Dr. Shivraj

Brain mapping is a technique where the biological quantities of a human brain are represented as spatial quantities resulting in maps. As with many other medical technologies, brain mapping is fast-evolving as well. Among several uses, brain mapping is chiefly used while performing surgery on the brain.

When surgery is to be performed on the brain such as surgery for epilepsy, the surgeon would want to comprehend how the brain areas are affected by seizures. The surgical intervention is meant for removing as much as seizure focus as possible while preserving crucial functions like understanding, speech, vision, movement, and sensation.

Why is brain mapping performed?
Brain mapping is a process which helps in identification of functions of various parts of the brain. Mapping the brain by stimulating different areas of the brain areas can aid in creating a map for a particular person. The map allows the doctor in understanding what parts of the brain are responsible for performing critical functions including sensation, movement, speech and other functions.

Which functions of the brain can be mapped electrically?
Typical areas of the brain which have motor, language, visual and sensory functions are needed to be mapped. When current is applied to a single area at a time, the doctor understands which part of the brain is responsible for which function.
When the patient is not able to speak due to the current, then the area is likely to be crucial for language function. If the limbs, face or trunk of the patient stop moving as the current passes, the area that is tested is responsible for movement. On the other hand, if the individual experiences tingling, numbing, and other sensations when the current is applied, it means that a sensory region is discovered.

How is electrical brain mapping performed?
Electrical brain mapping for guiding brain surgery for epilepsy can be performed in two distinct processes: directly during the surgery or in a two-stage procedure.

Two-stage procedure:
In the first stage of the process, the surgeon creates an opening in the skull which helps in exposing the surface of the brain. Small electrical contacts or electrodes are placed on the brain surface even though no brain tissue is removed. As soon as the electrodes are in the right position, the scalp is closed. The electrodes not only record the seizure of the patient electrically but also allow mapping of various areas of the brain. The last stage is surgery where abnormal brain tissues are removed.

Brain mapping process during surgery:
Electrical brain mapping may also be performed during the surgery which exposes part of the brain. This is termed as intraoperative brain mapping since it occurs while performing the main operation. The process of mapping may last for an hour to several hours at a stretch.

Brain mapping is also used to diagnose neurodegenerative diseases like Alzheimer’s and Parkinson’s. In these cases, the brain map shows extreme shrinkage of the brain due to tissue loss. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.

Becoming a mum can lay down a whole lot of stress on you. But now you know that your brain is going to help you with all the adjustment s! ah ah a relief you get when your baby gives you a hug by kissing your cheecks the joy you get is amazing and gratitude to the almighty creater

Different methods to treat Disc problems

Hello friends, I am Dr Gaurav Khera. I am an orthopaedic surgeon, doing joint replacements and spine surgeries at the Access healthcare. Now today I will be talking about the lumbar degenerative disc disease. Now it sounds very big, but it is not as complicated as it sounds. It basically is what you people commonly know as a disc disease. So it is a fairly common problem that is seen in our population today. In fact about 30 or 40% of the patients who come to our OPD have lower back pains, some have other disc problems and very commonly seen after 40 years of age and this incidence gradually increases up to 60-70 years of age. The other ecological factors which are associated with this are, first of all smoking, secondly it is, mild to moderate trauma, thirdly its seen in people who lift heavy weights, fourth is obesity, especially central obesity, that is if you have a very heavy waistline.

Now what is Lumbar degenerative disc disease? Now, our spine is composed of multiple bones, which are starting from your neck and they come all the way down to your hip, divided into the cervical, dorsal, lumbar and sacral spine. And between these bones, there are these small pieces of discs, which act as cushions. When your body walks, these act as shock absorbers between your body’s bones. Now this discs, when these come out of their normal place, it gives or presses against the nerves which are passing through these areas and it causes pain. This is what happens in the disc disease. Basically, in the patient it will come as a lower back pain, and this pain will be travelling down to the hip, and it will also be coming down to the legs. Some people complain that as they walk, the pain increases.

They also complain of tingling numbness. They complain that sometimes their fingers or their toes are feeling numb. These are some of the very common symptoms which are being seen. Few people may have only lower back pain, and these are the people who do not have very significant disc disease. Now there are two main causes of the disc disease. First is an inflammatory reaction that occurs in the disc, and second is the micro motion instabilities that occur. Inflammatory reactions may occur as a result of some small traumas which may occur such as when you may injure your back. Such inflammatory reactions occur in the form of small swellings in the body. And micro motion instabilities are when the body ages, the disc which has an outer fibrous thick layer, that degenerates, and as it degenerates, the pulp which is there at the centre, of the discs, tends to degenerate. What I mean is it comes out of its normal space. And as it comes out of the normal place, it comes and tends to press on the nerves and these are the two most common causes.

All disc patients are not to be operated. When we get these patients, the first and foremost investigation that we do is a X-Ray. And if required, we go in for a MRI. Frankly MRI is the known standard to diagnose the disc disease. The findings of a MRI are always coordinated with the clinical findings. Once we have diagnosed that it is a disc problem, we have to establish that what the compression on the nerves is. If the nerve compression is a lot, and if we think that we cannot do anything other than surgery, then we take the patient for a surgery.

If not, we take the patient fro physiotherapy, lifestyle changes and few medications. These medications may carry on for few weeks to few months. And a lot of exercise has to be carried on regularly. Lifestyle changes such as weight loss, stoppage of smoking is very important. And if you can achieve this, then your problems are very easily solved. If you have any queries regarding your disc problems or back pains, then you can get in touch with me for the same.

You can reach me in my clinic, which is there in Indrapuri, by the name of Dr Khera’s Wellness Clinic or you can also contact me through Lybrate for the same. Thank You.
 

Even though we have 206 bones in our bodies, breaking just one is enough to bring our daily lives to a standstill. A partial or complete break in a bone is termed as a fracture. While minor fractures can heal in as little as 6 weeks major fractures can take 3-4 months to heal properly. In cases of complex fractures, you may need physical therapy even after this time period to get back complete mobility. Hence patience is essential when a fracture is healing, but here are a few tips on how to speed up the process.

1. Increase your protein intake: Proteins are essential for the healing and repairing of damage to bones and tissues. Proteins also give the bone structure its strength, Hence, depriving the body of adequate protein will result in the formation of soft bones rather than hard, strong bones. This prevents a bone from fracturing in the same place again.
2. Have a diet rich in antioxidants: Inflammation is one of the first symptoms of a fracture. This inflammation can continue for many days after the incident and until the inflammation reduces, healing cannot take place properly. Antioxidants help rid toxins from the body and help reduce inflammation thereby initiating the healing process. Antioxidants can also help relieve pain.
3. Exercise: While you must take care not to apply too much pressure on the affected area it is essential to move the limb as much as possible. Being active promotes blood flow and in this way speeds up the healing process.
4. Avoid alcohol and caffeine: In most cases, a doctor will prescribe pain relievers to deal with the pain of a fracture. Under no circumstances should you consume alcohol when taking these medications. Even after the antibiotic course is over it is a good idea to abstain from alcohol as this can increase inflammation. Similarly, caffeine and all caffeinated products should also be avoided as they contain compounds that can prevent calcium from being absorbed.
5. Have an alkaline diet: Having an alkaline diet with lots of fruits and vegetables helps stabilise the pH levels of the body and conserves minerals and proteins needed to build strong bones. In this way, it creates the optimal environment for healing. An alkaline diet also increases the production of growth hormones and other growth factors like IGF insulin in the body. These are crucial to speeding up the healing process and aid in new bone formation.

Test to screen for breast cancer:

Mammogram:

1. Mammography is the most common screening test for breast cancer. A mammogram is an x-ray of the breast. This test may find tumors that are too small to feel. A mammogram may also find ductal carcinoma in situ (dcis). In dcis, there are abnormal cells in the lining of a breast duct, which may become invasive cancer in some women.

2. Mammograms are less likely to find breast tumors in women younger than 50 years than in older women. This may be because younger women have denser breast tissue that appears white on a mammogram. Because tumors also appear white on a mammogram, they can be harder to find when there is dense breast tissue.

Enlarge Mammography:

1. The left breast is pressed between two plates. An x-ray machine is used to take pictures of the breast. An inset shows the x-ray film image with an arrow pointed at abnormal tissue.

2. The breast is pressed between two plates. X-rays are used to take pictures of breast tissue.

The following may affect whether a mammogram is able to detect (find) breast cancer:

1. The size of the tumor. How dense the breast tissue is. The skill of the radiologist.

2. Women aged 40 to 74 years who have screening mammograms have a lower chance of dying from breast cancer than women who do not have screening mammograms.

Clinical Breast Exam (CBE):

1. A clinical breast exam is an exam of the breast by a doctor or other health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual. It is not known if having clinical breast exams decreases the chance of dying from breast cancer.

2. Breast self-exams may be done by women or men to check their breasts for lumps or other changes. It is important to know how your breasts usually look and feel. If you feel any lumps or notice any other changes, talk to your doctor. Doing breast self-exams has not been shown to decrease the chance of dying from breast cancer.

3. Mri (magnetic resonance imaging) in women with a high risk of breast cancer

4. Mri is a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (nmri). Mri does not use any x-rays.

MRI is used as a screening test for women who have one or more of the following:

1. Certain gene changes, such as in the brca1 or brca2 genes. A family history (first degree relative, such as a mother, daughter or sister) with breast cancer. Certain genetic syndromes, such as li-fraumeni or cowden syndrome.

2. Mris find breast cancer more often than mammograms do, but it is common for mri results to appear abnormal even when there isn't any cancer.

3. Other screening tests are being studied in clinical trials.

Thermography:

1. Thermography is a procedure in which a special camera that senses heat is used to record the temperature of the skin that covers the breasts. A computer makes a map of the breast showing the changes in temperature. Tumors can cause temperature changes that may show up on the thermogram.

2. There have been no clinical trials of thermography to find out how well it detects breast cancer or if having the procedure decreases the risk of dying from breast cancer.

Tissue sampling:

Breast tissue sampling is taking cells from breast tissue to check under a microscope. Abnormal cells in breast fluid have been linked to an increased risk of breast cancer in some studies. Scientists are studying whether breast tissue sampling can be used to find breast cancer at an early stage or predict the risk of developing breast cancer. Three ways of taking tissue samples are being studied:

Fine-needle aspiration: a thin needle is inserted into the breast tissue around the areola (darkened area around the nipple) to take out a sample of cells and fluid.

Nipple aspiration: the use of gentle suction to collect fluid through the nipple. This is done with a device similar to the breast pumps used by women who are breast-feeding.

Ductal lavage: a hair-size catheter (tube) is inserted into the nipple and a small amount of salt water is released into the duct. The water picks up breast cells and is removed.