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Bio Medical Waste Report For Shalimar Bagh

Month Red Autoclave(Infected Plastic Waste) Yellow- Incineration(AnatomicalWaste & Soiled Waste) Blue Autoclave (Glass- Bottles) Black Cytotoxic- Incineration( Cytotoxic Contaminated Items) White- Sharp Total Bags Total Weight(In KG's)
  No. of Bags Weight (in KG's) No. of Bags Weight (in KG's) No. of Bags Weight (in KG's) No. of Bags Weight (in KG's) No. of Bags Weight (in KG's)    
Apr-17 924 2963.50 954 2994.10 239 1017.30 103 279.20 1645 606.40 3865 7861.00
May-17 1175 4624.12 1028 3498.40 276 1524.34 87 195.01 1803 823.85 4369 10665.71
Jun-17 1060 4511.45 902 2886.66 293 1324.05 76 194.00 2057 1100.69 4388 10016.85
Jul-17                     0 0.00
Aug-17                     0 0.00
Sep-17                     0 0.00
Oct-17                     0 0.00
Nov-17                     0 0.00
Dec-17                     0 0.00
Jan-18                     0 0.00
Feb-18                     0 0.00
Mar-18                     0 0.00
YTD 3159 12099.065 2884 9379.155 808 3865.69 266 668.705 5505 2530.94 12622 28543.555

Orthopaedics and Joint Replacement

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For more info please call 8744 888 888 (Delhi – NCR) & 9988 422 333 (Chandigarh Tri-city), or mail at homecare@maxhealthcare.com

At Max Institute of Orthopaedics & Joint Replacement Surgery, our primary objective is "early mobilisation, minimal discomfort". This state-of-the-art specialised health care facility is designed to provide the highest levels of professional expertise and patient care. Here, every patient is tended to by a multi-disciplinary unit.

What Do You Need To Know About Shoulder Arthroscopy?

May 28, 2018 0 122 1 minute, 55 seconds read

Shoulder arthroscopy is a surgical procedure used to visualize, diagnose, and treat various problems inside the shoulder joint and in the space surrounding the rotator cuff. This is done through small incisions that allow the insertion of specialized instruments. The arthroscope is a 4mm pencil-sized tool that contains magnifying lenses and a light source. This is attached to a small camera that projects a clear, enlarged image of the joint on a TV monitor, allowing your surgeon to see all the structures inside your shoulder.

When is arthroscopic shoulder surgery used?

Dr. Raju Easwaran, Senior Consultant, Max Super Speciality Hospital, Shalimar Bagh says, Arthroscopic shoulder surgery is used to treat a variety of common shoulder problems, including bursitis, tendonitis, arthritis, impingement, rotator cuff tears, lateral tears and shoulder instability/ multiple dislocation Usually patients who need shoulder arthroscopy have not responded well to other treatment options like rest, physical therapy, anti-inflammatory medications, and steroid injections (if required).

As with any injury, your doctor will be the best source of advice on the appropriate treatment method for your situation.

How is shoulder arthroscopy performed?

Arthroscopy is typically performed in an inpatient surgery setting. The type of anaesthesia used is decided after discussion between the patient, surgeon, and anaesthesiologist. Two or three small incisions, each the size of 4mm-6mm are needed to insert the scope and any necessary instruments. The joint is filled with sterile fluid to allow the surgeon to see more clearly. Most procedures take less than one hour to perform. Following surgery you may be in a sling or a special shoulder immobilizer' depending on the type of surgery performed. You will be given specific instructions about whether or not you are allowed to move your arm immediately after the surgery.

Rest, icing, and anti-inflammatory medications will help decrease pain and swelling. The surgical area should be kept dry when showering for the first 3-5 days. Modern dressing is water proof & allow direct shower over the dressing. Patients usually begin light exercise in 1 week.

Return to full activities may take several weeks to several months depending on the type of surgery performed.

Benefits of arthroscopic shoulder surgery

Benefits of arthroscopic surgery compared with older open surgical techniques include:

  • Minimal scars
  • Minimal hospital stay
  • Minimal pain and swelling
  • Minimal stiffness
  • Minimal risks and complications

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What Do You Need to Know About Rotator Cuff Injury?

May 8, 2018 0 78 2 minutes, 40 seconds read

A rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff generally produces severe pain in the affected shoulder especially at night, often preventing sleep!

Rotator cuff injuries occur most often in people who repeatedly perform overhead motions in their jobs or sports. Examples include painters, carpenters, and people who play baseball or tennis. The risk of rotator cuff injury also increases with age and with certain diseases like diabetes & thyroid disorders.

Many people recover from a rotator cuff injury with physical therapy exercises that improve flexibility and strength of the muscles surrounding the shoulder joint. Severe rotator cuff injuries, involving complete tears of the muscle or tendon, may require surgical repair.

It’s Symptoms:

The pain associated with a rotator cuff injury may:

  • Be described as a dull ache deep in the shoulder
  • Disturb sleep, particularly if you lie on the affected shoulder
  • Make it difficult to comb your hair or reach behind your back
  • Be accompanied by arm weakness

Dr. Raju Easwaran, Senior Consultant, Max Super Speciality Hospital, Shalimar Bagh, mentions few causes of rotator cuff injuries like:

  • Falling. Using your arm to break a fall or falling on your arm can bruise or tear a rotator cuff tendon or muscle.
  • Lifting or pulling. Lifting an object that's too heavy or doing so improperly — especially overhead — can strain or tear your tendons or muscles. This applies especially to people doing shoulder pressures in gym using unusually heavy weights or improper techniques.
  • Repetitive stress. Repetitive overhead movement of your arms can stress your rotator cuff muscles and tendons, causing inflammation and eventually tearing. This is the usual mechanism in racquet sports.
  • Bone spurs. An overgrowth of bone can occur on a part of the shoulder blade that protrudes over the rotator cuff. This extra bone can irritate and damage the tendon. This generally happens with ageing.

The following factors may increase your risk of having a rotator cuff injury:

  • Age. As you get older, your risk of a rotator cuff injury increases. Rotator cuff tears are most common in people older than 40.
  • Certain sports. Athletes who regularly use repetitive arm motions, such as baseball pitchers, archers and tennis players, have a greater risk of having a rotator cuff injury.
  • Construction jobs. Occupations such as carpentry or house painting require repetitive arm motions, often overhead, that can damage the rotator cuff over time.

Although resting your shoulder is necessary for your recovery, keeping your shoulder immobilized can cause the connective tissue enclosing the joint to become thickened and tight (frozen shoulder).

If you are at risk of rotator cuff injuries or if you've had a rotator cuff injury in the past, daily shoulder stretches and exercises can help prevent future injury.

Most people exercise the front muscles of the chest, shoulder and upper arm, but it is equally important to strengthen the muscles in the back of the shoulder and around the shoulder blade to optimize shoulder muscle balance. Your doctor or a physical therapist can help you plan an exercise routine. In extreme cases, you may require an arthroscopic cuff repair.

 

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Shoulder Pain: What Could Be the Reason?

May 4, 2018 0 391 5 minutes, 3 seconds read

The shoulder is a ball and socket joint, wherein the ball (humeral head) is large and the socket (glenoid) is small, facilitating movement in an almost 360 degree arc.

The two surfaces are covered by a polish (much like the paint on the wall) that reduces friction between the two surfaces when they glide against each other, constituting the gleno-humeral joint. However, the shoulder due to this anatomy is inherently unstable. To overcome this shoulder joint has certain special features- the socket has banking all around it (labrum) that is a slightly elevated region made of cartilage. This is akin to a plate that has raised edges and prevents food from spilling over. Apart from this, the shoulder is covered with muscles all around that contain the ball within the socket.

The muscles that move the shoulder are attached via rope like structures called rotator cuff tendons to a part of the ball. The whole functioning is much like a water well as it has a man/woman, a rope and a bucket. The bucket is the arm, the muscles the individual and the rope the tendons. If there is any problem with the rope or individual the bucket won’t come up. There are two more accessory joints that are less spoken of but part of the shoulder joint complex.

The joint between the collarbone and sternum (breast bone) is called as sterno-clavicular joint and between the collarbone and shoulder blade is called as the acromio-clavicular

joint). These joints are responsible for performing overhead activities like the extreme raising of the arms.

What are the common types of Shoulder Pain?

Adhesive Capsulitis (Frozen Shoulder): This condition is most commonly seen in people suffering from diabetes. The shoulder joint gets inflamed (swollen) and movement gradually gets restricted ultimately leading to a frozen shoulder. The condition is more often than not self-limiting, i.e. after on an average 6-9 months the condition subsides. However, during this period it is intensely debilitating with an inability to use/ sleep on the affected side. The condition has three stages:

a. Freezing: when it gradually gets stiff

b. Frozen: when movements are grossly restricted

c. Thawing: when movements begin to return

Treatment largely centres on pain management and preserving movement via physiotherapy. Injections into the shoulder are attempted at times to ease pain and facilitate physiotherapy. However if the condition does not subside within 6-9 months, arthroscopic (keyhole) release of the shoulder may be tried which is a quick and immediate solution to the problem.

Gleno-humeral (Ball & Socket) Arthritis: This condition is seen frequently in people who have suffered an injury to the shoulder or suffering from long-standing disease like rheumatoid arthritis or inflammatory arthritis. One presents with a gross restriction of movement in all directions with a grinding feeling in the joint whenever it is moved. In this condition essentially the cartilage /paint coating the two bony surfaces get rubbed off and ultimately bone grinds against bone. Treatment initially centers on local physiotherapy like a heat therapy. If the pain doesn’t subside an injection may be tried for temporary relief. Ultimately when the quality of life is grossly compromised a shoulder replacement may be the only solution.

Injury: Injuries to the shoulder are varied, ranging from bony (fractures), tendon (rotator cuff tendons) or dislocations. Fractures around the shoulder are relatively common with the ball being more frequently fractured than the socket. They are treated based on the fracture, a number of pieces and age of the patient. Treatment ranges from just an arm sling to plaster, external wires, internal plates and rarely replacements.

Tendon injuries occur largely in two groups of population: the sporty and elderly. People who are into sports may injure themselves while playing sport, while the elderly may get a trivia injury to an already weak tendon. The tendons when broken more often are difficult to fix back. This is one condition where vigorous physiotherapy, pre-operative methods may be detrimental because they may worsen the tear. The tear is repaired via arthroscopic (keyhole) or open surgery using tiny plastic/metal screws with threads coming out of them that are used to stitch the tendons.

Dislocations: These largely occur due to falls. If it’s the first time, then the treatment is largely conservative with rest in a sling for 3 weeks. If it occurs more than once, in all probability the banking of the socket has flattened out making way for the ball to slide out of the socket. Treatment involves repairing the banking via arthroscopic (keyhole) surgery.

Impingement: Above the tendons is a bone called the acromion. The space between the tendons and bone is enough so that the tendons never touch the bone when the arm is lifted up. Sometimes the shape of the bone above is more hooked and touches the tendons when the arms are lifted up. This causes swelling of the tendon covering and severe pain. This is called impingement. Treatment largely centres on physiotherapy and injecting local steroids in the region that reduce inflammation. If it still doesn’t subside arthroscopic surgery is done to flatten out the bone above to create more space.

Acromioclavicular Joint Arthritis: This pain typically occurs on the top of the shoulder and is worsened on the overhead lifting of the arm. Treatment involves physiotherapy and injection of a local steroid into this joint. Arthroscopic surgery is rarely used for rubbing bone surfaces.

Other causes:

Infection like tuberculosis may affect the shoulder causing severe pain, restricted movement with fever and significant weight loss. Occasionally a wound with draining pus may form. This condition is treated with antibiotics and anti TB drugs. Surgery may also be required in some cases. Taking care of one’s nutrition and general health is of paramount importance.

Tumours of both non-cancerous and cancerous may occur in the shoulder presenting with swelling and sometimes a fracture due to the weakening of the bone. There may be no antecedent injury preceding the fracture in these cases. Treatment involves surgical removal of tumours and fixing the bone to replacement.
 

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Dr. Narender Kumar Magu

Dr. Narender Kumar Magu
Senior Consultant – Hip and Pelvis – Actebular Surgery
Dr. Narender Kumar Magu
Memberships: 
  • Fellow National Academy of Medical Sciences
  • Orthopaedic Association of SAARC Countires “Past Secretary General 2012-2014”
  • SICOT International
  • AO Trauma India
  • Indian Orthopaedic Association
  • Association of Surgeons of India
  • North Zone Indian Orthopaedic Association (President 2015-2017)
  • Haryana Chapter of Indian Orthopaedic Association member, secretary and past President
  • Indian Society of Hand Surgeons
  • Indian Association for Adolescent Health
  • Delhi Orthopaedics Association
  • Association of Pelvi-Actebular Surgeons of India
  • APASI – President and founder member of the association
     
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PROFESSIONAL JOURNEY

Work Experience: 
  • 35 years exp. in Orthopaedic speciality in teaching institutions in various positions.
  • Retired Senior Professor & Head, Orthopaedics at PGIMS, Rohtak
  • Prof. Orthopaedics at SGT Medical College Chandu Budhera Gurgaon.
  • Professor and Head Orthopaedics – Maharaja Agrasen Institute of Medical Sciences and Research, Agroha
     
Education & Training: 
  • M.B.B.S. from Medical College, Rohtak
  • MS (Ortho) from Medical College, Rohtak
  • FAMS
     
Speciality Interest: 
  • Hip Preservation, Reconstruction of Pelvi - Actebular surgery and Hip Arthoplasty
Duration Of OPD: 

   Max Super Speciality Hospital, Saket

  • Tue : 1:30 PM  - 3:00 PM
Research & Publication: 
  • “Campbell Operative orthopaedics “ and Turek orthopaedics; 12 Chapters in books
  • Convenor Symposia and hands on cadaveric workshops in Japan, UK, US, Russia, Australia, Sweden, Cheque Republic, Thailand, Egypt, Israel, Colombo, Dhaka, Capetown, Italy, Brazil-RIO
  • Orations: Six Prestigious Orations
  • Reviewer: Nearly 12 Journals including JBJS, CORR and Various Indian Journals

5 Common Reasons Behind Knee Pain

March 27, 2018 0 143 2 minutes, 37 seconds read

A knee joint is made up of a thigh bone (femur), leg bone (tibia) and the patella (kneecap. Sandwiched between the thigh and leg bone are two cushions (the menisci) and 4 ropes (ligaments) that keep the bones together. Also the bony surfaces are covered by a 1 cm thick polish called cartilage that prevents friction between the bones when they glide over each other. The knee is a joint that is critical for walking and therefore taking care of its health is critical to lead a mobile lifestyle. Knee pain is a very common condition that affects the young and elderly alike. However, the causes may vary in both. It is important to identify that there is a problem and get timely treatment for the same. Pain in the knee can be broadly due to age-related causes (degenerative) or injury related (trauma).

Dr Vikram Mhaskar, Consultant - Knee & Shoulder Surgery, Max Multi Speciality Centre, Panchsheel Park, lists down below 5 reasons that could aggravate the knee problems.

1. Age-related problems start gradually as a little niggle in the knee that progresses over time, with an occasional feeling of the knee getting stuck. The pain may be confined to one part of the knee, or in the knee as a whole. Often it is associated with swelling in the knee that occurs due to friction when the cartilage (polish) gets rubbed off. Treatment may vary from just medication and removal of fluid from the knee to surgery depends on the severity of the problem.

2. Injury-related pain may come from the bones, cartilage, ligaments or cushions. Such pains are preceded by an injury to the knee like twisting, fall, road traffic accident.

3. Fractures or bony injuries are very painful and prevent you from keeping the limb on the ground or even move it. They are usually accompanied by swelling and deformity in the bone. Fractures are well visualized on an X-ray more often than not and require either plaster application or a surgery to fix them.

4. Ligament injuries accompany most commonly sporting injuries or fall from a two-wheeler. They are accompanied by pain and swelling initially and later on after few weeks may cause a feeling of not being stable on the knees and the feeling that it would twist again. These injuries do not show up on an X-ray and need an MRI. Certain ligaments heal up well themselves and some don’t. Treatment largely depends on the activity profile of the patient, ligament/ligaments torn and if any associated injuries are present. Largely these surgeries are done by keyhole (arthroscopic) technique and you are likely to be discharged on the same day as your operation.

5. Cartilage/Meniscus injuries can happen in isolation or with ligament injuries with similar injury mechanisms. These injuries cause pain and a feeling of locking, which is a sudden inability to straighten the knee completely. Treatment for meniscus injuries is by keyhole technique (arthroscopic) that involves repairing/removing a part of it. Timely attention by a knee specialist is the key to success in addressing knee pain, and at Max Panchsheel we have a specialised Orthopaedic doctors team for every joint in the body.

 

 

 

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