S L Raheja Fortis Hospital (On Call)

Hello,

I am Dr. Suresh Kumar Bhagat, Urologist. Today I will talk about kidney stones. Sabse pehle mai bataunga ki kidney stones ka rate 10-12% hota hai. India mein 100 mein se 12 logon ko kidney stones hain. Jismein se 50% logon ka kidney kharab ho jata hai. Sahi samay pe agar ilaj na kia jaaye toh ye problem hoti hai. Ab iska karan kya hai?Iske 2 factors hain. Ek factor hai jo humare body ke andar hai jisko hum change nhi kar sakte. Dusra hai bahar ke factors jisko hum kuch hadd tak badal sakte hain. Kuch age range hain jaise 20-45 ki age mein stones jyada hote hain. Male mein females se jyada stones hota hai. Plus ye hereditary bhi kam karta hai. Next hai aap ka climate, water intake, toh ye bhi affect karte hain. Iske symptoms kya hote hain?

Agar 2mm ka stones hai toh jyada problem nahi hoti hai agar vhi vo 6mm se jyada ho gaya toh aap ko pain hota hai. Agar stones bada hai jo kidney ko block kar deta hai ya fir chota stone ureter ko block kar deta hai toh aap ko severe pain hota hai. Vomiting hoti hai aap ko pain ke sath and emergency mein aap ko hospital jana padta hai. Ismein aap ko injection ke through medicine di jaati hai. Kabhi kabhi yadi vhi ureter ka stone aap ignore kar dete hain timely treatment nahi karate hain toh us se infection hota hai. Jiski vajaha se aap ko thand lagti hai and bukhar hota hai. Plus ye infection blood mein jata hai. Agar aap ko aisi problem ho rahi hai toh aap ko kisi na kisi urologist ko dikhani chaiye. Aur vo aap ko sahi salah denge. Dusri baat hai ki iska treatment kaisa kia jata hai. Ab latest technology ke according agar aap ke stones ka size up to 15-20 mm hai toh kidney mein surakh kia peshab ke raste se plastic ka durbin daal kar nikalate hain. Ye treatment mein deta hun.

Ab dusra point hai ki agar aap ne ilaj kar dia toh uske baad kya karna hai. Iske baad hum stones analysis karte hain. Hum aap ko salah dete hain ki aap ko kya karna hai ki stones formation na ho. Stones na form hon iske lia sabse badya dawayi hai paani. Paani ki matra badhayein. Jis se aap ka urine clear hoga. Is se stones banne ke chances kam ho jaate hain. Jisko ek baar stone hua hai use 1 saal ke anadar hi 5-10% stones dubara banne ke chances hote hain. Iske lia humein paani ki matra badhani chaiye. Kidney stones ko kabhi bhi ignore na karein kyuki jab vo chota hota hai toh use nikalana asan hota hai. Kabhi kabhi log puchte hain ki kya y apne aap dissolve hota hai? Aisa nahi hai. Koi bhi kidney stones apne aap dissolve nahi hota hai.

Surgery ki jarurat bhi tabhi padti hai jab stones bada hota hai. Aap ko medicines di jaati hai 3-4 weeks ke lia urologist ke dwara. Yadi bukhar aa raha hai ya fir pain hai toh use nikalna padta hai. Kab kab stones nikalna jaruri hai. Agar aap diabetic hain, ureter stones hain toh wait na karein aur treatment lein. Agar aap ko ek hi kidney hai toh use endoscopic technique ke dwara stones nikalana jaruri hai. Prevention is better than cure. Isliye adhik matra mein paani pijiye. Red meat kam khayein. Namak kam lein. In sabko karne se aap ko stones ki samasya fir se nahi hogi. Asah karta hun ki aap ko meri baat samajh aayi hogi.

Thank You.

Hi,

I am Dr. Suresh Kumar Bhagat, Urologist. Aaj mai aap ko blood in urine ke baare mein btaunga. Agar aap ko ye problem hai toh ise andekha na karein. Urine mein blood aane ke kayi reason ho sakte hain. Agar aap ka age 40 above hai aur aap ko urine mein blood aa raha hai and pain bhi nahi hai toh aap urologist se suggestion lein. Agar aisa hota hai toh aap ko kidney ke aas pass kahin tumor ho sakta hai and cancerous sabit ho sakta hai. Agar aap ko aisi problem hai toh without fail urologist se consult karein. Kyuki jab bhi koi tumor initial stage mein hota hai toh iska ilaj asan hai and kafi successful hai.

Urine mein blood aane ke kayi karann hain. Aap ko prostate ho sakta hai, dusra peshab ke thaile mein tumor ho sakta hai, kidney stone ho sakta hai ya fir aap ko kidney ya fir kidney ki naali mein TB bhi ho sakta hai. Toh mai aap ko yahi salah dunga ki agar aap ko urine mein blood aya hai toh isko ignore na karein. Infection ho sakta hai, tumor ho sakta hai jo cancerous ho sakta hai, stone ho sakta hai and TB ho sakta hai. Isliya aap ko aisa kuch bhi dikhta hai toh aap jaldi ho urologist se consult karein. Peshab ke thaile ka cancer, kidney ya kidney ki naali ka cancer, ye bimariyan cigrette peene vale ya fir die factory mein kam karne valon mein jyada dekha gaya hai. Isliye aap urologist se consult jarur karein. Agar aap initial stage pe hi consult karte hain to durbin se bimari ka ilaj asani se kiya ja sakta hai. Treatment ka outcome bhi patient ke liya acha hota hai. Mai umid karta hun ki aap ko meri baat samajh mein aayi hogi.

Thank You.

Hi

I am Dr. Suresh Kumar Bhagat hai. Aaj hum aapko kidney failure ke bare mein kuch batana chahte hain. Jo kidney failure ke 2 mukhya karan hain. Diabetes aur high blood pressure. India mein diabetes ka incidence bohot jyada hai aur India ko world ka diabetic capital bola jata hai. Ab main aapko thoda bohot diabetes ke bare mein bataun jo aaj kal humare jeevan ki shaili jo hai hum Jyada gaadi use karte hain, paidal kam chalte hain, jo hamara khane peene ka Jo lifestyle hai usme kafi change ho gaya hai. Hum chalte nahi hain, hum exercise bhi nahi karte hain, junk food khate Hain, tel-gheei Jyada kehte hain aur sabse badi baat hai ki aaj kal ka jo jeevan hai wo kaafi (stressed) tanavpurn ho gaya hai to hum diabetes se kaise bache. Sabse pahli baat ki aap santulit khana khayein, aap Jada urja wala khana nahin khaya, jaise ki aapke khane Mein salaad hona chahiye aadhe sex adhik aur carbohydrate kam hona chahiye aur tel-ghee barabar kamm matra mein hona chahiye.

Jo kidney failure hota hai uske do mukhyatar Karan hain, madhumeh Ki bimari aur ucch rakt chaap(Diabetes aur high blood pressure). To hum diabetes ko control rakhen aur high blood pressure wale jo bhi marij hain wo niyamit roop se dawai lein aur namak kam khaye aur jo sabse jaroori cheezein hain wo hai vyayam. Aadmi ko physical activity karni chahi kam se kam aap Saptah(week) mein 4 Din 45 minutes brisk walk karen aur aapko ye dhyaan rakhna chahiye ki aapki Jo kaamr hai aur aap ka jo pet hai, kamar Se Jyada pet ki motayi nahi honi chahiye. Dusra hai diabetes. Diabetes ke liye bhi Jin logo ko diabetes hai madhumeh hai usko diabetes ki dawa niyamit roop se leni chahiye. Blood pressure niyamit roop se janch karni chahyie aur aapko Kidney failure se bachne ke liye aapko apne doctor ki salah leni chahiye aur koi bhi bina salah ke koi bhi dawai nahin khaye. Ab Jo kidney failure hai uske mukhya kya karan hote hain?

Mukhya karan maine aap ko bataye madhumeh ki bimari aur ucch eakt chaap. Iske lakshan kya hai? Shuru mein Jab kidney bimari hoti hai, kidney failure Ki bimari hoti hai to uske bohot lakshan najar nahin aate hain to kaise maloom hoga ki jo patient ko high blood pressure hai aur diabetes ki bimari hai uska kidney failure to nhi develop ho raha unko? Uske liye bohot aasan screening test hai. Blood test karte hain usme serum creatinine dekhte hain, proteinuria dekhte hain proteinuria mein protein to nahin aata hai. Serum creatinine badh to nahi raha hai aur samay samay par ultrasound karte hain kidney ka uski andruni bnawt dekhte hain ki usme koi changes to nahi aa rahe hain, yadi aapka creatinine normal hai, urine mein protien nahi aa raha hai to aapka kidney sahi hai. Kidney failiure ke Mukhyta jo lakshan hai, aapke chehre par sujan aana jo aakh ka eye lid hai usme bhi sujan aata hai, pairon me sujan aata hai, aapko bhukh Lagna kam ho jata hai aur aapko peshab ki matra bhi kam ho jati hai. To is tarah ka yadi lakshan hai to aap kidney ke chikitsak se milen jisko nephrologist bolte hain aur nephrologist ki salah lein aur kuch haad tak kidney failure ko roka ja sakta hai. Nephrologist ki salah se.

Jab aapko kidney failure ka lakshan najar aane lage to aap kidney ke physician ki salah lete hain aur dheere-dheere uska ilaaj karte hain. Lekin ek samay aisa ataa hai ki jab aapka kidney permanently fail ho jata hai usko bolte hain CKD stage 5 aur usme aapka kidney ka jo kam karne ki shmta Hai vah 10% se bhi kam ho jata hai us samay aapko dialysis ki jarurat padti hai. Dialysis ki jarurat Kabh padti hai yadi aapka saans full raha hai, aapke shareer mein potassium ki matra jyada ho gayi hai aur aapke poore body mein sujan ho gaya Hai. Is tarah ke lakshan jo hote hain usme dialysis ki jarurat padti hain. Dekhiye dialysis ki jarurat aap temporary dialysis kar sakte hain. Jo Kidney failure ka last stage hai uska end stage renal disease ya CKD 5 stage bolte hain. Uska jo best treatment hai wo kidney transplant hai, Gurde ka pratyaropan. Ab mai ye batana chahta hoon Ki dialysis aur kidney transplant mein kya antar hai. Dekhiye dialysis se aap sirf khoon ki safai karte hain lekin jo transplant hai usme aapko ek normal kidney aap ke shareer mein lagaya jata hai kyunki blood filtration ke alawa kidney jo blood ko saaf karne ka kaam karta hai uske alawa kidney se khoon banne mein bhi sahayata hoti hai.

kidney se ek hormone bhi release hota jisko erythropoietin bolte hain wo khoon banne mein sahayata karta hai, fir vitamin D ke synthesis ko bhi madat karta hai kidney aur kaafi saare cheezein hai jo ki aapki normal kidney se nikalta hai. To normal kidney or dialysis mein bohot fark hai. Yadi aap dialysis par rehte ho toh aapko hafta-hafta khoon banne ka injection diya Jata hai aur fir vitamin D ki goli khani padti hai aur dialysis ke liye aapko hafte mai 3 bar hospital jana padta hai aur aapke saath ek adami hota hai. Jiska bhi kam apna rojgar band karke aapke sath hota hai. To dialysis ka jo kharcha hai kaafi jyada hota hai mahine mein kam se kam to 30,000 rupaya jata hai ek admi ko dialysis karne mein kyunki aapko injection lagta hai aur aap ka jana aana aur aap ke saath jo aadmi jaate hain unka bhi jo kaam hota hai wo kaam band karke jana padta hai. Yadi aap dialysis par rehte hain jo diabetic patient hai usme dialysis mein logon Ko 4 ya 5 saal ya 6 saal mein logon ki death ho jati hai. Kafi logon ki kam se kam 30% se 40% logo ki death ho jati hai aur jo transplant hota hai usko karne ke 2 tarike hote hain.

Ya to aapke family member, aapke mata, pita, bhai, behen, aapki patni aapko ek gurda de se agar wo normal hai to. Normal kahane ka matlab ki jo donor hai jo aapko gurda dena chahte hain unko diabetes ki bimari nahi honi chahiye, high blood pressure hai to bhi de sakte hain to bhi gurda de sakte hain bas shart hai ki unka end organ damage nahi hai. End organ damage ka matlab hota hai unko aankh mein retina mein koi bimari na ho, urine mein protein na aa raho ho aur yadi aap ECG karte hain ya echo karte hain to usme heart mein koi soojan nahi ho, left ventricular hypertrophy bolte hain wo nahin hona chahiye aur aapka blood pressure ek single medicine par control hai to aap kideny de sakte hain. Abhi aapke pass 2 kidney hai or koi bhi adami, normal aadmi jiski umar 18 se 65 saal tak hai apni 1 kidney donate ker sakta hai isko bolte hai live related kideny transplant aur dusra tarika hota ha dusra hota hai cadaveric transplant iska matlab hua ki yadi kisi bhi vayakti ka road-traffic accident mein head injury hota hai ya kisi ko brain hemorrhage ki wajah se behosh ho jata hai aur vah ICU main admit rehta hai aur usko neurosurgeon intensivist sab log braindead ghoshit kar diya jata hai.

Braindead ka matlab hua ki aap bina life support ke ventilator ke aur blood pressure maintain karne wali dawa ke bagair aap nahi raha sakte hain aap ka jo saans ki parkriya hi nahi chal rahi hai aur aap ka blood pressure nahin maintain ho raha hai to us patient ko braindead bolte hain. Uske liye hum log apnea test karte hain aur yadi ye test positive hota hai to usko braindead declare karke aur unke family walon se unki consent ya sehmati karke aapka kidney transplant ho sakta hai Jisko cadaveric transplant bolte hain to mai yahan par kafi transplant karta hoon, cadaveric bhi karta hoon aur live related bhi karta hun aur sabse badi baat hai ki jo donor nephrectomy hai, mai laproscopic method se nephrectomy karta haun jisme ki marij ko pain kam hota hai aur 3 din se 4 din ke andar uski chutti ho jati hai aur kafi accha patient ki recovery hoti hai Kafi achha hota hai.

To jo transplant hota hai, transplant karne ke baad aapko 3 se 4 din ICU mein rakha jata hai. Transplant ICU mein aur dheere-dheere aapka jo serum creatinine hai. Urine output sab measure karte hain, blood pressure monitor karte hain aur aap haft-din mein chutti hoke ghar chale jate hai. To transplant ke kitne fayde hain ki aapko dialysis se chutkara mil jata hai aur ek normal zindagi vyatit karte hain to kidney transplant ke bohot fayde hain lekin Yehi hai ki aapko zindagi bhar immunosupression wali dawa Di jati hai jisko khana padta hai aur Iske alawa dialysis aur kidney transplant mein kafi difference hai. Mai yahi samajhta hoon ki kidney transplant jo hai kidney failure ke liye sabse best ilaaj hai sabse uttam ilaaj hai aur logon ko kidney transplant ke liye aage aana chahiye aur jo aapki family hai unko acche se council karke ek gurda de sakte hain normal aadmi usme koi takleef nahi hoti hai logon ko.

Ek aur mahatvapurna baat batana chahta hoon ki India mein kaafi saare patient kidney transplant ke hote hai jinko ki organ nahi milta hai ya to unke family mein diabetic patient hote hain aur kyunki aajkal to jo family ka size hai kafi chhota ho gaya hai wife, husband, ek ya do bacche to jyadatar live donor milne mein takleef hoti hai isliye mera ye aapse nivedan hai ki aang-daan kare aap 1 organ donor bane jisse ki aap 5 se 6 logo ka jeevan bacha sakte hain aur logon ko jeevan daan de sakte hain yadi bhagwan na kare kisi road traffic accident mein aapko head injury ho aur apka bachana mushkil ho jaaye to us condition mein aap 1 organ donor bane aur un logo ko jeevan daan dein. To kidney failure se bachne ke liye kya upay hai main aapko shortcut mein, bohot brief mein batana chahta hoon ki aapko yadi diabetes hai to diabetes yani blood sugar ka control kare. Regular apna routrin urine dekhte rahe, blood urea, serum creatinine check karte rahe aur BP (blood pressure) ko control rakhe aur koi bhi aadmi yadi dard ki dawa regular khate hai to ek isko nonsteroidal anti-inflammatory Jaise combiflame hua, ibuprofen hua, diclofenac hua ye sab dawa khaane se bhi kidney par bhi iska nuksandeh asar hota hai aur mera to yahi sujav rahega ki jab aapko jod aur ghutne ka dard ho to bina doctor ki salah se dawa na khaye aur apna blood urea, creatinine hamesha karte rahe. Apne man se kabhi bhi dard ki dawa naa lein adhik matra mein kyunki wo aapke gurde ke liye hanikarak siddh ho sakti hai. Main asha karta hoon ki meri baat aapko samajh mein aayi hogi.

Thanks!

Hi,

I am Dr. Suresh Kumar Bhagat, Urologist. Aaj hum aap ko kidney stone ke baare mein btayenge. Kidney stones ko kabhi bhi andekha na karein. Agar aap ki kidney mei 4-5mm ka stone hai toh pani jyada peejeye lekin ek baar urologist ki salah jarur lein. Yadi vahi stone ureter mein aake fus jata hai toh vo aap ke gurde ko nuksan phucha sakta hai. Jyadatar yahi dekha gaya hai ki 6mm se chote stones nikal jaate hai. Stones ka problem jyadatar un logon mein dekha jaata hai jo bahar kam karte hain and paani kam peete hain ya fir patient ki family mein vo bimari run kar rahi hai ya fir unmein ye problem hoti hai jo mountains ya fir desert jaisi jagaha mein rehte hain. Isliya main aap ko ye suggest karta hun agar aap ko stones hai toh urologist se consult karein. Unse khaane peene ke baare mein puche ki kya khana chahiyai and kitna paani peena chahiyai.

Agar aap ka stine 5-6 mm se bada hai toh stones ki problem aap ke liya dangerous ho sakti hai. Aur agar aisa stone hai toh aap ko niklvana chahiyai kyuki aise case mein apne aap stones nikalne ka instances kam hota hai. Aise stone ko ignore nahi karna chahiyai. Jarur urologist se consult karein kyuki agar aap ko fever ho raha hai ya vomiting ho raha hai toh aap ko kidney mein infection ho sakta hai. Isliya aapke ureter ka kam karna kabhi bhi band ho sakta hai. Logon ko lagta hai ki ayurveda medicines lene se stone dissolve ho jata hai. Agar stone 4-5 mm ka hai toh stone dissolve ho jayega lekin aap ko diabetes nahi hona chahiyai, single kidney nahi hona chahiyai, aap ko fever nahi aana chahiyai.

Aise condition mein aap 2-3 weeks wait kar sakte hain. Paani piyein and Dr se consult karein. Agar aap ka stone nahi nikal raha hai toh use nikalne ka bahut hi easy method hai. Endoscopy method se nikala jaata hai. 6mm se bade stone ka apne aap nikalne ka chance bahut kam hota hai. Isliye urologist ka suggestion leke use nikalwayein. Aur puchein ki aisa kya karna hai ki kidney stones aap ko baar baar na ho. Sabse easy way hai ki paani jyada lein. Aap ko kaise pata chalega ki aap pani sahi matra mein le rahein hai. Aap ka urine color paani jaisa hona chahiyai. Main aasha karta hun jo maine aap ko kidney stones ke baare mein bataya hai vo aap ko samajh aaya hoga.

Thank You.

Hi!

I am Dr. Shailesh Mishra, I am orthopaedic surgeon. I am specialized in arthroscopic surgery and joint replacement. Today I am going to talk about shoulder injuries particularly shoulder dislocation. Dislocation means popping up of joint that is joint is made up of two bones together joined by the fibrous tissue. The shoulder joint is made up of glenoid; glenoid which is part of scapula bone and humeral head which is part of humerus bone. These two are held together by fibrous tissue which is capsule and the thicker portion of capsule is labrum. In case of a dislocation, these capsular-labral structures are tonged and this humeral head pops out of the joint. Why shoulder dislocation is the most common dislocation? The shoulder is made up of two bones where glenoid is smaller as compared to the humeral head, because of this mismatch in the two bones, the shoulder joint is inherently unstable joint and hence this dislocation is the most common. What are the types of dislocation? The dislocation can be anterior, posterior or inferior.

The dislocation can be partial where not the entire head has come out, only the half of head has come out and it reduces back, it can be complete dislocation where the entire humeral head pops out of the joint. Typically, patient presents with pain around the shoulder joint, swelling, deformity where the roundness of the shoulder is lost, patient is not able to touch the opposite shoulder, the rotations of the shoulders are restricted. Causes of the shoulder dislocation: shoulder dislocation can occur because of the sudden blow as it is during the vehicular accident, because of the sudden force around the shoulder joint like in sports injuries like hockey, football, rugby. It can occur also because of the sudden fall where the patient falls on the shoulder joint and because of sudden force shoulder joint pops out of the capsule. Treatment for the shoulder dislocation in case of the acute event the manual reduction of the shoulder joint is recommended. The reduction should be under sedation or general anaesthesia. Manual reduction without anaesthesia or sedation can cause more damage to the shoulder joint because of the contraction of the muscle along the shoulder joint.

When there are two or more episodes of dislocation that is recurrent dislocation of shoulder joint it requires a surgery. There is a dictum in the shoulder once dislocated always dislocated that is that means once a dislocation has occurred the capsular-labular structure which is damaged do not repair on their own and repeated dislocation can occur. There is almost 80-90% of the incidents of repeated dislocation after the first dislocation. Particularly in sports injury cases, there is always surgery is required. When there are two or more episodes of dislocation that is recurrent dislocation, surgery is recommended because in case of recurrent dislocation this capsular-labular structure has not healed. Surgery, we recommend, is in the form of arthroscopic surgery where the 2-3 keyholes are made around the shoulder joint and the repair is performed with the help of arthroscope and vidoescope, through specialized thing 4-6mm instruments.

The advantage of the surgery is that it is painless, there is no blood loss or very minimal blood, loss recovery is very fast, the patient can be discharged same day or at the max next day. In case of multiple dislocations, the glenoid bone may be lost to a certain extent, depending upon the magnitude of the glenoid bone loss different surgery is recommended as a portion of the clavicoid bone is transferred to the anterior part of the glenoid which is called latarjet surgery. In this, the dislocation is prevented because of the coracoid bone which is transferred and the muscle attached along the coracoid bone which acts as a sling effect. After surgery patient has to undergo physiotherapy and rehabilitation which lasts for around 6 months to 12 months, to undergo rehabilitation and physiotherapy. Physiotherapy goes for around 3 months to 12 months depending upon the lifestyle activity. In sports injuries, the physiotherapy and rehabilitation go for around 12 months. We make sure that they reach to their pre-injury level and they resume their sports. If you have any query, you can contact Lybrate.

Thanks!

Hi,

I am Dr. D G Saple, Dermatologist. This clinic was started 11 years back. There is growing demand from the patient for clinical dermatology that Dr you being a skin specialist will give good cosmetology. Why don't you start cosmetology clinic? We are expert in skin, hair, acne, pigmentation, filler and botox. This group of us came together and started this clinic. We take proper history of the patient.

Decision is taken by the group of the Drs not a single Dr to plan the treatment. We have facility like skin biopsy, allergy test, microscopic examination for fungus and tricloscan for hair. We have Q-switched for pigmentation, laser hair removal, anti-ageing equipment. We do hair restoration therapy, stim therapy, PRP and laser therapy. We have a good counseling team. Our centre is well known for academic career and interest. So lastly, our centre is for skin, hair problems. We group of Drs working together to give better result.

Thank You.

Hi!

I am Dr. Shailesh Mishra an orthopedic surgeon and specialized in shoulder surgery, sports injury and joint replacement. Today I will be talking about anterior cruciate ligament (ACL) injury. It is a very important structure of knee joint. This is knee joint which is made up of thigh bone which is femur, shin bone i.e. tibia and the patella cap. ACL is a stabilizer of knee joint while doing sports or routine activity or walking. It helps in maintaining the stability of knee joint. ACL might get injured because of various activities like sudden stoppage while running. While jumping from a height because of improper landing the ACL might get damaged. In other support activities like football, volleyball and rugby, injury can harm ACL. Immediately after injury, rest, anti-inflammatory compression is the treatment when there is swelling and pain in the knee. It is very important to immobilize the knee with the help of long knee brace. After that, you must consult an ortho who will assess the degree of the injury to the ACL and to the other structure of the ligament to the knee.

The treatment varies as per the structure and injury. If the injury is partial or there is only sprain, it can healed. Symptoms are pain, swelling, restricted movement of the knee and there can also be a locking of the knee, when meniscus gets locked and torn in the knee. There can be clicking or popping sensation in the knee. While climbing stairs there can be instability of the knee. Patient may feel imbalance when they put weight on that particular injury. Treatment depends on the extend of the knee. If injury is just the sprain then ACL can heal on its own. And patient can regain the strength by exercises. If it is completely toned, it does not heal on its own. There is the fluid inside it which doesn't allow to form. Clot formation is very important for any healing processing the body. In such cases, patient usually has to go for surgery.

Surgery is in the form of arthroscopy surgery. Surgery can be performed through 3 holes. While surgery 2 tunnels are made. One is in the upper bone and one in the lower bone. And the graph is passed from the tibia inside the joint to the upper bone. This is the new tissue which can be either taken out from the patient himself that it is called autographt and if it taken from some other body than it is called allograft. In India allograft is not available. It is also not allowed by the government. My preference for autographt is hamstring tendon. With the latest technology the recovery is much faster and it saves more bones in the revision scenario. Patient might get the same injury in the future also. We have to reconstruct the new ligament for the patient. Now patient can walk from next day onwards with the help of walker or crutch.

And after 2 weeks patient can walk on his own. The patient may have questions, when they can start driving. It actually depends on the individual's strength. Neuromascular require the coordination between foot muscles and hand muscles for driving. We ask them to drive at around 6th week. After reconstruction, the ligament is fixed to the bone with the help of screw. However, there is a constant process of new collagen formation and ligament takes a year. The ligament which we are putting is totally substituted by patient own new collagen formation and this whole procedure takes around 1 year. Ligament continues to develop more strength. It also depends upon how well the patient is doing physiotherapy and rehabilitation process. Usually, by end of 1 year, sports man can resume his activities for sports. Sports person also questions whether they can perform on the same level or not. But it is entirely upon the rehabilitation and the physiotherapy.  When they have complied more than 90% of strength, we allow them for the sports activity. With the help of the tests, we can assess the strength. Can they have this kind of injury again in their life? Of course, they can have. Because they are engaging in high risk activities, if they injured for the first time, they can get injured for the next time as well. However, the treatment is possible for 2nd time also. For more information or to book an appointment with me, please contact lybrate.com.

Thank You

I am Prof. Dr. D G Saple. I was the head of the department of Dermatology Venereology and Leprology at Grand Medical College, JJ hospital Mumbai and practicing Dermatology for last 39 years. Also running clinic at Dadar Hindu colony for many years including Centre for Dermatology and Cosmetology. Cosmetology practice we started for last 15 years but Dermatology practice we’re doing for last 38 years. The patient coming to our clinic they are given at most important, first what is their need, what is their problem and what are their solution. We explain to the patient properly then patient has to take a call, patient has to decide. We only explain to the patient about their illness what test is required what is the treatment which is necessary and accordingly we ask patient to take their decision.

In skin mainly patient come for Atopic dermatitis some people call it Eczema, Psoriasis, white patches, Urticaria allergy and now days fungus infection has become very common and unfortunately there is not much literature on this fungus infection but we are work for last 5 years and found solution for this fungal infection. Because there are not much literature many Dermatologist are not aware this fungus disease can be treated, we can prevent their relapse, we can prevent their spread. That is our speciality or that is the work we're done for last 5 years. In Cosmetology we have published many National and International papers mainly the patient that come for cosmetology either they come for the pigmentation, for the acne or they called it pimple, scars or sometimes they come with the photosensitivity so these are the common things they come.

As per hair is concerned now the hair losses become suddenly it is a big problem. Almost one third of the young population all the world they are suffering for the hair loss when they come for the hair loss many people feel there is a prototype treatment but it is not so because you have to find out the cause of the hair loss weather it is because of the low hemoglobin, because Vitamin D3 deficiency, because a vitamin B12 deficiency we have to find out, otherwise underlying cause like thyroid problem or blood sugar problem or kidney disease and accordingly or to treat. But most of the patient young boys they come with hair loss they are suffering from it what we called male pattern or in the ladies or the girls it is called female pattern hair loss which is the natural, it is a natural evolution of people.

But there we find the history either father or mother or grandfather or grandmother somebody was suffering from these and there's a family history which is very important, so we have to find out what is the cause of the hair loss and accordingly we have to treat. So when we're treating the hair loss it can be medical treatment it can be injectables or sometimes they need hair transplant, but when they need hair transplant there are certain conditions we have to rule out whether the person's hair transplant would be useful or not, it will give good results or not, otherwise we should not be in hurry. Many time patient comes, doctor my friend you have done the head transplant he has got good hair.

But then after seeing him we find their donor area they do not have enough to transplant so those patients they do not get good results. So we have to see in many factors before going for the hair transplant, whether it will be useful, it will last long or not. Then other diseases like Vitiligo that is a white patch. When they come for white patches, all white patches are not leucoderma. Again there are many causes of white patches. One of them is Vitiligo another is Albinism there are many causes. So we have to find out again what is the cause of this white patches and every patch is not leucoderma. Once we know what is it, accordingly we treat and in the leucoderma nowadays we have medical treatment, we have got surgical treatment that is skin transplant and we have got a laser therapy. All these skin hair pigmentation and acne problems when you have any query or if you want to consult you can contact La Mer clinic of Dr. Saple through Lybrate.

Thank you!