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Dr. J.S Josan

MBBS, MD - Radio Diagnosis

Radiologist, Delhi

19 Years Experience
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Dr. J.S Josan MBBS, MD - Radio Diagnosis Radiologist, Delhi
19 Years Experience
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Personal Statement

To provide my patients with the highest quality dental care, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies....more
To provide my patients with the highest quality dental care, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies.
More about Dr. J.S Josan
Dr. J.S Josan is one of the best Radiologists in Rajouri Garden, Delhi. He has over 19 years of experience as a Radiologist. He is a MBBS, MD - Radio Diagnosis . He is currently associated with Josan Diagnostic in Rajouri Garden, Delhi. Book an appointment online with Dr. J.S Josan on Lybrate.com.

Lybrate.com has a number of highly qualified Radiologists in India. You will find Radiologists with more than 31 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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Specialty
Education
MBBS - G.S.V.M. Medical College,Kanpur - 1999
MD - Radio Diagnosis - G.S.V.M. Medical College,Kanpur - 2003
Languages spoken
English
Hindi

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Mehta Chowk, Gurudwara, Shivaji Enclave, Rajouri GardenDelhi Get Directions
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How Herniated Disk Effects Your Health?

IFAANS, DNB (Neurosurgery), MBBS
Neurosurgeon, Ghaziabad
How Herniated Disk Effects Your Health?

The symptoms caused due to herniated disc can be very severe and can also cause a bit of disability. The disc of the spine is like a cushion and separates the set of bones on the backside. The discs are shock absorbers of the spine and are mainly composed of 2 parts, a soft jelly centre called the nucleus and a tough outer covering called the annulus.

Effects of Herniated Disk
A herniated or cracked disc is a severe condition and it seems to happen most commonly in the lower back.  It happens when a fraction of the soft centre gets pushed through the destabilized area due to degeneration, trauma or by putting pressure on the spinal cord. 

Nerves are located precisely at the back of every disc and are responsible for controlling everything in our body. While a disc gets herniated, the external covering of the disc tears and creates a bulge. The soft jelly gets shifted from the centre of the disk to the region where the damage has occurred on the disc. Most commonly, the bulge occurs in areas where the nerve is located and it causes strain on the affected nerve. It has been observed that individuals do not feel any painful sensations even if their disc gets damaged.

When is Surgery Recommended for Herniated Disc?
Surgery for herniated disc is recommended only after options like  pain relievers, exercise and non-steroid anti-inflammatory drugs do not work. If the pain persists even after these options, then it becomes important to go for surgery. There are certain risks involved in this surgery like infection, bleeding or nerve damage. 

There are chances that the disc may get ruptured again if it is not removed. If you are a patient suffering from degenerative disc disease, then there are chances that problem occurs in other discs. It is very important that a patient maintains healthy weight to prevent any further complications.

The main factor that increases the risk of herniated disc is excess body weight, which causes a lot of stress on the lower back. A few people become heir to a tendency of developing this condition. Even individuals with physically demanding jobs are prone to this condition. 

Surgery for herniated disc is recommended only after options like pain relievers, exercise and non-steroid anti-inflammatory drugs do not work. If the pain persists even after these options, then, needs to be removed as steroid injections is not advisable per se.

Activities like bending sideways, pushing, twisting, repetitive lifting can increase the risk of a herniated disk. At times, emergency surgery is also required to avoid paralysis in a patient. In case you have a concern or query you can always consult an expert & get answers to your questions!

1 person found this helpful

Hello doctor. I am I 32 years female and I have slip disc problem from last two years .I have 2 years baby vd normal delivery. I am not able to sleep properly because when I sleep suddenly I awake 2-3 times at night nd I try to sleep again but I sleep after 30 to 40 min. Now I am gaining fat and weight also. I take proper meal and I don't take more junk food also. Please tell me what to do? My all checkup report are normal & thyroid also.

BAMS, MD (Panchkarma)
Ayurveda, Mumbai
Hello doctor. I am I 32 years female and I have slip disc problem from last two years .I have 2 years baby vd normal ...
Hello lybrate user, thanks for writing. If you want fast, permanent weight loss, you can try our research oriented holistic medicines for assures results. You can lose up to 10 kg weight per month, without crush dieting, with out side effect, without gym, without surgery. Tips for you: 1. Eat plenty vegetable and fruits. 2. Drink 9 glass of water per day. 3. Avoid dieting for weight loss. 4. Avoid oily thing. 5. Have 5to 6 servings of food per day. If you have any questions you can contact us by lybrate.
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Hi doctor. I have a severe backache as per Dr. Advice I have done mri. My mri report is as under kindly advise in matter degenerative lumber spondylitis are seen in the form of marginal osteophytes and multilevel disc dessication. 1. D12-l1 & l1-l2 discs show mild bulge, indenting anterior thecal sac without significant never root compression 2. L2-l3 disc reveals right paracentral disc extrusion, indenting anterior thecal sac and causing right lateral recess narrowing, impinging on right traversing l3 nerve root. 3. L3-l4 disc shows mild diffuse disc protrusion, indenting anterior thecal sac and causing bilateral mild neural foraminal narrowing, minimally abutting bilateraltraversing l4 nerve roots. 4. L4-l5 disc reveals mild diffuse disc protrusion, indenting anterior thecal sac and causing bilateral mild neural foraminal narrowing, minimally abutting right existing l4 nerve root-bilateral traversing l5 nerve roots. Nerve roots. Cord is seen ending at d11 vertebral level. Distal cord and conus appear normal. Both hip and si joints are normal. No pre / paravertebral, epidural soft tissue or haematoma is seen. Bilateral psoas and posterior paraspinous muscles are normal. Please advise for home exercise / medicine.?

Bachelor of Physiotherapist
Physiotherapist, Noida
Hi doctor. I have a severe backache as per Dr. Advice I have done mri. My mri report is as under kindly advise in mat...
Sir you should back strengthening and stretching exercise. It will relax and strengthen or back muscles. If you personally want to consult me Please consult privately.
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Cervical Lordosis Straightening Treatment

BPTh/BPT, MPTh/MPT
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.

4 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.

12 people found this helpful

When Should You Go For Brain Surgery?

MBBS, Cerebrovascular and Micro neurosurgery fellowship, MS - General Surgery, MCh Neurosurgery
Neurosurgeon, Jaipur
When Should You Go For Brain Surgery?

Brain surgery involves several medical procedures, which incorporate fixing issues with the brain, including changes in the tissues of the brain, cerebrospinal fluid and brain blood flow. Brain surgery is quite a complicated method of surgery and the type of surgery to be conducted depends on the underlying conditions.

Reasons for Brain Surgery:
Brain surgery is performed for the correction of physical brain abnormalities. These abnormalities could occur because of diseases, birth defects and injuries. A brain surgery is required when the following conditions arise in the brain:

  1. Abnormal blood vessels
  2. Aneurysm
  3. Bleeding
  4. Blood clots in the brain
  5. When the protective tissue or dura is damaged
  6. Epilepsy
  7. Due to nerve damage
  8. Parkinson's disease
  9. Any kind of pressure after an injury
  10. Abscesses
  11. Skull fractures
  12. In case of stroke and tumors

A surgery may not be required for all the above mentioned conditions, but in case of many, a brain surgery is very important as the conditions may worsen health problems.

Types of brain surgeries:

  1. Craniotomy: During this open brain surgery, an incision is made in the scalp, and a hole is created in the skull, near the area, which is being treated. After this process is complete, the hole or bone flap is secured in its place using plates or wires.
  2. Biopsy: This form of brain surgery helps in the removal of a small amount of brain tissues or tumors. After removal, the tissues or tumors are examined under a microscope. The creation of a small incision and a hole in the skull is indicated as a part of this process.
  3. Minimally invasive endonasal endoscopic surgery: This form of brain surgery enables the removal or lesions and tumors via the nose and sinuses. Private parts of the brain can be accessed without creating an incision. An endoscope is utilized in the process which is used to examine tumors all across the brain.
  4. Minimally Invasive neuroendoscopy: This process is similar to the minimally invasive endonasal endoscopic surgery. This method also involves the use of an endoscope for removal of brain tumors. Small, dime sized holes may be made in the skull to access some brain parts.

Risks:
Brain surgeries may be associated with several risks. They may be:

  1. Allergic reactions to anesthesia
  2. Bleeding
  3. Blood clot formations
  4. Swelling of the brain
  5. A state of coma
  6. Impairment in speech, coordination and vision.
  7. Problems in memory
  8. Strokes and seizures
  9. Infections in the brain

A brain surgery is a serious and very complex surgery. There are different kinds of brain surgeries, which are conducted depending on the condition and severity of the disease. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.

2009 people found this helpful

Breast Cancer - What's The Right Way Of Diagnosing It?

MBBS, DGO, DNB
Gynaecologist, Noida
Breast Cancer - What's The Right Way Of Diagnosing It?

Breast cancer is a form of cancer which develops from the breast tissue. Breast cancer is indicated by signs such as a lump in the breast, changes in breast shape, fluid flowing from the nipple, dimpling of skin, or the development of red scaly patches. Breast cancer is a fatal form of cancer in women and immediate diagnosis is required on observing the symptoms.

Diagnosis of breast cancer
Other than the regular breast screening, the diagnosis of breast cancer involves the following steps and methods:

  1. Seeing your general practitioner (GP): It is very important to visit your GP soon after noticing the symptoms of breast cancer. Your GP will examine you properly and in case your symptoms need more assessment, he/she will refer you to a breast cancer clinic.
  2. Mammogram and breast ultrasoundYou will be required to have a mammogram, as recommended by a specialist breast unit. This is an X-ray of the breasts. An ultrasound scan may also be required. Breast ultrasound should be undertaken only if you are less than 35 years of age. This is because, young women have denser breasts and a mammogram is not as effective as ultrasound in the diagnosis of breast cancer. In ultrasound, high frequency sound waves are used for obtaining an image of your breasts. It is observed to notice any abnormality or lumps. A breast ultrasound is also important for determining whether a lump is solid or contains liquid.
  3. Biopsy: In this diagnosis process, a sample of the tissue cells is taken from the breasts and tested under a microscope to find out if it is cancerous. A scan and needle test for the lymph nodes present in your armpit is also done to check whether they have also been affected. A biopsy is undertaken in several ways, depending upon the condition and severity. A needle aspiration biopsy is used for testing a sample of your breast cells without the removal of the tissues. This is the most common form of biopsy and it is also used for draining a small fluid-filled lump or benign cyst. During the process, you will be given a local anesthetic. Usually, a needle biopsy is carried out guided by an X-ray, ultrasound and an MRI scan as well. This helps in distinguishing it from non-invasive changes such as ductal carcinoma in situ.

Another form of biopsy used for the diagnosis of breast cancer is called vacuum assisted biopsy or mammotome biopsy. In this process, a needle gets attached to a suction tube, which helps in obtaining the sample and for clearing the bleeding.

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

3323 people found this helpful

Top 4 Symptoms Of Liver Cancer

MD - Oncology
Oncologist, Hubli-Dharwad
Top 4 Symptoms Of Liver Cancer

If you are concerned about liver cancer, you should know that most people do not experience signs and symptoms of the cancer in the early stages. Liver cancer is a form of cancer which occurs in the cells of the liver. There are various types of cancer which can develop in the liver. Hepatocellular carcinoma (HCC) is the most common liver cancer which begins in the hepatocyte, which is the main liver cell.

Symptoms-

Usually there are no specific primary stage symptoms of liver cancer. Some symptoms which may develop include the following:

  1. Unusual weight loss is observed

  2. Loss of appetite and developing food aversion

  3. Pain in the upper abdomen

  4. Nausea followed by vomiting

  5. General weakness with intense fatigue

  6. Swelling in the abdomen

  7. The skin may become yellow

  8. White and chalky stools are likely

Causes-

In most cases, the causes of liver cancer cannot be clearly determined. In some cases, the cause is known, such as chronic infection with the hepatitis virus, which may lead to liver cancer. Liver cancer occurs when the liver cells undergo changes or mutations in their DNA structure. DNA mutations lead to changes in instructions of chemical processes taking place in the body. The cells may grow out of control and develop into a cancerous tumour.

Risk Factors-

There are several factors which enhance the risk of liver cancer. They are as follows:

  1. Chronic infection with hepatitis B or hepatitis C increases the risk of liver cancer.

  2. A progressive and irreversible condition known as cirrhosis leads to scar tissue formation in the liver, increasing the risk of liver cancer.

  3. Certain inherited liver diseases such as Wilson’s disease and hemochromatosis also increase the chances of liver cancer.

  4. People with diabetes are also at a greater risk of having liver cancer.

  5. Non-alcoholic fatty liver disease (NAFLD), which is the accumulation of fat in the liver, also increases the chances of getting this condition.

  6. Excessive alcohol consumption is another factor which causes irreversible damage to the liver and the chances of getting liver cancer get boosted.

  7. Exposure to aflatoxins, which are poisons produced by molds growing on poorly stored crops, make you more likely to get liver cancer.

Several tests and procedures are carried out for the diagnosis of liver cancer. These include blood tests for diagnosing liver function problems, and imaging tests such as ultrasound, CT scan and MRI scan.

9 people found this helpful

Breast Cancer Screening - Ways It Can Be Done!

MBBS, MD - Obstetrics & Gynaecology
IVF Specialist, Delhi
Breast Cancer Screening - Ways It Can Be Done!

Breast cancer is usually genetic in nature and it may affect women whose mother or grandmother may have suffered from the disease. This disease may start from the inner portion of the milk duct, in which case it is called ductal carcinoma. In case the cancer initiated through the lobules, it is called lobular carcinoma. In order to find the existence of the disease on a timely basis, it is imperative to get regular screening done. This can also prevent the disease and its spread. Read on to find out more about symptoms and breast cancer screening methods.

Symptoms
There are many symptoms of breast cancer, which can point at the existence of the same. Therefore, it is imperative to be vigilant and take note of such changes and symptoms so that the disease may be tackled on time. Persistent and unexplained pain in and around the breasts is one of the major symptoms that one should not ignore. Also, dimpling and the formation of new lumps under the armpits are other changes that should be reported to the doctor for more advanced screening. Further, irritation and redness in the area which does not go away after the onset of periods and remains for many weeks, should be checked. Bleeding, swelling and pulling of the nipple area can also point at the existence of breast cancer.

How screeing can be done?

Physical examination
The doctor will, first of all, carry out a physical examination. This is due to the fact that breast cancer is not a mere existence of the lump. The various changes in the breasts as discussed above, especially dimpling of the breasts and pulling of the nipples, can point at the beginning of the disease, which must be tackled so as to prevent the full-fledged onset of the same. During this kind of clinical breast exam, the doctor will also show the patient how to conduct the test on her own every few weeks.

Mammogram
This is essentially an X-Ray of the breasts and is usually carried out for women who have been facing consistent symptoms or even for those who are going through menopause. This kind of a test should not be done too frequently as it can expose the patient to the risk of breast cancer, in case she does not already have the problem. This test is usually carried out with the help of a mammogram machine that will give a reading once the breasts are placed on the metal plates.

Breast MRI
Magnetic resonance imaging (MRI) test seeks to create pictures of the area of the body in question with the help of radio waves. This is usually conducted for those patients who already run a high risk of breast cancer due to a family history of the same. If you wish to discuss about any specific problem, you can consult an IVF Specialist.

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