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Dr. Puneet Jain

Radiologist, Delhi

Dr. Puneet Jain Radiologist, Delhi
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To provide my patients with the highest quality healthcare, 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 healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies.
More about Dr. Puneet Jain
Dr. Puneet Jain is one of the best Radiologists in Paschim Vihar, Delhi. You can meet Dr. Puneet Jain personally at Sri Balaji Action Medical Institute in Paschim Vihar, Delhi. Book an appointment online with Dr. Puneet Jain and consult privately on Lybrate.com.

Lybrate.com has an excellent community of Radiologists in 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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Hello doctor plzz say me is surgery essential for Diffuse annular disc bulge seen at l4 and l5 level causing indentation over thecal sac with bilateral recess narrowing and significant nerve decompression.

MS - Orthopaedics, MBBS
Orthopedist, Hyderabad
Pivd l4-l5 initially can be treated with rest, physical therapy, medication, epidural steroid injection. If the problem is severe n you are having numbness n weakness in the feet n radiculopathy then you will meed surgery.
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L4-l5 and l5-s1 between disk problems years-44-women. Please give advise operation after disk moving

Hand Surgery SR Ship, MS - Orthopaedics, Thesis Work, M.B;B.S
Orthopedist, Jaipur
Dear, surgery in spine disorders is not a full proof guarantee that all will be well once surgery is done. As we all have multiple discs, so the key is to get surgery if pain is severe, and there are neurological weakness, but once you are off from surgery change lifestyle if you want no more problems.
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Know All About Gynae Laparoscopy Surgery

Panchkula & Delhi
Mother and Child Care, Panchkula
Know All About Gynae Laparoscopy Surgery

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.

4326 people found this helpful

I have a disc bulge at L4-L5 and L5-S1, its being more then 7 months now. My physiotherapy session is going on but i still have pain and weakness in my legs

M.Ch, DNB (Orthopedics), MBBS
Orthopedist, Mohali
You need and MRI and clinical assessment and may end up having a surgery if you have weakness which has not improved on censervative treatment for 7 months.
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I am a 25 years old male, I have been suffering from bulging disk at l5-s1. I have been resting for 2 months, now my neck has started paining too and left pelvic joint is making popping sound everytime it is bend. So I got my blood acid checked. And its been 8 for last two months, I have been drinking like 6 lts water everyday. Is uric acid main reason of pain? And how can I get it down as I don't want to start the medicine so early in life and drinking water is not working. Please suggest, my career is suffering a lot.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Requires detailed examination and investigation. Preliminary investigations suggested: hb, tlc, dlc, esr, blood sugar fasting & pp, uric acid vit d urine r/e x-ray of the affected part. Anyway it may be tried sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick mattress are harmful use no pillow under the head. Do hot fomantation paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back, knee & general exercises. It may have to be further investigated. Do not ignore it. Let it not become beginning of a bigger problem. Make sure that patient is not allergic to any of the medicines that he/she is going to take. If it does not give relief in 4-5days, inform.
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I am 20 years old. But my weight is 85 and my height is 5.11 so is it correct weight or should reduce my weight? tell me how to reduce. And I have a backache means one disk in my back has pressed inside than the normal of other disks. So please give a perfect solution.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I am 20 years old. But my weight is 85 and my height is 5.11 so is it correct weight or should reduce my weight? tell...
Sleep on a hard bed with soft bedding on it. SPRING BEDS, FOLDING BEDS OR THICK MATTRESS ARE HARMFUL Use no pillow under the head. DO HOT FOMENTATION. Paracetamol 250mg OD & SOS x 5days. Caldikind plus 1tab OD x10. Do neck back knee & general exercises. It may have to be further investigated. Make sure you are not allergic to any of the medicines you are going to take. For emergency treatment contact your nearest hospital or family doctor. Weight reduction can not be done overnight. You have to take it as a way of life. Do Diet control. no sugar in tea,coffee,milk etc. NO sweets Take small frequent meals. When you get used to it, skip one meal. Then after 3 months skip another meal, & so on? You should do non weight bearing Yoga exercises. Do ask for detailed treatment plan. Do not ignore It. could be beginning of a serious problem. Why not discuss with me in a video conference?( Facility Provided by lybrate.com) Why not discuss with me in a video conference? (Facility provided by lybrate.com)
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I am 63 year old male, having- (1) a sciatica on right side (2) herniation between in lumber, as a result suffering from leg and lower back pain. I want your valued answer of treatment.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. For me to answer your question, I need some information from your side: - a detailed neurological examination including assessment of motor, sensory ex and analysis of deep tendon reflexes of lower limbs - dynamic x rays of ls spine - mri ls spine to correlate clinical findings with radiology. Do not hesitate to contact me if you need any further assistance. You can also discuss your case and treatment plans with me in a greater detail in a private consultation.
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I have L4, L5 disc bulging problem , some time it pains me that I am unable to move also , How to recover from this. Please help me out.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I have L4, L5 disc bulging problem , some time it pains me that I am unable to move also , How to recover from this. ...
Spine physiotherapy, posture care and pain killer as and when needed. If persistent problem, please visit.
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What should I be doing to releave the pain for two herniated disc's one above and one below a fusion surgery of the cervical spine.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Sleep on a hard bed with soft bedding on it. SPRING BEDS, FOLDING BEDS OR THICK MATRESS ARE HARMFUL Use no pillow under the head. DO HOT FOMANTATION. Paracetamol 250mg OD & SOS x 5days. Caldikind plus 1tab OD x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 4-5days, contact me again.. Do not ignore .It could be beginning of a serious problem.
1 person found this helpful
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Breast Cancer - Know More to Say 'No' More!

MBBS, DGO, MD - Obstetrics & Gynaecology, MRCOG
Gynaecologist, Delhi
Breast Cancer - Know More to Say 'No' More!

Cancer is the abnormal, uncontrolled growth of cells in a particular body part. With continued growth, pieces of this tissue travel through the blood to different body parts and continue to grow in the new area. This is known as metastases. Breast cancer is one of the most common forms of cancer and affects about 1 in 8 women in the USA. Read on to know more details of breast cancer – breast anatomy, causes, symptoms, risk factors, detection, prevention, and of course treatment.

Anatomy: The main function of the breast is lactation through its milk-producing tissue that are connected to the nipple by narrow ducts. In addition, there is surrounding connective tissue, fibrous material, fat, nerves, blood vessels and lymphatic channels which complete the structure. This is essential to know as most breast cancers develop as small calcifications (hardened particles) in the ducts or as small lumps in the breast tissue which then continues to grow into cancer. The spread can happen through lymphatic or blood flow to other organs.

Warning signs/symptoms: The following are some symptoms that need to be watched out for if you have a predisposition to breast cancer.

  1. A lump in either of the breasts or armpits
  2. Change in size, shape, or contour of either breast
  3. Redness of your breast or nipple
  4. Discharge of clear or bloody fluid
  5. Thickening of breast tissue or skin that lasts through a period
  6. Altered look or feel of the skin on the breast or the nipple (dimpled, inflamed, scaly, or puckered)
  7. One area on the breast that looks very different from the other areas
  8. Hardened area under the breast skin

Either one or a combination of these should be an indication to get a detailed checkup done. Early diagnosis results in controlling the disease with minimal treatment and reduced complications.

Causes and risk factors: The exact cause for breast cancer is yet to be pinned down. However, risk factors are clearly identified, and women with risk factors need to watch out for warning signs.

  1. Family history: Of all the risk factors, the family history is the most important. Breast cancer runs in families, and if there is a first-degree relative with the breast cancer, the chances of developing it are almost double. Two genes BRCA1 and BRCA2 are the carriers of the disease, and this testing can be done in women to identify if they are at risk.
  2. Family history of other cancers: Even if there is no breast cancer, if there are other cancers that run in the family, watch out.
  3. Age: Women over 50 are at higher risk of developing breast cancer.
  4. Race: Caucasian and Jewish women are at higher risk of breast cancer than African-American women.
  5. Hormones: Greater exposure to the female hormone estrogen increases the chances of developing breast cancer. Women who use birth control pills for contraception and hormone replacement after menopause are at a higher risk of developing breast cancer.
  6. Gynecologic milestones: Women who have abnormal menstrual milestones need to watch out. These include those who attain menarche before 12 years of age, get pregnant after 30, attain menopause after 55, and have menstrual cycles shorter than 26 days or longer than 29 days.
  7. Obesity and alcohol abuse are also likely to increase a woman’s chances of developing breast cancer.

Stages: Starting from stage 0, higher stages indicate advanced disease.

  1. Stage 0: The growth which has begun in the milk-producing tissue or the ducts has remained there (in situ) and not spread to any other area, including the rest of the breast.
  2. Stage I: The tissue slowly becomes invasive and has begun to affect the surrounding healthy tissue. It could have spread to the fatty breast tissue and some breast tissue may be found in the nearby lymph nodes.
  3. Stage II: The cancer at this stage grows considerably or spreads to other parts. There are chances that cancer may grow and also spread.
  4. Stage III: It may have spread to the bones or other organs but small amounts are present in up to 9 to 10 of the lymph nodes in the armpits and collar bones which makes it is difficult to fight.
  5. Stage IV: The cancer is widespread to far-flung areas like the liver, lungs, bones, and even the brain.

Screening: This is one of the most effective ways to identify the disease in its early stages. This will help in controlling cancer from spreading with minimal treatment.

  1. Self-examination: A thorough self-examination to look for changes in terms of shape, size, colour, contour, and firmness should be learned by all women. Watch for any discharge, sores, rashes, or swelling in the breasts, surrounding skin, and nipple. Examine them while standing and when lying down.
  2. In most women, annual screening mammograms are advised after the age of 40. However, in women who have a strong family history or genetic makeup, it is advisable to have screening mammograms starting at age 20 every 3 years and then annually from the age of 40.
  3. Women in high-risk categories should have screening mammograms every year and typically start at an earlier age.
  4. Ultrasound screening can also be given in addition to mammograms.
  5. Breast MRI is another way to screen for breast cancer if the risk is greater.

Breast Cancer Prevention: Now that there is so much awareness about causes and risk factors, there are definitely ways to prevent or delay the onset of the disease.

  1. Exercise and a healthy diet with reduced amount of alcohol are definitely effective in minimising the chances of developing cancer.
  2. Tamoxifen is used in women who are at high risk for breast cancer.
  3. Evista (raloxifene) which is used to treat osteoporosis after menopause. It is also widely used in preventing breast cancer.
  4. In high-risk women, breasts are surgically removed to prevent the development of cancer (preventive mastectomy).

Treatment: As with all cancers, treatment would depend on the stage at which it is identified and include a combination of chemotherapy, radiation, and surgery. As noted earlier, if you are at risk, look out for warning signs as early diagnosis is the key to maximum recovery.

2622 people found this helpful

My MRI report says, Mild posterior broad base protrusion of L4-L5 intervertebral disc resultant mild central and lateral canal narrowing causing mild compression over thecal sac and right traversing L5 nerve root. I am doing bed rest from 10 days, what's the report says.

Fellowship of the Royal College of Surgeons (FRCS), Membership of the Royal College of Surgeons (MRCS)
Orthopedist, Trichy
the report says that you have a disc prolapse and the disc is compressing one of the right nerve root. So if you have back and right leg pain then it would fit with your MRI findings. Absolute bed rest is not required for disc prolapse. as it is a mild prolapse there is a chance that the symptoms will improve with medications. avoid lifting heavy weight and reduce your body weight too
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Please suggest exercises for disc bulge L4-5 and L5-S1 level indenting anterior thecal sac effacing bilateral recesses and impinging on descending nerve roots AP canal diameter- 1.3 cm (L4-5 level) and 1.2 cm (L5-S1) please suggest the best exercises to cure it fully and strengthen the particular area thanks help would be appreciated :)

Diploma In Orthopaedics (D. Ortho), DNB (Orthopedics), Diploma SICOT, Fellowship in Spine Surgery, Fellowship in Endoscopic Spine Surgery
Orthopedist, Vadodara
Exercise doesn't cure a MRI report just lead a healthy lifestyle with good cardio exercises and back exercises.
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I am a man of 50 years and have no complications except slip disc between l4-l5 which is ok if I take proper precaution. From last few months I feel considerable pain in my both knee after sitting on a chair for few hours constantly and then trying to move. When I am keep walking pain is not there. I have to sit in front of computer whole day long. Kindly advise.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Kindly show me a photograph of the affected part--knees rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back, knee & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 4-5days, contact me again. Do not ignore. It could be beginning of a serious problem.
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Should You Get a Mammogram?

MHA, PGDPMC, DGO, MBBS
Gynaecologist, Delhi
Should You Get a Mammogram?

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.
2765 people found this helpful

How Is Breast Cancer Diagnosed?

MBBS, MD - Obstetrtics & Gynaecology
Gynaecologist, Delhi
How Is Breast Cancer Diagnosed?

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 ultrasound: You 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. If you wish to discuss about any specific problem, you can consult a general-surgeon.

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I met accident and my back disk d8 and d12 injured and operted in banglore now i am paraplegia patient from 7 years any treatment to cure it please reply me i went for stem cell in chenni also

MS ORTHOPEDIST, MBBS
Orthopedist, Noida
Its sad to know about your conditions. Stem cell can provide little help on immediate spinal trauma... there r other parameters to evaluate the neurology which is not possible with chatting.. prognosis is not good in long standing cases...
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I am suffering from sciatica for the last 6 months. Tried back exercises and muscle relaxants. The condition is due to L4/L5 disc herniation. Kindly advice.

DNB (Orthopaedics), Diploma In Orthopaedics (D. Ortho), MBBS
Orthopedist, Gurgaon
Herniated disc is likely to have a course with repetitive episodes of back and leg pain. It is important to avoid postures that may complicate the situation. Surgery is usually recommended, if there is any evidence of neurologic deficit, such as weakness of toes, persistent numbness or bladder/ bowel dysfunction. Most such cases can be managed conservatively with a combination of medication and physio.
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I am 29 years old. I am from bangladesh. I have a problem with my backbone. I have slipped disc. I have been suffering from this since 2011. I consulted with some local doctors. They prescribed me with some exercise but no improvement till now. I feel that a bone or two is/are displaced somewhere my waist. I need expert suggestion.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
I am 29 years old. I am from bangladesh. I have a problem with my backbone. I have slipped disc. I have been sufferin...
Ok as your requirement avoid all exercise for 3 days and do rest tk physiotherapy treatment for few days swd ift ultrasonic therapy it will help you and giving you relief after 3 days you can start spine extension exercise with treatment. For future avoid forward bending, heavyweight, long sitting and standing keep your posture straight.
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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.

MD - Radiothrapy
Oncologist, Ahmedabad
hi, In ca breast, surgery is the primary treatment. Then chemotherapy and radiotherapy to prevent recurrence and metastasis . So go for surgery first then other treatments according to stage.
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