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My MRI report of LS Spine is as: Diffuse Disc bulge at L3 /L4 indenting the thecal sac Partial desiccation of L4 / L5 with diffuse posterior disc bulge Indenting the thecal sac encroaching bilateral neural foramina (left>right) Partial desiccation of L5 / S1 Please tell. Me the seriousness of the problem with precautions Is this normal.
Dear sir, I am suffering from disc slip since 10 years. I have consulted both allopathy and ayurveda doctors. Allopathy doctors are saying it is first grade disc, after some years I need to do an operation. But ayurvedic doctors are saying I do not have any problems with disc and backbone. They are saying I have high uric acid problem and ASO and I took panchakarma treatment. Panchakarama treatment is giving some relief from the pain, but I am not sure about the problem with the disc slip. Still I am feeling some stiffness with my lower back. I have taken an MRI and x-ray. But doctors are confusing me. Can you please suggest me what to do. Is there any permanent solution for disc slip and lower back stiffness. Please help me.
Please advice some treatment for bulging of disc I tried everything possible. Visited all type of doctor, did physical exercise and massage as well but still pain persists.
The most powerful and amazing organ in our body is the brain. It differs from many other organs of our body not only by its shape, but also by its special type of cell called neurons. When these cells gets affected or dead it can never be reverted or regenerated which is the most exclusive nature found only in brain cells. The cells in other parts of our body has the capacity to regenerate (can be replaced or new one can be grown or produced), but brain cells are exception. Hence any damage to the brain, injury or trauma is really a crucial thing to be considered with utmost care.
Brain surgeries really need skill, proper training, confidence and intelligence to perform this highly complicated and risky surgery.
Brain surgeries are performed to:
- Remove the brain tissues that are grown abnormally
- Aneurysm is clipped to prevent flow of blood cliff off an aneurysm
- Biopsy purpose or to remove the tumour
- Make a nerve free
- Drain the abnormal blood or clot collection or to drain any excessive fluid collection caused by infection.
- To implant artificial electronic device as a treatment for conditions like Parkinson's disease
- Biopsy: A part of brain tissue is removed for the brain or whole tumour is removed.
- Craniotomy: The skull bone is opened to remove tumour, an aneurysm and drain fluid or blood from infection.
- Minimally invasive endonasal endoscopic surgery: Endoscopic devices are inserted through the nose to remove the lesions or tumour.
- Minimally invasive neuroendoscopy: Similar to endonasal surgery but small incision is made.
- Anaesthesia risks like breathing difficulty, allergic reaction to medications, excessive bleeding or clots and infection.
- Risk related to the brain surgeries are seizures, coma, swelling of brain, infection to brain or meanings, surgical wound infection that intrudes to the brain structures, abnormal clot formation and bleeding.
- General risks include muscle weakness, disturbances in memory, speech, vision, coordination, balance and other functions that are controlled by the brain.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Symptoms, causes and treatment for Breast Cancer Patients
Hello friends. My name is Dr. Gayatri Juneja. I’m a practicing gynecologist in Model Town for the last 20 years. I’m a visiting consultant in Apollo Cradle Hospital Moti Nagar, and Fortis Hospital Shalimar Bagh, and Sunder Lal Hospital Ashok Nagar. It’s a great pleasure for me to talk to you about certain problems which I think is becoming very important for all of us to know. I am going to talk about Breast Cancer.
Unfortunately, even in India, cancer breast is becoming very common. And it is not that it is a cancer which we cannot pick up at time. The only thing we need is to be aware of it. Only if we know what is happening with our body, is only then we can do what is normal, only then we can see what is not normal, right? It is one of the breast cancer is one of the easiest cancers to pick up. How? My body is my own. I should know what’s happening to me. So minimum a lady can do is do a self examination. Teach your daughters how to do a self examination for the breast. If you find any lump, any time, if you feel there is some pain, which was not there, if you see the nipple is not in the normal position, it is retracted inside, if you see there is skin changes on your breast, if you see any size difference. See minor size difference will be there. That is a natural thing. But if you see there is drastic change, and if you are not comfortable with something, do not neglect it. It’s not at all a normal thing. Go, see a gynaecologist.
It is a confidential thing between you and your doctor. Let her examine you. Let her guide you. You give her a proper history, if you have taken any contraceptive pills, even I-pill is very dangerous. I’ll come to it later how. The thing is…your doctor has examined you, then she will guide you what has to be done. There are various ways of diagnosing cancer of breast. First step is, you do a self examination. First step is over. You find the lump, you go to a doctor. Your doctor will ask for a sonography, that is ultrasound of the breast. And another part of it is an x-ray of the breast. Sometimes in younger age group the breast is very dense, and you cannot diagnose anything on mammogram.
You still are suspecting something, then your doctor might ask for an MRI. MRI is very effective in diagnosing, but we do not suggest it as first line treatment, first line of diagnosis. Once it is confirmed that yes, there is a lump, then what we do is, we ask for a biopsy. Now biopsy can be in 2 forms. It can be taken through the needle, which we call FNAC – Fine Needle Aspiration Cytology, and other is open biopsy, where we remove the whole lump, and send it for testing. If the test comes negative, good, fine, everything is fine. If it comes positive, then further treatment depends upon the type. Then they will do a special CT scan for you, where the will diagnose if any lymph nodes are involved.
Depending on preliminary staging, your doctor will ask for a surgery. Now the surgery will…it is better that the whole breast gets removed. Or what has to be done will be diagnosed, because it is not a single person specialty, it is going to be a multi-specialty treatment then. Now let’s come down to who are the people who are at higher risk. Why should I consider that I am at higher risk? What…who are those people? First, specially after menopause, obesity. If your lifestyle is not at all healthy, your food habits you eat lot of non-veg and processed food, like pizzas and burgers and frozen food, yes you are at risk. Then comes genetics.
If you have a family history of cancer in your nani, dadi, your bua, maasi, cousin, ya sister ya brother, or even cancer of ovaries, you are at high risk. But that doesn’t mean who all have had the history of cancer will also develop this. You are at higher risk, but it is better only to be careful. Then comes very tall ladies it has been seen they are also prone for diabetes. Obesity, and people who have had hormonal replacement therapy with…and once you’re diagnosed don’t get scared. It is a curable cancer, and life expectancy with variable modalities these days is quite good.The quality of life is also good.
So my suggestion would be, to conclude, that please be aware of what is happening with you, and take good care of yourself. If you are healthy, only then you can look after your family. Thank you so much.
1. What are the symptoms of liver disease? When to see a doctor?
Most of the liver diseases present with similar symptoms with some variations. Some of the common symptoms can be loss of appetite, nausea and vomiting, vomiting of blood, jaundice(yellowish discoloration of the eye), abdominal pain, itching, distension of abdomen( accumulation of fluid- ascites), swelling of lower limbs, weight loss, altered sensorium, confusion, and in a late stage- coma.
2. Can liver disease be prevented?
Liver is a crucial body organ which is responsible for processing essential nutrients from the food you eat, synthesizing bile and most importantly removing harmful toxins from the system. To ensure that your liver keeps performing its functions, you need to follow a healthy lifestyle.
Some of the liver diseases are metabolic and hence inherent at the time of birth and manifest later. However, some of the more common liver diseases are preventable like alcohol induced liver disease, fatty liver induced liver disease (NAFLD), Hepatitis A, B and C.
3. What is liver transplantation? What is the average cost of liver transplantation?
Liver transplantation is the treatment for end stage liver disease in both adults and children. In this operation, the diseased liver is removed and replaced by a healthy one. The success rate for the operation is high and terminally ill patient can return to normal lives.
The average cost of liver transplantation is Rs 18 to 20 Lakhs at Sahyadri specialty hospital, Pune Maharashtra. The cost of investigations of the donor and recipient is Rs 90,000. When patients are too sick and require prolonged stay following liver transplantation, the cost of treatment can escalate; hence it is advisable to patients to have the liver transplantation before they develop complications secondary to the liver disease (Cirrhosis).
Most of the patients seek help at a very late stage or referred late to a Surgeon. It is advisable for patients to seek the opinion of a Surgeon at a very early stage of the disease. The patient needs to take medicines for the rest of his life to prevent rejection of the new liver. The cost of medicines and the investigations in the first year is approximately Rs 10-15000/-. The number of medicines and the frequency of blood investigations are much less after the first year of liver transplantation.
The cost of liver transplantation in India is one-twentieth when compared to USA, UK and other European Countries.
4. When should a liver transplant be performed?
When a person’s liver is severely damaged and cannot function properly or complications may develop and liver transplantation should be considered. Conditions like hepatic coma, massive upper gastrointestinal bleeding, and liver cancer is the best treated by complete removal of the liver (cirrhotic liver).
In general, when a patient needs a new liver, the earlier the operation, the higher the success rate is.
Urgent liver transplantation is recommended in patients who have acute liver failure and this could be due to many reasons. The common conditions are Hepatitis B, Hepatitis A, Hepatitis E and drug induced. In such patients, liver transplantation is urgently needed in order to save the life of the individual.
5. What are the advantages/benefits to the recipient of getting a living donation vs cadaver?
A new liver can come from either of the two sources: A living donor or a brain-dead deceased donor.
Living donor transplantation:
It is technically feasible to remove part of the liver from a living person and transplant it to a patient who needs a new liver. The operation has now been done since 1989. Depending on the size matching of the donor and recipient, either the left side (about 35-40%) or the right side (60-65%) of the liver will have to be removed. The liver remnant in the donor will grow to its original size in 6-8 weeks time.
This process helps in an earlier transplantation before the recipients’ conditions deteriorates. It is a planned procedure whilst cadaver liver transplantation is an emergency procedure. It avoids the risk of death while waiting for a deceased donor liver graft(40% overall and 75% for patients in Intensive care units). The survival rate of a living donor transplant is over 90%.
There are risks like complications of the investigations and surgical procedures but the possibility of donor death rate is of 0.2-0.5%. Seventeen donor deaths have been reported in Brazil, France, Germany, Egypt, Hong Kong, Japan, USA and India.
This is well established in the Europe and USA. Unfortunately, the availability of deceased donor liver is not very often in India. Depending on your blood group, you may have to wait for 0 to 6 months before you get a new liver.
During this waiting period, you may develop complications like spontaneous bacterial peritonitis (infection of the fluid in the abdomen) which, if repetitive may produce severe adhesions in your abdomen rendering liver transplantation difficult if not impossible.
It is important for everyone to register for organ donation, so that when we die, this noble act will help many people to lead normal lives. In the Western world the organ donation rate is between 15-18/million population where as in Indi it is less than 1/million.
6. Who can be a suitable living donor?
The most important criteria is that the donation of portion of the liver is done voluntarily. The donor has to be less than 50 years of age, body mass index of less than 25 and is a near relative of the recipient. Both the donor and the patient should have the same Blood group or O Blood group.
Besides, the potential donor should understand clearly that
- The donor operation carries complication rate of 10-15%.
- The recipient is successful in 90-95%, which means that there is 5-10% chance of dying.
- The donation is done out of his/her own wish and without any coercion.
- There is no financial gain related to the act of donation.
- The donor has the right to withdraw at any time without the need of giving any reasons to do so.
7. Which patients are excluded from liver transplantation procedure?
Patients who have cancer in another part of the body, active alcohol or illegal drug abuse, active or severe infection in any part of the body, serious heart, lung or neurological conditions or those who are unable to follow doctors’ instructions are excluded generally.
8. What are the risks to the recipient from the surgery?
The overall success rate of liver transplant is over 94% and the majority of recipients can return to normal activities and achieve 95% of their quality of life which they had prior to liver disease. Since the recipients’ body may reject the new liver, it is essential for them to take immunosuppressive medications and continue follow up at the liver transplant clinic. They will need to continue these medications for life, at a reducing dosage.
The risk for the recipient is the return of the original problem that necessitated the liver transplant in the first place, e.g. hepatitis C, recidivism (return to alcoholism), noncompliance of medications. The other complications that can arise are thrombosis of blood vessels going into or out of the liver, primary or delayed graft non-function, bile duct complications, renal failure and other infections.
9. What are the side effects of having a liver transplant?
After a successful liver transplantation (95% of patients) – the patient is advised to take care of infections and to take anti-rejection medicines for life. The patient can return to normal quality of life and can return back to work in three months time. The patient has to regularly follow up with the surgeon in the first year and later at regular intervals as advised by his doctor. He will require blood tests to determine that his liver functions and to adjust his medications in the beginning and later the tests are infrequent. The patient is advised not to take any herbal or alternative drug treatment.
The transplant patient is assessed regularly for various complications like rejection, infection, narrowing of blood vessels etc., and appropriate treatment is initiated. Post transplantation, he is under the guidance of his doctor throughout his life. Any health problems that do come up have to be investigated and treated, though they are infrequent.
In case you have a concern or query you can always consult an expert & get answers to your questions!
I was having Slip Disc problem in year 2005 and was confined on bed for 35 days. MRI reports revealed problem in L5 S 1 area. Doctors advised me not to sit on ground and sleep sideways by bending both the knees and keeping pillow in between them. Although I do not have that pain again but Now my body has become very stiff, I can not bend my knees and having very poor flexibility what should I do.
Hi I am Dr. Kirti Yadav, senior physiotherapist from Mat-Harbor family clinic, Gurgaon.
Today I want to talk about a very common problem which every one, if we count about the population 100% then 70% of people they talk about Disk pain. So I want to enlighten this topic today. If there is a normal pain and ache in your neck or back you go to a doctor and the doctor assess you and tells you to get an MRI done. Whenever you get an MRI done there is some level of disk involvement and the doctor ask you to take rest, not to do exercise and all those things and then just being fear of disk pain you don’t exercise for the rest of your life.
So just to come onto that area, just to enlighten this topic, as a physiotherapist I want to tell you about the fact. Disk pain, YES it happens but it happens in 20% of the cases. The rest 50% of the cases have been misdiagnose, they take disk pain and they don’t do exercise all of their life. Now we don’t exercise, we don’t strengthen up our muscle that is the problem that we get these pains and aches and the muscle is being stretched which is counted to be as the disk pain. Now when we talk about this, when you get an MRI done even today if I get my MRI done I will have some level of disk involvement whether the disk is causing you pain or not that is more important. The nature of pain tells you about the disk involvement.
So if you have tingling sharp shooting burning kind of pain which travels through a nerve, which travels through area, it dignifies, it signifies the disk pain. But if you have a localized dull, aching kind of pain please don’t take it as a disk pain and don’t take it as a nerve pain. So just coming to the treatment part. About 50% of the people who don’t have disk pain, who says we have cervical spondylitis but they don’t have cervical spondylitis they have trapezius muscle involvement. In that case what we do please strengthen up your trapezius muscle, please strengthen up your shoulder muscle so that you don’t have these pains and aches again and again. Why this happens? This happens because of repetitive strain injuries that happens because of more of computer use more of mobile use, texting and other sedentary live cells which we are going in. So the ultimate solution for pains and aches muscular is strengthening the particular part.
If you want to know more about this, if you want to talk more about it you can contact me through Lybrate.
Of all cancer types that affect the female population, breast cancer is the most common one. Statistics show that above 1 in 8 women in the USA are likely to develop breast cancer (invasive type, which is often severe). Changing lifestyles including prolonged use of birth control, smoking, alcohol abuse, lack of physical activity, dietary changes, etc., have led to an increased incidence. As these are here to stay, the only way is to prevent.
The likelihood of developing breast cancer is determined by risk factors. Some of these risk factors cannot be changed. For instance, age, ethnicity, and history of familial breast cancer. However, there are others, which can be acted upon or modified to reduce the chances of developing breast cancer.
Some of the preventable risk factors are as follows:
- Nicotine abuse: Quitting smoking has multiple benefits for a woman, and one major benefit is the reduced risk of developing breast cancer. Other benefits include reduced incidence of diabetes, heart disease, and other cancers.
- Hormone replacement therapy: To the extent possible, avoid prolonged use of birth control pills or hormones for other treatment purposes. In addition to using non-hormonal methods, if not avoidable, constantly monitoring hormone levels is very important. Birth control pills should especially be avoided by women over 35 years of age who smoke. The risk associated with developing cancer reduces as soon as the hormone supplement is stopped.
- Weight Management: One of the major risk factors is obesity, and in people with other non-alterable risk factors, it is best to work on weight management from an early age. Talk to your doctor about your ideal BMI and ensure this is maintained.
- Physical Activity: Regular physical activity, at least 30 minutes per day, in addition to strength training will help in keeping the body agile and managing weight. It also reduces the risk of breast cancer.
- Breastfeeding: Studies have shown that breastfeeding has protective effect against breast cancer; longer a baby is breast fed, greater is the protective benefit.
- Screening: Even if not completely preventable, early detection of breast cancer is very important. This will help in less severe treatment and better prognosis. Recommended ages for mammography are as follows:
- In the age of 40 to 44, an annual mammogram is advised along with a discussion with the doctor on the risks.
- An annual mammogram for all women in the age of 45 – 54 is important as most women enter menopause by this time. This needs to be continued annually, as self-breast exams alone cannot detect cancer, thus it is a good practice and anything abnormal will not go undetected.
- These will help reduce the risk of developing breast cancer, help in early detection, and improve prognosis.
In case you have a concern or query you can always consult an expert & get answers to your questions!