Dr. Anil Kumar M

A broken bone or a fracture can be painful and it requires medical attention for the fracture to heal properly. Proper healing is necessary for the right alignment of the bone. A doctor chooses to either reduce or set the bone in terms of new alignment. The bone reduction can happen manually or surgically depending on the severity of the injury. A Surgical procedure known as the open reduction internal fixation is performed for serious fractures. It ensures that the all the broken pieces are fixed together and the injury can heal properly.

Post the fracture, the bone need to be immobilised for proper healing. This is generally achieved by imposing a cast. For fractures that are not severe in nature, a doctor might choose to impose a temporary cast so that simple motion can happen around the site of the injury. For serious fractures, a permanent cast is placed around the injury site. In the case of a shoulder injury, a patient is required to wear a sling so that the bones are immobilised.

Time Duration of a Therapy Session:

While the exact duration of physiotherapy can vary from individual to individual, it takes a minimum of 2-8 weeks for the fracture to completely heal. Certain fractures take more time to heal. The rate of healing also depends on the severity of the injury, pain threshold level of the patient, extent of work with the physiotherapist, the robustness of the physiotherapy program, extent of the injury of the soft tissue and certain other factors. Typically shoulder and neck injuries heal quicker than a fracture of the legs. The time duration of fracture healing also depends on the type of bone that has been affected.

Physiotherapy in a Hospital:

If the fracture happens in the ankle or leg, a physiotherapist might have to intervene in the hospital in order to teach patient about using assistive devices such as crutches and cane. Things that are taught during this time include using the device in order to climb stairs, right walking posture, getting into a car, taking the device off while sitting and such other techniques.

Physiotherapy at Home:

Physiotherapy can also happen from home if the doctor specifically instructs to do the same. This is typically done for people where the condition is too serious to go outside and get the physiotherapy done. Certain weight bearing restrictions are imposed around this time. The training remains the same as in the case with a hospital.

In the Clinic:

Once the patient becomes mobile enough, a doctor might suggest a patient go to a clinic to get the physiotherapy done. A physiotherapist evaluates certain things such as pain, range of motion, gait, flexibility etc. of the patient before suggesting a certain exercise plan. If you wish to discuss any specific problem, you can consult a physiotherapist.

Rubbery cushions (discs) between the bones (vertebrae) stack up to form the spine. When a nerve between the disc and vertebrae is pressed and inflamed, that condition is called herniated disc. The herniated disc is also referred to as the ruptured disc or the slipped disc. This is caused when the soft jelly is pushed out due to a tear in the exterior. Herniated discs can lead to an irritation of the nerves and result in tremendous pain. It may also cause the arms and legs to become numb and weak. However, some people suffering from this condition may not display any symptoms at all.

Herniated disc generally occur in the lower part of the vertebral column. The herniated disc may also be seen in the thoracic spine or cervical spine. The symptoms of a herniated disc include pain in the legs, feet, or the buttocks, pain in the shoulder blade, tingling of the feet, numbness of the feet and hands, muscle weakness, neck pain or muscle spasm in the neck. Most common causes of herniated discs are aging, excessive weight or lifting of heavy weight.

Prevention of herniated disc

1. Herniated discs are very commonly found in people who are aged between 35 or 55 years. They are seen more commonly in the men in comparison to the women.
2. A herniated disc cannot be prevented easily, but there certain things that you can do to reduce the risks. Maintaining the proper techniques of lifting is important. You should not be bending at your waist. You should always bend the knees and keep the back straight. This helps you to use your leg muscles which are very strong to support the weight.
3. As the saying goes, precaution is better than ​cure, so here are few precautions that can be taken to avoid herniated discs. Practicing a proper posture can help in reducing the risk of a herniated disc. It is extremely important for an individual to maintain a healthy posture while standing, sitting, walking, and even sleeping. It is imperative that you stretch your muscles when you are sitting in one position for a long time.
4. Another important thing to avoid is high-heeled shoes, as they are few of the most common causes of a herniated disc. It would be a good idea to go for flat and well cushioned comfortable footwear as they can go a long way in reducing the risk of the herniated disc.
5. Exercising regularly can go a long way in keeping the muscles of the legs, stomach, and back very strong. You should try to balance your flexibility and strength by exercising regularly. The best form of exercise to avoid herniated disc or ruptured disc is aerobic exercise.
6. It is true that as you start to age, the chances of getting a herniated disc increase significantly. However, if proper precautions are taken, the stress put on the spine can be effectively reduced, thereby eliminating the risk of a herniated disc. In case you have a concern or query you can always consult an expert & get answers to your questions!

While you cannot cure breast diseases, family history and maturing, but there are some hazards or risks that you can control. Keeping in mind the fact that there is no certain approach to forestall breast cancer, there are things you can do that may bring down the hazard. Here are five approaches to ensure your breast's well-being:

1. Watch your weight: Being overweight or hefty expands breast cancer chances. This is particularly true after menopause and for women who have put on weight as grown-ups. After menopause, the vast majority of your estrogen originates from fat tissue. Having more fat tissue can heighten your chances of getting breast cancer by raising the estrogen levels. Additionally, women who are overweight have a tendency to have more elevated amounts of insulin, than other hormones. Higher insulin levels have been associated with a few tumors, including breast cancer.
2. Exercise routinely: Many reviews have found that exercise is the sign of having a healthy breast. Studies show that one to two hours of energetic walking each week, lessened a woman’s cancer risk by eighteen percent. Walking ten hours seven days decreased the hazard all the more.
3. Constrain liquor: Women who have two to five mixed beverages every day have a higher danger of breast cancer than women who have just one drink a day or none . As much as three to six glasses of wine seven days have been found to somewhat increase breast cancer chances. It is not clear how or why liquor raises the hazard. In any case, constraining liquor is particularly essential for women who have other hazard variables for breast cancer, like, breast cancer running in their families.
4. Restrain time spent sitting: Research has shown that sitting time, regardless of how much exercise you get when you are not sitting, increases the probability of growing cancer, particularly for women. Women who sit six hours or more a day outside of work have a ten percent more serious risk for breast cancer compared to the ladies who sit under three hours a day, and an increased hazard for other cancer types as well.
5. Stay away from or confine hormone substitution treatment: Hormone Replacement Treatment (HRT) was utilized frequently in the past to control night sweats, hot flashes, and other troublesome manifestations of menopause. In any case, specialists now realize that postmenopausal ladies who take a blend of estrogen and progestin might probably create breast tumors or cancer. Breast cancer disease seems to come back within five years in the wake of ceasing the blend of hormones. Therefore, get a breast cancer test even if you feel a small lump. If you wish to discuss about any specific problem, you can consult a gynaecologist.

Lung cancer is the uncontrolled growth of abnormal cells in one or both lungs. These abnormal cells do not carry out the functions of normal lung cells and do not develop into healthy lung tissue. As they grow, the abnormal cells can form tumors and interfere with the functioning of the lung, which provides oxygen to the body via the blood.

Lung cancer is the most common cause of death due to cancer in both men and women throughout the world. According to the U.S. National Cancer Institute, approximately one out of every 14 men and women in the U.S. is diagnosed with cancer of the lung at some point in their lifetime. Lung cancer is predominantly a disease of the elderly; almost 70% of people diagnosed with lung cancer are over 65 years of age, while less than 3% of lung cancers occur in people under 45 years of age.

What Causes Lung Cancer?

The development of lung cancer is strongly associated with cigarette smoking, approximately 90% of lung cancers are attributable to use of tobacco. Pipe and cigar smoking can also cause lung cancer, but the risk is not as high as with cigarette smoking. Tobacco smoke contains more than 4,000 chemical compounds, many of which are cancer causing (carcinogens). Passive smoking, i.e. the inhalation of tobacco smoke by non-smokers who live or work with smokers, is also an established risk factor for the development of lung cancer.

Genetic susceptibility (i.e. family history) may play a role in the development of lung cancer. Other causes of lung cancer include air pollution (from vehicles, industry, and power generation) and inhalation of asbestos fibres (usually in the workplace).

Lung Cancer Symptoms:

Early symptoms and signs of lung cancer:

There may be no symptoms at the onset of the disease. When present, common symptoms of lung cancer may include:

1. Coughing: This includes a persistent cough that doesn't go away or changes to a chronic smoker's cough, such as more coughing or pain.
2. Coughing up blood: Coughing up blood or rust-colored sputum (spit or phlegm) should always be discussed with your doctor.
3. Breathing Difficulties: Shortness of breath, wheezing or noisy breathing (called stridor) may all be signs of lung cancer.
4. Loss of Appetite: Many cancers cause changes in appetite, which may lead to unintended weight loss.
5. Fatigue: It is common to feel weak or excessively tired.
6. Recurring infections: Recurring infections, like bronchitis or pneumonia, may be one of the signs of lung cancer.

Signs of advanced stages of lung cancer: Advanced stages of lung cancer are often characterized by the spread of cancer to distant sites in the body. This may affect the bones, liver or brain. As other parts of the body are affected, new lung cancer symptoms may develop, including:

1. Bone pain
2. Swelling of the face, arms or neck
3. Headaches, dizziness or limbs that become weak or numb
4. Jaundice
5. Lumps in the neck or collar-bone region

Treatment: Treatment for cancer involves a combination of surgery to remove cancer cells, chemotherapy and radiation therapy to kill cancer cells. Lung cancer is incurable unless complete surgical removal of the tumour cells can be achieved. Surgery is the most effective treatment for lung cancer, but only a few percentage of lung cancers are suitable for surgery i.e. Stage I and II NSCLC and cancer that has not spread beyond the lung.

Radiation therapy may be used for both NSCLC and SCLC and is a good option for people who are not suitable for surgery or who refuse surgery. Chemotherapy is used for both NSCLC and SCLC. Chemotherapy drugs may be given alone or in combination with surgery or radiation therapy. Chemotherapy is the treatment of first choice for SCLC since it has usually spread extensively in the body by the time it has been diagnosed.

Also used in the treatment of lung cancer are targeted therapies. These are drugs (gefitinib and erlotinib) or antibodies (cetuximab, bevacizumab) that block the growth and spread of cancer by interfering with specific molecules involved in tumor growth and progression. They are used in some patients with NSCLC that does not respond to standard chemotherapy.

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: Breastfeeding for almost one year or more brings down the danger of breast cancer. It additionally has extraordinary medical advantages for the baby as well, especially in terms of immunity.
6. Keep away from Birth Control Pills: Contraceptive pills have both dangers and advantages. In many cases, the more young a lady is, the lower the danger is. While ladies are taking birth control pills, they have more chances of falling prey to breast cancer as per various medical studies. This danger leaves rapidly in the wake of stopping the pill. The danger of stroke and heart attack is increased while on the pill, especially if the woman smokes. Long term use can likewise have essential advantages, such as bringing down the danger of ovarian cancer, colon tumor and uterine cancer and undesirable pregnancy. In case you are exceptionally worried about breast cancer, staying away from birth control pills is also an alternative to lower the risk.

Breast cancer is an abnormal growth of cells in the tissues of the breast. Mainly it occurs in females but less than 1% of all the breast cancer cases develop in males. The majority of breast cancers start in the milk ducts. A small number start in the milk sacs or lobules. It can spread to the lymph nodes and to the other parts of the body such as bones, liver, lungs and to the brain.

With more reliable early detection methods as well as the trend towards less invasive surgery, there is hope that even more women with breast cancer will be treated successfully and will go on to resume their normal lives.

Signs & Symptoms 
It is painless, especially, during the early stage. Watch out for the following changes in the breast:

1. A persistent lump or thickening in the breast or in the axilla. 
2. A change in the size or shape of the breast. 
3. A change in the colour or appearance of the skin of the breast such as redness, puckering or dimpling. 
4. Bloody discharge from the nipple. 
5. A change in the nipple or areola such as scaliness, persistent rash or nipple retraction (nipple pulled into the breast).

Consult a doctor immediately if you notice any of these changes.

Risk Factors 
Being a woman puts you at risk of getting breast cancer. There are certain factors that increase the risk of breast cancer. Some of them have been listed below:

1. The risk increases with age; most cases of breast cancer develop after the age of 50 
2. Genetic alterations in certain genes such as BRCA1 and BRCA2 
3. Family history of breast cancer 
4. Being overweight 
5. Early menarche (onset of menstruation before the age of 12) 
6. Late menopause (after the age of 55) 
7. Never had children 
8. Late childbearing 
9. No breast feeding 
10. Excessive consumption of alcohol 
11. Use of hormonal replacement therapy (HRT) for a long period of time

However, most women who have breast cancer have none of the above risk factors. Likewise, not having any of these risk factors does not mean that you will not get breast cancer.

Early Detection and Screening

More treatment options are available when breast cancer is diagnosed at an early stage and hence the chances of recovery is also higher. So regular breast screening is important for early detection even if there are no symptoms. Following are the ways of screening:

1. Breast Self-Examination (BSE): Perform BSE once a month about a week after your menses are over. If you no longer menstruate, choose a date each month which is easy to remember e.g. your date of birth or anniversary.
2. Clinical Breast Examination: Get a breast specialist to examine your breast once a year if you are 40 years and above.
3. Mammogram: Go for a screening mammogram once a year if you are 40 to 49 years old and once every two years if you are 50 years and above even if you do not have any symptom. It is not recommended for younger women (less than 40 years of age) as they have dense breasts, making it difficult for small changes to be detected on a mammogram. So ultrasonography of the breasts is advisable to them.

Types of Breast cancer

1. Non-Invasive Breast cancer: These are confined to the ducts within the breasts. They are known as Ductal carcinoma in-situ (DCIS).
2. Invasive Breast cancer: It occurs when cancer cells spread beyond the ducts or lobules. Cancer cells first spread to the surrounding breast tissue and subsequently to the lymph nodes in the armpit (Axillary lymph nodes). These cells can also travel to the other parts of the body such as bones, liver, lungs or brain and hence known as metastatic breast cancer.

Making A Diagnosis 

If you notice any unusual changes in your breasts, you should see a doctor immediately. He will examine you clinically and may ask you to undergo some tests so that a definitive diagnosis can be made. Further, the staging work up is done to find out the stage of the disease and management accordingly.

Treatment options 
Treatment of breast cancer may include various methods such as surgery with or without breast reconstruction, chemotherapy, radiation therapy, hormonal therapy and targeted therapy. Treatment options offered, depend upon the number of factors such as the stage of cancer and likelihood of cure, your general health and your preference. If you wish to discuss about any specific problem, you can consult an oncologist.