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Dr. Praveen Kochar Tejmal

Radiologist, Bangalore

Dr. Praveen Kochar Tejmal Radiologist, Bangalore
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Our team includes experienced and caring professionals who share the belief that our care should be comprehensive and courteous - responding fully to your individual needs and preferences....more
Our team includes experienced and caring professionals who share the belief that our care should be comprehensive and courteous - responding fully to your individual needs and preferences.
More about Dr. Praveen Kochar Tejmal
Dr. Praveen Kochar Tejmal is a renowned Radiologist in Santhosh Hospital, Bangalore. He is currently associated with Dr. Praveen Kochar Tejmal in Santhosh Hospital, Bangalore. Save your time and book an appointment online with Dr. Praveen Kochar Tejmal on Lybrate.com.

Lybrate.com has a number of highly qualified Radiologists in India. You will find Radiologists with more than 37 years of experience on Lybrate.com. You can find Radiologists online in Bangalore and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Cervical Lordosis Straightening Treatment

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
Cervical Lordosis Straightening Treatment

Most commonly known as a military neck a straight or forward curve of the neck is abnormal and may cause an unkind progression of symptoms leading ultimately to cervical disk degeneration.

Reversal of cervical lordosis explained

The anatomy of the neck features a lordotic curvature in its typical and healthy state. This means that the cervical region has a gentle curvature with the open end of that curve facing the rear of the body. The base and top of the curve will be further posterior than the mid point, which will be further anterior.

When the lordosis is straightened, the neck becomes more upright and linear. This is more common than the next progression of atypical curvature, which is the subject of this article.

Actual reversal of curvature means that part or all of the cervical spine develops a kyphotic profile, with the open end of the curve facing anteriorly. Usually, this reversal is extremely mild, but is still very abnormal. What we now see is the middle of the curve being positioned posterior to the top and bottom.

In essence, picture the letter c and now turn it backwards: This is the shape of a reversed cervical lordosis.

Reversal of cervical lordosis causes

The spinal curvature in the neck is constantly in flux to some degree.

Congenital conditions and developmental conditions can have lasting effects on the natural degree of curvature typically demonstrated from patient to patient. These circumstances may be explainable due to injury or degeneration, or may be idiopathic:

Scoliosis can affect the normal lordotic curvature in the neck.

Cervical spondylolisthesis is a major source of reversed lordotic curvature.

Severe disc pathologies can facilitate a gradual loss or reversal of cervical lordosis.

Vertebral irregularities, such as wedging, can definitely contribute to lordotic alteration.

Traumatic injury, including vertebral fracture, can create the ideal circumstances for a reversal of lordosis to take place.

Severe neck muscle spasms can actually reshape the spinal curves, although these are usually temporary expressions and not actual structural conditions.

Effects of reversal of cervical lordosis
The neck is designed to curve in order to balance the spine, absorb stress, distribute force and provide proper movement of the head. When this curvature is diminished or reversed, symptoms may result, although this is not an inherent part of any altered lordotic condition.

Patients may experience stiffness and tension in the neck. Pain may be present and may even be severe in rare cases. Neurological dysfunction is possible in extreme cases, since the neuroforamen might not align properly, thereby causing a cervical pinched nerve.

In the worst circumstances, central spinal stenosis in the neck might affect the viability of the spinal cord, possible enacting the most dire of symptoms throughout the body.

Patients will also be more prone to injury, since the normal shock absorption qualities of the typical curvature have been lost.

While all these effects are certainly possible, they are not usual. In fact, a great majority of patients have minor symptoms or even no symptoms at all from mild reversed lordotic curvatures.

The pathology leading to a neck curve reversal (cervical kyphosis shown below right) may be inspired by a multitude of conditions as follows:
Post whiplash
Post head injury
Stomach sleeping
Poor sitting/working postures
Congenital spinal curvatures
Osteoporosis
Degenerative cervical discs (a form of osteoarthritis that can either be the cause of or the result of a cervical kyphosis)
Compression fracture of vertebral body
Infection of the cervical spine

Anatomy: straight vs. Curved

I've always heard that it was good to stand up straight.

stand upright, stick your chest out and hold your shoulders back! otherwise you're going get widows hump.

Are these expressions as familiar to you as they are to me? one might think that having a curved neck goes against what we heard from parents and teachers as we were growing up, but the reality is that there is a little bit a truth in both. Maintaining good posture throughout our lives is crucial to both the health of our spine and vital organs. On the contrary, a special type of curve called a lordosis is a good thing, both in the neck and lower back.

When we look at a person from the back their spine should be truly straight, so that the left and right sides of one's body is symmetrical. However, when we view a person from the side, the front and back of their body is different and this is reflected in a coinciding curvature of the spine. Both the lower back and neck are hollowed out (concave) and the mid or thoracic spine is protrudes (convex). Thus there is an alternation of curves functioning to provide stability, shock absorption and aid in propulsion. A straight spine would be very stiff and not flexible. Imagine the plight of a pole vaulter with an inflexible pole.

Nature's design of our spine and rib cage facilitates breathing and offers protective and supportive framework for vital organs. Spinal disks are shock absorbers and because they are in the front of the spine, lordotic curvatures keep them from having to bear weight. Kyphosis or loss of such curvatures bears weight upon the disks, leading to their ultimate degeneration. This process of deterioration is a form of osteoarthritis and in the spine is known as degenerative spondylosis.

Diagnosis
Although most physiotherapists or conservative orthopedists can recognize a cervical curve reversal upon viewing the patient's posture, a definitive diagnosis may be obtained via a standing lateral (side view) x-ray of the neck. Cause can often be determined by corroborating a comprehensive history, a thorough examination, x-rays and questions about sleep, work and lifestyle.

In my professional career I found that the majority of young adults presenting with cervical kyphosis either had a whiplash or were stomach sleepers from an early age. For desk jockeys 40-60 years of age, many hours of sitting with their head flexed forward almost dictates the fate of developing kyphosis. In prior years I considered cervical kyphosis a job hazard for the careers of accountants, attorneys and often teachers because of years spent with their head in a book or paperwork. However, the digital age offers some relief in that respect. A well-planned, ergonomically-friendly office can do wonders for protecting the spine in the sedentary worker.

Treatment for cervical curve reversal (kyphosis)
During my chiropractic practice I had the opportunity to note a good percentage of correction toward a more normal lordosis (noted on x-ray) for 70% of patients under my care. This was almost always consistent with those patients that followed all recommendations and were model participants in their own care. Here is the recommended treat plan:

Spinal manipulation of stiff and fixated spinal segments by a qualified physio
Flexibility exercises for flexion and extension of cervical spine
Resistance exercises for flexors and extensors of the neck
Learn the Alexander technique for maintaining good posture (hint: the basic philosophy is to sit and stand like you were hanging by a string from the vertex of your skull. Liken it to a puppet on a string).
Elimination of stomach sleeping
Avoid standing on your head, although some yoga postures may be beneficial
Use of orthopedic neck pillow while sleeping.

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Lung Cancer: Causes, Symptoms and Treatments

MD PULMONARY, DTCD
Pulmonologist, Faridabad
Lung Cancer: Causes, Symptoms and Treatments

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.

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Flattening of thoracic curvature ,to some extent .diminution of disc spaces with small osteophytes formation at the adjacent vertebral margins at T4>T8. No other obvious abnormality IMPRESSION - (Early/min) spondylitis changes -Mid-thoracic spine This is my x ray report please tell me is that a major problem or it can be heal with medicine and exercise and what r the reason for this. Please tell.

MPTh/MPT, BPTh/BPT
Physiotherapist, Gurgaon
Flattening of thoracic curvature ,to some extent .diminution of disc spaces with small osteophytes formation at the a...
This happens because foulty sitting posture. You should consult a good physiotherapist nearby and learn some stretching and strengthening exercises. Try to maintain neutral posture while sitting and standing. Avoid continues sitting for more than 30 minutes at a stretch.
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I want to know about disk pain. i am suffering from this pain from very long . please suggest me good treatment

MBBS
General Physician, Delhi
It is due to the pressure of disk on nerves. It is treated by relieving the pressure of disk surgically or by conservative treatment like medicines, physiotherapy ans rest etc .
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Hello, Due to C5 & C6 disc buldge in neck I have severe neck pain. Please tell me a remedy. I have gone under dr treatments, pills & psychotherapy but still have a severe pain

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi , This is Dr Akshay from Fortis Hospital. Please upload latest x rays and MRI images for me to opine. Thanks & Regards Dr Akshay Kumar Saxena
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I am 24yr old male and have backache for 7 month. My mri report is mild annular disc bulge is seen at l4-5 level with subtle anterior thecal sac impression. What should I do?

Diploma in Radio-Diagnosis
Radiologist, Shimla
At this age only excersises-lumber and sacral, har, bed rest, avoid jjerky movements, and sitting posture normal advised.
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I am suffering from slipped disc in cervical spine from 6 months. So my question is that I am a dance choreographer should I continue with my dance or not can you suggest me and how this problem Will be cured.

Fellowship in Joint Replacement, MS - Orthopaedics
Orthopedist, Dhamtari
24 years old with slipped cervical disc. Depends upon the extent of slip and your symptoms if you are experiencing neck pain and upper limb pain then you should not do activities involving sudden, jerking movements of neck. Medicines and neck muscle strengthening exercises can very well take care of this problem further intervention is needed only of disc is causing nerve or cord compression.
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I have slip disc problem in l4 n l5. Is it possible to get relief with problem by exercise only. I have this problem from last 5 years. My age is 30 years.

MD - Radio Diagnosis/Radiology
Radiologist, Jammu
Hi, definitely you be benefitted by exercise of lower back, avoid unnecessary postures, keep your back straight while studying better to keep a pillow to support your back, avoid lifting heavy objects, medications are only required when you have severe pain and surgery is only required in cases of severe pain radiating to limbs with major weakness of limbs.
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I am bodybuilder I had a disc replacement due to bulge in my disc. Is it possible to continue bodybuilding. Lifting weights etc. Plzz help me.

Fellowship of the Royal College of Surgeons (FRCS), Membership of the Royal College of Surgeons (MRCS)
Orthopedist, Trichy
lifting weights is not advisable once you have had problems in your spine. there are other discs in the spine that can always create the same problem you had initially.
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How does neuclus pulposus take to decay when it comes out of annulus fibrosus and extruded to nerve root as for example in L5-S1? Does it decay over the time or it never?

MPT - Orthopedic Physiotherapy, Diploma in Diet and Nutrition
Physiotherapist, Delhi
disc herniation develops with time if you are having constant pain and swelling. good circulation is required for healing. if you are having constant pain that disc will degenerate. take physiotherapy and back extensor exercises n apply hot pack or ice pack whatever gives u better result.
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I have L5-S1 disc extrusion condition from a year resulting in severe pain in the right leg. Is surgery the only solution?

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I have L5-S1 disc extrusion condition from a year resulting in severe pain in the right leg. Is surgery the only solu...
Apply hot fomentation twice daily. Avoid bending in front. Postural correction- sit tall, walk tall.
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I am 30 years old. Diagnosed with 11 % of vitamin D. Calcium and phosphate levels are also down. Besides cervical 6-7 disc have chronic black bulge. Pain in neck shoulder upper back. Also lumbar spine 4-5 also bulge. It is sending pain down till sole of feet. What is the treatment ways?

MBBS, D.P.H
General Physician, Gurgaon
I am 30 years old. Diagnosed with 11 % of vitamin D. Calcium and phosphate levels are also down.
Besides cervical 6-7...
Madam lybrate-user you have sever deficiency of these minrals and vitakins with L4- 5 bulge in my openion you should immediately consult local Orthopedic surgeon and got your treatment according to his advice. At this age this short of deficiency can lead to further complication.
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Annular tear with right paracentral, foramina extrusion of L1-S1 intervertebral disc causing significant compression of the traversing right S1 nerve root Kindly suggest treatment and Medicines.

MS - Orthopaedics
Orthopedist, Surat
You must consult orthopaedic surgeon, get mri done than we can decide whether you can be treated conservatively treated or to get operated.
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Disk Pain

MSPT (Master of Physical Therapy), BPT
Physiotherapist, Gurgaon
Play video

Here are some facts related to Disk pain.

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Hi sir my mother 72 year old she is suffering slip disk problem mri report conclusion/impression- Mr. Imaging reveal degenerative changes affecting lumbar spine with disc bulge-herniation at l1-2, l3-4, l4-5 and l5-si levels, more at l2-3, l3-4, l4-5 and l4-s1 level (protrusion), together with ligamentum flavum hypertrophy and facetal arthropathy are producing secondary canal stenosis with narrowing of bilateral neural foraming. Canal stenosis is most sever at l4-5 level.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. It is good that you have actually mentioned mri report of your mother which shows degenerative changes in spine with degenerative discs at multiple levels and ligamentum hypertrophy. But since we have to treat the patient and not mri, please elaborate her problem as to a detailed discussion of back pain which means duration of pain and mode of onset. I would also like to ask you if it is associated with any leg pain or any other neurological symptoms like numbness, paraesthesias (electrical shock like abnormal sensations) or any weakness in limbs. Please also tell me about any associated symptoms like fever, weight loss etc. What medications she generally takes and what has been her treatment history till now for existing problem. Do not hesitate to contact me if you need any further assistance.
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I have small disk. And my lift leg paining I went doctor he proscribed me some pain lure and nerve medication but still my leg paining. How I can get well and don't take medication. Thanks.

Fellowship of the Royal College of Surgeons (FRCS), Membership of the Royal College of Surgeons (MRCS)
Orthopedist, Trichy
I have small disk. And my lift leg paining I went doctor he proscribed me some pain lure and nerve medication but sti...
if the disc is small then its unlikely to cause nerve root irritation. other causes of leg pain like inflammatory arthritis, vascular causes and Vit D levels have to be checked.
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I have got pain in my leg from two years. The MRI shows this diffuse posture lateral iv disc at L4-L5 level causing anterior epidural space and lateral recess narrowing with mild thecal sac indentation and abutting transversing nerve fibres and existing neural foramen stenosis.(2) subtle L3 -L4 diffuse posture lateral iv disc bulge causing anterior epidural space and lateral recess effacement. What is the treatment of it .is surgery necessary for it.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I have got pain in my leg from two years. The MRI shows this diffuse posture lateral iv disc at L4-L5 level causing a...
: keep your leg raised while sitting or lying quadriceps strengthening exercises- quad clenches: lie flat on your back or sit upright on a chair with leg kept horizontally on another surface. Now, tighten the muscle on the front of the thigh by pushing your knee down. You should feel your thigh muscles clench, hold for 3 secs. Repeat 10 times twice a day. Short arcs: lie flat on your back or sit upright with your leg placed horizontally on a flat surface like a chair or bed. Place a rolled up towel under the knee. Pull your toes towards you and clench you thigh muscles. Slowly lift your foot up off the bed until your knee is straight (keep your knee resting on the towel). Hold for 3 secs and slowly lower them on the chair. Repeat 10 times twice a day. Straight leg raise: lie flat on your back. One leg and knee will be straight and other leg should be bent. Pull your toes towards you and tighten/clench the muscle on the front of the thigh, locking your knee straight. Lift your foot up in the air, about 6 inches off the bed. Hold for 3 secs and slowly lower the leg. The knee must remain straight the whole time you are doing this exercise.
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I am suffering from disk and Knee joint pains for the past 10 years I have already done panchakarma treatment. There is no result? What can I Do?

MD - Alternate Medicine, BHMS
Homeopath, Surat
I am suffering from disk and Knee joint pains for the past 10 years I have already done panchakarma treatment. There ...
Just do this small exercise: Sleep with legs raised up from waist against the wall straight up, making 90 degree angle for 5 mins. Its better you do in early morning, else you can do it anytime. This will make your blood flow increased towards brain and increase your memory and physical strength too will be increased. And your knee joint pain will also be relieved. And try to apply ice-packs over it for 2 times in a day for 5 mins. Still if you have any queries, please ask. Take care. :)
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