Dr. Shivraj

Lung cancer occurs at slightly younger age in women than in men. Adenocarcinoma is the commonest type of lung cancer in women. It warrants testing for some molecular markers which form the basis of targeted therapies. Thus lung cancer in women behaves biologically and clinically different from that in men

Women should take care of their health, stay away from tobacco and think positive

What is Giant cell arteritis?

Giant cell arteritis causes inflammation of the lining of the body’s medium and large arteries that carry oxygen-rich blood from your heart to the rest of your body.

Symptoms of Giant cell arteritis-

• Scalp tenderness
• Jaw pain when you chew
• Severe headache
• Tenderness over one or both sides of the forehead
• Permanent loss of vision in one eye
• Fever
• Weight loss

Causes of Giant cell arteritis-

What causes these arteries to become inflamed isn’t known. However, it is thought that a combination of genetic and environmental factors is responsible for the condition.

Risk factors of Giant cell arteritis-

• Older adults
• Being women
• Polymyalgia rheumatica
• People born in Northern European countries

Complications of Giant cell arteritis-

• Aortic aneurysm
• Blindness
• Stroke 

Diagnosis of Giant cell arteritis-

Diagnosis of Giant cell arteritis includes the following tests and procedures:

• Physical exam
• Blood tests
• Biopsy
• MRI/angiography
• Duplex ultrasound
• Positron emission tomography (PET)

Precautions & Prevention of Giant cell arteritis

• Regular aerobic exercise, such as walking, can help prevent bone loss, high blood pressure and diabetes
• Eat fresh fruits and vegetables, whole grains
• Limit your intake of salt and sugar
• Get adequate amounts of calcium and vitamin D
• Avoid alcohol

Treatment of Giant cell arteritis-

• Homeopathic Treatment of Giant cell arteritis
• Acupuncture & Acupressure Treatment of Giant cell arteritis
• Psychotherapy Treatment of Giant cell arteritis
• Conventional / Allopathic Treatment of Giant cell arteritis
• Surgical Treatment of Giant cell arteritis
• Dietary & Herbal Treatment of Giant cell arteritis
• Other Treatment of Giant cell arteritis

Treatment of Giant cell arteritis- 

Homeopathic Treatment of Giant Cell Arteritis-

Homeopathy heals the tissue and brings it back to normal. It treats the person as a whole. Treatment is constitutional. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. It balances the energy system, improves immunity and body functions. It naturally cures the root cause of disorder. Some of the homeopathic medicines for treatment of giant cell arteritis are:

• Ars alb
• Calc
• Carb V
• Kali iod
• Echin
• Lach

Acupuncture and Acupressure Treatment of Giant Cell Arteritis-

Acupuncture relieves by improving the physiological function of the organs and organ system. In acupuncture therapist will first diagnose the case on the basis of energy system or chi blockage as well as on the basis of status of five elements. On this basis certain disease specific acupoints are selected and stimulated.

Psychotherapy and Hypnotherapy Treatment of Giant Cell Arteritis-

Psychotherapy and hypnotherapy can help in stress relief. They can help in better coping and early relief.

Conventional / Allopathic Treatment of Giant cell arteritis-

In the allopathic treatment of giant cell arteritis, inflammatory drugs such as corticosteroids are used. These drugs can effectively relieve pain.

Dietary & Herbal Treatment of Giant cell arteritis-

• Eat fresh fruits and vegetables, whole grains
• Eat lean meats and fish
• Limit your intake of salt and sugar

In case you have a diseased uterus, which makes you infertile, you can undergo a procedure known as uterus transplant or uterine transplant to get pregnant. In the process of sexual reproduction, a diseased uterus does not allow embryonic implantation. This factor is referred to as uterine factor infertility or UFI. As a result, you will not be able to get pregnant. Learn more about having healthy pregnancy.

Who requires a uterus transplant?
This procedure involves women who have UFI and women who had their uterus removed by hysterectomy. Women who have a damaged uterus on account of an injury or infection, which does not function anymore, can also undergo a uterus transplant procedure. Women from the age of 21 to 45 are eligible for this procedure. Many women are born without having a uterus. This condition is called Mayer-Rokitansky-Küster-Hauser syndrome.

Procedure
Uterus transplantation begins with undertaking a uterus retrieval surgery on the uterus donor. The uterus, which is recovered has to be stored and transported to the location of the patient undergoing the transplant. An ischemic tolerance may last over 24 hours. Three major surgeries have to be carried out with the recipient. Firstly, a transplantation surgery is required in which the donor’s uterus gets transplanted. In case pregnancy develops, a caesarean section surgery has to be performed. The patient is given immune suppressive therapy. After childbirth, a hysterectomy is done in order to terminate the immune suppressive therapy.

Will the women be able to get pregnant after having sex?
Women receiving a uterus transplant will not be capable of becoming pregnant without undergoing fertility treatments. The transplanted uterus is not connected with the fallopian tubes, which is the location of the normal fertilisation process. The women will require to carry out IVF or in vitro fertilisation to become pregnant after a uterus transplant. IVF is a process in which the eggs are removed from the ovaries and get fertilised in a laboratory. Then, they are implanted in the uterus. After undergoing the uterus transplant procedure, a woman has to wait for a period of one year. The uterus requires time for healing and after recovery, the embryo may be implanted for pregnancy. After giving birth successfully, a woman will be able to keep the transplanted uterus. This is a reason why IVF is a popular procedure.

She has the option to get pregnant again. However, after giving birth twice, a hysterectomy must be carried out for the removal of the uterus. This is done so that the woman can stop using the immune suppressant drugs, which are associated with major risks. Uterus transplant is a relatively new technology. In October 2014, the first healthy baby was born to a woman who had undergone a uterus transplant. This surgery is kind of experimental in nature and is usually the last option for getting pregnant.

The uterus is set up inside the pelvis with different muscles, tissue, and tendons. Due to pregnancy, labour or complicated delivery, in a few ladies, these muscles tend to weaken. Additionally, as a woman ages and with a loss of the hormone oestrogen, her uterus can drop into the vaginal canal, bringing about the condition known as a uterine prolapse.

The following conditions can bring about a prolapsed uterus:

1. Pregnancy with complicated or even ordinary delivery through the vagina.
2. Weakness in the pelvic muscles with the increase in age.
3. Weakening and loss of tissue after menopause and loss of normal oestrogen.
4. Conditions leading to increased weight in the abdomen, for example, constant coughing (with bronchitis and asthma), straining along with constipation, pelvic tumours (uncommon), or clogging of liquid in the abdomen.
5. Being overweight puts extra strain on pelvic muscles.
6. Previous surgery in the pelvic region leading to loss of outer support
7. Smoking

However, this condition can be treated effectively:

1. Self care at Home: You can strengthen your pelvic muscles by performing Kegel workouts. You do these by contracting your pelvic muscles, as though attempting to stop the stream of urine. This exercise makes the pelvic muscle strong and gives some support. Have your specialist train you on the best possible approaches to exercise your muscles.
2. Medications: Oestrogen (a hormone) cream or suppository ovules or rings embedded into the vagina help in strength and endurance building of the tissues in the vagina. However, oestrogen is just for use in some of the postmenopausal ladies.
3. Surgery: Based on your age and whether you wish to conceive a child naturally, surgery can repair the uterus or remove it. The uterus as in many cases can be expelled with a hysterectomy. During the surgery, the specialist can repair the hanging or saggy vaginal dividers, urethra, bladder, or rectum. The surgery might be performed by an open abdomen procedure, through the vagina, or through little cuts in the abdomen or vagina with particular instruments.
4. Other Therapy: In case that you do not need surgery or have a poor possibility for surgery, you may choose to wear a steady gadget, called a pessary. It is worn in the vaginal tract to strengthen the falling uterus. It can be utilised briefly or can be long-lasting. They come in different shapes and sizes and should be fitted according to the person. In case that the prolapse is extreme, a pessary may not work. Prolapse surgery is always preferred by vaginal route. Likewise, pessaries can disturb the insides of the vagina and may bring about a noxious release.

It can be prevented in the following manner:

1. Decrease your weight.
2. Try to avoid constipation by consuming a high-fiber diet.
3. Do Kegel exercises to strengthen the pelvic muscles.
4. Stay away from heavy lifting or straining.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Symptoms, causes and treatment for Breast Cancer Patients

Hello friends. My name is Dr. Gayatri Juneja. I’m a practicing gynecologist in Model Town for the last 20 years. I’m a visiting consultant in Apollo Cradle Hospital Moti Nagar, and Fortis Hospital Shalimar Bagh, and Sunder Lal Hospital Ashok Nagar. It’s a great pleasure for me to talk to you about certain problems which I think is becoming very important for all of us to know. I am going to talk about Breast Cancer.

Unfortunately, even in India, cancer breast is becoming very common. And it is not that it is a cancer which we cannot pick up at time. The only thing we need is to be aware of it. Only if we know what is happening with our body, is only then we can do what is normal, only then we can see what is not normal, right? It is one of the breast cancer is one of the easiest cancers to pick up. How? My body is my own. I should know what’s happening to me. So minimum a lady can do is do a self examination. Teach your daughters how to do a self examination for the breast. If you find any lump, any time, if you feel there is some pain, which was not there, if you see the nipple is not in the normal position, it is retracted inside, if you see there is skin changes on your breast, if you see any size difference. See minor size difference will be there. That is a natural thing. But if you see there is drastic change, and if you are not comfortable with something, do not neglect it. It’s not at all a normal thing. Go, see a gynaecologist.

It is a confidential thing between you and your doctor. Let her examine you. Let her guide you. You give her a proper history, if you have taken any contraceptive pills, even I-pill is very dangerous. I’ll come to it later how. The thing is…your doctor has examined you, then she will guide you what has to be done. There are various ways of diagnosing cancer of breast. First step is, you do a self examination. First step is over. You find the lump, you go to a doctor. Your doctor will ask for a sonography, that is ultrasound of the breast. And another part of it is an x-ray of the breast. Sometimes in younger age group the breast is very dense, and you cannot diagnose anything on mammogram.

You still are suspecting something, then your doctor might ask for an MRI. MRI is very effective in diagnosing, but we do not suggest it as first line treatment, first line of diagnosis. Once it is confirmed that yes, there is a lump, then what we do is, we ask for a biopsy. Now biopsy can be in 2 forms. It can be taken through the needle, which we call FNAC – Fine Needle Aspiration Cytology, and other is open biopsy, where we remove the whole lump, and send it for testing. If the test comes negative, good, fine, everything is fine. If it comes positive, then further treatment depends upon the type. Then they will do a special CT scan for you, where the will diagnose if any lymph nodes are involved.

Depending on preliminary staging, your doctor will ask for a surgery. Now the surgery will…it is better that the whole breast gets removed. Or what has to be done will be diagnosed, because it is not a single person specialty, it is going to be a multi-specialty treatment then. Now let’s come down to who are the people who are at higher risk. Why should I consider that I am at higher risk? What…who are those people? First, specially after menopause, obesity. If your lifestyle is not at all healthy, your food habits you eat lot of non-veg and processed food, like pizzas and burgers and frozen food, yes you are at risk. Then comes genetics.

If you have a family history of cancer in your nani, dadi, your bua, maasi, cousin, ya sister ya brother, or even cancer of ovaries, you are at high risk. But that doesn’t mean who all have had the history of cancer will also develop this. You are at higher risk, but it is better only to be careful. Then comes very tall ladies it has been seen they are also prone for diabetes. Obesity, and people who have had hormonal replacement therapy with…and once you’re diagnosed don’t get scared. It is a curable cancer, and life expectancy with variable modalities these days is quite good.The quality of life is also good.

So my suggestion would be, to conclude, that please be aware of what is happening with you, and take good care of yourself. If you are healthy, only then you can look after your family. Thank you so much.

A Herniated disc also known as a slip disc or prolapsed disc and it refers to the problem where one of the discs located in between the bones of the vertebrae(backbone) gets damaged and stacks itself upon the nerves. The tender inner portion of the disc gets protruded over the outer ring. Herniated disc causes severe neck pain and back pain. It occurs when the outer ring gets weak and tears down. The most common symptoms include pain and numbness, especially on one side of the body. The pain extends down to the arms and legs. It worsens during nighttime. The muscles become weak. Overweight people are likely to have this disease, as the discs carry extra weight. Old people are vulnerable to a slip disc.

Effects of Herniated Disc:

1. An untreated case of Herniated disc may cause permanent damage to the nerves.
2. In certain cases, a Herniated disc is capable of cutting off nerve impulses to the "caudal equine"nerves, present in the lower back and legs. This leads to loss of bladder control or bowel control.
3. Saddle anaesthesia is another long-term effect. Nerves are compressed by the slip disc, causing loss of sensation in the inner portions of your thighs, the back of your legs and surrounding the rectum region.
4. Symptoms may improve or worsen.

Diagnosis of Herniated Disc:
Treatment or diagnosis of Herniated disc or slipped disc can be either conservative or surgical in nature. The nature of treatment is determined according to your discomfort level and the kind of pain you are experiencing, or how much the disc has slipped out.

1. The pain caused by Herniated disc can be relieved by undertaking an exercise schedule, which includes stretching and strengthening the spine and its surrounding muscles.
2. A physiotherapist should be appointed for recommending the types of exercises.
3. Taking pain relievers also soothes the pain.
4. Stronger medicines prescribed by doctors include-muscle relaxants, narcotics to deal with the pain, medicines for nerve pain such as "gabapentin"  or "duloxetine".
5. In case of the symptoms not subsiding within a span of six weeks, a surgery may be recommended by your doctor. The surgeon may have to remove the damaged part of the disc. This surgery is called a microdiscectomy. If you wish to discuss about any specific problem, you can consult an orthopedist.