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Category: blog

17 Jan 2023
Arthroscopic Surgery in Mulund

As winter chill plays havoc on joints, here’s how to keep them healthy

The problem in joints and bones does not just restrict your movement but can also cause a lot of discomfort and pain. If you do not take care of them properly, with the onset of winter, problem in bones and joints is inevitable.

What causes joint pains in winter?

Due to the cold temperature, the pain threshold of the body decreases as the nerve endings become sensitive, exceeding the pain tremendously. Another reason for joint pains is that the blood doesn’t circulate properly in the body parts causing pain and stiffness in the joints.

In winter, the physical activity of the body also decreases and hence, the joints start paining. Another reason behind this can be the restricted absorption of Vitamin D (sunlight) in your body during winter.

What to do?

Healthy Lifestyle: Balanced Diet and Exercise

A balanced diet is key to overall healthy living. Eat a diet which comprises fruits, vegetables, cereals, dairy products and pulses. Along with diet, physical activity is also important. Your physical activity may not necessarily be an hour in the gym but can also be a 30-minute brisk walk. To maintain a healthy life, one needs to eat calories and then burn them, so keep moving. Exercising also strengthens the muscles and maintains your weight and thus supports your knees to balance your weight

Warm-up before exercise is important:

Exercise is important but makes sure that you warm up before starting any rigorous exercise. This will avoid injury and make your body more flexible. The warm-up also increases your blood circulation which increases the effect of exercise. 

Stay Hydrated:

Many associates it with combating dehydration but water is essential for joint pain relief as well. In winter, we tend to reduce our water consumption but it is necessary because the cartilage between the joints has to be smooth and in order to maintain the right amount of friction, the body needs to be hydrated

Stay Active, Maintain Weight:

Changes in dietary habits and reduced physical activity during winter can result in weight gain. This increases the load on major joints like the knees which can cause or worsen joint pain. Reducing body weight can help prevent pain

Say No To Carbonated Drinks:

Caffeinated drinks like cola and other fizzy ones minimise the absorption of calcium. And calcium deficiency can lead to problems in bones. So, apart from having calcium-rich food, one should avoid having fizzy drinks so that the calcium that you are having is absorbed by your body

Avoid Smoking:

It is a lesser-known fact that people who smoke tend to have lower bone density and hence, are at higher risk of issues related to bones and joints. Quit smoking for a healthier lifestyle and robust bones!

Maintain Right Posture:

Standing and sitting in the right posture prevents problems in joints and bones. Slouching can affect your bones and create a problem for you. Posture is important even when you are carrying something. If you pick up something heavy, then don’t bend your back rather bend your knee

Comfort Aching Joints:

Application of heat in the form of a hot water bag or electric heating pad can provide comfort to aching joints. Warm baths can also help relax muscles and relieve joint pain

Calcium-rich Diet:

Your body needs calcium to maintain stronger bones. Some calcium-rich foods are milk, yoghurt, broccoli, cheese, legumes, dry fruits, seafood and green leafy vegetables. And your body needs Vitamin D to absorb calcium. Both calcium and Vitamin D are essential in maintaining healthy bones and joints.

Watch Out For CKD ( VITAMIN C, K AND D)

People who have a problem with their joints and muscles are prescribed to have foods rich in vitamins D, K and C.

During winters we don’t get sufficient sunlight which is a vital source of Vitamin D. Apart from having a diet rich in Vitamin D you can also have a Vitamin D supplement once a week. A deficiency of Vitamin D can lead to osteoporosis if it persists for a longer time. These three Vitamins help in the absorption of calcium in the bones and also help in the production of cartilage. Examples of some foods rich in Vitamin D are fatty fish, egg yolks, milk and cheese. Some foods rich in Vitamin K are green leafy vegetables like broccoli, spinach, cabbage and kale. Some foods rich in Vitamin C are oranges, lemons, strawberries and kiwi.

Positive Mindset and Good Company:

From Our Ancient Texts:

नित्यं हिताहारविहारसेवी समीक्ष्यकारी विषयेष्वसक्त: ।

दाता सम: सत्यपर: क्षमावानाप्तोपसेवी च भवत्यरोग: ॥

One who indulges daily in healthy foods and activities, who discriminates the good and bad of everything and then acts wisely, who is not attached too much to the objects of the senses, who develops the habit of charity, of considering all as equal, of truthfulness, of pardoning and keeping the company of good persons only, becomes free from all diseases.

– Article by 

 Dr Tanay Nahatkar

MS Orthopedics

24 Nov 2022

Young Boy’s life saved by a Balloon

This is an interesting and motivating story of a young 21year old boy, who came from a remote village in Uttar Pradesh for his treatment in Mumbai. He had been suffering from fever, cold, cough and voice change for two months from July 2021. He kept visiting nearby physicians and surgeons but had no relief. His condition worsened and he could no longer eat or drink.

He came to consult Dr Binhi H. Desai, a practising ENT and Voice surgeon (Laryngologist) at Desai Orthopedics and ENT clinic and Apex Superspeciality Hospital, Borivali west, Mumbai. The patient had a nasogastric feeding tube and was coughing incessantly. He had lost weight and had become weak. Stroboscopic evaluation with Olympus Flexible system (World’s best technology) was performed at Apex Superspeciality Hospital, Borivali west. This facility (Olympus) is available only at this hospital in the western suburb. The larynx (voice box) was severely inflamed (refer to image 1). Sputum was sent for microbiological evaluation. It came as a bacterial infection for which he received the appropriate treatment. The patient showed improvement and the feeding tube was also removed. Gradually over two months, he started developing breathlessness which became so severe that he could not even tie his shirt. He developed a fear of dying due to breathlessness. He was afraid, he would not survive if he had an attack and hence, he started staying in a hospital. He again visited Dr Binhi H. Desai. At that time, he was in severe respiratory distress. Saturation on the oxygen cylinder was 88 per cent. He was immediately admitted for a detailed evaluation and to know the exact cause of his breathlessness, Dr Binhi H. Desai did an Endoscopic evaluation of airways with Laryngol-Bronchoscope (Flexible and Rigid) under general anaesthesia.  He had developed severe narrowing of the windpipe(trachea) measuring 8 cm in length. It was starting at the level of vocal folds (voice box) going below into the windpipe (total length of the windpipe is 10-12cm). The narrowing was the widest above and it tapered down to pinpoint with a diameter of just 3mm (The normal diameter of the windpipe is 20-25mm). His previously inflamed vocal folds had healed with scar formation. Multiple tissue specimens were taken for microbiological and pathological evaluation (refer to images 2, 3 and 4).

This required urgent surgery otherwise it could be fatal. 

Dr Binhi H. Desai performed a highly challenging procedure of Tracheal Balloon dilatation (images 5,6) under Thrive anaesthesia. The anaesthesia technique was also very challenging. In this, narrowed trachea with opened endoscopically with a balloon three times in the same setting. The surgery is very challenging as it is associated with complications and can also cause death on the table. The surgery was successful (refer to image 7 showing the completely opened windpipe). Immediately after the procedure, the patient further showed complete relief in his symptoms of breathlessness.  

His tissue report came as tuberculosis. Thus, he had a very rare presentation of primary tuberculosis of the trachea(windpipe). He was immediately started on anti-tubercular treatment.

Gradually he resumed his routine activities.

After the intensive phase (two months) and completion of anti-tubercular treatment. check Laryngol-Bronchoscopy of airways under short anaesthesia was done to access the previous site of surgery. He showed excellent healing. 

Presently, the patient is under regular follow-up. He has returned to his home town and is doing all his regular activities without any fear.

This is an inspiring and motivating story of a young boy who would not have survived had he not come at the right time to the right doctor. This also is a story of deep faith and trust instilled by the patient in his treating doctor. 

In the end, we want to conclude by saying that any symptoms such as voice change, breathing difficulty or swallowing difficulty requires a detailed assessment by a Laryngologist (ENT surgeon specializing in voice, swallowing and airways). These difficulties can severely affect your quality of life and can occasionally become fatal. Hence, timely help from a trained professional can go a long way in improving your health and life.

17 Mar 2020
Medical services

Medical Services that you can trust | Know patient feedback

Mr. Rajesh Desai, a 45 yr old male was transferred to Apex Multispecialty Hospital, on 23/01/2020. Before getting referred to our hospital, he was treated at multiple various corporate hospitals across. Thane and Mulund & was on mechanical Ventilator for more than 45 days and had many failed attempts of extubation and hence was tracheostomised and continued to be on a mechanical ventilator. At the outside hospital, he also developed VAP( Ventilator associated pneumonia ) with Multi-Drug resistant Klebsiella pneumonia & MRSA (Methicillin resistant staphylococcus aureus) bacteria which was resistant to all carbapenems and beta-lactam antibiotics except colistin only. Also when we received the patient, he was in septic shock on Norad infusion and had a multiorgan failure. The patient had Renal shutdown outside and was on maintenance dialysis. Also, there was thrombocytopenia (PT count 90,000)  and raised WBC counts. His 2decho was done outside and was found to have severe LV dysfunction, hence was shifted to Apex Multispecialty hospital Mulund under the care of Cardiologist Dr. Mayur Jain who is DM cardiology (Gold Medalist)for getting a Coronary angiography. His Angiography turned out to be normal  and his LV dysfunction could only be explained due to cardiomyopathy secondary to alcohol or severe sepsis. Then the patient was shifted to ICU under the care of Dr.Mayur Jain & Intensive critical care treatment of the patient was done by Dr. Nitin Kumar Reddy who has vast experience in critical care and also recently finished his course training in DNB cardiology.Our first and foremost Goal was to treat sepsis, improve his blood pressure/tissue perfusion  and early weaning off the ventilator as he already started developing critical illness neuropathy as he was on a ventilator for more than 45 days.What we did differently which saved patient life.

  • First, as soon as the patient was received to us a detailed evaluation of his blood reports and multiple antibiotics he received in various outside hospitals were reviewed. We reduced his number of antibiotics and used only rational combinations as per bacterial culture sensitivity reports.
  • Coronary angiography was performed on the same day of admission to rule out the correctable cause and a possible reason for the inability to wean the patient off the ventilator considering recurrent LV failure secondary to ischemia as the patient had severe LV dysfunction. But to our surprise and to make thing even difficult for us his angiography was normal and the only another possible explanation for his severe LV dysfunction was cardiomyopathy secondary to severe sepsis/ alcoholic cardiomyopathy ( A condition in which the heart muscle becomes weak in spite of having normal circulation and difficult to treat)
  • Post angiography we kept the patient in ICU for further treatment of his medical condition. We gave him two sessions of dialysis on consecutive days to clear off the dye and treat his uremia secondary to his Renal shutdown.
  • Meticulous selection & calculation of each and every antibiotic dose was done as per creatinine clearance and also every time patient was given dialysis we made sure that post-dialysis patient received full loading dose of all those antibiotics which were dialyzable. Also the mode of administration of antibiotics was modified based on pharmacokinetics of each antibiotic to have maximum bioavailability. For eg., Drugs like Meropenem which has time dependent pharmacological action was given as an infusion over 3 hrs.
  • Every day in morning treating consultant doctor had a detailed discussion with dietician to calculate is a total calorie and protein requirement and every day the fluid intake, feeds and calories given to the patient was monitored.
  • Since the patient had developed respiratory muscles weakness due to long duration ventilator support, we got a dedicated physiotherapist for him who started him on passive bed exercises and breathing exercises to strengthen his respiratory muscles.
  • Meticulous Nursing care was done like 3 hourly changing turning the patient in the bed and back care to prevent bedsores.
  • During the course of treatment, we observed that since the patient had severe LV dysfunction (EF=20%) he was given less fluids but when we scanned his IVC (inferior vena cava) and found that it was completely collapsed which was suggestive of severe dehydration and we started to give him a lot of IV fluids to correct his dehydration and withheld his dialysis. Eventually after 6 liters of IV fluids infusion over a period of 2 days patient started pouring out urine and his vital parameters also started improving. Gradually his acidosis corrected, Norad infusion got weaned off and stopped, the patient became independent of dialysis and started pouring urine with iv diuretics.
  • When the patient’s vitals were stabilizing, we started to wean the ventilator and we believed in early mobilization and made him out of bed to sit on a chair while being on the ventilator.
  • Eventually patient was on T-Piece on 5 th day. After 24 hrs of T-piece we decannulated the tracheostomy of the patient and was maintaining good saturation and normal ABG even on room air.
  • On 6 th day we shifted the patient to the room and started to mobilize him with walker and with support.
  • On 8 th day patient could manage to get up and walked on his own without support and he his wbc counts got normalized, his platelet counts improved.
  • On 10 th day we discharged the patient and now he comes to our opd for regular follow-ups and check-ups.
  • Achieving this incredible feat of success in treating such difficult case wouldn’t have been possible without Dr. Mayur Jain, Dr. Nitin Kumar Reddy, Physiotherapist , Dietician ,ICU doctors ,Nursing staff and other supportive staffs who really worked very hard in making this patient well and giving him a new life to live when all his family member have lost hopes.
09 Jan 2020
Distal Radial Access

DRA (Distal Radial Access)

Distal radial access for angiography and angioplasty is now the buzz. It is done by very few cardiologists in India.
Interest in distal radial artery access (DRA) is growing rapidly. Among the benefits of DRA are the low risk of entry site bleeding complications and the low rate of radial artery occlusion
At Apex hospital Mulund now Dr Mayur Jain does many of the diagnostic procedures from distal radial artery.
The advantages of this technique include:
1. Minimal Risk of Hand Ischemia Due to Preservation of Blood Flow in the Forearm
2. Advantages for Hemostasis
3. Reduction in Nursing Staff Time
4. Greater Comfort for the Patient and the Operator
5. The Sheath is Secured with Less Movement in the Distal Segment
6. DRA Leaves Additional Arterial Access Options Open for Crossover
Dr Mayur Jain a gold medalist in DM cardiology is well known for his innovative work and complex angioplasty. He is now available daily for procedures at Apex hospital, Mulund.
We promise better patient care, patient safety and patient comfort by using new technology at our hospital.
09 Jan 2020
Optical Coherence Tomography

OCT (Optical Coherence Tomography)

OCT is an imaging technique that uses low-coherence light to capture micrometer-resolution, two- and three-dimensional images from within optical scattering media (e.g., biological tissue)
It is an imaging tool used in angioplasty to give precise results and to prevent complications.
This imaging method helps the cardiologist to use proper size of stent and to see the details of the stent to the level of 200 microns so that all the complications related to stent opposition can be avoided.
It is a very small catheter which is negotiated in the coronary arteries to get these images from within the coronary artery.
This technology is now available at Apex hospital during angioplasty.
Dr Mayur Jain, DM cardiology, Gold medalist has learnt this technique at Cleveland clinic USA, and in multiple OCT workshops to make his angioplasty results even better. He is available daily at Apex hospital Mulund for the procedures.
All Multi specialty & Super specialty hospitals of Apex Group is delivering total patient care in an ethical and open environment with state-of-the-art equipment.
It is a chain of Hospitals managed and run by expert Medical Professionals with experience of 25 years. Currently we are managing more than 350+ beds and providing qualitative healthcare services to the people of Mumbai and surrounding areas.

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