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One GOOD reason to switch off your phone when you’re with your Doctor.

Monday, December 23rd, 2019

One GOOD reason to switch off your phone when you’re with your Doctor.

In day-to-day practice, we come across amusing instances that stump the doctor for a moment. This was one of them. This will be understood better if read in the light of the common Indian sociocultural mindset regarding children and marriage.

I usually ask ladies whether they’re likely to be pregnant, so that I can avoid potentially harmful drugs, in case they are.

I had just finished listening to a young lady. She had walked in alone. Looked well groomed; dressed in what most of the 100% literate society here would derisively call “modern” – i.e jeans and a top. Lipstick, yes. Well touched eyes. A fancy, glittery handbag, yes. Looked like she’s spent 5K on her hair this week, yes. Literate? Definitely yes, since she was looking into her mobile every 30 seconds or so. Looked busy, yes or at least pretended to be. But not in a real hurry to go anywhere.

We discussed her problem which was not so difficult to manage. At the same time, my attempts at a careful thought process and communication to help her recover from her seemingly trivial illness were frequently being distracted by her attention into her mobile phone.

I say nothing to such distracters now. After all, it’s their life. There is a prominent notice on my consultation door, in two languages- English and local- requesting people in the waiting area to “kindly” switch off their phones BEFORE entering the doctor’s room.

The words have had little effect. If people from a proudly 100% literate state fail to comply with a simple suggestion, I usually don’t spend any more time requesting them to keep their mobiles aside. Previously, when I did, however politely, their faces frequently put up purposeful cringes. At best, there would be mocking apologies. The apologies were usually followed by closing whatever windows they had used the whole day or week, touching various buttons to put the phone in silent mode, and then switching off their mobiles, and then keep staring at the screen till it went completely blank. This took another full precious minute. On busy days, even these single minutes saved, when added up, would result in avoiding confrontations with the last few patients for the day.

Instead, if someone’s obsession with their mobile phone keeps distracting me too much, I now actually put it in the case notes– so in case they come with accusations of negligence later on, I know what to show them.

I don’t know if we realize it. Using the mobile phone when a consultation is on can lead to poor communication and errors in decision making for both parties.
Lets come back to our young lady.

Dr (in all seriousness): “Madam, are you married?”
Young Lady“Yes”.
Dr“Are you likely to be pregnant?”
Young lady (distracted by her mobile, smiling at something): “I don’t know. My husband will be back after 2 more months”.
It sunk in a second 

I’m puzzled about the timing of that smile- was it the joke in her mobile, or was it her own response to the doctor’s question??

Now that will remain a mystery. For the problem she came to see me for, I decided that I didn’t need to know her intimate details.

But I’m still wondering whether to put her exact words on permanent record, potentially inviting trouble for her later on. Technically, nothing wrong with that. Isn’t it?

But in the end, you know how tolerant and alert and careful and what a nice chap your family doctor is 

We proceeded to discuss this point. In the end, we had a good laugh and she promised never to let the mobile distract her when she’s in the midst of anything else that deserves due respect.

That’s why one should be attentive when the doctor is trying to help. Of course, one may expect the doctor also to stay away from the mobile. Believe me, we try our level best. But we do have to attend to genuine calls. It’s not practically possible for the doctor to switch off the mobile for hours at a stretch while at work- in fact, the mobile is a vital need for the 8-12 or 36 hour shifts for the doctor while at work. Its common sense.

All we request from patients and carers is to keep it away during the 5-30 minutes of the consultation.

Moral of the story:


So here’s one good reason for that. God only knows- it may help an unborn child figure out his/her real father’s name in case need arises in future 


Thursday, November 7th, 2019


Malnutrition is a condition that results from eating a diet in which one or more nutrients are either not enough or are too much such that the diet causes health problems.It may involve caloriesproteincarbohydratesvitamins or minerals. Not enough nutrients is called undernutrition or undernourishment while too much is over nutrition. Malnutrition is often used to specifically refer to undernutrition where an individual is not getting enough calories, protein, or micronutrients. If undernutrition occurs during pregnancy, or before two years of age, it may result in permanent problems with physical and mental development. There are two main types of undernutrition: protein-energy malnutrition and dietary deficiencies. 

In some developing countries, over nutrition in the form of obesity is beginning to present within the same communities as undernutrition. Other causes of malnutrition include anorexia nervosa.

Efforts to improve nutrition are some of the most effective forms of development aid. Breastfeeding can reduce rates of malnutrition and death in children, and efforts to promote the practice increase the rates of breastfeeding. In young children, providing food (in addition to breastmilk) between six months and two years of age improves outcomes. Management of severe malnutrition within the person’s home with ready-to-use therapeutic foods is possible much of the time. In those who have severe malnutrition complicated by other health problems, treatment in a hospital setting is recommended.

Signs and symptoms

The signs and symptoms of malnutrition depends on the type. Being able to recognize the effects of malnutrition can help people and health care providers identify and treat issues related to under or over nutrition


Undernutrition typically results from not getting enough nutrients in the diet.

This can cause the following…

Weight loss

Loss of fat and muscle mass

Hollow cheeks and sunken eyes

A swollen stomach

Dry hair and skin

Delayed wound healing



Depression and anxiety

Difficulty in concentrating

People with undernutrition may have one or several of these symptoms. Some types have significant effects.

Kwashiorkor, a severe protein deficiency, cause fluid retention and a protruding abdomen.

Marasmus which results from severe calorie deficiency, leads to wasting and significant fat and muscle loss.

Undernutrition can also result in micro nutrient deficiencies. Some of the most common deficiencies and their symptoms are as follows.

Vitamin A : dry eyes, night blindness, increased risk of infection.

Zinc : loss of appetite, stunted growth, delayed healing of wounds, hair loss diarrhoea.

Iron : impaired brain function, issues with regulating body temperature, stomach problems

Iodine : enlarged thyroid glands, decreased production of thyroid hormones, growth and development issues.

Over nutrition

The main signs of over nutrition are overweight and obesity. It can also lead to nutrient deficiencies. Research shows that people who are overweight or obese are more likely to have inadequate intakes and low blood levels of certain vitamins and minerals compared to those who are at a normal weight. This is likely because of an over consumption of fast and processed foods that are high in calories and fats but low in nutrients.

Dietary practices


A lack of adequate breastfeeding leads to malnutrition in infants and children, associated with the deaths of an estimated one million children annually. Illegal advertising of breast milk substitutes contributed to malnutrition and Maternal malnutrition can also factor into the poor health or death of a baby. Deriving too much of one’s diet from a single source, such as eating almost exclusively corn or rice, can cause malnutrition. This may either be from a lack of education about proper nutrition, or from only having access to a single food source.It is not just the total amount of calories that matters but specific nutritional deficiencies such as vitamin A deficiencyiron deficiency or zinc deficiency can also increase risk of death.


Overnutrition caused by overeating is also a form of malnutrition. Many parts of the world have access to a surplus of non-nutritious food, in addition to increased sedentary lifestyles. The issue in these developed countries is choosing the right kind of food. The reason for this mass consumption of fast food is its affordability and accessibility. Often fast food, low in cost and nutrition, is high in calories and heavily promoted. When these eating habits are combined with increasingly urbanized, automated, and more sedentary lifestyles, it becomes clear why weight gain is difficult to avoid.

Not only does obesity occur in developed countries, problems are also occurring in developing countries in areas where income is on the rise. Overeating is also a problem in countries where hunger and poverty persist. Overeating leads to many diseases, such as heart disease and diabetes, that may result in death.


The common causes of malnutrition includes:

Food insecurity or a lack of access to sufficient and affordable food.

Digestive problems and issues with absorption such as crohn’s disease, celiac disease and bacterial overgrowth in the intestines.

Excessive alcohol consumption

Mental health disorders

Inability to obtain and prepare foods

Population at risk

Malnutrition affects people in all parts of the world but some people are at a higher risk.

Populations that are prone to malnutrition include:

People living in developing countries or areas with limited access to food.

Individuals with increased nutrient needs especially children and pregnant or breast feeding women.

People that live in poverty or have low incomes.

Older people who live alone or have disabilities.

People with issues that affect nutrient absorption


In response to child malnutrition, the government recommends ten steps for treating severe malnutrition. They are to prevent or treat dehydrationlow blood sugarlow body temperature, infection, correct electrolyte imbalances and micronutrient deficiencies, start feeding cautiously, achieve catch-up growth, provide psychological support, and prepare for discharge and follow-up after recovery.Among those who are hospitalized, nutritional support improves protein, calorie intake and weight.


The evidence for benefit of supplementary feeding is poor.Specially formulated foods do however appear useful in those from the developing world with moderate acute malnutrition.In young children with severe acute malnutrition it is unclear if ready-to-use therapeutic food differs from a normal diet. In those who are severely malnourished, feeding too much too quickly can result in refeeding syndrome.This can result regardless of route of feeding and can present itself a couple of days after eating with heart failuredysrhythmias and confusion that can result in death.Manufacturers are trying to fortify everyday foods with micronutrients that can be sold to consumers For example, flour has been fortified with iron, zinc, folic acid and other B vitamins such as thiamine, riboflavin, niacin and vitamin B12.


Treating malnutrition, mostly through fortifying foods with micronutrients (vitamins and minerals), improves lives at a lower cost and shorter time than other forms of aid. Those with diarrhoea, once an initial four-hour rehydration period is completed, zinc supplementation is recommended. Daily zinc increases the chances of reducing the severity and duration of the diarrhoea, and continuing with daily zinc for ten to fourteen days makes diarrhoea less likely recur in the next two to three months.

In addition, malnourished children need both potassium and magnesium. This can be obtained by following the above recommendations for the dehydrated child to continue eating within two to three hours of starting rehydration, and including foods rich in potassium as above. Low blood potassium is worsened when base is given to treat acidosis without simultaneously providing potassium. As above, available home products such as salted and unsalted cereal water, salted and unsalted vegetable broth can be given early during the course of a child’s diarrhoea along with continued eating. Vitamin A, potassium, magnesium, and zinc should be added with other vitamins and minerals if available.

For a malnourished child with diarrhoea from any cause, this should include foods rich in potassium such as bananas, green coconut water, and unsweetened fresh fruit juice.


The World Health Organization (WHO) recommends rehydrating a severely undernourished child who has diarrhoea relatively slowly. The preferred method is with fluids by mouth using a drink called oral rehydration solution (ORS). The oral rehydration solution is both slightly sweet and slightly salty and the one recommended in those with severe undernutrition should have half the usual sodium and greater potassium. Fluids by nasogastric tube may be use in those who do not drink. Intravenous fluids are recommended only in those who have significant dehydration due to their potential complications. These complications include congestive heart failure. Drinks such as soft drinks, fruit juices, or sweetened teas are not recommended as they contain too much sugar and may worsen diarrhoea.Broad spectrum antibiotics are recommended in all severely undernourished children with diarrhoea requiring admission to hospital.

Low blood sugar

Hypoglycemia, whether known or suspected, can be treated with a mixture of sugar and water. If the child is conscious, the initial dose of sugar and water can be given by mouth.[126] If the child is unconscious, give glucose by intravenous or nasogastric tube. If seizures occur after despite glucose, rectal diazepam is recommended. Blood sugar levels should be re-checked on two hour intervals.


Hypothermia can occur. To prevent or treat this, the child can be kept warm with covering including of the head or by direct skin-to-skin contact with the mother or father and then covering both parent and child. Prolonged bathing or prolonged medical exams should be avoided. Warming methods are usually most important at night.



Cardiology Perspective : New Technologies in Diagnosis and Treatment

Wednesday, April 24th, 2019

How technology helps in diagnosis and treatment: A cardiac perspective

Technological innovations has created a revolution in the health care sector and changed the way how diseases are viewed and managed across the world. Cardiovascular science has advanced so far that the diagnosis and treatment has not only become simple but health information is available at the finger tips of both the health care provider and health care receiver. Starting from the age old tradition when teaching was limited to the patient bedside, we are living in the age of electronic gadgets and internet where diagnosis and treatment is possible anywhere in the world even from a pocket mobile. The global health care has been miniaturized as a result of these innovations.Cardiovascular medicine is undergoing radical changes day by day as a result of the vast amount of information and resources being channeled into the field across the globe. Important advances are being made in all areas starting from acute ischaemic syndromes to heart failure and end of life care.

The evolution of cardiovascular science:

Before the advent of the stethoscope, heart sounds were heard by putting the ear to the chest wall of the subject. Then came the stethoscope, the main tool for the diagnosis of diseases related to the heart. It was invented in France in 1816 by René Laennec at the Necker-Enfants Malades Hospital in Paris. However its importance is coming down day by day all because of technological advancement. The first diagnostic coronary angiogram was performed by Dr. Mason Sones in 1958. This was followed by the first balloon angioplasty procedure on a coronary artery in Zurich, Switzerland, by Andreas Gruentzig, a German-born physician in 1977. Coronary artery bypass surgeries, valve replacement and heart transplants followed.In the 1980s most of the critical coronary artery disease was managed by coronary artery bypass surgeries (CABG). Now only 15% of the cases are managed by CABG for the same indication.Catheter based technologies have improved so much that even valve replacements are performed via catheter based routes ( TAVR) . Now we are living in an era where people walk with wearable gadgets and integrated systems that monitor, control and optimize the functions of the heart. 

A peep into the world of technology:

Advances in cardiovascular science can be stratified into 3 main areas:

  1. diagnostic technologies
  2. drug treatments
  3. interventions

The scenario has changed drastically from what was 50 years ago to the present day and we shall discuss how the management of heart diseases has evolved over the decades.

 Diagnostic technologies:

Since the late 1990s, imaging in cardiovascular field has evolved from routine coronary angiography to computerized tomography [CT], cardiac magnetic resonance, electron-beam computerized tomography [EBCT], and advanced echocardiography. Intravascular coronary imaging techniques like IVUS (intra vascular ultrasound) & OCT (optical coherence tomography) has created a revolution in the field of coronary angiography and angioplasty.Functional imaging techniques like Fractional flow reserve (FFR) has changed the way we manage atherosclerotic diseases.3 D electrophysiologic mapping techniques have in fact created a revolution the way rhythm disorders of the heart are managed and treated.

Now hand-held biosensors capable of detecting a wide range of diseases within minutes by analyzing a drop of blood, urine, saliva, or breath have been introduced. This is in fact  a  “lab on a chip” (a miniature chemical laboratory as small as 3 mm square also called micro-chip) that detects the presence ofparticular proteins or gene expressions as well as compares patterns of genes or proteins characteristic of particular disease states. Micro- chips also are capable of detecting single-nucleotide polymorphisms (SNPs), which are patterns of gene expressions which can predict heart diseases.

Drug treatments:

The work of the Human Genome Project, in the early 2000s was a turning point in the history ofcardiovascular medicine and health care. The Genomic revolution has been able to provide individualized and personalized treatment and changed the health scenario drastically. The end result was this: genomics (thestudy of the genome), proteomics (the study of the fullcomplement of human proteins), bioinformatics (the methods of gathering and processing the above information) and systems biology (the study of how all of these processes work as a complex adaptive system). As a result, in cardiovascular medicine two vast fields were created: predictive diagnostics and pharmaceuticals. Pharmacogenomics encompasses all genes in the genome that may determine drug response.


The device therapies have continued their rapid improvements during the course of the last 30 years. Stents have evolved from bare metal stents to drug eluting stents to absorbable ones of late. The platforms have changed and can be placed as small as 2 mm coronary arteries. New materials have greatly reduced the incidence of re-stenosis. Catheters have become more maneuverable and smaller, affording interventionists awide range of capabilities, from the traditional angioplasty. Laser techniques encouraging the growth of new blood vessels, and the direct placement of new angiogenesis drugs are in the evolving phases.

Apart from this, smart phones, smart watches and a wide variety of gadgets have surfaced which accurately capture various biochemical and vital information without the need to draw blood as was the case before. We have pacemakers, AICDs and CRT devices which are MR compatible to those which automatically switch modes when a magnetic field is detected. Leadless pacemakers have been launched. Telemetric monitoring is increasingly been used to detect events and administer therapies as is routine in our institution.

Beating heart surgeries have become the talk of the day. Minimally invasive surgery and intervention techniques are now used for all routine heart surgeries. Sternotomy is now becoming rare and employed only in difficult cases or for full organ replacement procedures. Aortic aneurysms and dissections which were previously unmanageable and associated with high mortalities and morbidity has been simplified with the advent of various endovascular repair techniques. 

Robotics has emerged as a tool for managing a wide variety of cardiovascular diseases. Tele robotics has made its advent in India of late and is leading the world stage. Replacement hearts (electro-mechanical and swine hearts) are going to be so common in the near future and we are expecting replacement coronaries constructed from bovine and swine collagenas well to be the talk of the day in the days to come.     Neo-organs grown in the laboratory from the patient’s own cells are starting to capture headlines. Now we are living in a world of 3 D printing where bioprinting of cellular material for creating patient specific tissue engineered implants is performed. Researchers have been successful in growing thin sheets of heart muscle capable of sustaining a heartbeat to growing entire hearts, complete with vessels for carrying the blood supply. Nano – gadgets have now entered the arenas which are capable of delivering pharmaceuticals and capable of targeted therapy. Nanotechnology has also produced substances that mimic natural human tissue and responds to hormonal and nervous signals naturally.

 The scope of technological innovations is increasing day by day and is continuously evolving. We would end this discussion with the following scenarios:

  1. Year 2000: Mr X aged 50, diabetic, with regular exercise and medications, walks into the laboratory for blood glucose monitoring- The technician puts a prick on his finger and on a hand held device takes a drop of blood. Comes back a few minutes later with a print of his result…
  2. Year 2030: Mr X is travelling in a jet plane and has a co-passenger by his side. He relentlessly talks with the co-passenger who is in the late 90s and finds that he as a transplanted swine heart.
  3. Year 2050: Mr X is 100 years of age and feels healthier than he was 50 years back. All because he has undergone a wholesale organ replacement and his ‘telomerase’ enzyme constantly renews, thanks to nano – technology which delivers the right pharmaceuticals to his cells. The ‘Hayflick’ limit does not bother him anymore and he is like the immortal Avenger Superhero for his grandchildren and great grandchildren. He is even thinking of travelling to Mars in a space jet, thanks to technology.


Dr.Shreetal Rajan Nair

Consultant – Cardiology




Non-Alcoholic Fatty Liver Disease(NAFLD)

Wednesday, April 24th, 2019

A growing public health problem

It is an umbrella term for a range of liver conditions affecting people, who drink little or no alcohol.  As the name implies, the main characteristics of NAFLD is too much fat stored in liver cells.  The disorder has a wide spectrum, ranging from symptomatic steatosis to steatohepatitis (potentially serious form marked by liver inflammation, which leads to scarring and irreversible liver damage) fibrosis and cirrhosis. 

Recent findings suggest that contrary to current dogma, simple steatosis can progress to non-alcoholic steatohepatitis (NASH) and clinically significant fibrosis.  Therefore, the majority of non-alcoholic fatty liver disease patients are at risk of progressive liver disease in the long-term.  In western world, now it is the second leading etiology of chronic liver disease among adults awaiting liver transplantation. 

What are the risk factors?

Common risk factors are Obesity , Type 2 Diabetes mellitus , Dyslipidaemia , Metabolic syndrome and Polycystic ovarian syndrome. Other conditions like hypothyroidism, hypopituitarism, hypogonadism, etc.

As per recent evidences, non-alcoholic fatty liver disease is now considered as a multisystem disease affecting several extrahepatic organs. i.e., there is increased risk of type 2 diabetes mellitus, cardiovascular, and chronic kidney disease.  It is also linked to sleep apnea, adenomatosis, polyps of the colon, colorectal cancer, osteoporosis, PCOD, psoriasis, and various endocrinopathies. So, NAFLD has become a growing public health problem

 Discussing about what we can do to prevent the development or progression of NAFLD

The single most important aspect is lifestyle modification, which includes diet modification, exercise, and weight loss.  

Diet modification

  1. Follow a good dietary pattern such as the Mediterranean diet – a plant based diet, which is high antioxidants and anti-inflammatory.
  • Consume small amounts of meat especially red meat.
  1. Avoid highly processed food, which contains added fructose.
  • Avoid sweetened beverages.
  1. Increased consumption of Omega 3 polyunsaturated fatty acids and monounsaturated fattyacids.
  • Consume fish two to three times per week especially oily fish such as salmon, sardines, jamfish, tuna, etc.
  • Use extra-virgin olive oil as the main added fat especially for dressing salads and
  • Consume nuts and seeds as snacks daily.
  1. Increased consumption of high fibre food.
  • Eat vegetables with all main meals, ensuring they compose the majority of the dish.
  • Choose the whole grain varieties of breads and cereals.
  • Have legumes two to three times per week in place of meat.
  • Have fresh fruit daily.
  1. Limit consumption of highly processed food.
  • Avoid food that is highly refined.
  • Avoid food that contains large amount of added sugars.
  • This may include fast food, commercial bakery goods, and sweets.


People with NAFLD engage in less physical activity than their healthy counterparts and higher levels of habitual physical activity.  Moderate intensity training, high intensity training, and resistant/aerobic exercise have shown improvement.  Therefore, all those with risk factors are advised to increase physical activity. 

  1. One approach is to recommend 30 minutes of moderate exercise 5 times weekly.
  2. Another approach is to try to increase daily step count to more than 10,000 steps per day.

Weight loss

Ideally, patient should be encouraged to lose more than 10 percentage of body weight and maintain the weight loss or bring their waist circumference or BMI into their ethnicity specific normal range.  

As WHO and the Governments worldwide are trying to provide universal health coverage for all, which ensures quality healthcare to people when and where they need them without suffering financial hardships, on World Health Day I would suggest all fellow citizens to have a healthy lifestyle, so that we can prevent lifestyle diseases to an extent.


Dr. Anup S. Nair, MD, DM

Consultant, Gastroenterology





Joint Replacement

Thursday, June 28th, 2018
What is joint replacement surgery?

Its procedure in which the abnormal bone and lining structures of the joint are removed surgically and new parts,called prostheis are inserted in their places. These new parts may be made of special metal, plastic or specific kinds of ceramic-coated implants. The new parts allow the joints to move again with little or no pain. The surgery can:

Benefits of surgery
  • Pain relief: Depending on the type of arthritis you have, you may experience constant pain in the affected joints or during the movement. Although, some pain can be alleviated with heat and cold treatments, exercise, splints and drugs, the amount and intensity of pain can dramatically be reduced by surgery as well.
  • Increased range of motion: If you wait until the joint is severely damaged before surgery, some movement can be recovered, but the extent of it will be different in each person. After the operation, it will gradually improve the joint function along with this you need to take time and undergo physical therapy to regain a greater range of joint motion.
  • Better use of joints: Arthritis can, over time, cause inflammation and damage to bone and cartilage. This results in loss of use of the joint, which will hinder the performance of daily activities. If your joints have reached this stage, surgery may help you to regain the use of the joints.
  • Joint alignment: Joints in the knees and feet can be deformed because of arthritis. Some types of surgery can help realign and straighten the joints, thus improving it’s ability to move or use.
What causes joint pain?

In a normal joint, bones have a smooth surface made of a substance called articular cartilage on their ends that allows one bone to glide against another easily. Joints are lubricated by a thin layer of fluid called synovial fluid that acts like oil in an engine to keep parts gliding smoothly. When the articular cartilage wears, is damaged or the joint fluid is abnormal, the joints become stiff and painful, causing arthritis, which may be possible to treat with this surgery.

Myth: Joint replacement surgery means a long hospital stay

Fact: There have been big advancements in joint replacement surgery. It was normal to spend up to 10 days in the hospital after joint replacement surgery, but today the average is 3-4 days. With improvements in technology and patient care, hospital stays are significantly shorter than before. Patients usually stay less than two days after hip replacements and less than three days after knee replacements.

Myth: Joint replacement surgery is highly invasive

Fact: The misconception is that some patients think that the entire knee is replaced in a knee replacement surgery but there’s only a minimal amount of bone that’s taken before inserting the new parts. In knee replacement surgery, these parts consist of a metal cap for the femur, a metal base plate on the tibia and a piece of plastic in between, acting as cartilage. Surgeons today are also using less-invasive techniques and smaller incisions to perform replacements. It’s much less invasive than many people think.

Myth: Replacement joints wear out in 10 years or less

Fact: Due to improvements in materials and surgical techniques, today’s knee and hip replacements can last up to twice as long as comparable replacements done in the past. The quality components used have improved significantly. Newer implant materials like verilast have been tested for 30 years wear performance and have US – FDA approval.

Myth: If you’re under 50, you’re too young to have a joint replaced

Fact: Orthopaedic surgeons today do not classify a specific age to determine whether a patient is a good candidate for a hip or knee replacement surgery. Instead, the decision depends on the levels of disability and pain the patient is experiencing. In the past, the parts used for joint replacements had limited life spans. Now with the advancement of technology, there’s better longevity of replacement parts so it’s viable to put them in younger patients. Patients with severe arthritis don’t have to suffer through years of excruciating pain just because they’re young.

Myth: You should wait as long as possible before having a joint replaced

Fact: Waiting too long can make things worse. If your pain is so great that it’s hindering your ability to walk, then you’re not keeping your muscles and your extremities strong. You could be hindering the recovery process. Waiting until the last possible moment isn’t good for you. Rather than waiting for their mobility and quality of life to decline, patients should get their knee or hip replacement soon. This will likely improve their outcomes.

Myth: You need to take long bed rest after the surgery

Fact: Patients will start walking with a help of a walker immediately after the surgery, need to continue the walking aid till he/she gain enough muscle strength to walk independently, which may take 2- 4 weeks. During this period patient can walk in their premises as much as they want.

Myth: There is high chance of infection after Joint Replacement surgery.

Fact: The chance of infection after a Joint replacement surgery depends of the patient immunity status, Operation theatre facilities, experience of the surgeon and his team. Hence it is very important to select the hospital where you are going to perform the surgery, because once the artificial joint gets infected, it is very difficulty to eradicate the infection.

We hope you have a better understanding of joint replacement surgery, the myths & facts behind it, the possible causes for why joints need to be replaced and how the surgery helps people who suffer from joint issues.


Dr. Sameerali Paravath

Consultant and Head of Joint Replacement and Arthroscopy

MEITRA Hospital, Kozhikode