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Dr. Gaganjit Khurana

Radiologist, Gurgaon

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Dr. Gaganjit Khurana Radiologist, Gurgaon
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My experience is coupled with genuine concern for my patients. All of my staff is dedicated to your comfort and prompt attention as well....more
My experience is coupled with genuine concern for my patients. All of my staff is dedicated to your comfort and prompt attention as well.
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Dr. Gaganjit Khurana is a popular Radiologist in Sector-54, Gurgaon. You can meet Dr. Gaganjit Khurana personally at HCL Avitas Gurgaon Sector 54 in Sector-54, Gurgaon. You can book an instant appointment online with Dr. Gaganjit Khurana on Lybrate.com.

Lybrate.com has top trusted Radiologists from across India. You will find Radiologists with more than 42 years of experience on Lybrate.com. You can find Radiologists online in Gurgaon 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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Hindi
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Medical Council of India (MCI)

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HCL Avitas Gurgaon Sector 54

Unit 9, Suncity Business Tower, Sector-54, Gurgaon, GurgaonGurgaon Get Directions
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Left paracentral L5-S1 disc protrusion causing compression of left traversing nerve roots associated with diffuse L1-L2 Disc bulge. Now what is best treatment for me.

MBBS
General Physician, Mumbai
Best treatment is to do go for laparoscopic surgery and treatment depends on the symptoms and if there are bearable symptoms than we can do ESWT through a physiotherapist.
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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

Why Is Cancer the Biggest Threat to India

PGD IN ULTRAASONOGRAPHY, Non invasive cardiology course, MD - Medicine, MBBS
General Physician, Narnaul
Why Is Cancer the Biggest Threat to India

Cancer is the one of the biggest threat to the young Indian population because of the factors that cause cancer, but also due to late detection. However, certain bad habbits and the factors increase the risk of cancer in India.

Causes of cancer in India:

  1. Overpopulation and the problem of nutrition: As per records, India is the world's third most populous country. However, it lacks in resources to feed the multiplying number of mouths. Nutrition plays a key role in deciding the quality of a person's life. Nutrition has therefore emerged as an essential branch of research and medical care in the last few decades. Lack of nutrition directly results in weakened immunity. Your body becomes prone to diseases, some of which can be fatal. To fight off cancer cells, one must have a strong immune system that comes from the right kind of nutrition.
  2. Smoking is a recurrent habit among children and adults: Smoking can cause cancer. Every cigarette packet reads the same warning messages but it doesn't actually deter smokers in any way. Smoking is prevalent among people of all age groups in India. From poor children to conscious educated adults, all are seen smoking.
  3. A Tropical country and its woes: Tropical countries are known to face the wrath of the sun. While most places in central, western, partly eastern and southern India experience extremes of temperature in summer, other places with moderately hot summers are not exempted from the harmful UV rays. Ultraviolet rays can be very harmful for one's skin, as it can cause skin cancer. Indians have a high amount of melanin, which protects them against sun rays, but the threat exists nonetheless.
  4. The concept of fast food: A global economy has opened avenues awaiting your attention in the realm of food. To suit the tones and moods of a fast life, fast food has been made available to you. We take pride in consuming things that can be prepared in an instant: instant noodles, soups and even curries. Packaged food and junk food are sources of cancer cells.
  5. Lack of awareness regarding the most common types of cancer: Breast and cervical cancer are the two most common types of cancer eating away the health of Indians. The problem lies in being unaware about the root causes, symptoms and treatment procedures related to these kinds of cancer. Social repression turns health concerns into matters of insignificance. Women fear social alienation after coming in the open with their problems.
5589 people found this helpful

5 months ago My father total serum cholesterol was 391, after getting through the report doctor prescribed Statins tablets to him. Now after 5 months his (my father) total serum cholesterol is 116, and serum LDLcholesteol is 44. Is is too low? It can be harmful? Or can leads to other disease? My father is also a patient of coronary artery disease.

MBBS, Dip.Cardiology, Fellowship in Clinical Cardiology(FICC), Fellowship in Echocardiology
Cardiologist, Ghaziabad
5 months ago My father total serum cholesterol was 391, after getting through the report doctor prescribed Statins ta...
No issues. Low cholesterol has no problems. But yes you can decrease the dose of the statins by half and recheck the lipid profile after 3 months. Long term statins treatment also has side effects. Also you need to understand about cholesterol Cholesterol is a waxy, fat-like substance that occurs naturally in all parts of the body. Your body needs some cholesterol to work properly. But if you have too much in your blood, it can combine with other substances in the blood and stick to the walls of your arteries. This is called plaque. Plaque can narrow your arteries or even block them. High levels of cholesterol in the blood can increase your risk of heart disease. Your cholesterol levels tend to rise as you get older. There are usually no signs or symptoms that you have high blood cholesterol, but it can be detected with a blood test. You are likely to have high cholesterol if members of your family have it, if you are overweight or if you eat a lot of fatty foods. You can lower your cholesterol by exercising more and eating more fruits and vegetables. You also may need to take medicine to lower your cholesterol. High LDL high cholesterol put you on a higher risk of atherosclerotic diseases and heart attacks especially if you have other is factors including hypertension diabetes or a history of smoking so I would advise you to start taking statins which are cholesterol medications the dose of which depends upon your cholesterol levels also you need to start changing your dietary habits and include a regular physical exercise at least 45 minutes a day 5 days a week into your schedule nonetheless you have to stop taking fatty and junk food good luck Check out - Simplified health explanation videos on my YouTube channel And Do not forget to Subscribe for upcoming videos.
1 person found this helpful
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Brain Surgery - What Should You Know About It?

IFAANS, DNB (Neurosurgery), MBBS
Neurosurgeon, Ghaziabad
Brain Surgery - What Should You Know About It?

Brain surgery involves several medical procedures, which incorporate fixing issues with the brain, including changes in the tissues of the brain, cerebrospinal fluid and brain blood flow. Brain surgery is quite a complicated method of surgery and the type of surgery to be conducted depends on the underlying conditions.

Reasons for Brain Surgery:
Brain surgery is performed for the correction of physical brain abnormalities. These abnormalities could occur because of diseases, birth defects and injuries. A brain surgery is required when the following conditions arise in the brain:

  1. Abnormal blood vessels
  2. Aneurysm
  3. Bleeding
  4. Blood clots in the brain
  5. When the protective tissue or dura is damaged
  6. Epilepsy
  7. Due to nerve damage
  8. Parkinson's disease
  9. Any kind of pressure after an injury
  10. Abscesses
  11. Skull fractures
  12. In case of stroke and tumors

A surgery may not be required for all the above mentioned conditions, but in case of many, a brain surgery is very important as the conditions may worsen health problems.

Types of brain surgeries:

  1. Craniotomy: During this open brain surgery, an incision is made in the scalp, and a hole is created in the skull, near the area, which is being treated. After this process is complete, the hole or bone flap is secured in its place using plates or wires.
  2. Biopsy: This form of brain surgery helps in the removal of a small amount of brain tissues or tumors. After removal, the tissues or tumors are examined under a microscope. The creation of a small incision and a hole in the skull is indicated as a part of this process.
  3. Minimally invasive endonasal endoscopic surgery: This form of brain surgery enables the removal or lesions and tumors via the nose and sinuses. Private parts of the brain can be accessed without creating an incision. An endoscope is utilized in the process which is used to examine tumors all across the brain.
  4. Minimally Invasive neuroendoscopy: This process is similar to the minimally invasive endonasal endoscopic surgery. This method also involves the use of an endoscope for removal of brain tumors. Small, dime sized holes may be made in the skull to access some brain parts.

Risks:
Brain surgeries may be associated with several risks. They may be:

  1. Allergic reactions to anesthesia
  2. Bleeding
  3. Blood clot formations
  4. Swelling of the brain
  5. A state of coma
  6. Impairment in speech, coordination and vision.
  7. Problems in memory
  8. Strokes and seizures
  9. Infections in the brain

A brain surgery is a serious and very complex surgery. There are different kinds of brain surgeries, which are conducted depending on the condition and severity of the disease. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.

1861 people found this helpful

One of my friend he is suffering due to dislocation of l5/s1 disc. The residual ap canal diameter at this level measures 6.7 mm only. Few of the doctors suggested him to do surgery but few of them not recommending surgery because he is just 27 years old. Now he is taking Ayurveda medicine. Kindly recommend the best solution or medication for this problem.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Zirakpur
Surgery should be avoided on vertebral column and spinal cord. It's better to get full panchakarma at good ayurveda hospital near you. Yoga postures, deep breathing will also help. Ayurvedic medicine once suit you, will be immensely beneficial.
2 people found this helpful
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What Therapy Is Best For Herniated Disc?

B.P.T, M.P.T
Physiotherapist, Hyderabad
What Therapy Is Best For Herniated Disc?

The pain which a person experiences as a result of having a herniated disc can be quite debilitating, to tell you the truth. However, taking into due account the fact that all a person in such a situation would want would be to be up and running as soon as possible.

In order for this to happen, as would be expected, he or she would need to go through the options which are available for treatment of a herniated disc. There are various types of herniated disc treatments which are available though it can be said that conservative treatments are preferred as these treatments do not require surgery to be carried out on the person who is suffering from the issue.

The course of this sort of treatment lasts somewhere between one month to one and a half months. The aim of conservative treatment is to reduce or minimise the pain that is automatically associated with a herniated disc. There is a strategy to help a person improve by which he or she is provided with medicine for the purpose of pain relief while physiotherapy is made use of to make the underlying condition better.

Surgical treatment may be required, if the case is such that the person has lost a great degree of function and is in pain that seems to be pretty much unbearable. `If the person has a lumbar herniated disc, then the conservative treatment for this sort of case would require him or her to apply ice and heat from a warm source to provide relief to the area. If the pain is very bad yet the person is determined not to undergo surgery then the answer would be to consume some oral steroids or narcotic pain medications. One should surely keep in mind that this is only to carried out as per the prescription of a doctor who is trained and experienced to a sufficient degree.

If surgery is required for this sort of herniated disc, then it is likely to be a lumbar decompression surgery which aims to allow for the growth of the spine back to health as a result of removing the herniated disc. When it comes to cervical herniated disc treatment, conservative solutions include using drugs like ibuprofen and physical therapy; similar to solving lumbar herniated discs. However, surgical treatment for cervical herniated discs warrants anterior cervical decompression; where the disc is removed from the front of the neck. If you wish to discuss about any specific problem, you can consult a Physiotherapist.

5589 people found this helpful

MRI IMPRESSION 29 August 2016 -Posterior diffuse disc herniation at L4 -5 level with bilateral ligamentum flavum hypertrophy causing narrowing of bilateral neural recesses with compression of bilateral traversing nerve roots at same level. -Posterior diffuse disc bulge at L5-S1 level indenting ventral thecal space at same level -Changes of lumbar spondylosis I was having pain at my right hip joint on 15/8/16. It went unbearable extending to RT leg. On 3rd September night as usual on bed all the 24 hours trying to sleep on 4th at 5 am all my pain went. Till then no pain but having burning sensation on right foot, tingling, falling rt foot asleep when I sit on chair. Please advise:- 1. Surgical intervention required? Or 2.Pregabalin,Tolperisone, methylcobalamin,Calcium and D3 with rest will cure me fully? Or 3. Somekind of spinal exercises also required? ERODHA.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
MRI IMPRESSION 29 August 2016
-Posterior diffuse disc herniation at L4 -5 level with bilateral ligamentum flavum hype...
This treatment is being suggested on bases of the information provided. I would like to examine & investigate you in detail. Any way it may be tried, --. Dolokind Plus (Mankind) [Aceclofenac 100 mg +Paracetamol 350 mg 1 tab. OD & SOS. X 5 days. --. Caldikind plus (Mankind) 1 tab OD x 10 days. (You may need help of your local doctor to get these medicines.)--. Fomentation with warm water. Avoid direct flow of AC or Cooler. --. Sleep on a hard bed with soft bedding. --. Use no pillow under the head. --. Avoid painful acts & activities. -- .Do mild exercises for Back Do not ignore, let it not become beginning of a major problem. Do ask for a detailed treatment plan. If no relief in 2-3 days, contact me again (through this platform only) Kindly make sure, there is no allergy to any of these medicines. (Contact your family doctor, if needed). For emergency treatment visit nearest hospital. I hope I have answered your question to your satisfaction. Kindly rate the answer.Wish you a quick recovery & good health.
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I want to know about disk pain. i am suffering from this pain from very long . please suggest me good treatment

MBBS
General Physician, Delhi
It is due to the pressure of disk on nerves. It is treated by relieving the pressure of disk surgically or by conservative treatment like medicines, physiotherapy ans rest etc .
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