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Dr. Sonal Singhal

MBBS, DMRD, DNB

Radiologist, Delhi

20 Years Experience  ·  400 at clinic
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Dr. Sonal Singhal MBBS, DMRD, DNB Radiologist, Delhi
20 Years Experience  ·  400 at clinic
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Personal Statement

I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage....more
I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage.
More about Dr. Sonal Singhal
Dr. Sonal Singhal is a renowned Radiologist in Janakpuri, Delhi. He has had many happy patients in his 20 years of journey as a Radiologist. He studied and completed MBBS, DMRD, DNB . You can visit him at Dr. Sonal Singhal@Mata Chanan Devi Hospital in Janakpuri, Delhi. Book an appointment online with Dr. Sonal Singhal and consult privately on Lybrate.com.

Lybrate.com has an excellent community of Radiologists in India. You will find Radiologists with more than 27 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.

Info

Education
MBBS - nagpur university - 1997
DMRD - nagpur university - 1998
DNB - National Board of Examinations - 2003
Awards and Recognitions
University Topper in DMRD
Professional Memberships
Indian Radiological & Imaging Association (IRIA)
Indian Medical Association (IMA)
Medical Council of India (MCI)

Location

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Mata Chanan Devi Hospital

Lal Sai Mandir Marg, Block C1 Landmark : Opposite BikanerwalaDelhi Get Directions
400 at clinic
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I have a herniated disk (bulged disk/slip disk) at c7 and the c7 nerve is compressed for last 2 months. Do you have treatment in ayurveda ?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
However you may try sleep on a hard bed with soft bedding on it. Use no pillow under the head. Kindly take biod3 max 1 tab dailyx10 paracetamol 250mg od & sos x5days do back (spine)/shoulder/knee exercises make sure you are not allergic to any of the medicines you are going to take do not ignore it. It may have to be further investigated. It could be beginning of a serious problem. If no relief in 4_5 days, then contact me again. Contact your family doctor or nearest hospital for emergency help.
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I am 54 year old male having MRI [LS-SPINE]. Finding Reveal Annular Tear, circumferential Disc Bulge With Small Posterocentral Protrusion at L4-L5 level, Causing No Significant Neural Compression Or Canal Stenosis" I have no pain anywhere since 5 months only difficulty in standing or on walking without pain. Become tired for few seconds, then start again walking. Ortho. Says no need to worry it will heal naturally. Spine Surgeon says need of "DISC FIX" treatment required. Getting confuse. WHAT TO DO.'

MBBS
General Physician,
Hi, Thanks for your question. I do understand your pain and discomfort. As per your history is concerned please follow: 1)If there is no neuro deficit then no need of surgical treatment so wait for that time to come during this time do physiotherapy and steroid treatment . I hope I was able to address your query. If you have any further questions, please do not hesitate to write to me. Wishing you all the best. Thanks
1 person found this helpful
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I am 52 yrs. Old. I want to knw dt I hv to pap test nd mammography. As I hv not done dt tests yet. I font hv any problem I hv only thyroid nd spondylities problem. Nf I am minor thalassemia present.

MBBS, MS - General Surgery, FBD (Fellowship in Breast Diseases), UICC Fellowship
Oncologist, Pune
Breast cancer and cervical cancer are the most common cancers in Indian Females. For these cancer screening mammogram, ultrasound of the breast, PAP smear with breast surgeon and gynaec consultation is advisable. So better to go for screening even you don't have any symptoms.
8 people found this helpful
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I am 63 year old. I am having sciatica, back pain and numbness in both legs. I do not have BP and my sugar level is with in limit. As per CT scan report the impression are as follows: Lumbar Spondylitis with Disc herniation at L4-5, L3-4 levels and disc bulge at L5-S1 level. Canal stenosis at L4-5 level. Cervical spondylosis - Decreased height of C5 and C6. Vertebral bodies with end plate irregularities at C4-C7 levels. Disc bulge at C3-4 level. Disc herniation with canal stenosis at C4-5, C5-6 and C6-7 levels. Can it be cured with Homeopathy.

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 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. If it does not give relief in 4-5days, contact me again. Why not discuss with me in a video conference? (facility provided by lybrate. Com)
2 people found this helpful
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I have diagnosed with infiltrating ductal carcinoma, NOS, in right breast (in biopsy report, triple negative (ER-negative, PR-NEGATIVE, HER 2-NEGATIVE). The tumor measures 4 cm* 3 cm mammographically. After giving 3 no. Of chemo My doctor suggest me for modified radical mastectomy. Please tell me if I go for complete breast removal & subsequent chemotherapy Radiotherapy is must or optional?

MD - Radiation Oncology, MBBS, DNB (Radiotherapy)
Oncologist, Howrah
Surgery is the definitive treatment for carcinoma breast. After surgery, remaining cycles of chemotherapy needs to be completed. Whether radiotherapy will be given or not depends on postoperative histopathology report.
1 person found this helpful
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Health Tip

Doctor Of Physical Therapy (DPT), Bachelor of Physical Therapy
Physiotherapist, Bangalore
Health Tip

Herniated disks or bone spurs in the vertebrae of the neck may become the reason behind severe neck pain. They sometimes take too much space and compress the nerves branching out from the spinal cord.

5 people found this helpful

How To Prevent Sagging of Breasts?

Vaidya Visharad
Sexologist, Narnaul
How To Prevent Sagging of Breasts?

How to prevent sagging of breasts?

Home remedies for sagging breasts

Breast sagging is a natural process that happens with age wherein the breasts lose their suppleness and elasticity. Breasts do not have muscle. They are made of fat, connective tissues and milk-producing glands, and they need proper care to keep them in good shape.

Yoga


The benefits of yoga for the entire body have been widely studied, and it is primarily a mechanism of toning the body and increasing flexibility. Some of that toning can occur within the breast, depending on which positions you commonly practice.

Massage

Massage your breasts at least 2-3 times per week with olive oil. It will help add firmness to the skin as well as improve the skin tone and texture. It will also tone your chest and increase the elasticity of the skin.

Pomegranate

Pomegranate is considered a wonderful anti-aging ingredient and can help prevent sagging breasts. Pomegranate seed oil is rich in phyto-nutrients that can lead to firm breasts.


    Make a paste of pomegranate peel and some warm mustard oil. Use it to massage your breasts in a circular motion for 5 to 10 minutes daily before going to bed.
    You can also use pomegranate seed oil to massage your breasts 2 or 3 times daily.
    Another option is to mix 4 teaspoons of neem oil with 1 teaspoon of dried and powdered pomegranate rind. Heat this mixture for a few minutes. Allow it to cool and then use it to massage your breasts twice daily for several weeks.


Avoid loose fitting bra / wrong bra size

Some women feel that they would feel comfortable if they wear loose bra. But this is totally a wrong step. You are going to invite your saggy breast by doing this. Avoid this and go for the best fitting bra to keep your breast stay upright and firm. For more details visit us at www.malhotraayurveda.in

52 people found this helpful

Kidney Failure Cure

MD - Homeopathy, BHMS
Homeopath, Indore
Kidney Failure Cure

Complete, permanent, easy, safe, fast & cost effective kidney failure
Health cure at aarogya super speciality modern homoeopathic clinic (computerised), Dr. Arpit chopra (md homoeopathy, 102, krishna tower, opposite curewell hospital, janjirwala chouraha, newpalasia, indore, you may check cured patients reports & feedbacks on website- www. Homoeopathycure. Com, email - arpitchopra23@gmail. Com, 9713092737, 9713037737, 9907527914 (whats up no, 0731-2532737, 0731-3961737.

7 people found this helpful

Lumbar Degenerative Disc Disease

MBBS, Diploma In Orthopaedics (D. Ortho), DNB - Orthopedics, mch
Orthopedist, Delhi
Play video

Different methods to treat Disc problems

Hello friends, I am Dr Gaurav Khera. I am an orthopaedic surgeon, doing joint replacements and spine surgeries at the Access healthcare. Now today I will be talking about the lumbar degenerative disc disease. Now it sounds very big, but it is not as complicated as it sounds. It basically is what you people commonly know as a disc disease. So it is a fairly common problem that is seen in our population today. In fact about 30 or 40% of the patients who come to our OPD have lower back pains, some have other disc problems and very commonly seen after 40 years of age and this incidence gradually increases up to 60-70 years of age. The other ecological factors which are associated with this are, first of all smoking, secondly it is, mild to moderate trauma, thirdly its seen in people who lift heavy weights, fourth is obesity, especially central obesity, that is if you have a very heavy waistline.

Now what is Lumbar degenerative disc disease? Now, our spine is composed of multiple bones, which are starting from your neck and they come all the way down to your hip, divided into the cervical, dorsal, lumbar and sacral spine. And between these bones, there are these small pieces of discs, which act as cushions. When your body walks, these act as shock absorbers between your body’s bones. Now this discs, when these come out of their normal place, it gives or presses against the nerves which are passing through these areas and it causes pain. This is what happens in the disc disease. Basically, in the patient it will come as a lower back pain, and this pain will be travelling down to the hip, and it will also be coming down to the legs. Some people complain that as they walk, the pain increases.

They also complain of tingling numbness. They complain that sometimes their fingers or their toes are feeling numb. These are some of the very common symptoms which are being seen. Few people may have only lower back pain, and these are the people who do not have very significant disc disease. Now there are two main causes of the disc disease. First is an inflammatory reaction that occurs in the disc, and second is the micro motion instabilities that occur. Inflammatory reactions may occur as a result of some small traumas which may occur such as when you may injure your back. Such inflammatory reactions occur in the form of small swellings in the body. And micro motion instabilities are when the body ages, the disc which has an outer fibrous thick layer, that degenerates, and as it degenerates, the pulp which is there at the centre, of the discs, tends to degenerate. What I mean is it comes out of its normal space. And as it comes out of the normal place, it comes and tends to press on the nerves and these are the two most common causes.

All disc patients are not to be operated. When we get these patients, the first and foremost investigation that we do is a X-Ray. And if required, we go in for a MRI. Frankly MRI is the known standard to diagnose the disc disease. The findings of a MRI are always coordinated with the clinical findings. Once we have diagnosed that it is a disc problem, we have to establish that what the compression on the nerves is. If the nerve compression is a lot, and if we think that we cannot do anything other than surgery, then we take the patient for a surgery.

If not, we take the patient fro physiotherapy, lifestyle changes and few medications. These medications may carry on for few weeks to few months. And a lot of exercise has to be carried on regularly. Lifestyle changes such as weight loss, stoppage of smoking is very important. And if you can achieve this, then your problems are very easily solved. If you have any queries regarding your disc problems or back pains, then you can get in touch with me for the same.

You can reach me in my clinic, which is there in Indrapuri, by the name of Dr Khera’s Wellness Clinic or you can also contact me through Lybrate for the same. Thank You.
 

3714 people found this helpful

6 Symptoms of Uterine Prolapse

MBBS, M.S( Gynaecology)
Gynaecologist, Surat
6 Symptoms of Uterine Prolapse

The uterus is a muscular structure held in place inside your pelvis with the help of muscles, ligaments, and tissues. These muscles weaken in women due to pregnancy, childbirth or delivery complications and can lead to severe complications. One such complication is a uterine prolapse. Uterine prolapse occurs when the uterus sags or slips from its normal position into the vaginal canal.

The causes of uterine prolapse are varied and include:

- Delivering a large baby
- Pregnancy
- Difficulty in labor and delivery
- Reduction in estrogen levels post menopause
- Traumatic childbirth
- Loss or weakening of the pelvic muscle
- Conditions which lead to increased pressure in the abdominal area such as a chronic cough, straining, pelvic tumors or accumulation of fluid in the abdomen
- Loss of external support due to major surgery in pelvic area

Uterine prolapse can be complete or incomplete depending on how far the uterus sags into the vagina. Women who have minor uterine prolapse may not have any visible symptoms. However, if the condition worsens, it manifests itself in visible signs.

Symptoms of moderate or severe prolapse are:

1. A feeling of fullness or pressure in your pelvis when you sit
2. Seeing the uterus or cervix coming out of the vagina
3. Vaginal bleeding or increased discharge
4. Painful sexual intercourse
5. Recurrent bladder infections
6. Continuing back pain with difficulty in walking, urinating and moving your bowels

Without proper attention, the condition can cause impairments in the bowel, and can also affect bladder and sexual function. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

2752 people found this helpful

Sir I am suffering from disc problem symptoms are: Hands and chest become pain and fire can I have solution.

BHMS
Homeopath, Faridabad
Sir I am suffering from disc problem symptoms are: Hands and chest become pain and fire can I have solution.
Hello, take gnaphalium 30 ch, 3 drops twice daily. Hypericum 1x, 2 tabs twice daily. Revert me after 7 days. Thanks.
1 person found this helpful
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Ultrasound - How it is Beneficial over Other Imaging Techniques?

DNB (Radio Diagnosis), MBBS
Radiologist, Hyderabad
Ultrasound - How it is Beneficial over Other Imaging Techniques?

Ultra sound is commonly known as sonography. It is a process of reproducing ultrasound images of soft tissues of a particular body part and other organs on the computer screen with the help of the echoes of the sound waves produced by the transducer, a high-frequency generating instrument.
Ultra sound is commonly used during the different stages of pregnancy to denote the foetal health, date of delivery, birth defects etc. However, in recent times, the ultra sound has also been associated with the diagnosis of other body parts such as the eyes, heart, gall bladder, liver, ovary, uterus, kidney, uterus, testicles, and ovaries. Ultra sound has also been useful in conducting biopsies for suspecting cancer patients, although not all of the cancers are detected by this imaging process. 3D & 4D ultrasound imaging are useful for looking at a particular body portion with much more precision and in slow motion respectively.

The advantages of ultra sound are:
1. The process of ultrasound imaging is a painless and a fast one. It does not require any insertion of needles or similar objects to denote the problems of the concerned body part.
2. The process is more convenient as compared to other similar imaging processes like MRI, mammogram and x-rays as they can capture images of the soft tissues, blood flow & cysts more clearly than the other processes.
3. The process is free of any harmful effects as there are no chances of exposure to radiation as compared to similar processes such as CT scans or X-rays. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

4891 people found this helpful

Good day to you. For a few months i've been having numbness and weakness in my left leg and scrotum. Got my mri results back and they say. Mild scoliosis at L4 L5 region with minor disc bulge with no nerve compression. No sign of cauda equina. Small annular tear at L4 region with muscular spasm. What's causing my numbness? How do I fix the disc bulge?

MBBS, MD - General Medicine, DM - Neurology
Neurologist, Hyderabad
Good day to you.
For a few months i've been having numbness and weakness in my left leg and scrotum. Got my mri resul...
Most likely, the cause of your symptoms are disc bulge. The best treatment at this stage is physiotherapy. Medications such as pregabalin and gabapentin are also helpful.
1 person found this helpful
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Breast Cancer Prevention:

Homeopath,

Breast Cancer Prevention:

  1. Anything that increases your chance of developing cancer is called a cancer risk factor; anything that decreases your chance of developing cancer is called a cancer protective factor.

  2. Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer. Different ways to prevent cancer are being studied, including:

  3. Changing lifestyle or eating habits. Avoiding things known to cause cancer. Taking medicine to treat a precancerous condition or to keep cancer from starting.


 

General information about breast cancer:

Key points:

  1. Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. Breast cancer is the second most common type of cancer in india

  2. Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.

  3. The breast is made up of lobes and ducts. Each breast has 15 to 20 sections called lobes, which have many smaller sections called lobules. Lobules end in dozens of tiny bulbs that can make milk. The lobes, lobules, and bulbs are linked by thin tubes called ducts.

  4. Enlarge Drawing of female breast anatomy showing the lymph nodes, nipple, areola, chest wall, ribs, muscle, fatty tissue, lobe, ducts, and lobules.

  5. Anatomy of the female breast. The nipple and areola are shown on the outside of the breast. The lymph nodes, lobes, lobules, ducts, and other parts of the inside of the breast are also shown.

  6. Each breast also has blood vessels and lymph vessels. The lymph vessels carry an almost colorless fluid called lymph. Lymph vessels lead to organs called lymph nodes. Lymph nodes are small bean-shaped structures that are found throughout the body. They filter lymph and store white blood cells that help fight infection and disease. Clusters of lymph nodes are found near the breast in the axilla (under the arm), above the collarbone, and in the chest.

     

Avoiding risk factors and increasing protective factors may help prevent cancer. The following are risk factors for breast cancer:

  1. Older agea personal history of breast cancer or benign (noncancer) breast diseasea family history of breast cancerinherited gene changesdense breasts

  2. Exposure of breast tissue to estrogen made in the bodytaking hormone therapy for symptoms of menopause radiation therapy


 

The following are protective factors for breast cancer:

  1. Less exposure of breast tissue to estrogen made by the bodytaking estrogen-only hormone therapy after hysterectomy,

  2. Estrogen-only hormone therapy after hysterectomyselective estrogen receptor modulatorsaromatase inhibitors and inactivators

  3. Risk-reducing mastectomy ovarian ablationgetting enough exercise


 

It is not clear whether the following affect the risk of breast cancer:

  1. Oral contraceptives

  2. Factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk


 

Older age:

  1. Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.

  2. A personal history of breast cancer or benign (noncancer) breast disease

     

Women with any of the following have an increased risk of breast cancer:

  1. A personal history of invasive breast cancer, ductal carcinoma in situ (dcis), or lobular carcinoma in situ (lcis). A personal history of benign (noncancer) breast disease.

  2. A family history of breast cancer

  3. Women with a family history of breast cancer in a first-degree relative (mother, sister, or daughter) have an increased risk of breast cancer.


 

Inherited gene changes:

  1. Women who have inherited changes in the brca1 and brca2 genes or in certain other genes have a higher risk of breast cancer, ovarian cancer, and maybe colon cancer. The risk of breast cancer caused by inherited gene changes depends on the type of gene mutation, family history of cancer, and other factors.

  2. Men who have inherited certain changes in the brca2 gene have a higher risk of breast, prostate, and pancreatic cancers, and lymphoma.


 

Dense breasts:

  1. Having breast tissue that is dense on a mammogram is a factor in breast cancer risk. The level of risk depends on how dense the breast tissue is. Women with very dense breasts have a higher risk of breast cancer than women with low breast density.

  2. Increased breast density is often an inherited trait, but it may also occur in women who have not had children, have a first pregnancy late in life, take postmenopausal hormones, or drink alcohol.

  3. Exposure of breast tissue to estrogen made in the body

  4. Estrogen is a hormone made by the body. It helps the body develop and maintain female sex characteristics. Being exposed to estrogen over a long time may increase the risk of breast cancer. Estrogen levels are highest during the years a woman is menstruating.


 

A woman's exposure to estrogen is increased in the following ways:

Early menstruation: beginning to have menstrual periods at age 11 or younger increases the number of years the breast tissue is exposed to estrogen. Starting menopause at a later age: the more years a woman menstruates, the longer her breast tissue is exposed to estrogen. Older age at first birth or never having given birth: because estrogen levels are lower during pregnancy, breast tissue is exposed to more estrogen in women who become pregnant for the first time after age 35 or who never become pregnant.

 

Taking hormone therapy for symptoms of menopause:

Hormones, such as estrogen and progesterone, can be made into a pill form in a laboratory. Estrogen, progestin, or both may be given to replace the estrogen no longer made by the ovaries in postmenopausal women or women who have had their ovaries removed. This is called hormone replacement therapy (hrt) or hormone therapy (ht). Combination hrt/ht is estrogen combined with progestin. This type of hrt/ht increases the risk of breast cancer. Studies show that when women stop taking estrogen combined with progestin, the risk of breast cancer decreases.


 

Radiation therapy to the breast or chest:

  1. Radiation therapy to the chest for the treatment of cancer increases the risk of breast cancer, starting 10 years after treatment. The risk of breast cancer depends on the dose of radiation and the age at which it is given. The risk is highest if radiation treatment was used during puberty, when breasts are forming.

  2. Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast.

  3. For women who have inherited changes in the brca1 and brca2 genes, exposure to radiation, such as that from chest x-rays, may further increase the risk of breast cancer, especially in women who were x-rayed before 20 years of age.


 

Obesity:

Obesity increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy.


 

Drinking alcohol:

Drinking alcohol increases the risk of breast cancer. The level of risk rises as the amount of alcohol consumed rises.


 

The following are protective factors for breast cancer:

  1. Less exposure of breast tissue to estrogen made by the body

  2. Decreasing the length of time a woman's breast tissue is exposed to estrogen may help prevent breast cancer. Exposure to estrogen is reduced in the following ways:


 

Early pregnancy: estrogen levels are lower during pregnancy. Women who have a full-term pregnancy before age 20 have a lower risk of breast cancer than women who have not had children or who give birth to their first child after age 35. Breast-feeding: estrogen levels may remain lower while a woman is breast-feeding. Women who breastfed have a lower risk of breast cancer than women who have had children but did not breastfeed.

Taking estrogen-only hormone therapy after hysterectomy, selective estrogen receptor modulators, or aromatase inhibitors and inactivators


 

Estrogen-only hormone therapy after hysterectomy

Hormone therapy with estrogen only may be given to women who have had a hysterectomy. In these women, estrogen-only therapy after menopause may decrease the risk of breast cancer. There is an increased risk of stroke and heart and blood vessel disease in postmenopausal women who take estrogen after a hysterectomy.


 

Selective estrogen receptor modulators:

Tamoxifen and raloxifene belong to the family of drugs called selective estrogen receptor modulators (serms). Serms act like estrogen on some tissues in the body, but block the effect of estrogen on other tissues.


 

Treatment with tamoxifen lowers the risk of estrogen receptor-positive (er-positive) breast cancer and ductal carcinoma in situ in premenopausal and postmenopausal women at high risk. Treatment with raloxifene also lowers the risk of breast cancer in postmenopausal women. With either drug, the reduced risk lasts for several years or longer after treatment is stopped. Lower rates of broken bones have been noted in patients taking raloxifene.


 

Taking tamoxifen increases the risk of hot flashes, endometrial cancer, stroke, cataracts, and blood clots (especially in the lungs and legs). The risk of having these problems increases with age. Women younger than 50 years who have a high risk of breast cancer may benefit the most from taking tamoxifen. The risk of having these problems decreases after tamoxifen is stopped.


 

Taking raloxifene increases the risk of blood clots in the lungs and legs, but does not appear to increase the risk of endometrial cancer. In postmenopausal women with osteoporosis (decreased bone density), raloxifene lowers the risk of breast cancer for women who have a high or low risk of breast cancer. It is not known if raloxifene would have the same effect in women who do not have osteoporosis. Talk with your doctor about the risks and benefits of taking this drug.


 

Aromatase inhibitors and inactivators:

Aromatase inhibitors (anastrozole, letrozole) and inactivators (exemestane) lower the risk of a new breast cancer in women who have a history of breast cancer. Aromatase inhibitors also decrease the risk of breast cancer in women with the following conditions:

Postmenopausal women with a personal history of breast cancer. Women with no personal history of breast cancer who are 60 years and older, have a history of ductal carcinoma in situ with mastectomy, or have a high risk of breast cancer based on the gail model tool (a tool used to estimate the risk of breast cancer).

In women with an increased risk of breast cancer, taking aromatase inhibitors decreases the amount of estrogen made by the body. Before menopause, estrogen is made by the ovaries and other tissues in a woman's body, including the brain, fat tissue, and skin. After menopause, the ovaries stop making estrogen, but the other tissues do not. Aromatase inhibitors block the action of an enzyme called aromatase, which is used to make all of the body's estrogen. Aromatase inactivators stop the enzyme from working.


 

Possible harms from taking aromatase inhibitors include muscle and joint pain, osteoporosis, hot flashes, and feeling very tired.


 

Risk-reducing mastectomy:

Some women who have a high risk of breast cancer may choose to have a risk-reducing mastectomy (the removal of both breasts when there are no signs of cancer). The risk of breast cancer is much lower in these women and most feel less anxious about their risk of breast cancer. However, it is very important to have a cancer risk assessment and counseling about the different ways to prevent breast cancer before making this decision.


 

Ovarian ablation:

The ovaries make most of the estrogen that is made by the body. Treatments that stop or lower the amount of estrogen made by the ovaries include surgery to remove the ovaries, radiation therapy, or taking certain drugs. This is called ovarian ablation.


 

Premenopausal women who have a high risk of breast cancer due to certain changes in the brca1 and brca2 genes may choose to have a risk-reducing oophorectomy (the removal of both ovaries when there are no signs of cancer). This decreases the amount of estrogen made by the body and lowers the risk of breast cancer. Risk-reducing oophorectomy also lowers the risk of breast cancer in normal premenopausal women and in women with an increased risk of breast cancer due to radiation to the chest. However, it is very important to have a cancer risk assessment and counseling before making this decision. The sudden drop in estrogen levels may cause the symptoms of menopause to begin. These include hot flashes, trouble sleeping, anxiety, and depression. Long-term effects include decreased sex drive, vaginal dryness, and decreased bone density.


 

Getting enough exercise:

Women who exercise four or more hours a week have a lower risk of breast cancer. The effect of exercise on breast cancer risk may be greatest in premenopausal women who have normal or low body weight.


 

It is not clear whether the following affect the risk of breast cancer:

  1. Oral contraceptives

  2. Certain oral contraceptives contain estrogen. Some studies have shown that taking oral contraceptives (" the pill") may slightly increase the risk of breast cancer in current users. This risk decreases over time. Other studies have not shown an increased risk of breast cancer in women who take oral contraceptives.

  3. Progestin -only contraceptives that are injected or implanted do not appear to increase the risk of breast cancer. More studies are needed to know whether progestin-only oral contraceptives increase the risk of breast cancer.


 

Environment

  1. Studies have not proven that being exposed to certain substances in the environment, such as chemicals, increases the risk of breast cancer.

  2. Studies have shown that some factors do not affect the risk of breast cancer.


 

The following do not affect the risk of breast cancer:

  1. Having an abortion. Making diet changes such as eating less fat or more fruits and vegetables. Taking vitamins, including fenretinide (a type of vitamin a). Cigarette smoking, both active and passive (inhaling secondhand smoke). Using underarm deodorant or antiperspirant. Taking statins (cholesterol -lowering drugs). Taking bisphosphonates (drugs used to treat osteoporosis and hypercalcemia) by mouth or by intravenous infusion.

  2. Cancer prevention clinical trials are used to study ways to prevent cancer.

ECMO New Era of Medicicne

Homeopath,
ECMO New Era of Medicicne

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.

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Umbilical Hernia Diet

M.Sc. in Dietetics and Food Service Management , Post Graduate Diploma In Computer Application, P.G.Diploma in Clinical Nutrition & Dietetics , B.Sc.Clinical Nutrition & Dietetics
Dietitian/Nutritionist, Mumbai

Umbilical hernia diet

An umbilical or belly button hernia occurs when a part of the intestines or the abdominal lining protrudes through an opening in the abdominal muscles. The protruding intestines may get squeezed or strangulated resulting in the blood supply getting cut off. Surgery may be required in serious cases of umbilical hernia. Doctors often suggest a special diet for umbilical hernia patients as this helps to prevent further complications.

Foods to avoid

Certain foods are not recommended for people with an umbilical hernia and should be avoided.

These include:

White refined flour foods made from white refined flour have a low fiber content. Eating these foods may cause constipation and should therefore be avoided. This is because constipation causes straining of the abdominal muscles during bowel movements and may cause further protrusion of the intestines through the abdominal muscles in the region of the belly button.

Low fiber fruits and vegetables the low fiber content in these foods can also lead to constipation. Examples of fruits and vegetables with low fiber content include skinless raw fruits, cooked fruits, and canned or cooked vegetables without seeds, hulls or skin.

Fatty foods foods with a high fat content should be avoided. This is because obesity results in greater pressure on the abdominal muscles and can increase the risk of umbilical hernia. Examples of foods with a high fat content include fatty meat such as pork, whole milk, butter, cream, margarine and fried foods.

Sugar limit your calorie intake by cutting down on foods such as pastries, cakes, chocolates and soda pop. Limiting your sugar intake will also help you to lose some weight, taking pressure off your abdominal region.

Foods to include

A special diet is required after umbilical hernia surgery. This will help you to minimize your convalescence time. The special dietary requirements include:

Fruits fresh fruits that have high fiber content and are rich in antioxidants should form a part of every meal. The high fiber content will ensure that you do not get constipated and the antioxidants will help protect your body and boost your immune system. Try to eat different types of fruits so as to get adequate amounts of different vitamins. Citrus fruits, berries, and apples are some examples of fruits with a high fiber and vitamin content.

Vegetables these too have a high fiber content that will guard against the dangers of constipation after an umbilical hernia surgery. They also have high levels of vitamins and minerals and should also be included with every meal.

Lean meat meat is a source of protein, which is essential to the repair of damaged tissue. Lean meat like poultry and fish is an excellent source of low fat protein. Have one good source of low fat protein with every meal.

Low fat dairy products these are a good source of protein and can be alternated with lean meats to provide your body with sufficient protein.
High fiber breakfast foods will aid digestion and so your breakfast should consist of foods made from whole wheat flour, wheat germ, oatmeal, or bran.

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The Breast Cancer Myth

Diploma in Endoscopic Surgery, DGO, MBBS
Gynaecologist, Delhi

1. You felt a lump in your breast and it always means you have breast cancer.

The Truth

It's a small percentage of breast lumps only that will turn out to be cancer.  If you discover a persistent lump in your breast or notice any changes in breast tissue,  never ignore it.  You  must see a physician for a clinical breast examination. He or she may possibly order breast imaging studies to determine if this lump is of concern or not.

Take charge of your health by performing routine breast self-exams, establishing ongoing communication and counseling with your doctor, getting an annual clinical breast exam, and scheduling your routine screening mammograms.

2. Only women get breast cancer, men do not.

The Truth

Quite the contrary, each year it is estimated that approximately 2,190 men will be diagnosed with breast cancer and 410 will die. While this percentage is still small, men should also check themselves periodically by doing a breast self-exam while in the shower and reporting any changes to their physicians. 

Breast cancer in men is usually detected as a hard lump underneath the nipple and areola.  Men carry a higher mortality than women do, primarily because awareness among men is less and they are less likely to assume a lump is breast cancer, which can cause a delay in seeking treatment.

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Benefits of Minimally Invasive Spine Surgery!

Diploma in Orthopaedics, MBBS
Orthopedist, Gurgaon
Benefits of Minimally Invasive Spine Surgery!

The spine plays a very crucial role, both from a person’s movement and sensation point of view. It carries the nervous supply for a lot of internal organs and the lower body. By virtue of its structure, it also helps in movement through the disks. Due to various reasons, spinal injury is common, causing pain along the back, lower extremities, neck etc.

Medicines and exercise are the first line of treatment for most spinal injuries. The issue, however, is that these only provide relief from the pain and the medicines, but do not actually ‘rectify’ the underlying problem. Whether it is a herniated disk or a pinched nerve, the medicines and exercise can relieve the symptoms, but the disk continues to be herniated and the nerve continues to be pinched. Definite treatment is in the form of surgery, and with recent advancements in the field of spinal surgery, there are minimally invasive surgical options, which provide complete cure with minimal recovery time. Some of the benefits of this are listed below-

  1. Smaller incision compared to traditional surgical procedures, where only the injured area is accessed

  2. The surrounding tissues are untouched, unless they are injured and require repair

  3. Lesser bleeding compared to earlier techniques

  4. Lesser painful procedure

  5. Reduced hospitalization period

  6. Quicker recovery and return to normal activities

The question, however, is whether this is indicated in everybody. A detailed discussion with your surgeon keeping the below points in mind will help identify the answer for this. The main driver should be the answer to the question – will the surgery be able to effectively relieve you of the pain and symptoms? Additionally, the following factors help in getting better results out of a minimally invasive spinal surgery.

  1. Presence of symptoms relating to nerve compression, including pain from the spine down the leg.

  2. Recent onset of symptoms, with pain starting days to months before seeing the doctor. This indicates the condition is relatively new and so damage is minimal, indicating favorable outcome. Chronic pain conditions take slightly longer time compared to recent injuries.

  3. People with active lifestyle who engage in regular physical exercise are likely to have better benefits from the minimally invasive procedure.

  4. Smoking reduces blood flow to the spine, leading to disk degeneration and weakening of bones. Healing is highly slowed down and recovery is overall delayed.

  5. Excessive weight puts strain on the back, and so healing can be delayed or badly affected with more complications. It is not a contraindication, but be prepared for a longer recovery period.

Talk to your doctor keeping these points in mind, and you can bid farewell to your back pain forever. If you wish to discuss about any specific problem, you can consult an Orthopedist.

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Breast Cancer - 8 Warning Signs Your Body Will Give You!

MBBS, MS - General Surgery, FBD (Fellowship in Breast Diseases), UICC Fellowship
Oncologist, Pune
Breast Cancer - 8 Warning Signs Your Body Will Give You!

Breast cancer is the most common forms of cancer in females, affecting one in every eight women in the US. There are huge awareness campaigns, which revolve around ways to recognize if you are prone for it and how to identify the disease in its early stages. Knowing the symptoms can help in early diagnosis and thereby early intervention and better prognosis.

How and why of breast cancer?
The breasts produce milk through the glands, which also contain connective tissue including fat, fibrous tissue, nerves, blood vessels, etc. The milk reaches the exterior through a fine network of ducts. Most cancers develop as small calcifications in these ducts, which continues to grow and spread to distant organs.

Warning signs and symptoms: Given the high incidence of breast cancer, knowing the symptoms helps in early identification. Read on to know more, especially if there is a family history.

  1. Any change in the size, shape, or contour of the breasts
  2. Appearance of a lump in the breasts or the armpits
  3. Presence of a clear or bloody discharge from the breast
  4. The breast or the nipple turning red
  5. Sudden thickening of breast tissue or skin that continues for a while
  6. Change in the feel or look of the skin (dimpling, puckering, scaliness, reddishness, warmth, etc.)
  7. Hardening of the tissue under the breast skin
  8. Difference in appearance or feel of one area in comparison with other areas

The presence of any of these or a combination of these symptoms should be an indication for a detailed checkup. As mentioned, early diagnosis helps in reducing complications and improving prognosis. It is also good to know risk factors, which also indicate if you need to watch for symptoms.

  • Family history: Breast cancer runs in families, and if you have a first-degree relative with breast cancer, watch out for symptoms.
    • Tested positive for BRCA1 and BRCA2
    • Family history of other cancers
  • Age: Women over the age of 50 are at an increased risk of developing breast cancer.
  • Race: Caucasian women carry greater risk than African-American women.
  • Hormones: Increased use of estrogen increases the chances of developing breast cancer. Therefore, women who have used birth control for long time or are on hormone replacement are at greater risk.
  • Abnormal gynecologic milestones: Women who have abnormal menstrual milestones are more predisposed to developing breast cancer. For instance, girls who attain menarche before age of 12, get pregnant after 30, and reach menopause after 55. Women with menstrual irregularities including cycles earlier than 26 days and later than 29 days are also likely to have hormonal issues and are, therefore, at higher risk of breast cancer.
  • Other factors: Smoking, alcohol abuse, and obesity also increase the chances of a woman developing breast cancer. If you wish to discuss about any specific problem, you can consult an Oncologist.
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