Doctor Samir Dilwale of Wockhardt Heart Center,Hyderabad shares his expertise about Bypass Surgery.What does bypass surgery mean? When is it recommended for patients? What are the benefits of this operation? What are the different ways in which it can be performed? These are some common queries that came immediately to mind when one hears this term.

Themogenic foods essentially take more energy to process/digest than what they provide, so they help raise your metabolism and burn body fat. Here is a list of the top ten thermogenic fruits and vegetables:

1. Cruciferous Vegetables (Broccoli, Cauliflower, Cabbage)
2. Asparagus
3. Leafy Greens (lettuce, spinach, kale, ect.)
4. Celery
5. Mushrooms
6. Chili peppers
7. Apples
8. Berries
9. Apricots/Peaches
10. Pears

3 cups Broccoli = 3 french fries = 7 jellybeans = 7 cups of mushrooms = 1 marshmallow= 14 cups of lettuce  

I have had insomnia all of my life, at least as long as I can remember.  A medicine cabinet of drugs have been thrown at me, most lately Ambien, Ambien CR, and Lunesta.  I have been on them so long that they have lost most of their effect on me and often I have to double up.  There is one drug that is helping some, that being the drug Zyprexa, but it has one side-effect - that being weight-gain - and lots of it.  Has anyone else gone through the carousel  of drugs and have the same sleeping problems that I have but have achieved more success?  If not, I recommend taking Ambien to fall asleep and the Zyprexa to stay asleep.  The only drawback is you will notice yourself gaining weight. 

ELIZABETH BORNTRAGER(PSYCHOLOGIST)A VERY SWEET LADY AND DOCTOR MY DAUGHTER LOVED HER AND SHE LOVED GOIN TO SEE HER.SHE NO LONGER SEES HER NOW DUE TO HER SECRETARY MARK VERY UNKIND MAN NEVER ANSWERS THE PHONE OR RETURN YOUR PHONE CALLS.WHEN I CALLED TO SCHELDUE ANOTHER APPOINTMENT HE INFORM ME THAT SHE WAS ON MATERNITY LEAVE I ASKED COULD SHE SEE SOMEONE  THAT WAS SEEING HER PATIENTS HE STATED THAT PERSON WOULD BE OUT FOR 2 WKS.HE WASNT TRYIN TO HELP ME AT ALL NOR MY DAUGHTER WHOM WAS ON MEDICATION PRESCRIBED BY MRS.BORNTRAGER.HE WAS ALWAYS RUDE AND I HATE TO SAY HE MADE ME FEEL HE HAD COLOR ISSUES.MRS. BORNTRAGER I WOULD LIKE TO SAY TO YOU CONGARATULATIONS ON THE NEW BABY.BUT PLEASE KNOW THAT YOUR SECRETARY IS VERY RUDE AND UNTHOUGHTFUL ALTHOUGH MY DAUGHTER LIKE SEEING YOU I NOR HER DIDNT CARE FOR HIM MUCH.PLEASE CHECK YOUR SECRETARY.....ALSO YOU MAY NEED TO CHECK WITH OTHERS&DOCTORS OFFICES THAT HAS BEEN RECOMMENDING YOUR PRACTICE...THEY SEEM TO FEEL THE SAME WAY CONCERNING MARK?WHAT IS HE GETTING PAID FOR?

Arthritis of knee is the world's leading cause of disability. Arthritis causes pain, swelling, inability to walk, reduced bending of knee, inability to sit cross legged, deformity and so on.

Conventional total knee replacement is a well-known treatment for advanced knee arthritis. Knee replacement surgery provides excellent results to the patient, relieving him from pain. The surgery also improves walking ability and allows pain-free knee bending. Most importantly, it improves the quality of life of the patients.

Flexion is the action of bending a joint, such as your knee or elbow. The opposite motion is extension, which is the straightening of a joint. Generally, traditional knee replacements accommodate flexion up to 110 degrees and have not been designed to allow the patients to squat and kneel, which require higher flexion. Many daily activities require a higher range of motion: Gardening, golfing or activities such as kneeling for prayer and sitting cross-legged can demand up to 130-150 degrees of bending.

Recent innovation of knee design (High Flexion Rotating Platform Knees) is a breakthrough where complete flexion upto 155 degrees could be achieved. Desire for high flexion may be dictated by patient's favourite activities or cultural background. Many daily activities require the ability to flex the knee beyond 120 degrees.

The fixed bearing conventional knee provides 110 degrees of flexion. For most patients, this is not enough. The rotating platform knee is specially designed to safely accommodate up to 155 degrees of flexion in patients who has good pre operative range of motion. This means that with appropriate rehabilitation a patient can resume an active life style after total knee replacement - deeply bending the knee for recreation. Day to day activities, which may include prolonged kneeling, squatting and cross-legged sitting, can be done.

Complete knee bending is a pre requisite for the patients of Asia, Japan and more so in Indian continent. This will raise high level of confidence in patients to get surgery done as they will also get good flexion. So now day's patients should not hesitate to get knee replacement done due to reduced knee bending after knee replacement.

Dr Neelam V. Ramana Reddy,Consultant Wockhardt Hospitals,Hyderabad shares his thoughts about Minimal Invasive Hip Replacement.

Total knee replacement (arthroplasty) is a surgery that is performed for severe degeneration of the knee joint. Knees wear out for a variety of reasons, which include inflammation from arthritis, injury or simple wear and tear arthritis.

Minimally invasive total knee arthroplasty (MIS) is one method of performing a knee replacement. It uses a smaller incision. Unlike conventional total knee replacement, which requires a large incision (8 to 12 inches) and significant disruption of the muscles and tendons. MIS Knee Joint Replacement is performed through an incision as small as 3 to 4 inches. In MIS procedures the amount of soft tissue (muscles and tendons, etc.) that are disrupted during surgery is reduced. Through that same small incision, the diseased surfaces of the knee joint are exposed and then replaced, one at a time, with the artificial joint components. This new technique is also called quadriceps-sparing knee replacement.

MIS Knee Joint Replacement is considered a giant step forward in total knee replacement for a number of reasons, which may include the following: a shorter hospital stay, faster recovery, less pain and much less scarring.


Potential benefits of this new techniques

1. More rapid return of knee function. Patients who undergo this procedure get muscle strength and control back more quickly than patients who have had traditional total knee replacement. This is because the quadriceps muscle and tendon are not divided in the course of the surgical exposure like in traditional knee replacement, and the kneecap is not everted (flipped out of the way) as it is in traditional total knee replacement. The recovery time is much quicker, often permitting patients to walk with a cane within a couple of weeks of surgery or even earlier.

2. Smaller incision. While this procedure would not be worth performing for cosmetic benefits, many patients do prefer the shorter incision. Traditional knee replacement incisions often measure 8" or longer; minimally invasive quadriceps-sparing knee replacement incisions are about 4" in length for most patients.


3. Decreased post-operative pain. This may be a function of the smaller incision and the fact that the incision stays out of the important quadriceps muscle/tendon group. The less-traumatic nature of the surgical approach also decrease post-operative pain and diminish the need for rehab and therapy compared to more traditional approaches.

4.Faster Recovery and Lesser Hospital Stay: Since minimally invasive procedure involves minimal incisions, there is less wounds to heal , which means faster recovery and early return to work.

Minimal invasive quadriceps-sparing total knee replacement is an evolution of surgical technique, which permits the use of time-tested implant designs. This gives some reassurance that while the surgical approach is new, the implants themselves have a good proven track record.

The Surgery would be a preferred choice for most patients, as there is no cost difference between the Conventional Surgery and the Minimally Invasive one. However as with all minimally invasive procedures the patient selection criteria is important, basically chronically deformed joints can not be dealt with, with this kind of surgery.


Article Courtesy :

Dr Neelam V. Ramana Reddy, MS Ortho; MCh Ortho (UK)
Consultant Joint Replacement Surgeon
Wockhardt Bone & Joint Hospital
Kamineni Wockhardt Hospitals,King Koti, Hyderabad.

Doctor Sachin Bhonsle,(MS (Orthopaedics, FRCS Glasgow, UK) Consultant Joint Replacement and Orthopaedic Surgeon Wockhardt Bone and Joint Care, Mumbai,India answers some most commonly asked questions on Knee Surgeries .



1. Evolution around knee surgeries in India over the years.

This decade has been very progressive for orthopaedics in India to the extent that we can call it an orthopaedic decade. A lot is now on offer to improve quality of life to those with arthritis and joint injuries. As late as 1980s most people with worn out joints had no choice but to lead an invalid life. There are very few surgeons in our country with resources to provide reconstructive joint surgery. Also to those few who could afford, the treatment options were limited as well as expensive. In late 80s Arthroscopic or keyhole surgery started gaining popularity in India. This was a boon to youngsters involved in sports. Around the same time Joint replacements became more readily available. This is when Indian companies started coming up with reliable prostheses. As we rolled into the third millennium standard knee and hip replacements were optimised in a number of cities and centers across the country.

2. Percentage of Indian undergoing Knee Replacements every year

This varies greatly compared to western countries. Reliable figures are not available but a vast majority of Indian patients tend to procrastinate on knee arthritis rather than having surgery. Knee tends to be most commonly replaced joint in India because of higher incidence of knee arthritis compared to hip in our subcontinent.

3. Who is a candidate for knee replacements?

Any person with a painful and irreparably worn out knee joint can be a candidate. There has been a classic approach to do it after the age of 60 because older prostheses tended to last only 10 to 15 years and revision surgery was difficult. But now the contemporary designs are long lasting, techniques are more refined and revision surgery facilities have been developed optimally. Therefore we contemplate doing joint replacements at much younger ages.

4. What advancements have been made in total knee replacements? Advancements in surgical methods and how it has been revolutionized over the years
To know more about Bone and Joint care at Wockhardt Hospitals, or to schedule an appointment with Doctor Sachin Bhosel,please write to enquiries@wockhardthospitals.net

At least one in five women in the United States suffers from a lifestyle-restricting condition and most do not seek treatment. Problem periods, characterized by heavy, prolonged bleeding that impacts a woman’s quality of life, affect more than ten million women in the U.S. Symptoms range from chronic fatigue and anemia to embarrassing accidents and restricted activity, causing major lifestyle changes.