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Diagnostic X- Ray
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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
- 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.
- 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.
- 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.
- 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.
- 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.
- 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!
The lower part of uterus, which eventually leads into the vagina in the female reproductive system in humans is called the cervix uteri or in simple words, cervix. The inflammation of this part of the reproductive system is called Cervicitis.
Inflammation in the cervix is caused due to irritation, infection or injury to the cells, which align the cervix. Any one of a number of infections, mainly sexually transmitted diseases can cause cervicitis, of which the most common are chlamydia , mycoplasma , ureaplasma and gonorrhea. Chlamydia accounts for almost 40% of the total cases. Less common causes of cervicitis are Trichomoniasis (Trichomonas vaginalis) and Genital herpes. Other than STDs, causes for Cervicitis include allergies, bacterial imbalance, injury or irritation resulting from pessaries, tampons, hormonal imbalance and even cancer or its treatment (radiation therapy).
Some cases of cervicitis in women can be symptomless. However, in most cases, symptoms are present, and they include:
1. Persistence of gray or white vaginal discharge that may or may not smell
2. Vaginal bleeding under certain conditions eg. in between periods or after sex
5. Difficulty or pain during urination
6. In rare cases, fever or pain in the abdomen
Cervicitis has no typical form of treatment. Treatment may not be needed in cases where the cause is not a sexually transmitted infection. On suspicion of an infection, the main objectives of the treatment are the removal of the infection and obstructing its spread to the fallopian tubes and uterus, or in case of pregnancy, to the baby.
The medical prescription issued by your doctor would depend on the organism, which is causing the infection. It may include Antibiotics, Antifungal medications or Antiviral medications. Cryosurgery, a process, which freezes the abnormal cells in the cervix using freezing temperatures, may also be performed by your doctor. In severe cases, where there is damage to the cervical cells, your doctor can apply silver nitrate (destroys abnormal cells).
Recommendations from your doctor may also ask your partner to be treated so as to prevent recurrence of the disease and to avoid intercourse as long as the treatment is in process. Treatment is mandatory if you are tested to be HIV positive. Moreover, having cervicitis makes you more prone to receive the virus from a HIV positive partner. If you wish to discuss about any specific problem, you can consult a gynaecologist.
Dr. Please tell me can you detect the baby's brain defect in ultrasound and any birth defects clearly in which ultrasound?
Test to screen for breast cancer:
Mammography is the most common screening test for breast cancer. A mammogram is an x-ray of the breast. This test may find tumors that are too small to feel. A mammogram may also find ductal carcinoma in situ (dcis). In dcis, there are abnormal cells in the lining of a breast duct, which may become invasive cancer in some women.
Mammograms are less likely to find breast tumors in women younger than 50 years than in older women. This may be because younger women have denser breast tissue that appears white on a mammogram. Because tumors also appear white on a mammogram, they can be harder to find when there is dense breast tissue.
The left breast is pressed between two plates. An x-ray machine is used to take pictures of the breast. An inset shows the x-ray film image with an arrow pointed at abnormal tissue.
The breast is pressed between two plates. X-rays are used to take pictures of breast tissue.
The following may affect whether a mammogram is able to detect (find) breast cancer:
The size of the tumor. How dense the breast tissue is. The skill of the radiologist.
Women aged 40 to 74 years who have screening mammograms have a lower chance of dying from breast cancer than women who do not have screening mammograms.
Clinical Breast Exam (CBE):
A clinical breast exam is an exam of the breast by a doctor or other health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual. It is not known if having clinical breast exams decreases the chance of dying from breast cancer.
Breast self-exams may be done by women or men to check their breasts for lumps or other changes. It is important to know how your breasts usually look and feel. If you feel any lumps or notice any other changes, talk to your doctor. Doing breast self-exams has not been shown to decrease the chance of dying from breast cancer.
Mri (magnetic resonance imaging) in women with a high risk of breast cancer
Mri is a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (nmri). Mri does not use any x-rays.
MRI is used as a screening test for women who have one or more of the following:
Certain gene changes, such as in the brca1 or brca2 genes. A family history (first degree relative, such as a mother, daughter or sister) with breast cancer. Certain genetic syndromes, such as li-fraumeni or cowden syndrome.
Mris find breast cancer more often than mammograms do, but it is common for mri results to appear abnormal even when there isn't any cancer.
Other screening tests are being studied in clinical trials.
Thermography is a procedure in which a special camera that senses heat is used to record the temperature of the skin that covers the breasts. A computer makes a map of the breast showing the changes in temperature. Tumors can cause temperature changes that may show up on the thermogram.
There have been no clinical trials of thermography to find out how well it detects breast cancer or if having the procedure decreases the risk of dying from breast cancer.
Breast tissue sampling is taking cells from breast tissue to check under a microscope. Abnormal cells in breast fluid have been linked to an increased risk of breast cancer in some studies. Scientists are studying whether breast tissue sampling can be used to find breast cancer at an early stage or predict the risk of developing breast cancer. Three ways of taking tissue samples are being studied:
Fine-needle aspiration: a thin needle is inserted into the breast tissue around the areola (darkened area around the nipple) to take out a sample of cells and fluid.
Nipple aspiration: the use of gentle suction to collect fluid through the nipple. This is done with a device similar to the breast pumps used by women who are breast-feeding.
Ductal lavage: a hair-size catheter (tube) is inserted into the nipple and a small amount of salt water is released into the duct. The water picks up breast cells and is removed.
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!
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.
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.
I am 42 year old female .After slip disc L1toL4 problem, pain in left heel and becomes severe at times. Is it spur in the foot ,slip disc or something else.
MY WIFE RECENTLY HAD A CT SCAN & THE IMPRESSIONS ARE AS FOLLOWS: * Bilateral vocal cord palsy (more prominent on left side) * Few enlarged left supraclavicular lymph nodes * ~3 x 2 cm irregular mass in medial aspect of right upper lobe of lung, infiltrating the mediastinal pleura-suggestive of malignancy (metastases - known carcinoma of left breast) * I11 defined soft tissue rind measuring ~1 cm in thickness in superior mediastinum, encasing the mediastinal structures- suggestive of malignancy (spread from pleura / metastatic lymphodes) * ~2 cm right perihilar mediastinal lesion. * Multiple nodules measuring about 2 mm to 5 mm in both lungs- suggestive of metastases. * Moderate pericardial effusion. * Thin layer of left pleural effusion. I KNOW IT IS RELATED TO CANCER, BUT I WANT TO KNOW EXACTLY WHAT TYPE OF CANCER IT IS & WHAT IS THE SURVIVAL CHANCE (PERIOD) FOR PATIENT TAKING TREATMENT & PATIENT NOT TAKING ANY TREATMENT. KINDLY GIVE YOUR VALUABLE SUGGESTION. Thanks & Regards
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-
- 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.
- 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.
- 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.
- 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.
- 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.
- 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. If you wish to discuss about any specific problem, you can consult an oncologist and ask a free question.