Lybrate.com has a nexus of the most experienced Radiologists in India. You will find Radiologists with more than 41 years of experience on Lybrate.com. Find the best Radiologists online in Hyderabad. View the profile of medical specialists and their reviews from other patients to make an informed decision.
Book Clinic Appointment
Diagnostic X- Ray
Bone Densitometry Procedure
Uterine Artery Embolization
Interventional Diagnostic Procedures
Angiography Radial Approach
Submit a review for Dr. Krishna Pavan PYour feedback matters!
Hello Doctor I have degenerative disc disease after a fall down a flight of stairs in 2013. I sometimes have difficulty in breathing while asleep at night and develop colds frequently, is this due to the lumbar fracture? Also is inability to fill bladder a symptom of disc injury? Thank you for your time Doctor.
What is Bone cancer?
Bone cancer is malignant tumour of the bones which can spread to lungs or other parts of the body. It may have arisen primarily from the bone itself (primary bone cancer) or more commonly, may have spread to the bones (secondary bone cancer) from cancer of some other body organ like Breast cancer, Prostate cancer etc.
Primary bone cancer usually occurs in growing children and young adolescents, whereas, secondary bone cancer usually occurs in older age group. Usually, the patient experiences pain in the affected area, which over the time, gets worse and continuous. There may also be swelling in the involved region. It can cause weakening of bones resulting in fracture. Some patients may attribute these symptoms to any prior antecedent trauma. Unintentional weight loss may also be seen. Sometimes, these patients are wrongly being treated for infection, thus delaying the correct treatment which may have a bearing on the final outcome.
How common is bone cancer?
Secondary bone cancer is the most common type of bone cancer with bone being the third most common site of cancer spread (metastasis) from other organs. However, primary bone cancers are rare accounting for less than 1% of all cancers.
Causes of bone cancer?
There are no known environmental or other hereditary factors which cause bone cancer, however, certain patients are at a greater risk for bone cancer which include:
- Patients who have received prior radiation therapy
- Patients with a history of Paget’s Disease
- Patients with hereditary retinoblastoma - a type of eye cancer that most commonly affects very young children
- Patients with Li-Fraumeni syndrome - a rare genetic condition
How is it diagnosed?
A patient suspected with bone cancer needs to be investigated thoroughly with blood tests, Xrays, MRI to look for local extent of disease. Since bone cancer can spread to lungs and other bones, staging of the disease is done either with whole body PET CT or a bone scan with CT Chest. Alongwith that, a biopsy (usually with a needle) is required to establish the diagnosis. It’s important to do biopsy from the correct site since wrong biopsy site can be detrimental in limb salvage and can result in amputation (cutting the limb). Therefore, it’s recommended that the biopsy should always be done by the surgeon (Orthopaedic Oncologist) who will be doing the final surgery for bone cancer.
Treatment of bone cancer is a multidisciplinary approach requiring an Orthopaedic Oncologist (Bone & Soft tissue tumour specialist), Medical Oncologist (Chemotherapy Specialist), Radiation Oncologist (Radiotherapy specialist) and Pathologist (Specialist in tissue diagnosis).
Usually in primary bone cancers, chemotherapy is given to the patient followed by surgery to remove the diseased bone which is further followed by adjuvant chemotherapy. Limb salvage surgery is possible nowadays for bone cancers in which the part of the bone involved with tumour is removed surgically (rather than cutting the whole limb) and the defect is reconstructed with artificial joint, thereby saving the limb. In some cases, the cancerous bone so removed is given very high dose of radiation so as to kill all the cancer cells and the sterilised bone so formed is fixed back to the parent bone with the help of plates and screws, a technique commonly called as Extra Corporeal Radiation Therapy (ECRT). In children, since the artificial joint will not grow as the child grows leading to unequal limb lengths over a period of time, the defect can be reconstructed with expandable joint which can be lengthened as the child grows which allows to maintain limb length equality at the time of skeletal maturity.
Is cure possible in bone cancer?
With the current chemotherapy regimes and advanced surgical technology, cure is possible in upto 70-75% patients with primary bone cancer. In patients with secondary bone cancer, cure can still be achieved depending upon the primary cancer and the extent of disease. In advanced cases also, a lot can be done to control the disease and give a quality of life to the patient.
Is it possible to prevent bone cancer?
Since the exact cause of bone cancer is not known, as of now it’s not possible to prevent bone cancer.
Whom to consult?
First chance is the best chance when it comes to curing bone cancers. So, it’s advisable to seek treatment from a trained Orthopaedic Oncologist when confronted with a bone cancer to achieve maximum beneficial outcome.
Sir I am 62 l have got disc prolapse of my spine spine. Backpain- radiated toy right leg causing severe pain please give remedy.
I have a back disc doctor has advised to take complete bed rest for 3 months but I am preparing for competitive exam which is not possible. is there any way so that I will be ok?
I have some disc problem, in MRI report L5S1, how can I remove this problem, which exercise is useful in this problem.
Breast Cancer - What exactly is it?
‘Breast cancer’ is a term that is used to refer to a malignant tumour, which has developed from cells present in the breast. Generally, all tumours can be divided into two categories i.e. benign and malignant and it is the malignant tumour that is responsible for causing cancer. Breast cancer generally originates in the cells the milk producing glands of the breast's or the passage, which carries milk from the glands to the lobules. Additionally, breast cancer can also originate in the stromal tissues, including the fibrous and fatty connective breast tissues.
Breast Cancer: Treatment Options
Treatment for breast cancer depends upon two things: the exact type of the cancer and how advanced the cancer is. Treatment options for breast cancer can thus be broadly divided into two categories as Local treatments and Systemic treatments.
Treatments that target the tumour without having any effect on the rest of the body are called local treatments. The following types of local treatment options are available for treating breast cancer:
- Surgery: Surgical breast cancer treatment involves removal of the malignant cancerous tumour in an operation. Smaller tumours can be removed using a surgical process referred to as ‘lumpectomy’, wherein the tumour along with a small amount of healthy tissue surrounding the tumour is removed. For larger tumours, removal of the entire breast becomes mandatory, in a surgical process known as ‘mastectomy’. Women who undergo mastectomy can choose to undergo reconstructive plastic surgery for reconstruction of the removed breast(s).
- Radiation Therapy: This basically involves using radiation to kill cancer cells present in the body. Radiation therapy is a long-drawn process that usually involves a set number of treatments administered over a long period of time. Radiation therapy is also generally the follow-up procedure after a lumpectomy, or more rarely, a mastectomy.
Treatments involving drugs that are administered via either the mouth or direct injection into the bloodstream are called systemic treatments. These include:
- Chemotherapy: This includes using drugs to destroy the cancer cells present in the body by stopping the cancer cells from growing and dividing. Chemotherapy can be administered using either an IV (intravenous) tube or via pills that can be swallowed.
- Hormone Therapy: This treatment option is used for treating tumours which have tested positive for progesterone or oestrogen receptors. Blocking hormones that fuel the tumour’s growth is the basis of this therapy.
- Targeted Therapy: This targets specific proteins and genes which contribute to growth and survival of the cancer cells. Targeted therapy is an extremely focused treatment, and is very effective in blocking the growth and division of cancer cells, as well as minimizing damage to surrounding healthy cells.
Cancer is the abnormal, uncontrolled growth of cells in a particular body part. With continued growth, pieces of this tissue travel through the blood to different body parts and continue to grow in the new area. This is known as metastases. Breast cancer is one of the most common forms of cancer and affects about 1 in 8 women in the USA. Read on to know more details of breast cancer – breast anatomy, causes, symptoms, risk factors, detection, prevention, and of course treatment.
Anatomy: The main function of the breast is lactation through its milk-producing tissue that are connected to the nipple by narrow ducts. In addition, there is surrounding connective tissue, fibrous material, fat, nerves, blood vessels and lymphatic channels which complete the structure. This is essential to know as most breast cancers develop as small calcifications (hardened particles) in the ducts or as small lumps in the breast tissue which then continues to grow into cancer. The spread can happen through lymphatic or blood flow to other organs.
Warning signs/symptoms: The following are some symptoms that need to be watched out for if you have a predisposition to breast cancer.
- A lump in either of the breasts or armpits
- Change in size, shape, or contour of either breast
- Redness of your breast or nipple
- Discharge of clear or bloody fluid
- Thickening of breast tissue or skin that lasts through a period
- Altered look or feel of the skin on the breast or the nipple (dimpled, inflamed, scaly, or puckered)
- One area on the breast that looks very different from the other areas
- Hardened area under the breast skin
Either one or a combination of these should be an indication to get a detailed checkup done. Early diagnosis results in controlling the disease with minimal treatment and reduced complications.
Causes and risk factors: The exact cause for breast cancer is yet to be pinned down. However, risk factors are clearly identified, and women with risk factors need to watch out for warning signs.
- Family history: Of all the risk factors, the family history is the most important. Breast cancer runs in families, and if there is a first-degree relative with the breast cancer, the chances of developing it are almost double. Two genes BRCA1 and BRCA2 are the carriers of the disease, and this testing can be done in women to identify if they are at risk.
- Family history of other cancers: Even if there is no breast cancer, if there are other cancers that run in the family, watch out.
- Age: Women over 50 are at higher risk of developing breast cancer.
- Race: Caucasian and Jewish women are at higher risk of breast cancer than African-American women.
- Hormones: Greater exposure to the female hormone estrogen increases the chances of developing breast cancer. Women who use birth control pills for contraception and hormone replacement after menopause are at a higher risk of developing breast cancer.
- Gynecologic milestones: Women who have abnormal menstrual milestones need to watch out. These include those who attain menarche before 12 years of age, get pregnant after 30, attain menopause after 55, and have menstrual cycles shorter than 26 days or longer than 29 days.
- Obesity and alcohol abuse are also likely to increase a woman’s chances of developing breast cancer.
Stages: Starting from stage 0, higher stages indicate advanced disease.
- Stage 0: The growth which has begun in the milk-producing tissue or the ducts has remained there (in situ) and not spread to any other area, including the rest of the breast.
- Stage I: The tissue slowly becomes invasive and has begun to affect the surrounding healthy tissue. It could have spread to the fatty breast tissue and some breast tissue may be found in the nearby lymph nodes.
- Stage II: The cancer at this stage grows considerably or spreads to other parts. There are chances that cancer may grow and also spread.
- Stage III: It may have spread to the bones or other organs but small amounts are present in up to 9 to 10 of the lymph nodes in the armpits and collar bones which makes it is difficult to fight.
- Stage IV: The cancer is widespread to far-flung areas like the liver, lungs, bones, and even the brain.
Screening: This is one of the most effective ways to identify the disease in its early stages. This will help in controlling cancer from spreading with minimal treatment.
- Self-examination: A thorough self-examination to look for changes in terms of shape, size, colour, contour, and firmness should be learned by all women. Watch for any discharge, sores, rashes, or swelling in the breasts, surrounding skin, and nipple. Examine them while standing and when lying down.
- In most women, annual screening mammograms are advised after the age of 40. However, in women who have a strong family history or genetic makeup, it is advisable to have screening mammograms starting at age 20 every 3 years and then annually from the age of 40.
- Women in high-risk categories should have screening mammograms every year and typically start at an earlier age.
- Ultrasound screening can also be given in addition to mammograms.
- Breast MRI is another way to screen for breast cancer if the risk is greater.
Breast Cancer Prevention: Now that there is so much awareness about causes and risk factors, there are definitely ways to prevent or delay the onset of the disease.
- Exercise and a healthy diet with reduced amount of alcohol are definitely effective in minimising the chances of developing cancer.
- Tamoxifen is used in women who are at high risk for breast cancer.
- Evista (raloxifene) which is used to treat osteoporosis after menopause. It is also widely used in preventing breast cancer.
- In high-risk women, breasts are surgically removed to prevent the development of cancer (preventive mastectomy).
Treatment: As with all cancers, treatment would depend on the stage at which it is identified and include a combination of chemotherapy, radiation, and surgery. As noted earlier, if you are at risk, look out for warning signs as early diagnosis is the key to maximum recovery.
Did you know barley water is good for kidney stones?
Barley (jau), a member of grass family, is a cereal that has been cultivated for over 13, 000 years. Packed with carbohydrates (78%), fat (1%), protein (10%) and water (10%), barley is a rich source of essential nutrients, dietary fiber, vitamins such as niacin, manganese, phosphorus and vitamin B6.
With several health benefits to its name, barley water is termed as the elixir to good health. It has been found to be beneficial in reducing chances of heart disease, soothing bowels, reducing blood cholesterol levels, improving blood sugar regulation in the body and acts as nutritive broth for fever, cold and cough. Additionally, studies support that barley water has also been found to play an integral role in maintaining renal health.
What is a renal stone?
A renal stone is a solid stony piece consisting of crystal forming substances in the urinary tract. They are usually formed when the urine is abundant in substances such as calcium, oxalate and uric acid and lack substances that inhibit their accumulation. While small kidney stones can pass through the urinary system without any symptoms, a stone larger than 5 mm can result in blockages in the urinary tract causing severe pain in the back and lower abdomen.
What causes renal stones?
- A family history for stones, lack of adequate water in the body, high BMI, excessive intake of diets rich in protein, sodium and sugar have been found to be some of the common causes for stone formation.
Try protein foods &amp; supplements
- Medical conditions such as hyperthyroidism, inflammatory bowel syndrome and renal tubular acidosis have also been found to alter the digestion of calcium.
How does barley water aid the dissolution of renal stones?
Studies show that regular use of barley water can dissolve and eliminate existing kidney stones and prevent the occurrence of stones and other kidney problems. Use of diuretics either natural or synthetic can help speed up the expulsion of the stone.
Diuretic in nature, barley water helps to flush toxins from the kidneys by creating bladder pressure and increasing the frequency of urination.
- It helps maintain the PH levels in the body, making it alkaline, preventing various urinary tract issues, including kidney stones.
- The vitamin B6 and magnesium in barley helps break down the masses of toxic calcium oxalate (primary cause for stones) in the kidney.
Dietary fiber in barley reduces the amount of calcium that is excreted by the body through urine, restoring renal health and cleansing the kidneys.
Ways to prepare barley water:
- Boil 1 litre of water with a tablespoon of barley pearls and boil on a low flame for about 30 minutes or until the water has reduced to half.
- Strain and cool this mix and drink it through the day.
- Add lemon juice or honey to make the mix tasty
Regular use of barley water ensures that the renal system is hydrated, healthy and free of depositions such as renal stones. So, go ahead and add this elixir to your diet to ensure a healthy renal system and a healthier you. Eat healthy, stay healthy!
Cerebral ischaemia or brain ischemia is a medical condition that restricts the flow of blood to the brain, resulting in an unmet metabolic demand. This leads to limited oxygen supply in the brain, which could result in death of brain tissues, cerebral infarction or an ischemic stroke. Thus, a cardiorespiratory arrest, a stroke, and irreversible brain damage are few possible consequences of cerebral ischaemia.
People with compressed blood vessels, low blood pressure, congenital heart defects or sickle cell anaemia have a high risk of developing cerebral ischaemia, since compressed blood vessels or very low pressure can lead to restricted blood flow. Also, sickle-shaped cells have a greater tendency to clot, causing obstructed blood flow.
Patients with cerebral ischaemia experience a host of symptoms, such as weakness in the body, problems in coordination and movement, vision and speech impairment and unconsciousness.
Cerebral congestion, on the other hand, refers to excessive quantity of blood in the brain vessels, causing pressure on the cerebral substance. Cerebral congestion is of two types. It is termed as active when there is too much arterial blood flow and passive when there is undue quantity of venous blood in the veins of the brain. Both conditions cause symptoms, such as severe headache, insomnia, irritability and unconsciousness. The patient gets little sleep and is disturbed, often followed by dreams. When awake, the patient’s mental activity in the brain is very high.
Homeopathy is now a well-established school of medicine backed with years of research and practice. Gone are the days when homeopathy was considered no more than an extension of herbal home remedies. Homeopathic laboratories around the world produce large number of medicines covering almost all ailments. The benefits of homeopathic treatment are now well established due to its holistic approach and minimal side effects. Homeopathy is undoubtedly a ray of hope for patients with cerebral ischaemia and cerebral congestion, as it delivers a comprehensive treatment plan designed to target the signs and symptoms of the disease and address its non-occurrence.
The medications deal with mild to severe symptoms, including inflammation of the brain, headache, vomiting, insomnia, stroke/convulsions and seizures. The stramonium drug, for example, deals with seizures. Belladonna is an effective remedy for sharp shooting headaches, a common symptom of cerebral congestion. Ferrum is believed to be a valuable remedy for brain ischaemia. Few drugs deal with the symptoms of both ischaemia and congestion—nux is a suitable drug for the treatment of ischaemia as well as for passive cerebral congestion. Similarly, phosphorus can be used to treat brain ischaemia and congestion. Zincum metallicum is a highly recommended drug for chronic cases of ischaemia.
The treatment is comprehensive and long term and shows substantive results. Regular follow-ups and consultation with a homeopath specialist is the key to an effective treatment.