Dr. Anil Kumar M

Fractures are simply a break in a bone. They can be caused due to injury, (traumatic fractures) or a pre-existing condition like osteoporosis that causes weakening of bones (pathologic fractures). There are many ways to classify fractures. All fractures fall into the major categories of simple and compound fractures. Simple fractures are fractures where bones remain inside the skin and don’t jut out. They are also called closed fractures.

Compound fractures, also called open fractures, are broken bones that penetrate through the skin. These types expose the bone and deep tissues to the environment. Compound fractures are more serious of the two. The healing here may be affected due to deep infections for which antibiotics need to be used. There are many different sub types of fractures and we’re only going to skim through them here.

1. Comminuted fractures: Severe fractures in which a bone breaks into several smaller pieces.
2. Avulsion fractures: A small piece of bone is completely torn off from the main bone due to fierce pulling off a part of the body.

Other types of fractures are characterised by the many different angles the bone breaks into like transverse, oblique and spiral fractures.

Diagnosis
When a bone is broken there are symptoms like swelling that doesn’t subside on its own and pain. In such a case it’s imperative that one goes to a doctor for a diagnosis. Doctors can usually recognise most fractures by examining the injury and taking an X-ray. The X-ray also provides a clear idea about the type of fracture and the degree of displacement of the bone. And, it’s important that the patient doesn’t wait too long before approaching a doctor. This is because bones begin to heal very quickly after a fracture and the bone tissue will heal using any tissue available. This can lead to a misalignment of broken pieces of bone and cause disability and loss of function.

There are cases when X-ray may not show a fracture. This is especially common in fractures in the hip and wrist in older people. For diagnosing these, doctors will get some other tests done such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or a bone scan.

Treatments
Fractures have to be treated by doctors. The doctors set the fractured bones in their proper place and hold them there so that they can heal. Setting a bone is called "reduction." Reduction without surgery is called "closed reduction." But if the fracture is serious, it’s going to require surgery with bone repositioning, called open reduction.

In extreme cases, pins, plates, screws, rods, or glue are used to hold the fractured bones in place, inside the body. Once the bone abutment has been treated, the bone is immobilised to allow the broken pieces to heal. In most cases, the fractured part is set in a rigid cast. The fractured ends of the bone can be fixed into place using metal pins connected to an external frame. This is removed after the bone has healed. If you wish to discuss about any specific problem, you can consult an orthopedist.

Galactorrhea is not a disease per se, but more of an underlying medical condition or a symptom that involves discharge of a milky fluid from the nipples, which is not the breast milk. It becomes especially crucial owing to the similarity of the two, when breastfeeding the baby is concerned. It may happen even while you are not lactating or not even pregnant, mostly in menopausal women. Strangely, the syndrome has also shown to have occurred to men and children, irrespective of gender.

What are the contributing factors to the development of Galactorrhea?

1. Galactorrhea is a major side effect of certain kinds of medication that leads to hormonal imbalance and ultimately leads to quasi-lactation.
2. Increase in the levels of prolactin can result in Galactorrhea which may be due to a number of reasons ranging from excessive stimulation in the nipples and chest area (during sexual activities), or pituitary and thyroid problems. The former is not a major cause of worry. The latter can be fixed with proper medication.
3. Kidney disease and spinal cord surgery may also result in this phenomenon.
4. Substance abuse and birth control pills may also be responsible for breast discharge.
5. At times, the causes for Galactorrhea may not be certifiably determined.

Various symptoms of Galactorrhea include:

1. Milky discharge from one or both breasts simultaneously.
2. Discharge may be continuous or intermittent.
3. Density and amount of discharge may also vary.
4. In case of women, this may have a direct effect on periods, leading to irregular menstruation.
5. The discharge may occur without pressure or when an external agency is involved.
6. Headaches and worsening vision are also said to occur.

When you experience a nipular discharge, the most common tests you should undergo include a pregnancy test, prolactin level exam, mammography, ultrasounds, even an MRI for the pituitary gland evaluation. Based on the result, your physician prescribes the required medicines or advises you to stop taking a particular medicine that might be causing this discharge in the first place.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Different methods to treat Disc problems

Hello friends, I am Dr Gaurav Khera. I am an orthopaedic surgeon, doing joint replacements and spine surgeries at the Access healthcare. Now today I will be talking about the lumbar degenerative disc disease. Now it sounds very big, but it is not as complicated as it sounds. It basically is what you people commonly know as a disc disease. So it is a fairly common problem that is seen in our population today. In fact about 30 or 40% of the patients who come to our OPD have lower back pains, some have other disc problems and very commonly seen after 40 years of age and this incidence gradually increases up to 60-70 years of age. The other ecological factors which are associated with this are, first of all smoking, secondly it is, mild to moderate trauma, thirdly its seen in people who lift heavy weights, fourth is obesity, especially central obesity, that is if you have a very heavy waistline.

Now what is Lumbar degenerative disc disease? Now, our spine is composed of multiple bones, which are starting from your neck and they come all the way down to your hip, divided into the cervical, dorsal, lumbar and sacral spine. And between these bones, there are these small pieces of discs, which act as cushions. When your body walks, these act as shock absorbers between your body’s bones. Now this discs, when these come out of their normal place, it gives or presses against the nerves which are passing through these areas and it causes pain. This is what happens in the disc disease. Basically, in the patient it will come as a lower back pain, and this pain will be travelling down to the hip, and it will also be coming down to the legs. Some people complain that as they walk, the pain increases.

They also complain of tingling numbness. They complain that sometimes their fingers or their toes are feeling numb. These are some of the very common symptoms which are being seen. Few people may have only lower back pain, and these are the people who do not have very significant disc disease. Now there are two main causes of the disc disease. First is an inflammatory reaction that occurs in the disc, and second is the micro motion instabilities that occur. Inflammatory reactions may occur as a result of some small traumas which may occur such as when you may injure your back. Such inflammatory reactions occur in the form of small swellings in the body. And micro motion instabilities are when the body ages, the disc which has an outer fibrous thick layer, that degenerates, and as it degenerates, the pulp which is there at the centre, of the discs, tends to degenerate. What I mean is it comes out of its normal space. And as it comes out of the normal place, it comes and tends to press on the nerves and these are the two most common causes.

All disc patients are not to be operated. When we get these patients, the first and foremost investigation that we do is a X-Ray. And if required, we go in for a MRI. Frankly MRI is the known standard to diagnose the disc disease. The findings of a MRI are always coordinated with the clinical findings. Once we have diagnosed that it is a disc problem, we have to establish that what the compression on the nerves is. If the nerve compression is a lot, and if we think that we cannot do anything other than surgery, then we take the patient for a surgery.

If not, we take the patient fro physiotherapy, lifestyle changes and few medications. These medications may carry on for few weeks to few months. And a lot of exercise has to be carried on regularly. Lifestyle changes such as weight loss, stoppage of smoking is very important. And if you can achieve this, then your problems are very easily solved. If you have any queries regarding your disc problems or back pains, then you can get in touch with me for the same.

You can reach me in my clinic, which is there in Indrapuri, by the name of Dr Khera’s Wellness Clinic or you can also contact me through Lybrate for the same. Thank You.
 

Breast cancer begins when the cells that are present in the breast start to go out of control. These cells generally form a tumor which can be seen on mammogram or one can feel it as a lump. The tumor is threatening if the cells can grow into the tissues that surround it or spread to other areas of the body. Breast cancer happens mostly in ladies. Here are a few methods with which you can prevent breast cancer:

1. Keep your weight in check: Maintaining a healthy weight is important for everyone although, it is easy to tune it out since it is said so often. Being overweight can expand the danger of a wide range of cancers, including breast cancer, particularly after menopause.
2. Be physically active: Women who are physically active for almost or at least 30 minutes a day have a lower danger of breast cancer. Normal activity is additionally one of the ideal approaches to keep weight under control.
3. Eat Your Fruits and Vegetables and Avoid Too Much Alcohol: A balanced and healthy diet can bring down the danger of breast cancer. Attempt to eat a considerable measure of fruits and vegetables and keep liquor at moderate levels or lower. While moderate drinking can be useful for the heart in most grown-ups, even low levels of intake can build the danger of breast cancer. If you do not drink, don't feel you have to begin. In case you drink modestly, there is less risk.
4. Try not to Smoke: Smokers and non-smokers alike know how undesirable smoking is. It brings down a person’s quality of life and expands the danger of heart and lung diseases, stroke, and no less than 15 types of cancer, including breast cancer. It additionally causes bad breath, awful teeth, and wrinkles.
5. Breastfeed, If Possible: Breast cancer is related to the hormone oestrogen. Many researchers believe the more our bodies are exposed to this hormone the greater the risk of the disease. Breast-feeding temporarily reduces a woman's oestrogen levels. It is also thought that breast-feeding causes the breast to go through certain physical changes that protect them against cancer-causing chemicals.
6. Eat less fat: There is much debate about the link between breast cancer and diet. But there is evidence that certain western lifestyle factors - particularly our high fat diet - appear to increase the risk of the disease. If you wish to discuss about any specific problem, you can consult a gynaecologist.