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Dr. Omesh Paul

Mbbs

Radiologist, Gurdaspur

13 Years Experience  ·  650 at clinic  ·  ₹250 online
Dr. Omesh Paul Mbbs Radiologist, Gurdaspur
13 Years Experience  ·  650 at clinic  ·  ₹250 online
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Personal Statement

My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them....more
My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them.
More about Dr. Omesh Paul
He has been a practicing Radiologist for 13 years. He studied and completed Mbbs . You can book an instant appointment online with Dr. Omesh Paul on Lybrate.com.

Find numerous Radiologists in India from the comfort of your home on Lybrate.com. You will find Radiologists with more than 31 years of experience on Lybrate.com. Find the best Radiologists online in Gurdaspur. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Education
Mbbs - Govt. Medical college. Patiala - 2005

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Modern Scan Center

Railway Road, fatehgarh churianGurdaspur Get Directions
650 at clinic
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Is homeopathic medicine helpful for disc extrusion (L5-S1) neurosurgeon is saying surgery is must otherwise you may loose control over foot movement and urine, please HELP.

Fellowship in Interventional Pain management , Diploma in Anesthesia, DA, MBBS
Pain Management Specialist, Jaipur
disc problems are mechanical one due associated with ur action like weight lifting. jumping.riding. forward flexion.etc. prognosis is depending entirely on radiological finding as well as clinical presentation too. a single criteria shouldn't be implement in every case. as in my opinions up to certain extent conservative management be institute. afterwards six week to six months. if ur ur bowl.bladder or motor powers affected. immediately go for minimal invasive technique. avoid open surgery. because its associated with failed back surgery syndrome in 30%case worldwide.
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My mother is suffering from DVT since one week. And is in the hospital by taking medicine. Doctor suggested to do surgery tomorrow. Please suggest what is correct to do?

General Surgeon, Mumbai
To guide you better, pls upload your investigation reports. Dvt surgery is done to avoid complications like embolism, mi, stroke. Or ischemia, increasing limb edema. Etc pls discuss with your doctor in detail. If you do not get required answers. Consult me online.
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My dad was diagnosed with renal cell carcinoma. But there were no symptoms. They removed half kidney by surgery. Will there be any chances of spreading cancer cells to other body parts or will the cancer be back? What are the precautions to be taken?

DNB (Urology), MS - General Surgery, MBBS
Urologist, Delhi
There’s a 5 percent risk of recurrence approximately Regular blood. Urine tests and follow up ct scans needed.
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Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

MBBS, MD, FIMSA, FIPP
Pain Management Specialist, Delhi
Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

  • Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
  • Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
  • High risk of primary or consequential damage to neural, bony or disc element
  • Increased wedging, deformity & increase incidence of adjacent VB
  • Chronic pain of altered spine mechanics
  • Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
  • Cost of surgery and hospital treatment
  • Cost of implants
  • Phobia of surgery
  • Prolonged recovery period & Extensive rehabilitation
  • Changed spinal mechanics & transition syndrome
  • Major surgery & anesthesia with its own complications

Results / Outcome

  • PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
  • Different studies show an immediate pain relief in (85 – 90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
  • PVP does augment height of VB but ideal would be kyphoplasty
  • Patient is either off medicine or on reduced doses.
  • Patient feels so well that he almost forgets if he had VB
     

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are  Metastatic VB,  Multiple myeloma VB, VB haemangioma,  Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF)   which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis.  Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient  back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

  • Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
  • Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
  • GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
  • High risk of primary or consequential damage to neural, bony or disc elements.
  • Increased wedging, deformity & increase incidence of adjacent VB
  • Chronic pain of altered spine mechanics.
  • Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.

Morbidity and complication of spinal surgery 

  • Cost of surgery and hospital treatment
  • Cost of implants
  • Phobia of surgery
  • Prolonged recovery period & Extensive rehabilitation
  • Changed spinal mechanics & transition syndrome
  • Major surgery & anesthesia with its own complications

Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

  • Cementing of fragments.
  • Thermal neurolysis of VB nerve ending due to heat of polymerization.
  • Washing away of nociceptor chemicals.
  • Neurolytic action of liquid monomer.
  • By allowing early ambulation decreasing pains of immobility & bed rest.

Complications 

  1. PVP is generally safe with low risk.
  2. Ectopic cement leak is frequent but generally inconsequential.

Outcome 

  1. PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
  2. Different studies show an immediate pain relief in (85 – 90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
  3. PVP does augment height of VB but ideal would be kyphoplasty.
  4. Patient is either off medicine or on reduced doses.
  5. Patient feels so well that he almost forgets if he had VB

In case you have a concern or query you can always consult an expert & get answers to your questions!

4342 people found this helpful

Breast Cancer: Diagnosis and Treatment

MBBS, MS - General Surgery, FICS (Surgical Oncology), Fellowship of Association of Indian Surgeons(FAIS), Fellowship in Minimal Access Surgery(FMAS) & Reproductive Medicine, Fellowship of Indian Association of Gastrointestinal Endo Surgeons (FIAGES)
Oncologist, Ghaziabad
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Namaskar,

Mai Dr. Arun Kumar Goel, Max Super Speciality Hospital, Vaishali, Ghaziabad mein Cancer Surgery department ka head hoon, aur breast oncology unit ka director bhi hoon.

Mere main area of interest me breast cancer ka management ek pramukh area hai, breast cancer mahilaon ka sabse common cancer hai jo major cities hai metropolitan Delhi- NCR, Bombay aur aisi cities mein. Aur iska jo incidence hai woh badhta ja raha hai jiske kai karan hai, isme breast cancer ke ilaj mein pichle 30-40 saalon mein bahut tarakki hui hai aur aaj ke din hum dekhte hain ki breast cancer ke marijoo ka survival rate hai woh 90% se upar hai, lekin itna achha survival achieve karne ke liye hame jo hai uski diagnosis bahut jaldi karni padti hai. Toh yeh ek bahut sabse important baat hai, jo sabse common symptom hai breast cancer ka woh hai breast mein ek lump ya ganth ka hona. Ab breast ki ganthe kuch cancerous hoti hai kuch non-cancerous hoti hai, lekin jab bhi koi ganth ho toh yeh possibility zaroor sochna chahiye ki kahi cancer to nahi hai aur turant ek cancer specialist ya breast surgeon se opinion lena chahiye. Cancer ki diagnosis banane ke liye usme kuch janche hoti hai jisme mammography ya ultrasound hota hai, fine needle aspiration cytology ya biopsy hoti hai aur kabhi kabhi breast ka MRI bhi kiya jata hai. Toh agar cancer confirm hota hai toh phir uske baad kuch staging test karte hain yeh dekhne ke liye ki bimari sharir mein kahin faili toh nahi hai, jyadatar cases me bimari localised hoti hai aur uska ilaj jo hai sabse pehle operation ya surgery ke dwara kiya jata hai jo meri main feild hai. Jyadatar logo ko breast cancer surgery mein jo pareshani hoti hai ki pehle ilaj hota tha usme purye breast ko remove kiya jata tha jise hum log mastectomy kehte thye, lekin agar mareez early stage mein aata hai ganth bahut badi nahi hai to pura breast nikalna zaroori nahi hai, hum log breast conservation surgery ke dwara breast ko bchaa sakte hain. Isme aage aur kafi advances huye hai aur aaj kal hum log jo approach follow karte hain jis bolte hain oncoplastic breast conservation surgery, jisme jo cosmetic results pehle se bhi bheter hai. Agar kuch marijoo mein pura breast nikalna zaroori bhi hota hai toh reconstruction bhi kiya ja sakta hai. Aur ek nai approach jo surgery mein aaj kal hum log use kar rahe hai jise kehte hain Sentinel lymph Node Biopsy, yeh armpit ki jo ganthe hoti hain nodes unke management ke liye ek latest approach hai aur iss approach ka istemal karne se jo hathon mein sujan aane ka risk hai Lymphedema wo kafi kam ho jati hai. Toh surgery basically jo ho jati hai uske baad kuch marijoo mein additional treatment ki zaroorat ho sakti hai jaise chemotherapy hai, radiotherapy hai, ya kuch dawaiya hai jo hormonal intervention karti hain. Toh surgery ke baad kafi marijoo mein jo pehela ilaj hoga woh chemotherapy hota hai, jo 4 se 8 cycle tak diya ja sakta hai. Radiotherapy jin marijoo mein hoti hai woh bhi again aaj kal karib 3 hafte mein puri ho jati hai jo ki pehle usme 6 se 7 hafte lagte thye, aur nahi radiation technology ke through jo side effects hai radiation ke wo kafi kam ho gaye hain. Isi prakar hormonal therapy jo hai woh yeh radiation or chemo khatam hone ke baad di jati hai jis mein sirf ek tablet hoti hai jo marijoo ko ghar pe regular istemal karna padta hai aur wo 5 se 10 saal tak use ki ja sakti hai. Ek aur important cheez yeh hai ki jo bhi cancer ke marij hote hain unko ek regular follow up pe chalna padta hai, toh ilaj pura hone ke baad har 3 mahine baad unhe apne surgeon ke pass follow up ke liye jana chahiye, jisme examination jo hai woh ek bahut important part hai. Phir uske baad kuch testing ho sakti hai jaise chhati ka x-ray hai, ultrasound hai, mammography hai, aur agar koi aur takleef hoti hai tu Bol Scan, MRI, CT ya Pet Scan bhi kiya ja sakta hai. Iske alawa breast cancer ke marijoo mein jo ek aur cheez hoti hai hum log ek jo usko promote karte hain woh hai support group ka concept, jisme breast cancer ke survival aapas mein milte hain, ek doosre se cheeze discuss karte hain aur support bhi provide kar sakte hain aur isse unki jo future life hai wo kafi better rehti hai. Toh mein yahi kahunga ke cancer se aapko waise bhi nahi darna chahiye aur breast cancer ke jo aaj ke din success rate hai wo bahut hi acchi hai toh bina darre janch karaye aur apna ilaj pura kare.

Dhanyavad, Thank you.

2545 people found this helpful

Sir I am 30 years old male and I have a problem of slip disk in l5 s1 from last one year. I have tried so many medicine for this but it pains regularly. What should I do now for proper relief from pain?

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
Sir I am 30 years old male and I have a problem of slip disk in l5 s1 from last one year.
I have tried so many medici...
avoid medicine do physiotherapy treatment for few days and stretching exercise and strength exercise in gradually process. avoid long sitting toward bending lifting weight.
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I have diagnosed with infiltrating ductal carcinoma, NOS, in right breast (in biopsy report. Please suggest me what is my treatment option.

MD - Radiothrapy
Oncologist, Ahmedabad
hi, In ca breast, surgery is the primary treatment. Then chemotherapy and radiotherapy to prevent recurrence and metastasis . So go for surgery first then other treatments according to stage.
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Uterine Cancer - 4 Treatment Techniques

MBBS, MD - Obstetrtics & Gynaecology
Gynaecologist, Gurgaon
Uterine Cancer - 4 Treatment Techniques

Uterine cancer is also known as endometrial cancer. It is a cancer which begins in the lining of the uterus. The uterus is the part of a woman's body where the fetus develops. Uterine cancer is one of those rare cancers in India, which can be diagnosed in its early stages. This is because excessive vaginal bleeding occurs, thus making it a very serious and an apparent symptom. It is also one of the few forms of cancer which can be cured as removing the uterus is often more than enough to cure the patient of uterine cancer.

Here are the causes, diagnosis and treatment of uterine cancer:

Causes:

The exact cause of uterine cancer is not yet known, however, there is a theory on what causes uterine cancer. Hormones in a woman's body have been thought to increase the chances of getting uterine cancer. This is because it has long been thought that having high levels of estrogen is the cause of uterine cancer. Increased estrogen thickens the endometrium and thus, increases the likelihood of uterine cancer.

Diagnosis:

1. Pelvic exam: This is an examination in which the vagina, bladder, rectum and uterus are scanned for lumps. If they are found, it might be due to uterine cancer.
2. Pap test: A pap test is a special test designed to scan for uterine cancer.
3. Transvaginal ultrasound: A transvaginal ultrasound uses high-intensity sound waves so that pictures of the uterus can be taken.
4. Biopsy: During a biopsy, the doctor will remove tissue from the endometrium and it will then be analyzed for cancerous growths.

Treatment:

1. Surgery: This is the most common treatment as it removes the entire uterus and prevents the spreading of the cancer.
2. Chemotherapy: Chemotherapy involves giving drugs which kill cancerous cells. They are given through either an intravenous line or even in pill form.
3. Hormone therapy: This is a therapy in which either progesterone levels are increased or estrogen levels are decreased.
4. Radiation therapy: In this treatment, high energy laser beams are used to destroy cancerous cells. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

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