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I am 22 years old my hair growth ids suddenly stopped and a more hairfall which shampoo and oil you must be required for me.
I am 53 years old, weight 76 kgs, height 163 cms, diabetic since 10 years and on insulin. Fasting sugar : 120, PP : 200. Please suggest a diet for me to control my diabetes and also lose weight.
Benefits of Bilateral Total Knee Replacement
I am Dr. Rakesh Nair. I am an exclusive knee replacement surgeon practicing at Zen Hospital in Chembur. I am also attached to the Fortis Group of Hospitals at Vashi and Mahim and Holy Family Hospital at Bandra. Today, I am going to talk about Bilateral One Stage Total Knee Replacement. To understand the basic term which I have used here when I say Bilateral One Staged, I say both knees and one sitting. They are done together once the patient is wheeled in. They are not done in a gap of a few days. That’s what I mean by both knees and one sitting.
In the surgery, all we remove is hardly 7-8 mm of bone from the thigh bone and around 7-8 mm from the shin bone, that is the lower part and all we do is just change the cap. It’s like changing the cap of a tooth, so your bone and your muscle are your own. We are not chopping off the whole knee and replacing it. So, that is the reason why I am using the terminology Knee Resurfacing, we are changing only the cap.
Once the cap is changed, we are able to mobilize the patient, the same evening if required. And, with the advanced anesthesia techniques that we have, I am able to make the patient walk the same evening. So, there are some videos here also which would tell you the same where the patient has been operated in the morning by around 12 o’clock once he or she is wheeled out the operation theatre. In another four hours by 4 o’clock evening, the patient is walking with full weight on the leg without much pain because of the pain techniques that we in terms of the pain management.
Now, why would I say that we should be doing both knees in one sitting? So, what are the advantages of doing both knees in one sitting? If you see the further videos which I would also show you, most of the patients who come to me have severe deformities. They, like, have severe bow legs, legs which are severely bent, either towards the inside or either towards the outside. So, doing one knee and then doing another knee is not going to help at all because the patient is not going to be able to walk. So, when I do both knees in one sitting it restricts the surgical procedure so it is like saying I do everything under one anesthesia. The patient gets short of medication. The medicines also which go into the body is once you are wheeled into the operation theatre. The most important part is that the patient can be mobilized very easily because immediately both the legs are straight and the patient can walk with full weight bearing on both the legs. So, I can make the patient walk in the evening or the next day depending on how strong the bones and the muscles are. Another thing is, it reduces the hospitalization also, plus the hospital cost also goes down because we don’t double use the medication nor the stay is doubled. The stay is same; it varies between 3-7 days depending on how strong the patient's knees are before surgery. So, I would definitely advocate doing both knees in one sitting.
What are the main advantages and what would you say in terms of why wouldn’t we do a knee after a week or 10 days? There are studies which say that it is not the number of joints, so the number of knees you do in which causes the problem or the commonest cause which is an infection. The problem arises if you keep on wheeling the patient into the operation theatre. So, if somebody says that we do a knee today and then we do a knee after 4 or 5 days then cases of infection will increase because the patient is being wheeled into the operation theatre on two separate occasions. So, it is not that I have not done both the knees in one sitting, which is a better option because the chances of infection are less than doing one knee now and then doing the other knee after 4-5 days, where the patient gets the same medicines repeatedly plus he is bought into the operation theatre again and his stay also increases in the hospital.
We would be showing you some videos where the patient, how the patient is walking before surgery. If you see most of these patients, the legs are severely deformed. So, all of them I have been able to do a One Staged Bilateral Knee Resurfacing where I have done both the knees in one sitting. You see them how they are walking before surgery, you see them how are they are walking after surgery. And, if you compare the function, they are really able to walk very comfortably.
My patients even sit cross-legged after surgery but that is not. I will show you one of these videos which are showing the patient sit cross-legged after surgery. But that is not something which we promote. It is just to show that they get very good function and they would definitely be able to sit cross-legged but that is not something we tell the patient to do because that compromises on the life of the knee. So, there are a lot of records and results which say that, whether we do a Bilateral One Staged Knee Replacement or whether we a One Staged Knee Replacement, the complications in terms of infection, an embolism is always similar. In fact, it is much more in a unilateral knee than in a bilateral knee.
We use body exhaust play suits, again, during surgery. I will show you this video which is showing you the body exhaust play suits where we are working in a very sterile environment. We would not want to give any infection even from the OT personnel to the patient. So, these are body exhaust playsuits which prevent the impure air breath out of the operating team, it is not allowing it to go to the patient. In fact, it is sucked up by a rotating fan which is there on top of the body exhaust playsuits and the whole impure air is taken out from the patient’s atmosphere. Even our conventional methods of mixing cement have been changed and we are using basically vacuum mixing for cement so there again is no impurities in the bowl in which we are mixing the bone cement to fix the implants to the bone.
We have all the options in terms of the knee replacement where we even have computer assisted Total Knee Replacement. We have Unilateral Knee Replacement where basically the unilateral knee replacement is used for younger patients who have deformities or pain in the insides of the knee where only a part of the knee has been damaged, the rest of the bone is all right, that’s where we use the Unilateral Knee Replacement. The latest what we have is the Customized Jigs in Total Knee Replacement where we get the MRI done of the affected knee. On the basis of the MRI, ceramic Jigs are made and on the basis of the ceramic Jigs, the positioning of the implant can be as perfect as required. Obesity has always been, the patient has always come up to me saying, “Doc, I am little on the heavier side, I am so heavy, is it a contraindication to my surgery?” So, obesity as such is not a contraindication to surgery. Definitely chances of wound healing are a problem but, instead of a week to ten days, it will take another week to ten days for healing. Otherwise, it is not a contraindication to the surgery.
Now, a very important question which comes from the patient is, “Doctor, how long will these knees last?” So, I give a very simple answer to that is that, the more you take care of it, the longer it will last. So, the longevity of the knee all depends on how strong your muscles are before surgery, how strong your bones are after surgery or before surgery and depending on that we normally get a bone density done for the patient and we treat the patient either on a yearly injection for osteoporosis or daily injection which are meant to fill up the bone and that decides on how well the implant is going to hold on and how long the life of the knee is going to last.
For further information, you need to contact me through lybrate.com.
I am suffering from mucus problem last 4 month and my weight is also decreasing day by day. Please provide me the solution.
Hi Doctor. Please suggest me. 1. After Intercourse I thinks after released my sperm that I should need some energy drink or food that scare for weakness. Please suggest. 2. I drink water always after Intercourse so Is It fine? 3. Can I do un-natural sex like, Can I insert penis in back side using Oil eg. Middle in buttock. 4. Nipple size increasing so much so she is worrying so much so please suggest how to decrease nipple size so she can wear fit cloth like Bra etc.
I have the habit of masturbation does it cause hair fall my hair is losing Give some tips for get rid hair fall My hair becoming tinny.
Hello sir my name is swidas mughante I am 40 year old man I am having white spot problem since last two year tell me what should I do.
I am 23 year male. I am married. I am having severe headache always atleast 3 to 5 times a day. Headache area is upper side of the eyes. I think it is sinus headache. I always have cold and I drink cold water also. I am very disturb and not getting any suggestion what to do please help me to understand and what to do now. I am having this problem since 5 years ir more. One more thing I have past high blood pressure treatment but now it is fine. Now my blood pressure is always. 140/80 or 130 /80. Waiting your your valuable reply thank you.
It is important for you to have a healthy and balanced body in order to perform your daily activities well. People often think health supplements are efficient alternatives to a healthy diet and regular physical exercise while most of the doctors and nutritionists believe that there is no need for any health supplement if you take in right quantity and quality of food and engage in regular exercise. While health supplements are not alternatives to a healthy lifestyle, they are somewhat necessary for everyday health in the hectic lifestyles of today.
Nowadays, stress (learn more about for Controlling Everyday STRESS) is a constant companion and the foods that we consume are often not of proper quality. You may think that you are taking foods full of nutrients but pesticides and chemicals used farming diminish the nutrient content from the crops. This creates a necessity for taking health supplements for the proper nourishment of body.People with certain medical conditions also need supplements. Supplements fill the gap in your diet.
Beneficial health supplements:
- Pregnant women and breastfeeding (leanr more about the Benefits of Breastfeeding) women need iron supplements. Folic acid can be supplemented in your diet in order to reduce the chances of birth defects.
- You can take in vitamin D supplements if they don't get enough sunlight every day. Adults, especially after the age of 40 need vitamin D and calcium supplements to maintain bone health.
- Adults above the age of 40 are also advised to take vitamin B-12 supplements.
Supplements have some side effects depending upon your health condition. If you take some supplements along with some other medicines or before surgeries, they can lead to serious complications. Research has concluded that some vitamin and minerals supplements particularly iron supplements, increase the risk of death. So it is necessary to have a proper examination of the body before you take health supplements. The risk factors include:
- Taking vitamin B6 regularly in excess of 100 mg may lead to damage of your nerves
- Taking 400 international units of vitamin E on a regular basis increases the health risk and may even lead to premature death
- Taking multivitamins does not supplement poor eating habits.