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Dr. Hemal Maniar

Radiologist, Mumbai

Dr. Hemal Maniar Radiologist, Mumbai
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To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies....more
To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies.
More about Dr. Hemal Maniar
Dr. Hemal Maniar is a popular Radiologist in Malad West, Mumbai. She is currently associated with Vinayak Maternity & General Hospital in Malad West, Mumbai. Book an appointment online with Dr. Hemal Maniar and consult privately on Lybrate.com.

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A-101, Ground Floor, Vikas Park Building, Link Road, Mith Chowk, Malad West. Landmark: Opposite Uncleâ??s Kitchen, MumbaiMumbai Get Directions
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Abnormal Uterine Bleeding - How Best to Diagnose It?

Fellowship and Diploma in Laparoscopic Surgery, FOGSI Advanced Infertility Training, Royal College of Obstetricians and Gynaecologists (MRCOG), MS - Obstetrics and Gynaecology, MBBS
Gynaecologist, Gurgaon
Abnormal Uterine Bleeding - How Best to Diagnose It?

It is perfectly normal for women to experience the periodic monthly bleeding cycle. However, if a woman experiences uterine bleeding which is abnormal and dysfunctional, it could be a symptom of infection. Other causes of abnormal uterine bleeding include hormonal imbalance, infection in cervix and cancer of the uterus. Many women can also experience abnormal uterine bleeding during first trimester of pregnancy.

The following are considered to be abnormal or dysfunctional uterine bleeding:

  1. A menstrual cycles occurs between 21 to 35 days, anything shorter or longer than this is abnormal
  2. No period for 3–6 months (amenorrhea) is abnormal
  3. Spotting or bleeding between periods
  4. Spotting or bleeding after intercourse
  5. Bleeding that is heavier or lasts longer than usual
  6. Spotting or bleeding after menopause

What can cause such a situation?

Some of the common causes leading to abnormal bleeding are as follows:

  1. Miscarriage
  2. Ectopic pregnancy
  3. Pregnancy
  4. Cervical or uterine infections
  5. Fibroids
  6. Hormonal imbalances
  7. Problems with blood clotting
  8. Polyps
  9. Polycystic ovaries
  10. Endometrial hyperplasia
  11. Cancer of the reproductive tract

How to Diagnose it?

Most women tend to ignore abnormal bleeding, taking it as something to do with age or hormones. A detailed physical examination and history is done to understand menstrual cycle patterns and family history. In addition, the following would be used.

  1. Ultrasound: The pelvic organs are examined through sound waves to locate the problem area
  2. Hysteroscopy: Through a thin device that is inserted into the vagina, the doctor takes a look at the inside of the organs and identify the cause for the bleeding
  3. Endometrial biopsy: The uterine lining tissue is removed and examined under microscope to look for tissue changes that could be causing the bleeding

How Best to Treat It?

This would depend on the reason for the abnormal bleeding. However, in most cases, combinations of the following are useful in treatment.

  1. Hormone replacement can be done depending on the age and gynecological history, the type and the dose of the hormone would be decided upon. These could be in the form of tablets, vaginal creams, injections, or through an intrauterine device
  2. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are useful in reducing bleeding and controlling cramps during excessive menstrual bleeding.
  3. Antibiotics may be useful if there is infection of the pelvic organs.
  4. Polyps, cysts, cancers, and other growths can be removed via hysteroscopy and sent for biopsy to confirm they are not cancerous.
  5. Endometrial ablation where the endometrial tissue is treated with heat can be used to control bleeding permanently.
  6. Hysterectomy would be done if other forms of treatment have failed. This could depend on their gynecologic history and other considerations as she cannot get pregnant after this.

Do not ignore if you see a change in the pattern of your uterine bleeding. It definitely calls for medical attention and if identified early, can be managed in much simpler ways.

3 people found this helpful

I am 34 years old male. I am suffering from back pain for the last 3 years. I have done MRI. In MRI it is found that 1. MILD DIFFUSE DISC BULGE IS NOTED AT L3-4 LEVEL CAUSING ANTERIORTHECAL SAC indentation MINIMAL NARROWING OF BILATERAL NEURAL forminal AS WELL AS LATERAL RECESSES. 2. MILD DIFFUSE DISC BULGE IS NOTED AT L4-5LEVEL CAUSING ANTERIOR THECAL SAC INDENTATION AND NARROWING OF BILATERAL NEURAL forminal AS WELL AS LATERAL RECESSES. MILD facial ARTHROPATHY IS NOTED BILATERALLY. please MAKE ME UNDERSTAND WHAT IS THE PROBLEM AND WHAT IS THE SOLUTION.

Fellowship of the Royal College of Surgeons (FRCS), Membership of the Royal College of Surgeons (MRCS)
Orthopedist, Trichy
I am 34 years old male. I am suffering from back pain for the last 3 years. I have done MRI. In MRI it is found that ...
the problem is you have disc bulge at 2 intervertebral levels causing compression of the nerve root that comes out of the spinal canal at that level causing pain in the back and legs . (disc is like gelatinous cushion inbetween two vertebral bones and it acts like a shock absorber . sometimes the disc comes out of its normal position and presses on the nerve which comes from the spinal cord. depending on the nerve that is compressed you can get pain in the back and / or legs, numbness, weakness etc.
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I have diagnosed with infiltrating ductal carcinoma, NOS, in right breast (in biopsy report. Please suggest me what is my treatment option.

MD - Radiothrapy
Oncologist, Ahmedabad
hi, In ca breast, surgery is the primary treatment. Then chemotherapy and radiotherapy to prevent recurrence and metastasis . So go for surgery first then other treatments according to stage.
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Breast Cancer - 6 Ways You Can Prevent it

MBBS, DGO, MD - Obstetrics & Gynaecology
Gynaecologist, Mumbai
Breast Cancer - 6 Ways You Can Prevent it

Breast cancer begins when the cells that are present in the breast start to go out of control. These cells generally form a tumor which can be seen on mammogram or one can feel it as a lump. The tumor is threatening if the cells can grow into the tissues that surround it or spread to other areas of the body. Breast cancer happens mostly in ladies. Here are a few methods with which you can prevent breast cancer-

  1. Keep your weight in check: Maintaining a healthy weight is important for everyone although, it is easy to tune it out since it is said so often. Being overweight can expand the danger of a wide range of cancers, including breast cancer, particularly after menopause.
  2. Be physically active: Women who are physically active for almost or at least 30 minutes a day have a lower danger of breast cancer. Normal activity is additionally one of the ideal approaches to keep weight under control.
  3. Eat Your Fruits and Vegetables and Avoid Too Much Alcohol: A balanced and healthy diet can bring down the danger of breast cancer. Attempt to eat a considerable measure of fruits and vegetables and keep liquor at moderate levels or lower. While moderate drinking can be useful for the heart in most grown-ups, even low levels of intake can build the danger of breast cancer. If you do not drink, don't feel you have to begin. In case you drink modestly, there is less risk.
  4. Try not to Smoke: Smokers and non-smokers alike know how undesirable smoking is. It brings down a person’s quality of life and expands the danger of heart and lung diseases, stroke, and no less than 15 types of cancer, including breast cancer. It additionally causes bad breath, awful teeth, and wrinkles.
  5. Breastfeed, If Possible: Breastfeeding for almost one year or more brings down the danger of breast cancer. It additionally has extraordinary medical advantages for the baby as well, especially in terms of immunity.
  6. Keep away from Birth Control Pills: Contraceptive pills have both dangers and advantages. In many cases, the more young a lady is, the lower the danger is. While ladies are taking birth control pills, they have more chances of falling prey to breast cancer as per various medical studies. This danger leaves rapidly in the wake of stopping the pill. The danger of stroke and heart attack is increased while on the pill, especially if the woman smokes. Long term use can likewise have essential advantages, such as bringing down the danger of ovarian cancer, colon tumor and uterine cancer and undesirable pregnancy. In case you are exceptionally worried about breast cancer, staying away from birth control pills is also an alternative to lower the risk. If you wish to discuss about any specific problem, you can consult an oncologist and ask a free question.
3959 people found this helpful

Dear sir, I am 33 year old. I have back ache since 2010 mri also have been done it shown herniated slip disk and doctor has advised me surgery. But I am not willing to get surgery please advise me what should I do.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Not all pt. Of backache need surgery. Most of them can be managed with out operation. Kindly show me a photograph of the affected part. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful Do hot fomantation. Paracetamol 250mg od & sos x 5days. Ubicar 1 tab odx10 caldikind plus 1tab od x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 1 wk, contact me again. Do not ignore. It could be beginning of a serious problem.
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sciatica

BPTh/BPT
Physiotherapist, Pune
Prolapsed Disc
Also known as slipped disc, herniated disc or sciatica. The discs are the shock absorbers of your spine. When they are injured the inner soft part of the disc can protrude out through a tear in the outer lining of the disc. This disc material can press on the nerves in the spinal column, injuring them through direct pressure and causing inflammation.
The most common age to develop a disc prolapse is between the ages of 30-50 years., twice as many men as women are affected. Prolpased discs occur mainly in the low back (lumbar) spine. Less than I in 20 cases of back pain are due to a disc prolapse, most are due to mechanical back pain. (see section back pain).
Symptoms
A slipped disc is characterised by sudden, severe back pain that is often made worse by movement and which can usually be eased by lying down flat.
Nerve root pain (sciatica) can also occur because a nerve is trapped or irritated by a prolapsed disc. Although the problem is in the back, patients experience pain along the course of the nerve, for example, down a leg to the calf or foot.
With a prolapsed disc, the sciatic nerve is most commonly affected. The sciatic nerve is a large nerve that is made up from several smaller nerves that come out from the spinal cord in the lower back and travels down each leg. The irritation or pressure on the nerve may also cause pins and needles, numbness or weakness in part of a buttock, leg or foot.
In rare cases, cauda equina syndrome can occur. This is a disorder where the nerves at the very bottom of the spinal cord are trapped. It can cause low back pain as well as problems with bowel and bladder function and weakness in one or both legs. These symptoms need urgent medical treatment to prevent permanent damage to the nerves that supply the bladder and bowel.
A large number of people can have a prolapsed disc without any symptoms if it doesn’t trap or irritate the nerve.
Investigation
A doctor will normally be able to diagnose a prolapsed disc from the symptoms and by examining the patient.
In most cases, no tests are needed, as the symptoms often settle within a few weeks.
Tests such as x-rays or scans may be advised if symptoms persist. In particular, an MRI scan can show the site and size of a prolapsed disc. This information is needed if surgery is being considered
12 people found this helpful

Sir I am suffering from. L4-5 problem since 2 years there is any treatment with out operation please help me.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Kindly show me a photograph of the affected part. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 1 wk, contact me again. Do not ignore. It could be beginning of a serious problem.
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Please tell me what can I do in slip disk problem please explain preventive & treatment methods without using drugs because I need not anymore drugs because I already taken lots of drugs.

Fellowship of the Royal College of Surgeons (FRCS), Membership of the Royal College of Surgeons (MRCS)
Orthopedist, Trichy
you have to avoid lifting heavy weight and doing strenuous activities. Core muscle strengthening exercises helps. weight reduction is necessary.
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I am suffering from l5-s6 disc prolapse from a year. Not undergone surgery. Little weight lift becomes problem in next morning. Is there a permanent solution for my problem. Thanks in advance.

Hand Surgery, M.S. (Orthopaedics
Orthopedist, Ahmedabad
Dear well, there is nonoperative treatment which is manipulation of spine, but should be done by a qualified person. There are risks involved and so you need proper evaluation and then I can decide if you are a proper candidate for the same or not.
2 people found this helpful
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Neck Pain - Health Tip

Master of Physical Therapy MPT CARDIO, BPTh/BPT
Physiotherapist, Rajkot
Neck Pain - Health Tip
Herniated disks or bone spurts in the vertebrae of the neck may become the reason behind severe neck pain. They sometimes take too much space and compress the nerves branching out from the spinal cord.
10 people found this helpful

I have got pain in my leg from two years. The MRI shows this diffuse posture lateral iv disc at L4-L5 level causing anterior epidural space and lateral recess narrowing with mild thecal sac indentation and abutting transversing nerve fibres and existing neural foramen stenosis.(2) subtle L3 -L4 diffuse posture lateral iv disc bulge causing anterior epidural space and lateral recess effacement. What is the treatment of it .is surgery necessary for it.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I have got pain in my leg from two years. The MRI shows this diffuse posture lateral iv disc at L4-L5 level causing a...
: keep your leg raised while sitting or lying quadriceps strengthening exercises- quad clenches: lie flat on your back or sit upright on a chair with leg kept horizontally on another surface. Now, tighten the muscle on the front of the thigh by pushing your knee down. You should feel your thigh muscles clench, hold for 3 secs. Repeat 10 times twice a day. Short arcs: lie flat on your back or sit upright with your leg placed horizontally on a flat surface like a chair or bed. Place a rolled up towel under the knee. Pull your toes towards you and clench you thigh muscles. Slowly lift your foot up off the bed until your knee is straight (keep your knee resting on the towel). Hold for 3 secs and slowly lower them on the chair. Repeat 10 times twice a day. Straight leg raise: lie flat on your back. One leg and knee will be straight and other leg should be bent. Pull your toes towards you and tighten/clench the muscle on the front of the thigh, locking your knee straight. Lift your foot up in the air, about 6 inches off the bed. Hold for 3 secs and slowly lower the leg. The knee must remain straight the whole time you are doing this exercise.
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Doctor my 13 year old daughter has developed slip disc in her L4 and L5 vertebrae. What should be her treatment?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Disc prolapse at age of 13 years is not common, though it still may occur. Treatment is analgesics, back care, rest and physiotherapy. However, the child needs to be examined before I can suggest precise treatment
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I am suffering from slip disc l4 l5 problem from last 5 yrs. I have tried all the treatment. But. please provide some tips.

Fellowship in Shoulder and Knee Surgeries, DNB (Orthopedics), Diploma In Orthopaedics (D. Ortho), MBBS
Orthopedist, Nagpur
Do not lift weight Use hot fomantation twice daily Don't bend forward Show MRI for further information on the problem
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I am having slip disc. I want to know to cure it with exercises and what are the precautions to took for this?

MS - Orthopaedics
Orthopedist, Surat
Till you have pain, exercises would have little help. Initially you have to take bed rest. Avoid forward bending & cross-legged sitting on ground. Sit with a straight back. You can wear l. S. Belt temporarily. When pain subsides you can start exercises as guided by your doctor to prevent future disc problems.
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I am suffring from slip disc, hernited disc problem sence last 1 year.Please do help

MBBS, MS - Orthopaedics
Orthopedist, Delhi
This is quite a common condition rule out diabetes & vit. D deficiency. Sleep on a hard bed with a soft bedding on it. Use no pillow under the head. Any way take caldikind plus 1 tab daily for 10days paracetamol 250mg tds x 3 days contact me after that. Make sure you are not allergic to any of the medicines you are going to take. It may have to be further investigated.
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MPT
Physiotherapist, Mumbai
Herniated disks or bone spurts in the vertebrae of the neck might take too much space and compress the nerves branching out from the spinal cord which may cause severe back pain.
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I want to know about exercises being done in case of diffuse disc bulge at l1-l2 level indenting anterior the cal sac mildly with bilateral mild neural foraminal narrowing.

Diploma in Radio-Diagnosis
Radiologist, Shimla
If pain is there no exercise indicated, after relief mild passive exercises, lumber exercise, lumbo-sacral exercise, mild lumber extension exercise; click on private quastion in my name for any clarification.
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Breast Cancer - Know More to Say 'No' More!

MBBS, DGO, MD - Obstetrics & Gynaecology, MRCOG
Gynaecologist, Delhi
Breast Cancer - Know More to Say 'No' More!

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.

  1. A lump in either of the breasts or armpits
  2. Change in size, shape, or contour of either breast
  3. Redness of your breast or nipple
  4. Discharge of clear or bloody fluid
  5. Thickening of breast tissue or skin that lasts through a period
  6. Altered look or feel of the skin on the breast or the nipple (dimpled, inflamed, scaly, or puckered)
  7. One area on the breast that looks very different from the other areas
  8. 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.

  1. 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.
  2. Family history of other cancers: Even if there is no breast cancer, if there are other cancers that run in the family, watch out.
  3. Age: Women over 50 are at higher risk of developing breast cancer.
  4. Race: Caucasian and Jewish women are at higher risk of breast cancer than African-American women.
  5. 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.
  6. 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.
  7. 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.

  1. 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.
  2. 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.
  3. Stage II: The cancer at this stage grows considerably or spreads to other parts. There are chances that cancer may grow and also spread.
  4. 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.
  5. 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.

  1. 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.
  2. 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.
  3. Women in high-risk categories should have screening mammograms every year and typically start at an earlier age.
  4. Ultrasound screening can also be given in addition to mammograms.
  5. 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.

  1. Exercise and a healthy diet with reduced amount of alcohol are definitely effective in minimising the chances of developing cancer.
  2. Tamoxifen is used in women who are at high risk for breast cancer.
  3. Evista (raloxifene) which is used to treat osteoporosis after menopause. It is also widely used in preventing breast cancer.
  4. 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.

2622 people found this helpful

I am 20yr old male. I had an accident 2 years ago & I had suffered severe back pain. My spinal cord's disc had moved a bit so that I have pain in my back till now. What should I do for this?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Kindly show me a photograph of the affected part. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 4-5days, contact me again. Do not ignore. It could be beginning of a serious problem.
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Does Knuckle breaking at neck at regular intervals when I'm feel stressed, will that leads to an disk injury or any problems in future. Usually I keep doing that when I work out in gym.

MBA (Healthcare), MRCPsych UK, MBBS
Psychiatrist, Bangalore
Does Knuckle breaking at neck at regular intervals when I'm feel stressed, will that leads to an disk injury or any p...
Try to sleep without pillows-it helps your neck and shoulder muscles to relax properly and maintain a good spine posture.
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