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Dr. Alka Karnik

Radiologist, Mumbai

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Dr. Alka Karnik Radiologist, Mumbai
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I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family....more
I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family.
More about Dr. Alka Karnik
Dr. Alka Karnik is one of the best Radiologists in Andheri West, Mumbai. You can meet Dr. Alka Karnik personally at Sona Sight in Andheri West, Mumbai. Save your time and book an appointment online with Dr. Alka Karnik on Lybrate.com.

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Guideline Steps for Breast Examine by Patient

Homeopath,

Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.


Here's what you should look for:

Breasts that are their usual size, shape, and color

Breasts that are evenly shaped without visible distortion or swelling

If you see any of the following changes, bring them to your doctor's attention:

Dimpling, puckering, or bulging of the skin

A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)

Redness, soreness, rash, or swelling


Step 2: now, raise your arms and look for the same changes.

 

Step 3: while you're at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).


Step 4: next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.

 

Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.

 

Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage.
 

Step 5: finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 4.

1 person found this helpful

One of my female frnd had some pain in breast. She thinks becoz of a fall in childhood. It does not pain now. But one of the breast is smaller than other. She is scared of breast cancer. Just married and not a mom. Please suggest. Age 20.

MBBS, MS - General Surgery, Post Doctoral Fellowship
General Surgeon, Lucknow
It is normal to have unequal breast sizes and that is nothing to worry about. Only if your friend notices any lump in breast or unusual nipple discharge she should get further evaluation.
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My age is 28 and I am suffering from back pain due to L3, L4, L5 Disc bulging. Kindly suggest me a solution to over come from back pain without surgery.

Diploma In Orthopaedics (D. Ortho)
Orthopedist, Amravati
My age is 28 and I am suffering from back pain due to L3, L4, L5 Disc bulging. Kindly suggest me a solution to over c...
Hello, Medication like methylcobalamine with muscle relaxant and analgesic will reduce pain; you can take them . I will advise to check your vit B12 and vit D3 level. Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.
1 person found this helpful
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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

My MRI report of LS Spine is as: Diffuse Disc bulge at L3 /L4 indenting the thecal sac Partial desiccation of L4 / L5 with diffuse posterior disc bulge Indenting the thecal sac encroaching bilateral neural foramina (left>right) Partial desiccation of L5 / S1 Please tell. Me the seriousness of the problem with precautions Is this normal.

MBBS
General Physician, Bangalore
My MRI report of LS Spine is as:
Diffuse Disc bulge at L3 /L4 indenting the thecal sac
Partial desiccation of L4 / L5...
hello, this means a part of your spine is bulging out and in later cases it may compress your nerve roots and may cause pain of your lower back and your one or both of your lower limbs causing sciatica. but then, there are two things one is simple bulging of the disc and another is herniation of the disc where there is a tear in the cartilage, the later condition more often causes pain. bulging usually causes no pain. i would like to advice you to have a good posture, sit straight. prefer chairs without cushion. your mattress should not be too soft. sleep on a regular less bulky mattress where you can keep your spine straight. while trying to get up from a lying down position do it from one side. never try to sit up straight from the lying down position. change your position to left or right lateral then take support with your hands and get up. do a set of spinal exercises at least 20 minutes a day. you can do twice a day of 10 minutes duration too. you can consult me for the types and instructions of the exercises. if you have not get pain yet, consider yourself fortunate and start making these lifestyle changes.the pain you get in sciatica is ugly. prevention is better than cure. wish you a very good health.
3 people found this helpful
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Hello doctor plzz say me is surgery essential for Diffuse annular disc bulge seen at l4 and l5 level causing indentation over thecal sac with bilateral recess narrowing and significant nerve decompression.

MS - Orthopaedics, MBBS
Orthopedist, Hyderabad
Pivd l4-l5 initially can be treated with rest, physical therapy, medication, epidural steroid injection. If the problem is severe n you are having numbness n weakness in the feet n radiculopathy then you will meed surgery.
1 person found this helpful
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I am having ls S1 disk bulge problems if I am having physiotherapist it will cure or not?

DNB (Radiodiagnosis), DMRD, MBBS
Radiologist, Bangalore
Hi, thanks for your query a l 5 - s 1 disc bulge might respond to physical therapy. It cannot be cured completely like before but with precautions and medicine you will feel much better and have a normal life. Please take care not to involve yourself in any activity which might stress your lower back. This will delay recovery and might also cause complications and the pain and discomfort to increase. Avoid doing sudden movement involving lower back and lifting weight more than 5 kg. This will help you recover quickly. For mild pain you should use ointments with muscle relaxant and pain relief. In severe pain plase adk your doctor for oral ner pain reluef medicine and non steroidal anti inflammatory pills. Use of heat pack is also recommended. Regards.
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Facts Of Human Brain

MBBS,CCA,DCA,AASECT,FPA,AAD,F.H.R.SM.I.M.S
General Physician, Gorakhpur
Facts Of Human Brain

The human brain is the most complex and least understood part of the human anatomy. There may be a lot we don’t know, but here are a few interesting facts that we’ve got covered.

Nerve impulses to and from the brain travel as fast as 170 miles per hour. Ever wonder how you can react so fast to things around you or why that stubbed toe hurts right away? it’s due to the super-speedy movement of nerve impulses from your brain to the rest of your body and vice versa, bringing reactions at the speed of a high powered luxury sports car.

The brain operates on the same amount of power as 10-watt light bulb. The cartoon image of a light bulb over your head when a great thought occurs isn’t too far off the mark. Your brain generates as much energy as a small light bulb even when you’re sleeping.

The human brain cell can hold 5 times as much information as the encyclopedia britannica. Or any other encyclopedia for that matter. Scientists have yet to settle on a definitive amount, but the storage capacity of the brain in electronic terms is thought to be between 3 or even 1, 000 terabytes. The national archives of britain, containing over 900 years of history, only takes up 70 terabytes, making your brain’s memory power pretty darn impressive.

Your brain uses 20% of the oxygen that enters your bloodstream. The brain only makes up about 2% of our body mass, yet consumes more oxygen than any other organ in the body, making it extremely susceptible to damage related to oxygen deprivation. So breathe deep to keep your brain happy and swimming in oxygenated cells.

The brain is much more active at night than during the day. Logically, you would think that all the moving around, complicated calculations and tasks and general interaction we do on a daily basis during our working hours would take a lot more brain power than, say, lying in bed. Turns out, the opposite is true. When you turn off your brain turns on. Scientists don’t yet know why this is but you can thank the hard work of your brain while you sleep for all those pleasant dreams.

Scientists say the higher your i. q. The more you dream. While this may be true, don’t take it as a sign you’re mentally lacking if you can’t recall your dreams. Most of us don’t remember many of our dreams and the average length of most dreams is only 2-3 seconds–barely long enough to register.

Neurons continue to grow throughout human life. For years scientists and doctors thought that brain and neural tissue couldn’t grow or regenerate. While it doesn’t act in the same manner as tissues in many other parts of the body, neurons can and do grow throughout your life, adding a whole new dimension to the study of the brain and the illnesses that affect it.

Information travels at different speeds within different types of neurons. Not all neurons are the same. There are a few different types within the body and transmission along these different kinds can be as slow as 0.5 meters/sec or as fast as 120 meters/sec.

The brain itself cannot feel pain. While the brain might be the pain center when you cut your finger or burn yourself, the brain itself does not have pain receptors and cannot feel pain. That doesn’t mean your head can’t hurt. The brain is surrounded by loads of tissues, nerves and blood vessels that are plenty receptive to pain and can give you a pounding headache.

80% of the brain is water. Your brain isn’t the firm, gray mass you’ve seen on tv. Living brain tissue is a squishy, pink and jelly-like organ thanks to the loads of blood and high water content of the tissue. So the next time you’re feeling dehydrated get a drink to keep your brain hydrated.

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Renal Cancer - Know Its Signs And Symptoms!

DM - Nephrology, DNB (Nephrology), MBBS , MD - Medicine
Nephrologist, Mumbai
Renal Cancer - Know Its Signs And Symptoms!

Renal cancer is also known as hypernephroma, renal cell carcinoma (RCC), kidney cancer or renal adenocarcinoma. The kidneys are organs in your body that dispose off waste, while additionally regulating fluid balance. There are small tubes in the kidneys called tubules. These filter the blood, help in discharging waste, and make urine. RCC happens when cancer cells start to grow out of control in the lining of the tubules of the kidney. Renal cancer is a progressive disease that spreads to the lungs and the organs around it.

Medical experts do not know the exact cause behind renal cancer. It is most commonly found in men between the ages of 50 and 70. There are some risk factors and signs that indicate one’s possibility of having renal cancer and these are as follows

  1. Family history of renal cancer
  2. Dialysis treatment
  3. Hypertension or high blood pressure
  4. Obesity
  5. Smoking cigarettes
  6. Polycystic kidney disease (a condition that causes cyst formation in the kidneys)

At a point when renal cancer is in its initial stages, patients might not see any symptoms. The symptoms are mainly seen in the later stages. Some of the most common symptoms are as follows:

  1. Blood in urine: Blood in urine is called hematuria. As indicated by the Renal Cancer Association, hematuria is the most widely recognized indication of kidney cancer. In case you have blood in your urine, you may see pink, rust or even a red staining.
  2. Lower back pain: The vast majority does not encounter pain until cancer is in later stages. Pain from renal cancer is felt on one side of the flank, the region over the pelvis, and beneath the ribs in the abdomen. This pain can go from a dull yearn to a sharp wound, frequently leaving the area blue. In case you have any sudden pain that continues for more than a couple of days, you need to see a specialist.
  3. A mass or lump: A mass or protuberance in the abdomen can be an indication of renal cancer. Kidney knots might be hard to feel since they are somewhere down in the abdomen. Once a bump is found, your specialist may arrange symptomatic tests such as an ultrasound or a CT scan. These tests may diagnose what your knot might be.
  4. Iron deficiency and fatigue: Weakness and a fall in your iron levels are the most common symptoms of any type of cancer. Cancer exhaustion is not quite the same as simply feeling tired.
  5. Weight reduction, loss of appetite and fever: Another normal side effect of cancer is sudden and startling weight reduction. This happens quickly without any excessive workouts or dieting. A person diagnosed with cancer can also face a loss of appetite. In fact, even their most loved food items can get to be unappealing. Frequent fever is yet another common symptoms among most cancer patients.

In case your specialist suspects that you may have renal cancer, they will take some information about your and family’s medical history. They will then do a physical exam. Discoveries that can show renal cancer include swelling or irregularities in the stomach area. In case of men, augmented veins in the scrotal sac (varicocele) may be found. In case you have a concern or query you can always consult an expert & get answers to your questions!

1993 people found this helpful

Tips to Prevent Herniated Discs

M.Ch. orthopaedics, M.S. (Orth)
Orthopedist, Ludhiana
Tips to Prevent Herniated Discs

Our spinal disk resembles a jelly donut, wherein the softer insides are protected by the hard exterior. Sometimes, as a result of some injury or an accident the jelly slips out, leading to an extremely painful condition which in medical parlance is known as herniated disc. The pain that you are subjected to, during herniated disc, occurs as the nerves nearby are damaged due to the concussion.

Apart from pain, herniated disc is preceded by other symptoms, some of them are:

  1. Pain in the arm or the leg: Depending on which part of the body you have suffered the herniated disc, in the neck or in your lower back, this condition is succeeded by intense pain either near the buttocks or near the shoulders. It goes without saying that this pain increases sharply with movement.
  2. NumbnessThat part of the body where the nerves are damaged due to herniated disc often becomes numb and has no sensation whatsoever.
  3. Weakness: Due to herniated disc, the muscles become weak that considerably impairs and curbs mobility.

However, there are various ways by which you can prevent a herniated disc. Some of them are:

  1. Exercise: Exercise in any form and even for a short while yields several benefits. Your body invariably gains momentum and agility. If you exercise daily, your spine becomes more stable and strong, thereby preventing a possible herniated disc.
  2. Maintaining the right and good postureA lot depends on the way you sit and walk, in fact more than you can imagine. If you sit badly, it exerts a pressure on the spine and the discs. Subsequently, a good posture does the very reverse and curbs chances of a herniated disc in the future.
  3. Keep a tab on the weight: It is always healthy to maintain the right weight, the one that keeps you away from the onset of various diseases. If you are overweight, it puts more pressure on the spine disk, thereby increasing the risk of developing a herniated disc.
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