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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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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.
3044 people found this helpful

I have a herniated disk (bulged disk/slip disk) at c7 and the c7 nerve is compressed for last 2 months. Do you have treatment in ayurveda ?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
However you may try sleep on a hard bed with soft bedding on it. Use no pillow under the head. Kindly take biod3 max 1 tab dailyx10 paracetamol 250mg od & sos x5days do back (spine)/shoulder/knee exercises make sure you are not allergic to any of the medicines you are going to take do not ignore it. It may have to be further investigated. It could be beginning of a serious problem. If no relief in 4_5 days, then contact me again. Contact your family doctor or nearest hospital for emergency help.
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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

All About Bone Cancer

M.Ch - Orthopaedics, Fellowship in Arthroscopy & Sports Medicine, MS - Orthopaedics, MBBS
Orthopedist, Delhi
All About Bone Cancer

Cancer that originates in the bones of a human body is referred to as bone cancer. Any bone could come under the threat of this disease, but generally the longer bones of your body, so to say the bones of your limbs, are at a greater risk. 

A few factors that might push you an inch closer to bone cancer are:

  1. Genes could jinx your health: A few typical genetic syndromes could increase a person's chances of contracting bone cancer. These syndromes could have been active in any person belonging to your lineage. One such syndrome is Li-Fraumeni.
  2. Treatment for one kind of cancer can make you prone to some other kind: Radiation affects your bones adversely. A patient of breast cancer might be undergoing radiation therapy that further increases his or her risk of contracting bone cancer in future.  
  3. Paget's disease can have unfavorable implications: Paget's disease is a disease that affects elderly people. This condition, if left untreated, can turn into bone cancer at a later stage. 

Several symptoms of bone cancer can be found below:

  1. Sudden loss of weight: If you lose a considerable amount of weight in a few weeks time without having made any effort at all, you should probably be worried about the health of your bones. Bone cancer can result in sudden and unintentional weight loss. 
  2. Unexpected bone fracture or breakage: Cancer of the bones is known to gnaw at the strength of your bones. Weakened and diseased bones can break or get fractured very easily. An unexpected fracture should not be overlooked so as to prevent chances of anything more harmful.
  3. Long spans of unyielding exhaustion: Constant fatigue and sleepiness might be hinting at a more serious underlying problem. The bones in your body hold you together; cancerous bone cells can make you feel exhausted without much exertion as your bones lose their inherent potency.
  4. Persistent pain in the bones: Excruciating cramps or pangs of stinging pain in a person's bones either continuously or at odd hours, could be indicative of bone cancer. Such instances require the advice and guidance of an experienced oncologist.
  5. Bone swelling: The area affected by bone cancer can grow big and tender or the bone itself can swell up.
3244 people found this helpful

I am 36 year old having problem of of disc slip in lumbar spine Dr. Asked for the surgery is only surgery is the option please suggest me other treatment.

DNB (Radiodiagnosis), DMRD, MBBS
Radiologist, Bangalore
Hi, thanks for writing in to us. It is possible that the disc bulge might have increased in severity recently. Please get a repeat mri scan done and discuss the findings please. It is possible that you might get relief through physical therapy or mild pain relief medications. If there is no relief with medicines then there is the option of steroid injection and radio frequency nerve block procedure. Surgery is the last resort and done only in extreme cases. Please do not worry. Regards,
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Breast Cancer Prevention:

Homeopath,

Breast Cancer Prevention:

  1. Anything that increases your chance of developing cancer is called a cancer risk factor; anything that decreases your chance of developing cancer is called a cancer protective factor.

  2. Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer. Different ways to prevent cancer are being studied, including:

  3. Changing lifestyle or eating habits. Avoiding things known to cause cancer. Taking medicine to treat a precancerous condition or to keep cancer from starting.


 

General information about breast cancer:

Key points:

  1. Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. Breast cancer is the second most common type of cancer in india

  2. Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.

  3. The breast is made up of lobes and ducts. Each breast has 15 to 20 sections called lobes, which have many smaller sections called lobules. Lobules end in dozens of tiny bulbs that can make milk. The lobes, lobules, and bulbs are linked by thin tubes called ducts.

  4. Enlarge Drawing of female breast anatomy showing the lymph nodes, nipple, areola, chest wall, ribs, muscle, fatty tissue, lobe, ducts, and lobules.

  5. Anatomy of the female breast. The nipple and areola are shown on the outside of the breast. The lymph nodes, lobes, lobules, ducts, and other parts of the inside of the breast are also shown.

  6. Each breast also has blood vessels and lymph vessels. The lymph vessels carry an almost colorless fluid called lymph. Lymph vessels lead to organs called lymph nodes. Lymph nodes are small bean-shaped structures that are found throughout the body. They filter lymph and store white blood cells that help fight infection and disease. Clusters of lymph nodes are found near the breast in the axilla (under the arm), above the collarbone, and in the chest.

     

Avoiding risk factors and increasing protective factors may help prevent cancer. The following are risk factors for breast cancer:

  1. Older agea personal history of breast cancer or benign (noncancer) breast diseasea family history of breast cancerinherited gene changesdense breasts

  2. Exposure of breast tissue to estrogen made in the bodytaking hormone therapy for symptoms of menopause radiation therapy


 

The following are protective factors for breast cancer:

  1. Less exposure of breast tissue to estrogen made by the bodytaking estrogen-only hormone therapy after hysterectomy,

  2. Estrogen-only hormone therapy after hysterectomyselective estrogen receptor modulatorsaromatase inhibitors and inactivators

  3. Risk-reducing mastectomy ovarian ablationgetting enough exercise


 

It is not clear whether the following affect the risk of breast cancer:

  1. Oral contraceptives

  2. Factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk


 

Older age:

  1. Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.

  2. A personal history of breast cancer or benign (noncancer) breast disease

     

Women with any of the following have an increased risk of breast cancer:

  1. A personal history of invasive breast cancer, ductal carcinoma in situ (dcis), or lobular carcinoma in situ (lcis). A personal history of benign (noncancer) breast disease.

  2. A family history of breast cancer

  3. Women with a family history of breast cancer in a first-degree relative (mother, sister, or daughter) have an increased risk of breast cancer.


 

Inherited gene changes:

  1. Women who have inherited changes in the brca1 and brca2 genes or in certain other genes have a higher risk of breast cancer, ovarian cancer, and maybe colon cancer. The risk of breast cancer caused by inherited gene changes depends on the type of gene mutation, family history of cancer, and other factors.

  2. Men who have inherited certain changes in the brca2 gene have a higher risk of breast, prostate, and pancreatic cancers, and lymphoma.


 

Dense breasts:

  1. Having breast tissue that is dense on a mammogram is a factor in breast cancer risk. The level of risk depends on how dense the breast tissue is. Women with very dense breasts have a higher risk of breast cancer than women with low breast density.

  2. Increased breast density is often an inherited trait, but it may also occur in women who have not had children, have a first pregnancy late in life, take postmenopausal hormones, or drink alcohol.

  3. Exposure of breast tissue to estrogen made in the body

  4. Estrogen is a hormone made by the body. It helps the body develop and maintain female sex characteristics. Being exposed to estrogen over a long time may increase the risk of breast cancer. Estrogen levels are highest during the years a woman is menstruating.


 

A woman's exposure to estrogen is increased in the following ways:

Early menstruation: beginning to have menstrual periods at age 11 or younger increases the number of years the breast tissue is exposed to estrogen. Starting menopause at a later age: the more years a woman menstruates, the longer her breast tissue is exposed to estrogen. Older age at first birth or never having given birth: because estrogen levels are lower during pregnancy, breast tissue is exposed to more estrogen in women who become pregnant for the first time after age 35 or who never become pregnant.

 

Taking hormone therapy for symptoms of menopause:

Hormones, such as estrogen and progesterone, can be made into a pill form in a laboratory. Estrogen, progestin, or both may be given to replace the estrogen no longer made by the ovaries in postmenopausal women or women who have had their ovaries removed. This is called hormone replacement therapy (hrt) or hormone therapy (ht). Combination hrt/ht is estrogen combined with progestin. This type of hrt/ht increases the risk of breast cancer. Studies show that when women stop taking estrogen combined with progestin, the risk of breast cancer decreases.


 

Radiation therapy to the breast or chest:

  1. Radiation therapy to the chest for the treatment of cancer increases the risk of breast cancer, starting 10 years after treatment. The risk of breast cancer depends on the dose of radiation and the age at which it is given. The risk is highest if radiation treatment was used during puberty, when breasts are forming.

  2. Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast.

  3. For women who have inherited changes in the brca1 and brca2 genes, exposure to radiation, such as that from chest x-rays, may further increase the risk of breast cancer, especially in women who were x-rayed before 20 years of age.


 

Obesity:

Obesity increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy.


 

Drinking alcohol:

Drinking alcohol increases the risk of breast cancer. The level of risk rises as the amount of alcohol consumed rises.


 

The following are protective factors for breast cancer:

  1. Less exposure of breast tissue to estrogen made by the body

  2. Decreasing the length of time a woman's breast tissue is exposed to estrogen may help prevent breast cancer. Exposure to estrogen is reduced in the following ways:


 

Early pregnancy: estrogen levels are lower during pregnancy. Women who have a full-term pregnancy before age 20 have a lower risk of breast cancer than women who have not had children or who give birth to their first child after age 35. Breast-feeding: estrogen levels may remain lower while a woman is breast-feeding. Women who breastfed have a lower risk of breast cancer than women who have had children but did not breastfeed.

Taking estrogen-only hormone therapy after hysterectomy, selective estrogen receptor modulators, or aromatase inhibitors and inactivators


 

Estrogen-only hormone therapy after hysterectomy

Hormone therapy with estrogen only may be given to women who have had a hysterectomy. In these women, estrogen-only therapy after menopause may decrease the risk of breast cancer. There is an increased risk of stroke and heart and blood vessel disease in postmenopausal women who take estrogen after a hysterectomy.


 

Selective estrogen receptor modulators:

Tamoxifen and raloxifene belong to the family of drugs called selective estrogen receptor modulators (serms). Serms act like estrogen on some tissues in the body, but block the effect of estrogen on other tissues.


 

Treatment with tamoxifen lowers the risk of estrogen receptor-positive (er-positive) breast cancer and ductal carcinoma in situ in premenopausal and postmenopausal women at high risk. Treatment with raloxifene also lowers the risk of breast cancer in postmenopausal women. With either drug, the reduced risk lasts for several years or longer after treatment is stopped. Lower rates of broken bones have been noted in patients taking raloxifene.


 

Taking tamoxifen increases the risk of hot flashes, endometrial cancer, stroke, cataracts, and blood clots (especially in the lungs and legs). The risk of having these problems increases with age. Women younger than 50 years who have a high risk of breast cancer may benefit the most from taking tamoxifen. The risk of having these problems decreases after tamoxifen is stopped.


 

Taking raloxifene increases the risk of blood clots in the lungs and legs, but does not appear to increase the risk of endometrial cancer. In postmenopausal women with osteoporosis (decreased bone density), raloxifene lowers the risk of breast cancer for women who have a high or low risk of breast cancer. It is not known if raloxifene would have the same effect in women who do not have osteoporosis. Talk with your doctor about the risks and benefits of taking this drug.


 

Aromatase inhibitors and inactivators:

Aromatase inhibitors (anastrozole, letrozole) and inactivators (exemestane) lower the risk of a new breast cancer in women who have a history of breast cancer. Aromatase inhibitors also decrease the risk of breast cancer in women with the following conditions:

Postmenopausal women with a personal history of breast cancer. Women with no personal history of breast cancer who are 60 years and older, have a history of ductal carcinoma in situ with mastectomy, or have a high risk of breast cancer based on the gail model tool (a tool used to estimate the risk of breast cancer).

In women with an increased risk of breast cancer, taking aromatase inhibitors decreases the amount of estrogen made by the body. Before menopause, estrogen is made by the ovaries and other tissues in a woman's body, including the brain, fat tissue, and skin. After menopause, the ovaries stop making estrogen, but the other tissues do not. Aromatase inhibitors block the action of an enzyme called aromatase, which is used to make all of the body's estrogen. Aromatase inactivators stop the enzyme from working.


 

Possible harms from taking aromatase inhibitors include muscle and joint pain, osteoporosis, hot flashes, and feeling very tired.


 

Risk-reducing mastectomy:

Some women who have a high risk of breast cancer may choose to have a risk-reducing mastectomy (the removal of both breasts when there are no signs of cancer). The risk of breast cancer is much lower in these women and most feel less anxious about their risk of breast cancer. However, it is very important to have a cancer risk assessment and counseling about the different ways to prevent breast cancer before making this decision.


 

Ovarian ablation:

The ovaries make most of the estrogen that is made by the body. Treatments that stop or lower the amount of estrogen made by the ovaries include surgery to remove the ovaries, radiation therapy, or taking certain drugs. This is called ovarian ablation.


 

Premenopausal women who have a high risk of breast cancer due to certain changes in the brca1 and brca2 genes may choose to have a risk-reducing oophorectomy (the removal of both ovaries when there are no signs of cancer). This decreases the amount of estrogen made by the body and lowers the risk of breast cancer. Risk-reducing oophorectomy also lowers the risk of breast cancer in normal premenopausal women and in women with an increased risk of breast cancer due to radiation to the chest. However, it is very important to have a cancer risk assessment and counseling before making this decision. The sudden drop in estrogen levels may cause the symptoms of menopause to begin. These include hot flashes, trouble sleeping, anxiety, and depression. Long-term effects include decreased sex drive, vaginal dryness, and decreased bone density.


 

Getting enough exercise:

Women who exercise four or more hours a week have a lower risk of breast cancer. The effect of exercise on breast cancer risk may be greatest in premenopausal women who have normal or low body weight.


 

It is not clear whether the following affect the risk of breast cancer:

  1. Oral contraceptives

  2. Certain oral contraceptives contain estrogen. Some studies have shown that taking oral contraceptives (" the pill") may slightly increase the risk of breast cancer in current users. This risk decreases over time. Other studies have not shown an increased risk of breast cancer in women who take oral contraceptives.

  3. Progestin -only contraceptives that are injected or implanted do not appear to increase the risk of breast cancer. More studies are needed to know whether progestin-only oral contraceptives increase the risk of breast cancer.


 

Environment

  1. Studies have not proven that being exposed to certain substances in the environment, such as chemicals, increases the risk of breast cancer.

  2. Studies have shown that some factors do not affect the risk of breast cancer.


 

The following do not affect the risk of breast cancer:

  1. Having an abortion. Making diet changes such as eating less fat or more fruits and vegetables. Taking vitamins, including fenretinide (a type of vitamin a). Cigarette smoking, both active and passive (inhaling secondhand smoke). Using underarm deodorant or antiperspirant. Taking statins (cholesterol -lowering drugs). Taking bisphosphonates (drugs used to treat osteoporosis and hypercalcemia) by mouth or by intravenous infusion.

  2. Cancer prevention clinical trials are used to study ways to prevent cancer.

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Common Side Effects of Uterine Fibroids

Certification in IVF & Infertility, Diplomate Gynae Laparoscopy, Royal College of Obstetricians and Gynaecologists (MRCOG), MD - Obstetrics & Gynaecology, MBBS
Gynaecologist, Ghaziabad
Common Side Effects of Uterine Fibroids

Many women develop uterine fibroids by the time they hit the age of 50 years and above. These are non-cancerous growths that may occur in the uterus. Most women go through severe bleeding and pain as well as discomfort as a result of these fibroids. Age, family history of the same condition, obesity or being overweight, eating habits and even ethnicity play a large role in deciding the risk of each individual patient. These fibroids can grow in the submucosal, intramural and subserosal areas.

Following are the common side effects of uterine fibroids:

  1. Frequent urination: Due to the pressure of the fibroids on the uterus, the patient may experience a constant feeling of fullness in the lower pelvic area of the body, which may lead to frequent filling of the bladder. This gives rise to frequent trips to the washroom for urination. 
  2. Heavy Bleeding: Severe bleeding is one of the most common causes of the presence of these kinds of fibroids. The patient may experience a lot of bleeding during menstrual periods, as well as pain and cramps the rest of the time. The periods will also be very painful when there are fibroids in the uterus or the uterine lining.
  3. Painful Intercourse: It is a well-known fact that any kind of infection or growth as well as sores and other such ailments can lead to vaginal dryness as well as pain during sexual intercourse. This is true for uterine fibroids as well, which can lead to severe pain during sexual activity. These fibroids can also give rise to pain in the lumbar or lower back region.
  4. Abdomen Swelling: The abdomen may go through significant swelling in such a condition and the patient may even look like she is pregnant. The growth can push the shape of the abdomen outwards and create a full feeling.
  5. Pregnancy Complications: The presence of uterine fibroids can give rise to several complications during pregnancy and even after child birth. One of the most common problems in this case is bleeding, followed by more severe outcomes like miscarriage. The women suffering from uterine fibroids are at greater risk of undergoing a caesarean section for the delivery of the baby. The baby may also be born breech and a premature delivery may take place. 
  6. Infertility: This is also a rare side effect of the uterine fibroids and is generally seen only in very severe cases. 
  7. Cancer: Only one in every 1000 cases might transform into malignant tumours. These uterine fibroids are generally known to be non-malignant. 

Any symptoms must be reported to a gynaecologist at the earliest to avoid any serious complications.

4635 people found this helpful

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.

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I am 26 years old boy, I am suffering fron hip disorder problem, Avn. How to get rid out of this, I do not have money for operation,

Fellowship of the Royal College of Surgeons (FRCS), Membership of the Royal College of Surgeons (MRCS)
Orthopedist, Trichy
AVN of the hip at this age is usually due to either Alcohol intake or Steroid intake. Once AVN has developed then it depends on the stage of the disorder. if its advanced then only hip replacement will help.
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Good day to you. For a few months i've been having numbness and weakness in my left leg and scrotum. Got my mri results back and they say. Mild scoliosis at L4 L5 region with minor disc bulge with no nerve compression. No sign of cauda equina. Small annular tear at L4 region with muscular spasm. What's causing my numbness? How do I fix the disc bulge?

MBBS, MD - General Medicine, DM - Neurology
Neurologist, Hyderabad
Good day to you.
For a few months i've been having numbness and weakness in my left leg and scrotum. Got my mri resul...
Most likely, the cause of your symptoms are disc bulge. The best treatment at this stage is physiotherapy. Medications such as pregabalin and gabapentin are also helpful.
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I am 24yr old male and have backache for 7 month. My mri report is mild annular disc bulge is seen at l4-5 level with subtle anterior thecal sac impression. What should I do?

Diploma in Radio-Diagnosis
Radiologist, Shimla
At this age only excersises-lumber and sacral, har, bed rest, avoid jjerky movements, and sitting posture normal advised.
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I am having problem in my spinal cord disc L4 -L5. With some loss of fluid. Now my knee joint also getting pain. What you wil suggest.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I am having problem in my spinal cord disc L4 -L5. With some loss of fluid. Now my knee joint also getting pain. What...
Core strengthening exercises- straight leg raised with toes turned outward, repeat 10 times, twice a day. Back stretching- lie flat, pull one of the knee forward to chest, hold for 3 seconds, then bring the other knee forward to the chest and again hold for 3 seconds. Then pull both knees towards the chest and hold for 3 seconds. Repeat 10 times each exercise twice a day. Do the cat/cow stretch. Get on all fours, with your arms straight and your hands directly under your shoulders; your knees hip-width apart.
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Breast Cancer - Local and Systematic Form of Treatment!

MBBS, DNB (Obstetrics and Gynecology), MNAMS, Training in USG
Gynaecologist, Delhi
Breast Cancer - Local and Systematic Form of Treatment!

Breast Cancer - What exactly is it?
‘Breast cancer’ is a term that is used to refer to a malignant tumour, which has developed from cells present in the breast. Generally, all tumours can be divided into two categories i.e. benign and malignant and it is the malignant tumour that is responsible for causing cancer. Breast cancer generally originates in the cells the  milk producing glands of the breast's or the passage, which carries milk from the glands to the lobules. Additionally, breast cancer can also originate in the stromal tissues, including the fibrous and fatty connective breast tissues.

Breast Cancer: Treatment Options
Treatment for breast cancer depends upon two things: the exact type of the cancer and how advanced the cancer is. Treatment options for breast cancer can thus be broadly divided into two categories as Local treatments and Systemic treatments.

Local Treatments
Treatments that target the tumour without having any effect on the rest of the body are called local treatments. The following types of local treatment options are available for treating breast cancer:

  1. Surgery: Surgical breast cancer treatment involves removal of the malignant cancerous tumour in an operation. Smaller tumours can be removed using a surgical process referred to as ‘lumpectomy’, wherein the tumour along with a small amount of healthy tissue surrounding the tumour is removed. For larger tumours, removal of the entire breast becomes mandatory, in a surgical process known as ‘mastectomy’. Women who undergo mastectomy can choose to undergo reconstructive plastic surgery for reconstruction of the removed breast(s).
  2. Radiation Therapy: This basically involves using radiation to kill cancer cells present in the body. Radiation therapy is a long-drawn process that usually involves a set number of treatments administered over a long period of time. Radiation therapy is also generally the follow-up procedure after a lumpectomy, or more rarely, a mastectomy.

Systemic Treatments
Treatments involving drugs that are administered via either the mouth or direct injection into the bloodstream are called systemic treatments. These include:

  1. Chemotherapy: This includes using drugs to destroy the cancer cells present in the body by stopping the cancer cells from growing and dividing. Chemotherapy can be administered using either an IV (intravenous) tube or via pills that can be swallowed.
  2. Hormone Therapy: This treatment option is used for treating tumours which have tested positive for progesterone or oestrogen receptors. Blocking hormones that fuel the tumour’s growth is the basis of this therapy.
  3. Targeted Therapy: This targets specific proteins and genes which contribute to growth and survival of the cancer cells. Targeted therapy is an extremely focused treatment, and is very effective in blocking the growth and division of cancer cells, as well as minimizing damage to surrounding healthy cells.
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How To Prevent Sagging of Breasts?

Vaidya Visharad
Sexologist, Narnaul
How To Prevent Sagging of Breasts?

How to prevent sagging of breasts?

Home remedies for sagging breasts

Breast sagging is a natural process that happens with age wherein the breasts lose their suppleness and elasticity. Breasts do not have muscle. They are made of fat, connective tissues and milk-producing glands, and they need proper care to keep them in good shape.

Yoga


The benefits of yoga for the entire body have been widely studied, and it is primarily a mechanism of toning the body and increasing flexibility. Some of that toning can occur within the breast, depending on which positions you commonly practice.

Massage

Massage your breasts at least 2-3 times per week with olive oil. It will help add firmness to the skin as well as improve the skin tone and texture. It will also tone your chest and increase the elasticity of the skin.

Pomegranate

Pomegranate is considered a wonderful anti-aging ingredient and can help prevent sagging breasts. Pomegranate seed oil is rich in phyto-nutrients that can lead to firm breasts.


    Make a paste of pomegranate peel and some warm mustard oil. Use it to massage your breasts in a circular motion for 5 to 10 minutes daily before going to bed.
    You can also use pomegranate seed oil to massage your breasts 2 or 3 times daily.
    Another option is to mix 4 teaspoons of neem oil with 1 teaspoon of dried and powdered pomegranate rind. Heat this mixture for a few minutes. Allow it to cool and then use it to massage your breasts twice daily for several weeks.


Avoid loose fitting bra / wrong bra size

Some women feel that they would feel comfortable if they wear loose bra. But this is totally a wrong step. You are going to invite your saggy breast by doing this. Avoid this and go for the best fitting bra to keep your breast stay upright and firm. For more details visit us at www.malhotraayurveda.in

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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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I am a 25 years old male, I have been suffering from bulging disk at l5-s1. I have been resting for 2 months, now my neck has started paining too and left pelvic joint is making popping sound everytime it is bend. So I got my blood acid checked. And its been 8 for last two months, I have been drinking like 6 lts water everyday. Is uric acid main reason of pain? And how can I get it down as I don't want to start the medicine so early in life and drinking water is not working. Please suggest, my career is suffering a lot.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Requires detailed examination and investigation. Preliminary investigations suggested: hb, tlc, dlc, esr, blood sugar fasting & pp, uric acid vit d urine r/e x-ray of the affected part. Anyway it may be tried sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick mattress are harmful use no pillow under the head. Do hot fomantation paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back, knee & general exercises. It may have to be further investigated. Do not ignore it. Let it not become beginning of a bigger problem. Make sure that patient is not allergic to any of the medicines that he/she is going to take. If it does not give relief in 4-5days, inform.
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I have slip disc l4 l5 over three years. What can I do for it some thing different?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Investigations advised - hb, tlc, dlc, esr, sugar f & pp, uric acid, vit d3 urine r/e x ray of the affected part. Anyway you may try- sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick mattress are harmful use no pillow under the head. Do hot fomentation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck back knee & general exercises. It may have to be further investigated. Make sure you are not allergic to any of the medicines you are going to take. If no relief in 4_5 days, then inform again.
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Doctor I have a compressed Disc that is L4 and l5 which is pressing my nerve and I find it very Difficult to stand straight or walk. And the pain is coming under the Thigh is there a cure either than Surgery Thanks expecting a Response soon thanks a lot. I am Diabetic and 55 years old.

MD Internal Medicine, MBBS
General Physician, Delhi
Doctor I have a compressed Disc that is L4 and l5 which is pressing my nerve and I find it very Difficult to stand st...
Being a diabetic, it's important to get your weight under control, for nerve compression you could try non surgical treatment, you need however to be aware that progression of the nerve pressure can result in paralysis of the legs.
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Fibroid Tumours - 8 Signs You are Suffering From it

MBBS, MD, Registrar, DNB, MNAMS
Gynaecologist, Delhi
Fibroid Tumours - 8 Signs You are Suffering From it

Fibroid tumour is the abnormal cell growth in the uterus and they are mostly benign. Fibroids usually affect women in the age bracket of 30 - 40. Fibroid tumours are of three types, depending on their location:

  1. Submucosal fibroids: The tumour develops under the lining of the uterus
  2. Intramural fibroids: The growth is found amongst the muscles in the wall of the uterus
  3. Subserosal fibroids: The growth develops on the wall of the uterus right in the pelvic cavity

Causes behind it
The exact cause of fibroids in not known clearly. But certain factors have been discovered that might influence their formation. These factors include:

  1. Hormones: Progesterone and estrogen are the hormones responsible for recreating the uterine lining during every menstrual cycle. These hormones might trigger the formation of tumour.
  2. Family history: If any member in your family; your mother, grandmother or sister has/had fibroids in their uterus, you may also develop it.
  3. Pregnancy: Your body produces excessive progesterone and estrogen when you are pregnant, which may cause an increase in the size of a pre-existing small fibroid. Myomectomy can be done by giving incision on the abdomen or by laparoscopy depending on the size and location of the fibroids.

Signs You are suffering from it

  1. Heavy bleeding along with blood clots during or between your periods
  2. Lower back or pelvic pain
  3. Elevated menstrual cramping
  4. Frequent urination
  5. Pain during sex
  6. Longer than normal periods
  7. Bloating or pressure in lower abdomen
  8. Enlargement or swelling of the abdomen

How it can be treated?
Your doctor will formulate the right treatment depending on your age, the mass of the fibroids and your overall health. Your doctor may choose a combination of treatment to cure your fibroids, and they include:

  1. Medication: Gonadotropin releasing hormones (GnRH) agonists, birth control pills and ibuprofen (anti-inflammatory medicine) are prescribed. GnRH agonists reduce the level of progesterone and estrogen in your uterus.
  2. Surgery: Myomectomy and hysterectomy are two common surgical procedures to treat fibroids. Myomectomy is performed by removing the fibroids only by making an incision on the abdomen. But hysterectomy completely removes the uterus. The latter is reserved for serious cases.
  3. Non-invasive surgery: Forced ultrasound surgery, myolysis (shrinking fibroids with laser or electric current), cryomyolysis (fibroids are frozen) and endometrial ablation (an instrument uses heat, hot water, microwaves or electric current to destroy fibroids) are some non-invasive surgical procedures. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
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