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Diagnostic X- Ray
Bone Densitometry Procedure
Uterine Artery Embolization
Interventional Diagnostic Procedures
Angiography Radial Approach
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I am Dr. Malvika Sabharwal from jeevan mala hospital and apolo spectral hospital in Karol Bagh, New Delhi India.
I am gonna tell you about uterus removal. Uterus removal is a very common operation. Bht commonly isko kara jata hai k patient ata hai apko bolta hai k ji hamary ko flah flah flah problem hai or ap hamara uterus nikal dijiye. Sb sy phly to main apko btaungi kya indications hain. Chahye wo fibroid k hn, ya bleeding zyada ho rai ho. Koi fibroid nai hai per bleeding bht zyada ho rai hai ya koi changes a rhy hain. Jaisa k agr mouth of the uterus main agr koi peps pal krty hain routinely jo k karna chahye, her ek marez k liye. Ap regular apasnaol kar ry hain us main koi changes any lag jaty hain ya aisi koi bhi problem ho to patient ata hai or wo bara clear mind sy kehta hai k ji mje uterus remove krwana hai. Kbhi kbhi wo refered cases hoty hain. Ya marez ko kahein kaha jata hai or hamary pas aty hain. Q k hamary pas jo uterus removal ka tareka hai wo hai durbeen sy or ek pait khol k. pait khol kr jo karty hain, ek bara 8 centimeter, 8 inches k kareeb ek insection hota hai pait k upper or us k through hm uterus ko, us ko pakar k baher nikal k us ki puri surgery kr k as pas disconnect kr k us ko nikal dety hain. Or abdomen ko stitch kr dety hain. Laparoscopic surgery jb sy hm ny shuru kari hai. Year was 92. I think ye sb sy bara bone hai. Doctor k lye bhi, patient k lye bhi. Ek to patient friendly surgery hai. Or doctor k liye offcourse, doctor ko sekhny main thora samain zaror lgta hai,but once you have commanded the technique of Laparoscopic surgery, it is the best. It is the best for the patient and for you it’s a very affective way of taking out the uterus without any problems. Ap us ko Laparoscopicly nikalty ho or Laparoscopicly jb nikalty ho 1 din ka stay rehta hai hospital main. 1 din main mareez back to normal work hota hai. Wo ghr ja kr k, serhioyon sy charhta hai. Serhiyon par jaye, upper rahy, ghar k khanay bnaye, baheer ghumny jaye, hr roz piture dekhy, us py koi issue nai hai. Bht minimal unko btaya jata hai do’s and don’t’s. unka upper charhny main koi problem nai ati. Sirf halki phulki jo problem, sirf 2 chezain ki hm log btaty hain which Is hardly any issue. So patient is back to normal routine. Ap apny ffice dubara ja skty hain itni jaldi. Loss of working days is very less. To loss of working days jaisy e kam oty hain, aj kal apko pta hi hai, mostly ladies are working, most of the women are working today. Chahy wo ghr py, ghr ka bhi kam itna hota hai. Bachon k aj kal kitny kam hoty hain, us k ilawa office girls bht hoti hain. Jo k office ko bhi sambhalti hain or ghr ko bhi sambalti hain. Let me tell you hamary bht patients hain un ko kbhi ye problem nai I k hum uterus nikalny k bad hm ghr ka kam nai kar paye. Ya office ka kam nai kar paye. Hamary pas doctors aty hain. Dur dur sy aty hain, in fact patients are coming from dubai, London, America, Canada all over. Wo aty hain apna operation krwaty hain or 2 din k bad they are ready to go home. Because this surgery has really picked up so much k jb o dekhty hain k kitny aram sy ye kam ota hai to unko aisa koi hesitancy nai lagti. Un k roz mara ki zindagi main koi change nai ata. Unko minimalistic thory sy do’s and don’ts hoty hain which is hardly anything. And aam tor per jb hum uterus nikalty hain, jaisa k main apko dekhati hn. This is one uterus. Two tubes and two ovaries. Aj agr main uterus nikal rai hn, lady ka age hai 45, I will tell her definetly ovary tubes to ap nikal hi lijye. Ovaries jo hain, wo apko hormones deti hain. Hormones ek lady ko femerity bna k rakhti hai. Femariti sy ye bhi matlab hai, tubes ka koi aisa role nai hai per ovaries apko hormones dy k, hormones k karan apka skin, hair, heart, sb k upper us ka zor hai. So ovaries ko hum bina puchy bilkul nai nikalty. Us k lye permission lety hain tabhi nikali jati hai. Per agr uterus nikal ry hain to aam tor per hum tubes ko bhi nikal dety hain.
Thank you very much.
How does neuclus pulposus take to decay when it comes out of annulus fibrosus and extruded to nerve root as for example in L5-S1? Does it decay over the time or it never?
The sciatic pain caused due to a lumbar herniated disc can radiate down your legs and may make you immobile. It is quite common for a herniated disc to press against a nearby nerve and inflame, leading to pain radiating along the length of the affected sciatic nerve. For getting relief from lumbar herniated disc pain, you need to become active. Daily hamstring stretches are considered to be an effective way to tackle such pain if you do them regularly.
Here are three important hamstring stretches which will help you in strengthening your hamstring muscles:
- Seated chair stretches: This stretch is perfect for people whose mobility is limited or for those who have unusually tight hamstrings. It is carried out in a sitting position. While performing this stretch, you have to sit on a chair with another chair placed across. By resting one foot on the ground and the other on the second chair, you need to straighten your back and lean forward over the leg which is extended. Once you feel a stretch in the upper and rear thigh, you should be in that position for at least 30 seconds. You should switch legs and repeat the stretching exercise thrice for each leg.
- Towel hamstring stretch: If you like stretching while lying down, this stretch is an ideal option for you. For performing a towel hamstring stretch, you have to lie down on the floor and keep one leg flat. Tighten your abdominal muscles while you lift the other leg and keep it straight. You should wrap a belt around the elevated leg’s instep and use it for pulling back the leg towards you. Hold the position for around 30 seconds when you feel a stretch.
- Wall hamstring stretch: This stretch is for people who find the towel hamstring stretch hard to execute. For such people, extra stability can be attained by taking help of a solid surface such as a door jamb or a wall. You can rest the raised leg against the wall for support. You need to lie on the floor near a wall corner and leave one leg straight while placing the other against the wall. Your hips should be on the floor.
While you do stretches of any kind, you should only stretch as far as you are comfortable. You must not stretch to a point which causes pain. These hamstring stretches are quite safe, but you should avoid them in case of any sudden, acute pain. In case you have a concern or query you can always consult an expert & get answers to your questions!
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.
Breast cancer is an abnormal growth of cells in the tissues of the breast. Mainly it occurs in females but less than 1% of all the breast cancer cases develop in males. The majority of breast cancers start in the milk ducts. A small number start in the milk sacs or lobules. It can spread to the lymph nodes and to the other parts of the body such as bones, liver, lungs and to the brain.
With more reliable early detection methods as well as the trend towards less invasive surgery, there is hope that even more women with breast cancer will be treated successfully and will go on to resume their normal lives.
Signs & Symptoms
It is painless, especially, during the early stage. Watch out for the following changes in the breast:
- A persistent lump or thickening in the breast or in the axilla.
- A change in the size or shape of the breast.
- A change in the colour or appearance of the skin of the breast such as redness, puckering or dimpling.
- Bloody discharge from the nipple.
- A change in the nipple or areola such as scaliness, persistent rash or nipple retraction (nipple pulled into the breast).
Consult a doctor immediately if you notice any of these changes.
Being a woman puts you at risk of getting breast cancer. There are certain factors that increase the risk of breast cancer. Some of them have been listed below:
- The risk increases with age; most cases of breast cancer develop after the age of 50
- Genetic alterations in certain genes such as BRCA1 and BRCA2
- Family history of breast cancer
- Being overweight
- Early menarche (onset of menstruation before the age of 12)
- Late menopause (after the age of 55)
- Never had children
- Late childbearing
- No breast feeding
- Excessive consumption of alcohol
- Use of hormonal replacement therapy (HRT) for a long period of time
However, most women who have breast cancer have none of the above risk factors. Likewise, not having any of these risk factors does not mean that you will not get breast cancer.
Early Detection and Screening
More treatment options are available when breast cancer is diagnosed at an early stage and hence the chances of recovery is also higher. So regular breast screening is important for early detection even if there are no symptoms. Following are the ways of screening:
- Breast Self-Examination (BSE): Perform BSE once a month about a week after your menses are over. If you no longer menstruate, choose a date each month which is easy to remember e.g. your date of birth or anniversary.
- Clinical Breast Examination: Get a breast specialist to examine your breast once a year if you are 40 years and above.
- Mammogram: Go for a screening mammogram once a year if you are 40 to 49 years old and once every two years if you are 50 years and above even if you do not have any symptom. It is not recommended for younger women (less than 40 years of age) as they have dense breasts, making it difficult for small changes to be detected on a mammogram. So ultrasonography of the breasts is advisable to them.
Types of Breast cancer
- Non-Invasive Breast cancer: These are confined to the ducts within the breasts. They are known as Ductal carcinoma in-situ (DCIS).
- Invasive Breast cancer: It occurs when cancer cells spread beyond the ducts or lobules. Cancer cells first spread to the surrounding breast tissue and subsequently to the lymph nodes in the armpit (Axillary lymph nodes). These cells can also travel to the other parts of the body such as bones, liver, lungs or brain and hence known as metastatic breast cancer.
Making A Diagnosis
If you notice any unusual changes in your breasts, you should see a doctor immediately. He will examine you clinically and may ask you to undergo some tests so that a definitive diagnosis can be made. Further, the staging work up is done to find out the stage of the disease and management accordingly.
Treatment of breast cancer may include various methods such as surgery with or without breast reconstruction, chemotherapy, radiation therapy, hormonal therapy and targeted therapy. Treatment options offered, depend upon the number of factors such as the stage of cancer and likelihood of cure, your general health and your preference.
Medical science constantly challenges the boundaries by finding not only the cures to the most dangerous diseases, but finds a way to prevent them even before they occur. With years of research, practice and data available for analysis, scientists are using advanced technology in combination with years of research to create a predicting mechanism for often fatal diseases like cancer.
Breast cancer screening has always been done with mammography. The fact is that this method is only 75% accurate, laden with false positives and misses a whole set of women totally- and that too when cancer has already developed. Part of the problem comes from the dense breast tissue which one in three women have. This tissue masks the lumps, which makes it difficult for mammograms to accurately screen cancer.
Some breakthrough scientific methods are changing this by drawing on years of research to predict this deadly disease, years before it can manifest itself.
A genetic test to predict cancer 10-11 years ahead of time. This test was performed to see how environmental factors could influence cancer, along with habits like smoking, abusing alcohol or hormones, genetic changes that occur and are put a large percentage of the women at a high risk of developing this disease.
A simple blood test is used for the genetic analysis of hereditary cancer. Researchers found a biological marker, methylation of the ATM gene, which has a very high ability to predict the risk of developing cancer, several years before diagnosis. 'Methylation' concluded that when one biological indicator is exposed to carcinogenic substances, or other abusive substances like tobacco and alcohol, it may trigger the development of cancer. On the flip side, this test will take time to reach the commercial market and even then cannot give an exact timeline as to when someone may develop the disease.
A simple blood test to predict breast cancer 5 years before it develops. This is the kind of medical miracle the world is looking for. Last year in April, researches in Denmark identified a simple blood test that can predict breast cancer five years before it actually develops with an accuracy of a whopping 80%.
It works by "measuring all of the compounds in the blood to build a 'metabolic profile' of an individual, in order to detect changes in the way chemicals are processed, during a pre-cancerous stage," says Laura Donnelly, health editor at The Telegraph, which covered this development. Danish researchers observed 57,000 participants over 20 years, gathering blood samples along the way, specifically comparing a set of 800 women who remained healthy or developed breast cancer within 7 years of their first blood sample. The researchers found they were able to predict, with 80 percent accuracy, which patients would be affected by the disease, just by looking at the metabolic profiles they built from the participants' blood samples. The results have been published in Metabolomics. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
Sir, I got MRI scan four years back. In the said report that posterior disc bulge noted at L4-5 & L5-s1 causing indentation over thecal sac and bilateral neural foramina more at L4-5 and degenerative cervical intervertebral disc with posterior disc bulge from c3-4 to c5-6. Please suggest me.
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 45.5 hrs by the CLOT BUSTER.
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
The good news is that 80 percent of all strokes are preventable. It startswith with managing keyrisk risk factors, including
More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control.
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.
Adenomyosis is a condition which occurs when the muscle wall of the uterus is broken by the endometrium lining. You experience pressure in the lower abdomen, menstrual cramps and bloating, before the onset of menstrual periods, resulting in heavy bleeding during the periods. This disorder is not life threatening but is known to cause pain and heavy bleeding.
The symptoms of adenomyosis are severe pain during periods, prolonged periods and pressure in the abdominal area. You may also experience heavy bleeding during the periods and may also experience intense pain. Sex may be very painful as well. The lower abdomen might feel tender and bigger; this occurs when the size of the uterus increases in this particular condition.
The exact cause of this disorder is not yet ascertained. However, certain possible causes could be:
- Congenital Defect: In this case, the condition is known to occur from birth wherein the endometrial tissue grows on the uterine muscle wall during the fetus formation.
- Invasive Growth of Tissues: This is said to occur when endometrial cells invade the uterus lining, leading to adenomyosis. This can also be triggered by a C-section operation.
- Inflammation During Childbirth: During the childbirth process, inflammation may occur in the lining of the uterus leading to this disorder.
In addition to the possible cause, there are certain risk factors which increase the risks of the disorder, such as:
- Giving birth to a child
- Surgery related to the uterus such as a C-section
Once you reach menopause, this disorder tends to subside. So depending on how close you are to menopause, the treatment is designed accordingly. The various treatments for adenomyosis are –
Anti-inflammatory Medications: If you are nearing menopause, then anti-inflammatory medications will be administered. This helps in reducing pain and the heavy blood flow.
Hormone Medications: Hormone medications such as hormone patches can also help with the bleeding and pain.
Hysterectomy: If the pain turns intense, then the doctor may recommend hysterectomy, a surgery to remove the uterus.
In case you have a concern or query you can always consult an expert & get answers to your questions!