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Dr. Sanjay Deorukhar

Audiologist, Navi Mumbai

Dr. Sanjay Deorukhar Audiologist, Navi Mumbai
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I pride myself in attending local and statewide seminars to stay current with the latest techniques, and treatment planning....more
I pride myself in attending local and statewide seminars to stay current with the latest techniques, and treatment planning.
More about Dr. Sanjay Deorukhar
Dr. Sanjay Deorukhar is one of the best Audiologists in Nerul West, Navi Mumbai. You can meet Dr. Sanjay Deorukhar personally at Dr. Sanjay Deorukhar@Terna Sahyadri Speciality Hospital & Research Centre in Nerul West, Navi Mumbai. Save your time and book an appointment online with Dr. Sanjay Deorukhar on Lybrate.com.

Lybrate.com has a nexus of the most experienced Audiologists in India. You will find Audiologists with more than 43 years of experience on Lybrate.com. Find the best Audiologists online in Navi Mumbai. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Plot No.12, Sector 22, Phase-2, Landmark : Opposite Nerul Railway Station, Navi MumbaiNavi Mumbai Get Directions
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I am losing hair quickly and have tried all shampoos but no effect yet . I am not sure what else can I do . Can you please help me with this.

BHMS
Homeopath, Raebareli
I am losing hair quickly and have tried all shampoos but no effect yet . I am not sure what else can I do . Can you p...
Please take a dose of acid phos 1 m single dose and revert after 2 weeks. Lifestyle changes 1. Along with a healthy hair diet it is important that you exercise properly as it will ensure that there is proper blood flow to your scalp and will help in the growth of hair. 2. Treat your hair delicately. Avoid unnecessary brushing, combing or handling. Use a soft, round bristles brush. 3. Have a weekly scalp massage to provide stimulation to the hair follicles. 4. Have regular trims to eliminate split ends and allow the hair to look and feel healthier. 5. Get plenty of rest and sleep to allow your body to grow hair.
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I have cold since 5 days. I can feel that my hearing experience lower then regular due to cold what to do?

BHMS
Homeopath, Faridabad
Hi. Take homoeopathic medicine - schwabe's alpha-nc and alpha-cf - both thrice daily for 4 days. Use bakson's nasal-aid spray/ 1-2 sprays after every 4 hours. S management: - avoid cold drinks and fried food, take healthy food. -avoid exposure to air-conditioner or cold air. -take steam-inhalation once before going to bed. -take enough sleep and rest.
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My friend has high blood pressure and now he finds it difficult to hear very well what is the cause.

MASLP, Bachelor of Audiology & Speech Language Pathology (B.A.S.L.P)
Speech Therapist, Nashik
My friend has high blood pressure and now he finds it difficult to hear very well what is the cause.
Hello sir, High blood pressure may cause inner ear hemorrhage, which is supplied by the a artery, which supports the inner ear artery and is divided into cochlear artery and anterior vestibular artery which maycause progressive or sudden hearing loss . Regards.
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My right ear has 106 desibles loss. I knew when I was 10 years old, still I have the problem. Is there any chance of getting my hearing power back. I had sinusitis and got treatment for it.

Masters in Audiology And Speech Language Pthology, Bachelor of Audiology & Speech Language Pathology (B.A.S.L.P)
Speech Therapist, Bangalore
My right ear has 106 desibles loss. I knew when I was 10 years old, still I have the problem. Is there any chance of ...
based on whatvyou mentioned you seem to have profound loss. if it is profound loss you cannot reverese it with any medications or surgery. you need to wear a hearing aid if it really affecting your quality of life.
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I have been diagnosed with moderate conductive hearing loss. The doctor has advised that I need a procedure - to be exact, stapedectomy. My hearing loss started after my pregnancy and I understand that it may be due to my genetics as well. My question is, how safe is this procedure and will my normal life change afterwards? I am a health freak and I love gymming, aerobics and constantly move around. Will my life change?

Bachelor of Audiology & Speech Language Pathology (B.A.S.L.P)
Audiologist, Hyderabad
You can lead a normal life after stapedectomy. Hearing improvement depends on the amount of boneconduction affected and intactness of cochlear haircells. So donot worry about surgery or its side affects.
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I suffered from Sensori-Neural Hearing loss in left ear last year in October due to viral infection. I got treatment with Hyperbaric oxygen therapy and steroid injections. I recovered only partial hearing. Is there any possibility of complete recovery. I am suffering from tinnitus since then. Is there any scope of recovery?

Ear-Nose-Throat (ENT) Specialist, Bangalore
Recovery after sudden sensory neural hearing loss is usually not complete and residual hearing loss is common. If tinnitus persists try tinnitus masking devices.
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Patients suffering from Microtia (left ear) Rt. Ear.ear severe Mixed Hearing loss Lt. Ear profound hearing loss So iske liye kya treatment hai.

Bachelor of Audiology & Speech Language Pathology (B.A.S.L.P)
Speech Therapist, Chennai
Patients suffering from Microtia (left ear) Rt. Ear.ear severe Mixed Hearing loss Lt. Ear profound hearing loss So is...
Consult the ENT Dr. For opinion and go for Audiological Evaluation once again. Audiologist will suggestive Hearing for Right ear for immediate remedy and left ear also will suggest hearing aid depends upon the microtia status of the client.
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My wife faces too much stress. She is telling she is hearing a sound some one speaking about her. She always telling that my neighbor house people is talking like that. She feels insecure feeling. We already went to psychologist and he given some tables to reduce stress after initial counseling. Doctor told me that some liquid in brain produced more. Nearly 4 weeks medicine she took, first two weeks she was in her sisters house, she feels better there, before one week we came to our house. Here also for first 5 - 6 days she was quit. But for last 2-3 days, she is telling the same. What I do now sir. I Know that no such sound is hearing by me. I want to bring out my wife from this situation. Please help me.

Reparenting Technique, BA, BEd
Psychologist, Bangalore
My wife faces too much stress. She is telling she is hearing a sound some one speaking about her. She always telling ...
It sounds like there is more to this than has been identified so far. Please seek a second opinion from another psychiatrist and she must go for counseling too along with the medication. It is the combination of these two therapies that she can get the best results. She will need to take her parents along to identify any childhood influences and for genetic factors too. She will need a lot of your support and careful monitoring to really help her through this.
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Meniere s Disease - What are the Reasons Behind It

MS - ENT
ENT Specialist, Gandhinagar
Meniere s Disease -  What are the Reasons Behind It

What Causes Meniere’s Disease?
Meniere's Disease is a disorder that basically affects the sense of balance and hearing of the patient. This condition takes place in the inner ear and it may cause problems like vertigo, where patients experience a spinning sensation and a ringing sound as well. This is a chronic disorder, which requires a number of lifestyle changes so that it can be managed and treated without becoming a debilitating problem.

Read on to know more about the symptoms and causes of the condition.

Symptoms: The various signs and symptoms of this disease include a feeling of fullness in the ear, which has been affected by the condition. Also, most patients have a spinning sensation and a ringing sound in the affected ear. Nausea and vomiting may also be caused by this condition, along with sweating and loss of balance. It is also normal to feel uncoordinated when you are suffering from this condition.

Secondary Symptoms: This condition may also cause many other complications, which are known as secondary symptoms. These include anxiety, depression and stress. This usually happens due to the problems in the ear and even the problem of vertigo. This may cause problems for people who climb heights or ladders for their work or even for other recreational causes. The constant sense of dizziness and spinning may cause a person to become anxious and undertake stress when it comes to carrying out various kinds of functions in day to day living.

Causes: There are various causes of this condition, even though many medical reports suggest that the exact cause has not really been understood so far. As any doctor will tell you, the in the inner ear there is a labyrinth which contains fluids. When there is a problem with the composition and level of these fluids, the patient may develop Meniere’s Disease. This condition specifically affects the inner part of the ear. This part is made up of passages and a cavity as well as soft membrane like structures with hair like sensors. These sensors respond to the fluid’s movement within the ear. When this fluid does not have the appropriate levels, it can lead to many complications like Meniere’s Disease, which affect the nerve impulse that these sensors catch and transmit to the brain.

Stages: This disease progresses over a set of three stages. In the very first stage, the patient will experience much dizziness and nausea, before that progresses to the second stage. In this stage, the patient will have moderate to severe vertigo. This is also known as the middle stage. Finally, this may culminate into the third or late stage, which leads to more frequent episodes of vertigo. The hearing of the patient and the ringing sound in the ears will also get worse in this stage.

2500 people found this helpful

I can't hear well when someone asked to me. I mean that I hear that someone is asking to me but I can't concentrate on words that the person had told. Please tell.

Bachelor of Audiology & Speech Language Pathology (B.A.S.L.P), Masters in Audiology and Speech language pathology (MASLP)
Audiologist, Ambala
I can't hear well when someone asked to me. I mean that I hear that someone is asking to me but I can't concentrate o...
Go for a hearing test and be careful as there are many quacks in this field. Hearing test should be done by a qualified audiologist.
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I have a earing loss from birth I have 70% of hearing loss in my childhood when I was born at that time I am jondish and for that reason my ear nerves are dry this doctor said.

Bachelor of Audiology & Speech Language Pathology (B.A.S.L.P), Masters in Audiology and Speech language pathology (MASLP)
Audiologist, Ambala
I have a earing loss from birth I have 70% of hearing loss in my childhood when I was born at that time I am jondish ...
I am sure you are using any kind of amplification, if not then go for it immediately as reduced auditory stimulus to brain can limit adequate brain development.
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Which type of hearing aid we get from govt schemes it free or costly it can IIC hearing aid by govt schemes.

MBBS, Diploma in Otorhinolaryngology (DLO)
ENT Specialist, Bangalore
Which type of hearing aid we get from govt schemes it free or costly it can IIC hearing aid by govt schemes.
Usually Government schemes only offer body worn and manual BTE devices which are practically obsolete! RIC type (receiver-in-the-canal) or ITC (in-the-canal) or CIC (completely-in-canal) are more expensive sophisticated Digital Multichannel hearing aids. The better hearing aids start at ₹20,000 per ear and go on to almost ₹4,00,000 per ear for the top of the line super-concealed nano-technology hearing aids!
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BHMS, M.D.
Homeopath, Bangalore
Ritu Charya
Ritu in Sanskrit means season. As mentioned earlier that ayurveda believes in maintaing health and prevention from disease. India is a land of diversity of seasons. In India there are 6 types of seasons. These are1. Shishir (winter season)

1. Shishir (winter season)
2. Basant (spring)
3. Gresham (summers)
4. Varsha (rainy)
5. Sharad (autumn)
6. Hemant (early winters)
Such a diversity of seasons only occurs in Indian subcontinent. But it can also lead to various troubles if life style is not maintained according to seasons.
First we will discuss the impact of sun on earth and on our body as the basic energy on earth is derived from sun. Sun has the direct impact on the vegetation and every living being. Rays of sun have different impacts on human body and vegetation as the intensity of rays and heat vary from season ro season.
First we will talk about the intensity and effect of sun on our health i.e. when sun rays fall on northern hemisphere (utrayan kaal) and when rays fall on the southern hemisphere it is called dakshiayan kaal.
As the sun rays fall directly on the northern hemisphere, this part of the globe experiences summers and this time there is winters in southern hemisphere and vice versa.

• Uttrayan kaal (Northern solstice)
• Dakshiayan kaal (southern solstice
• Hemant Ritu and shishir Ritu
• Basant Ritu
• Grisham Ritu
• Varsha Ritu
• Sharad Ritu
• Ritu viparyaya (perverted season)

Ritu satmyam
Utrayan kaal (northern solstice)
It is the phase of the earth when sun rays are falling directly on northern hemisphere. The countries above the equator faces summers. In Indian context it is the phase that progress to wards the summer season which falls during the months of January to June. This phase is also known as aadan kaal and is agneye i.e. extremely hot in nature.This phase faces intense rays and heat of the sun. Due to its property rays from the sun makes the air dry and heated and takes away all the coolness present in air. This character of air makes all the moisture in air to dry and air becomes rough. This makes all the animals and plants gain the ruksh (dry) and filled with katu (pungent), tickt (bitter) and kashaya (astringent) rasa (taste). These factors diminishes strength of an individual. More over environment around him also contributes to this factor. His food is also influenced by these factors. You might have noticed that people get tired during summers easily and also loses their weight. There energy levels also decreases and the stamina fades away. According to ayurveda it includes three ritus (seasons) these are shishir, basant and hemant.
Dakshiayan kaal (southern solstice)
This the phase when sun rays fall directly on the southern hemisphere therefore has great heating effects on that phase but in northern hemisphere rays of the sun falls in slanting way. This phase comes between July to December. In this phase northern hemisphere approaches winters as the rays of the sun are falls slanting. During this phase there is good moisture in air and vegetation is also juicy and pulpy. This phase represent growth of body. In this phase there is good amount of growth. Energy levels in individual are high and stamina is at its peak. This phase is also known as visarg kaal. Due to increase in madhur (swet), amal (sour) and lavan (salt) rasa. Body is provided with good nourishment and is important for good growth in the body. In this phase there is also increase in strength in the body. Dryness also disappears from body and the enviornment. According to ayurveda it included three ritus. These are varsha, sharad and hemant.
Hemant Ritu and Shishir Ritu
Referred to as the season that is the beginning of winters. Indian calendar months are magha-phagun-chaitra-vaishakha According to ayurveda in this season, there is quite dusty environment. Visibility is less, due to fog . There is flow of cold breeze coming from northern direction. Due to cold environment rivers start freezing and thus water level decreases. Birds and reptiles start hibernating. Seasonal plants like (priyangu) callicarpa macrophylla, lodhra (symphlocos racemosa), and lavly (cicca acidc Merrih) starts flowering. According to modern calendar it falls in month of November and December as of hemant Ritu and January and February as of shishir Ritu.
Effect of Hemant Ritu and Shishir Rituon body
Jatharagni (digestive fire) get ignited and appetite increases. Due to this capacity body easily digest guru aahar (heavy food). As this lies in dakshiayan phase hence body grows due to increased appetite. Heavy food is not consumed accordingly then this increased metabolism of the body start consuming bodies dhatus therefore leading to weaknesses body.
Lifestyle to be lead in Hemant Ritu and Shishir Ritu

1. Food rich in madhur, amal and lavan rasa should be consumed to satisfy bodies metabolic desires
2. Snigdh food should be consumed so as jatharagni does not start consuming bodies own stored energy.
3. People should exercise regularly. Regular body massage with oil according to individuals prakruti should be done.
4. Stream bath (swedan) should regularly be taken.
5. Person should reside in warm and cozy place and should not directly be exposed to outer cold environment.
6. Body should be properly covered and wrapped with proper warm clothes.
7. Kesar (crocus stavis) and Aguru (aquilaria agallocha) should be applied on body
8. Indulge in sexual activities

Diet
• People who are non vegetarian should eat meat preferably of rat, audak like fish and tortoise, anoop like ox and goat, prasar like vultures, animals flesh which helps in providing good energy.
• Sweet products made from sugarcane extracts like jaggery etc
• Milk and dairy products should be consumed like cheese, butter, ghee etc
• Pithi (made from pulses) products should be taken regularly
• New rice is beneficial for body.
• Hot drinks should be preferred.

Basant Ritu
This season is commonly known as spring season in common language. In this season, breeze flows from south to north direction. Sun is not having intense heat. Hence sun appears reddish in colour. New leaves originate from trees. Old bark of trees gets replaced by new one. Environment is clear and non dusty. Flowers blossoms on trees and there is fragrance in environment. In this Ritu, shlesham (mucous) which had got accumulated in winter season melts off due initiation of increase in temperature. According to modern day calendar it falls in the season of March and April.
Lifestyle

1. Person should exercise regularly during this season.
2. Sleeping in day time is strictly prohibited in this Ritu.
3. Body should regularly be cleaned by following panchkarma procedures like tikshan (strong) Vaman, tikshan Dhumapanam, tikshan Gandusha, and tikshan nasya.
4. One should bathe regularly and should apply some natural fragrance on body.
5. Avoid exposure to direct air.
6. Oils massage should be done.
7. Chandan (santanam album) and aguru (aquilaria agallocha) should be applied on the body.
8. Uptan (facial) should be done
Diet

1. Honey should be consumed daily as it helps in avoiding diseases caused by kapha.
2. Yav (hordeum vulgare) should be taken during basant ritu
3. Godhum (triticum vulgare) should be taken
4. Non vegetarian people should have flesh
5. Asavs, sidhu, mardik, mardvik, madhav and arishtas should be consumed on the regular basis.
6. Shunti (zingiber officinale), nagarmotha (Cyperus rotundus) should be boiled in water and then should be consumed with honey.
7. All cold stuff should be avoided.
8. Snigdh (oily) food stuff should be avoided.
9. Stuff that contains madhur and amal rasa should be avoided.

Grisham Ritu
This season in commonly known as summer season. In Indian calendar it is jyeshtha – ashadha. Sun is hot and penetrating, sun heat is maximum, environment is hot and sky remains clear. Wind is in direct North West direction Air is dry, light, hot, unpleasant day. Moonlight is pleasant. Atmosphere is bright and hot. Effect of moon is negligible. Land becomes hot and dry especially during day time. Water becomes hot and light, very little water in rivers. They are always muddy and meshy, and do not have any current.
Life style

1. People should not do over exertion and excess of physical work
2. Avoid exercise.
3. Should make arrangements to keep one self cool
4. Should avoid outside work during day time
5. Should fan your self with taadh (borasus flabellifer) feather
6. To keep your self cool one should wear ornaments made of utpal (Nyphaea stellata) and lotus
7. Should apply a mixture of chandan and kapur on the body to protect one self from heat.
8. Avoid sexual intercourse everyday.
9. Try to wear soft, light colored and thin clothes made out of cotton
Diet

1. Avoid usage of katu, amal and lavan rasa and products containing these rasa.
2. Drinking of alcohol should be avoided as it has properties which dries up the bodies fluids and makes it week.
3. Consume plenty of fluids which help in combating lost fluid of the body by sweat.
4. Also should consume chilled sweet tasting liquids like panna (extracts of juicy fruits especially of ripe mango) and manth (commonly known as sattu)
5. Consume draksha (vitis vinifera), nariyal (cocus nucifera) should be consumed with water
6. Avoid heavy food stuff and oily food
7. Start taking dairy products.

Varsha Ritu
In this season varun (synonym of rain) and Vayu (considered to be as monsoon) starts flowing, this is very essential for agriculture purpose. In this whole sky gets filled with clouds. Western winds blow. Air is damp and chilled. Rivers are flooded with water. Lotus (Nelumbo nucifera) flowers bloom in rainy season. There is lightening in sky. Thunder sound is quite common in rainy season. Peacock (pavao cristasus) and an insect named indragopa (mutella occidentalis) appears in this season. Rainbow appears in sky after rain. Land is muddy and wet and there is vegetation all over the earth due to enough supply of water. In this season the digestive fire which got decreased in summers gets ignited again. Indian calendar marks this season as shravan-bhadrapada
Life style

1. Should protect yourself from getting wet in rainy season
2. Pragharshan (cleaning body with piece of clothes), Udvartanam, snanam and Dhumapanam should be regularly done.
3. Apply aguru (aquilaria agallocha) on your body.
4. Protect your self from insects like mosquitoes and drum stick insect and animals like snakes, scorpion and rats that might come out of burrows during rainy season.
5. One should perform panchkarma procedure especially Vaman and virechan.
Diet

1. Avoid heavy and oily foods as digestive fire is just better than that of summer season but not at its best
2. Avoid water directly from the well. First one should boil water and then consume it.
3. It has been said to consume all types of anna (wheat etc.) mixed with honey as honey protects vata to get aggravated which is predominant in this season
4. old rice, kanak (triticum vulgare) and yav (hordeum vulgare) should be consumed with krityush (processed in oils or ghee)
5. Should avoid consumption of alcohol
6. On the day of rain one should avoid oily food and vata suppressant food should be consumed.
7. In varsha ritu (rainy season) one should take food full of amal and lavan rasa.

Sharad Ritu
In Indian calendar months for sharad ritu is ashwin- kartik. In this season sky is filled with scanty white clouds and earth is damped with water. Though the sun is hot, the heat effect is normal. Air is damp and hot. Atmosphere is clear. Effect of moon is moderate. Land emanates water vapors remains slightly wet-muddy and covered with lush green grass, water is clear and pure (hansodaka) due to rays of rising star agasti. In this sekaash (saccharum spontaneum), saptahv (alstonia scholaris) and kumud (Nymphaea alba) start blooming. Lotus also blooms in lakes. Kraunch birds are seen flying in air. Hans (anser indicus) are seen in lakes and ponds creating ripples in water.in this seaeon dominat rasa (taste) is lavana (salty).
Life style

• One should avoid heavy food as jathar Agni (digestive fire) is just moderate.
• One should apply usher (veteriveria zizanioides) on the body and then sit in moon light.
• Person should save himself from direct sun light and eastern winds
• Never sleep in day time.
• Clothes should loose and of light colored.
• One should purify his body by virechan and raktmokshan
Diet
• Person should use kashaya, madhur and tickt rasa in this season.
• One should eat shali rice, sathi rice, gehun (triticum vulgare), yav (hordeum vulgare), mung (phaseolus mungo)
• Person should consume sugar products, honey, parval (trichosanthes cucmerina). Amlaki (Emblica officinale) and draksha (vitis vimifera)
• One should avoid heavy foods, curd, oils and alcohol
• Ritu sandhi and its regimen
It is very obvious thing that a ritu (season) would not change suddenly. In between two ritus there is a transitional period which is called ritu sandhi kaalam. In this phase there is a combined effect of both the ritus i.e. one previous one and other which have to come. It is of 14 days duration and consists of last week of the outgoing season and first week of in coming season. In this phase the seasonal regimen of previous season should be gradually omitted and regimen of the forthcoming season gradually introduced. If one does not follow this regimen properly then one can get affected by asatmya janaya roga.

Ritu Viparyaya (perverted season)
When we get the unnatural and unexpected seasonal symptoms, i.e. different symptoms in a season, it is called ritu viparyaya, e.g. in the month on May-June (grisham ritu), we are expecting clear sky with a sharp rays of sun and hot temperature or in the month or January and February (shishir ritu) we get the hot climate. But if we experience, cloudy sky and rains in that month then this is perverted season
Ritu viparyaya is one of the cause in which bodies doshas gets imbalanced thus leads to cause of disease. More over due environmental changes it cause huge damage to human resources like agriculture etc thus ultimately plays part in disturbing human body physiology.

Ritu satmyam
Man is epitome of the universe. Environmental changes always affect the human being. But man responds to the seasonal changes in variety of ways. As an example few people sweat profusely, as of pitta prakruti, in summers then in other people.
Hence it becomes essential to understand that of what prakruti a person is and what effect it has on his health.




1 person found this helpful

I have hearing problems if any my mind catch on seconds time only this from my age at 21 from but now only recognize my prb pls help to solve my problem I have 2 kid both r normal both, age diff around 7.

Diploma in Anesthesia, MBBS
General Physician, Hyderabad
I have hearing problems if any my mind catch on seconds time only this from my age at 21 from but now only recognize ...
To know the level of your hearing defect get Audiometry test done where you will know the exact type of deficiency and you can take appropriate remedial measures. My assumption is it will be norma and the reason for not able to hear first time is due to inattentiveness. Probably your mind is on different things and is not concentration when some body is speaking, second time when you pay attention you are able to hear because you are listening then. So change your life style and try to concentrate on the things at hand and do not allow the mind to wander. You can use some vitamin supplements for increasing your concentration capacity. Good luck.
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I talk very loudly though I don't feel so. It gives people feeling as if I am shouting or fighting. I have mild hearing loss. Is it related.

MASLP
Speech Therapist, Mumbai
I talk very loudly though I don't feel so. It gives people feeling as if I am shouting or fighting. I have mild heari...
Yes, it can happen because of mild hearing loss. When you don't get enough feedback of you own voice, you tend to increase loudness. Consult an ENT to know the cause of mild hearing loss, if treatable get rid of it.
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I want to remove my wisdom tooth as there is cavity. I want to know that is there any hearing will be effected aftr making it removed. I have heard it effects ear.

MS - ENT, MBBS
Ear-Nose-Throat (ENT) Specialist, Bangalore
I want to remove my wisdom tooth as there is cavity. I want to know that is there any hearing will be effected aftr m...
Wisdom tooth removal doesn't affect your hearing. Get it removed by a good omfs doctor.(oral and maxillofacial surgeon)
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Having loss of hearing in both ears is it due to accumulation of wax in the ears or shall I visit ENT specialist. Using hearing aid for last 6 years.

MBBS, D.P.H
General Physician, Gurgaon
Having loss of hearing in both ears is it due to accumulation of wax in the ears or shall I visit ENT specialist. Usi...
Mr. lybrate-user loss of hearing is not possible by wax it only minimizes. If you feel loss of hearing then you must consult to ent surgeon.
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