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Q1. What exactly is Laparoscopy?
Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.
Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?
Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.
Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?
Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.
Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?
Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.
Q5. Will there be much pain or discomfort after Laparoscopic Surgery?
There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.
Q6. When can I be discharged from hospital?
Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.
Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?
Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.
Please advice some treatment for bulging of disc I tried everything possible. Visited all type of doctor, did physical exercise and massage as well but still pain persists.
I am 40 years old I was suffering from disc dislocation and recovered from it in 2007, but now I am suffering from Neck pain at vertebral column and my left Knee is also paining.
It is very common for women to have heavy and painful periods or have a feeling of fullness in the lower abdomen. Although, it may not sound very alarming these could be the symptoms of uterine fibroids. These are the most common types of benign tumours found in women. The fibroids are basically some tissues and muscle cells that grow within the uterus, outside the uterus, or along the wall of the uterus. The fibroids are usually benign and asymptomatic and do not require any treatment unless they cause problems.
Know the causes
Though the exact cause of fibroid formation is not known, it is believed that the female hormones estrogen and progesterone have a role to play in their formation. Fibroids are formed only when a woman is producing these hormones and they are not seen in women in non-reproductive age i.e. before starting of menses or after stoppage of menses (menopause). If fibroids are persisting even after menopause or especially if increasing in size then it is an alarming sign. Such a fibroid needs to be taken care of immediately.
What are the symptoms?
Fibroids often remain quiet for long periods of time. They cause nonspecific symptoms in the pelvis and abdomen including:
- Fullness in the abdomen
- Low back pain
- Irregular menstruation
- Cramping with menstruation
- Painful sex
- Increased urgency to urinate
- Anemia, leading to tiredness and weakness
- Infertility Diagnosing the fibroids
When these symptoms are recurrent, it is good to confirm the diagnosis. This can happen with a pelvic exam followed by ultrasound scanning to confirm the size and location of the fibroids. A blood test also may be done to confirm anemia, which is common due to heavy periods.
Management of fibroids can range from doing nothing to periodic monitoring to surgical removal.
- If pain and heavy bleeding are the only symptoms, then pain killers like ibuprofen should suffice for symptomatic relief. Anemia, if severe, may require iron supplementation.
- Embolization is an option which shrinks the fibroid, at the same time preserving the uterus. The blood flow to the fibroid is cut off, thereby preventing its further growth. It takes about 1 to 3 hours and requires some bed rest after the procedure. There could be some pelvic pain and vaginal bleeding, which will gradually subside. The fibroids may grow back, but the benefits of keeping the uterus are definitely there. This is suitable in case of single fibroid with specific blood supply.
- The next surgical option is myomectomy, where the portion of the uterus which contains the fibroid alone is removed. This is done in women who still wish to get pregnant and in women who would like to retain the uterus. This can also be achieved laparoscopically( key hole surgery). In such cases, fibroids are cut into small pieces and then removed from the body. This procedure should be done by a doctor specialised in advanced gynecological endoscopy as all this cutting should be done in a bag to avoid any spillage of cells inside the abdominal cavity. This procedure is known as Laparoscopic Myomectomy with In-bag Moecellation.
- In women who have crossed their pregnancy phase, hysterectomy or complete removal of the uterus is advised. In these women, the bleeding and pain may not have subsided even after years of treatment with hormones. The growing fibroids could be pressing on the adjacent organs, causing pressure. This is the only definitive treatment and should be done in women have completed their family and don’t desire to be pregnant.
- Myomectomy and hysterectomy may be done laparoscopically or with an open method depending on the overall health, the size and location of the fibroids in the uterus.
In case you have a concern or query you can always consult an expert & get answers to your questions!
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.
Is there any other possible cure for herniated disc except operation when the patient has started losing power in one leg while other leg is having radiative pain.
Due to night fall my nerve system is very week and now I am suffering from disk in my back please suggest me some medicine fr improvement of nerves.
Your ankle may get injured at any point in time, sometimes it can be driven by sudden trauma or injury or it may find its virtual roots into such serious problems like venous insufficiency, arthritis, heart disease and so on. When a complaint of the swallen ankle is made by a patient, at first before prescribing anything homoeopathic treatment follows a procedure of detailed investigation to manage it.
There are basically two types of treatments for swollen ankles. In the case of swollen ankles aggravated by some kind of injuries, arthritis homoeopathic medicines work independently while if any vital organ is involved in the swallen ankle, homoeopathic treatment would act there as a support to other medicines.
Homoeopathic Remedies For Swollen Ankles:
The most effective homoeopathic medicines for swollen ankles are as follows
- In the case of dropsical swelling over ankles: Apis Mellifica and Apocynum are the first to be named in this series. These are effectively used when one is found with dropsical swelling due to an accumulation of excessive fluids in the tissues. When the ankle gets swollen due to certain kind of injury it is preferable to use Apis Mellifica. On the other hand, dropsical swelling of ankles soon after cardiac diseases are likely to be treated with Apocynum.
- For Swollen Ankles Due To Arthritis: Where the ankle swelling is owing to arthritis, doctors generally prefer to prescribe Ledum Pal in such cases. The characteristic symptoms of this type of ankle swelling are hot and painful ankles. Ledum Pal has the reputation for working substantially in such cases.
- About The Top Grade Homeopathic Medicine For Swollen Ankles: Arnica is the most popular homoeopathic medicine for swollen ankle owing to injury. Arnica works wonderfully in resolving the swelling and reconciles the painful symptoms arising out of the injuries to the ankle.
- In Case Swollen Ankles Resulting From Sprain: Sometimes overstretching of the ligaments may lead to a sprain as the ligaments hold the joints in a place. Sprain ankle can be cured successfully with one of the most excellent homoeopathic medicines called Ruta. Besides curing sprain ankle, it also appears helpful in case of lameness or weakness in ankle joint. For its added effectiveness Ruta has been ranked among the best medicines for Swollen ankles.
- For The Ankle Swelling Due To Varicose Veins: If the ankle swells due to the varicose veins, there is a medicine called Hamamelis which works very fast in treating ankles swelled for varicose veins. If swelling happens due to varicose veins you may have come through the symptom like cutting pain.
In case you have a concern or query you can always consult an expert & get answers to your questions!
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?
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.
A Pap Smear is a screening test done to to test for occurrence of uterine cancer. Carried out in a quick and simple way to extract a sample, the sample is collected from the cervix area of a woman during a pelvic exam. The examination of the sample takes place under a microscope thereafter to find abnormalities that can point towards cancer and pre cancer changes.
There are many reasons why women should get a pap smear screening done:
1. Women who are HIV positive should get this test done regularly so as to detect any anomalies in the cervix. This condition usually comes with higher risk of infections and cancer, which is why regular screening is required.
2. Age is also another factor and women over the age of 30 should go through an annual screening on a compulsory basis. This is also true for women who have been through pregnancy and child birth.
Preparing for a Pap Smear: To prepare for a pap smear test, you need to ensure that you are not menstruating at the time. Also, you may want to avoid sexual activity just before the test so as to get the most accurate readings. During the process, remember to stay calm and relax your body physically.
Procedure: The pap smear procedure is a quick one that might be only slightly uncomfortable. This test is usually carried out on the examination table at the gynecologist's clinic. The legs will need to be spread and placed in stirrups. The doctor will insert a speculum to hold open the vaginal opening so that the spatula can be inserted easily to take a sample from the area. This sample of the cells will be tested in a lab after due preservation.
Test Results: The test results can either be normal or abnormal. An abnormal result does not point at the presence of cancer. Rather it can simply mean that abnormal cells exist in the cervix. The doctor may ask you to go through these tests and screening more frequently so as to study the anomalies in a more detailed manner.
I am having problem in my spinal cord disc L4 -L5. With some loss of fluid. Now my knee joint also getting pain. What you wil suggest.
Sir my mom suffering from pain in almost all of the body specially in the backside, headache is there and also some sort of problem in breathing. Her protein is 9.8,albumin is 3.0,globulin 6.8,crp, alp,creatinine, vit D all are normal. Her MRI report says "study revels central & bilateral paracentral disc herniations with annular tear at L4-L5 and L5-S1 levels with thecal compression & bilateral traversing nerve root impingement. Mild retrolisthesis of L4 over L5 vertebral body is noted. There are degenerative osteophytes & disc desiccation as described in the text. Sir please tell me how can I treated her, doctor advice her tab maxgalin and accuvin what is the problems she can relief or not or any serious concern. Please help Sir.
Lung cancer is the uncontrolled growth of abnormal cells in one or both lungs. These abnormal cells do not carry out the functions of normal lung cells and do not develop into healthy lung tissue. As they grow, the abnormal cells can form tumors and interfere with the functioning of the lung, which provides oxygen to the body via the blood.
Lung cancer is the most common cause of death due to cancer in both men and women throughout the world. According to the U.S. National Cancer Institute, approximately one out of every 14 men and women in the U.S. is diagnosed with cancer of the lung at some point in their lifetime. Lung cancer is predominantly a disease of the elderly; almost 70% of people diagnosed with lung cancer are over 65 years of age, while less than 3% of lung cancers occur in people under 45 years of age.
What Causes Lung Cancer?
The development of lung cancer is strongly associated with cigarette smoking, approximately 90% of lung cancers are attributable to use of tobacco. Pipe and cigar smoking can also cause lung cancer, but the risk is not as high as with cigarette smoking. Tobacco smoke contains more than 4,000 chemical compounds, many of which are cancer causing (carcinogens). Passive smoking, i.e. the inhalation of tobacco smoke by non-smokers who live or work with smokers, is also an established risk factor for the development of lung cancer.
Genetic susceptibility (i.e. family history) may play a role in the development of lung cancer. Other causes of lung cancer include air pollution (from vehicles, industry, and power generation) and inhalation of asbestos fibres (usually in the workplace).
Lung Cancer Symptoms:
Early symptoms and signs of lung cancer:
There may be no symptoms at the onset of the disease. When present, common symptoms of lung cancer may include:
- Coughing: This includes a persistent cough that doesn't go away or changes to a chronic smoker's cough, such as more coughing or pain.
- Coughing up blood: Coughing up blood or rust-colored sputum (spit or phlegm) should always be discussed with your doctor.
- Breathing Difficulties: Shortness of breath, wheezing or noisy breathing (called stridor) may all be signs of lung cancer.
- Loss of Appetite: Many cancers cause changes in appetite, which may lead to unintended weight loss.
- Fatigue: It is common to feel weak or excessively tired.
- Recurring infections: Recurring infections, like bronchitis or pneumonia, may be one of the signs of lung cancer.
Signs of advanced stages of lung cancer: Advanced stages of lung cancer are often characterized by the spread of cancer to distant sites in the body. This may affect the bones, liver or brain. As other parts of the body are affected, new lung cancer symptoms may develop, including:
- Bone pain
- Swelling of the face, arms or neck
- Headaches, dizziness or limbs that become weak or numb
- Lumps in the neck or collar-bone region
Treatment: Treatment for cancer involves a combination of surgery to remove cancer cells, chemotherapy and radiation therapy to kill cancer cells. Lung cancer is incurable unless complete surgical removal of the tumour cells can be achieved. Surgery is the most effective treatment for lung cancer, but only a few percentage of lung cancers are suitable for surgery i.e. Stage I and II NSCLC and cancer that has not spread beyond the lung.
Radiation therapy may be used for both NSCLC and SCLC and is a good option for people who are not suitable for surgery or who refuse surgery. Chemotherapy is used for both NSCLC and SCLC. Chemotherapy drugs may be given alone or in combination with surgery or radiation therapy. Chemotherapy is the treatment of first choice for SCLC since it has usually spread extensively in the body by the time it has been diagnosed.
Also used in the treatment of lung cancer are targeted therapies. These are drugs (gefitinib and erlotinib) or antibodies (cetuximab, bevacizumab) that block the growth and spread of cancer by interfering with specific molecules involved in tumor growth and progression. They are used in some patients with NSCLC that does not respond to standard chemotherapy.
The procedure of breast reduction surgery-
Breast reduction surgeries can be conducted in an outpatient facility. You may have to stay for one night at a hospital as well. While performing this surgery, a patient is given general anaesthesia, which will make the patient asleep during the process.
Breast reduction surgery requires about two to five hours to be completed successfully. During the process, the surgeon will create a cut around the nipple and then on the breast. The cut is made in the shape of a keyhole. Extra skin, tissue and fat will be removed from the breast through the keyhole-shaped incision. Drainage tubes are also utilized for removal of excess skin and fat. After the removal is complete, and enough skin has been removed, the breasts are stitched. They are then wrapped in a special gauze. Sometimes, a surgical bra is required to be worn by the patient during the surgery.
Recovery from breast reduction surgery-
After a breast reduction surgery is performed, the patient must take a minimal one week off from any kind of work or school. Some women require two weeks or more to recover. However, this varies from patient to patient, but not more than three weeks are required for recovery.
You will be having a follow-up appointments with your surgeon, where the bandages and stitches on the breasts are removed.
As a part of the recovery process, a woman must abstain from all kinds of physical activities for one month following the surgery. After the surgery, it is likely for a patient to feel tired and experience breast pain. However, this is normal and you can have oral pain killers prescribed by your surgeon to get relief and ease. Heavy lifting should be strictly restricted.
Breast reduction surgery is an efficient cosmetic surgery, which enables women to reduce their breast size and volume. The results of such a surgery are quite satisfactory. If you wish to discuss about any specific problem, you can consult a Cosmetic/Plastic Surgeon.
Being diagnosed with cancer is a scary thought but with medical intervention, most breast cancer cases can be treated. The most common forms of treatment are radiation and chemotherapy. Along with this, there are many forms of alternative and complementary treatment that may be followed. This can help reduce the side effects of chemotherapy and radiation and boost the immune system. Here are some things you can do as an alternative and complementary form of treatment.
- Have a special diet: Having a healthy, well-balanced diet is necessary for everyone. This becomes more important when a person is recovering from cancer. Foods that have a high level of saturated fats and salt should be avoided. Intake of smoked, highly processed and pickled foods should also be reduced. On the other hand, you should increase your intake of vegetables, fruits and other foods derived directly from plants.
- Get your antioxidants: Antioxidants can protect a person from the damage caused by free radicals. This aids in the treatment of breast cancer and speeds up the healing process. Some of the antioxidants that can be beneficial in treating breast cancer are vitamins A, C and E, Lycopene and Beta Carotene. This can be found in wild blueberries, pecans, dark chocolate, kidney beans and goji berries. You can also increase your antioxidant consumption with dietary supplements. However, consult your doctor before taking any antioxidant supplements as it can interact with other drugs.
- Massage therapy: Massages can help relax the mind. They also have a number of other benefits. They are known as immunity boosters and can ease fatigue and pain. Thus a massage can also reduce the need for pain medication. It also helps increase the concentration of white blood cells in cases where women are being treated for stage I and stage II breast cancer.
- Acupuncture: Acupuncture is an alternative form of treatment that is considered part of traditional Chinese medicine. This involves the placement of sterile, needles that are very thin into specific points on the skin. These are then gently moved to stimulate the nervous system. In some cases, herbal supplements may also be incorporated into the treatment. Acupuncture is believed to help relieve fatigue, control vomiting and hot flashes and reduce pain.
It is important to note that these forms of treatment should not replace medical treatment but should be carried out along with it. You must also ensure that your doctor is aware of any supplements of alternative forms of treatment that you may be taking along with the medical treatment.
Cancer of the kidneys is amongst the ten most common types of Cancer. There are many types of renal cancer with Renal cell carcinoma being the most common amongst them. Renal cancer is said to be triggered by a genetic mutation but the cause for this mutation is yet unknown. While kidney cancer appears suddenly in some cases, in others it is inherited from the parents. Here are 4 things you should know about cancer of the kidneys.
Along with a mutation of the genes which is beyond our control, some lifestyle factors can also increase a person’s risk of suffering from renal cancer. Some of these factors are:
An early diagnosis can make the treatment of renal cancer much easier than if it is left undiagnosed. Hence, it becomes important to recognise the symptoms of this disease. Common renal cancer symptoms include:
- Blood in the urine
- A lump on either side of the abdomen
- Persistent pain on one side of the abdomen
- Unexplained weight loss
These symptoms are common to a number of other diseases as well and hence if you experience them, it is best to get yourself checked out by a doctor. In order to confirm a diagnosis, your doctor is likely to ask for blood tests, urine tests, an ultrasound and a CT scan or an MRI. In most cases, your doctor will also schedule a biopsy to check for cancer cells in the kidney tissue.
Stages of kidney cancer
Once cancer has been diagnosed, your doctor will need to determine the extent of damage caused in order to find the best form of treatment for the disease. Stages of kidney cancer are determined by the size of the tumour and on how much it has spread from the original location. There are four stages of kidney cancer.
Stage I – When the cancer cells are restricted to the kidneys and the tumour is no bigger than 3” in diameter
Stage II – The tumour has grown bigger in size but is still restricted to the kidney
Stage III – The tumour may be big or small but has spread to at least one lymph node or has affected the blood vessels
Stage IV – The cancerous cells have spread to nearby lymph nodes or other organs or the tumour has grown through the fatty layer and outer fibrous layer of the kidney.
Kidney cancer can be cured easily if detected in the early stages by removing the tumour and adjacent tissue or the entire kidney if need be. Removing one kidney is not fatal as a person can live a healthy life with a single kidney.