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Dr. Sachin Deshmukh

Radiologist, Mumbai

Dr. Sachin Deshmukh Radiologist, Mumbai
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I believe in health care that is based on a personal commitment to meet patient needs with compassion and care....more
I believe in health care that is based on a personal commitment to meet patient needs with compassion and care.
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Dr. Sachin Deshmukh is a popular Radiologist in Sahar, Mumbai. You can consult Dr. Sachin Deshmukh at Metro Imaging Centre in Sahar, Mumbai. Book an appointment online with Dr. Sachin Deshmukh and consult privately on Lybrate.com.

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I met accident and my back disk d8 and d12 injured and operted in banglore now i am paraplegia patient from 7 years any treatment to cure it please reply me i went for stem cell in chenni also

MS ORTHOPEDIST, MBBS
Orthopedist, Noida
Its sad to know about your conditions. Stem cell can provide little help on immediate spinal trauma... there r other parameters to evaluate the neurology which is not possible with chatting.. prognosis is not good in long standing cases...
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All About Breast Cancer

MS, MBBS
Gynaecologist, Delhi
All About Breast Cancer

Breast cancer is a type of cancer, which occurs due to the development of cancerous cells in breasts. Women are usually affected by breast cancer and breast cancer is one of the most common forms of cancer after skin cancer. Usually fatal if not diagnosed in its early stage, breast cancer is a very serious medical ailment. Read on more to find all about the different symptoms, causes, preventive measures and treatment of breast cancer.

Symptoms: Breast cancer has few distinct characteristics and if you have a few or all the following symptoms you could be more likely to suffer from breast cancer. 

  • The formation of a lump in your breast, which is different from the surrounding tissue and usually more thickened.
  • The discharge of bloody fluid  material from the nipples.
  • Sudden change of the size, shape and appearance of the breast.
  • Certain distinct changes to the skin over the breast for example an indentation in the skin similar to that of a dimple.
  • Appearance of an extra nipple which is inverted.
  • If the darkened area around the nipples known as the areola is flaking or peeling off. 

Causes: Studies and researches remain inconclusive on what causes breast cancer. Breast cancer occurs due to abnormal division of the cells located in the breast, which over time accumulate and form lumps. They
might spread to other parts of the body. Breast cancer is caused mainly due to a complex interaction of personal genetics, environment and lifestyle choices. Breast cancer can also be caused due to genetics as about 5% to 10% of cases are due to gene mutations which pass onto generations.

Risk factors: There are certain factors, which increase the probability of contracting breast cancer. Increasing age, personal and family history of breast cancer, obesity, radiation exposure, pregnancy at an older age, postmenopausal hormone therapy are some of the factors that increase the chances of breast cancer.

Treatment: Several forms of surgical methods exist to treat breast cancer. Depending on the condition and spread of the disease a suitable surgery is performed. These include mastectomy, lumpectomy, axillary lymph node dissection and removal of both breasts. Other forms of treatment include chemotherapy or the use of high doses of drugs to destroy cancerous cells. Radiation therapy where X-rays are used to destroy the cancer cells is also effective.

3359 people found this helpful

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

MBBS
General Physician, Bangalore
My MRI report of LS Spine is as:
Diffuse Disc bulge at L3 /L4 indenting the thecal sac
Partial desiccation of L4 / L5...
hello, this means a part of your spine is bulging out and in later cases it may compress your nerve roots and may cause pain of your lower back and your one or both of your lower limbs causing sciatica. but then, there are two things one is simple bulging of the disc and another is herniation of the disc where there is a tear in the cartilage, the later condition more often causes pain. bulging usually causes no pain. i would like to advice you to have a good posture, sit straight. prefer chairs without cushion. your mattress should not be too soft. sleep on a regular less bulky mattress where you can keep your spine straight. while trying to get up from a lying down position do it from one side. never try to sit up straight from the lying down position. change your position to left or right lateral then take support with your hands and get up. do a set of spinal exercises at least 20 minutes a day. you can do twice a day of 10 minutes duration too. you can consult me for the types and instructions of the exercises. if you have not get pain yet, consider yourself fortunate and start making these lifestyle changes.the pain you get in sciatica is ugly. prevention is better than cure. wish you a very good health.
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My husband is diabetic & his height is 5ft n 11 inch & weight 94 kg. From two months he is having edema in both foot. His blood reports of kidney I s. Cretenine 1.09. He is suffering from disc slip problem also so cant walk. I am worried about foot edema.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
My husband is diabetic & his height is 5ft n 11 inch & weight 94 kg. From two months he is having edema in both foot....
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. 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. KINDLY CONSULT A PHYSICIAN FOR OEDEMA & RELTED PROBLEMS.
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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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Herniated Disc - What are the Risks Involved in it?

MCh - Neurosurgery, MBBS
Neurosurgeon, Chennai
Herniated Disc - What are the Risks Involved in it?

The symptoms caused due to herniated disc can be very severe and can also cause a bit of disability. The disc of the spine is like a cushion and separates the set of bones on the backside. The discs are shock absorbers of the spine and are mainly composed of 2 parts, a soft jelly centre called the nucleus and a tough outer covering called the annulus.

Effects of Herniated Disk
A herniated or cracked disc is a severe condition and it seems to happen most commonly in the lower back.  It happens when a fraction of the soft centre gets pushed through the destabilized area due to degeneration, trauma or by putting pressure on the spinal cord. 

Nerves are located precisely at the back of every disc and are responsible for controlling everything in our body. While a disc gets herniated, the external covering of the disc tears and creates a bulge. The soft jelly gets shifted from the centre of the disk to the region where the damage has occurred on the disc. Most commonly, the bulge occurs in areas where the nerve is located and it causes strain on the affected nerve. It has been observed that individuals do not feel any painful sensations even if their disc gets damaged.

When is Surgery Recommended for Herniated Disc?
Surgery for herniated disc is recommended only after options like steroid injections, pain relievers, exercise and non-steroid anti-inflammatory drugs do not work. If the pain persists even after these options, then it becomes important to go for surgery. There are certain risks involved in this surgery like infection, bleeding or nerve damage. 

There are chances that the disc may get ruptured again if it is not removed. If you are a patient suffering from degenerative disc disease, then there are chances that problem occurs in other discs. It is very important that a patient maintains healthy weight to prevent any further complications.

The main factor that increases the risk of herniated disc is excess body weight, which causes a lot of stress on the lower back. A few people become heir to a tendency of developing this condition. Even individuals with physically demanding jobs are prone to this condition. 

Activities like bending sideways, pushing, twisting, repetitive lifting can increase the risk of a herniated disk. At times, emergency surgery is also required to avoid paralysis in a patient. If you wish to discuss about any specific problem, you can consult an orthopedist.

3506 people found this helpful

Lung Cancer: Causes, Symptoms and Treatments

MD PULMONARY, DTCD
Pulmonologist, Faridabad
Lung Cancer: Causes, Symptoms and Treatments

Lung cancer is the uncontrolled growth of abnormal cells in one or both lungs. These abnormal cells do not carry out the functions of normal lung cells and do not develop into healthy lung tissue. As they grow, the abnormal cells can form tumors and interfere with the functioning of the lung, which provides oxygen to the body via the blood.

Lung cancer is the most common cause of death due to cancer in both men and women throughout the world. According to the U.S. National Cancer Institute, approximately one out of every 14 men and women in the U.S. is diagnosed with cancer of the lung at some point in their lifetime. Lung cancer is predominantly a disease of the elderly; almost 70% of people diagnosed with lung cancer are over 65 years of age, while less than 3% of lung cancers occur in people under 45 years of age.

What Causes Lung Cancer?

The development of lung cancer is strongly associated with cigarette smoking, approximately 90% of lung cancers are attributable to use of tobacco. Pipe and cigar smoking can also cause lung cancer, but the risk is not as high as with cigarette smoking. Tobacco smoke contains more than 4,000 chemical compounds, many of which are cancer causing (carcinogens). Passive smoking, i.e. the inhalation of tobacco smoke by non-smokers who live or work with smokers, is also an established risk factor for the development of lung cancer.

Genetic susceptibility (i.e. family history) may play a role in the development of lung cancer. Other causes of lung cancer include air pollution (from vehicles, industry, and power generation) and inhalation of asbestos fibres (usually in the workplace).

Lung Cancer Symptoms:

Early symptoms and signs of lung cancer:

There may be no symptoms at the onset of the disease. When present, common symptoms of lung cancer may include:

  1. Coughing: This includes a persistent cough that doesn't go away or changes to a chronic smoker's cough, such as more coughing or pain.
  2. Coughing up blood: Coughing up blood or rust-colored sputum (spit or phlegm) should always be discussed with your doctor.
  3. Breathing Difficulties: Shortness of breath, wheezing or noisy breathing (called stridor) may all be signs of lung cancer.
  4. Loss of Appetite: Many cancers cause changes in appetite, which may lead to unintended weight loss.
  5. Fatigue: It is common to feel weak or excessively tired.
  6. Recurring infections: Recurring infections, like bronchitis or pneumonia, may be one of the signs of lung cancer.

Signs of advanced stages of lung cancer: Advanced stages of lung cancer are often characterized by the spread of cancer to distant sites in the body. This may affect the bones, liver or brain. As other parts of the body are affected, new lung cancer symptoms may develop, including:

  1. Bone pain
  2. Swelling of the face, arms or neck
  3. Headaches, dizziness or limbs that become weak or numb
  4. Jaundice
  5. Lumps in the neck or collar-bone region

Treatment: Treatment for cancer involves a combination of surgery to remove cancer cells, chemotherapy and radiation therapy to kill cancer cells. Lung cancer is incurable unless complete surgical removal of the tumour cells can be achieved. Surgery is the most effective treatment for lung cancer, but only a few percentage of lung cancers are suitable for surgery i.e. Stage I and II NSCLC and cancer that has not spread beyond the lung.

Radiation therapy may be used for both NSCLC and SCLC and is a good option for people who are not suitable for surgery or who refuse surgery. Chemotherapy is used for both NSCLC and SCLC. Chemotherapy drugs may be given alone or in combination with surgery or radiation therapy. Chemotherapy is the treatment of first choice for SCLC since it has usually spread extensively in the body by the time it has been diagnosed.

Also used in the treatment of lung cancer are targeted therapies. These are drugs (gefitinib and erlotinib) or antibodies (cetuximab, bevacizumab) that block the growth and spread of cancer by interfering with specific molecules involved in tumor growth and progression. They are used in some patients with NSCLC that does not respond to standard chemotherapy.

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Left paracentral L5-S1 disc protrusion causing compression of left traversing nerve roots associated with diffuse L1-L2 Disc bulge. Now what is best treatment for me.

MBBS
General Physician, Mumbai
Best treatment is to do go for laparoscopic surgery and treatment depends on the symptoms and if there are bearable symptoms than we can do ESWT through a physiotherapist.
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I am 63 year old. I am having sciatica, back pain and numbness in both legs. I do not have BP and my sugar level is with in limit. As per CT scan report the impression are as follows: Lumbar Spondylitis with Disc herniation at L4-5, L3-4 levels and disc bulge at L5-S1 level. Canal stenosis at L4-5 level. Cervical spondylosis - Decreased height of C5 and C6. Vertebral bodies with end plate irregularities at C4-C7 levels. Disc bulge at C3-4 level. Disc herniation with canal stenosis at C4-5, C5-6 and C6-7 levels. Can it be cured with Homeopathy.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
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. 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. For emergency treatment contact your nearest hospital or family doctor. If it does not give relief in 4-5days, contact me again. Why not discuss with me in a video conference? (facility provided by lybrate. Com)
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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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What should I be doing to releave the pain for two herniated disc's one above and one below a fusion surgery of the cervical spine.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
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. 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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I have L4, L5 disc bulging problem , some time it pains me that I am unable to move also , How to recover from this. Please help me out.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I have L4, L5 disc bulging problem , some time it pains me that I am unable to move also , How to recover from this. ...
Spine physiotherapy, posture care and pain killer as and when needed. If persistent problem, please visit.
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Hi sir my mother 72 year old she is suffering slip disk problem mri report conclusion/impression- Mr. Imaging reveal degenerative changes affecting lumbar spine with disc bulge-herniation at l1-2, l3-4, l4-5 and l5-si levels, more at l2-3, l3-4, l4-5 and l4-s1 level (protrusion), together with ligamentum flavum hypertrophy and facetal arthropathy are producing secondary canal stenosis with narrowing of bilateral neural foraming. Canal stenosis is most sever at l4-5 level.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. It is good that you have actually mentioned mri report of your mother which shows degenerative changes in spine with degenerative discs at multiple levels and ligamentum hypertrophy. But since we have to treat the patient and not mri, please elaborate her problem as to a detailed discussion of back pain which means duration of pain and mode of onset. I would also like to ask you if it is associated with any leg pain or any other neurological symptoms like numbness, paraesthesias (electrical shock like abnormal sensations) or any weakness in limbs. Please also tell me about any associated symptoms like fever, weight loss etc. What medications she generally takes and what has been her treatment history till now for existing problem. Do not hesitate to contact me if you need any further assistance.
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I am 63 year old male, having- (1) a sciatica on right side (2) herniation between in lumber, as a result suffering from leg and lower back pain. I want your valued answer of treatment.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. For me to answer your question, I need some information from your side: - a detailed neurological examination including assessment of motor, sensory ex and analysis of deep tendon reflexes of lower limbs - dynamic x rays of ls spine - mri ls spine to correlate clinical findings with radiology. Do not hesitate to contact me if you need any further assistance. You can also discuss your case and treatment plans with me in a greater detail in a private consultation.
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Brain Stroke - Things You Must Know!

MBBS, MD - Internal Medicine, Fellow in Pain Management, DM - Neurology
Neurologist, Delhi
Brain Stroke - Things You Must Know!

A brain stroke can affect anyone at any point of time when the supply of blood to the brain is interrupted. It can threaten major physical functions and can prove to be fatally dangerous at times. The brain stem which is placed right above the spinal cord controls the breathing, heartbeat and levels of blood pressure. It is also in charge of controlling some elementary functions such as swallowing, hearing, speech and eye movements

What are the different types of strokes?
There are three main kinds of stroke: ischemic strokes, hemorrhagic strokes and transient ischemic attacks. The The most common type of brain stroke is the ischemic stroke is caused by narrowing or blocking of arteries to the brain, which prevents the proper supplyof of blood to the brain. Sometimes it so happens that the blood clot that has formed elsewhere in the body have travelled via the blood vessels and has been trapped in the blood vessel which provides blood to the brain. When the supply of blood to a part of the brain is hindered, the tissue in that area dies off owing to lack of oxygen. The other variant of brain stroke is termed as hemorrhagic stroke is caused when the blood vessels in and around the brain burstor or leak. Strokes need to be diagnosed and treated as quickly as possible in order to minimize brain damage.

What are the common symptoms of a brain stroke?
The symptoms of the brain stroke are largely dependent on the area of the brain that has been affected. It can interfere with normal functioning, such as breathing and talking and other functions which human beings can perform without thinking such as eye movements or swallowing. Since all the signals from the brain as well as other parts of the body traverse through the brain stem, the interruption of blood flow often leads to numbness or paralysis in different parts of the body.

Who is likely to have a stroke?
Anyone is at a risk of developing brain stroke although ageing is directly proportional to the risk of having a stroke. Not only that an individual with a family history of brain stroke or transient ischemic attack is at a higher risk of developing stroke. People who have aged over 65 accounts for about 33 percent of all brain strokes. It is important to point here that individuals with high blood pressure, high blood sugar, cholesterol, cancer, autoimmune diseases and some blood disorders are at a higher risk of developing brain stroke.

There are a few factors which can increase the risk of developing stroke beyond any control. But there are certain lifestyle choices as well which aids in controlling the chances of being affected by stroke. It is crucial to refrain from long-term hormone replacement therapies as well as birth control pills, smoking, lack of physical activity, excessive use of alcohol and drug addiction. A brain stroke is a life-threatening medical condition, and when an individual has symptoms that resemble that of stroke, it is crucial to seek immediate medical help.

Treatment for stroke:

  • Treatment depends on the type of stroke.
  • Ischemic strokes can be treated with 'clot-busting' drugs.
  • Hemorrhagic strokes can be treated with surgery to repair or block blood vessel weaknesses.
  • The most effective way to prevent strokes is through maintaining a healthy lifestyle.

What is TPA?
TPA is a thrombolytic or a “Clot Buster” drug. This clot buster is used to break-up the clot that is causing a blockage or disruption in the flow of blood to the brain and helps restore the blood flow to the area of the brain. It is given by intravenous (IV). This can be given only within 45.5 hrs of the onset of symptoms

Time is brain

Remember Every second Loss means brain cells die.

Rush to the nearest Stroke Centre whenever you experience such symptoms.

You can save the brain cells dying if you reach within 45.5 hrs by the CLOT BUSTER. 

Endovascular procedures:
Another treatment option is an endovascular procedure called mechanical thrombectomy, strongly recommended, in whichtrained  trained doctors try  removing a large blood clot bysending sending a wired-caged device called a stent retriever, to the site of the blocked blood vessel in the brain

Stroke prevention:
The good news is that 80 percent of all strokes are preventable. It startswith with managing keyrisk risk factors, including 

  • High blood pressure,
  • Cigarette smoking,
  • Diabetes Atrial fibrillation and
  • Physical inactivity.

More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control. 

Rehabilitation:
The best way to get better after a stroke is to start stroke rehabilitation ("rehab"). In stroke rehab, a team of health professionals works with you to regain skills you lost as the result of a stroke. If you wish to discuss about any specific problem, you can consult a neurologist.

  

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I am 55 year, last 4 month back Dr. Report slip disk Dr. Suggest me complete rest. I am admitted in hospital 9 day. Some relief but now also problem I can not sit more than 1 hours. If I seat both leg heavy & just. I cannot put my leg in ground

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. To actually answer your question, I need some information from you: - firstly, I need a detailed neurological examination done by a physical therapist - mri of your affected region of spine - dynamic x rays if they were also done. Do not hesitate to contact me if you need any further assistance. You can also discuss your case and treatment plans with me in a greater detail in a private consultation.
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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 27 year boy I have back pain l4 and l5 disk light move. I there any full relief treatment means contact me sir. Back pain person do sex fully or not. After two month marriage fixed so im tired.

BPTh/BPT
Physiotherapist, Delhi
I am 27 year boy I have back pain l4 and l5 disk light move. I there any full relief treatment means contact me sir. ...
Start with physiotherapy treatment. Learn spinal exercise. Don't sit on floor. Don't lift heavy things. Share your x ray report for further discussion.
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I am 42 year old female .After slip disc L1toL4 problem, pain in left heel and becomes severe at times. Is it spur in the foot ,slip disc or something else.

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
I am 42 year old female .After slip disc L1toL4 problem, pain in left heel and becomes severe at times. Is it spur in...
Do Take IFT and laser Therapy for pain relief for 12 days followed by strengthening exercise from physiotherapist and need to be with Clinical examination.
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