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I have diagnosed with infiltrating ductal carcinoma, NOS, in right breast (in biopsy report. Please suggest me what is my treatment option.
A uterine cyst, also called as ovarian cyst, is the formation of a fluid-filled sac within the ovary of a woman. Uterine cysts may sometimes cause several physical symptoms. They can cause great pain and unpleasant sensations. Most cysts go away by themselves, but still sufficient measures should be taken to deal with the inconvenience caused by a uterine cyst. In severe cases, the cyst can damage the ovaries. Scar tissue is also likely to build up in such cysts to form an adhesion, which causes discomfort.
Uterine cysts can cause great damage to the sexual organs of a woman, and hence, it should never be ignored. Here are 5 ways to deal with uterine cysts:
Using Birth Control Pills: In case of recurrent uterine cysts, you can take oral contraceptives with the prescription of a doctor. This will prohibit ovulation, and the development of new cysts will be prevented. The risk of ovarian cancer is also reduced.
Laparoscopy: In case the cyst is small, a laparoscopy surgery can be conducted by a doctor. This will enable the surgical removal of the cyst. The process of laparoscopy involves making of a small incision around the navel region. A small instrument or device is inserted into the abdomen, which removes the cyst.
Laparotomy: Laparotomy is a surgical procedure of removing a large uterine cyst. This procedure is applied when a cyst becomes too large to be removed using laparoscopy. The procedure involves the removal of the cyst via an incision made in the abdomen. An immediate biopsy is conducted and in case the cyst is found out to be cancerous, a hysterectomy surgery is conducted, which removes the ovaries and uterus completely.
Herbal Tea: Moving from medical procedures to natural ways for dealing with uterine cysts, herbal tea is believed to be one of the best natural treatments for uterine cysts. Herbal tea helps in the breakdown of large cysts and the side effects of the cysts such as discomfort or pain are eased. Have a cup of herbal tea every day to get rid of uterine cysts.
Diet: Uterine cysts may develop due to an unhealthy diet. Modern food items contain synthetic and natural estrogens, which cause disruption in ovarian health. Consuming adulterated meat, where the animals are given hormones, and antibiotics may result in uterine cysts. Soy contains a great amount of estrogen, which leads to uterine cysts. All the food items which may lead to ovarian cysts should be avoided.
Uterine cysts are common in women and are caused due to several complications. You should not let uterine cysts develop as development increases severity.
A brain stroke can affect anyone at any point of time when the supply of blood to the brain is interrupted. It can threaten major physical functions and can prove to be fatally dangerous at times. The brain stem which is placed right above the spinal cord controls the breathing, heartbeat and levels of blood pressure. It is also in charge of controlling some elementary functions such as swallowing, hearing, speech and eye movements
What are the different types of strokes?
There are three main kinds of stroke: ischemic strokes, hemorrhagic strokes and transient ischemic attacks. The The most common type of brain stroke is the ischemic stroke is caused by narrowing or blocking of arteries to the brain, which prevents the proper supplyof of blood to the brain. Sometimes it so happens that the blood clot that has formed elsewhere in the body have travelled via the blood vessels and has been trapped in the blood vessel which provides blood to the brain. When the supply of blood to a part of the brain is hindered, the tissue in that area dies off owing to lack of oxygen. The other variant of brain stroke is termed as hemorrhagic stroke is caused when the blood vessels in and around the brain burstor or leak. Strokes need to be diagnosed and treated as quickly as possible in order to minimize brain damage.
What are the common symptoms of a brain stroke?
The symptoms of the brain stroke are largely dependent on the area of the brain that has been affected. It can interfere with normal functioning, such as breathing and talking and other functions which human beings can perform without thinking such as eye movements or swallowing. Since all the signals from the brain as well as other parts of the body traverse through the brain stem, the interruption of blood flow often leads to numbness or paralysis in different parts of the body.
Who is likely to have a stroke?
Anyone is at a risk of developing brain stroke although ageing is directly proportional to the risk of having a stroke. Not only that an individual with a family history of brain stroke or transient ischemic attack is at a higher risk of developing stroke. People who have aged over 65 accounts for about 33 percent of all brain strokes. It is important to point here that individuals with high blood pressure, high blood sugar, cholesterol, cancer, autoimmune diseases and some blood disorders are at a higher risk of developing brain stroke.
There are a few factors which can increase the risk of developing stroke beyond any control. But there are certain lifestyle choices as well which aids in controlling the chances of being affected by stroke. It is crucial to refrain from long-term hormone replacement therapies as well as birth control pills, smoking, lack of physical activity, excessive use of alcohol and drug addiction. A brain stroke is a life-threatening medical condition, and when an individual has symptoms that resemble that of stroke, it is crucial to seek immediate medical help.
Treatment for stroke:
- Treatment depends on the type of stroke.
- Ischemic strokes can be treated with 'clot-busting' drugs.
- Hemorrhagic strokes can be treated with surgery to repair or block blood vessel weaknesses.
- The most effective way to prevent strokes is through maintaining a healthy lifestyle.
What is TPA?
TPA is a thrombolytic or a “Clot Buster” drug. This clot buster is used to break-up the clot that is causing a blockage or disruption in the flow of blood to the brain and helps restore the blood flow to the area of the brain. It is given by intravenous (IV). This can be given only within 45.5 hrs of the onset of symptoms
Time is brain
Remember Every second Loss means brain cells die.
Rush to the nearest Stroke Centre whenever you experience such symptoms.
You can save the brain cells dying if you reach within 45.5 hrs by the CLOT BUSTER.
Another treatment option is an endovascular procedure called mechanical thrombectomy, strongly recommended, in whichtrained trained doctors try removing a large blood clot bysending sending a wired-caged device called a stent retriever, to the site of the blocked blood vessel in the brain
The good news is that 80 percent of all strokes are preventable. It startswith with managing keyrisk risk factors, including
- High blood pressure,
- Cigarette smoking,
- Diabetes Atrial fibrillation and
- Physical inactivity.
More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control.
The best way to get better after a stroke is to start stroke rehabilitation ("rehab"). In stroke rehab, a team of health professionals works with you to regain skills you lost as the result of a stroke. If you wish to discuss about any specific problem, you can consult a neurologist.
Myth: Brain damage is always permanent.
Fact: The brain can repair or compensate for certain losses, and even generate new cells.
People once believed that we were born with a finite number of brain cells, and that was it for life; if you damaged any of them you could never get them back. Similarly, many scientists believed that the brain was unalterable; once it was" broken" it could not be fixed.
Now, of course, we know that the brain remains plastic throughout life, and can rewire itself in response to learning. It can also generate new brain cells under the right circumstances.
Breast cancer awareness
October is breast cancer awareness month and a great time to highlight the importance of maintaining healthy habits to support breast health. One disease that most women fear these days, you would probably reply" breast cancer.
Understand what you can do to reduce your breast cancer risk. So follow these guidelines and know that you are doing all that you possibly can to protect yourself from developing breast cancer. Be thankful every day that your breasts are healthy.
Check your own breasts regularly. Do monthly self-breast examinations after your period is over. If you find any lumps or tenderness that concerns you, have it checked out right away. Fortunately, 80% of breast lumps are benign. When you examine your breasts, remember that lumps which are soft, movable, and change with your menstrual cycle are much less likely to be cancerous. Any discharge from the nipple other than breast milk should be checked out by your health professional.
Get regular mammograms. In a woman without breast symptoms and with no significant risk of breast cancer, I recommend mammograms beginning age 35 or 40 every two years. For women without breast symptoms who are at higher risk of breast cancer, I recommend yearly mammograms beginning at age 35. Beginning at age 50, the rate of breast cancer goes up, so yearly mammograms are advised.
Limit alcohol intake. The more alcohol you drink, the greater your risk of developing breast cancer.
Get to and maintain a healthy weight - if your bmi is out of the healthy range, find a program and tools to help you get to a healthy weight, which is important for maintaining health in general, including breast health. Obesity, particularly after menopause, can greatly increase your risk of breast cancer. Aim for gradual weight loss by choosing minimally processed foods and eating smaller portions.
Don't smoke - accumulating evidence suggests a link between smoking and breast cancer risk, particularly in pre -menopausal women.
Exercise regularly - physical activity can help you maintain a healthy weight, which, in turn, helps prevent breast cancer.
Limit dose and duration of hormone therapy - if you're taking hormone therapy for menopausal symptoms, ask your doctor about other options. You might be able to manage your symptoms with non-hormonal therapies and medications.
Choose the right supplements - filling in nutrition gaps with supplements can help you support breast health. Look for options that contain vitamin d and omega-3 fatty acids, as they have both been associated with maintaining breast health.
Breast-feed your babies for as long as possible - women who breast-feed their babies for at least a year in total have a reduced risk of developing breast cancer later.
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.
Test to screen for breast cancer:
Mammography is the most common screening test for breast cancer. A mammogram is an x-ray of the breast. This test may find tumors that are too small to feel. A mammogram may also find ductal carcinoma in situ (dcis). In dcis, there are abnormal cells in the lining of a breast duct, which may become invasive cancer in some women.
Mammograms are less likely to find breast tumors in women younger than 50 years than in older women. This may be because younger women have denser breast tissue that appears white on a mammogram. Because tumors also appear white on a mammogram, they can be harder to find when there is dense breast tissue.
The left breast is pressed between two plates. An x-ray machine is used to take pictures of the breast. An inset shows the x-ray film image with an arrow pointed at abnormal tissue.
The breast is pressed between two plates. X-rays are used to take pictures of breast tissue.
The following may affect whether a mammogram is able to detect (find) breast cancer:
The size of the tumor. How dense the breast tissue is. The skill of the radiologist.
Women aged 40 to 74 years who have screening mammograms have a lower chance of dying from breast cancer than women who do not have screening mammograms.
Clinical Breast Exam (CBE):
A clinical breast exam is an exam of the breast by a doctor or other health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual. It is not known if having clinical breast exams decreases the chance of dying from breast cancer.
Breast self-exams may be done by women or men to check their breasts for lumps or other changes. It is important to know how your breasts usually look and feel. If you feel any lumps or notice any other changes, talk to your doctor. Doing breast self-exams has not been shown to decrease the chance of dying from breast cancer.
Mri (magnetic resonance imaging) in women with a high risk of breast cancer
Mri is a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (nmri). Mri does not use any x-rays.
MRI is used as a screening test for women who have one or more of the following:
Certain gene changes, such as in the brca1 or brca2 genes. A family history (first degree relative, such as a mother, daughter or sister) with breast cancer. Certain genetic syndromes, such as li-fraumeni or cowden syndrome.
Mris find breast cancer more often than mammograms do, but it is common for mri results to appear abnormal even when there isn't any cancer.
Other screening tests are being studied in clinical trials.
Thermography is a procedure in which a special camera that senses heat is used to record the temperature of the skin that covers the breasts. A computer makes a map of the breast showing the changes in temperature. Tumors can cause temperature changes that may show up on the thermogram.
There have been no clinical trials of thermography to find out how well it detects breast cancer or if having the procedure decreases the risk of dying from breast cancer.
Breast tissue sampling is taking cells from breast tissue to check under a microscope. Abnormal cells in breast fluid have been linked to an increased risk of breast cancer in some studies. Scientists are studying whether breast tissue sampling can be used to find breast cancer at an early stage or predict the risk of developing breast cancer. Three ways of taking tissue samples are being studied:
Fine-needle aspiration: a thin needle is inserted into the breast tissue around the areola (darkened area around the nipple) to take out a sample of cells and fluid.
Nipple aspiration: the use of gentle suction to collect fluid through the nipple. This is done with a device similar to the breast pumps used by women who are breast-feeding.
Ductal lavage: a hair-size catheter (tube) is inserted into the nipple and a small amount of salt water is released into the duct. The water picks up breast cells and is removed.
I have small disk. And my lift leg paining I went doctor he proscribed me some pain lure and nerve medication but still my leg paining. How I can get well and don't take medication. Thanks.
Breast cancer, is a type of cancer, which is common to women, where cancer cells grow on the breasts or the female mammary gland. It starts out with the formation of a small lump in your breast and can spread out to your other organs very rapidly. It generally affects women above forty years of age. Breast cancer can be classified into two types. They can either start forming on the inner linings of your milk ducts ( known as Ductal carcinoma) or in the lobules which supply milk (known as Lobular carcinoma).
There are many causes responsible for breast cancer they are mentioned below:
- Obesity or post-menopausal obesity (Learn more about Heart Diseases Post Menopause)
- Exposure to frequent radiation (X-ray)
- Consumption of alcohol
- Being taller than average
- Start of periods at an early age
- Late menopause
- Hormone replacement therapy
- Consumption of birth control pills
The most common symptoms of breast cancer are as follows:
- Formation of a lump in your breast
- Swelling or shrinking of your breast
- Change of size, shape and color of your nipple
- Blood or milk discharge from the nipple
- Breast pain
- Itching sensation
- Appearance of rashes (Learn more about to maintain the skin health)
Breast cancer if not diagnosed and treated at an early stage may turn out to be fatal. Ayurveda offers promising cures for breast cancer.
A few of the Ayurvedic remedies are mentioned below:
- Include foods, which are well supplied with vitamin D in your diet. Researches show that women with less amount of vitamin D in their bodies are more likely to develop breast cancer. Consider including foods like eggs, orange juice, dairy products and fish like salmon in your diet.
- Drink more of green tea as it has anti cancer properties.
- Exercises like walking, yoga, meditation and certain breast exercises can help you to relax the pain sensation, reduce stress and also get cured.
- Incorporate bitter gourd in your diet. Researches show that bitter gourd can kill those cancer cells, which cause breast cancer.
- Ayurvedic herbs like Ashwagandha, tulsi, curcumin have certain properties that can destroy cancer cells.
Since, breast cancer has less survival rates, it is absolutely essential for you to visit an Ayurvedic practitioner if you wish to get cured through Ayurvedic treatment.
Left paracentral L5-S1 disc protrusion causing compression of left traversing nerve roots associated with diffuse L1-L2 Disc bulge. Now what is best treatment for me.
Hi I'm from South Africa. I need to have a hysterectomy done .What are cost of hospital fees, Dr. and anesthetic ,theatre fees etc awaiting your response kind regards Mariam Patel.
It is perfectly normal for women to experience the periodic monthly bleeding cycle. However, if a woman experiences uterine bleeding which is abnormal and dysfunctional, it could be a symptom of infection. Other causes of abnormal uterine bleeding include hormonal imbalance, infection in cervix and cancer of the uterus. Many women can also experience abnormal uterine bleeding during first trimester of pregnancy.
The following are considered to be abnormal or dysfunctional uterine bleeding:
- A menstrual cycles occurs between 21 to 35 days, anything shorter or longer than this is abnormal
- No period for 3–6 months (amenorrhea) is abnormal
- Spotting or bleeding between periods
- Spotting or bleeding after intercourse
- Bleeding that is heavier or lasts longer than usual
- Spotting or bleeding after menopause
What can cause such a situation?
Some of the common causes leading to abnormal bleeding are as follows:
- Ectopic pregnancy
- Cervical or uterine infections
- Hormonal imbalances
- Problems with blood clotting
- Polycystic ovaries
- Endometrial hyperplasia
- Cancer of the reproductive tract
How to Diagnose it?
Most women tend to ignore abnormal bleeding, taking it as something to do with age or hormones. A detailed physical examination and history is done to understand menstrual cycle patterns and family history. In addition, the following would be used.
- Ultrasound: The pelvic organs are examined through sound waves to locate the problem area
- Hysteroscopy: Through a thin device that is inserted into the vagina, the doctor takes a look at the inside of the organs and identify the cause for the bleeding
- Endometrial biopsy: The uterine lining tissue is removed and examined under microscope to look for tissue changes that could be causing the bleeding
How Best to Treat It?
This would depend on the reason for the abnormal bleeding. However, in most cases, combinations of the following are useful in treatment.
- Hormone replacement can be done depending on the age and gynecological history, the type and the dose of the hormone would be decided upon. These could be in the form of tablets, vaginal creams, injections, or through an intrauterine device
- Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are useful in reducing bleeding and controlling cramps during excessive menstrual bleeding.
- Antibiotics may be useful if there is infection of the pelvic organs.
- Polyps, cysts, cancers, and other growths can be removed via hysteroscopy and sent for biopsy to confirm they are not cancerous.
- Endometrial ablation where the endometrial tissue is treated with heat can be used to control bleeding permanently.
- Hysterectomy would be done if other forms of treatment have failed. This could depend on their gynecologic history and other considerations as she cannot get pregnant after this.
Do not ignore if you see a change in the pattern of your uterine bleeding. It definitely calls for medical attention and if identified early, can be managed in much simpler ways.
Hello Dr. My mother facing the problem regarding slip disk in the year of 2012 now she is fine but some time he faced pain what I will do so he will get normal.
Please advice some treatment for bulging of disc I tried everything possible. Visited all type of doctor, did physical exercise and massage as well but still pain persists.
Please tell me what can I do in slip disk problem please explain preventive & treatment methods without using drugs because I need not anymore drugs because I already taken lots of drugs.
My age is 28 and I am suffering from back pain due to L3, L4, L5 Disc bulging. Kindly suggest me a solution to over come from back pain without surgery.
I am suffering from slipped disc in cervical spine from 6 months. So my question is that I am a dance choreographer should I continue with my dance or not can you suggest me and how this problem Will be cured.
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.
ICU patients’ lungs fail for a number of reasons including pneumonia, lung cancer, pulmonary edema, pulmonary embolism and COPD.
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.