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I am 38 years old man having back pain lasting for 20 days from mild to severe in left hip side. In consultation to orthopedic surgeon and after MRI one doctor told me the disease sciatica and another its slip disc. MRI of LS SPINE report says the result of AP diameter L1-L2=15, L2-L3=08, L3-L4=15, L4-L5=10 , L5-S1=09 Impression: 1) Degenerative DISC DISEASE with generalised disc bulge at L3-L4. Please tell.
I am a student and suffering from lumbar disc herniation since last two years or more treatments are being done but there have been no proper result but severe development in sciatic pain, numbness and feeling some effect on other leg also. And please suggest me some solution for this herniation.
When the skin of a breast looks uneven, it is known as a dimpled skin. Sometimes the skin might appear to be red or inflamed. In this condition, the breast tissue gets affected and this can be a serious sign of concern for cancer. Moreover, this sign is hard to detect on your own. Usually when the sign occurs, it only occurs in one of the breasts. If a woman has it in both the breasts, then likely that it has not been caused by cancer.
Causes of breast cancer dimpling are as follows
1. Advanced breast cancer
2. Breast abscess: A hollow space in the breast that is filled with pus and is at times surrounded by an inflamed tissue.
3. Duct obstruction: The ducts that carry the milk from the nipple are obstructed causing rapid abnormal growth and functioning of the cells present in the breasts causing cancer.
4. Fat necrosis: In this condition, the neutral fats are split into glycerol and fatty acids because the adipose tissue tends to degenerate.
5. Inflammation: Inflammation in the fatty tissue of the breast
6. Mastitis: The breast tissue tends to swell up and get infected. This happens because of the bacteria that enter the breasts through the nipple and this may cause infection in the milk glands.
7. Genetic: Carrying the faulty gene is one of the main reasons why many women end up literally inheriting breast cancer. This can usually be tested with a mammography, especially if one has a history of breast cancer in the family. Yet, one must remember that it is not advisable to take this test too many times as it puts you at risk of contracting breast cancer even if you do not have it, when there is repeated exposure.
First, the doctor might perform certain tests to diagnose and determine the problem. Tests like an ultrasound, MRI or even a mammogram might be used. Depending on what the diagnoses is, the doctor might even want to perform a biopsy. In case breast cancer is diagnosed, there are certain treatments that are available. These include:
- Surgery: The cancerous tissue is removed from the breast or at times when the tissue is too big, the entire breast might have to be removed.
- Chemotherapy: Chemotherapy is a medication that uses a method to send fluids that tend to kill the cancerous cells or prevent them from growing. It is a three to four hour long session at times.
- Radiation: High beam x-rays are used in order to target and destroy the cancer cells present in the breasts.
- Hormonal therapy: In this treatment, the hormones that fuel the growth of cancerous cells are blocked either through medications or surgically. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
What are the alternatives to avoid surgery for my brother aged 47 identified with Listhesis with foot drop and disc extrusion. In fact I had disc bulge (L3 L4 L5) at the age of 41 in 2013 and took oil massage in Kerala for 15 days and I am doing good now.
Sir I have slip disk problem in l4 l5 Vert disk and pain in lower spine and pain goes to leg randomly both legs. This is from last 6 months What is easiest way to solve this problem.
The womb or the uterus is a muscular structure that is fixed in its place by the ligaments and the pelvic muscles. If these ligaments or muscles become weak or stretch, they no longer will be capable of holding the uterus, resulting in a prolapse. Uterine prolapse happens when the uterine slips or sags from its usual position into the birth canal or vagina. The main indications of uterine prolapse are recurrent bladder infections, constipation, a tug at the pelvic area, the cervix or uterus protruding out of the vagina, problems during sexual intercourse, increased discharge and vaginal bleeding.
What causes it?
1. Age is the most important reason for this condition to manifest itself.
2. A dip in the estrogen level as this hormone keeps the pelvic muscles strong.
3. Damage to the pelvic tissues and muscles due to pregnancy or during childbirth can also contribute to this condition.
4. A woman who has undergone multiple vaginal births is at an increased risk of this condition.
5. Any physical activity that exerts pressure on the pelvic muscles can also result in this disorder.
6. Chronic constipation and obesity, over time, can lead to this disorder.
How it can be treated?
1. Nonsurgical methods:
- Shedding the extra kilos helps reduce stress from the pelvic structures. This helps to avert this disorder.
- Avoid lifting heavy objects throughout the course of the treatment.
- Pelvic floor exercises or Kegel exercises help build up the vaginal muscles.
- Estrogen replacement therapy or Hormone Replacement Therapy can help relieve the symptoms of this disease.
- Wearing a pessary (an instrument that is placed into the vagina and fits under the cervix) helps to push up and stabilize the cervix and the uterus.
2. Surgical treatments:
- Uterine suspension- In this case, the surgeon inserts the uterus back into its former position by reattaching the pelvic ligaments by the use of surgical techniques.
- Hysterectomy- Here, the surgeon removes either the whole or just a part of the womb.
Flattening of thoracic curvature ,to some extent .diminution of disc spaces with small osteophytes formation at the adjacent vertebral margins at T4>T8. No other obvious abnormality IMPRESSION - (Early/min) spondylitis changes -Mid-thoracic spine This is my x ray report please tell me is that a major problem or it can be heal with medicine and exercise and what r the reason for this. Please tell.
Q1. What exactly is Laparoscopy?
Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.
Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?
Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.
Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?
Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.
Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?
Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.
Q5. Will there be much pain or discomfort after Laparoscopic Surgery?
There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.
Q6. When can I be discharged from hospital?
Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.
Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?
Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.
जिगर शरीर में सबसे बड़ा ग्रंथियों वाला अंग है और शरीर को विषाक्त पदार्थों और हानिकारक पदार्थों से मुक्त रखने के लिए विभिन्न महत्वपूर्ण कार्य करता है। पेट के दाहिने ऊपरी चतुर्भुज मंर स्थित है, पसलियों के ठीक नीचे। लिवर पित्त के उत्पादन के लिए जिम्मेदार है, जो एक पदार्थ है जो आपको वसा, विटामिन, और अन्य पोषक तत्वों को पचाने में मदद करता है। यह ग्लूकोज जैसे पोषक तत्वों को भी स्टोर करता है और दवाओं और विषाक्त पदार्थों को तोड़ता है।
लिवर कैंसर, जिसे हेपेटिक कैंसर भी कहा जाता है, एक कैंसर होता है जो लिवर में शुरू होता है। जब कैंसर लिवर में विकसित होता है, तो यह लिवर कोशिकाओं को नष्ट कर देता है और सामान्य रूप से कार्य करने के लिए लिवर की क्षमता में दखल देता है। लिवर कैंसर के दो प्रकार होते हैं। प्राथमिक लिवर कैंसर, जो लिवर की कोशिकाओं में शुरू होता है। जबकि, कैंसर जो कि कहीं और से शुरू होता है और अंततः जिगर तक पहुंच जाता है, उन्हें जिगर मेटास्टेसिस या द्वितीयक लिवर कैंसर कहा जाता है।
प्राथमिक लिवर कैंसर के विभिन्न प्रकार
विभिन्न प्रकार के प्राथमिक लिवर कैंसर लिवर के विभिन्न कोशिकाओं से उत्पन्न होते हैं। प्राथमिक लिवर कैंसर लिवर में एक गांठ के रूप में, या एक ही समय में लिवर के भीतर कई स्थानों में शुरू हो सकता है।
1. हेपैटोसेलुलर हेपैटोसेलुलर:
हेपेटोसेल्यूलर कार्सिनोमा (एच.सी.सी), जिसे हेपेटामा भी कहा जाता है, सबसे सामान्य प्रकार का लिवर कैंसर है। एचसीसी मुख्य प्रकार के लिवर कोशिकाओं में शुरू होता है, जिसे हेपोटोसेल्यूलर कोशिका कहा जाता है। एचसीसी के अधिकांश मामले हेपेटाइटिस बी या सी, या शराब के कारण जिगर के सिरोसिस के संक्रमण का नतीजा है।
2. फाइब्रोलैमेलर एचसीसी:
फाइब्रोलामेरेलर एचसीसी एक रेअर प्रकार का एचसीसी है, जो आम तौर पर अन्य प्रकार के लिवर कैंसर की तुलना में उपचार के लिए अधिक संवेदनशील होता है।
कोलेंजियोकार्सिनोमा, जिसे आमतौर पर पित्त नली के कैंसर के रूप में जाना जाता है, लिवर में छोटे, ट्यूब जैसे पित्त नलिकाओं में विकसित होता है। पाचन में मदद करने के लिए, ये नलिकाएं पित्ताशय में पित्त को ले जाने के लिए जिम्मेदार हैं। जब कैंसर लिवर के अंदर नलिकाएं के खंड में शुरू होता है, तो इसे इंट्राहेपेटिक पित्त नलिका कैंसर कहा जाता है। यद्यपि, जब लिवर के बाहर नलिकाओं के अनुभाग में कैंसर शुरू होता है, तो एक्स्ट्राहेपाटिक पित्त वाहिका कैंसर कहलाता है।
एंजियोनेसकोमा लिवर कैंसर का एक रेअर प्रकार है जो लिवर के रक्त वाहिकाओं से शुरू होता है। इस प्रकार का कैंसर बहुत तेज़ी से प्रगति करता है, इसलिए यह आमतौर पर एक और अधिक उन्नत चरण में डिटेक्ट किया जाता है।
हेपोटोब्लास्टोमा एक अत्यंत असामान्य प्रकार का लिवर कैंसर है।
लिवर कैंसर के लक्षण
ज्यादातर लोगों के प्राथमिक जिगर कैंसर के शुरुआती चरणों में लक्षण नहीं होते। जिसके परिणामस्वरूप, लिवर कैंसर बहुत देर से डिटेक्ट किया जाता है। लिवर कैंसर के लक्षणों में शामिल हैं:
- भूख में कमी
- वजन घटना
- एबडोमीनल पेन
- मतली और उल्टी
- सामान्य खुजली
- हेपटेमेगाली (बढ़े हुए जिगर)
- बढ़े हुए स्प्लीन
चूंकि लिवर कैंसर के लिए कोई व्यापक रूप से अनुशंसित नियमित स्क्रीनिंग टेस्ट नहीं हैं, इसलिये बीमारी के परिवार के या अन्य जोखिम कारकों के इतिहास वाले लोगों को उनके डॉक्टर से बात करनी चाहिए ताकि वे अपने जोखिम को मॉनिटर करने या कम करने के लिए सही कदम उठा सकें।
लिवर कैंसर के जोखिम कारक
प्राथमिक लिवर कैंसर के खतरे को बढ़ाने वाले कारकों में शामिल हैं:
- उपचय स्टेरॉयड्स
- कम प्रतिरक्षा और मोटापा
Uterine fibroids, also known as leiomyoma or myoma, are benign growths on the uterus, occurring mostly during the years of childbearing. Few of the common symptoms of fibroids are leg pain or backache, constipation, difficulty in emptying the bladder, frequent urination, pain or pressure in the pelvic region, menstrual periods stretching over a week and excessive menstrual bleeding.
Certain genetic changes of the uterus which are different from the ones normally present in the muscle cells of the uterus can cause this disorder.
Substances which help the body maintain its tissues trigger fibroid growth as well.
Family history, excessive consumption of alcohol and red meat while going low on foods such as dairy products, fruits, green vegetables and vitamin D, obesity, usage of birth control pills and early onset of the menstruation cycle are other factors that may escalate the risks of one suffering from fibroids.
Be careful and take a closer look: Fibroids are fundamentally non-cancerous and they hardly interfere with pregnancy. Often, they do not exhibit notable symptoms and are prone to shrinkage after menopause. Hence giving them and yourself some time might be the best option.
Medications generally aim at the hormones controlling the menstrual cycle and treating symptoms such as pelvic pressure and excessive menstrual bleeding. However, they do not treat fibroids completely but work towards contracting them. They include-
Gonadotropin-releasing hormone (Gn-RH) agonists to block estrogen and progesterone production
Progestin-releasing intrauterine device (IUD) to alleviate severe bleeding caused due to fibroids
Tranexamic acid to ease excessive menstrual periods
Progestins or oral contraceptives to regulate menstrual bleeding
Nonsteroidal anti-inflammatory drugs (NSAIDs) to ease pain associated with fibroids
Surgeries to Treat Fibroids:
Depending on symptoms and whether medical therapy has failed, the patient may have to undergo surgery. The following surgical procedures may be considered:
Hysterectomy: removing the uterus. This is only considered if the fibroids are very large, or if the patient is bleeding too much. Hysterectomies are sometimes an option to prevent fibroids coming back.
Endometrial ablation: removing the lining of the uterus. This procedure may be used if the patient's fibroids are near the inner surface of the uterus; it is considered an effective alternative to a hysterectomy.
UAE (Uterine artery embolization): this treatment cuts off the fibroid's blood supply, effectively shrinking the fibroid.
Magnetic-resonance-guided focused ultrasound surgery: an MRI scan locates the fibroids, and sound waves are used to shrink the fibroids.