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Haemorrhoids, also known as piles, are swellings containing enlarged blood vessels that are found inside or around the bottom (the rectum and anus). Hemorrhoids become an issue only when they begin to swell, causing itching, pain and/or bleeding.

Rectal prolapse is a condition in which the rectum loses the normal attachments that keep it fixed inside the body, allowing it to slide out through the anal opening, turning it “inside out.” Rectal prolapse can range from mild to severe.

Hello,

Mera naam Doctor Kunal Makhija hai. Main ek orthopedic aur joint replacement surgeon hoon jo especially knee surgeries mein practice karta hoon. Aaj ham baat karenge Knee ligament injuries ki uske liye humko yeh samajhna jaruri hai ki jo hamara knee hai wo banaa hua hai upar ki jo bone rahti hai, thigh bone usko bolate hain femur, niche ki jo bone rahti hai usko leg bone ko bolate hain tibia ye jo dono bones hai, jo knee banaa rahe hain knee joint ye dono jude hue rahte hain bohot saare ligament se jismein se four main ligament jo hai wo hai, aage ka anterior cruciate ligament, andar ke hisse ka medial collateral igament, bahar ke hisse ka lateral collateral ligament, aur piche posterior cruciate ligament ye chaar ligament sabse jaroori hai ligament hain knee ke ismein se jab bhi ham girte gain khaskar sports injury, bike injury mein jo sabse common ligament jo tear hota hai wo hai anterior cruciate ligament.

Generally jabh bhi aap football khel rahe hain, badminton khel rahe hain, bike se injury hui hai ya fir seedhi se gire hain tabhi jo knee mein swelling ajaati hai aur hamara ligament injury ham bolate hain most common is anterior cruciate ligament injury ye jo injury hai ya fir partial ho sakti hai ya ligament aadha tut sakta hai ya complete tut sakti hai ya ligament puri tarah se tut sakta hai.

Jabh bhi ye partial hoti hai tabhi jo hamara treatment protocol rehta hai yeh partial ya complete decide hogi doctor ke examination ya MRI ke baad. Jabh bhi partial hoti hai jo hamara treatment protocol rehta hai wo rehta hai rest, humko sports koi nahin khelna 3 se 6 mahine, ice lagana hai aur pain killers lene hain aur kam se kam 6 hafte physiotherapy karni hai to ye charon cheez on se jo partial tear hai wo 95% of the time theek ho jata hai, lekin at the same time wo under the doctor supervision hona chahiye.

Jo baaki second injury rahti hai wo rehti hai hamari complete ligament injury usmein generally patient jab bhi aata hai doctor ke paas tabhi sabse main complaint pain aur imbalance ki hoti hai. Imbalance jab bhi aap fast chal rahe ho, jabh bhi aap seedhi niche utaar rahe ho fast to aapki knee mein imbalance hota hai aur buckle up ho jata hai knee aap jab bhi bhagte ho tabhi aap achanak se girne ka dar laga hua rahata hai.

To inshort jab bhi aapko, aapke sharir mein balance na ho aur dar lage ki abhi mera knee gir jaega ya main gir jaunga to that suggest ki aapko complete ligament injury hui hai jo after examination doctor ke aur MRI ke baad confirm ho jaega ki complete ligament injury hai. Is case mein most of the time jo treatment rahega wo hamara surgery rahega. Wo surgery mein hum sharir ka hi knee ke neeche ka ek extra ligament rehata hai wo use karke durbin ke dwara ya naya ligament fix kar dete hain aur wo ligament jo ham fix karte hain yah wala wo kuch 3 se 6 mahine ke physiotherapy ke baad as good as original ligament ho jata hai. To isiliye jab bhi humko ligament injury ya knee mein injury hui hai turant doctor ke pass jakar humko pata karna chahiye ki partial hi ya complete hai.

Thank you.

Hello,

My name is Dr. Kunal Makhija. I'm a practicing orthopedic and joint replacement surgeon, specializing in knee surgeries. Today we will talk about the very common ailment, the anterior cruciate ligament injury or ligament injury of the knee as the common people know. What happens exactly where is the ligament situated? What is the function of the ligament and what will happen if it is torn partially or it is torn fully and what are the treatment options available with us? That we will discuss in today's talk.

First of all, we have to understand that knee is made up of two bones the thigh bone and the leg bone, the femur and the tibia, these two bones are attached with each other with the help of cord-like structures known as ligament. The four most common ligament injuries are either lateral ligament, the medial ligament, the Posterior ligament or the most common which is anterior cruciate ligament or ACL.

Usually, in sports injuries like football, badminton or bike injuries or when you miss a step and fall down, the ligament which is injured is the anterior cruciate ligament because of the rotary motion of the upper bone on the lower bone, whenever this is torn, the ligament. The function of this ligament is mainly balancing the knee so after the ligament is torn, if it is torn partially the balance won't be hampered but if it is torn fully the balance of the knee would be hampered, in which case you won't be able to run fast, you won't be able to climb down staircase quickly, you won't be able to jump, you won't be able to do hops or in case you won't be able to do langri.

So these are the things which will determine whether you have an anterior cruciate ligament injury or not so if it is partially torn, the treatment protocol is painkillers, icing and physiotherapy at least for four to six weeks and avoiding sports for next three to six months and if it is fully torn, the ligament and you are not able to run fast, you miss a step or there is feeling of giving away at the knee, at that time you need to consult an orthopedic surgeon and mostly the treatment in these cases is an arthroscopic ligament surgery in which we take the ligament from the body itself and arthroscopically by the means of small cameras we fix the ligament over here and it is as good as the original one.

It is a lifetime procedure you need not go revision surgery and you can get back to sports as soon as three to six months but we have to take care that when the ligament injury has happened we consult a doctor as soon as possible because if it is a full tear and we ignore it, it will further deteriorate the knee condition and may cause arthritis, may cause meniscus tear and again, and again fall may lead to a major fall and you might end up having a fracture. So any ligament injury should be seen by an orthopedic surgeon as soon as possible.

Thank you

Hi,

I am Dr. Kunal Makhija, Orthopedist. Aaj mai aap ko techniques mein farak batana chahta hun jo normal surgeons karte hain and hum karte hain. Jab conventional joint replacement karte hain usmein patient ke ghutne ke aage ke muscle ko cut karke kia jata hai. Lekin ab nayi technique aayi hai jismein hum bina muscle cut kia joint replacement karte hain. Jismein hum skin cut kar ke pure ke pure muscle ko baaju mein leke aate hain aur puri sugery kar ke vapas aa jate hain. Patient surgery ke baad pain kam hota hai, blood loss bhi kam hota hai. Patient mein movements kafi jaldi aur better aa jaati hai. Patient ko physiotherapy ke sessions bhi kam lagte hain.

Patient ko medicines and injections bhi kam lagate hain. Surgery ke baad patient ka compliant rehta hai ki surgery ke baad bahut dukhta hai, bahut din rehena pada ya unka recovery period bahut hi lamba chala. Lekin is surgery mein recovery period kuch ghanton and dino mein hi khatam ho jata hai and patient 15-20 days mein hi normal life jee sakta hai. Yhi fayada hai is surgery ka. Umeed hai ki aap ko ye knee replacement ke baare mein samajh aya hai aur iskekya kya fayde hain.

Thank You.

Hi,

I am Dr. Hitesh Kubadia, Orthopedist. I will talk about the queries being asked about knee replacement.

Q1: How long my replaced knee lasts?

Ans: The knee should last for almost 15-20 years if you are taking good care of it. It also depends on the patient's moving activities. If a patient is in sports, it will not last for a long.
 

Q2: How long will it take for me to be back to the normal routine?

Ans: It is major surgery. The body takes time to adapt it. With minimally invasive surgery, it takes less time. But I would say that within a few days, the patient is able to take a round of their compound. They are able to go to the market and come back. Maximum time is required for 6-12 weeks to live a normal life. But yes, the patient may suffer from a little pain because the body is accepting the new joint. There is a bit of swelling around the knee. It causes some burning sensations around the knee. These are all the normal process of healing. They all settle down over a period of time.


Q3: Patients ask when I would be able to sit down and use Indian toilet?

Ans: I would never suggest my patients do those activities on a routine basis but doing once a while will not cause much harm. But if a patient is doing this activity continuously, the life of the knee will become much small. That is why it is never suggested to do these activities.

Q4: Patients ask, can I postpone my knee replacement with alternative methods, non-surgical methods.

Ans: Yes, osteoarthritis is a debilitating disease. It is a degenerative disease which happens with the age. Yes, there are times when we try to protect the knee. When we fail to give pain-free treatment then we talk about knee replacement. Physiotherapy in such cases helps a lot. Body muscles are very important to be strong. So, they decrease the load of the knee. And causes less degeneration around the knee. Sometimes, we also inject certain gels in the knee and helps the knee for the frictionless movements. And that also helps in causing less pain around the knee. These are a few methods tried in early and moderate arthritis. It is only when these methods actually do not help the patient to get enough pain relief in their daily routine. Then we talk about replacement.

Hi,

I am Dr. Hitesh Kubadia, Orthopedist. I will talk about the problem of the shoulder joint. Patients tell me that they have frozen shoulder. They may have frozen shoulder but what I have seen that it is not frozen shoulder in a few of the cases. What they have is called subacromial. They have some swelling in between 2 bones. Because of this, the movement of the shoulder gets restricted. This causes a lot of pain. This reduces the movement of the shoulder. This can be easily diagnosed in the clinical examination. Very rarely we need to do an MRI scan. We insert an injection in the joint which helps in reducing the swelling and pain.

The moment pain is reduced, the shoulder starts moving comfortably. Another common problem is of shoulder dislocation. The shoulder is a kind of a socket joint. It has a ball and a socket. The shoulder is a very versatile joint and requires a lot of movement. The socket is very shallow. To increase the depth, the tissue is called liberal tissue. Something will get teared then the only shoulder will come out. And when we put the shoulder back to its place, tissue also goes at its place. So, it becomes common for the shoulder to get dislocate again and again. Every time when shoulder gets dislocated, there is no damage causing in the ligaments. So, what is recommended?

We impair the tissue and then it is back to its place. This is done arthroscopically. When tissue is back to its origin, it prevents the shoulder from coming out. Another common problem we see in the older age group is the tear in the rotator cuff. Now, what is it? It is a very common pathology. A rotator cuff is a group of muscles. When tender tear, it actually goes back and comes and lies between the 2 bones. Again it causes pain. Being a very important stabilizer of the shoulder, taking out the shoulder becomes very difficult. So, what is to be done as it causes a problem in the routine activity. These are the common pathology are seen around for shoulders and they have a very good system of the treatment. So, treatment helps in decreasing the pain.

Thanks!

Hi,

I am Dr. Aparna Govil Bhasker, Bariatrician with an experience of about 13 years practicing in Mumbai. I deal with patients who are suffering from obesity. First thing I would like to share that obesity is a disease. Whenever we see the patient we see that somewhere they are also responsible for the weight that they are carrying. So, the first thing we need to realize that obesity is a disease like any other chronic disease. It is very similar to diabetes or heart disease and the progression is very similar to various stages. Today we define the stages on the basis of body mass index. That is the parameter that we use. So, if the BMI is between 23.5-27.5 then these patients are considered to be overweight. People between 27.5-32.5 suffers from grade 1 obesity. Any person with BMI more than 32.5-37.5 suffering from grade 2 obesity. Any person whose BMI is more than 37.5 suffering from grade 3 obesity.

When we talk about bariatric surgery, it is actually a treatment option for grade 3 obesity. And sometimes, for grade 2 obesity with 2 associated diseases like diabetes, hypertension, sleep apnea or say any other problem which is associated with obesity. The treatment will depend upon the grade of obesity. Now when we talk about bariatric surgery, it is basically a laparoscopic surgery, gastrointestinal surgery where we actually reduce the size of the stomach and some kind of surgeries where we re-route the intestines and join it to the stomach. There are 2 types of surgeries which are commonly performed in India: Laparoscopic sleeve gastrectomy. In this, we divide the stomach vertically. We create a small tube of the stomach. In this 65% of the stomach is removed out of the body. So, a small tube of the stomach remains inside the body. So, the amount of food gets reduced and they feel full early.

Another advantage, the person doesn't feel hungry much after the surgery. The other surgery is called a laparoscopic gastric bypass. This is one of the common and oldest surgery. It has one of the best results. In this small pouch of the stomach is created. So, here we are not removing any part of the stomach, we actually re-route the intestine to reduce the size of the stomach. This also has similar effects. The person is able to eat less. They don't absorb all the calories from the food. Now, it totally depends upon the patient's clinical profile. After a thorough evaluation, we see what surgery will be comfortable. All surgeries will lead to 65-75% of excess weight. Bariatric surgery also leads to very significant results and improves the quality of life. Associated diseases like diabetes, high blood pressures, sleep apnea, liver disease, lung disease, all these leads to a lot of improvement after bariatric surgery and overall health of the patient improves.

Weight loss happens over a period of about a year-year and a half. Most patients are able to maintain their weight. For the long term of weight maintained, a little bit of work is required from the patient's end as well. We do some degree of lifestyle and behavioral modification. Follow-up is a very important part of the whole program. Because good follow-up and great attendance keep the patient motivated. So, bariatric surgery is safe. In the end, I would like to say that when you are suffering from obesity, if you do not get treated properly, there are repercussions for that. And that can actually lead to a life-threatening problem. Doing surgery is always a risk and patients always think twice about it. But doing bariatric surgery for obese patients is much better than going into further risk. If you have any query regarding weight loss or bariatric surgery, you can contact me through Lybrate.

Thank You!

Hi,

 I am Dr. Pravin Gore, Proctologist. Today I will talk about Constipation. It is a very common problem. What is constipation? Is it the hard stool which is difficult to pass? Or patient has to push the stool? Or is it the blockage which happens? So, there are various definition. Patient feels no urge to go to the toilet. And they have to take medications. Patient would never be able to understand since when he is suffering from constipation. So, there are various tests that can be done to treat constipation.

We do the lab testing to identify the problems. We have scientific methods to overcome this problem. It is not always surgery. We do holistic approach. Dietary and lifestyle changes are required. We do pelvic therapy. 70-80% of the patients have found relief by taking this therapy. We also offer different kinds of surgeries to the patient like Stapled transanal rectal resection (STARR). 2nd is laparoscopic surgery. We do botox to get rid of constipation. So, constipation is a surgically curable domain. So, it has to be investigated properly and diagnosed properly.

Thank You!

Hi,

 I am Dr. Pravin Gore, Proctologist. Today I will talk about Constipation. Iss mein aap ko stools mein problem aati hai. 100 mein se 60 people constipation se suffer kar rahein hote hain. Logon ke alag-alag concept hain constipation ke liye. Log medical store se medicines lete hain aur kuch log treatment lete hain. Is type ke treatments se kuch dino tak hi patient ko aaram milta hai. Lekin baad mein pressure banna band ho jata hai. Kuch logon ko itni problem ho jati hai ki kabhi-kabhi unhein finger se waste ko nikalna padta hai.

So iska treatment bahut important hai kyunki hume janna hai ki constipation kis type ka aap ko hua hai. Ek bar hume vajha pata chal jaye to iska ilaj bohot easy ho jata hai. Isiliye humne dietition rakhein hain aap ko solution dene ke liye. Ye aap ko help karte hain ki bina kisi operation ke aap ko kaise help mil sakti hai. Medicines and pelvic floor therapy aap ko kaise help kar sakti hai. Isliye hum confidence ke sath kehte hain ki hum patient ki life mein change la sakte hain. Operation ke 4 types hain jiss se constipation ki problem ko thik kiya ja sakta hai. 1st is Stapled transanal rectal resection (STARR). 2nd is laparoscopic surgery, isme hum aap ki constipation se related jo bhi problem ho jati hai vo sab hum thik kar dete hain. Childbirth bhi aap ko constipation ka problem deta hai. Aise patients ke liye pelvic floor therapy bohot achi hoti hai. So, constipation bohot common problem hai. Isiliye iska treatment bahut important hai and ye problem thik ho sakti hai.

Thank You!