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Dr. Poonam Khera

Radiologist, Mumbai

Dr. Poonam Khera Radiologist, Mumbai
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Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; a......more
Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; as a health provider being ethical is not just a remembered value, but a strongly observed one.
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Dr. Poonam Khera is an experienced Radiologist in Mumbai, Mumbai. You can visit her at Bombay Hospital & Medical Research Centre in Mumbai, Mumbai. Don’t wait in a queue, book an instant appointment online with Dr. Poonam Khera on Lybrate.com.

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Cervical Lordosis Straightening Treatment

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
Cervical Lordosis Straightening Treatment

Most commonly known as a military neck a straight or forward curve of the neck is abnormal and may cause an unkind progression of symptoms leading ultimately to cervical disk degeneration.

Reversal of cervical lordosis explained

The anatomy of the neck features a lordotic curvature in its typical and healthy state. This means that the cervical region has a gentle curvature with the open end of that curve facing the rear of the body. The base and top of the curve will be further posterior than the mid point, which will be further anterior.

When the lordosis is straightened, the neck becomes more upright and linear. This is more common than the next progression of atypical curvature, which is the subject of this article.

Actual reversal of curvature means that part or all of the cervical spine develops a kyphotic profile, with the open end of the curve facing anteriorly. Usually, this reversal is extremely mild, but is still very abnormal. What we now see is the middle of the curve being positioned posterior to the top and bottom.

In essence, picture the letter c and now turn it backwards: This is the shape of a reversed cervical lordosis.

Reversal of cervical lordosis causes

The spinal curvature in the neck is constantly in flux to some degree.

Congenital conditions and developmental conditions can have lasting effects on the natural degree of curvature typically demonstrated from patient to patient. These circumstances may be explainable due to injury or degeneration, or may be idiopathic:

Scoliosis can affect the normal lordotic curvature in the neck.

Cervical spondylolisthesis is a major source of reversed lordotic curvature.

Severe disc pathologies can facilitate a gradual loss or reversal of cervical lordosis.

Vertebral irregularities, such as wedging, can definitely contribute to lordotic alteration.

Traumatic injury, including vertebral fracture, can create the ideal circumstances for a reversal of lordosis to take place.

Severe neck muscle spasms can actually reshape the spinal curves, although these are usually temporary expressions and not actual structural conditions.

Effects of reversal of cervical lordosis
The neck is designed to curve in order to balance the spine, absorb stress, distribute force and provide proper movement of the head. When this curvature is diminished or reversed, symptoms may result, although this is not an inherent part of any altered lordotic condition.

Patients may experience stiffness and tension in the neck. Pain may be present and may even be severe in rare cases. Neurological dysfunction is possible in extreme cases, since the neuroforamen might not align properly, thereby causing a cervical pinched nerve.

In the worst circumstances, central spinal stenosis in the neck might affect the viability of the spinal cord, possible enacting the most dire of symptoms throughout the body.

Patients will also be more prone to injury, since the normal shock absorption qualities of the typical curvature have been lost.

While all these effects are certainly possible, they are not usual. In fact, a great majority of patients have minor symptoms or even no symptoms at all from mild reversed lordotic curvatures.

The pathology leading to a neck curve reversal (cervical kyphosis shown below right) may be inspired by a multitude of conditions as follows:
Post whiplash
Post head injury
Stomach sleeping
Poor sitting/working postures
Congenital spinal curvatures
Osteoporosis
Degenerative cervical discs (a form of osteoarthritis that can either be the cause of or the result of a cervical kyphosis)
Compression fracture of vertebral body
Infection of the cervical spine

Anatomy: straight vs. Curved

I've always heard that it was good to stand up straight.

stand upright, stick your chest out and hold your shoulders back! otherwise you're going get widows hump.

Are these expressions as familiar to you as they are to me? one might think that having a curved neck goes against what we heard from parents and teachers as we were growing up, but the reality is that there is a little bit a truth in both. Maintaining good posture throughout our lives is crucial to both the health of our spine and vital organs. On the contrary, a special type of curve called a lordosis is a good thing, both in the neck and lower back.

When we look at a person from the back their spine should be truly straight, so that the left and right sides of one's body is symmetrical. However, when we view a person from the side, the front and back of their body is different and this is reflected in a coinciding curvature of the spine. Both the lower back and neck are hollowed out (concave) and the mid or thoracic spine is protrudes (convex). Thus there is an alternation of curves functioning to provide stability, shock absorption and aid in propulsion. A straight spine would be very stiff and not flexible. Imagine the plight of a pole vaulter with an inflexible pole.

Nature's design of our spine and rib cage facilitates breathing and offers protective and supportive framework for vital organs. Spinal disks are shock absorbers and because they are in the front of the spine, lordotic curvatures keep them from having to bear weight. Kyphosis or loss of such curvatures bears weight upon the disks, leading to their ultimate degeneration. This process of deterioration is a form of osteoarthritis and in the spine is known as degenerative spondylosis.

Diagnosis
Although most physiotherapists or conservative orthopedists can recognize a cervical curve reversal upon viewing the patient's posture, a definitive diagnosis may be obtained via a standing lateral (side view) x-ray of the neck. Cause can often be determined by corroborating a comprehensive history, a thorough examination, x-rays and questions about sleep, work and lifestyle.

In my professional career I found that the majority of young adults presenting with cervical kyphosis either had a whiplash or were stomach sleepers from an early age. For desk jockeys 40-60 years of age, many hours of sitting with their head flexed forward almost dictates the fate of developing kyphosis. In prior years I considered cervical kyphosis a job hazard for the careers of accountants, attorneys and often teachers because of years spent with their head in a book or paperwork. However, the digital age offers some relief in that respect. A well-planned, ergonomically-friendly office can do wonders for protecting the spine in the sedentary worker.

Treatment for cervical curve reversal (kyphosis)
During my chiropractic practice I had the opportunity to note a good percentage of correction toward a more normal lordosis (noted on x-ray) for 70% of patients under my care. This was almost always consistent with those patients that followed all recommendations and were model participants in their own care. Here is the recommended treat plan:

Spinal manipulation of stiff and fixated spinal segments by a qualified physio
Flexibility exercises for flexion and extension of cervical spine
Resistance exercises for flexors and extensors of the neck
Learn the Alexander technique for maintaining good posture (hint: the basic philosophy is to sit and stand like you were hanging by a string from the vertex of your skull. Liken it to a puppet on a string).
Elimination of stomach sleeping
Avoid standing on your head, although some yoga postures may be beneficial
Use of orthopedic neck pillow while sleeping.

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She is 63 years old suffering from diabetes-on Insulin+other allopathy medicines but the sugar level running from 70 to 200 and more. Today fasting 90 but PP is going high between 200 to 300. She is on Insulin from last 15 years. Can she be treated with you? And I am also suffering from Slip Disc. L4 L5 S1 and taken 15 days Ayurvedic treatment such as Katibastyi, Malish, Steam bath etc but there is nothing complete and permanent. Please advise us to permanent treatment.

PDDM, MHA, MBBS
General Physician, Nashik
She is  63 years old suffering from diabetes-on Insulin+other allopathy medicines but the sugar level running from 70...
This means either her diet is wrong or she is not receiving proper treatment kindly mention ongoing treatment in detail and revert. Slip disc is difficult to treat but you should use lumbosacral belt and proper posture is really important in your case. Avoid massages by inexperienced people.
1 person found this helpful
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I am bodybuilder I had a disc replacement due to bulge in my disc. Is it possible to continue bodybuilding. Lifting weights etc. Plzz help me.

Fellowship of the Royal College of Surgeons (FRCS), Membership of the Royal College of Surgeons (MRCS)
Orthopedist, Trichy
lifting weights is not advisable once you have had problems in your spine. there are other discs in the spine that can always create the same problem you had initially.
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Hi doctor. I have a severe backache as per Dr. Advice I have done mri. My mri report is as under kindly advise in matter degenerative lumber spondylitis are seen in the form of marginal osteophytes and multilevel disc dessication. 1. D12-l1 & l1-l2 discs show mild bulge, indenting anterior thecal sac without significant never root compression 2. L2-l3 disc reveals right paracentral disc extrusion, indenting anterior thecal sac and causing right lateral recess narrowing, impinging on right traversing l3 nerve root. 3. L3-l4 disc shows mild diffuse disc protrusion, indenting anterior thecal sac and causing bilateral mild neural foraminal narrowing, minimally abutting bilateraltraversing l4 nerve roots. 4. L4-l5 disc reveals mild diffuse disc protrusion, indenting anterior thecal sac and causing bilateral mild neural foraminal narrowing, minimally abutting right existing l4 nerve root-bilateral traversing l5 nerve roots. Nerve roots. Cord is seen ending at d11 vertebral level. Distal cord and conus appear normal. Both hip and si joints are normal. No pre / paravertebral, epidural soft tissue or haematoma is seen. Bilateral psoas and posterior paraspinous muscles are normal. Please advise for home exercise / medicine.?

Bachelor of Physiotherapist
Physiotherapist, Noida
Hi doctor. I have a severe backache as per Dr. Advice I have done mri. My mri report is as under kindly advise in mat...
Sir you should back strengthening and stretching exercise. It will relax and strengthen or back muscles. If you personally want to consult me Please consult privately.
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Can Physiotherapy Cure cervical disc prolapse and L5 S1 Disc bulge.I am suffering from Neck pain for the Past 6 years

BPTh/BPT
Physiotherapist, Gurgaon
these days there is lots of advanced techniques in physiotherapy can cure disc prolapse in various levels. At my experience if you go for a right physiotherapy center you will get result..
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I am 54 year old male having MRI [LS-SPINE]. Finding Reveal Annular Tear, circumferential Disc Bulge With Small Posterocentral Protrusion at L4-L5 level, Causing No Significant Neural Compression Or Canal Stenosis" I have no pain anywhere since 5 months only difficulty in standing or on walking without pain. Become tired for few seconds, then start again walking. Ortho. Says no need to worry it will heal naturally. Spine Surgeon says need of "DISC FIX" treatment required. Getting confuse. WHAT TO DO.'

MBBS
General Physician,
Hi, Thanks for your question. I do understand your pain and discomfort. As per your history is concerned please follow: 1)If there is no neuro deficit then no need of surgical treatment so wait for that time to come during this time do physiotherapy and steroid treatment . I hope I was able to address your query. If you have any further questions, please do not hesitate to write to me. Wishing you all the best. Thanks
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ECMO New Era of Medicicne

Homeopath,
ECMO New Era of Medicicne

What is ECMO?
Like dialysis for unfunctional kidney, Ecmo for unfunctional lung.

Ecmo stands for extracorporeal membrane oxygenation. It is a method of giving oxygen for the body when icu pateint lungs and/or heart are not able to supply oxygen on their own. 

Why ICU pateint put on ECMO?

Doctors place ICU patients on ECMO when patients are not able to supply oxygen to the body.

ICU patients’ lungs fail for a number of reasons including pneumonia, lung cancer, pulmonary edema, pulmonary embolism and COPD.

 When a patient’s lungs fail, he/she first is intubated (breathing tube) and hooked up to a ventilator (breathing machine).
 However, sometimes lungs are so damaged that providing oxygen through intubation is not enough.

This is when doctors turn to v-v ecmo.
A heart can fail for many reasons including heart attack, pulmonary embolism, bad valve disease, or worsening heart failure. When a heart fails, doctors try to fix the underlying problem. They may also start medications (called ionotropes) to help improve the pump function of the heart. If medications are not enough, doctors will turn to v-a ecmo.

How long can someone stay on ecmo?

That is a complicated question. Due to the risks of ecmo discussed above, doctors try to keep patients on ecmo for as short a time as possible. Often patient will be on ecmo for several days up to 1-2 weeks. Every day, several blood and imaging tests are done to determine if a patient is ready to come off ecmo. As the technology of ecmo improves, hopefully side effects will decrease and patients can remain on ecmo for longer periods of time.

What is the difference between ecmo and a ventilator (breathing machine)?

Both ecmo and a ventilator aim to provide oxygen to the body when the patient’s own lungs and breathing are failing. The ventilator assists the patient’s own lungs by pushing oxygen with pressure into the lungs. Ecmo instead provides oxygen directly via a catheter placed in a patient’s vein or artery. We almost always try oxygenating a patient with a ventilator first. However, when a patient’s lungs are too sick for this, we turn to ecmo to assist in providing oxygen to the body. V-v ecmo provides oxygen through a vein. This blood then has to travel to the heart and be pumped around the rest of the body through arteries. Therefore, with v-v ecmo or with a ventilator, a patient must have a well-functioning heart to get the oxygen pumped throughout the body. V-a ecmo has the additional advantage of pumping blood directly to arteries. This “by-passes” the heart and is therefore the method of ecmo we use when a patient’s heart is failing.

1 person found this helpful

5 Easy Ways to Decrease Your Breast Cancer Risk

MBBS, MS - Obstetrics and Gynaecology
Gynaecologist, Noida
5 Easy Ways to Decrease Your Breast Cancer Risk

Breast cancer is the form of cancer that occurs from breast tissues in women. Signs of breast cancer may include a lump in the breast, changes in the shape of the breast, dimpling of the breast skin, a fluid coming out of the nipples or development of red scaly patches on the skin. There might be pain in the bones, swollen lymph nodes, shortness of breath, or the skin turning yellow and pale.

Breast cancer is a fatal mode of cancer in women, and one must try to abstain from this cancer in all possible ways. Here are 5 ways you can decrease the risk of breast cancer.

  1. Keeping a check on your weight: Although the process is tough to maintain, keeping up a sound and healthy weight is a critical objective for everybody. Being overweight can expand the danger of a wide range of cancers, including breast cancer, particularly after menopause in women. Exercise is very important for maintaining a healthy body and lifestyle. Women who exert physically regularly are fitter than others and are at a much lower risk of acquiring diseases of any kind. Regular exercise decreases the chance of getting breast cancer and also keeps the body weight in check.
  2. Maintaining a healthy diet: Maintaining a healthy and balanced diet is a key for keeping away from any kind of cancer or major health problem. Include a sufficient amount of fresh fruits and green vegetables in your daily diet to ensure the supply of all vital nutrients to your body. This would increase your immunity.
  3. Avoid smoking and consume less alcohol: Smoking is a very unhealthy and harmful habit. Smoking lowers the quality of your life, and causes numerous diseases. Heart diseases, stroke and many kinds of cancer, including breast cancer can be caused from smoking. If you drink alcohol, you should moderate your drinking habits and drink less, as drinking in excess may lead to breast cancer.
  4. Practice breast feeding: Breast feeding your children for a span of one year or more is likely to reduce the risk of breast cancer.
  5. Avoid taking birth control pills: Birth control pills, in spite of having several benefits are associated with risk factors as well. Birth control pills have got worse effects in younger women than older aged women. Using birth control pills may cause breast cancer and these pills should be avoided.

There are many ways, adapting which you can lower the chances of getting breast cancer.

2 people found this helpful

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 have slip disc is operation only option or do we have any alternative

DNHE, BPTh/BPT
Physiotherapist,
First take rest for few days,avoid bending forward,lifting,sitting unsupported for long time,use a lumbar support for sitting or standing,take physiotherapy for pain relief and gradually start back exercises.
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Please suggest exercises for disc bulge L4-5 and L5-S1 level indenting anterior thecal sac effacing bilateral recesses and impinging on descending nerve roots AP canal diameter- 1.3 cm (L4-5 level) and 1.2 cm (L5-S1) please suggest the best exercises to cure it fully and strengthen the particular area thanks help would be appreciated :)

DNB (Orthopedics), Fellowship in Spine Surgery, Diploma In Orthopaedics (D. Ortho), Diploma SICOT, Fellowship in Endoscopic Spine Surgery
Orthopedist, Vadodara
Exercise doesn't cure a MRI report just lead a healthy lifestyle with good cardio exercises and back exercises.
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Hello sir. I have lower back pain since 2 months back. I have done mri there is disk problem. What is permanent solution is surgery kindly 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 mattress are harmful Do hot fomentation. 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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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

How to Reduce Urea Levels in Blood Naturally

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Navi Mumbai
How to Reduce Urea Levels in Blood Naturally

All healthy individuals will always have some amount of urea in the blood. Yet, when the urea level in the blood becomes too high, that means there is a malfunction in some part of the body due to which the body is not being able to remove this excess urea successfully. This urea can be formed in the liver when there is a process in terms of the protein metabolism's chemical balance. This urea is then transported to various parts of the body until the kidney cleans it out as urine. But when this urea does not get cleaned out properly, the urea gets concentrated in the blood and signifies a problem with the kidneys and other internal organs as well as the blood flow to the kidneys. 

The cause may include burns, heart failure, renal artery embolism, vomiting and loose motions as well as more serious ailments like Diabetes. This can lead to long term kidney damage and symptoms like thirst, fluid retention, headaches, fatigue, dizzy spells, accelerated pulse, restlessness in limbs, pain in the abdomen and more. Here are the best ways to reduce the blood urea levels in a natural manner.

Herbal Medicines:

Ayurveda is an ancient science that can be used for the benefit of many patients suffering from chronic and painful ailments like diabetes, kidney failure, cardiovascular ailments and more. One of the mainstays of Ayurveda includes the use of herbs to create medicines and concoctions that will help in giving relief with their 100% natural elements. Medicines like Mutrakrichantak Churna, Punarnava Mandur, Varunadi Vati and many others can be used to avoid dialysis and bring down the urea levels in the blood by aiding better functioning of the kidneys.

  1. Punarnava: The name of this herb has been derived from two words - Puna and Nava. While Puna means again, Nava means new and together they help in renewed functioning of the organ that they treat. This herb helps in flushing out the excess fluid in the kidneys by reducing the swelling without any side effects. This herb is basically a kind of hogweed.
  2. Varun: This is the common caper which can be used to break down the stones present in the renal region and even as a cure for urinary tract infection. This herb helps in removing any element that may be obstructing the urinary tract and finally removes the excess fluid build up and inflammation.
  3. Gokshur: This is a diuretic that can be used as a herbal tonic to give strength to the weak kidney cells for regeneration.

Other aspects of Ayurvedic treatment for this condition include proper protein intake and better hydration along with massages and Yogic postures.

3266 people found this helpful

I have back pain before 3 years. I have checked MRI test in hospital that result show the mild disc dics bulge noted at L4 and L5 level intending the thecal sac without neurological compression. Doctor has given pain relief tablets but no get relaxation. Please give me solution.

DNB (Orthopedics), MS - Orthopaedics, MBBS
Orthopedist, Bhopal
I have back pain before 3 years. I have checked MRI test in hospital that result show the mild disc dics bulge noted ...
Your mri is normal as mild disc bulge is inconsequential. You better start some lower back muscle strengthening exercise (available on internet or visit a physio)
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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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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. Numbness: That 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 posture: A 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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I am suffering from suffering from slip disk. What would be the best treatment for it?

DNB, Diploma in Medical Radio Diagnosis (DMRD)
Radiologist, Durg
Is it confirmed on MRI. If not you need to get an MRI done first. Then visit an orthopedic surgeon who would assess the severity of the condition. Minor bulges may be taken care off with medicine and lifestyle changes. However severe ones may require surgery depending on your health status.
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I am 46 year old I have slip discs problem in l-4, l-5 it is curebel? and what should I do to get my self cure in this regards.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Kindly show me digital x rays of ls spine. Not all patients of backache need surgery. Most of them can be managed without operation. 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 use no pillow under the head. Do hot fomantation. Ibuprofen 200mg od & sos x 5days bio d3 max 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. Do reply back for detailed treatment plan. Do not ignore. It could be beginning of a serious problem.
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