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Dr. Sarojini Prahlad

Radiologist, Chennai

Dr. Sarojini Prahlad Radiologist, Chennai
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I believe in health care that is based on a personal commitment to meet patient needs with compassion and care....more
I believe in health care that is based on a personal commitment to meet patient needs with compassion and care.
More about Dr. Sarojini Prahlad
Dr. Sarojini Prahlad is a renowned Radiologist in Mandaveli, Chennai. You can visit her at Pennalam Cancer Care Center in Mandaveli, Chennai. Don’t wait in a queue, book an instant appointment online with Dr. Sarojini Prahlad on Lybrate.com.

Lybrate.com has an excellent community of Radiologists in India. You will find Radiologists with more than 33 years of experience on Lybrate.com. You can find Radiologists online in Chennai 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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Pennalam Cancer Care Center

ââ?¬Å?Abhinav Palaceââ?¬Â? Flat No.2, No.23, 1st Main Road, Jeth Nagar, Mandaveli. Landmark: Opp To LV Road, ChennaiChennai Get Directions
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What should I be doing to releave the pain for two herniated disc's one above and one below a fusion surgery of the cervical spine.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Sleep on a hard bed with soft bedding on it. SPRING BEDS, FOLDING BEDS OR THICK MATRESS ARE HARMFUL Use no pillow under the head. DO HOT FOMANTATION. Paracetamol 250mg OD & SOS x 5days. Caldikind plus 1tab OD x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 4-5days, contact me again.. Do not ignore .It could be beginning of a serious problem.
1 person found this helpful
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Dear sir. My mother is suffering from pain in waist and legs unable to stand for sometime and unable to walk due to L5 L6 displaced and make pressure on nerve. I don't want to operate for this . Is any other solution.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi , This is Dr Akshay from Fortis Hospital. Kindly upload her x ray and MRI images so that i can see and opine accordingly. Thanks & Regards Dr Akshay Kumar Saxena
1 person found this helpful
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I am suffering from l5-s6 disc prolapse from a year. Not undergone surgery. Little weight lift becomes problem in next morning. Is there a permanent solution for my problem. Thanks in advance.

Hand Surgery, M.S. (Orthopaedics
Orthopedist, Ahmedabad
Dear well, there is nonoperative treatment which is manipulation of spine, but should be done by a qualified person. There are risks involved and so you need proper evaluation and then I can decide if you are a proper candidate for the same or not.
2 people found this helpful
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Dear sir I have problem of slip disc or disc herniation in cervical. Kindly solve my problem?

MBBS, cc USG
General Physician, Gurgaon
Hello kindly review with X ray cervical AP and Lateral report consult neurosurgeon/orthopedic surgeon
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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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I have had a limbo sacral spine MRI. Conclusion of result is "Mild annular disc bulge with superimposed broad based posterocentral disc protrusion and annular tear at L4-L5 level is causing indentation on thecal sac. No central canal or existing foramina stenosis or nerve root compression" can anybody tell is it worrisome.

MBBS
General Physician, Mumbai
The report is not very worrisome coz there is no nerve compression .But you should be careful ,follow your exercise routine and treatment properly. Do spine extension exercises. Do not lift weights. Take calcium supplements. Take anti-inflamatory medication when needed.
4 people found this helpful
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Diseased Uterus - Can it be Replaced?

Health and Medical ARC Fertility
IVF Specialist, Chennai
Diseased Uterus - Can it be Replaced?

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.

3818 people found this helpful

I have back pain before 3 years. I have checked MRI test in hospital that result show the mild disc dics bulge noted at L4 and L5 level intending the thecal sac without neurological compression. Doctor has given pain relief tablets but no get relaxation. Please give me solution.

DNB (Orthopedics), MS - Orthopaedics, MBBS
Orthopedist, Bhopal
Your mri is normal as mild disc bulge is inconsequential. You better start some lower back muscle strengthening exercise (available on internet or visit a physio)
1 person found this helpful
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Back Injury

BPTh/BPT
Physiotherapist, Delhi
Back Injury
Herniated disks or bone spurts in the vertebrae of the neck may become the reason behind severe neck pan. They sometimes take too much space and compress the nerves branching out from the spinal cord.
225 people found this helpful

I am an advocate and have got sitting job for long hours and walking job too. I am suffer from slip disc. Any treatment?

Fellowship In Arthroplasty and Arthroscopy, MS Orthopaedics, MBBS
Orthopedist, Gurgaon
Regular exercises and maintaining good posture whie sitting is the key to avoid most of the back pain problems. Please do take frequent breaks every hr and strech your muscles and do not sit for long.
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Breast Cancer - Know More to Say 'No' More!

MBBS, DGO, MD - Obstetrics & Gynaecology, MRCOG
Gynaecologist, Delhi
Breast Cancer - Know More to Say 'No' More!

Cancer is the abnormal, uncontrolled growth of cells in a particular body part. With continued growth, pieces of this tissue travel through the blood to different body parts and continue to grow in the new area. This is known as metastases. Breast cancer is one of the most common forms of cancer and affects about 1 in 8 women in the USA. Read on to know more details of breast cancer – breast anatomy, causes, symptoms, risk factors, detection, prevention, and of course treatment.

Anatomy: The main function of the breast is lactation through its milk-producing tissue that are connected to the nipple by narrow ducts. In addition, there is surrounding connective tissue, fibrous material, fat, nerves, blood vessels and lymphatic channels which complete the structure. This is essential to know as most breast cancers develop as small calcifications (hardened particles) in the ducts or as small lumps in the breast tissue which then continues to grow into cancer. The spread can happen through lymphatic or blood flow to other organs.

Warning signs/symptoms: The following are some symptoms that need to be watched out for if you have a predisposition to breast cancer.

  1. A lump in either of the breasts or armpits
  2. Change in size, shape, or contour of either breast
  3. Redness of your breast or nipple
  4. Discharge of clear or bloody fluid
  5. Thickening of breast tissue or skin that lasts through a period
  6. Altered look or feel of the skin on the breast or the nipple (dimpled, inflamed, scaly, or puckered)
  7. One area on the breast that looks very different from the other areas
  8. Hardened area under the breast skin

Either one or a combination of these should be an indication to get a detailed checkup done. Early diagnosis results in controlling the disease with minimal treatment and reduced complications.

Causes and risk factors: The exact cause for breast cancer is yet to be pinned down. However, risk factors are clearly identified, and women with risk factors need to watch out for warning signs.

  1. Family history: Of all the risk factors, the family history is the most important. Breast cancer runs in families, and if there is a first-degree relative with the breast cancer, the chances of developing it are almost double. Two genes BRCA1 and BRCA2 are the carriers of the disease, and this testing can be done in women to identify if they are at risk.
  2. Family history of other cancers: Even if there is no breast cancer, if there are other cancers that run in the family, watch out.
  3. Age: Women over 50 are at higher risk of developing breast cancer.
  4. Race: Caucasian and Jewish women are at higher risk of breast cancer than African-American women.
  5. Hormones: Greater exposure to the female hormone estrogen increases the chances of developing breast cancer. Women who use birth control pills for contraception and hormone replacement after menopause are at a higher risk of developing breast cancer.
  6. Gynecologic milestones: Women who have abnormal menstrual milestones need to watch out. These include those who attain menarche before 12 years of age, get pregnant after 30, attain menopause after 55, and have menstrual cycles shorter than 26 days or longer than 29 days.
  7. Obesity and alcohol abuse are also likely to increase a woman’s chances of developing breast cancer.

Stages: Starting from stage 0, higher stages indicate advanced disease.

  1. Stage 0: The growth which has begun in the milk-producing tissue or the ducts has remained there (in situ) and not spread to any other area, including the rest of the breast.
  2. Stage I: The tissue slowly becomes invasive and has begun to affect the surrounding healthy tissue. It could have spread to the fatty breast tissue and some breast tissue may be found in the nearby lymph nodes.
  3. Stage II: The cancer at this stage grows considerably or spreads to other parts. There are chances that cancer may grow and also spread.
  4. Stage III: It may have spread to the bones or other organs but small amounts are present in up to 9 to 10 of the lymph nodes in the armpits and collar bones which makes it is difficult to fight.
  5. Stage IV: The cancer is widespread to far-flung areas like the liver, lungs, bones, and even the brain.

Screening: This is one of the most effective ways to identify the disease in its early stages. This will help in controlling cancer from spreading with minimal treatment.

  1. Self-examination: A thorough self-examination to look for changes in terms of shape, size, colour, contour, and firmness should be learned by all women. Watch for any discharge, sores, rashes, or swelling in the breasts, surrounding skin, and nipple. Examine them while standing and when lying down.
  2. In most women, annual screening mammograms are advised after the age of 40. However, in women who have a strong family history or genetic makeup, it is advisable to have screening mammograms starting at age 20 every 3 years and then annually from the age of 40.
  3. Women in high-risk categories should have screening mammograms every year and typically start at an earlier age.
  4. Ultrasound screening can also be given in addition to mammograms.
  5. Breast MRI is another way to screen for breast cancer if the risk is greater.

Breast Cancer Prevention: Now that there is so much awareness about causes and risk factors, there are definitely ways to prevent or delay the onset of the disease.

  1. Exercise and a healthy diet with reduced amount of alcohol are definitely effective in minimising the chances of developing cancer.
  2. Tamoxifen is used in women who are at high risk for breast cancer.
  3. Evista (raloxifene) which is used to treat osteoporosis after menopause. It is also widely used in preventing breast cancer.
  4. In high-risk women, breasts are surgically removed to prevent the development of cancer (preventive mastectomy).

Treatment: As with all cancers, treatment would depend on the stage at which it is identified and include a combination of chemotherapy, radiation, and surgery. As noted earlier, if you are at risk, look out for warning signs as early diagnosis is the key to maximum recovery.

2622 people found this helpful

Breast Cancer - 8 Things You Must Do To Avoid it!

DNB (Obstetrics and Gynecology), MBBS
Gynaecologist, Mumbai
Breast Cancer - 8 Things You Must Do To Avoid it!

Breast cancer is one of the most common cancers in women about 1 in 8 women in the USA develop invasive breast cancer. The incidence of breast cancer has increased with changes in lifestyle including smoking, drinking and loss of physical activity. The risk factors are age, ethnicity and family history cannot be changed. However, there are some risk factors that can definitely be acted upon to reduce the chances of developing breast cancer.

  1. Weight management: Obesity is one of the major risk factors for breast cancer and managing weight and a good body mass index will help reduce the risk of developing breast cancer. This is especially important in women undergoing menopause.
  2. Reducing smoking: The benefits of quitting it are manifold and reducing the risk for breast cancer is one of them. This will, as a byproduct, also result in a host of other benefits including improved quality of life, reduced chances of heart disease, stroke, and other cancers.
  3. Physical activity: In addition to helping in weight management, this also helps reduce the risk of breast cancer. Ideal recommendation is 30 minutes of physical activity per day, plus strength training.
  4. Breastfeeding: This helps in reducing the risk of breast cancer. Prolonged feeding is shown to have a greater protective benefit.
  5. Hormone replacement therapy: When possible, limit the use of hormone replacement therapy for prolonged periods of time. Explore options of non-hormonal substitutes or use the least permissible or required dose. Be sure to get periodic check-ups when on hormone therapy.
  6. Reduce exposure to environmental pollution: Higher levels of pollutants are linked to a higher incidence of breast cancer. When possible, avoid getting exposure to environmental pollutants.
  7. Screening: If there is a strong family history or other risk factors, then screening can help detect breast cancer very early in the process. Recommended ages for mammography are as follows:
    • If you are age 40 – 44: Go for annual mammograms after discussing risks and benefits with the doctor.
    • If you are age 45 – 54: Go for annual mammogram.
    • If you are age 55 or over: Mammograms are recommended every other year. You can choose to continue to have them every year. Self-breast exams are not sufficient. However, if being done, they can also be an input to an abnormality.
  8. Cautious use of birth control pills: Birth control pill usage to be discussed with your gynaecologist if you are above 35 years of age and smoke. The good news is that the risk associated with it disappears slowly after the pill is stopped.

These will help reduce the risk of developing breast cancer, early detection, and improved prognosis.

11 people found this helpful

Breast Cancer - Can Ayurveda Help You Treat it?

BAMS, MD - Ayurveda
Ayurveda, Navi Mumbai
Breast Cancer - Can Ayurveda Help You Treat it?

If you are suffering from breast cancer, it is recommended that you undertake Ayurvedic measures for an effective and natural treatment. Breast cancer is a form of cancer that occurs in the cells of your breasts. The breast cells undergo abnormal growth and go out of control. This form of cancer is likely to occur in both women and men, although it is most common in women. A lot of breast cancer cases start from the ducts or lobes, while others start from the cellular lining of your milk ducts.

Ayurvedic view
According to the principles of Ayurveda, your body is based on the tridoshas, which include vata, pitta, and kapha.

  1. An imbalance in these doshas can lead to diseases and disruption in your health. Cancer occurs when an imbalance of all the three doshas is experienced.
  2. An improper diet and lifestyle account for being the primary reason for this imbalance in doshas, leading to breast cancer.
  3. Your digestive fire is also affected, which leads to the accumulation of toxins, thereby blocking all the channels of your body.
  4. All these factors are collectively responsible for the development of breast cancer.

Ayurvedic treatment

  1. Ayurvedic treatment for breast cancer is very effective because of its natural approach.
  2. Without the use of any chemicals and radiation, you get efficient management by using Ayurvedic remedies for breast cancer.
  3. Your body functioning is enhanced without the concern of any negative effect on your health.
  4. Several Ayurvedic herbs are used for breast cancer treatment. These herbs help in controlling the abnormal growth of breast cells, and in the later stages of breast cancer, these also help in reducing pain.

The herbs play an important role in preventing the condition from spreading to other organs.

Ashwagandha

  • This powerful Ayurvedic herb contains natural rejuvenating properties for your body.
  • It also helps in eliminating stress, weakness and fatigue, which are associated with breast cancer.

Curcuma

  • This effective Ayurvedic herb contains several medicinal properties.
  • It is an antioxidant and helps in reducing free radicals from your body. This is beneficial for an improved health and immunity.
  • The herb is capable of dealing with toxins and infections, and is super effective in treating malignant cancers.

Kanhnaar Guggul

  • This is an Ayurvedic product, which is obtained by mixing several herbs such as amalaki, haritaki, ginger, kachnar bark and a lot more.
  • This is effective in maintaining healthy tissues and cells. It also stops the abnormal growth of cancerous cells.

It is important for you to visit a licensed and experienced Ayurvedic practitioner for getting the best Ayurvedic remedies for breast cancer treatment. This will ensure that you get the most effective remedies, based on your condition.

5774 people found this helpful

Dear sir, I am 33 year old. I have back ache since 2010 mri also have been done it shown herniated slip disk and doctor has advised me surgery. But I am not willing to get surgery please advise me what should I do.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Not all pt. Of backache need surgery. Most of them can be managed with out operation. Kindly show me a photograph of the affected part. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful Do hot fomantation. Paracetamol 250mg od & sos x 5days. Ubicar 1 tab odx10 caldikind plus 1tab od x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 1 wk, contact me again. Do not ignore. It could be beginning of a serious problem.
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I have disc bulge and getting pain in my left leg. I have MRI report my nerve is compressed of left leg.

MS - Orthopaedics, MBBS
Orthopedist, Hyderabad
If it's small disc bulge then it's treated with medication, exercises, physiotherapy. If no much relief then needs epidural steroid injection. Last resort with no improvement then needs discectomy.
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Common Side Effects of Uterine Fibroids

Certification in IVF & Infertility, Diplomate Gynae Laparoscopy, Royal College of Obstetricians and Gynaecologists (MRCOG), MD - Obstetrics & Gynaecology, MBBS
Gynaecologist, Ghaziabad
Common Side Effects of Uterine Fibroids

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.

4637 people found this helpful

Breast Cancer - 4 Common Symptoms

MD, MBBS, Advanced Infertility
Gynaecologist, Jalandhar
Breast Cancer - 4 Common Symptoms

Breast cancer is a type of a cancerous infection that develops in the skin cells of the breast. This condition is more commonly diagnosed after you have skin cancer and is more common in women than men. There are certain signs to identify this disease, which are as follows.

1. Breast lumps - Lumps are patches of skin that occur due to the thickening and swelling of the skin. Breast lumps is a very common phenomenon for women but that does not always lead to a breast cancer; however, frequent and reoccurring instances of the same increases the risk of breast cancer. A breast lump is easily identifiable through the naked eye as it looks different from the surrounding tissues.

2. Blood discharge - The nipple is one of the most sensitive areas in the human body. In case of women, it is meant to emit milk during pregnancy, in order to feed the infant externally. A probable symptom of breast cancer can also be a frequent discharge of blood from the nipple without any visible damage or injury.

3. Breast changes - If you are experiencing any visible changes in the size, appearance or shape of the breast, then it is an indicative sign that you may have breast cancer. Thus, it is of paramount importance that you observe, touch and physically examine your breast regularly for changes. If there is any major change detected then it is advisable to consult a doctor.

4. Inverted nipple - The tip of the nipple is generally bulging and pointing outwards both in cases of men and women. But sometimes the tip of the nipple is pushed inside due to excessive suction caused by the skin tissues present inside the breast around the nipple area. This suction forces the nipple to grow inwards which is abnormal and might harm the breast and skin in various ways.

However, apart from these main symptoms, some other signs are also there that increase your chances of being diagnosed with breast cancer. They are redness or pitting of the skin over your breast like an orange, peeling or scaling of the pigmented area around the nipple, dimpling of the skin on the breasts, and such others. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

4700 people found this helpful

Hello doctor plzz say me is surgery essential for Diffuse annular disc bulge seen at l4 and l5 level causing indentation over thecal sac with bilateral recess narrowing and significant nerve decompression.

MS - Orthopaedics, MBBS
Orthopedist, Hyderabad
Pivd l4-l5 initially can be treated with rest, physical therapy, medication, epidural steroid injection. If the problem is severe n you are having numbness n weakness in the feet n radiculopathy then you will meed surgery.
1 person found this helpful
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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
: 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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