, luncheon meats, etc.) has
been repeatedly associated with increased risk of co-
lon cancer.28–30
Not surprisingly, nonvegetarians have
a higher risk for colorectal cancer than do vegetar-
ians.12, 31
Meat consumption also appears to increase
the risk of bladder 5
, prostate12
, and pancreatic 32
can-
cer. One study of South Asian migrant women from
the Indian subcontinent living in England found that
women who ate the most meat had a greater risk of
cancer than lifelong vegetarians.33
Vegetarians’ risk
of lung, uterine, and stomach cancer does not ap-
pear to differ from non-vegetarians. Dairy products
have been associated with an increased risk of pros-
tate cancer.34
A low-fat vegetarian diet has been used in men
with prostate cancer.35
After one year, PSA decreased
4 percent in the men on the vegetarian diet but in-
creased 6 percent in controls. No members of the
experimental group required conventional medical
therapy after a year whereas six men in the control
group had significant progression of the prostate
cancer.
The lower risk of cancer seen in vegetarians may
be due to vegetarians’ higher intakes of fiber, dried
beans, and fruits and vegetables. In addition, vege-
tarians tend to have a lower proportion of secondary
bile acids in feces 36
and lower levels of fecal muta-
gens 37
while vegans have lower levels of serum in-
sulin-like growth factor-I 38,39
, all of which may offer
significant protection against specific cancers.
– Continued page 129

128 AAPI 2006 129
Medical
Hypertension
Vegetarians tend to have lower blood pressure
than non-vegetarians 1, 14
. Vegetarians also tend to
have a much lower incidence of hypertension, even
when controlled for vegetarians’ lower body weights
40–42
. Non-vegetarians are almost three times as likely
to have severe hypertension, requiring medication
compared to vegetarians.5
Vegans tend to have the
lowest blood pressure and the least hypertension,
followed by lacto-ovo vegetarians and fish eaters.5
The lower blood pressures seen in vegetarians do
not appear to be due to differences in BMI, exercise,
dietary fat, fiber, potassium, sodium, magnesium, or
calcium.1
Perhaps the lower glycemic index of vegetar-
ian diets or a composite effect of many synergistic fac-
tors is responsible for the lower blood pressures seen
invegetarians.1
Vegetariandietshavebeensuccessfully
used as treatment for high blood pressure.43
Type 2 Diabetes
SDA vegetarian men and women have almost half
the risk of developing type 2 diabetes when com-
pared with non-vegetarians.12
British vegetarians
are much less likely to die from diabetes compared
to non-vegetarians.5
Vegetarians’ lower mean body
mass index (BMI) and higher fiber intakes may ex-
plain part of the difference in incidence of type 2 dia-
betes. Even after adjustment for weight, however,
vegetarian men still were at much lower risk for dia-
betes than were non-vegetarian men in a study of
SDAs.12
Vegetarians have also been shown to have
greater insulin sensitivity and lower blood glucose
levels than non-vegetarians.44
Low-fat vegetarian diets have been used in the
treatment of type 2 diabetes.45, 46
For example, more
than one-third of the subjects who followed a veg-
etarian diet and who were being treated with insu-
lin were able to discontinue insulin use.45
Similarly,
close to three-quarters of those taking oral hypogly-
cemic agents were able to discontinue these medi-
cations.45
Serum cholesterol was reduced 22% and
triglycerides were reduced 33% in those following a
low-fat vegetarian diet.45
Obesity
On average vegetarians are leaner than non-veg-
etarians.47
In a British study, overweight or obesity
was twice as common in non-vegetarian men and
1.5 times more common in non-vegetarian women
compared to vegetarians.48
In Sweden, middle-aged
women who were vegan had a 65% lower risk of
obesity than non-vegetarians; lactovegetarian wom-
en had a 46% lower risk.49
Vegan diets with 10% of
calories from fat have been successfully used to pro-
mote weight loss50, 51
.
Other Diseases
Vegetarians are less likely to have di-
verticulitis than non-vegetarians 52
pos-
sibly because of their higher fiber intake.
Even after controlling for obesity, gender,
and age, non-vegetarians are more than
twice as likely as vegetarians to suffer
from gallstones.53
Vegetarians also ap-
pear to have a lower risk of rheumatoid
arthritis and osteoarthritis.5
Meat consumption averaging 2.5 serv-
ings per day is associated with a relative
risk of gout of 1.41 compared to meat
consumption averaging 0.5 servings per
day.54
Beef, pork, and lamb were all asso-
ciated with an increased risk of gout.54
Summary
Vegetarians have lower rates of cardiovascular dis-
ease, colon and prostate cancer, hypertension, type 2
diabetes, and obesity than non-vegetarians. Numer-
ous factors in vegetarian diets can account for these
differences. Vegetarian diets have been successfully
used in the treatment of cardiovascular disease, hy-
pertension, diabetes, and obesity.
– Continued from page 127
Dr. Sudhakar Jonnalagadda
Clinical Assistant Professor, Division of Gastroenterology/Hepatology
at the Medical College of Georgia
Diplomat, American Board of Internal Medicine
Board Certified in Gastroenterology
Highly Specialized in Liver Diseases and Liver Transplant Medicine
 
State-of-the-art Endoscopy Center, utilizing the latest technology to
screen for colon cancer, ulcer disease as well as diseases of the small
bowel with capsule endoscopy.  Our staff are comprised of highly trained
professionals, ensuring privacy and personalized care.
 
Licensed by the state, 034-295 • Nationally Accredited by AAAHC
References, Pg. 218; About the authors, page 210–213.
PHOTOGRAPHY : © 2006 JOHN ELLIOTT

138 AAPI
Our Universe
• M O T I V A T I O N • P R A C T I C E • F I N A N C E •
• C O M M U N I T Y • E S S A Y S •
2006 139 2006 139

140 AAPI 2006 141
Universe
10
DEEPAKChopra
Understandthatthe
physicalworldisjusta
mirrorofadeeperintel-
ligence.Intelligenceisthe
invisibleorganizerofall
matterandenergy,and
sinceaportionofthis
intelligenceresidesin
you,youshareinthe
organizingpowerofthe
cosmos.Becauseyou
areinseparablylinked
toeverything,youcan-
notaffordtofoulthe
planet’sairandwater.
Butatadeeperlevel,
youcannotaffordtolive
withatoxicmind,because
everythoughtmakesanim-
pressiononthewholefield
ofintelligence.Livingin
balanceandpurityis
thehighestgood
foryouandthe
Earth.
Take time to be silent, to meditate, to quiet the
internal dialogue. In moments of silence,
realize that you are re-contacting
your source of pure awareness.
Pay attention to your inner life
so that you can be guided by in-
tuition rather than externally
imposed interpretations of what is or
isn’t good for you.
Know that the world “ out
there” reflects your
reality “in here.”
The people you
react to most
s t r o n g l y ,
whether with
love or hate,
are projections
of your inner
world. What you
most hate is what
you most deny in
yourself. What you
most love is what
you most wish for
in yourself. Use
the mirror of rela-
tionships to guide
your evolution. The
goal is total self-
knowledge. When you
achieve that, what you
most want will auto-
matically be there, and
what you most dislike
will disappear.
2006 2006 141
TEN KEYS TO HAPPINESS
1
Listen to your body’s wisdom, which expresses
itself through signals of comfort and
discomfort. When choosing a certain
behavior, ask your body, “How
do you feel about this?” If your
body sends a signal of physical or
emotional distress, watch out. If
your body sends a signal of comfort
and eagerness, proceed.
32
Live in the present, for it is the
only moment you have. Keep
your attention on what is
here and now; look for the
fullness in every moment.
Accept what comes to you
totally and completely so that you can ap-
preciate it, learn from it, and then let it go.
The present
is as it should
be. It reflects
infinite laws
of Nature
that have
brought you
this exact
thought, this
exact physi-
cal response. This moment is as it is because
the universe is as it is. Do not struggle against
the infinite scheme of things; instead, be at
one with it.
4
Relinquish your need for
external approval. You alone
are the judge of your worth,
and your goal is to discover
infinite worth in yourself,
no matter what anyone
else thinks. There is great
freedom in this realization.
6
5
When you find yourself reacting with
anger or opposition to any person
or circumstance, realize that
you are only struggling with
yourself. Putting up resistance
is the response of defenses created
by old hurts. When you relinquish this
anger, you will be healing yourself and
cooperating with the flow of the universe.
7
Shed the burden of judgment – you will
feel much lighter. Judgment imposes
right and wrong on situations
that just are. Everything can be
understood and forgiven, but
when you judge, you cut off
understanding and shut down
the process of learning to love.
In judging others, you reflect your
lack of self-acceptance. Remember that
every person you forgive adds to your
self-love.
8
Do not contaminate your body with
toxins, either through food,
drink, or toxic emotions.
Your body is more than a
life-support system. It is
the vehicle that will carry
you on the journey of your
evolution. The health of
every cell directly contributes
to your state of well being, because
every cell is a point of awareness within
the field of awareness that is you.
9
Replace fear-motivated behavior with love-
motivated behavior. Fear is the product
of memory, which dwells in the
past. Remembering what hurt us
before, we direct our energies
toward making certain that an
old hurt will not repeat itself.
However, trying to impose the
past on the present will never
wipe out the threat of being hurt. That
happens only when you find the security of
your own being, which is love. Motivated
by the truth inside you, you can face any
threat because your inner strength is
invulnerable to fear.
140 AAPI
–About the author, page 210-213
PHOTOGRAPHSCOURESYAUTHOR

2006 Program for AAPI, American Association of Physicians of Indian Origin

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