Dr. Rohit Madhurkar

स्तन वसा, संयोजी ऊतक, और लोब में विभाजित ग्रंथि ऊतक से बना होता है। स्तन कैंसर तब शुरू होता है जब स्तन में कोशिकाएं नियंत्रण से बाहर निकलने लगती हैं। नलिकाएं का एक नेटवर्क लोब से निपल तक फैलता है। एक स्तन आमतौर पर दूसरे से छोटा होता है। महीने में अलग-अलग समय पर आपके स्तन अलग-अलग महसूस कर सकते हैं स्तनों के लिए आपकी अवधि के ठीक पहले लंपट महसूस करना आम बात है। आपके स्तन महीने में अलग-अलग समय पर अलग-अलग महसूस हो सकते हैं। स्तनों का आपकी अवधि के ठीक पहले लंपट महसूस होना आम बात है। 
स्तन कैंसर सामान्यतः कोशिकाओं जो स्तन के नलिकाएं होती हैं, में शुरू होता है। स्तन कैंसर तब शुरू होता है जब स्तन में कोशिकाएं नियंत्रण से बाहर बढ़ने लगती हैं। कोशिकाओं का यह उत्परिवर्तन एक ट्यूमर को जन्म देता है, जिसे एक गांठ के रूप में महसूस किया जा सकता है। अगर अनुपचारित छोड़ दिया जाता है, तो घातक कोशिका अंततः शरीर के अन्य भागों में फैल सकती हैं, एक प्रक्रिया जिसे मेटास्टैसिस कहा जाता है। 
स्तन कैंसर के लक्षण
स्तन में एक गांठ आमतौर पर स्तन कैंसर से जुड़ा है, लेकिन अधिकतर समय, स्तन में गांठ कैंसर नहीं होता। किशोरावस्था में हार्मोनल परिवर्तन से लेकर क्षतिग्रस्त वसा ऊतक तक, महिलाओं में शुरुआती 20 से लेकर शुरुआती 50 की उम्र तक सभी स्तन गांठों में से 90 प्रतिशत से ज्यादा गैर-कर्कश (सौम्य) हैं। 
स्तम्भों में लंप्स स्तन संक्रमण, फाइब्रोकाइसटिक स्तन रोग (ढेलेदार स्तन), फाइब्रोएडीनोमा (गैर-कन्सेसर ट्यूमर), वसा-परिगलन (क्षतिग्रस्त ऊतक) जैसे कई अन्य कारणों के कारण हो सकते हैं।
यद्यपि अधिकांश स्तन गांठ कम गंभीर स्थितियों के कारण होते हैं, नए, पीड़ारहित गांठें फिर भी स्तन कैंसर का सबसे आम लक्षण हैं। एक महिला अपने स्तन में बदलाव देख सकती है, और मामूली असामान्य दर्द जो दूर जाता प्रतीत नहीं होता। इन परिवर्तनों के लिए देखें:

1. स्तन या निपल का अलग महसूस होना:
- निपल कोमलता, या स्तन या अंडरआर्म क्षेत्र में या उसके पास एक गांठ या मोटा होना।
- त्वचा की बनावट में परिवर्तन या स्तन की त्वचा में छिद्रों का इज़ाफ़ा
- स्तन में एक गांठ

2. दिखने में बदलाव:
- स्तन के माप या आकार में कोई भी अस्पष्टीकृत परिवर्तन
- स्तन पर कहीं भी गढ़ा
- स्तन की अस्पष्ट सूजन (खासकर अगर यह केवल एक तरफ है)
- स्तन का अस्पष्ट संकुचन (खासकर अगर यह केवल एक तरफ है)
- निप्पल जो थोड़ा सा आवक हो जाता है, या उलटा हो गया है

3. निपल निर्वहन:
किसी भी प्रकार के निप्पल निर्वहन, विशेष रूप से साफ़ निर्वहन या खूनी निर्वहन स्तन कैंसर का संकेत हो सकता है। एक दूधिया निर्वहन जब महिला स्तनपान नहीं कर रही है, हालांकि स्तन कैंसर से जुड़ा नहीं है, लेकिन एक डॉक्टर द्वारा जांच कराया जाना चाहिए।
इन लक्षणों में से एक या अधिक होने का मतलब यह नहीं है कि आपको स्तन कैंसर है। यदि आप इन संकेत और लक्षणों में से किसी का अनुभव करते हैं, तो एक पूर्ण मूल्यांकन के लिए अपने चिकित्सक को देखें।

Noncancerous growths of the muscle tissue surrounding the uterus are known as uterine fibroids. This is a common disease which about 70 to 80% of women contract by the time they are 50 years of age. The uterine fibroids can sometimes be very big and cause heavy periods as well as severe abdominal pain while at other times, uterine fibroids give no signs or symptoms whatsoever and go away on their own. This is why it is crucial to know what type of uterine fibroids you have and how to diagnose them. Here are the types of uterine fibroids and how to diagnose them;

Types
There are three main types of uterine fibroids. They are;

1. Intramural fibroids: The most common type of uterine fibroids are intramural fibroids. They typically appear in the endometrium and may grow larger which results in your womb getting stretched.
2. Subserosal fibroids: Subserosal fibroids are called so because they form on the serosa. The serosa is the outside of your uterus. Sometimes, Subserosal fibroids may grow so large that your uterus appears bigger on one side.
3. Pedunculated fibroids: Pedunculated fibroids tumors are basically Subserosal fibroids with a stem. A base which supports the tumor is called the stem.

Diagnosis
There are a number of tests done to diagnose uterine fibroids. They are;

1. Pelvic exam: A pelvic exam is a thorough inspection of a woman’s pelvic area. The organs which are in the pelvic area include the cervix, ovaries, uterus and vagina. Normally, this and the next test in this article are enough to diagnose uterine fibroids.
2. Medical history: The history of your periods as well as the other symptoms you have will often be enough to diagnose the uterine fibroids. If your medical history is not enough, then you might need to undergo a pelvic exam.
3. Pelvic ultrasound: An ultrasound is when high-intensity sound waves are used to produce images of the pelvic area. This is only done when a pelvic exam and your medical history are not enough to diagnose uterine fibroids. If you wish to discuss any specific problem, you can consult a general surgeon.

Cerebral ischaemia or brain ischemia is a medical condition that restricts the flow of blood to the brain, resulting in an unmet metabolic demand. This leads to limited oxygen supply in the brain, which could result in death of brain tissues, cerebral infarction or an ischemic stroke. Thus, a cardiorespiratory arrest, a stroke, and irreversible brain damage are few possible consequences of cerebral ischaemia.

People with compressed blood vessels, low blood pressure, congenital heart defects or sickle cell anaemia have a high risk of developing cerebral ischaemia, since compressed blood vessels or very low pressure can lead to restricted blood flow. Also, sickle-shaped cells have a greater tendency to clot, causing obstructed blood flow.

Patients with cerebral ischaemia experience a host of symptoms, such as weakness in the body, problems in coordination and movement, vision and speech impairment and unconsciousness.

Cerebral congestion, on the other hand, refers to excessive quantity of blood in the brain vessels, causing pressure on the cerebral substance. Cerebral congestion is of two types. It is termed as active when there is too much arterial blood flow and passive when there is undue quantity of venous blood in the veins of the brain. Both conditions cause symptoms, such as severe headache, insomnia, irritability and unconsciousness. The patient gets little sleep and is disturbed, often followed by dreams. When awake, the patient’s mental activity in the brain is very high.

Homeopathy is now a well-established school of medicine backed with years of research and practice. Gone are the days when homeopathy was considered no more than an extension of herbal home remedies. Homeopathic laboratories around the world produce large number of medicines covering almost all ailments. The benefits of homeopathic treatment are now well established due to its holistic approach and minimal side effects. Homeopathy is undoubtedly a ray of hope for patients with cerebral ischaemia and cerebral congestion, as it delivers a comprehensive treatment plan designed to target the signs and symptoms of the disease and address its non-occurrence.

The medications deal with mild to severe symptoms, including inflammation of the brain, headache, vomiting, insomnia, stroke/convulsions and seizures. The stramonium drug, for example, deals with seizures. Belladonna is an effective remedy for sharp shooting headaches, a common symptom of cerebral congestion. Ferrum is believed to be a valuable remedy for brain ischaemia. Few drugs deal with the symptoms of both ischaemia and congestion—nux is a suitable drug for the treatment of ischaemia as well as for passive cerebral congestion. Similarly, phosphorus can be used to treat brain ischaemia and congestion. Zincum metallicum is a highly recommended drug for chronic cases of ischaemia.

The treatment is comprehensive and long term and shows substantive results. Regular follow-ups and consultation with a homeopath specialist is the key to an effective treatment.

What is ECMO?
Like dialysis for unfunctional kidney, Ecmo for unfunctional lung.

Ecmo stands for extracorporeal membrane oxygenation. It is a method of giving oxygen for the body when icu pateint lungs and/or heart are not able to supply oxygen on their own. 

Why ICU pateint put on ECMO?

Doctors place ICU patients on ECMO when patients are not able to supply oxygen to the body.

ICU patients’ lungs fail for a number of reasons including pneumonia, lung cancer, pulmonary edema, pulmonary embolism and COPD.

 When a patient’s lungs fail, he/she first is intubated (breathing tube) and hooked up to a ventilator (breathing machine).
 However, sometimes lungs are so damaged that providing oxygen through intubation is not enough.

This is when doctors turn to v-v ecmo.
A heart can fail for many reasons including heart attack, pulmonary embolism, bad valve disease, or worsening heart failure. When a heart fails, doctors try to fix the underlying problem. They may also start medications (called ionotropes) to help improve the pump function of the heart. If medications are not enough, doctors will turn to v-a ecmo.

How long can someone stay on ecmo?

That is a complicated question. Due to the risks of ecmo discussed above, doctors try to keep patients on ecmo for as short a time as possible. Often patient will be on ecmo for several days up to 1-2 weeks. Every day, several blood and imaging tests are done to determine if a patient is ready to come off ecmo. As the technology of ecmo improves, hopefully side effects will decrease and patients can remain on ecmo for longer periods of time.

What is the difference between ecmo and a ventilator (breathing machine)?

Both ecmo and a ventilator aim to provide oxygen to the body when the patient’s own lungs and breathing are failing. The ventilator assists the patient’s own lungs by pushing oxygen with pressure into the lungs. Ecmo instead provides oxygen directly via a catheter placed in a patient’s vein or artery. We almost always try oxygenating a patient with a ventilator first. However, when a patient’s lungs are too sick for this, we turn to ecmo to assist in providing oxygen to the body. V-v ecmo provides oxygen through a vein. This blood then has to travel to the heart and be pumped around the rest of the body through arteries. Therefore, with v-v ecmo or with a ventilator, a patient must have a well-functioning heart to get the oxygen pumped throughout the body. V-a ecmo has the additional advantage of pumping blood directly to arteries. This “by-passes” the heart and is therefore the method of ecmo we use when a patient’s heart is failing.

1. Eat calcium-rich foods

In addition to dairy products, choose fish with bones such as salmon, sardines or whitebait. For additional benefits, serve them with a side of dark leafy green vegetables or broccoli. Almonds, dried figs, fortified tofu and soy milk are also calcium-rich choices, says registered dietitian laura jeffers, med, rd, ld.

2. Take calcium supplements

The u. S. Recommended daily allowance for calcium is 1, 000 mg a day during your 20s, 30s and 40s. But your need rises as you age. Check with your doctor before starting supplements to find out what amount is right for you. For example, after menopause, most women need 1000 to 1, 500 mg a day unless they take hormone therapy. Your body only absorbs 500 mg of calcium at a time, Ms. Jeffers notes, so spread your consumption out over the course of the day.

3. Add d to your day

To help absorb calcium, most adults need 1, 000 to 2, 000 iu of vitamin d daily, combined calcium-vitamin d pills usually do not meet this requirement. And most of us who live north of atlanta do not get enough vitamin d the old-fashioned way — from the sun. Taking a vitamin d supplement will ensure you meet your daily needs.

4. Start weight-bearing exercises

To boost your bone strength, try exercise that “loads” or compresses your bones, says exercise physiologist heather nettle, ma. “running, jogging, high-impact aerobics, repetitive stair climbing, dancing, tennis and basketball are best for building bones. But if you have osteopenia, osteoporosis or arthritis, try walking or using an elliptical or other machine,” she says. Be sure to clear any exercise plans with your doctor first.

5. Don’t smoke, and don’t drink excessively

Bad news for bad habits: loss of bone mineral density is associated with tobacco use and excessive alcohol consumption, Dr. Sikon says. If you smoke, look into a program to help you quit. If you drink, stick to no more than one libation a day, she advises.

6. Get your bone mineral density tested

Doctors can get a quick and painless “snapshot” of bone health using a simple x-ray test called dxa. This test measures bone mineral density and helps determine risks of osteoporosis and fracture. Dr. Sikon recommends testing for women within two years of menopause. Earlier tests are recommended for men and women with certain diseases and for those taking medications that increase risk, such as long-term steroid therapy.

7. Medication

Perimenopausal women may consider hormone therapy to increase waning estrogen levels, which are linked to bone loss. And women and men diagnosed with osteopenia or osteoporosis can take various medications to prevent dangerous hip and spine fractures.

Breast cancer, is a type of cancer, which is common to women, where cancer cells grow on the breasts or the female mammary gland. It starts out with the formation of a small lump in your breast and can spread out to your other organs very rapidly. It generally affects women above forty years of age. Breast cancer can be classified into two types. They can either start forming on the inner linings of your milk ducts ( known as Ductal carcinoma) or in the lobules which supply milk (known as Lobular carcinoma).

There are many causes responsible for breast cancer they are mentioned below: 

• Obesity or post-menopausal obesity (Learn more about Heart Diseases Post Menopause)
• Exposure to frequent radiation (X-ray)
• Consumption of alcohol
• Being taller than average
• Start of periods at an early age
• Late menopause
• Hormone replacement therapy
• Consumption of birth control pills

The most common symptoms of breast cancer are as follows: 

1. Formation of a lump in your breast
2. Swelling or shrinking of your breast
3. Change of size, shape and color of your nipple
4. Blood or milk discharge from the nipple
5. Breast pain
6. Itching sensation
7. Appearance of rashes (Learn more about to maintain the skin health)

Breast cancer if not diagnosed and treated at an early stage may turn out to be fatal. Ayurveda offers promising cures for breast cancer.

A few of the Ayurvedic remedies are mentioned below: 

1. Include foods, which are well supplied with vitamin D in your diet. Researches show that women with less amount of vitamin D in their bodies are more likely to develop breast cancer. Consider including foods like eggs, orange juice, dairy products and fish like salmon in your diet.
2. Drink more of green tea as it has anti cancer properties.
3. Exercises like walking, yoga, meditation and certain breast exercises can help you to relax the pain sensation, reduce stress and also get cured.
4. Incorporate bitter gourd in your diet. Researches show that bitter gourd can kill those cancer cells, which cause breast cancer.
5. Ayurvedic herbs like Ashwagandha, tulsi, curcumin have certain properties that can destroy cancer cells.

If you wish to discuss about any specific problem, you can consult an Ayurveda.

Liver cancer is when the cells in the liver grow uncontrolled. As the liver filters blood from all parts of the body, one of the most common reasons for liver cancer is perhaps metastasis, which is spread from other parts. Through the blood, cancer cells from other parts reach the liver for filtration and can then make the organ cancerous.

In addition to this, there are other risk factors that can lead to liver cancer. For example, people suffering from obesity, alcohol and tobacco abuse, viral hepatitis (B or C), chronic liver disease (especially in men, who are more prone than women to develop cancer), cirrhosis and someone who has a history of a prolonged use of steroids can suffer from the disease. Also, while liver cancer is very rare in the Americas, it is very common in Africa and Southeast Asia as the prevalence of hepatitis is higher in these regions.

When it comes to the symptoms, it’s acceptable that liver cancer is insidious, and the exact point of origin cannot be identified. It continues to grow until symptoms become evident, which are also nonspecific. Before analyzing your health on your own, it’s always recommendable to seek an expert’s final word on it. Let’s take a look at the top signs that might point out towards liver cancer.

1. Abdominal pain: When you suffer a strong pain in the abdominal area, especially in the upper portion on the right side, it can signal a lump or a growing tumor in the liver. This can also be accompanied by middle or lower back pain.
2. Weight loss: Many a time, women who suffer from a sudden loss of weight can be going through a deadly disease like this one. In most cases, these weight loss cases show no attempts on the patient’s side, that is, the weight loss occurred for unknown reasons. A loss of appetite, without any reasons, is another indicator. These can result due to unexplained reasons and should be taken seriously.
3. White, chalky stools:This one is another tell-tale sign of liver cancer. Often, people tend to ignore stools in light, flaky colors. It is always better to consult a doctor, as you might be ignoring a sign of potential cancer.
4. Bloating: When you feel certain heaviness or bloating in the upper part of the abdomen due to fluid accumulation it indicates, which is one of the indicators for testing liver cancer.
5. Frequent body conditions: Apart from the above mentioned symptoms, one can also consider personal health history when facing any liver- related problems. Recurring severe nausea and vomiting and general signs of lethargy and weakness can also indicate liver cancer. Also, personal health history with claims the patient suffered from jaundice (due to the accumulation of bile pigments in the sclera and skin) can also be taken into consideration. If you wish to discuss about any specific problem, you can consult an Oncologist.

In case you have a diseased uterus, which makes you infertile, you can undergo a procedure known as uterus transplant or uterine transplant to get pregnant. In the process of sexual reproduction, a diseased uterus does not allow embryonic implantation. This factor is referred to as uterine factor infertility or UFI. As a result, you will not be able to get pregnant. Learn more about having healthy pregnancy.

Who requires a uterus transplant?
This procedure involves women who have UFI and women who had their uterus removed by hysterectomy. Women who have a damaged uterus on account of an injury or infection, which does not function anymore, can also undergo a uterus transplant procedure. Women from the age of 21 to 45 are eligible for this procedure. Many women are born without having a uterus. This condition is called Mayer-Rokitansky-Küster-Hauser syndrome.

Procedure
Uterus transplantation begins with undertaking a uterus retrieval surgery on the uterus donor. The uterus, which is recovered has to be stored and transported to the location of the patient undergoing the transplant. An ischemic tolerance may last over 24 hours. Three major surgeries have to be carried out with the recipient. Firstly, a transplantation surgery is required in which the donor’s uterus gets transplanted. In case pregnancy develops, a caesarean section surgery has to be performed. The patient is given immune suppressive therapy. After childbirth, a hysterectomy is done in order to terminate the immune suppressive therapy.

Will the women be able to get pregnant after having sex?
Women receiving a uterus transplant will not be capable of becoming pregnant without undergoing fertility treatments. The transplanted uterus is not connected with the fallopian tubes, which is the location of the normal fertilisation process. The women will require to carry out IVF or in vitro fertilisation to become pregnant after a uterus transplant. IVF is a process in which the eggs are removed from the ovaries and get fertilised in a laboratory. Then, they are implanted in the uterus. After undergoing the uterus transplant procedure, a woman has to wait for a period of one year. The uterus requires time for healing and after recovery, the embryo may be implanted for pregnancy. After giving birth successfully, a woman will be able to keep the transplanted uterus. This is a reason why IVF is a popular procedure.

She has the option to get pregnant again. However, after giving birth twice, a hysterectomy must be carried out for the removal of the uterus. This is done so that the woman can stop using the immune suppressant drugs, which are associated with major risks. Uterus transplant is a relatively new technology. In October 2014, the first healthy baby was born to a woman who had undergone a uterus transplant. This surgery is kind of experimental in nature and is usually the last option for getting pregnant.

1. You felt a lump in your breast and it always means you have breast cancer.

The Truth

It's a small percentage of breast lumps only that will turn out to be cancer.  If you discover a persistent lump in your breast or notice any changes in breast tissue,  never ignore it.  You  must see a physician for a clinical breast examination. He or she may possibly order breast imaging studies to determine if this lump is of concern or not.

Take charge of your health by performing routine breast self-exams, establishing ongoing communication and counseling with your doctor, getting an annual clinical breast exam, and scheduling your routine screening mammograms.

2. Only women get breast cancer, men do not.

The Truth

Quite the contrary, each year it is estimated that approximately 2,190 men will be diagnosed with breast cancer and 410 will die. While this percentage is still small, men should also check themselves periodically by doing a breast self-exam while in the shower and reporting any changes to their physicians. 

Breast cancer in men is usually detected as a hard lump underneath the nipple and areola.  Men carry a higher mortality than women do, primarily because awareness among men is less and they are less likely to assume a lump is breast cancer, which can cause a delay in seeking treatment.

Many women develop uterine fibroids by the time they hit the age of 50 years and above. These are non-cancerous growths that may occur in the uterus. Most women go through severe bleeding and pain as well as discomfort as a result of these fibroids. Age, family history of the same condition, obesity or being overweight, eating habits and even ethnicity play a large role in deciding the risk of each individual patient. These fibroids can grow in the submucosal, intramural and subserosal areas.

Following are the common side effects of uterine fibroids:

1. Frequent urination: Due to the pressure of the fibroids on the uterus, the patient may experience a constant feeling of fullness in the lower pelvic area of the body, which may lead to frequent filling of the bladder. This gives rise to frequent trips to the washroom for urination. 
2. Heavy Bleeding: Severe bleeding is one of the most common causes of the presence of these kinds of fibroids. The patient may experience a lot of bleeding during menstrual periods, as well as pain and cramps the rest of the time. The periods will also be very painful when there are fibroids in the uterus or the uterine lining.
3. Painful Intercourse: It is a well-known fact that any kind of infection or growth as well as sores and other such ailments can lead to vaginal dryness as well as pain during sexual intercourse. This is true for uterine fibroids as well, which can lead to severe pain during sexual activity. These fibroids can also give rise to pain in the lumbar or lower back region.
4. Abdomen Swelling: The abdomen may go through significant swelling in such a condition and the patient may even look like she is pregnant. The growth can push the shape of the abdomen outwards and create a full feeling.
5. Pregnancy Complications: The presence of uterine fibroids can give rise to several complications during pregnancy and even after child birth. One of the most common problems in this case is bleeding, followed by more severe outcomes like miscarriage. The women suffering from uterine fibroids are at greater risk of undergoing a caesarean section for the delivery of the baby. The baby may also be born breech and a premature delivery may take place. 
6. Infertility: This is also a rare side effect of the uterine fibroids and is generally seen only in very severe cases. 
7. Cancer: Only one in every 1000 cases might transform into malignant tumours. These uterine fibroids are generally known to be non-malignant. 

Any symptoms must be reported to a gynaecologist at the earliest to avoid any serious complications.

If you are concerned about liver cancer, you should know that most people do not experience signs and symptoms of the cancer in the early stages. Liver cancer is a form of cancer which occurs in the cells of the liver. There are various types of cancer which can develop in the liver. Hepatocellular carcinoma (HCC) is the most common liver cancer which begins in the hepatocyte, which is the main liver cell.

Symptoms-

Usually there are no specific primary stage symptoms of liver cancer. Some symptoms which may develop include the following:

1. Unusual weight loss is observed

2. Loss of appetite and developing food aversion

3. Pain in the upper abdomen

4. Nausea followed by vomiting

5. General weakness with intense fatigue

6. Swelling in the abdomen

7. The skin may become yellow

8. White and chalky stools are likely

Causes-

In most cases, the causes of liver cancer cannot be clearly determined. In some cases, the cause is known, such as chronic infection with the hepatitis virus, which may lead to liver cancer. Liver cancer occurs when the liver cells undergo changes or mutations in their DNA structure. DNA mutations lead to changes in instructions of chemical processes taking place in the body. The cells may grow out of control and develop into a cancerous tumour.

Risk Factors-

There are several factors which enhance the risk of liver cancer. They are as follows:

1. Chronic infection with hepatitis B or hepatitis C increases the risk of liver cancer.

2. A progressive and irreversible condition known as cirrhosis leads to scar tissue formation in the liver, increasing the risk of liver cancer.

3. Certain inherited liver diseases such as Wilson’s disease and hemochromatosis also increase the chances of liver cancer.

4. People with diabetes are also at a greater risk of having liver cancer.

5. Non-alcoholic fatty liver disease (NAFLD), which is the accumulation of fat in the liver, also increases the chances of getting this condition.

6. Excessive alcohol consumption is another factor which causes irreversible damage to the liver and the chances of getting liver cancer get boosted.

7. Exposure to aflatoxins, which are poisons produced by molds growing on poorly stored crops, make you more likely to get liver cancer.

Several tests and procedures are carried out for the diagnosis of liver cancer. These include blood tests for diagnosing liver function problems, and imaging tests such as ultrasound, CT scan and MRI scan.