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Dr. Sunil S. Dikshit

Orthopedist, Mumbai

400 at clinic
Dr. Sunil S. Dikshit Orthopedist, Mumbai
400 at clinic
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Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; a......more
Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; as a health provider being ethical is not just a remembered value, but a strongly observed one.
More about Dr. Sunil S. Dikshit
Dr. Sunil S. Dikshit is a popular Orthopedist in Andheri East, Mumbai. He is currently practising at Dr. Sunil Dikshit's Fracture & Orthopaedic Hospital in Andheri East, Mumbai. You can book an instant appointment online with Dr. Sunil S. Dikshit on Lybrate.com.

Lybrate.com has a number of highly qualified Orthopedists in India. You will find Orthopedists with more than 27 years of experience on Lybrate.com. You can find Orthopedists online in Mumbai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Hindi

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Green Homes, Ground Floor, Marol Pipeline Road, Sahar Andheri East.Landmark: Near Gulab Joshi Bungalow,Mumbai Get Directions
400 at clinic
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I am 56 years old male, I have gout - 9% and high pressure (taking zilos-50) pl. Inform any medicine?

B.H.M.S, M.D in Homoeopathy
Homeopath, Anand
You should have reduced the protein intake. You can switch over to homeopathy (consulting your homeopath nearby) which can very well take you to the comfort zone of uric acid levels.
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Sir I have problem with my right arm its paining from last fifteen day its not getting recovering annd I also have problem with my mouth its paining from last ten days tell me what should I do should I tale something to eat or anything else should be proffered.

PG Diploma in Emergency Medicine Services (PGDEMS), Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Alternate Medicine
Ayurveda, Ghaziabad
Sir I have problem with my right arm its paining from last fifteen day its not getting recovering annd I also have pr...
Hi apply pranacharya restopain oil or prasarini oil on your affected part then give hot fomentation. Take maha rasnadi kwath 2-2 tsf twice a day. And agni tundi vati and maha yograj guggul 1-1 tab twice a day.
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Hi, I am 40 years old and has pain in my heels since more than 2 years. Consulted ortho doctors but no relief. Can you help in this regards.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. This kind of pain is usually due to inflammation of your heel fascia. It is chronic pain which get aggravated especially when you walk more and is better with rest. Treatment modalities are aimed at relieving inflammation of the fascia, like ice packs, physical therapy, footwear modification and anti-inflammatory therapy. Do not hesitate to contact me if you need any further assistance.
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I have shin pain. It is from 1 month it pains a lot I am Unable to recover from it buy using icing and cold and hot water. Please suggest me any solution. Thank you.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I have shin pain. It is from 1 month it pains a lot I am Unable to recover from it buy using icing and cold and hot w...
Avoid sitting cross legged. Ankle stretching. Ankle strengthening exercises. Avoid squatting. Quadriceps exercises. Core strenthening exercises.
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I am 68 years old man I am suffering from knee pain I take medical treatment but not cured. Please advise.

BPTh/BPT
Physiotherapist, Delhi
Start with physiotherapy sessions and learn exercise for knee joint. Wear knee cap open patella also. Don't sit on floors. Take calcium and methylcobalamine supplement with glucosamine and omega3 for 2 months minimum.
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My mom age is 35 years . Her toes are cracked and feeling pained while walking. How come this be solved.

Membership of the Royal College of Surgeons (MRCS), MS - Orthopaedics
Orthopedist, Gurgaon
My mom age is 35 years . Her toes are cracked and feeling pained while walking. How come this be solved.
Ask her to wear shoes with socks use lots of moisturiser on foot and heal take multivitamins tabs twice aday.
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My sister in law has severe backache and eyes pain. It came to be 1 years. What should she do ?

M.D. (Ayurveda )
Ayurveda, Patiala
My sister in law has severe backache and eyes pain. It came to be 1 years. What should she do ?
Please take panchamruta loha guggal, 2 tabs, twice a day after meals. Take gandharvahastadi kshayam, 3 tsf in half a glass of warm water, before meals, twice a day. Do massage with murivinna oil on back up to both legs. Avoid cold eatables and cold water in your routine. Consult some good ayurveda physician for panchakarma. Continue the regime for 45 days. Good luck.
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By playing football I got partial damage on my knee ligament and I am not able to play now. How much rest I should take? So please suggest me how to recover this injury fast.

Fellowship of the Royal College of Surgeons (FRCS), Membership of the Royal College of Surgeons (MRCS)
Orthopedist, Trichy
By playing football I got partial damage on my knee ligament and I am not able to play now. How much rest I should ta...
You should refrain from contact sports for a minimum of 4 - 6 months for the ligaments to heal. Prior to starting playing again you need to do a course of knee muscle strengthening exercises.
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My wife feeling body ache always over muscle and bone especially, heel pain on stepping, always lethargic feeling. During last two months. I visited Apollo Kolkata, Ruby hospital Kolkata. But her problems still persisted. Pls help for right treatment.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
My wife feeling body ache always over muscle and bone especially, heel pain on stepping, always lethargic feeling. Du...
Avoid sitting cross legged. Avoid squatting- quadriceps exercises- lie straight, make a towel role and put it under the knee, press the keen against the role, hold it for 20 secs. Repeat 20 times twice a day. This will help relieve some pain. Core strengthening exercise- straight leg raised with toes turned outward, repeat 10 times, twice a day.
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Sir I suffered from acidity from 4 months and I take medicine for this and its starting improve but my throat is always feel sure or pain and I also feel pain in back.

MS - ENT, MBBS
Ear-Nose-Throat (ENT) Specialist, Bhopal
Sir I suffered from acidity from 4 months and I take medicine for this and its starting improve but my throat is alwa...
Lybrate-user first of all you have to make sure that you maintain a proper diet schedule i. E. Have breakfast, lunch and dinner on time. Not taking meals at the right time is one of the most common cause of gastric reflux leading to acidity causing throat pain, difficulty in swallowing etc. So first of all make a proper diet schedule and avoid staying empty stomach for long durations.
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Hello doctor, good evening, I am 47 year old lady , k/c/o diabetes border level, with rheumatoid arthritis. I am 5 feet 2 inches tall and 54 kg weight. Kindly suggest me proper diet.

Practical Course in Diabetology, POST GRADUATE COURSE IN DIABETOLOGY, MBBS
Endocrinologist, Srinagar
Hello doctor, good evening, I am 47 year old lady , k/c/o diabetes border level, with rheumatoid arthritis. I am 5 fe...
Breakfast: one chapatti with vegetable, one cup tea without sugar Midmorning ;one fruit. Lunch ; one chapatti, one katori rice, one katori dal, one katori vegetable and salad. Evening ;one cup tea and two marrie biscuit. Dinner ; same as lunch. Avoid sugar, junk food, fried food and fruit juices.
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Hi ny self ranveer I have problem with my back when I am awake in morning than my back pain so plsss tell what is issue with me plss revert me my issue asap.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
Hi ny self ranveer I have problem with my back when I am awake in morning than my back pain so plsss tell what is iss...
That is strain according your age so firstly maintain your posture sit straight and do stretching exercise of both limbs. But nw do hot fermentation twice a day and apply pain relief ointment and rest must. Avoid toward bending, long sitting, lifting weight.
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Rheumatoid Arthritis: A mystery solved with lucidity

MBBS, MD - Internal Medicine, Diploma in Echocardiography, Diploma in Rheumatology
Internal Medicine Specialist, Kolkata
Rheumatoid Arthritis: A mystery solved with lucidity

Vital notes:

  • RA is a chronic debilitating joint disease that affects small joints of hands and foot.
  • More common in females aged 20 to 50 years.
  • It is not synonymous with Rheumatic Fever which occurs in children aged less than 15 years.
  • It has got nothing to do with monthly Penicillin injections and checking ASO titre. Somebody on Penicillin injections or being checked for ASO titre should change the doctor immediately.
  • Untreated disease may cause deformity of hands and foot causing deterioration of quality of life.
  • Erosion of small joints along with loss of entire joint architecture is the basic disease process.
  • Early morning stiffness of joints along with swelling of one or more small joints of hands is very characteristic.
  • Treatment is done with Methotrexate, Hydroxychloroquine Sulfate, Sulfasalazine, Leflunomide and short courses of steroids.
  • Difficult diseases are treated with costly injections called biologics.
  • The motto of treatment is “ catch early, hit hard and achieve and maintain treatment goal “
  • Lung and cardiac complications are common in long term disease.
  • Rheumatologists but not the Orthopedicians nor neurologist are the best person to treat the disease.                    

 

Introduction:

Rheumatoid Arthritis is an autoimmune disease of mankind where the cells and molecules who are responsible for security of our body, misidentify the joint tissue as foreign substance and start destroying them similar to the way they usually do when a bacteria or virus enters the body. This misdirected attack towards our own body is called autoimmune phenomenon.

The worst affected parts of the body are the joints of hands and foot. These small joints that are responsible for performance of day to day activities like eating, holding, writing, typing, washing etc become painful and swollen causing stiffness and deformity.

This results in poor quality of life and subsequent depression. Early diagnosis and continuous treatment with specific medicines is cornerstone of treatment.

 

What are the symptoms?

Symptoms vary from person to person and also from early stage to late stage of the disease.

 In early stage there may be mild pain and stiffness involving 1 to 4 small joints of the hands and feet with a typical pattern of stiffness of those joints after rising from bed. During this phase it is very difficult to diagnose the disease. But it is very important to catch the disease in this stage. Researchers have proved that joint damage and bony erosions start even before the symptoms have manifested and hence earlier the treatments better the results.

In a full blown case of Rheumatoid arthritis the picture is very classical of a middle aged female presenting with pain and swelling of hand and foot joints along with early morning stiffness that responds to steroids brilliantly. Wrists and the knuckles are predominantly involved. Patients are unable to hold a pen or open the door or do cooking etc. Gripping the wrist firmly causes pain and the hand joints are warm.

In a advanced case of the disease we often find elderly people presenting with crooked hands with areas of permanent swelling and skin changes due to chronic friction. The skin fold may contract chronic fungal infections and the joints are swollen and painful.

A few other organs are damaged in silence and they create serious problem at the advanced stage of the disease. Lungs, Heart and Blood Vessels are frequently affected. There is accelerated cholesterol deposition in arteries of heart causing increased risk of heart attack and brain stroke. These patients frequently contract infections which are difficult to treat.

Involvement of spine or low back is uncommon. However, cervical spine or the neck region is the only part of the spine that may be affected in this disease.

 

What is the difference between Rheumatic Fever & Rheumatoid Arthritis?

There is a heaven & hell difference between these two entities. Rheumatic Fever is a disease of childhood. It usually occurs in children aged less than 15 years and is characterised by excruciating pain, swelling and redness of one or more big joints of arms and legs that responds excellently to Aspirin. This disorder may cause cardiac problems and is the leading cause of Valvular Herat disease in India. It is often characterised by some skin rashes and rarely neurologic problems. The disease process, the causative agent and the clinical symptoms are completely different from that of Rheumatoid arthritis.

 

Why Penicillin injections are given on a monthly basis?

Patients of Rheumatic fever often suffer a damage to the valves of the heart during the attack of Rheumatic fever. This damaged valves are potential sites of infections that may develop in the later part of the life. This infection is called Infective Endocarditis and may cause serious complications if not addressed properly. Penicillin injections are given as a form of prevention of development of this infection and have got no relationship with the wellness or cure of the disease. People who are aged above 15 years and are being treated with penicillin for the first time for joint pain occurring in small joints of hands should immediately change their doctor and consult a rheumatologist.

 

How is Rheumatoid Arthritis diagnosed?

Rheumatoid Arthritis is diagnosed by its classical symptoms and some laboratory investigations. To identify early rheumatoid cases we usually follow a scoring system which includes counting of number of joints involved, the duration of the symptoms, checking ESR and CRP in blood and looking for the positivity of Rheumatoid Factor and Anti CP Antibody. Patients with high values of Anti CP Antibody are very much likely to suffering from rheumatoid arthritis and also they are very much likely to suffer a aggressive disease course

 

Does each and every patient of rheumatoid arthritis develop crooked hands and foot?

No. Not all patients suffer from such a devastating complications. There are important characteristics which if present predict severe destructive disease. Females, Smokers, High values of Anti CCP or Rheumatoid Arthritis, Family History of Rheumatoid Arthritis, Early evidence of Joint destruction on X Ray are a few important features who will go forward to develop destructive disease.

 

How Rheumatoid Arthritis is treated?

Continuous Physical activity of the involved joints is the corner stone of treatment. More the joints are active, less the damage.

Cessation of smoking is mandatory. Smokers tend to develop early joint destruction

Medicines that used in treating rheumatoid arthritis are together called Disease Modifying Anti Rheumatoid Drugs or DMARDs.

Methotrexate, Hydroxychloroquine Sulfate, Sulfasalazine, Leflunomide are the principal DAMRDs. Of these, methotrexate is the backbone of therapy. Methotrexate is used on a once a weekly basis starting from a dose of 5 mg to 50mg/week and a weekly 5mg of Folic Acid supplement is given to neutralise the adverse effects of Methotrexate. The detail of the drugs is mentioned below.

 

Why I am being given Steroids?

Steroids are given for a short period of increased disease activity. In rheumatoid arthritis we do not prescribe steroids in a regular basis. It is often prescribed when the patient is put on the DMARDs for the first time and when there is break through pain or active disease during the treatment.

Steroids are used in low dose in a decreasing dosage pattern over weeks and usually are not continued more than a month.

 

What are Biologic agents? Why they are so costly?

Biologic agents are highly specific molecules who directly block the action of the culprit chemicals in our body that cause the joint destruction. They are highly researched molecule an d is manufactured abroad. They are usually available in injection formats and have their own side effect profile which includes reactivation of Tuberculosis and other opportunistic infections. Usually patients are checked for latent Tuberculosis Infections, HIV, Hepatitis B and C before the treatment is started.

Biologics cause excellent response to the disease causing alleviation of pain and swelling and sense of well being but unfortunately they do not provide any cure. Hence, if biologics are stopped then there are chances that the disease activity may worsen requiring more biologics or aggressive treatment with DMARDs.

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I have fever from several six days. Heavy back and joint pain also. Please consult me how my fever will reduce.

BPTh/BPT
Physiotherapist, Delhi
I have fever from several six days. Heavy back and joint pain also. Please consult me how my fever will reduce.
Take physiotherapy session and learn exercise for spine. For faver you can take multivitamin and calcium with vitamin d 3.
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How to recognize whether someone is suffering from arthritis or not. If no what are preventive measures and if yes what is the medication required. Please tell in detail. Specially tell preventive measures about osteoarthritis in form of exercise and diet.

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Ludhiana
1. Watch for any joint pain, swelling or redness on joints 2. Watch for any joint stiffness and inability or less mobility of body due to pains 3. Watch forany unusual fatigue, as walking or exerting even a slight will increase the joint pains 4. Other types of arthritis, such as osteoarthritis (oa), can trigger chronic fatigue if the joint pain is great enough to significantly affect your sleeping and eating patterns.-5. Chronic lack of sleep is also associated with non-specific muscle and joint achiness throughout the body, which is often called fibromyalgia. Homoeopathic medicine adel-4 (adel) drink 10 drops in 20 ml fresh water 3 times daily haemocal (sbl) chew 4 tab twice daily vitamin-d plus (bakson) chew 1 tab daily exercise-20-30 minutes standing cycle report after 30 days.
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My caesarean delivery done 15th day before. I have back pain. Please advise me what to do.

Fellowship In Arthroplasty and Arthroscopy, MS Orthopaedics, MBBS
Orthopedist, Gurgaon
My caesarean delivery done 15th day before. I have back pain. Please advise me what to do.
Hot fomentation and any pain killer gel, also continue your vit d and calcium supplements. Start doing exercises for your back muscles.
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Hi doctor i am suffering from lower back pain in which I did mri and came to knw that in between of l4 l5 the disc is bulged out and pressing d nearby nerve due to which the pain is there which is not bearable. I am using lumbar sacro belt with an ointment(nano gel) and a capsule mysopisis th its been now almost 4 days d pain is same. Can you please help me out of it?

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi please thanks for your query and welcome to lybrate. I am dr akshay from fortis hospital, new delhi. Please since you have mentioned that your total duration of pain is only 4 days, I recommend conservative treatment for now, please but I would like to see your neurological status and mri films if possible to give an accurate opinion. Please do not hesitate to contact me if you need any further assistance. Thanks & regards Dr Akshay Kumar Saxena
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I am suffering fever since yesterday night. I took Dola 650 in night and morning, How many tables can take in day. Symptoms like joint pains, body pains and feverish. So please advise how many dola 650 can take in a day. Best one.

MBBS
Diabetologist, Bangalore
I am suffering fever since yesterday night. I took Dola 650 in night and morning, How many tables can take in day. Sy...
Hello Mr. lybrate-user, I understand you have fever with body pain and joint since one day. You can safely take paracetamol 650 mg upto 3 to 4 times/ day. Please get back to me if the fever doesnot settle in 3 days time.
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