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Dr Ashit

Dr Ashit Hegde  | Answer  |Ask -

Consultant Physician, Internal Medicine and Critical Care Expert - Answered on Jul 09, 2023

Dr Ashit Hegde specialises in internal medicine and intensive care. He has nearly 40 years of experience and is consultant physician, intensivist and head of the critical care section at the PD Hinduja Hospital and Medical Research Centre.
He is actively involved in teaching and training residents for post graduate programmes in internal medicine and critical care.
He holds an MD degree in general medicine and therapeutics from the Lokmanya Tilak Municipal Medical College, Mumbai, and an MRCP from the Royal College of Physicians, Edinburgh.... more
PADMAKUMAR Question by PADMAKUMAR on Jul 09, 2023Hindi
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Dear sir, I was operated for spine in 2016 and post operative status was PIVD L5-S1. After a period of two years, again back pain and weakness in left leg was felt. On taking treatment, improvement was seen. The same occurred in 2018, 2020 and now in 2022 I was diagnosed with ACUTE LUMBOSACRAL PAIN AND PIVD L5-S1 as was finding it difficult to walk, weakness in both the legs (extreme weakness in left leg and other complications. I was administered with EPIDURAL INJECTION. Thought at present relief is felt but still finding it difficult to climb the stairs, continuous walking etc and severe back pack is sometimes felt. Doctor had advised for second surgery but I am not open to the surgery. Can you please guide for further medical process.

Ans: I don't think I am qualified to answer your question. You can take a second opinion from another spine surgeon.
DISCLAIMER: The answer provided by rediffGURUS is for informational and general awareness purposes only. It is not a substitute for professional medical diagnosis or treatment.
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Dr Hemalata

Dr Hemalata Arora  | Answer  |Ask -

General Physician - Answered on May 25, 2023

Asked by Anonymous - May 25, 2023Hindi
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Hello Doctor-DD here and am 50 years old. I had lower back pain on left hand side along with radiating pain in left groin area since end of March 2023. After initial local pain management, the pain did not go, so my GP asked me to do LS Spine MRI. The report suggested some nerve root issue in L4 and L5, so I was asked to refer it to spine specialist. I tried to connect with Dr. Bapat at Nanavati Hospital, but could not see him as his assistant reviewed the reports and said its mild and suggested medicines – Ultracet 1-0-1 for 10 days, Vitencial – 0-1-0 for 30 days and Calciman K10 – 0-1-0 for 30 days. However, the pain persisted with bit of increase in pain in groin area. So the assistant suggested that for pain in groin area better to check with general surgeon about hernia and / or prostate. Since my regular GP is out of town and I had to take my mother to see Dr. Pande, Urologist at Kokilanben Hospital for Urinary Tract problems. So I checked with him about my problem. So he first did Uroflow test and then physically examined the prostate also and later said it’s all fine. He said due to L4-L5 nerve issue, there is pain in groin area and suggested medication – Synaptol 50mg 1-0-1 for 3 weeks, Pregablin (50mg) 0-0-1 for 6 weeks and Etoshine 90mg – 1-0-0 for 10 days and said to do USG of Groin, PSA (total) test and HBA1C after 6 weeks and then again see him. I have started his medication from 20.5.23. He said this type of pain is due to L4-L5 nerve falls under his area and now there is no need to again see Dr. Bapat (I am scheduled for his appointment on 29.5.23). I had also done MRI for hip joints in Nov 22 and the reports were normal. Please note all through last 2-3 months, most of the time the pain is dull and mild specially when in sitting position and at times in sleeping position. If I stand, walk, there is as good as no pain or very very minimal pain. But the pain still continues but in less intensity. Since yesterday, I have also started getting pain on right hand side also, but it pains only while getting up and / or twisting the body a bit here and there. Also, today morning I was having some burning sensation in pelvic area in sleeping position but no pain at that time. I am worried about all this and do not understand what the problem could be and why it is taking so long to become normal and whether all these pains is only due to L4-L5 nerve root issue or is it due to some other complications. I had done CBC test, LFT, KFT, Routine Urine and stool test around one month back and the reports were all normal.
Ans: This would need a thorough examination in addition to the tests that were done. The possibilities are nerve root pain both in the lumbosacral and cervical areas accounting for the arms pain and pelvis and leg pain, vitamin B12 deficiency, folic acid deficiency, or a kind of nerve inflammation. Please do keep your appointment with Dr Bapat on 29th and in fact you may please come meet me as well on the same day.

..Read more

Nidhi

Nidhi Gupta  |187 Answers  |Ask -

Physiotherapist - Answered on Oct 16, 2023

Asked by Anonymous - Aug 10, 2023Hindi
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Hi, I am 46 years old male having post polio paralysis of both lower limbs but can walk and climb stairs as well with holding sideways support. After 8th class my classmates noticed that my back was bending too much, since on govt schools we had to sit on mats. When I reached 9th and 10th class, it was a bend in backbone and belonging to poor family, we could not afford medical advice. Now that i have scoliosis and feel constant pressure on left side of chest which increases in intensity after a moderate physical activity. I have consulted a cardio and his suggestion was to do angiography as it is a sign of CAD. He also gave medications like Rancad, Atorsave cv and halfdol, but there is a marginal improvement. My body weight has recently increased from 59 to 64 Kgs, i am 5 feet tall. Please help me how can I manage this medical condition and lead a healthy life. Thanks for your valuable time.
Ans: Hello Anonymous,
Did you do the angiography? What did it show?
Yes, scoliosis starts putting pressure on one side of the body and hence starts affecting the inner organs as well as the musculoskeletal system too.
You should definitely take the help either of a good yoga teacher or a physiotherapist.
They need to evaluate you in details, check your core muscles, muscle strength and accordingly give you a home program to do. You need to also learn some breathing exercises from them. If you do general exercises on your own you will tend to pressurise one side more. When you do therapeutic exercises you will feel more balanced and you can manage this condition much better.
You should also once consult a nutritionist who can guide you towards some healthier choices.
Even if you just do one consult with a nutritionist and maybe 2-3 sessions with a physiotherapist/yoga teacher rest you can then continue at home. So it will be cost effective for you to.
Wishing you all the best for a healthier life ahead!

..Read more

Nidhi

Nidhi Gupta  |187 Answers  |Ask -

Physiotherapist - Answered on Oct 16, 2023

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i am 55 years old. Retired defense pilot. Have lots of sports injury which is showing up at this age. Body biochemistry is all with in limits, only fasting sugar is 108. For last few months i am having pain in outer left thigh muscles which increases during sleep as well as while lying down resulting in sleepless nights hence general body fatigue due lack of sleep. My exercise includes 5-6 km walk in the morning and occasionally thrice a week cycling. Orthopedic , General surgeon, neurologist as well as ayurvedic doctor has been consulted with MRI report. FINDINGS: Dorsal and lumbar vertebrae are normal in attenuation and alignment. Straightening of lumbar lordosis. Desiccation of lumbar intervertebral disc from L2-L3 to L5-S1 levels. Mild diffuse disc bulges at L2-L3, L3-L4 and L4-L5 intervertebral discs indenting anterior thecal sac with mild narrowing of lateral recesses and neural foramina. No significant compression of the cauda equina. Mild disc bulge at L5-S1 level indenting anterior thecal sac. Bilateral facet arthropathy is seen at L4-L5 level. Dorsal spinal cord, conus medullaris and cauda equine are normal. Para spinal soft tissues are normal. IMPRESSION: Mild lumbar spondylosis with mild diffuse disc bulges from L2-L3 to L5-S1 levels. Kindly help me and advice
Ans: Hello Partha,
You need to consult a physiotherapist who knows the Mckenzie treatment for slipped disc. At times pain in outer thigh can be due to slipped disc.
Or you may have a hip bursitis which will not come up in lumbar spine MRI, only hip MRI will show it. Outer thigh pain while sleeping on left side can cause pain if it is a left hip bursitis.
Or this could be a Iliotibial band tightness which is a band of muscles on the outer thigh.
A good sports physiotherapist who also knows the Mckenzie treatment needs to evaluate you, understand the root cause and accordingly give you the treatment and you should be fine.
All the best!

..Read more

Latest Questions
Ramalingam

Ramalingam Kalirajan  |7596 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Jan 21, 2025

Asked by Anonymous - Jan 21, 2025Hindi
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I'm 32, with no savings other than my monthly SIP of 5000 which i have been doing since 2022 september. I have no financial backing, could you help me with a break up of how i can start investing and saving.
Ans: At 32, starting with Rs. 5,000 monthly SIP is a good first step. Building wealth requires a structured approach to saving and investing. Here's a step-by-step guide to help you achieve financial stability and growth.

Assessing Your Current Situation
You have no financial backing, so an emergency fund is critical.

Your monthly SIP indicates discipline in investing.

Prioritising goals and systematic planning will strengthen your finances.

Step 1: Establish an Emergency Fund
Save at least 6 months' worth of monthly expenses in a liquid fund or savings account.

Allocate a fixed portion of your income every month for this purpose.

Emergency funds should be easily accessible but not used for routine expenses.

Step 2: Manage Expenses Effectively
Create a monthly budget to track income and expenses.

Identify unnecessary expenses and redirect the savings towards investments.

Follow the 50-30-20 rule:

50% for necessities (rent, food, bills).
30% for discretionary spending (entertainment, hobbies).
20% for savings and investments.
Step 3: Continue and Enhance SIP Contributions
Your Rs. 5,000 SIP in equity mutual funds is a good start.

Gradually increase the SIP amount as your income grows.

Choose funds based on your risk tolerance and investment horizon.

Step 4: Diversify Your Investments
Equity Mutual Funds

Continue investing in actively managed funds for long-term growth.
Focus on funds with consistent performance over 5-10 years.
Debt Funds or Fixed Deposits

Allocate a portion to safer instruments for stability.
These options can balance risk in your portfolio.
PPF (Public Provident Fund)

Open a PPF account for tax-saving benefits and long-term compounding.
Invest a fixed amount annually to build a secure retirement corpus.
Gold for Wealth Protection

Allocate a small percentage (5-10%) to gold (SGB or gold mutual funds).
Gold acts as a hedge against inflation.
Step 5: Focus on Insurance and Risk Coverage
Purchase a term insurance policy with adequate coverage (10-15 times your annual income).

Ensure you have comprehensive health insurance to cover medical emergencies.

Avoid investment-cum-insurance policies as they deliver low returns.

Step 6: Plan for Long-Term Goals
Define specific financial goals like buying a house, retirement, or children's education.

Assign timelines and cost estimates to each goal.

Invest in equity for long-term goals (10+ years) and debt for short-term goals (1-3 years).

Step 7: Tax-Saving Investments
Use Section 80C instruments like ELSS, PPF, or NPS to save taxes.

ELSS funds provide equity exposure with tax benefits under Section 80C.

Avoid locking excessive funds in low-return tax-saving options.

Step 8: Automate Savings and Investments
Set up auto-debit for SIPs and savings to maintain consistency.

Automating investments reduces the temptation to spend unnecessarily.

Step 9: Regular Monitoring and Review
Review your portfolio every 6 months to track performance.

Rebalance your portfolio to maintain the right asset allocation.

Avoid frequent fund switching, as it may impact long-term returns.

Final Insights
Starting with limited resources can feel challenging but is achievable with discipline. Build an emergency fund, manage expenses wisely, and grow your investments systematically. Consult a Certified Financial Planner to optimise your portfolio and achieve your goals.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in
https://www.youtube.com/@HolisticInvestment

...Read more

Ravi

Ravi Mittal  |514 Answers  |Ask -

Dating, Relationships Expert - Answered on Jan 21, 2025

Ravi

Ravi Mittal  |514 Answers  |Ask -

Dating, Relationships Expert - Answered on Jan 21, 2025

Asked by Anonymous - Jan 19, 2025Hindi
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I am a divorced working woman , with a daughter 8 yrs. I have been pursued for remarriage with a guy who is 10 yrs older to me and have 2 kids. 11 and 14 yrs respectively living in a small town. Initially it was agreed the elder child who is a boy would be living in hostel , but now since we are approaching near to the marriage, it seems the elder male child is going to stay at home and not hostel. This is making me really uncomfortable as I won't get much privacy also the male child is aggressive.Already handling one kid was difficult before. Also moving to small town was difficult transition from a metropolitan that I stay in. Moving there could mean losing job opportunities in future. I am really worried if I let this match go, I end up alone again. I am not able to make a decision, it's difficult to raise others children. It's just not naturally inbuilt in us.Although I try really hard to mould my thinking and be more generous, but somehow it suffocates me.
Ans: Dear Anonymous,
Let me ask you one thing, if you knew a plane was going to crash, would you still get on it because you are worried you will reach your destination late? No, right? Similarly, if you know this marriage could be really tough on you, with the added responsibilities of a teenager and another soon-to-be teenager, do you still want to go ahead with it, just because you might have to stay alone for a while longer?

I can't really make a decision for you, but I can urge you to rethink this alliance. It's great that you are trying to compromise but do not compromise so much that nothing that you want is given any importance. You cannot ask a father to send his child to a hostel so that you can have some privacy; similarly, no one can force you to raise him as well. The best decision would be to either reconsider the relationship or have an open conversation and come to a middle ground that works for all.

Best Wishes.

...Read more

Ravi

Ravi Mittal  |514 Answers  |Ask -

Dating, Relationships Expert - Answered on Jan 21, 2025

Asked by Anonymous - Jan 16, 2025Hindi
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How do I 32M get over my insecurity with 30F? (Seeking Advice) Met this girl via matrimony exactly 2 months back. We connect well. Our families have met recently and it went well. Somehow we found a lot of connections between our families. That's just a bonus. Her family likes me a lot and they wanted to do Roka when they met us last week. I had told her, that no matter our bond, we should talk a lot and give it 3 months before going for roka. We live in different metro cities and have met twice now. About her: She is 30, well behaved & spoken(most important thing for me), smart, good looking, and is extremely polite. She is an army brat, has had a lot of freedom from family. Due to her father's job, they kept getting posted to different cities so she doesn't really understand family part of things. She's in a IT job. About me: I'm 32, okayish guy, in IT. To take things ahead I need to know my partner's past. I have no judgements at all but need to know stuff. Getting to know things over time bothers me a lot. I've tried to work on it, and have always made sure I don't bother the other person too much. After a month of talking, she told me that she had a casual boyfriend for an year. All her friends were dating in Bangalore and she decided to try it out. Found a guy through bumble and started dating him. So, according to her there were no feelings, just a person for her to go to places with, have drinks, and party. She likes drinking a lot and I have never taken a sip. She said that it was just a phase and she was immature. This happened between 2018(Nov) to 2020(march). So, it's been like 5 years. Never dated anyone after that. Since covid(2020) she's been living with her parents due to wfh. I have been completely ok with that but new things surfaced and they are messing with my head. While snooping around her facebook I figured out who that person was and this guy is super close to a person in my distant family. In fact they both were flatmates until their respective marriages. This distant cousin of mine knows me and knows her really well. These 3 used to hangout a lot and he has seen her come to their flat regularly. Infact, she had a good bond with my cousin as well. There are things that bother me and I really can't shake things and feel super awful in my gut. She mentioned that she and her ex had a common love for drinking and regularly visited pubs, got drunk, and partied. This means that they would be staying at each other's place as well. This is something super old but bothers me a lot. Specifically the fact that she would be drunk partying with someone for an year and sleeping with him, with no feelings. Secondly, I found some posts where she has liked a post about this guy on fb/insta from mid-2021. I have already confronted her twice to share everything and we shall never discuss this again but this bothers me a lot. Secondly, now that I know the timelines I can figure out what photos have been taken by her ex. There's even a photo of her sitting on a messy bed, where she's cutting her bday cake. They celebrated it together. I found my cousins page and some other pages from which I knew it's the guy's room/flat. I know everyone has a past. She has come clean to me but somehow my brain is so split. Sometimes her nature and behaviour with me make me not care about anything. And then I know the bed, flat, and her actions with some guy. Then there is this angle where the ex's flatmate is my distant cousin and knows about her well.
Ans: Dear Anonymous,
I understand that it is important for you to need to know her past and you mentioned that you merely want to know, and would not judge. But judging is exactly what you are doing. A lot of people have exes, a lot of people have occasional drinks- we can't judge people based on their past. She has opened up to you and all you are doing is snooping around. To be honest, it seems like you are really more concerned about her ex and past than about how amazing a person she is. I have only one piece of advice, if you think you can't get past her past, let her go. No one deserves to be judged by their past.

And think of it this way- you asked, and she told you. She was not obliged to, but still understanding your 'need' to know 'everything,' she confided in you. And this is how you are paying her back. Moreover, so what if she had an ex, or dated casually? How does that affect you right now? Ask yourself the same question and I think you will know the answer to your own dilemma.

Having said it all, marriage is a big decision. If you think her past can hamper your future, please rethink this relationship. It is best for both of you.

Best Wishes

...Read more

Ramalingam

Ramalingam Kalirajan  |7596 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Jan 21, 2025

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I am 49 and plan to retire in 2 years time.. I currently have a MF corpus of about 1.8 Cr, a PF of about 1 Cr and properties worth 2 Cr. I have been investing in MF's since 2014 through SIP's and currently have 70K monthly SIP. Please advise if I would be comfortable in 2 years, my estimated monthly expense post retirement would be approx 2 Lakhs per month
Ans: Your current corpus of Rs. 1.8 crore in mutual funds and Rs. 1 crore in PF is significant. The additional Rs. 2 crore in properties adds to your wealth but doesn’t provide immediate liquidity. Let us evaluate if your corpus will sustain your post-retirement expense of Rs. 2 lakh per month.

Estimating Post-Retirement Corpus Requirement
You plan to retire in 2 years, at age 51.

Assuming a life expectancy of 85 years, the corpus needs to last for 34 years.

An expense of Rs. 2 lakh per month means Rs. 24 lakh annually.

Adjust this amount for inflation to calculate future needs.

Current Investment Contributions
Your Rs. 70,000 monthly SIP builds your corpus over the next 2 years.

SIPs offer rupee cost averaging, reducing market volatility impact.

Assess the fund performance regularly to maximise growth.

Diversification of Investments
Your corpus is spread across mutual funds, PF, and properties.

PF provides a stable, fixed return but lacks flexibility.

Properties offer wealth accumulation but are less liquid for immediate needs.

Mutual funds remain a primary source of liquidity and growth post-retirement.

Evaluating Monthly Withdrawals Post-Retirement
Withdrawals should balance your monthly expenses and ensure corpus longevity.

Avoid withdrawing large amounts in the early years of retirement.

Consider a mix of equity and debt mutual funds for withdrawal strategies.

Role of Inflation and Healthcare Costs
Factor in inflation’s effect on expenses over 30+ years.

A 6% inflation rate doubles your monthly expense in 12 years.

Allocate for increasing healthcare costs with age.

Importance of Emergency and Medical Coverage
Keep at least 6 months' expenses in a liquid fund for emergencies.

Ensure you have comprehensive health insurance for unexpected medical costs.

Tax Efficiency in Withdrawals
Equity mutual funds' LTCG above Rs. 1.25 lakh is taxed at 12.5%.

Debt fund returns are taxed as per your income tax slab.

Plan withdrawals to minimise tax liability on gains.

Active Funds vs. Direct Funds
Actively managed funds optimise returns by responding to market changes.

Direct funds lack professional support, affecting long-term efficiency.

Work with a Certified Financial Planner to select regular funds.

Disadvantages of Relying on Real Estate
Properties are illiquid and may take time to convert to cash.

Rental income may not cover Rs. 2 lakh monthly expenses reliably.

Maintenance and property taxes further reduce returns.

Recommendations for Portfolio Restructuring
Increase Allocation to Growth Assets

Continue SIPs in equity mutual funds for growth potential.

Review funds for consistent performance and portfolio alignment.

Add Balanced and Debt Funds for Stability

Include balanced advantage and debt funds for steady income.

Debt funds reduce overall portfolio risk.

Plan a Withdrawal Strategy

Use the SWP (Systematic Withdrawal Plan) for predictable income.

Withdraw from equity funds after 3 years for tax efficiency.

Avoid Over-reliance on PF and Real Estate

PF offers safety but limited returns.

Use properties strategically for potential downsizing or sale.

Final Insights
You are on track to retire comfortably, provided you optimise your investments. Plan your withdrawals carefully, factoring in inflation and tax efficiency. Work with a Certified Financial Planner to refine your portfolio and achieve your goals.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in
https://www.youtube.com/@HolisticInvestment

...Read more

DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Investment in securities market are subject to market risks. Read all the related document carefully before investing. The securities quoted are for illustration only and are not recommendatory. Users are advised to pursue the information provided by the rediffGURU only as a source of information and as a point of reference and to rely on their own judgement when making a decision. RediffGURUS is an intermediary as per India's Information Technology Act.

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