General Infromation

What all should I carry for my first appointment?

Nothing in particular is required on the first appointment as the doctor usually take medical history i.e. history of any previous illnesses, previous surgeries, list of medications that you are on. If you have any recent test reports you may carry them along.

Internal Medicine

What is the difference between common cold and flu?

Common cold and flu are both respiratory diseases. However, common cold is a milder problem than the flu. It is easy to treat cough, sneeze and nasal congestion but if you are suffering from flu symptoms then you can feel ill for a few days to months. It can also cause serious health problems like pneumonia.

How can I treat cold?

Factually, nothing can cure a common cold. You can stick to a few remedies that can definitely make you feel better. At the most, what you can do is:

- Try to relieve your sore throat by doing gargling. Since children who are below 5 years of age cannot gargle so it is advisable to give them warm water with lemon and honey.
- Drink enough juices, lemonade, and water to stay hydrated. Avoid consuming caffeine, alcohol that can worsen your dehydration.
- A humidifier at your home can help you feel better and loose congestion.
- You can use Over the Counter Medicines (OTC) to shorten the duration of the cold to give you instant relief.

What should be the lifestyle changes to treat high blood pressure?

Lifestyle changes to treat high blood pressure:
No matter what medications your doctor prescribes to treat your high blood pressure, you'll need to make lifestyle changes to lower your blood pressure.
• Eating a healthier diet with less salt. Fruits and vegetables are rich in certain antioxidants that prevent narrowing of blood vessels.
• Exercising regularly at least 40 minute.
• Quitting smoking
• Limiting the amount of alcohol you drink
• Maintaining a healthy weight or losing weight if you're overweight or obese
• Stress management: Continuous stress may lead to the activation of sympathetic nervous system and causes hypertension.

Do antibiotics work against all infections?

No. Antibiotics only work against infections caused by bacteria, fungi and certain parasites. They don't work against any infections caused by viruses. Viruses cause colds, the flu and most coughs and sore throats.

Can we be antibiotic resistance?

The fundamental reasons for the development of antimicrobial resistance are use of the wrong drug, incorrect dose and duration, and self-medication. Thus develops the resistance of a microorganism to an antimicrobial medicine to which it was previously sensitive. The inappropriate and irrational use of medicines provides favorable conditions for resistant microorganisms to emerge and spread.

How will I know I need antibiotics?

The answer depends on what is causing your infection. The following are some basic guidelines:
• Colds and Flu: Viruses cause these illnesses. They can't be cured with antibiotics.
• Sore throat, Cough or Bronchitis: These can be caused by both bacteria and Viruses. Your doctor may decide to try using an antibiotic.
• Ear infections: There are several types of ear infections. Antibiotics are used for some (but not all) ear infections.
• Sinus infection: Antibiotics are often used to treat sinus infections. However, a runny nose and yellow or green mucus do not necessarily mean you need an antibiotic.
• Dengue fever: Antibiotics are not required. Take paracetamol, adequate fluid and rest under mosquito net.
• Acute diarrhoea in children does not require an antibiotic, but oral rehydration salts and clear instructions to parents.

What are the different types of headaches?

Headaches can be classified mainly into 4 types
• Migraine Headache – A common form of headache which occurs on one part of the head
• Tension Headache – Headache which occurs at the back of the head, temples, forehead, the feeling is as if a tight hat were in place.
• Hypnic headache – A rare headache that affects the age group of 40 – 80. It occurs only at night at a fixed time of the night lasting for 15 – 60 minutes.
• Cluster Headache – A headache which occurs several times a day but lasts for a short while. It is always one sided headache and is associated with symptoms such as stuffy nose, tearing and enlarged pupil.

How can we treat headaches naturally?

There are many ways of treating headaches. The first initiative to treat headaches would be by bringing a change in lifestyle. Proper sleep, clean surroundings, eating at the right time, exercising etc. would be one of the few things to do to reduce headaches. Other home remedies to follow can be Yoga, meditation, counselling (if needed). Proper nutritional diet and physical exercises also help treating headaches

Does migraine lead to stroke?

Migraine does not directly lead to stroke. Only in cases where the migraine gets complicated can it lead to stroke. Statistically, it is shown that people who have a history of migraine are more prone to get a stroke if the migraine gets worse. For people suffering from migraine, it is advised to reduce smoking and not take up activities which lead to high blood pressure. You should start living and practicing a “stroke-smart” lifestyle.

Is there a cure for chicken pox?

Yes, there is a vaccine for chicken pox and it is recommended for children. They should be routinely vaccinated at 12 – 15 months of age initially followed by a second dose at the age of 4 – 6. The vaccine is also given to adults who are susceptible to the virus on or within 3 days of the exposure.

What should a person infected with chicken pox do to prevent it from spreading?

Chicken pox is a highly contagious disease and can make it very sick, so a person infected should ensure that he does not spread it to other people. Some points to keep in mind are.
• Stay away from work/school
• Stay away from people who are more prone to risk for eg. People with weaker immune system
• Stay clean at all times
• Get vaccinated as early as possible

What is diabetes and what causes it?

Diabetes is a metabolic disease where the blood sugar levels are high. If untreated, it leads to serious complications affecting major organs of the body.

Glucose, found in carbohydrates, is a major source of fuel. We need insulin, a hormone made by the pancreas, for appropriate utilization of glucose in the body. Any disturbance in the production or action of insulin leads toa rise in blood glucose.

Different types of diabetes are caused due to a complex interplay of genetic and environmental factors.

What are the different types of diabetes?

Depending on the genetic & environmental cause of diabetes, there are different types of diabetes:

Type 1 Diabetes Mellitus: This is an autoimmune disorder where the insulin secreting cells of the pancreas gets destroyed due to an inappropriate response of the defense system. As a result insulin production from the pancreas stops. It is seen most commonly in young children and was previously known as juvenile diabetes
Type 2 Diabetes Mellitus: Insulin resistance is a condition in which the cells do not respond normally to insulin. Insulin resistance results in decreased absorption of glucose into the cells. Insulin resistance in combination with a partial deficiency of insulin secretion from pancreas is believed to be responsible for development of type 2 diabetes. It was previously a disease which was limited to adults but now it is common in people of all ages including children.
Gestational diabetes mellitus occurs due to hormonal changes during pregnancy and usually resolves after the delivery.

What should I do to control Diabetes?

If one suffers from type 1 diabetes, the mainstay of therapy is insulin injection as discontinuation of insulin may result in life threatening diabetic emergencies like diabetic ketoacidosis. Till today’s date, there is very little that can be done to restart insulin production from pancreas in type 1 diabetes. The main focus should be on timely administration of correct dosage of insulin and periodic health check up.

Those with type 2 diabetes should adopt a low-sugar and low fat diet; maintain a regular exercise regimen, take timely medicines and schedule timely follow ups with treating doctor.

Can diabetes be cured?

As of now, there is no cure for diabetes. Those with type 1 need life-long insulin injections. Those with type 2 can bring it under control with a regimen of medication, diet and exercise. Rarely, there might be a window period where the doctor might discontinue medicines, but it usually recurs.

What are the complications caused because of diabetes? Diabetes, if unchecked, leads to complications that involve multiple organs.

Increased risk of coronary artery disease, heart attacks, strokes & atherosclerosis (narrowing of arteries)
Eye damage – Retinopathy, cataracts, glaucoma, blindness.
Kidney damage, which can lead to end-stage kidney disease or renal failure.
Nerve damage – tingling numbness, pain or burning sensation in limbs
Erectile Dysfunction
Diabetic foot disease that may lead to gangrene, resulting
Increased risk of bacterial and fungal skin infections
Poor wound healing in amputation.

Does the treatment of diabetes have any side effects?

Diabetic medications are usually safe. They sometimes cause side effects like nausea, loss of appetite, bloating and diarrhea. Some of the diabetic medications can cause low sugar which has to be recognized and corrected immediately. If a medication is causing any side effect please contact your doctor for optimizing your medicines.

What should be my diet plan if I have diabetes?

If you have diabetes you must consult a nutritionist and get a diet plan that suits your lifestyle. Diabetic diet should be low in simple sugars and rich in fiber.

My family members have diabetes. Does that increase my risk?

Yes, as genetic factors are responsible for development of diabetes, those with parents or siblings with diabetes are more likely to get diabetes.

Can diet and exercise help prevent diabetes?

Yes, diet and exercise can help prevent diabetes. There is a stage known as pre-diabetes, where chance of progression to diabetes increases. This stage is reversible. It is crucial to control diet and exercise regularly in order to prevent development of diabetes in future. Maintaining a healthy lifestyle is the first line of defense against diabetes.

How often should I get a blood test after being diagnosed with diabetes?

This varies from person to person. Depending on your type of diabetes and treatment plan, it can range from 4-6 times daily to once in a month. If you are on insulin, it is recommended to take your blood sugar levels 1-7 times a day. If you are feeling dizzy or fatigued, you should immediately check your blood sugar levels with glucometer and if low take sugar or glucose.

Will insurance help cover the cost for treatment?

As diabetes is a serious disease leading to fatal complications if unchecked, it is covered by insurance. Check with your insurance provider about your treatment costs.

Does diabetes cause hair loss?

Diabetes interrupts the hair growing process, which decreases the rate of hair growth. At the same time, it is responsible for the loss of hair from the head, chest, arms and legs.

How do you treat tonsillectomy?

Tonsillectomy refers to the procedure in which the tonsils are removed. There are several ways to remove the tonsils the most common method being “cold knife (steel) dissection”. This technique involves the surgeon removing the tonsils with the help of a scalpel (sharp bladed instrument). Another common method used is “cauterization”. In this method, the tonsil tissues are completely burnt away. Other methods include the use of ultrasound to treat tonsils as well.

Nutrition and Dietiecs

What all should I carry for my first appointment with a dietician?

It is important to carry all your medical reports, doctor’s prescription. A diet dairy with the necessary details (if you have maintained any) like: Your weight, daily intake of calories, any exercise plan you have maintained, and what you have been eating for 10-15 days etc. In case you are using any nutrition supplement, do remember to mention it too. If you are Diabetic remember to carry blood sugar charting. Try to maintain the short term and long terms goals of your diet and take assistance from dietician in achieving it.

What should be my ideal diet to stay healthy?

Healthy eating means consuming the right portions (Quantity) of foods from all food groups to lead a healthy life. We need a wide range of nutrients to lead a healthy and an active life style. The requirement of nutrient keeps changing in different phase of life. For e.g. Infancy would require breastfeed for 6 month followed by good weaning, whereas a preschooler a balanced diet ,more of proteins containing the essential food groups and nutrients - vitamin A, C, calcium, iron and zinc.
A Healthy good diet should be fitting in your nutritional lifestyle and not lifestyle fitting in diet, if later is followed compliance would be only for a short span.

What happens if we consume excess nutrients?

Even when you're eating healthy foods and staying active, it's still possible for you to consume more nutrients than your body needs. Excess nutrients can come from dietary supplements containing high amounts of vitamins and minerals or simply from eating more calories daily than your body uses. If you are eating excess calories than you are able to burn the side effect is overweight or obesity . Obesity is a key to non-communicable diseases like Hypertension. DM , CVD , etc
"Excesses of all nutrients, from water, to iron, to water-soluble B vitamins, can potentially cause toxicities, if you take vitamins and minerals in amounts above the established upper limits of the Recommended Dietary allowances (RDI) may harm tissues where the vitamin is stored in their body. That’s why you shouldn’t take more than the recommended amount.
"Certain water-soluble vitamins in excess can cause problems, such as too much vitamin B6 can cause nerve problems, too much niacin can cause flushing, and excess vitamin C can cause kidney stones.
"Too much vitamin A, D, or K can lead to increased levels that are unhealthy and can cause health consequences, too much vitamin A can lead to birth defects, and too high levels of vitamin E may increase the risk of hemorrhaging. Excess vitamin K can lessen or reverse the effect of blood thinner medicines and prevent normal blood clotting. Excess of vitamin D can increase blood level of calcium and eventually cause calcium deposits in soft tissues.

Will proper diet help me reduce excess weight?

A healthy body has a healthy mind. Not only does a good diet keeps you rejuvenated throughout but also helps in maintaining your body weight. Few simple steps of working towards weight loss can be :
• Eat 5 – 6 Small frequent meals
• Snack Smart (Handful nuts, fruits , Roasted Grams , granola bars, soups, bhel , dhokla, khandvi, idli , boiled egg, Fruit smoothies made with low cal dairy / sugar, sprouts ,etc)
• Remember Funda of 5 (Daily intake 5 fruits and vegetables)
• Pack homemade food, avoid junk and high calorie, high on oil canteen food.
• Moderation in sugar (2tsp / Day) and oil (3 - 4tsp/day) consumption, Use combination of oils
• Use toned or double toned milk and its products
• Never skip meals specially Breakfast and eat early dinner by 8:00 - 8:30pm, Remember the saying eat Breakfast like a king, Lunch like a prince and dinner like a pauper
• Maintain the equilibrium: Eating the same number of calories as you would burn to maintain a healthy diet
• Controlling salt/sodium consumption and ensuring that you use iodized salt.
• Drink enough water
A combination of physical activity of atleast a 30 minute walk per day with a moderation in calorie intake would do wonders. Drastic weight loss programs can be rarely sustain.

What should be the diet during pregnancy?

Diet in pregnancy needs to be carefully planned under the supervision of a gynecologist and dietician. What you will eat will ultimately benefit your baby therefore experts’ advice to consume nutritious meals for an overall development of fetus. Typically, you will need to consume an extra 300 calories a day, additional 15gms of protein , 1000mg of calcium , 30mg of iron. Your prenatal diet should primarily consist of:
• Fruits and vegetables
• Lean proteins
• Whole grains
• Dairy products
• Fish
• Coconut water

What should be the diet post pregnancy?

Like in pregnancy it is equally important to eat a healthy diet during lactation, nutrition demand during lactation is higher than pregnancy but All mothers are eager to get back into shape post pregnancy. The solution for this is not start dieting immediately but to follow a steady diet which will take care of your metabolism and at the same time provide essential nutrients to your body and help you secrete more breast milk.
To support lactation and maintain maternal reserves, most mothers will need to eat about 500 additional kilocalories every day (an increase of 20 percent to 25 percent over the usual intake before pregnancy). Well-nourished mothers who gain enough weight during pregnancy need less because they can use body fat and other stores accumulated during pregnancy. Lactation also increases the mother’s need for water, so it is important that she drink enough to satisfy her thirst.
A mother who is eager to get back in shape just need to reduce the intake of fats and sugars in her diet, but focus on other nutrients .

Bariatric/Weightloss Surgery

How do i know if i am eligible for weight loss surgery?

Weight-loss surgery is only recommended if the patient has had unsuccessful attempts at weight loss and sustenance and keep it off by dieting, changing your overall lifestyle and exercising alone. Doctors often use the body mass index (BMI) and health conditions such as type 2 diabetes and high blood pressure to determine which patients are most likely to benefit from weight-loss surgery. Patients who qualify are those with BMI above 32.5 kg/m2, with associated co-morbidities like diabetes etc or patients with BMI above 37.5 kg/m2, with or without associated co-morbidities.The right candidates are the ones who:
1) Have a BMI>32.5 and associated diseases like diabetes, hypertension, osteoarthritis, obstructive sleep apnea.
2) Have a BMI>37.5, with or without associated illnesses
3) Did not benefit from the weight loss management techniques
4) Are uncomfortable in performing routine activities due to excess weight

What are the risks of weight loss surgery?

During your counselling and evaluation, the doctor will explain the risks pertaining to each individual.

How much weight can i lose after surgery?

One loses approximately 60 to 80 % of excess body weight at a pace of 6 kilograms weight loss every month. The weight loss is long term and sustained.

How long do i have to stay in hospital after surgery?

Generally, hospital stay can be between three to four nights, unless there are situations demanding longer stay due to co-morbid conditions/high risk patients and adverse events.

When can i resume my work?

It will depend on the type of surgery and the type of your work. You must plan to take out 7-10 days from work if recovery is uneventful.

Should i exercise after weight loss surgery?

Yes, regular exercise is necessary for maintaining weight loss.

What are the lifestyle changes necessary post surgery?

• Eat small meals
• Eat nutritious and balanced diet (high in protein and low in carbohydrates and fats).
• Exercise regularly.
• Regular follow up with your surgeon.

Will my social relationships suffer because of weight loss surgery?

No. You can opt for many healthy alternatives like foods and drinks at social functions with the help of your nutritionist.

Is there a possibility that i might lose my hair after surgery?

Not always observed and not true for everyone. However, since there are fat cells between your hair follicles, you can expect some hair loss which can be managed with a zinc rich diet and supplementation. Better quality hair will come back once the weight stabilizes.

Can I get pregnant after weight loss surgery?

Weight loss surgery improves fertility especially in women suffering with PCOD (Polycystic Ovarian Syndrome) and the ones who are having difficulty in conceiving. In fact, several women who are trying to conceive are advised to lose weight to increase the chance of conception and a healthy pregnancy.

How frequent should be the follow ups?

Twice to thrice in the first year and then once in every year for at least 5 years.

Caseless Facilities FAQs

How should I test for Cancer?

It is advisable to go for regular medical check-ups rather than waiting for symptoms or pain to occur. It is not correct to jump to conclusions as only a doctor has the qualification to tell the patient whether it is cancer or any other condition. Apart from the physical examination, he may conduct a series of tests and imaging procedures. If the initial tests do not reveal any mutations, the doctor will advise a biopsy that removes a sample of tissue that is then diagnosed by a pathologist. A pathologist is able to judge what kind of cancer cells have manifested and their likely chances of growth.
When to visit the doctor?
• Fever higher than 100.5°F
• Cough or sore throat
• Vomiting that continues for longer than 12 hours
• Severe constipation or diarrhoea
• Bleeding or bruising
• Shortness of breath/chest pain
• Urinary burning
• Blood in the urine or stool
• Pain in a new place or pain that is not relieved by your pain medicine


Is cancer a communicable disease?

Cancer is not a contagious disease. It does not spread from one person to another. A healthy person cannot get it from a cancer patient by close contact or breathing the same air. The only time when cancer has the possibility to spread is when there is a transplantation of tissue or organ.
We know that germs like bacteria and virus are communicable with any form of physical contact. This leads to the misconception that cancers are contagious. It is worth knowing that the cancer cells from an infected person are thoroughly destroyed by the cells of a healthy person. This is so because the immune system of a healthy person is very strong whereas that of a cancer stricken patient is quite weak. The immune system of the patient further takes a great deal of beating during the entire process of treatment.

Can I safely interact with children and others at home?

You may worry that these lifesaving treatments could somehow be harmful to your loved ones. The general answer to this concern is that physical contact is fine with children and other members at home.

If no one in my family has had cancer, does that mean I’m risk-free?

No. Based on the most recent data, about 40 percent of men and women will be diagnosed with cancer at some point during their lives. Most cancers are caused by genetic changes that occur throughout a person’s lifetime as a natural result of aging and exposure to environmental factors, such as tobacco smoke and radiation. Other factors, such as what kind of food you eat, how much you eat, and whether you exercise, may also influence your risk of developing cancer.

Am I too old for cancer treatment?

There is no age limit for cancer treatment. Decisions about cancer treatment for older adults should take into consideration the same factors as for younger adults and should not focus on the person’s age alone. Many older patients benefit as much as younger patients from treatment. However, some older adults may have other illnesses that limit the use of specific treatments.

How to manage fear, anxiety and panic attacks?

If you have a panic attack:
• Take slow deep breaths.
• Distract yourself. For example go for a walk, ring a friend, or listen to music.
• Do relaxation exercises.

How to cope with the depression?

Many people go through a time of grief and sadness when they first learn that they have cancer. They grieve the loss of health and certainty in their lives. This sadness may seem like depression, but it’s not the same. Grieving – feeling sadness, fear, anger, or going through crying spells – is a common reaction to learning you have cancer. It usually doesn’t last a long time, and is normal.

Does radiotherapy causes hair loss from scalp/head?

Patients receiving Radiotherapy - RT on their head lose their scalp hair (that too partially). If you are getting radiation on any other body part, you will not lose your scalp hair. Radiation causes only hair loss in local area. Patient receiving radiation to breast might lose some hair in arm pit or male patients with RT might lose facial/beard/moustache hair.

How can I develop my behavioral skills to overcome the changes in the body image?

Sometimes people may stare, make comments, ask questions or avoid people with body changes. This can be upsetting and hard to deal with. Social skills focus on how to communicate well and can help you manage social gatherings and the reactions of other people.
You may wish to think about:
• Presentation – The way you present yourself overall is important, for example, dress and accessories. It conveys a message to other people about how you feel about yourself.
• Posture – Communication involves the whole body. Standing with your shoulders back and head up makes you look confident and assertive.
• Engaging with people – Making eye contact, smiling and nodding tells others that you’re approachable.
• Taking the initiative – You may wish to talk about your body changes at an appropriate point in a conversation.
• Having self-confidence and believing in one self is of utmost importance.

How can I manage the fear and anxiety I feel before my follow-up test or appointment?

It’s normal to feel anxious before your follow-up tests and appointments, but there are ways to ease your mind.
Tips and strategies
• Writing down questions about any issues you are currently or have been experiencing — whether it’s long-standing symptoms, emotional aspects, or practical issues such as questions about health insurance — and
• Asking a friend or family member to sit with you while you wait for your scans.
• In the days before your appointments, schedule activities that can help distract you from worrying, such as going for walks, talking with friends and family, or doing a calming exercise like yoga.
• Positive feedback by self : “ I am alright”.
You may find that your anxiety lessens or disappears over time.

What is follow-up cancer care and why is it important?

• Follow-up cancer care involves regular medical checkups that include a review of a patient’s medical history and a physical exam. Follow-up care may include imaging procedures(X Rays, Utrasound, CT Scan, MRIs etc), blood tests, and other lab tests.
• Follow-up care is important because it helps to identify changes in health. The purpose of follow-up care is to check for recurrence (the return of cancer in the primary site) or metastasis (the spread of cancer to another part of the body) or be sure that one is cancer free.
• Follow-up care visits are also important to help in the prevention or early detection of other types of cancer, address ongoing problems due to cancer or its treatment, and check for physical effects that may develop months to years after treatment ends. All cancer survivors should have follow-up care.

What actions can I take to improve my health after completing treatment for cancer?

There are several important things you can to do safeguard your health.
• Stop Smoking / Alcohol
Quitting smoking is one of the best ways to improve your general health. Quitting will help you breathe easier and feel better overall. It will also reduce your risk of developing certain cancers and will help prevent cardiovascular disease.
• Eat a Nutritious Diet
Eating a nutrient-rich diet with plenty of fruits and vegetables can help you feel better and may lower your chances of developing other health problems. Our Eating Your Way to Better Health and Eating Well during and after Your Cancer Treatment guides offer general dietary guidance.
• Achieve and Maintain a Healthy Weight
After cancer treatment, speak with your healthcare provider about whether you need to gain or lose weight.
• Exercise Regularly and management of weight.
Exercise after cancer treatment, regardless of how active you were prior to your diagnosis, can improve cardiovascular fitness and muscle strength. Regular exercise may also reduce fatigue in some cancer survivors.


What is endoscopy and how is it done?

Endoscopy is done by inserting a thin line instrument (endoscope), in the patients’ body to view the internal blood vessels. It does not require the surgeon to make incisions and despite that view the problems.

Is endoscopy a painful procedure?

Endoscopy is not a painful procedure but most people may experience a mild discomfort. In case the patient is still not comfortable, then the doctor gives a local anesthesia to numb the particular area or a sedative to help you relax more.

What is colonoscopy?

The procedure involves the use of a colonoscope where the surgeon views the inner lining of large intestine in order to identify tumors, colon polyps, ulcers, internal bleeding or inflammation. The surgeon can also take samples of tissues for biopsy.

Mental Health and Behavioral

Do you treat mental disorders?

We do provide treatment for mental disorders. The best advice would be to visit the doctor in case of such situations as they will be able to analyze the case in more depth and offer more accurate treatment methods. However some common approaches to treat mental disorders are

Anti-anxiety medications
Mood treating medications
Home treatment programs
Brain stimulating treatments

How can I improve my approach towards being healthy?

Prevention is the key to stay healthy and happy, so plan to prevent the toxic build up. For this you need to get rid of all irregular habits specifically linked to diet, work, sleep and even use of excessive technology
Follow a regular diet and a healthy lifestyle routine
Exercise daily to improve digestion and elimination of toxins. Even 1000 brisk steps a day will do the trick
Proper and adequate sleep at night
Meditate after a days’ work or unwind with something that will lighten up your mood like listening to your favorite music, cuddling a pet that you have at home
Sufficient use of spices having enough micro nutrients and vitamins that we regularly need on a daily basis. These will help to promote good health.
Fasting with only liquid diet and fruits only once a month .Fix a day as per your convenience and follow it regularly.
Practice Yoga and Pranayama under supervision to start with till you master the art and make it a part of your daily routine that will work towards a healthy body and a very positive mind
Acts of kindness, compassion and feeling optimistic and grateful will have a positive impact on your mood and make you happy and healthy

Which stress management techniques will you use?

Every person has their individual level of stress and has different ways of dealing and coping up with stress. So there are no pre-determined techniques to deal with stress. Some methods which you can try and inculcate are

Do something that interests you - As busy as you are, try and take out time to pursue something apart from work and which you enjoy doing like some hobby, playing with your pets, volunteering work etc
Meditate – Meditation really helps you in clearing your mind and you are able to focus on the things that happening right now. It also helps in dealing with stress effectively.
Exercise – Exercising helps you in focusing on other aspects of your body to develop which contributes to tackling stress. Regular exercises like walking, jogging or even doing household jobs can help fight stress
Get the right amount of sleep – Overworking or over burdening yourself is one of the major factors which adds to stress levels and eats up our sleep time. Not getting enough sleep will not give you the energy to deal with the existing stress or more that may pile up later on. Ensure that you get atleast 8 hours of sleep for your brain and body to get enough rest and deal with the situation as and when they come.

My family has no history of mental illness. Does that mean I am immune?

While family history plays a large role in developing mental illness, it is not the only factor. There are environmental and psychosocial factors that add to the risk factors. No one is immune from developing mental health illness.

Is treatment covered by insurance?

Most psychiatric conditions are not covered by insurance. Contact your insurance provider to get more details

Laparoscopic Surgery

What are the advantages of laparoscopic surgery over conventional surgery?

Endoscopic surgery causes much less pain and patients are mobile within hours after surgery. They are also allowed to resume all activities much earlier and can go back to work within 5-7 days. Another advantage is that both sides can be operated in the same sitting without any extra pain or stay. The cosmetic results are excellent.

Don’t people need their gallbladders?

Fortunately, the gallbladder is an organ that people can live without. Losing it won’t even require a change in diet. Once the gallbladder is removed, bile flows out of the liver through the hepatic ducts into the common bile duct and goes directly into the small intestine, instead of being stored in the gallbladder.

Why are men prone to hernia than women?

Men are more prone to inguinal hernias than women because of basic differences in anatomy. The area where hernias occur most often has a very different function in men than in women.


What are the techniques you use for different procedures?

Nephrologist use oral and IV medications; Ultrasound Guided Biopsies/ aspirations. Nephrologists use Hemodialysis/Plasmapheresis/CRRT/Peritoneal Dialysis to manage ESKD/AKI patients. Depending on the underlying cause, there are different procedures with different techniques.

When is dialysis required?

Your kidneys are responsible to filter out your body’s blood, absorb minerals and produce urine. Due to end stage kidney failure, your kidney loses 85 – 90 % of its functionality, leading to the need of dialysis, which in turn help filter out the waste, salt and extra water.

What should be lifestyle to avoid kidney problems?

The kidney is one of the essential organs of the body. It is linked to pathologies of other organs and can be damaged irreversibly, which may result in dialysis or transplant.

Thus, there are certain precautions one can take:

 Quit smoking/recreational drugs
 A balanced diet: Low salt, low carb, balanced protein, balanced acidity, calcium-rich.
 Lose weight in a safe manner, avoid diet pills/crash diets
 Drink copious amounts of water, especially in the summers.
 Read food labels of all food to know the sodium content


What are early warning signs of neurological diseases?

You can witness:
- Sudden numbness or weakness
- Loss of hearing or speech difficulties
- Confusion
- Poor cognitive skills
- Double vision
- Difficulty in vision
- Seizures
- Difficulty in walking
- Severe Headache
- Bladder/ Blood Dysfunction

Is spine surgery a failure?

No, spine surgery has a success rate of 92-95%. It is indicated for conditions like disc prolapse, spinal canal stenosis and spinal instability, Spine tumours, when the symptoms and signs pertaining to above conditions match the MRI findings.
However, in the absence of neurological deficit like weakness in the limbs, loss of sensation, bowel/bladder disturbances, you should opt for a trial of adequate conservative management- the period of which is normally 3 weeks to 3 months. Conservative therapy can be in the form of analgesics, physiotherapy and lifestyle changes. Despite that, if the pain persists or if there is progression of symptoms, then surgery is advised. Indications for surgery include:
- Onset of a new neurological deficit.
- Bowel / Bladder problems
- Failure of adequate conservative trial
- Neurogenic intermittent claudication (pain, tingling & numbness in legs while walking)
- Intractable back pain interfering with activities of daily living.

What causes slipped disc? Are there any treatment options available?

As you get older, your spinal discs start to lose their water content, making them less flexible and more likely to rupture. A slipped disc occurs when the outer case of the disc splits, resulting in the gel inside to bulge out of the disc. The damaged disc can put pressure on the whole spinal cord or on a single nerve. A slipped disc can cause pain both in the area of the protruding disc and in the area of the body controlled by the nerve that the disc is pressing on. Smoking also plays a role as it causes the discs to lose their natural flexibility.
There are a number of factors that can put increased pressure and strain on your spine. These include:
• bending awkwardly
• Jobs that involve heavy or awkward lifting
• Jobs that involve lots of sitting, particularly driving
• being overweight or obese
• Weight bearing sports, such as weightlifting
• A traumatic injury to your back, such as a fall or accident
Situations such as these can weaken the disc tissue and can sometimes lead to a slipped disc.
An initial treatment will usually involve a combination of physiotherapy and medication to relieve the pain. Though in some severe cases like if the pain continues for more than 6 weeks, surgery may also be recommended to release the compressed nerve and remove a part of slipped disc.

Gynaecology And Obstetrics

Can I travel during pregnancy?

Unless you have been identified with any complications, it is perfectly safe to travel during pregnancy. Most women find the second trimester the most ideal time to travel as you are done with the morning sickness of the first trimester and won’t get as easily tired as one does in their third trimester. Indian airline carriers allow women to travel up to 32 weeks of their pregnancy.

How often should I get checked by my doctor during my pregnancy?

In a normal pregnancy, you can be expected to come in for a check up on the following days:

• 4 weeks to 28 weeks: 1 visit/month
• 28 weeks to 36 weeks: 1 visit/2 weeks
• 36 weeks to 40 weeks: 1 visit/week

If it is a high-risk pregnancy such as twins, advanced age of women or a complicated pregnancy, your doctor may want to see you more often depending on your condition.

What should my diet be once I am pregnant?

A pregnant woman needs more folic acid, calcium, iron & protein than a non-pregnant woman. Hence pre-natal vitamins, which contain an ideal amount is prescribed to every expecting woman. Leafy vegetables, whole grains, dairy products, fruits and lean meats should make up 80 % of the diet. There can be cravings for salty and sugary food in pregnancy but one should try to eat as healthily as possible to avoid gaining excess weight.

What changes do I expect in my body once I am pregnant?

Your body will undergo a multitude of changes as you go through your pregnancy. The most obvious change is your abdomen. It will start looking globular by 12 weeks, an ovoid shape by 28 weeks and turns spherical beyond 36 weeks. The change in the shape of your abdomen is accompanied by slight discomfort, gastric reflux and stretch marks over the next 9 months. The breasts become larger and the areola becomes darker as the pregnancy advances. Your skin may undergo changes such as stretch marks on your buttocks, thighs and abdomen in the second half of pregnancy. Hyperpigmentation of the umbilicus, nipples, abdominal midline & face may be seen due to the hormonal changes in pregnancy. Spider veins and reddening of the palms is commonly seen due to hyperdynamic circulation. Sometimes, there is change in growth rate and texture of nails and hair. Feet and ankles swell during pregnancy due to the increased fluid carried by the body. Leg cramps may occur due to the excessive fluid, shortage of calcium and phosphorus and fluctuation of hormones. A healthy weight gain in pregnancy is 11 kg– 1 kg in the first trimester, 5kg in the second trimester and 5kg in the third trimester. Anything between 11- 17 kgs is taken as a normal weight gain of pregnancy. There is an increase in your body temperature which will get back to normal by the 16th week. Due to increased ligament laxity, many women suffer from back pain during their pregnancy.


How common is arthritis and can it be prevented?

Arthritis is one of the most common ailments seen in the country. This disease is difficult to control because it is caused primarily by increasing age and family history. However, one can reduce the risks of developing arthritis by exercising regularly and maintaining a healthy lifestyle.

Is arthritis genetic?

Primary osteoarthritis is a degenerative disorder due to ageing process. In some cases arthritis is an auto-immune disorder that develops due to genetic & environmental factors. While it is still unclear what is the exact cause of arthritis but you have a higher risk of developing arthritis if a close relative has arthritis.

What is the common age for osteoporosis to occur?

Osteoporosis is commonly seen in women post-menopause. Around 2 in 100 women have osteoporosis by the age of 50 which increases to 1 in 4 by the age of 80. However, there have been cases where osteoporosis occurred at any age.

Does consumption of soft drinks have an impact on my bones?

Yes, soft drinks have an impact on your bones. Firstly, the increased intake of soft drinks displaces milk or fruit juice from your diet. Secondly, phosphoric acid is a main component of soft drinks. Due to the increased intake of phosphorus, there is not enough calcium to maintain the balance which directly leads to lowering the bone density. Lastly, most soft drinks have caffeine in them which interferes with calcium absorption.

What are do’s and don’ts of a person suffering from spondylosis?

There are certain precautions one needs to takes when dealing with spondylitis

 DO follow up with your doctor regularly.
 DON’T avoid exercising. Regular exercising & a healthy body weight leads to a better quality of life
 DO inform your doctor of any side effects of any of the medications you take
 DON’T slouch or sit without support. While standing, make sure you a
 DO eat a healthy and alkaline-based diet to help reduce the inflammation.
 DON’T skip your medicines under any circumstances
 DO strengthening exercises for your neck/back on a regular basis
 DON’T lift heavy weights.


What can a physical therapist do?

A physical therapist is a highly-trained medical professional who helps in restoring mobility & function, reduce pain and/or prevent disability. In most cases, an intensive physiotherapy plan conducted by a skilled physiotherapist rules out the need for interventional surgery and helps reduce the need for long-term medication.

Physical therapists diagnose and manage multiple conditions that reduce quality of life. These include any movement dysfunction, chronic pain especially in weight-bearing joints, post-operative recovery, etc

Who are the right candidates for physiotherapy?

The right candidates for physiotherapy are:
 Patients who do not want to undergo surgery to treat their condition
 Post-surgery patients
 Patients with mobility dysfunction, chronic pain and/or diseases that reduce quality of life such as spinal stenosis, Parkinson’s, strokes
 Anyone who has been recently injured
 Immobilized patients

What is treatment for frozen shoulder?

Frozen shoulder is pain, stiffness and limited range of movement of your shoulder due to an injury or overuse of the shoulder. It is common in women between 40-60 years of age.

Proper stretching is the mainstay of physiotherapeutic treatment. Make sure you warm up your shoulder before stretching (10 – 15 minutes prior). The aim is to bring maximum tension with no pain.

There are different stretches one can do such as the Pendulum stretch. Relax your shoulders and lean over the edge of a table. Let your affected arm loose so it feels like it is hanging offwith the unaffected arm supporting your weight. Make a small, circular motion while keeping the arm hung. Repeat these motions 10 times a day.

Another good stretch is the Finger Walk stretch. Face a wall a little less than an arm’s length away. Reach out to the wall with your affected arm and place the index & middle finger at the level of your waist. Slowly, start “walking” up the wall with your fingers, as high as you can without causing pain. Bring the hand back down slowly. Repeat 10 – 20 times a day.

My pregnant wife suffers from serious back ache. Can you suggest a few exercises for her?

Pregnant women often complain of backache, due to increase of girth around the abdomen. A few muscle-strengthening exercises might help. It is important not only to strengthen the back but the abdominal, buttock, pelvic floor & thigh muscles as well.
Arm & Leg Raises: Kneel on the floor on all fours, with the distance between both hands & both legs roughly the distance from shoulder to shoulder. Raise one leg, tilting your pelvis to give you more balance. Once you feel you are stable, slowly raise the opposite hand. Hold for 10 seconds. Bring them both down together. Repeat on opposite side. Do 10 repetitions each day, slowly increasing the number.
Cat Position: Kneel on the floor on all fours, with your arms straight, directly under the shoulders. Take a deep breath and arch your back upwards, your chin resting on your chest. Stretch as much as you can. Exhale and flatten the arch, with your head rising and chest puffed out, stretching as back as you can. Once you are comfortable in this position, slowly shift your weight on to your arms, leaning as forward as you can. Repeat this motion 10 times a day
Pelvic Tilt on the wall: Stand straight against the wall, your legs shoulder-width apart. Let your hands rest on the side of your body. Feel the gap between your lower back and the wall. Once you’ve felt it, remove your hand and press your lower back against the wall, eliminating the space. Hold this for 10 seconds. Get back to your starting position. Repeat 15 times a day.

Is yoga and physiotherapy inter-related?

There are certain exercises that overlap between physiotherapy and yoga, clearly showing that while they are different in their ideologies, they are similar in different aspects.

Physiotherapy is a rehabilitation program that concerns itself with only one specific problem area at a time; whereas yoga has a more holistic approach where the spiritual and mental health is as important as the physical health.

What unites them is the emphasis on slow movements, with no jerks, focusing on increasing blood circulation and increasing tensile strength. It is about the reaching maximum tension without pain.

My neck hurts while working on the computer. Please suggest some exercises.

Posture while sitting, the vertebral support of the chair & placement of the computer on the desk contribute to workplace neck pain. Apart from rectifying this, there are a few exercises one can do to strengthen the neck:

Side to Side: Stand straight with your arms loosely placed in front. Turn your neck slowly to one side, rolling it to the other side, dipping your chin to your chest in the process. Repeat this movement 30 times.
Shoulder shrug: Stand straight, with your shoulders relaxed. Slowly, raise both shoulders together, like a shrugging gesture, to maximum tension and lower them back to starting position. Repeat 20 times
Tilt to Side: Stand straight, with your shoulders relaxed. Tilt your head slowly towards one side, the corresponding arm gently pushing it down further. Keep for 10 – 20 seconds, repeat on the other side. Practice this exercise 8 – 10 times a day.


What are the two main conditions of COPD? Are there any diagnostic criteria?

COPD includes two main conditions

EMPHYSEMA - In Emphysema, the air sacs and their walls get damaged and larger air sacs are formed instead of small ones.
Chronic BRONCHITIS - In Chronic Bronchitis, the lining of the air tubes is inflamed and thickened. This produces a large amount of mucus (balgam) and makes it hard to breathe.
Your doctor or pulmonologist will diagnose COPD based on your signs and symptoms, history, physical examination and tests reports. Below mentioned are few tests

What will happen to my body if I sleep less?

Sleep is one of the key factors that determine the health of an individual. How one wakes up in the morning is a fair indicator whether one is getting a proper sleep or not. Therefore, if you have been snoozing your alarm too often, you might be damaging your own health. Experts believe that under normal circumstances, one should be able to wake up refreshed. And if you are not then you might be suffering from a sleep disorder. This can cause neurological changes in your body and can reduce the productivity at work. Moreover, in the short run it can cause memory problems and severe hormonal changes in your body.

How will I know if I am suffering from sleep apnea?

Sleep apnea is one of the most common disorders that often go undiagnosed. Sleep apnea should not be overlooked because its symptoms are so broad that it can interrupt your hard day at work and can lead to serious complications. The most common symptoms are:

Waking up with sore or dry throat
Loud snoring
Occasionally waking up with a choking or gasping sensation
Sleepiness or lack of energy during the day
Sleepiness while driving
Morning headaches
Restless sleep
Forgetfulness and mood changes
In addition to this, Obstructive Sleep Apnea (OSA) can have a negative impact on your health and can cause:

Heart attack and Blood Pressure
Lead to Weight Gain
Aging of Skin

What is Pulmonary (Lung) Function Test (PFT)

PFT measures how much air you can breathe in and out and how fast you can do it and how well your lungs are working to deliver oxygen to your blood. PFT is a painless test and a technician will ask you to take a deep breath and then blow as hard as you can into a tube connected to PFT machine.

PFT is the most important test for the diagnosis and management of COPD. PFT is similar to ECG of the lungs


Will any urinary problems affect my sex life?

Urinary problems such as incontinence, prostate problems or UTI’s (Urinary Tract Infection) have a detrimental effect on the sex life. Patients with urinary problems should talk to their doctor openly about sexual issues if any.

What are the risk factors of prostatitis?

The risk factors of prostatitis are:
 Infrequent Ejaculation or abstinence from sexual activity
 Urination immediately after ejaculation
 Bladder outlet obstruction such as BPH, Stricture urethra, Stones, Tumors
 A suppressed immune system,
 Catheterization
 Unprotected sex / Multiple Partners
 Diabetes Mellitus

What steps can I take to prevent prostate problems?

The certain steps one can take to prevent prostate problems:
 Exercising regularly
 Healthy balanced vegetarian diet
 Healthy frequency of ejaculation
 Hygiene of the penis and the surrounding areas
 Safe sex