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Dr. Gyaneesh Aggarwal

Radiologist, Delhi

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Dr. Gyaneesh Aggarwal Radiologist, Delhi
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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. Gyaneesh Aggarwal
Dr. Gyaneesh Aggarwal is one of the best Radiologists in Saket, Delhi. You can meet Dr. Gyaneesh Aggarwal personally at Max Super Specialty Hospital-Saket in Saket, Delhi. Book an appointment online with Dr. Gyaneesh Aggarwal on Lybrate.com.

Lybrate.com has top trusted Radiologists from across India. You will find Radiologists with more than 43 years of experience on Lybrate.com. You can find Radiologists online in Delhi 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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#2, Press Enclave Road, Saket. Landmark: Near Malviya Nagar Metro Station & Hauz Rani Bus Stop, Select City Walk Mall, DelhiDelhi Get Directions
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I am 40 year old women. Unable to walk without support. MRI report shows multiple disc degeneration. Surgeon said, this is not the cause of walking problem. Physiotherapy was started. Is this serious? Can you please suggest me. Is this curable?

DM - Neurology, Fellowship in Stroke Neurology, MD - General Medicine, MBBS Bachelor of Medicine and Bachelor of Surgery
Neurologist, Kolkata
Dear lybrate-user, Walking is final outcome of a coordinated action of multiple components of our body’s neuroaxis. They have their individual contributions namely of muscles, nerves, different tracts of the spinal cord and different areas of the brain including motor, sensory and balance areas.In short, we need to examine you throughly to localize the exact area of the neuroaxis involvement. Focus investigations according ly and provide a definitive management.
3 people found this helpful
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Physiotherapy - 5 Ways It Can Help Post Fracture!

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
Physiotherapy - 5 Ways It Can Help Post Fracture!

A fracture requires quick and careful medical attention to ensure proper healing and alignment of the bone. Most fractures usually recover within six weeks but that is only half the problem. A lot of other tissues get damaged in the process when there is enough stress placed in the body to fracture a bone. Additionally, when you are unable to move that bone, you will have joint stiffness and significant muscle weakness.

After a fracture, physiotherapy might be recommended to guarantee that you come back to your ideal capacity. You might have to go for regular appointments to your physiotherapist in order to achieve full recovery. Usually, your physiotherapist will try to prevent your post-fracture stiffness in the nearby joints and muscles after the initial six weeks while you are recovering from your fracture. After six weeks or later, if x-rays show that the bone has not been fully healed, your physiotherapist can take a shot at recovering full movement of the joints and muscles near the affected area.

Here are five ways in which physiotherapy helps heal post-fracture:

  1. Physiotherapy after a fracture can help you enhance your muscle movement. In case you have fractured your leg, your physiotherapist can help you improve your walk and help you decide whether you need to take the support of a walking stick, crutches or a cane. In case you have broken an arm or shoulder, exercises focused on reaching and grasping are included.
  2. Modalities might be used to help with the pain and swelling. Your physiotherapist may choose to use ice, heat or whirlpool baths.
  3. Electrical stimulation can also be used to improve your muscle movement. You need to keep in mind that while inactive treatments like electrical stimulation or ultrasound might be used, you also need to keep your muscles physically active to better your movement and strengthen your bones.
  4. If you have had surgery to join the fractured bone, you may have surgical scar tissue. Scar massage can decrease scar attachments and increase movement around the scar.
  5. Exercise to improve the scope of movement and strength can also be started. Particular focus points need to be treated in the joints around the fractured area. If you have fractured a bone close to your elbow, exercises need to be included for your elbow, wrist, and shoulder. Moreover, a fracture in the shin needs to include exercises for the knee, lower leg, and hip. Exercise can guarantee that your bone can endure the load during daily routine work. Make sure to consult with your physiotherapist to learn the correct exercises for your condition.

A fracture can be very painful and might lead to a disability or problem in movement. Depending on the seriousness of the damage, the loss may be temporary or permanent. Physiotherapy can help you come back to your optimum function as quickly as possible. In case you have a concern or query you can always consult an expert & get answers to your questions!

3666 people found this helpful

Due to night fall my nerve system is very week and now I am suffering from disk in my back please suggest me some medicine fr improvement of nerves.

BHMS
Homeopath, Chennai
Nocturnal Emissionis defined as the involuntary ejaculation of semen during a night without sexual intercourse allied with sexual dreams. Furthermore, nocturnal emission is commonly known as "Nightfall" or "Wet dream". Nightfall or nocturnal emissions are simply a reaction of reproductive system to chuck out the excessively produced fluid in it and male’s reproductive organ ejaculates this excess fluid when he is sleeping. Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat night emission but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat night emission that can be selected on the basis of cause, sensations and modalities of the complaints. A homeopathic constitutional treatment will give you a permanent cure naturally You can easily take an online consultation for further treatment guidance and permanent cure without any side effects
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What is The Purpose Behind Brain Surgery?

MBBS, Cerebrovascular and Micro neurosurgery fellowship, MS - General Surgery, MCh Neurosurgery
Neurosurgeon, Jaipur
What is The Purpose Behind Brain Surgery?

The most powerful and amazing organ in our body is the brain. It differs from many other organs of our body not only by its shape, but also by its special type of cell called neurons. When these cells gets affected or dead it can never be reverted or regenerated which is the most exclusive nature found only in brain cells. The cells in other parts of our body has the capacity to regenerate (can be replaced or new one can be grown or produced), but brain cells are exception. Hence any damage to the brain, injury or trauma is really a crucial thing to be considered with utmost care.

Brain surgeries really need skill, proper training, confidence and intelligence to perform this highly complicated and risky surgery.

Purpose:
Brain surgeries are performed to:

  1. Remove the brain tissues that are grown abnormally
  2. Aneurysm is clipped to prevent flow of blood cliff off an aneurysm
  3. Biopsy purpose or to remove the tumour
  4. Make a nerve free
  5. Drain the abnormal blood or clot collection or to drain any excessive fluid collection caused by infection.
  6. To implant artificial electronic device as a treatment for conditions like Parkinson's disease

Types:

  1. Biopsy: A part of brain tissue is removed for the brain or whole tumour is removed.
  2. Craniotomy: The skull bone is opened to remove tumour, an aneurysm and drain fluid or blood from infection.
  3. Minimally invasive endonasal endoscopic surgery: Endoscopic devices are inserted through the nose to remove the lesions or tumour.
  4. Minimally invasive neuroendoscopy: Similar to endonasal surgery but small incision is made.

Risks:

  1. Anaesthesia risks like breathing difficulty, allergic reaction to medications, excessive bleeding or clots and infection.
  2. Risk related to the brain surgeries are seizures, coma, swelling of brain, infection to brain or meanings, surgical wound infection that intrudes to the brain structures, abnormal clot formation and bleeding.
  3. General risks include muscle weakness, disturbances in memory, speech, vision, coordination, balance and other functions that are controlled by the brain.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2124 people found this helpful

Please suggest. What should be done for slip disk problem along with allopathic treatment?

MBBS, D'Ortho, DNB (Orthopedics)
Orthopedist, Mumbai
Hello lybrate-user slip disc common at this age, as you already taking medication would suggest to start physiotherapy core stabilising exercises.
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Breast Cancer - Signs That Help You Spot It!

MBBS, DNB - Surgery, Fellowship in Breast Surgical Oncology
Oncologist, Gurgaon
Breast Cancer - Signs That Help You Spot It!

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:

  1. A persistent lump or thickening in the breast or in the axilla. 
  2. A change in the size or shape of the breast. 
  3. A change in the colour or appearance of the skin of the breast such as redness, puckering or dimpling. 
  4. Bloody discharge from the nipple. 
  5. 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.

Risk Factors 
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:

  1. The risk increases with age; most cases of breast cancer develop after the age of 50 
  2. Genetic alterations in certain genes such as BRCA1 and BRCA2 
  3. Family history of breast cancer 
  4. Being overweight 
  5. Early menarche (onset of menstruation before the age of 12) 
  6. Late menopause (after the age of 55) 
  7. Never had children 
  8. Late childbearing 
  9. No breast feeding 
  10. Excessive consumption of alcohol 
  11. 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:

  1. 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.
  2. Clinical Breast Examination: Get a breast specialist to examine your breast once a year if you are 40 years and above.
  3. 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

  1. Non-Invasive Breast cancer: These are confined to the ducts within the breasts. They are known as Ductal carcinoma in-situ (DCIS).
  2. 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 options 
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. If you wish to discuss about any specific problem, you can consult an oncologist.

1932 people found this helpful

Herniated Disc - Effects And Diagnosis

M Ch. Ortho, MS - Orthopaedics, MBBS
Orthopedist, Delhi
Herniated Disc - Effects And Diagnosis

A Herniated disc also known as a slip disc or prolapsed disc and it refers to the problem where one of the discs located in between the bones of the vertebrae(backbone) gets damaged and stacks itself upon the nerves. The tender inner portion of the disc gets protruded over the outer ring. Herniated disc causes severe neck pain and back pain. It occurs when the outer ring gets weak and tears down. The most common symptoms include pain and numbness, especially on one side of the body. The pain extends down to the arms and legs. It worsens during nighttime. The muscles become weak. Overweight people are likely to have this disease, as the discs carry extra weight. Old people are vulnerable to a slip disc.

Effects of Herniated Disc:

  1. An untreated case of Herniated disc may cause permanent damage to the nerves.
  2. In certain cases, a Herniated disc is capable of cutting off nerve impulses to the "caudal equine"nerves, present in the lower back and legs. This leads to loss of bladder control or bowel control.
  3. Saddle anaesthesia is another long-term effect. Nerves are compressed by the slip disc, causing loss of sensation in the inner portions of your thighs, the back of your legs and surrounding the rectum region.
  4. Symptoms may improve or worsen.

Diagnosis of Herniated Disc:
Treatment or diagnosis of Herniated disc or slipped disc can be either conservative or surgical in nature. The nature of treatment is determined according to your discomfort level and the kind of pain you are experiencing, or how much the disc has slipped out.

  1. The pain caused by Herniated disc can be relieved by undertaking an exercise schedule, which includes stretching and strengthening the spine and its surrounding muscles.
  2. A physiotherapist should be appointed for recommending the types of exercises.
  3. Taking pain relievers also soothes the pain.
  4. Stronger medicines prescribed by doctors include-muscle relaxants, narcotics to deal with the pain, medicines for nerve pain such as "gabapentin"  or "duloxetine".
  5. In case of the symptoms not subsiding within a span of six weeks, a surgery may be recommended by your doctor. The surgeon may have to remove the damaged part of the disc. This surgery is called a microdiscectomy. If you wish to discuss about any specific problem, you can consult an orthopedist.
2585 people found this helpful

Cervical Lordosis Straightening Treatment

MPT, BPT
Physiotherapist, Noida
Cervical Lordosis Straightening Treatment

Most commonly known as a military neck a straight or forward curve of the neck is abnormal and may cause an unkind progression of symptoms leading ultimately to cervical disk degeneration.

Reversal of cervical lordosis explained

The anatomy of the neck features a lordotic curvature in its typical and healthy state. This means that the cervical region has a gentle curvature with the open end of that curve facing the rear of the body. The base and top of the curve will be further posterior than the mid point, which will be further anterior.

When the lordosis is straightened, the neck becomes more upright and linear. This is more common than the next progression of atypical curvature, which is the subject of this article.

Actual reversal of curvature means that part or all of the cervical spine develops a kyphotic profile, with the open end of the curve facing anteriorly. Usually, this reversal is extremely mild, but is still very abnormal. What we now see is the middle of the curve being positioned posterior to the top and bottom.

In essence, picture the letter c and now turn it backwards: This is the shape of a reversed cervical lordosis.

Reversal of cervical lordosis causes

The spinal curvature in the neck is constantly in flux to some degree.

Congenital conditions and developmental conditions can have lasting effects on the natural degree of curvature typically demonstrated from patient to patient. These circumstances may be explainable due to injury or degeneration, or may be idiopathic:

Scoliosis can affect the normal lordotic curvature in the neck.

Cervical spondylolisthesis is a major source of reversed lordotic curvature.

Severe disc pathologies can facilitate a gradual loss or reversal of cervical lordosis.

Vertebral irregularities, such as wedging, can definitely contribute to lordotic alteration.

Traumatic injury, including vertebral fracture, can create the ideal circumstances for a reversal of lordosis to take place.

Severe neck muscle spasms can actually reshape the spinal curves, although these are usually temporary expressions and not actual structural conditions.

Effects of reversal of cervical lordosis
The neck is designed to curve in order to balance the spine, absorb stress, distribute force and provide proper movement of the head. When this curvature is diminished or reversed, symptoms may result, although this is not an inherent part of any altered lordotic condition.

Patients may experience stiffness and tension in the neck. Pain may be present and may even be severe in rare cases. Neurological dysfunction is possible in extreme cases, since the neuroforamen might not align properly, thereby causing a cervical pinched nerve.

In the worst circumstances, central spinal stenosis in the neck might affect the viability of the spinal cord, possible enacting the most dire of symptoms throughout the body.

Patients will also be more prone to injury, since the normal shock absorption qualities of the typical curvature have been lost.

While all these effects are certainly possible, they are not usual. In fact, a great majority of patients have minor symptoms or even no symptoms at all from mild reversed lordotic curvatures.

The pathology leading to a neck curve reversal (cervical kyphosis shown below right) may be inspired by a multitude of conditions as follows:
Post whiplash
Post head injury
Stomach sleeping
Poor sitting/working postures
Congenital spinal curvatures
Osteoporosis
Degenerative cervical discs (a form of osteoarthritis that can either be the cause of or the result of a cervical kyphosis)
Compression fracture of vertebral body
Infection of the cervical spine

Anatomy: straight vs. Curved

I've always heard that it was good to stand up straight.

stand upright, stick your chest out and hold your shoulders back! otherwise you're going get widows hump.

Are these expressions as familiar to you as they are to me? one might think that having a curved neck goes against what we heard from parents and teachers as we were growing up, but the reality is that there is a little bit a truth in both. Maintaining good posture throughout our lives is crucial to both the health of our spine and vital organs. On the contrary, a special type of curve called a lordosis is a good thing, both in the neck and lower back.

When we look at a person from the back their spine should be truly straight, so that the left and right sides of one's body is symmetrical. However, when we view a person from the side, the front and back of their body is different and this is reflected in a coinciding curvature of the spine. Both the lower back and neck are hollowed out (concave) and the mid or thoracic spine is protrudes (convex). Thus there is an alternation of curves functioning to provide stability, shock absorption and aid in propulsion. A straight spine would be very stiff and not flexible. Imagine the plight of a pole vaulter with an inflexible pole.

Nature's design of our spine and rib cage facilitates breathing and offers protective and supportive framework for vital organs. Spinal disks are shock absorbers and because they are in the front of the spine, lordotic curvatures keep them from having to bear weight. Kyphosis or loss of such curvatures bears weight upon the disks, leading to their ultimate degeneration. This process of deterioration is a form of osteoarthritis and in the spine is known as degenerative spondylosis.

Diagnosis
Although most physiotherapists or conservative orthopedists can recognize a cervical curve reversal upon viewing the patient's posture, a definitive diagnosis may be obtained via a standing lateral (side view) x-ray of the neck. Cause can often be determined by corroborating a comprehensive history, a thorough examination, x-rays and questions about sleep, work and lifestyle.

In my professional career I found that the majority of young adults presenting with cervical kyphosis either had a whiplash or were stomach sleepers from an early age. For desk jockeys 40-60 years of age, many hours of sitting with their head flexed forward almost dictates the fate of developing kyphosis. In prior years I considered cervical kyphosis a job hazard for the careers of accountants, attorneys and often teachers because of years spent with their head in a book or paperwork. However, the digital age offers some relief in that respect. A well-planned, ergonomically-friendly office can do wonders for protecting the spine in the sedentary worker.

Treatment for cervical curve reversal (kyphosis)
During my chiropractic practice I had the opportunity to note a good percentage of correction toward a more normal lordosis (noted on x-ray) for 70% of patients under my care. This was almost always consistent with those patients that followed all recommendations and were model participants in their own care. Here is the recommended treat plan:

Spinal manipulation of stiff and fixated spinal segments by a qualified physio
Flexibility exercises for flexion and extension of cervical spine
Resistance exercises for flexors and extensors of the neck
Learn the Alexander technique for maintaining good posture (hint: the basic philosophy is to sit and stand like you were hanging by a string from the vertex of your skull. Liken it to a puppet on a string).
Elimination of stomach sleeping
Avoid standing on your head, although some yoga postures may be beneficial
Use of orthopedic neck pillow while sleeping.

5 people found this helpful

My MRI INDICATE 1. Lumbosacral transitional Vertebra with complete socialization of L5 2. Disc desiccation with diffuse disc bulge and broad based posterior central disc protrusion at L4-L5 level causing ventral thecal sac indentation and significant compromise of bilateral neural forminal (right>left). Mild ligamentum flavum thickening is also seen at this level with maintained spinal canal dimensions. 3. Cervical spondylitis changes with disc osteophyte complexes at C4-C5 and C5-C6 levels. Broad based left paracentral disc protrusion at C4-C5 level causing ventral thecal sac indentation and moderate compromise of left sided neural forminal. 4. Mild disc bulge at d5-d6 (screening of rest of spine revealed) I am confused. Dr. Said physio will fix it. I read too many damages. Please guide and suggest sustainable solutions. I am willing to take prolonged treatment. What does this report mean?

Radiologist, Delhi
Hello Mr. lybrate-user. The report says that there is significant compression of nerves at L4-5, C4-5 and C5-6 vertebral levels. You need to wear lumbar hot belt on regular basis, have to take medicines, you have to undergo physiotherapy and take precautions like no forward bending, no lifting weight, using ortho matress to keep spine straight. I would advise you to meet an orthopedician and discuss your symptoms in detail. Clinical examination and some further tests are required before prescribing medicines.
3 people found this helpful
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Treatment For Uterine Fibroids In Homeopathy!

MD - Homeopathy, BHMS
Homeopath, Indore
Treatment For Uterine Fibroids In Homeopathy!

Uterine fibroids are the most frequently occurring tumors in the female reproductive system. These are non-cancerous, grow in or on a female’s uterus, and is curable. Many women above the age of 40 suffers from Uterine Fibroids. These Fibroids can grow as a single tumour or can grow in multiple numbers in the Uterus. The size of these fibroids may vary from a tiny spec to as large as a grape. In very rare cases, the fibroid becomes excessively large. However, such an occurrence is unusual. Homeopathy has several treatments to cure Uterine Fibroids:

  1. Uterine Fibroids- These tumors are benign (non-cancerous) in nature. The growth of the fibroids raises from the uterine muscle layers. Fibroids occur in women who fall under the standard age group of conceiving a child. Uterine Fibroids originate from uterus muscle cells that start growing unusually and gradually and give rise to the formation of a benign tumor.
  2. Uterine Fibroid and Homeopathy- In the treatment of fibroids, many homeopathic remedies are used. All of these homeopathic treatments are proven and valid. Fibroids are treated accordingly after the treatments condition matches with the patient’s symptoms of the fibroid. Once the proper matching is found then that particular homeopathic treatment is conducted to cure the fibroid of the patient. Following are a few effective homeopathic medicines that are used to treat the Uterine Fibroids.
  3. Phosphorus- When there is profuse and prolonged bleeding along with uterine fibroids, one of the best homeopathic medicines is Phosphorus.
  4. Calcarea Carb- A few women with uterine fibroids may experience sweating, anxiety, and/or a sensation of coldness. For such women, Calcarea Carb is one of the best homeopathic medicine. A Calcarea Carb patient is usually obese and has a tendency to sweats a lot. The patient might have a pungent odor, and the menses may last for too long. There are can also be itching and burning sensations in the genitals, prior to menses.
  5. Thlaspi Bursa Pastoris- This Natural substance is yet another Homeopathic medicine that works wonders in curing Uterine Fibroids. In some Fibroid cases where there is profuse and heavy bleeding during menses, this medicine helps extensively.
  6. Sepia- When the uterine fibroids come with indifference, irritability, and bearing down pains, Sepia is a good homeopathic treatment to choose. There is a sharp pain in the lower abdomen region. The patient feels as if there will be an outflow of everything through her vagina. To block the jutting out of the contents, the patient might feel the urge to sit cross-legged. The periods are too late and scanty. During coition, there may be a pain in the vagina as well.

Women with fibroids may experience heavy menstrual bleeding, pelvic pain, and such symptoms. However, the fibroids being non-cancerous are not to be worried, and they can be cured with the help of the proper homeopathic treatment. If you wish to discuss about any specific problem, you can consult a Homeopath.

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