Dr. Atul Prasad

Dr. Atul Prasad

  • Dr. Atul Prasad is a Director Neurologist Department  at BLK Super Speciality Hospital in Delhi .
  • Most experience neurologist doctor in Delhi with 28 years as specialist.
  • Dr. Atul Prasad is a leading name in the field of neurology.
  • Dr. Atul Prasad, in his vast experience extending to few decades has served under different roles practicing for elite medical institutions like the Fortis Escorts, Flt Lt Rajan Dhal Fortis, New Delhi; Artemis Health Sciences, Gurgaon; Fortis Hospital, Noida; Universiti Sains Malaysia (USM), Malaysia; and Institute of Human Behavior & Allied Sciences.
  • Dr. Atul Prasad is also the professional member and active member of medical societies like Indian Academy of Neurology, Neurologist Society of India, Indian Epilepsy Association, Association of Physicians of India, and Malaysian Society of Neuro Sciences.
  • He completed MBBS from the prestigious Grant Medical College & JJ Hospital, University of Bombay. He further went on to do DM in Neurology from the elite neuroscience institute the National Institute of Mental Health and Neurosciences.

His Interest

  • Movement Disorder (Parkinson’s disease and Botulinum Toxin Injection) & Acute Stroke Unit,

Top Neurologist Doctor in Delhi-Click Here 

Medical Qualification

  • MBBS
  • DM (Neurology)


Previous Experience:

  • Senior Consultant & Head of Neurology – Fortis Escorts, Flt Lt Rajan Dhal Fortis, New Delhi
  • Consultant – ARTEMIS Health Sciences, Gurgaon
  • Senior Consultant & Head of Neurology – Fortis Hospital, Noida
  • Associate Professor of Medicine & Consultant Neurologist – Universiti Sains Malaysia (USM), Malaysia
  • Associate Professor and Head of Neurology – Institute of Human Behavior & Allied Sciences (IHBAS), Delhi
  • Senior Resident – Safdarjung Hospital, New Delhi
  • Senior Resident – National Institute of Mental Health & Neuro Sciences ( NIMHANS), Bangalore
  • Resident – Rama Krishna Mission Seva Pratisthan & Vivekanand Institute of Medical Sciences (VIMS), Calcutta

Speciality Interest

  • Movement Disorder (Parkinsons disease and Botulinum Toxin Injection), Stroke: Acute Stroke Unit


  • Taly A.B. ; Prasad A. ; Vasanth A. ; Shankar S.K. ;Nagaraja D. Acute Ataxic Neuropathy : A Clinical Electrophysiological & Morphological Study Acta . Neurol . Scand 1991 : 84 : 398 – 402 .
  • Swamy H. S . ; Chandramukhi A. ; Shankar S.K.;Ravikumar R.; Prasad A.; Vasanth A. V. – Neurological Complication Of Salmonella Typhi -Clinical , Microbiological and Pathological Study – NIMHANS Journal Vol . 8 . No . 2 , July 1990 , Pg . 111-126 .
  • Anand KS, Prasad A.. Cysticercal Vasculites- An uncommon cause of Ataxic hemiparesis, JAPI , Vol. 45, 77, 1997.
  • Anand KS, Prasad A . Neurocysticercosis amidst clinical diversity and diagnostic dilemma . The Antiseptic Vol. 93 , No. 8 , Pg. 293-294. August 1996.
  • Prasad A , Anand KS. Bulbar Myasthenia . JAPI ( Lesson of the month )., Vol. 45.,No. 5., Pg. 385. 1997.
  • Anand KS , Prasad A , Biswas A . Memory Disturbances in Neurodegenerative disorders . Psychiatry Today Vol. 1., No. 1 , Pg. 21-24. January 97 – March 1997.
  • Biswas A, Porwal S, Singh S, Prasad A , Anand KS. Olivopontocerebellar Atrophy with Slow eye Movements and Peripheral Neuropathy – Wadia Type . JAPI ( Case report ) . Vol. 45, No. 10 , Pg 812 – 813. 1997
  • Anand KS , Guchhait A , Prasad A. Epidemiology and Epidemiological Correlates of Parkinson’s Disease. JAMA – India: Parkinson’s Disease Special. July -Sep 1997 ( Supplement -II ). Pg. 11-14.
  • Prasad A , Anand KS. Management of Parkinson’s Disease in the Post levodopa Era. JAMA – India: Parkinson’s Disease Special. July – Sep 1997 ( Supplement -II ). Pg. 15-19.
  • Anand KS , Biswas A , Prasad A. Cognitive and mood Disturbances in Parkinsons Disease. JAMA – India: Parkinson’s Disease Special. July – Sep 1997 ( Supplement -II ). Pg. 20-24.
  • Anand KS, Guchhait A, Biswas A, Prasad A. Management of Neuropsychiatry Syndromes in AIIDS : A Comprehensive Review. Psychiatry Today 1997 ; 1(384) : 147 -152.
  • Anand KS, Prasad A, Biswas A, Singh S. Unusual MRI Findings in Young Onset Parkinson’s Disease . Neurology India , Vol. 45 , No. 4 Pg. 273 – 274 , Dec. 1997.
  • Anand KS, Prasad A, Biswas A. Effect of Clozapine on Psychosis and Levodopa-Induced Dyskinesias in Parkinson’s Disease. JAPI 1997., Vol.45., No. 12., Pg.983-984.
  • Biswas A, Anand KS, Prasad A, Ghosh S, Bansal J. Clinico – Radiological Profile of Kluver – Bucy Syndrome. JAPI 1998., Vol. 46., No. 3., Pg. 318-319.
  • Ghosh S, Biswas A, Guchhait A, Bansal J, Prasad A, Anand KS. Diabetic Ketoacidosis in Friedreich’s Ataxia – Not a mere Coincidence. JAPI 1998, Vol 46., No. 5, Pg. 490
  • Anand KS , Biswas A , Singh S, Prasad A . Seizure , mental retardation and abnormal cranial CT in a child. Post Graduate Medical Journal . 74 (867) Pg. 49 – 51. 1998.
  • Biswas A , Anand KS , Prasad A .Cysticercal Dementia JAPI 1998, Vol 46., No. 6, Pg. 569. 18. Anand KS , Prasad A. Epilepsies : An Overview .JAMA India – The Physicians update, Oct. 1998, Vol. 1, No. 8 Pg. 78 – 84
  • Pradhan SC , Anand KS , Prasad A . Self – mutilation and behavioral disorder. Post Graduate Medical Journal 74 ( 878 ) : 759 – 60. Dec. 1998.
  • Prasad A, Biswas A, Anand KS. Pictorial CME . JAPI 1999, Vol 47 No. 2, Pg. 212.
  • Anand KS, Prasad A , Pradhan SC, Biswas A. Fluoxetine-Induced Tremors. JAPI 1999, Vol 47 , No. 6, Pg. 651-652.
  • Anuradha S, Singh NP, Anand KS, Prasad A. A rare case of radiculopathy . Postgrad Med J 1999 Jan;75(879):53-5
  • Anand KS, Agarwal J, Biswas A, Prasad A. Ocular Muscle Cysticercal Granuloma – An unusual presentation of neurocysticercosis – A case Report. Annals of Indian Academy of Neurology, Volume 2 Number 1 , March 1999. Pg 41-42.
  • Pradhan SC, Prasad A. Compensated Hypothyroidism – Post Graduate Medical Journal 1999; 75 : 445 – 448.
  • Pratik Mittal , Atanu Biswas , Prasad A. Anand KS. Can a case of Transverse Myelitis have a normal Vaginal delivery ? JIMSA April – June 1999 , Vol. 12. No. 2. Pg. 145-146.
  • Sangeeta Sharma , Prasad A. , Anand KS. Nonsteroidal Anti – Inflammatory Drugs in the Management of Pain and Inflammation : A Basis for drug Selection. American Journal of Therapeutics Vol. 6 1999 Pg. 3-11.
  • Biswas A, Anand KS , Prasad A. Trigeminal Neuropathy in NIDDM. JAPI 1999, Vol. 47 , No. 11. Pg. 1125-1126.
  • Anand KS, Mittal A , Biswas A, Prasad A. Resistant Neurotuberculosis – Grim Scenario Emerging . Journal International Medical Sciences Academy (JIMSA) Oct – Dec. 1999 Vol 12 No 4 Pg 245-247.
  • Anand KS, Prasad A. Migraine – Diagnosis and Therapy . IMA ( East Delhi Branch ) Journal. Vol 1/99 August 1999 Pg. 37 – 46
  • Anand KS, Prasad A., Meghachandra Singh M, Gautam Roy. Postpartum cortical Venous thrombosis and socio – cultural practices in South India. The Antiseptic Vol 97 No 7 July 2000 . Pg. 256 – 258
  • Biswas A., Mittal P., Chaturvedi S., Prasad A. Risperidone Induced Cytopenias . JAPI – Vol 48., No. 11., Page 1122-11 23.Nov. 2000.
  • Anand KS, Biswas A, Prasad A . Cortico – Basal Ganglionic Degeneration – A Frequently Undetected Syndrome : Letter to Editor. Neurology India Vol. 48 Dec 2000. Pg. 405-406.
  • Bedi S., Prasad A. , Anand KS. Neurocysticercal Serodiagnosis – Updated. J. Indian Medical Association , Vol. 99 , No. 2 , Feb. 2001 Pg. 96-99.
  • Sangeeta Sharma , Prasad A. , Ravi Nehru , Anand KS, Rishi RK,Chaturvedi S, Et al. Efficacy and Tolerability of Prochlorperazine Buccal Tablets in Treatment of Acute Migrine . HEADACHE (The Journal of Head and Face Pain). Vol. 42 , No. 9 , Oct 2002 Pg. 896 – 902.
  • Malhotra V, Singh S, Tandon OP, Madhu SV, Prasad A, Sharma SB. Effect of Yoga asanas on nerve conduction in type 2 diabetes. Indian J Physiol Pharmacol 2002 Jul;46(3):298-306
  • Prasad A , KK Bhoi , K Bala , KS Anand , HK Pal. Phenylpropanolamine induced intraventricular hemorrhage. Neurology India January – March 2003; Vol 51; Issue 1; Pg. 117 – 118
  • Man K , Kareem AMM, Ahmad Alias NA , Tharakan J , Abdullah JM , Prasad A , Hussin AM , Naling NN. Computed tomography perfusion of ischaemic stroke patients in a rural Malaysian tertiary referral centre. Singapore med J 2006; 4793) : 194-197.
  • Mohamed Saufi Awang, Jafri Malin Abdullah, Mohd Rusli Abdullah, John Tharakan, Atul Prasad, Zabidi Azhar Husin, Ahmad Munawir Hussin, Adnan Tahir and Salmi Abdul Razak NERVE CONDUCTION STUDY AMONG HEALTHY MALAYS. THE INFLUENCE OF AGE, HEIGHT AND BODY MASS INDEX ON MEDIAN, ULNAR, COMMON PERONEAL AND SURAL NERVES
  • Malaysian Journal of Medical Sciences, Vol. 13, No. 2, July 2006, pp. 19-23


BLK Super Speciality Hospital

Who is the best doctor for microsurgical varicocelectomy in India?

Satyug Healthcare-Your Medical Advisor in India

  Low Cost Varicocelectomy in India

Bilateral Subungual Microscopic Varicocelectomy/Varicocele Surgery

Booked Apointment

Surgery NameCostRoom CategoryHospitalization
Bilateral Subungual Microscopic Varicocelectomy/Varicocele Surgery2100 USDEconomy2

1.Room Rent,
2.Cost of Surgery,
3.Consultation by Primary Team in Package days,
4. Basic Investigations.
5. Routine Pharmacy and Consumables,
6.Patient Food.


1.Overstay more than package days,
2. Any other Specialty Consultations,
3. Special Equipment,
4. Additional Procedure/Surgery.

About Package

What is Varicocelectomy?

A varicocele is an enlargement of the veins in your scrotum. Varicocelectomy is a surgery performed to remove those enlarged veins. The procedure is done to restore proper blood flow to your reproductive organs.

When a  varicocele develops in your scrotum, it can block blood flow to the rest of your reproductive system. The scrotum is the sac that contains your testicles. Because blood can’t return to your heart through these veins, blood pools in the scrotum and the veins become abnormally large. This can decrease your sperm count

Bilateral Subungual Microscopic Varicocelectomy

Frequently Asked QuestionsWill sperm count increase after varicocele surgery?men with low sperm count and a varicocele found that surgery increased their sperm count, on average, from 2.4 to 11.6 million per milliliter. However, in the same study, fertility rates remained relatively low 

What are the Tests done before a Varicocelectomy Surgery?Routine tests:

Routine tests which are done before any surgery include:

  • Ultrasound / Doppler of the scrotum
  • Angiography: It is used to study the abnormal blood vessels in the varicocele
  • CT scan / MRI scan
  • Blood tests like hemoglobin levels, blood group, liver and kidney function tests
  • Urine tests
  • ECG (Electrocardiogram) to study the electrical activity of the heart
  • Chest X-ray 

What are the Indications for Varicocelectomy Surgery?

Varicocelectomy involves ligation of the spermatic veins. A varicocele may require surgery if it is associated with any of the following:

  • Small size of the gonads or slow testicular growth in children or teens
  • Pain in the scrotum
  • Aesthetic problems
  • Presence of infertility due to the varicocele

How is Varicocelectomy Performed?

Type of Anesthesia – Varicocele surgery is done either under general anesthesia or spinal anesthesia. In some cases, local anesthesia may also be used. If you undergo general anesthesia, you will be asleep during the procedure and will not be aware of what is going on. Under spinal or local anesthesia, you will be awake but will not be able to feel any pain during the surgery. Laparoscopic surgery is done under general anesthesia

Fasting before Surgery : Overnight fasting is required if you are undergoing the surgery under general anesthesia and occasionally intravenous fluid maybe required to keep you well hydrated. Sedation is sometimes required for good overnight sleep before the surgery. 

How Much Time Varicocelectomy Surgery Takes ?

The surgery lasts about 30 minutes per side so that a right and left varicocelectomy should take about 1 hour of operating time. This procedure is typically performed as outpatient.How many days rest after varicocele surgery?After surgery, you may have slight pain in your groin for 3 to 6 weeks. Your scrotum and groin may be bruised and swollen. This will go away in 3 to 4 weeks. You will probably be able to return to work or your normal routine in 2 to 3 days after microscopic surgery Can a man with varicocele get a woman pregnant?If men with a palpable varicocele and poor sperm quality have treatment, the chances of their partner becoming pregnant could possibly improve. Most couples who are trying for a baby will succeed within two years. If it takes them longer, they are considered to have a fertility problem

What are the Types of Varicocelectomy Surgery?

Types of varicocelectomy surgery include the following:

  • Open varicocelectomy, which involves an open surgery. Depending on the location of the incision, this type of surgery can be divided into the following types:
  • Retroperitoneal high ligation, where the incision is taken in the lower abdomen
  • Inguinal ligation
  • Sub-inguinal ligation. In inguinal and sub-inguinal ligation, the incision is taken in the groin.
  • Laparoscopic varicocelectomy, which uses a telescope-type instrument called laparoscope
  • Microsurgical varicocelectomy, which uses an operating microscope and microsurgical instruments

What are the possible side effects of this procedure?

  • fluid buildup around your testicle (hydrocele)
  • difficulty peeing or fully emptying your bladder.
  • redness, inflammation, or drainage from your incisions.
  • abnormal swelling that doesn’t respond to cold application.
  • infection.
  • high fever (101°F or higher)
  • feeling nauseous.

 How long after varicocele surgery does sperm improve?

After treatment, it typically takes 3 to 6 months for patients’ semen parameters to improve; thus, other therapies, including assisted reproductive technology, should be considered if infertility persists after this interval, especially in older couplesCan varicocele surgery cause erectile dysfunction?Therefore, bilateral varicocele (grade 3) is associated with significant reduction in testicular function with significant increase in serum levels of FSH and LH, which may cause erectile dysfunction and male infertility. Best Urologist In Delhi –  Click Here 
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Total Elbow Replacement

Total Elbow Replacement

Total Elbow Replacement is a surgical procedure which is done to the patients with defect in elbow.


The elbow is the visible joint between the upper and lower parts of the arm. The upper arm bone (humerus) and two bones in the forearm (ulna and radius). It includes prominent landmarks such as the olecranon, the elbow pit, the lateral and medial epicondyles, and the elbow joint.

Elbow Replacement

This procedure is done to


  • Arthritis or Rheumatoid Arthritis
  • Old Age or Osteo-Arthritis
  •  Fracture due to accident



  • Pain in Elbow joint
  • Numbness in hand



  • Blood Tests
  • MRI Scan
  • CT Scan
  • X-Ray



The Elbow replacement surgery replaces the damaged joint surfaces. Elbow replacement usually consist of metal and plastic. The surfaces are replaced to give a hinge joint. In addition the top of one of the forearm bones (radius) is removed as this joint can also give elbow pain. See picture below. To get into the joint, the muscle on the back of your arm (triceps) is split and cut away from the bone. This is then re-stitched at the end of the operation. The main reason for doing the operation is to reduce the pain in your elbow. Ultimately you may also have more movement in your elbow. Bending your elbow to allow your hand to reach your mouth and rotating the forearm usually show the greatest improvement. However, your arm may not straighten-out more after the operation.



Lumbar Spinal Stenosis

Lumbar Spinal Stenosis

Lumbar Spinal Stenosis caused by narrowing of the spinal canal.

Lumbar SpineLumbar spine

The lumbar spine is made up of five vertebral bodies in the lower back, where the spine curves inward toward the abdomen. It starts about five or six inches below the shoulder blades, and connects with the thoracic spine at the top and extends downward to the sacral spine. These nerves transmit sensations from the buttocks and lower extremities through the spinal cord to the brain and transmit motor signals from the brain to the lower extremities to produce movement of the legs, toes, and joints of the lower extremities.

Lumbar Spinal Stenosis

Lumbar spinal stenosis is a condition caused by narrowing of the spinal canal. This narrowing occurs when the growth of bone or tissue or both reduces the size of the openings in the spinal bones. This narrowing can squeeze and irritate the nerves that branch out from the spinal cord.


  • Back injuries— Can both cause spinal stenosis or can worsen already existing low-level symptoms.
  • Tumor growth—Can narrow the spinal canal, but the occurrence of spinal tumors is rare.
  • Bone spurs—As cartilage deteriorates between the joints of the back, small bone growths, called bone spurs, or osteophytes, can develop. Bone spurs sometimes develop due to arthritis in the spine.
  • Herniated discs—As the discs in the back deteriorate they can herniate, meaning the disc swells, bulges, or ruptures. When this occurs some of the disc material can protrude into the spinal canal. A herniated disc, while painful, doesn’t always cause lumbar spinal stenosis.
  • Changes to ligaments—Changes can occur, especially to the ligamentum flavum, the ligament that runs along the inside of the spinal canal. This ligament can become thickened, taking up more space in the spinal canal. Or, as deteriorating discs lose some of their height, this ligament can buckle.
  • Enlarged facet joints— Enlargement of the facet joints in the spine can also cause narrowing of the spinal canal.
  • Spondylolisthesis—Refers to the forward slippage of one vertebra over another in the spine. This can cause narrowing of the spinal canal and result in pinching of the nerves. Learn more about spondylolisthesis.



  • Back pain: People with spinal stenosis may or may not have back pain, depending on the degree of arthritis that has developed.
  • Burning pain: Pressure on spinal nerves can result in pain in the areas that the nerves supply. The pain may be described as an ache or a burning feeling. It typically starts in the area of the buttocks and radiates down the leg. The pain down the leg is often called “sciatica.” As it progresses, it can result in pain in the foot.
  • Numbness: As pressure on the nerve increases, numbness and tingling often accompany the burning pain. Although not all patients will have both burning pain and numbness and tingling.
  • Weakness or “foot drop”: Once the pressure reaches a critical level, weakness can occur in one or both legs. Some patients will have a foot-drop, or the feeling that their foot slaps on the ground while walking.
  • Pain with leaning forward or sitting: Studies of the lumbar spine show that leaning forward can actually increase the space available for the nerves. Many patients may note relief when leaning forward and especially with sitting. Pain is usually made worse by standing up straight and walking. Some patients note that they can ride a stationary bike or walk leaning on a shopping cart. Walking more than 1 or 2 blocks, however, may bring on severe sciatica or weakness


Surgery – Laminectomy

This procedure involves removing the bone, bone spurs, and ligaments that are compressing the nerves. This procedure may also be called a “decompression.” Laminectomy is a surgical procedure to remove a portion of the vertebral bone called the lamina. The minimal form of the procedure requires only small skin incisions, the back muscles are pushed aside rather than cut, and the parts of the vertebra adjacent to the lamina are left intact. Recovery from the minimal procedure can occur within a few days.

Lumbar Spine1Spinal fusion

If arthritis has progressed to spinal instability, a combination of decompression and stabilization or spinal fusion may be recommended. Spinal fusion is a surgical procedure used to correct problems with the small bones of the spine (vertebrae). It is essentially a “welding” process. The basic idea is to fuse together the painful vertebrae so that they heal into a single, solid bone.

Lumbar traction

Although it may be helpful in some patients, traction has very limited results. There is no scientific evidence of its effectiveness.

Steroid injections

Cortisone is a powerful anti-inflammatory. Cortisone injections around the nerves or in the “epidural space” can decrease swelling, as well as pain. It is not recommended to receive these, however, more than 3 times per year. These injections are more likely to decrease pain and numbness but not weakness of the legs.



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Reverse Shoulder Arthroplasty

Reverse Shoulder Arthroplasty

Reverse Shoulder Arthoplasty is a surgical procedure which is done to the patient with shoulder problem.


The human shoulder is made up of three bones: the clavicle, the scapula, and the humerus as well as associated muscles, ligaments and tendons. The articulations between the bones of the shoulder make up the shoulder joints.


Shoulder Arthritis

Shoulder arthritis is damage to the cartilage inside the shoulder joint. The shoulder has two joints. Shoulder arthritis commonly refers to the bigger ball-and-socket joint named the glenohumeral joint after the bones it connects (glenoid and humerus). The cartilage covers both the ball (the humeral head) and the socket (the glenoid).



  • Complex Fracture of the shoulder joint
  • Tumor of the shoulder joint
  • Chronic shoulder dislocation
  • Unsuccessful shoulder replacement


  • Pain in shoulder
  • Numbness in hand


  • MRI Scan
  • CT Scan
  • X-Ray


Surgery is the only procedure to cure severe shoulder pain.

The procedure is performed through a deltopectoral approach, in which the space between the deltoid muscle and pectoralis major muscle is developed. The subscapularis muscle, one of the four muscles of the rotator cuff, is typically detached to perform the operation. The native humerus and scapula bones are prepared using precise machining to accommodate their respective implants. At the end of the procedure, the subscapularis muscle is typically repaired, although some surgeons advocate not repairing this muscle due to the excess tension placed on it by the altered mechanics of the reverse shoulder design.


Spine Surgery

Spine Surgery

Spine surgery is a procedure done to the patient having problem with lower spine.

SpineSpinal Cord

The spinal cord is a collection of nerves that travels from the bottom of the brain down your back. There are 31 pairs of nerves that leave the spinal cord and go to your arms, legs, chest and abdomen. These nerves allow your brain to give commands to your muscles and cause movements of your arms and legs.


Spinal Cord Injury

The spinal cord is very sensitive to injury. Unlike other parts of your body, the spinal cord does not have the ability to repair itself if it is damaged. A spinal cord injury occurs when there is damage to the spinal cord either from trauma, loss of its normal blood supply, or compression from tumor or infection.


Types of Injuries

  • Complete: – If almost all feeling (sensory) and all ability to control movement (motor function) are lost below the spinal cord injury.
  • Incomplete: – If you have some motor or sensory function below the affected area.

When spinal cord injuries occur in the neck area, symptoms can affect the arms, legs, and middle of the body. The symptoms may occur on one or both sides of the body. Symptoms can also include breathing difficulties from paralysis of the breathing muscles, if the injury is high up in the neck.

  • Cervical Herniated Disc

This type of cervical spine injury happens when the soft spinal discs bulge or rupture out of the spinal canal and put pressure on nearby nerve roots or the spinal cord. The culprit is usually some type of sudden force.

  • Cervical Disc Degeneration

Over time, wear and tear on the cervical spine can injure it and cause the discs in the cervical spine to degenerate. The degeneration process can be exacerbated by a fall or twisting injury to the neck.



When spinal injuries occur at chest level, symptoms can affect the legs. Injuries to the cervical or high thoracic spinal cord may also result in blood pressure problems, abnormal sweating, and trouble maintaining normal body temperature.

  • Thoracic intervertebral joint sprain

The intervertebral joint is the joint that joins the levels of the spine together. Injury to this joint is usually due to a forced movement forward or backward of the thoracic spine. Pain can be felt locally about 2 cm to the side of the spine and may radiate around the chest wall to the front of the chest. Pain is increased with forward or backward movement of the spine.

  • Thoracic muscle rupture

This injury is common in many sports such as throwing sports, football, basketball and boxing. It is also commonly done when lifting heavy objects.

  • Ostovertebral joint disorders

The costovertebral joint is a joint in the back that joins the rib and the spine. Common problems arise from spraining the joint during forced chest movement or from inflammation due to arthritis.

  • Rib brushing/fracture

This injury is very common in contact sports such as football and rugby. It most commonly occurs as a result of a blow to the ribs.

  • Scheuermann’s disease (Osteochondrisis)

This is the most common cause of pain in the thoracic spine in adolescents, especially boys. It is a hereditary back disease in which the back becomes rounded due to the bodies of the vertebrae becoming wedged shaped.

  • Scoliosis (Curvature of the spine)

This is a curvature of the spine in a sideways direction which causes the spine to be S-shaped. Symptoms with scoliosis are not always present. Symptoms include complications due to muscle weakness and joint ‘looseness’ on the convex side and muscle tightness and spasm with joint tightness on the concave side.



When spinal injuries occur at the lower back level, symptoms can affect one or both legs, as well as the muscles that control the bowels and bladder.

  • Non-specific Low Back Pain (NSLBP)

Low back pain can be caused by structures being too tight (hypo-mobility) or too loose (hyper-mobility). The pain producing structures in the lumbar spine include the vertebra, the facet joints (links two vertebra together in your spinal column), intervertebral disc, ligaments, nerves and their protective coverings, muscles and their attachments.

  • Intervertebral Disc Degeneration / Sciatica

The intervertebral discs are composed of a soft, inner nucleus pulposus surrounded by a tough fibrous outer ring, the annulus fibrosus. With trauma and / or ageing, the annulus fibrosus can weaken and thin (disc degeneration or herniation), particularly with the repetitive combination of bending forwards while rotating the trunk i.e. lifting.

  • Lumbar Stress Fractures

LBP may also be caused by spondylolysis, or a stress fracture of the pars interarticularis, a region of the vertebra. This is often seen in sports involving repeated back extension and rotation, such as gymnastics, cricket fast bowling or tennis. While it was thought to be congenital, it is probably an acquired overuse injury. The fracture usually occurs on the opposite side to the one performing the task i.e. a left sided fracture occurs in a right handed tennis player.

  • Spinal Canal Stenosis

Another commonly encountered cause of LBP is spinal canal stenosis. It is a condition that is rare in young and middle-aged athlete’s, but may be seen occasionally in older athletes. The condition is caused by arthritic degeneration of the spine, resulting in the vertebra, facet joints, and ligaments which surround the spinal nerves of the spinal cord to become enlarged. In this manner, these structures may compress one or several spinal nerves, causing LBP, leg pain, and leg numbness while walking.


  • Loss of movement
  • Sensation loss, including the ability to feel heat, cold and touch
  • Loss of bowel or bladder control
  • Exaggerated reflex activities or spasms
  • Changes in sexual function, sexual sensitivity and fertility
  • Pain or an intense stinging sensation caused by damage to the nerve fibers in your spinal cord
  • Difficulty breathing, coughing or clearing secretions from your lungs
  • Extreme back pain or pressure in your neck, head or back
  • Weakness, incoordination or paralysis in any part of your body
  • Numbness, tingling or loss of sensation in your hands, fingers, feet or toes
  • Loss of bladder or bowel control
  • Difficulty with balance and walking
  • Impaired breathing after injury
  • An oddly positioned or twisted neck or back




  • Spinal Decompression Surgery

Spinal decompression surgery is a general term that refers to various procedures intended to relieve symptoms caused by pressure, or compression, on the spinal cord and/or nerve roots. Bulging or collapsed disks, thickened joints, loosened ligaments and bony growths can narrow the spinal canal and the spinal nerve openings (foramen), causing irritation. 

  • Diskectomy

Diskectomy is a surgery to remove all or part of a cushion that helps protect your spinal column. These cushions, called disks, separate your spinal bones (vertebrae).

  • Minimally invasive spine surgery

Minimally invasive spine surgery uses very small surgical incisions (often less than one inch) and specially designed surgical tools to treat spinal disorders. Because minimally invasive surgery is performed through small tubes, there is little disruption of normal structures. This reduces postoperative pain, speeds recovery, and leads to shortened hospital stays. Many minimally invasive spine procedures can be performed on an outpatient basis.

  • Foraminotomy

Foraminotomy is a surgery that widens the opening in your back where nerve roots leave your spinal canal. You may have a narrowing of the nerve opening (foraminal stenosis).

  • Spinal fusion

Spinal fusion is a surgery to join together two bones (vertebrae) in the spine. Fusion permanently joins two bones together so there is no longer movement between them. Spinal fusion is usually done along with other surgical procedures of the spine.

Alternative Treatments

  • Vertebroplasty

Vertebroplasty is performed by a radiologist, without surgery, and involves inserting a glue-like material into the center of the collapsed spinal vertebra to stabilize and strengthen the crushed bone. The material is inserted through anesthetized skin with a needle and syringe, entering the midportion of the vertebra under the guidance of specialized X-ray equipment. Once inserted, the material hardens to form a cast-like structure within the broken bone. Relief of pain comes quickly from this casting effect, and the newly hardened vertebra is then protected from further collapse.

  • Rehabilitation

The rehabilitation process following a spinal cord injury typically begins in the acute care setting. Physical therapists, occupational therapists, social workers, psychologists and other health care professionals typically work as a team under the coordination of a physiatrist to decide on goals with the patient and develop a plan of discharge that is appropriate for the patient’s condition.

Total Hip Replacement

Total Hip Replacement

Total Hip Replacement is a surgical procedure which is done to replace one hip joint completely sometimes both joints. Hip Arthritis(HA) or Total Hip Replacement(THR) Surgery.

Hip Replacement

Hip ReplacementTotal hip replacement (THR) – also called a Hip Arthroplasty- is a surgical procedure that re-forms the hip joint. In THR, the head of the femur (the bone that extends from the hip to the knee) is removed along with the surface layer of the socket in the pelvis (the two large bones that rest on the lower limbs and support the spinal column).


The hip is a ball-and-socket joint comprised of the following structures:

  • Head of the femur
  • Acetabulum of the pelvis
  • Ligaments of the hip joint

The head of the femur or “ball” of the hip joint articulates or moves within the cup-like “socket” called the acetabulum of the pelvic bone. Together, these structures are referred to as a “ball and socket” joint. The femoral head and acetabulum are covered by a specialized surface called articular cartilage. This allows smooth and painless motion of the hip joint.



Total hip replacement can benefit individuals suffering from a variety of hip problems resulting from either wear and tear from a lifetime of activity or from disease and injury. Some of the common hip problems leading to total hip replacement are

  • Osteoarthritis resulting from “wear and tear” is the most common reason for individuals to undergo Hip replacement surgery.
  • Rheumatoid arthritis, an inflammation of the tissue surrounding the joints, can cause deterioration of cartilage and other parts of the joint and also result in the need for hip replacement.
  • Post-traumatic arthritis, a type of arthritis that can arise following an injury to the joint cartilage or through damage to the ligaments leading to an unstable hip.
  • Avascular necrosis results from an inadequate supply of blood to the bone end inside the joint.
  • Others :- Benign and malignant bone tumors can alter the shape and congruency of the joint and also disrupt blood supply of the joint, affecting articular cartilage.



  • Hip/groin pain that keeps you awake, or awakens you, at night.
  • Hip pain that limits activities necessary to go about your daily activities (getting up from a chair, climbing stairs, etc.).
  • Hip pain that limits activities that give you pleasure (walking for exercise, traveling, shopping, etc.).
  • Tried other treatments for a reasonable period of time, and still having persistent hip pain.



During surgery, once the hip joint is exposed, the head and neck of the femur are removed. The shaft of the femur is then reamed to accept the metal component consisting of the head, neck, and stem. The acetabulum is then reamed to accept a plastic cup. The ball and socket are then replaced into normal position. Both of these implants can be fastened into the bone with or without special cement.

  • Cemented procedure: – The cemented procedure utilizes a doughy substance mixed at the time of surgery that is introduced between the artificial component and the bone.
  • Non-cemented procedure: – Artificial joint covered with a material that allows bone tissue to grow into the metal. A tight bond of scar tissue if formed, which anchors the metal to the bone. This is called a cementless total hip replacement.



Postoperative care begins with a team approach of health professionals within the hospital with special emphasis on Physiotherapy regime. The regime is focused on Circulation, Range of motion, Mild muscle strengthening exercises, Gait training, deep breathing exercises. These are all centered on getting the patient back to doing Activities of Daily Living.



  • The general goal of total hip replacement is designed to provide painless and unlimited standing, sitting, walking, and other normal activities of daily living. It Improves quality of life and restores mobility.
  • It has very high success rates, relieves the pain and disability from degenerative arthritis, meniscus tears, osteoarthritis, cartilage defects, and ligament tears
  • Technology has led to the development of materials used in the artificial hip joint allowing it to last over fifteen years.
  • Artificial joint replacement for arthritis of hip is one of the most successful surgeries of the last century.

Success Rate

Individuals are able to begin walking the day following surgery and pain relief is achieved in greater than 95% of people.

Total Knee Replacement

Total Knee Replacement

Total Knee Replacement(TKR) or Total Knee Arthritis(TKA) is a surgical procedure done to replace a knee or both. This is done to the patient with severe pain in knees due to damage.


The Knee is the largest joint in the body. Normal knee function is very important to perform day today activities. Knee is made up of the lower end of thigh bones (femur) which rotates on the upper end of the shin bone (tibia) and the knee cap which slides in a groove on the end of the femur.

The Joint surface is covered with a smooth substance that cushions the bones and enables them to move easily. All remaining surfaces of the knee are covered by a thin, smooth tissue liner .This is membrane releases a special fluid that lubricates the knee, reducing friction to nearly zero in a healthy knee. Normally, all of this mechanism works in harmony. But disease or injury can create disorder in this harmony, resulting in pain, muscle weakness, and reduced function.



The knee joint performs similar to a hinge joint. It consists of three bones:

  • Thigh bone (Femur)
  • Leg bone (Tibia)
  • Knee cap (Patella)


The junction where the femur and tibia couple together is called the femorotibial joint. The region of the knee where the patella and femur form a junction is called the patella femoral joint. These two joints are what allow the bending and straightening of the knee. It is these joints that are replaced in a total knee joint replacement.


Total Knee ReplacementTotal knee replacement

Total knee replacement (TKR), also referred to as Total Knee Arthroplasty (TKA), is a surgical procedure where worn, diseased, or damaged surfaces of a knee joint are removed and replaced with artificial surfaces.

Knee replacement surgery is performed to treat advanced or end-stage arthritis or to the patient who has severe pain in the knee joint.



  • Osteoarthritis resulting from “wear and tear” is the most common reason for individuals to undergo knee replacement surgery.
  • Rheumatoid arthritis, an inflammation of the tissue surrounding the joints, can cause deterioration of cartilage and other parts of the joint and also result in the need for knee replacement.
  • Post-traumatic arthritis, a type of arthritis that can arise following an injury to the joint cartilage or through damage to the ligaments leading to an unstable knee.
  • Avascular necrosis results from an inadequate supply of blood to the bone end inside the joint



Generally a person would be considered for a Total Knee Replacement if the individual experiences daily pain, restricting not only work and recreation, but also the ordinary activities of daily living. There must also be evidence of significant destruction of the knee as seen on an x-ray.



Once the anesthesia has been given and the patient is prepared, the damaged joint surfaces are removed. An incision approximately eight inches in length is made on the front of the knee. The damaged joint surfaces are removed from all 3 bones making up the knee joint. Sometimes, depending on the surgeon, the back of the knee cap is left intact if it is not badly affected by the arthritis. The surrounding muscles and most of the ligaments are preserved. The lower end of the thigh bone (femur) is resurfaced with a metal cap. The upper end of the leg bone (tibia) is replaced with a plastic and metal implant with cement and or screws. The actual procedure takes about 1 ½ to 2 hours.



  • Cemented Implants: – The components of the implant are fixed to the bone with a grout-like cement known as polymethyl-methacrylate. This cement allows the implants to perfectly fit to the irregularities of the bone.
  • Non-cemented Implants: – In a non-cemented procedure, components of the implant have a roughened porous surface designed to allow bone to grow into it, eliminating the need for cement. The implants are “press fit” against the bony surfaces that are precisely cut through the use of multiple cutting jigs.
  • Hybrid Fixation Implants: – Consists of a combination of the cemented and non-cemented technique. In this method the femoral component is not cemented and the tibia component is cemented.



Postoperative care begins with a team approach of health professionals within the hospital with special emphasis on Physiotherapy regime. The regime is focused on Circulation, Range of motion, Mild muscle strengthening exercises, Gait training, deep breathing exercises. These are all centered on getting the patient back to doing Activities of Daily Living.




  • The general goal of total knee replacement is designed to provide painless and unlimited standing, sitting, walking, and other normal activities of daily living. It Improves quality of life and restores mobility.
  • It has very high success rates, relieves the pain and disability from degenerative arthritis, meniscus tears, osteoarthritis, cartilage defects, and ligament tears
  • Technology has led to the development of materials used in the artificial knee joint allowing it to last over fifteen years.
  • Artificial joint replacement for arthritis of the knee and hip is one of the most successful surgeries of the last century.

Individuals are able to begin walking the day following surgery and pain relief is achieved in greater than 95% of people.

With proper care individuals who have had a Total Knee Replacement can expect many years of faithful function. Studies show that patients can expect a greater than 95 percent chance of success for at least 20 years.

Tetralogy of Fallot

Tetralogy of Fallot

Tetralogy of Fallot ImageTetralogy of Fallot

This  is a rare, complex congenital heart defect. A congenital heart defect is a problem with  the heart’s structure that’s present at birth.

This involves four heart defects:

  • A large ventricular septal defect (VSD)
  • Pulmonary stenosis
  • Right ventricular hypertrophy
  • An overriding aorta


Tetralogy of Fallot Symptoms/Signs

  • With tetralogy of Fallot, not enough blood is able to reach the lungs to get oxygen, and oxygen-poor blood flows to the body.
  • Doctors often don’t know what causes tetralogy of Fallot. Some conditions or factors that occur during pregnancy may raise your risk of having a child who has tetralogy of Fallot. Heredity and some genetic disorders also may play a role in causing the condition.
  • Cyanosis is an important sign of tetralogy of Fallot. Cyanosis is a bluish tint to the skin, lips, and fingernails. Low oxygen levels in the blood cause cyanosis.
  • Other signs and symptoms include a heart murmur, delayed growth and development, and clubbing. Clubbing is the widening or rounding of the skin or bone around the tips of the fingers.
  • Babies who have unrepaired tetralogy of Fallot sometimes have “tet spells.” A tet spell occurs when the oxygen level in the blood suddenly drops. This causes the baby to become very blue. He or she also may have trouble breathing, become very tired and limp, not respond to a parent’s voice or touch, become very fussy, or pass out.



  • Echocardiography(Echo)
  • Electrocardiography(EKG/ECG)
  • Chest X-Ray
  • Pulse Oximetry
  • Cardiac Catheterization


Treatment – Surgery

  • Tetralogy of Fallot is repaired with open-heart surgery, either soon after birth or later in infancy. The goal of surgery is to repair the four defects of tetralogy of Fallot so the heart can work as normally as possible.
  • Surgery involves widening or replacing the pulmonary valve and enlarging the passage from the right ventricle to the pulmonary artery. This improves blood flow to the lungs. Surgeons also close the VSD with a patch. The patch stops oxygen-rich and oxygen-poor blood from mixing between the ventricles.
  • Fixing pulmonary stenosis and the VSD resolves problems caused by the other two defects (right ventricular hypertrophy and an overriding aorta).
  • Some babies who are very small or weak have temporary surgery (Palliative Surgery)  that improves blood flow to the lungs and gives the baby time to grow and get strong enough for the full repair.


After Surgery

  • Regular visit to doctor
  • Maximum Care to the child