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Even though brain aneurysms are becoming common these days, not all of them are required to be treated. In some cases, the physician may choose to observe an aneurysm closely before adopting any treatment measure. But in patients in whom an aneurysm has progressed to a severe level, there are two treatment options:
- Open surgical clipping
- Endovascular therapy or coiling
Open surgical clipping for brain aneurysms:
This procedure is typically performed by a neurosurgeon who makes an incision in the head. An opening in the bone is made, and then a clip is positioned by dissecting through the spaces of the brain. This aids in preventing the flow of blood into an aneurysm. In this procedure, the patient is required to stay in the hospital for two to three nights after which he or she is discharged.
Considerable modifications have been made in the open surgery techniques in the recent years. Neurosurgeons are now able to perform eye brow incisions or mini craniotomies for clipping an aneurysm. In these procedures, a small incision is cut out in the skin above the eyebrow for making a window. A tiny clip is placed across the mouth of an aneurysm to help it heal. But it is worthy of mention here that these are all invasive procedures and take relatively longer time to recover compared to the coiling process.
- This treatment is also performed by a neurosurgeon, and it has been proved that this process is exceptionally suitable for patients with a ruptured aneurysm. Endovascular coiling is often done in coalesce with an angiogram, where a catheter is inserted into the vessel over the hip, which is then gradually carried to the vessels of the brain and finally to an aneurysm.
- Then the coils are packed to the point where it rises from the blood vessel, which prevents the blood from flowing intothe blood vessel. Most patients undergoing this minimally invasive procedure can go home the day following the surgery. The success rate of this process is very high, and over 125,000 patients have been treated all across the globe with the help of detachable platinum coils.
- Over the last few years, a substantial amount of advancements have taken place in the endovascular techniques. Recent developments show the use of flow diverting embolization devices, which are similar to a stent and are placed in the primary vessel, adjacent to an aneurysm. It diverts the flow away from an aneurysm and therefore, allows the neurosurgeons to treat the brain aneurysms, which were previously considered inaccessible and untreatable.
Both the procedures are quite efficient in treating a brain aneurysm. The most suitable option is dependent on a host of factors such as size, shape, location and overall health condition of the patient. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.
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 an advocate and have got sitting job for long hours and walking job too. I am suffer from slip disc. Any treatment?
Breast cancer is an abnormal growth of cells in the tissues of the breast. Mainly it occurs in females but less than 1% of all the breast cancer cases develop in males. The majority of breast cancers start in the milk ducts. A small number start in the milk sacs or lobules. It can spread to the lymph nodes and to the other parts of the body such as bones, liver, lungs and to the brain.
With more reliable early detection methods as well as the trend towards less invasive surgery, there is hope that even more women with breast cancer will be treated successfully and will go on to resume their normal lives.
Signs & Symptoms
It is painless, especially, during the early stage. Watch out for the following changes in the breast:
- A persistent lump or thickening in the breast or in the axilla.
- A change in the size or shape of the breast.
- A change in the colour or appearance of the skin of the breast such as redness, puckering or dimpling.
- Bloody discharge from the nipple.
- A change in the nipple or areola such as scaliness, persistent rash or nipple retraction (nipple pulled into the breast).
Consult a doctor immediately if you notice any of these changes.
Being a woman puts you at risk of getting breast cancer. There are certain factors that increase the risk of breast cancer. Some of them have been listed below:
- The risk increases with age; most cases of breast cancer develop after the age of 50
- Genetic alterations in certain genes such as BRCA1 and BRCA2
- Family history of breast cancer
- Being overweight
- Early menarche (onset of menstruation before the age of 12)
- Late menopause (after the age of 55)
- Never had children
- Late childbearing
- No breast feeding
- Excessive consumption of alcohol
- Use of hormonal replacement therapy (HRT) for a long period of time
However, most women who have breast cancer have none of the above risk factors. Likewise, not having any of these risk factors does not mean that you will not get breast cancer.
Early Detection and Screening
More treatment options are available when breast cancer is diagnosed at an early stage and hence the chances of recovery is also higher. So regular breast screening is important for early detection even if there are no symptoms. Following are the ways of screening:
- Breast Self-Examination (BSE): Perform BSE once a month about a week after your menses are over. If you no longer menstruate, choose a date each month which is easy to remember e.g. your date of birth or anniversary.
- Clinical Breast Examination: Get a breast specialist to examine your breast once a year if you are 40 years and above.
- Mammogram: Go for a screening mammogram once a year if you are 40 to 49 years old and once every two years if you are 50 years and above even if you do not have any symptom. It is not recommended for younger women (less than 40 years of age) as they have dense breasts, making it difficult for small changes to be detected on a mammogram. So ultrasonography of the breasts is advisable to them.
Types of Breast cancer
- Non-Invasive Breast cancer: These are confined to the ducts within the breasts. They are known as Ductal carcinoma in-situ (DCIS).
- Invasive Breast cancer: It occurs when cancer cells spread beyond the ducts or lobules. Cancer cells first spread to the surrounding breast tissue and subsequently to the lymph nodes in the armpit (Axillary lymph nodes). These cells can also travel to the other parts of the body such as bones, liver, lungs or brain and hence known as metastatic breast cancer.
Making A Diagnosis
If you notice any unusual changes in your breasts, you should see a doctor immediately. He will examine you clinically and may ask you to undergo some tests so that a definitive diagnosis can be made. Further, the staging work up is done to find out the stage of the disease and management accordingly.
Treatment of breast cancer may include various methods such as surgery with or without breast reconstruction, chemotherapy, radiation therapy, hormonal therapy and targeted therapy. Treatment options offered, depend upon the number of factors such as the stage of cancer and likelihood of cure, your general health and your preference.
In case you have a concern or query you can always consult an expert & get answers to your questions!
A spinal cord injury is damage to the spinal cord. It’s an extremely serious type of physical trauma that’s likely to have a lasting and significant impact on most aspects of daily life.
The spinal cord is responsible for sending messages from the brain to all parts of the body. It also sends messages from the body to the brain. We are able to perceive pain and move our limbs because of messages sent through the spinal cord.
If the spinal cord sustains an injury, some or all of these impulses may not be able to ‘get through’. The result is a complete or total loss of sensation and mobility below the injury. A spinal cord injury closer to the neck will typically cause paralysis throughout a larger part of the body than one in the lower back area.
A spinal cord injury is often the result of an unpredictable accident or violent event. The following can all result in damage to the spinal cord:
- a violent attack such as a stabbing or a gunshot
- diving into water that’s too shallow and hitting the bottom
- trauma during a car accident (specifically trauma to the face, head and neck region, back, or chest area)
- falling from a significant height
- head or spinal injuries during sporting events
- electrical accidents
- severe twisting of the middle portion of the torso
Some symptoms of a spinal cord injury include:
- problems walking
- loss of control of the bladder or bowels
- inability to move the arms or legs
- feelings of spreading numbness or tingling in the extremities
- pain, pressure, stiffness in the back or neck area
- signs of shock
- unnatural positioning of the head
If you suspect that someone has a back or neck injury:
- Don’t move the injured person – permanent paralysis and other serious complications may result
- Call 911 or your local emergency medical assistance number
- Keep the person still
- Place heavy towels on both sides of the neck or hold the head and neck to prevent them from moving until emergency care arrives
- Provide basic first aid, such as stopping any bleeding and making the person comfortable, without moving the head or neck
Treatment should be focused upon that individual and tailored specifically to their condition. A treatment programme is formulated following a thorough physical assessment which might include:
- Stretching activities to maintain muscle and tendon length and reduce or keep muscle spasms/spasticity to a minimum.
- Flexibility and strengthening exercises for the whole body.
- Breathing exercises to maximise lung function and prevent chest infection.
- Balance and posture exercises which can help to reduce pain associated with poor posture and balance impairment and ensure correct transfer techniques (in/out of wheelchair, bed, toilet/bath, car etc.)
- Functional activities to improve fundamental movement patterns such as rolling over and sitting up, and standing where appropriate.
- Walking re-education, if there is sufficient muscle activity and power in the legs.
Your physiotherapist might also be able to advise an individual on use of appropriate equipment such as wheel-chairs and pressure releasing cushions, exercise equipment and electrical muscle stimulators.
Because spinal cord injuries are often due to unpredictable events, the best you can do is reduce your risk.
Some risk-reducing measures include:
- Always wearing a seatbelt while in a car
- Wearing proper protective gear while playing sports
- Never diving into water unless you’ve examined it first to make sure it’s deep enough and free of rocks
In case you have a concern or query you can always consult an expert & get answers to your questions!
Uterine cancer of cancer of the uterus is a fairly common type of cancer. In fact, this is the fourth most common type of cancer to affect women. This type of cancer is usually diagnosed in its early stages and hence can be easily treated. However, did you know that this type of cancer can be prevented? This is primarily because most cases of uterine cancer are caused by an increased amount of estrogen as compared to progestin. Here are a few tips to keep in mind.
- Birth control pills: The regular use of birth control pills for at least a year is believed to reduce the risk of uterine cancer by at least 50%. The longer these contraceptives are used for, the more effective they are. The protection provided by them lasts for 15 years after their use has been discontinued.
- Reduce weight: Being overweight not only increases the risk of lifestyle diseases such as diabetes and high blood pressure but can also increase a woman’s risk of suffering from uterine cancer. This is because fat cells produce estrogen that further dis-balances the estrogen to progestin ratio. Reducing weight can thus help lower the estrogen levels in the body and prevent cancer. To lose weight, one must keep a strict control over portion sizes, eat nutritious food and exercise regularly.
- Use an IUD: Some methods of contraception not only prevent unwanted pregnancy but also reduce the risk of uterine cancer. Many IUDs or Intrauterine Devices contain progestin. This helps balance the estrogen and progestin levels in the body. Additionally, it also reduces the risk of hyperplasia. This is a condition marked by the abnormal thickening of the lining of the uterus. In many cases, this condition is a precursor to uterine cancer.
- Question Your Family: Genetics can also influence the risk of developing uterine cancer. For example, people carrying the gene responsible for Lynch Syndrome or hereditary nonpolyposis colorectal cancer have a much higher risk of uterine cancer as compared to others. Thus, if you know of family members who have suffered or are suffering from uterine or colon cancer, it is a good idea to undergo genetic testing.
- Broccoli - A super food: Some foods can also help strengthen the immune system and reduce the risk of uterine cancer. Broccoli is one such vegetable. This is known as a super food that can prevent cancer. The best way to eat broccoli is by steaming it. This has the higher amounts of glucosinolate as compared to fried or boiled broccoli. If you wish to discuss about any specific problem, you can consult an Oncologist.
Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.
Here's what you should look for:
Breasts that are their usual size, shape, and color
Breasts that are evenly shaped without visible distortion or swelling
If you see any of the following changes, bring them to your doctor's attention:
Dimpling, puckering, or bulging of the skin
A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)
Redness, soreness, rash, or swelling
Step 2: now, raise your arms and look for the same changes.
Step 3: while you're at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).
Step 4: next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.
Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.
Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage.
Step 5: finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 4.
Back bone slip disk, sitika. I ask in Hindi rid ki haddi ke manke sarke hue hai. Unka koi ilaj hai kya. Koi bhi ilaj jese aurved ya koi or ilaaj hai to please batana. Unko bahut pain hota hai. Or koi kam bhi nahi kar sakte hai. Pura bed rest hai.
Umbilical hernia diet
An umbilical or belly button hernia occurs when a part of the intestines or the abdominal lining protrudes through an opening in the abdominal muscles. The protruding intestines may get squeezed or strangulated resulting in the blood supply getting cut off. Surgery may be required in serious cases of umbilical hernia. Doctors often suggest a special diet for umbilical hernia patients as this helps to prevent further complications.
Foods to avoid
Certain foods are not recommended for people with an umbilical hernia and should be avoided.
White refined flour foods made from white refined flour have a low fiber content. Eating these foods may cause constipation and should therefore be avoided. This is because constipation causes straining of the abdominal muscles during bowel movements and may cause further protrusion of the intestines through the abdominal muscles in the region of the belly button.
Low fiber fruits and vegetables the low fiber content in these foods can also lead to constipation. Examples of fruits and vegetables with low fiber content include skinless raw fruits, cooked fruits, and canned or cooked vegetables without seeds, hulls or skin.
Fatty foods foods with a high fat content should be avoided. This is because obesity results in greater pressure on the abdominal muscles and can increase the risk of umbilical hernia. Examples of foods with a high fat content include fatty meat such as pork, whole milk, butter, cream, margarine and fried foods.
Sugar limit your calorie intake by cutting down on foods such as pastries, cakes, chocolates and soda pop. Limiting your sugar intake will also help you to lose some weight, taking pressure off your abdominal region.
Foods to include
A special diet is required after umbilical hernia surgery. This will help you to minimize your convalescence time. The special dietary requirements include:
Fruits fresh fruits that have high fiber content and are rich in antioxidants should form a part of every meal. The high fiber content will ensure that you do not get constipated and the antioxidants will help protect your body and boost your immune system. Try to eat different types of fruits so as to get adequate amounts of different vitamins. Citrus fruits, berries, and apples are some examples of fruits with a high fiber and vitamin content.
Vegetables these too have a high fiber content that will guard against the dangers of constipation after an umbilical hernia surgery. They also have high levels of vitamins and minerals and should also be included with every meal.
Lean meat meat is a source of protein, which is essential to the repair of damaged tissue. Lean meat like poultry and fish is an excellent source of low fat protein. Have one good source of low fat protein with every meal.
Low fat dairy products these are a good source of protein and can be alternated with lean meats to provide your body with sufficient protein.
High fiber breakfast foods will aid digestion and so your breakfast should consist of foods made from whole wheat flour, wheat germ, oatmeal, or bran.