Dr. Prashant Bothra

Many women develop uterine fibroids by the time they hit the age of 50 years and above. These are non-cancerous growths that may occur in the uterus. Most women go through severe bleeding and pain as well as discomfort as a result of these fibroids. Age, family history of the same condition, obesity or being overweight, eating habits and even ethnicity play a large role in deciding the risk of each individual patient. These fibroids can grow in the submucosal, intramural and subserosal areas.

Following are the common side effects of uterine fibroids:

1. Frequent urination: Due to the pressure of the fibroids on the uterus, the patient may experience a constant feeling of fullness in the lower pelvic area of the body, which may lead to frequent filling of the bladder. This gives rise to frequent trips to the washroom for urination. 
2. Heavy Bleeding: Severe bleeding is one of the most common causes of the presence of these kinds of fibroids. The patient may experience a lot of bleeding during menstrual periods, as well as pain and cramps the rest of the time. The periods will also be very painful when there are fibroids in the uterus or the uterine lining.
3. Painful Intercourse: It is a well-known fact that any kind of infection or growth as well as sores and other such ailments can lead to vaginal dryness as well as pain during sexual intercourse. This is true for uterine fibroids as well, which can lead to severe pain during sexual activity. These fibroids can also give rise to pain in the lumbar or lower back region.
4. Abdomen Swelling: The abdomen may go through significant swelling in such a condition and the patient may even look like she is pregnant. The growth can push the shape of the abdomen outwards and create a full feeling.
5. Pregnancy Complications: The presence of uterine fibroids can give rise to several complications during pregnancy and even after child birth. One of the most common problems in this case is bleeding, followed by more severe outcomes like miscarriage. The women suffering from uterine fibroids are at greater risk of undergoing a caesarean section for the delivery of the baby. The baby may also be born breech and a premature delivery may take place. 
6. Infertility: This is also a rare side effect of the uterine fibroids and is generally seen only in very severe cases. 
7. Cancer: Only one in every 1000 cases might transform into malignant tumours. These uterine fibroids are generally known to be non-malignant. 

Any symptoms must be reported to a gynaecologist at the earliest to avoid any serious complications.

Breast cancer is a type of cancer, which occurs due to the development of cancerous cells in breasts. Women are usually affected by breast cancer and breast cancer is one of the most common forms of cancer after skin cancer. Usually fatal if not diagnosed in its early stage, breast cancer is a very serious medical ailment. Read on more to find all about the different symptoms, causes, preventive measures and treatment of breast cancer.

Symptoms: Breast cancer has few distinct characteristics and if you have a few or all the following symptoms you could be more likely to suffer from breast cancer. 

• The formation of a lump in your breast, which is different from the surrounding tissue and usually more thickened.
• The discharge of bloody fluid  material from the nipples.
• Sudden change of the size, shape and appearance of the breast.
• Certain distinct changes to the skin over the breast for example an indentation in the skin similar to that of a dimple.
• Appearance of an extra nipple which is inverted.
• If the darkened area around the nipples known as the areola is flaking or peeling off. 

Causes: Studies and researches remain inconclusive on what causes breast cancer. Breast cancer occurs due to abnormal division of the cells located in the breast, which over time accumulate and form lumps. They
might spread to other parts of the body. Breast cancer is caused mainly due to a complex interaction of personal genetics, environment and lifestyle choices. Breast cancer can also be caused due to genetics as about 5% to 10% of cases are due to gene mutations which pass onto generations.

Risk factors: There are certain factors, which increase the probability of contracting breast cancer. Increasing age, personal and family history of breast cancer, obesity, radiation exposure, pregnancy at an older age, postmenopausal hormone therapy are some of the factors that increase the chances of breast cancer.

Treatment: Several forms of surgical methods exist to treat breast cancer. Depending on the condition and spread of the disease a suitable surgery is performed. These include mastectomy, lumpectomy, axillary lymph node dissection and removal of both breasts. Other forms of treatment include chemotherapy or the use of high doses of drugs to destroy cancerous cells. Radiation therapy where X-rays are used to destroy the cancer cells is also effective.

A mammogram is an imaging test where an X-ray is taken to recreate the internal imagery of your breasts. This is a screening test that is widely used to find the earliest signs of cancer. There have been instances where the early signs of cancer have been found up to three years before the actual development of the same. There are a number of benefits and risks in this screening method. So let us find out more about getting a mammogram, and whether or not you should get one.

• Procedure: A special X-ray machine is used for conducting a mammogram. There is a clear plastic plate on which the specialist will place the breast while another plate will press on the breast from above. While both the plates serve to flatten the breast and hold it still, the X-ray will be taken. Some pressure will be felt and the same steps will be repeated so as to get the side view of the breasts. The same procedure will be repeated for the other breast. Meanwhile, once it is done, you will need to wait so that the technician can check for clarity, and whether or not the procedure needs to be done again. The results of this procedure cannot be relayed by the technician, and all the images will be different because all breasts are slightly different from each other.
• Preparation: You will need to remember that the process can be a slightly painful one, especially once the pressure gets applied. Many women complain of discomfort and pain. Yet, this discomfort gets over before you know it. The pressure and pain will depend on the size of your breasts and how much they will have to be pressed in order to get a picture. The skill of the technician will also come into play here. One must remember not to get this procedure done a week or so before or after the menstrual cycle, as the breasts tend to be tender around this time, and the pain will be much more.
• Radiologist: Within a few weeks after the procedure, the radiologist will usually deliver the result. This is the professional who does an accurate reading of the X-ray.
• Normal and Abnormal Readings: If your mammogram result has a normal reading, then you can resort to getting one done every once in a while. But an abnormal reading will require further X-ray and tests so as to be able to tell for sure.
• Why should I get one: If you are over 40 and have a family history of such ailments, then you will have to get a mammogram done regularly. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

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. If you wish to discuss about any specific problem, you can consult a neurosurgeon.

Cancer that originates in the bones of a human body is referred to as bone cancer. Any bone could come under the threat of this disease, but generally the longer bones of your body, so to say the bones of your limbs, are at a greater risk. 

A few factors that might push you an inch closer to bone cancer are:

1. Genes could jinx your health: A few typical genetic syndromes could increase a person's chances of contracting bone cancer. These syndromes could have been active in any person belonging to your lineage. One such syndrome is Li-Fraumeni.
2. Treatment for one kind of cancer can make you prone to some other kind: Radiation affects your bones adversely. A patient of breast cancer might be undergoing radiation therapy that further increases his or her risk of contracting bone cancer in future.  
3. Paget's disease can have unfavorable implications: Paget's disease is a disease that affects elderly people. This condition, if left untreated, can turn into bone cancer at a later stage. 

Several symptoms of bone cancer can be found below:

1. Sudden loss of weight: If you lose a considerable amount of weight in a few weeks time without having made any effort at all, you should probably be worried about the health of your bones. Bone cancer can result in sudden and unintentional weight loss. 
2. Unexpected bone fracture or breakage: Cancer of the bones is known to gnaw at the strength of your bones. Weakened and diseased bones can break or get fractured very easily. An unexpected fracture should not be overlooked so as to prevent chances of anything more harmful.
3. Long spans of unyielding exhaustion: Constant fatigue and sleepiness might be hinting at a more serious underlying problem. The bones in your body hold you together; cancerous bone cells can make you feel exhausted without much exertion as your bones lose their inherent potency.
4. Persistent pain in the bones: Excruciating cramps or pangs of stinging pain in a person's bones either continuously or at odd hours, could be indicative of bone cancer. Such instances require the advice and guidance of an experienced oncologist.
5. Bone swelling: The area affected by bone cancer can grow big and tender or the bone itself can swell up.

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.

Broken bone is commonly known as bone fracture a d it occurs when an exorbitant amount of force is applied causing the bone to split or shatter. While some minor fractures lead to cracks and crannies, others may lead to complete breakage of the bones. Despite being hard, bones are formed in such a way that they can absorb pressure to only a certain extent, beyond which they break. Statistically, the incidence of broken bones are most common in children and in old age people.

Causes of Bone Fracture
Bone fracture can be caused due to a number of reasons; both intentional and accidental. Some of them include:
1. Accidents and injuries: Sports injuries, being hit by a car and tripping and falling are some of the typical episodes.
2. Old age: Diseases such as osteoporosis and brittle bone disease are common in aged people. As bones tend to become more fragile among the aged, they are at a greater chance of bone fractures.

Type of bone fractures
Primarily bone fractures are of four types, based on the way the bone splits. They are:

1. Complete fracture: This type of fracture refers to a complete breakage of the bone wherein the fracture may occur at various parts of the bone.
2. Incomplete fracture: In this type of fracture, the bone partially breaks instead of splitting entirely.
3. Compound fractures: This is a type of a fracture wherein the bone breaks past the skin. It is also known as an open fracture.
4. Simple fracture: In this type of a fracture, the bone breaks without causing an open wound on the skin.

Treatment of bone fractures
In case of a broken bone, the immediate course of action would be to reach for the first aid box. This can be done to stabilize the bone prior to hospitalization. Icing the injury, elevating the injured area to prevent further swelling and covering the wound with bandages are common measures. In many cases, people also make household splints (made of newspapers) to keep the bone stabilized. Hospitalization and especially surgery, can be also opted for in case of severe fractures. Consult a doctor for more details.