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Dr. Yogendera Mittal

Radiologist, Delhi

Dr. Yogendera Mittal 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.
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Dr. Yogendera Mittal is a popular Radiologist in Krishna Nagar, Delhi. She is currently practising at Medicos Clinic in Krishna Nagar, Delhi. Save your time and book an appointment online with Dr. Yogendera Mittal on Lybrate.com.

Lybrate.com has an excellent community of Radiologists in India. You will find Radiologists with more than 32 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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#383, #11 A, East Azad Nagar, Krishna Nagar. Landmark: Opp. Swaran Cinema, DelhiDelhi Get Directions
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I am 39 years my weight is 95 kg, my height is 5.4, I have ligament tear in my right knee, I have slip disc in l4, l5, high bp. Etc, please suggest how to loose weight. Rapidly fast if any medicine that can help to reduce the weight.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I am 39 years my weight is 95 kg, my height is 5.4, I have ligament tear in my right knee, I have slip disc in l4, l5...
Weight reduction can not be done over night. 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 feeds. When you get used to it, skip one meal. You should do non weight bearing yoga exercises. For your knee problem you would need arthroscopic knee surgery. It is a very safe procedure in our hands with uniformly good results. We have very good well equipped center in delhi. Do ask for detailed treatment plan. Don? t ignore it lest it become beginning of a bigger problem.
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Brain Stroke: Things You Must Know

BHMS
Homeopath, Ajmer
Brain Stroke: Things You Must Know

A brain stroke can affect anyone at any point of time when the supply of blood to the brain is interrupted. It can threaten major physical functions and can prove to be fatally dangerous at times. The brain stem which is placed right above the spinal cord controls the breathing, heartbeat and levels of blood pressure. It is also in charge of controlling some elementary functions such as swallowing, hearing, speech and eye movements

What are the different types of strokes?
There are three main kinds of stroke: ischemic strokes, hemorrhagic strokes and transient ischemic attacks. The The most common type of brain stroke is the ischemic stroke is caused by narrowing or blocking of arteries to the brain, which prevents the proper supplyof of blood to the brain. Sometimes it so happens that the blood clot that has formed elsewhere in the body have travelled via the blood vessels and has been trapped in the blood vessel which provides blood to the brain. When the supply of blood to a part of the brain is hindered, the tissue in that area dies off owing to lack of oxygen. The other variant of brain stroke is termed as hemorrhagic stroke is caused when the blood vessels in and around the brain burstor or leak. Strokes need to be diagnosed and treated as quickly as possible in order to minimize brain damage.

What are the common symptoms of a brain stroke?
The symptoms of the brain stroke are largely dependent on the area of the brain that has been affected. It can interfere with normal functioning, such as breathing and talking and other functions which human beings can perform without thinking such as eye movements or swallowing. Since all the signals from the brain as well as other parts of the body traverse through the brain stem, the interruption of blood flow often leads to numbness or paralysis in different parts of the body.

Who is likely to have a stroke?
Anyone is at a risk of developing brain stroke although ageing is directly proportional to the risk of having a stroke. Not only that an individual with a family history of brain stroke or transient ischemic attack is at a higher risk of developing stroke. People who have aged over 65 accounts for about 33 percent of all brain strokes. It is important to point here that individuals with high blood pressure, high blood sugar, cholesterol, cancer, autoimmune diseases and some blood disorders are at a higher risk of developing brain stroke.

There are a few factors which can increase the risk of developing stroke beyond any control. But there are certain lifestyle choices as well which aids in controlling the chances of being affected by stroke. It is crucial to refrain from long-term hormone replacement therapies as well as birth control pills, smoking, lack of physical activity, excessive use of alcohol and drug addiction. A brain stroke is a life-threatening medical condition, and when an individual has symptoms that resemble that of stroke, it is crucial to seek immediate medical help.

Treatment for stroke:

  • Treatment depends on the type of stroke.
  • Ischemic strokes can be treated with 'clot-busting' drugs.
  • Hemorrhagic strokes can be treated with surgery to repair or block blood vessel weaknesses.
  • The most effective way to prevent strokes is through maintaining a healthy lifestyle.

What is TPA?
TPA is a thrombolytic or a “Clot Buster” drug. This clot buster is used to break-up the clot that is causing a blockage or disruption in the flow of blood to the brain and helps restore the blood flow to the area of the brain. It is given by intravenous (IV). This can be given only within 45.5 hrs of the onset of symptoms

Time is brain

Remember Every second Loss means brain cells die.

Rush to the nearest Stroke Centre whenever you experience such symptoms.

You can save the brain cells dying if you reach within 4.5 hrs by the CLOT BUSTER. 

Endovascular procedures:
Another treatment option is an endovascular procedure called mechanical thrombectomy, strongly recommended, in whichtrained  trained doctors try  removing a large blood clot bysending sending a wired-caged device called a stent retriever, to the site of the blocked blood vessel in the brain

Stroke prevention:
The good news is that 80 percent of all strokes are preventable. It startswith with managing keyrisk risk factors, including 

  • High blood pressure,
  • Cigarette smoking,
  • Diabetes Atrial fibrillation and
  • Physical inactivity.

More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control. 

Rehabilitation:
The best way to get better after a stroke is to start stroke rehabilitation ("rehab"). In stroke rehab, a team of health professionals works with you to regain skills you lost as the result of a stroke. If you wish to discuss about any specific problem, you can consult a neurologist. Homoeopathic Remedies which may be helpful during stroke or after stroke: Creategus, Terminalia Arjuna, Arnica, Glonoine, Glycyrrhiza Glabra, Lachesis, Opium, Staphysagria, Gelsemium, Phosphorous etc. 

Note : Do not take any Homoeopathic medicine without consulting any Homoeopath.

Herniated disk l3-14 mm L4-11 mm L5-10 mm S1-8 mm My age 23 /M Dr. suggest for surgery but I didn't want that any chances for normal.

MBBS, MD (Anaesthesiology)
Pain Management Specialist, Varanasi
It seems that you are having multiple disc herniation. I cannot comment unless I see you MRI but definitely you having at least two slipped disc at L4/5 & L5/S1. These days non surgical treatment are available like TFSI, Disc Fix and Percutaneous Endoscopic Lumbar Discectomy (PLED) done under Local anaesthesia, no blood loss, no stich required, patient walks within next few days. We will provide you detailed information if you wish or you may see on website. I may need your blood inv. Like TLC/DLC/ESR/CRP/HLA B-27 before giving further opinion.
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Kindly prescribe ayurvedic medicine for l5s1 disc herniation. Kindly note I am taking jointhar from last six months but cud not find any relieve.

MBBS
General Physician, Mumbai
I will suggest you to take Panchkarma therapy treatment as a part of ayurved treatment for a minimum of five sessions
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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.
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7 Tips For Good Bone Health

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

1. Eat calcium-rich foods

In addition to dairy products, choose fish with bones such as salmon, sardines or whitebait. For additional benefits, serve them with a side of dark leafy green vegetables or broccoli. Almonds, dried figs, fortified tofu and soy milk are also calcium-rich choices, says registered dietitian laura jeffers, med, rd, ld.

2. Take calcium supplements

The u. S. Recommended daily allowance for calcium is 1, 000 mg a day during your 20s, 30s and 40s. But your need rises as you age. Check with your doctor before starting supplements to find out what amount is right for you. For example, after menopause, most women need 1000 to 1, 500 mg a day unless they take hormone therapy. Your body only absorbs 500 mg of calcium at a time, Ms. Jeffers notes, so spread your consumption out over the course of the day.


3. Add d to your day

To help absorb calcium, most adults need 1, 000 to 2, 000 iu of vitamin d daily, combined calcium-vitamin d pills usually do not meet this requirement. And most of us who live north of atlanta do not get enough vitamin d the old-fashioned way — from the sun. Taking a vitamin d supplement will ensure you meet your daily needs.


4. Start weight-bearing exercises

To boost your bone strength, try exercise that “loads” or compresses your bones, says exercise physiologist heather nettle, ma. “running, jogging, high-impact aerobics, repetitive stair climbing, dancing, tennis and basketball are best for building bones. But if you have osteopenia, osteoporosis or arthritis, try walking or using an elliptical or other machine,” she says. Be sure to clear any exercise plans with your doctor first.


5. Don’t smoke, and don’t drink excessively

Bad news for bad habits: loss of bone mineral density is associated with tobacco use and excessive alcohol consumption, Dr. Sikon says. If you smoke, look into a program to help you quit. If you drink, stick to no more than one libation a day, she advises.

6. Get your bone mineral density tested

Doctors can get a quick and painless “snapshot” of bone health using a simple x-ray test called dxa. This test measures bone mineral density and helps determine risks of osteoporosis and fracture. Dr. Sikon recommends testing for women within two years of menopause. Earlier tests are recommended for men and women with certain diseases and for those taking medications that increase risk, such as long-term steroid therapy.

7. Medication

Perimenopausal women may consider hormone therapy to increase waning estrogen levels, which are linked to bone loss. And women and men diagnosed with osteopenia or osteoporosis can take various medications to prevent dangerous hip and spine fractures.

5 people found this helpful

Breast Cancer - The Most Common Cancer In India

FICMCH, Diploma In Laproscopic Surgery, Certified in Laparoscopy & Hysteroscopy, DNB (Obstetrics and Gynecology), MBBS
Gynaecologist, Gurgaon
Breast Cancer - The Most Common Cancer In India

Breast cancer(स्तन कैंसर) is on the rise in india. Surveys show that every 4 out of 5 Indian women who have breast cancer, suffer from an advanced stage of the disease by the time they reach the doctor. Urban women are at two times more risk of being diagnosed with breast cancer than rural women. Being overweight, eating unhealthy food, and consuming excessive alcohol or tobacco are some of causes that can make you susceptible to this disease.

How you can avoid breast cancer?

  1. Every woman should do a self-breast examination every month after the periods. You should check for any abnormal lump, change in skin texture or any abnormal discharge from the nipples. Any abnormality above aspects should be promptly investigated by a doctor's appointment, and an ultrasound or Mammography, as required.
  2. Apart from self-examining your breasts every month for a lump, going for a mammography (an X-Ray of the breast) is vital for early detection of the problem.
  3. Consult a gynaecologist before going for the test as its frequency depends on your age and risk factor. About 80-90% of tumours can be traced through this screening.

Breast cancer may run in family. If there is no family history of breast cancer, you start doing mammogram at 40 yrs of age but if there is a family history you start even earlier as advised by your gynaecologist.

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When Is Surgery Recommended For Herniated Disc?

DNB NEUROSURGERY, M.B.B.S.
Neurosurgeon, Durgapur
When Is Surgery Recommended For Herniated Disc?

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

Effects of Herniated Disk

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

Nerves located at the back of every disc are responsible for transmitting pain, motor impulse, bladder control etc. in our body. While a disc gets herniated, the external covering of the disc tears and creates a bulge. The soft jelly gets shifted from the centre of the disk to the region where the damage has occurred on the disc. Most commonly, the bulge occurs in areas where the nerve is located and it causes strain and irritation of the affected nerve. It has been observed that individuals may or may not feel any painful sensations even if their disc gets damaged. Other symptoms may be weakness of muscle groups or difficulty in controlling the bladder.

When is surgery recommended for herniated disc?

Surgery for herniated disc is recommended only after options like rest and pain relievers do not work. If the pain persists even after these options, then it becomes important to go for surgery. Surgery is also considered early if there is weakness of muscle groups or acute problem in bladder control. At times, emergency surgery is also required to avoid paralysis in a patient.

However, there are certain risks involved in this surgery like infection, bleeding or nerve damage.  There are chances that the leftover disc may bulge out again. If you are a patient suffering from degenerative disc disease, then there are chances that problem occurs in other discs. It is very important that a patient maintains healthy weight to prevent any further complications.

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

Activities like bending sideways, pushing, twisting, repetitive lifting can increase the risk of a herniated disk. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.

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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

Hello, I am 41 yr. Old, female. I have got breast cancer & undergoing chemotherapy. I have completed 5 chemo out of 8. Since 2 days I am experiencing severe and unbearable pain in right leg. Is this a symptom of chemotherapy? We have tried all kinds of balm and oils, but nothing is working. Pls prescribe me some medicine or home remedy for it.

MD - Radio Diagnosis/Radiology
Radiologist, Kolkata
Kindly get venous Doppler b/l lower limb done .it can be due to DVT. Its a serious condition. It can occur in a cancer patient as well as pt on chemotherapy.
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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.

My dad had arteries blockage which TVD (triple vessel disease) all 3 arteries are blocked 2 major and one minor doctors are suggesting for by pass surgery however I am afraid of that is there any treatment or cure for this? So that he be well soon.

MBBS, Dip.Cardiology, Fellowship in Clinical Cardiology(FICC), Fellowship in Echocardiology
Cardiologist, Ghaziabad
In coronary artery disease (CAD), the arteries that supply blood and oxygen to your heart muscle grow hardened and narrowed. You may try treatments such as lifestyle changes, medicines, and angioplasty, a procedure to open the arteries. If these treatments don't help, you may need coronary artery bypass surgery. The surgery creates a new path for blood to flow to the heart. The surgeon takes a healthy piece of vein from the leg or artery from the chest or wrist. Then the surgeon attaches it to the coronary artery, just above and below the narrowed area or blockage. This allows blood to bypass (get around) the blockage. Sometimes people need more than one bypass. The results of the surgery usually are excellent. Many people remain symptom-free for many years. You may need surgery again if blockages form in the grafted arteries or veins or in arteries that weren't blocked before. Lifestyle changes and medicines may help prevent arteries from becoming clogged again.
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I'm 25 years old. I've mild disk bulge in L4 and L5. Whether I can lead normal life or not? And it's curable completely or not? Pls tell me.

Fellowship of the Royal College of Surgeons (FRCS), Membership of the Royal College of Surgeons (MRCS)
Orthopedist, Trichy
Mild disc bulge is nothing serious. As long as you do not have any back pain radiating to your legs then the nerve roots are not getting compressed. Make sure you do not lift heavy objects or strain urself, avoid long distance 2 and 4 wheeler rides, back exercises help.
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Sir my sister aged 32 years is going under total hip replacement. I much confused about prosthetic which one to go for Ceramic with poly or Ceramic on Ceramic Please advice which one is better.

Fellowship of the Royal College of Surgeons (FRCS), MRCS, DNB (Orthopedics), MBBS
Orthopedist, Visakhapatnam
Hi Lots of studies are there. As per my experience in UK 12 yrs, ceramic on ceramic is good in long term. But risk of fracture is there always when ever patient jumps. Ceramic on poly is more safe and it's better combination too. I preserve ceramic on ceramic. Hope it solves you r question.
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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.

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She is 63 years old suffering from diabetes-on Insulin+other allopathy medicines but the sugar level running from 70 to 200 and more. Today fasting 90 but PP is going high between 200 to 300. She is on Insulin from last 15 years. Can she be treated with you? And I am also suffering from Slip Disc. L4 L5 S1 and taken 15 days Ayurvedic treatment such as Katibastyi, Malish, Steam bath etc but there is nothing complete and permanent. Please advise us to permanent treatment.

PDDM, MHA, MBBS
General Physician, Nashik
She is  63 years old suffering from diabetes-on Insulin+other allopathy medicines but the sugar level running from 70...
This means either her diet is wrong or she is not receiving proper treatment kindly mention ongoing treatment in detail and revert. Slip disc is difficult to treat but you should use lumbosacral belt and proper posture is really important in your case. Avoid massages by inexperienced people.
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I am suffering from disk and Knee joint pains for the past 10 years I have already done panchakarma treatment. There is no result? What can I Do?

MD - Alternate Medicine, BHMS
Homeopath, Surat
I am suffering from disk and Knee joint pains for the past 10 years I have already done panchakarma treatment. There ...
Just do this small exercise: Sleep with legs raised up from waist against the wall straight up, making 90 degree angle for 5 mins. Its better you do in early morning, else you can do it anytime. This will make your blood flow increased towards brain and increase your memory and physical strength too will be increased. And your knee joint pain will also be relieved. And try to apply ice-packs over it for 2 times in a day for 5 mins. Still if you have any queries, please ask. Take care. :)
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I am 36 year old having problem of of disc slip in lumbar spine Dr. Asked for the surgery is only surgery is the option please suggest me other treatment.

DNB (Radiodiagnosis), DMRD, MBBS
Radiologist, Bangalore
Hi, thanks for writing in to us. It is possible that the disc bulge might have increased in severity recently. Please get a repeat mri scan done and discuss the findings please. It is possible that you might get relief through physical therapy or mild pain relief medications. If there is no relief with medicines then there is the option of steroid injection and radio frequency nerve block procedure. Surgery is the last resort and done only in extreme cases. Please do not worry. Regards,
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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.
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Test to Screen for Breast Cancer

Homeopath,

Test to screen for breast cancer:

 

Mammogram:

  1. Mammography is the most common screening test for breast cancer. A mammogram is an x-ray of the breast. This test may find tumors that are too small to feel. A mammogram may also find ductal carcinoma in situ (dcis). In dcis, there are abnormal cells in the lining of a breast duct, which may become invasive cancer in some women.

  2. Mammograms are less likely to find breast tumors in women younger than 50 years than in older women. This may be because younger women have denser breast tissue that appears white on a mammogram. Because tumors also appear white on a mammogram, they can be harder to find when there is dense breast tissue.


 

Enlarge Mammography:

  1. The left breast is pressed between two plates. An x-ray machine is used to take pictures of the breast. An inset shows the x-ray film image with an arrow pointed at abnormal tissue.

  2. The breast is pressed between two plates. X-rays are used to take pictures of breast tissue.


 

The following may affect whether a mammogram is able to detect (find) breast cancer:

  1. The size of the tumor. How dense the breast tissue is. The skill of the radiologist.

  2. Women aged 40 to 74 years who have screening mammograms have a lower chance of dying from breast cancer than women who do not have screening mammograms.


 

Clinical Breast Exam (CBE):

  1. A clinical breast exam is an exam of the breast by a doctor or other health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual. It is not known if having clinical breast exams decreases the chance of dying from breast cancer.

  2. Breast self-exams may be done by women or men to check their breasts for lumps or other changes. It is important to know how your breasts usually look and feel. If you feel any lumps or notice any other changes, talk to your doctor. Doing breast self-exams has not been shown to decrease the chance of dying from breast cancer.

  3. Mri (magnetic resonance imaging) in women with a high risk of breast cancer

  4. Mri is a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (nmri). Mri does not use any x-rays.


 

MRI is used as a screening test for women who have one or more of the following:

  1. Certain gene changes, such as in the brca1 or brca2 genes. A family history (first degree relative, such as a mother, daughter or sister) with breast cancer. Certain genetic syndromes, such as li-fraumeni or cowden syndrome.

  2. Mris find breast cancer more often than mammograms do, but it is common for mri results to appear abnormal even when there isn't any cancer.

  3. Other screening tests are being studied in clinical trials.


 

Thermography:

  1. Thermography is a procedure in which a special camera that senses heat is used to record the temperature of the skin that covers the breasts. A computer makes a map of the breast showing the changes in temperature. Tumors can cause temperature changes that may show up on the thermogram.

  2. There have been no clinical trials of thermography to find out how well it detects breast cancer or if having the procedure decreases the risk of dying from breast cancer.


 

Tissue sampling:

Breast tissue sampling is taking cells from breast tissue to check under a microscope. Abnormal cells in breast fluid have been linked to an increased risk of breast cancer in some studies. Scientists are studying whether breast tissue sampling can be used to find breast cancer at an early stage or predict the risk of developing breast cancer. Three ways of taking tissue samples are being studied:


 

Fine-needle aspiration: a thin needle is inserted into the breast tissue around the areola (darkened area around the nipple) to take out a sample of cells and fluid.


 

Nipple aspiration: the use of gentle suction to collect fluid through the nipple. This is done with a device similar to the breast pumps used by women who are breast-feeding.


 

Ductal lavage: a hair-size catheter (tube) is inserted into the nipple and a small amount of salt water is released into the duct. The water picks up breast cells and is removed.

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