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Dr. Smita Ramanarayan

Radiologist, Mumbai

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Dr. Smita Ramanarayan Radiologist, Mumbai
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I'm a caring, skilled professional, dedicated to simplifying what is often a very complicated and confusing area of health care....more
I'm a caring, skilled professional, dedicated to simplifying what is often a very complicated and confusing area of health care.
More about Dr. Smita Ramanarayan
Dr. Smita Ramanarayan is a renowned Radiologist in Santacruz East, Mumbai. She is currently associated with Niron Hospital & Research Centre Pvt. Ltd in Santacruz East, Mumbai. Book an appointment online with Dr. Smita Ramanarayan and consult privately on Lybrate.com.

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Niron Hospital & Research Centre Pvt. Ltd

Kadamwadi, Vakola,Santacruz East. Landmark: Near Vishwakarma Hall, MumbaiMumbai Get Directions
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Breast Cancer - Know Its Symptoms And Treatments!

MS - Obstetrics and Gynaecology
Gynaecologist, Chennai
Breast Cancer - Know Its Symptoms And Treatments!

Breast cancer is a type of cancer which occurs due to the development of cancerous cells in a person's 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 a few distinct characteristics and if you have a few or all the following symptoms you could be more likely to suffer from breast cancer. 

  1. The formation of a lump in your breast which is different from the surrounding tissue and usually more thickened.
  2. The discharge of bloody fluid  material from the nipples.
  3. Sudden change of the size, shape and appearance of the breast.
  4. Certain distinct changes to the skin over the breast for example an indentation in the skin similar to that of a dimple.
  5. Appearance of an extra nipple which is inverted.
  6. 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, post-menopausal 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. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

4483 people found this helpful

ECMO New Era of Medicicne

Homeopath,
ECMO New Era of Medicicne

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

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

Why ICU pateint put on ECMO?

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

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

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

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

How long can someone stay on ecmo?

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

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

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

1 person found this helpful

Hi doctor, What are the chances of me getting breast cancer if my mom has got it during her menopause? I am getting married soon and this has raised a concern in my fiance's mind.

MS - General Surgery
General Surgeon, Kanpur
yes there is 2 to 5 times more risk than general population of developing breast cancer if 1 or 2 member of 1st degree relatives are suffering from breast cancer, do routine self examination of your breast.
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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.

4640 people found this helpful

I have a disc bulge at L4-L5 and L5-S1, its being more then 7 months now. My physiotherapy session is going on but i still have pain and weakness in my legs

M.Ch, DNB (Orthopedics), MBBS
Orthopedist, Mohali
You need and MRI and clinical assessment and may end up having a surgery if you have weakness which has not improved on censervative treatment for 7 months.
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3 Ways To Diagnose Breast Cancer!

GYNAE ONCOLOGY
Gynaecologist, Jaipur
3 Ways To Diagnose Breast Cancer!

Breast cancer is a form of cancer which develops from the breast tissue. Breast cancer is indicated by signs such as a lump in the breast, changes in breast shape, fluid flowing from the nipple, dimpling of skin, or the development of red scaly patches. Breast cancer is a fatal form of cancer in women and immediate diagnosis is required on observing the symptoms.

Diagnosis of breast cancer
Other than the regular breast screening, the diagnosis of breast cancer involves the following steps and methods:

  1. Seeing your general practitioner (GP): It is very important to visit your GP soon after noticing the symptoms of breast cancer. Your GP will examine you properly and in case your symptoms need more assessment, he/she will refer you to a breast cancer clinic.
  2. Mammogram and breast ultrasoundYou will be required to have a mammogram, as recommended by a specialist breast unit. This is an X-ray of the breasts. An ultrasound scan may also be required. Breast ultrasound should be undertaken only if you are less than 35 years of age. This is because, young women have denser breasts and a mammogram is not as effective as ultrasound in the diagnosis of breast cancer. In ultrasound, high frequency sound waves are used for obtaining an image of your breasts. It is observed to notice any abnormality or lumps. A breast ultrasound is also important for determining whether a lump is solid or contains liquid.
  3. Biopsy: In this diagnosis process, a sample of the tissue cells is taken from the breasts and tested under a microscope to find out if it is cancerous. A scan and needle test for the lymph nodes present in your armpit is also done to check whether they have also been affected. A biopsy is undertaken in several ways, depending upon the condition and severity. A needle aspiration biopsy is used for testing a sample of your breast cells without the removal of the tissues. This is the most common form of biopsy and it is also used for draining a small fluid-filled lump or benign cyst. During the process, you will be given a local anesthetic. Usually, a needle biopsy is carried out guided by an X-ray, ultrasound and an MRI scan as well. This helps in distinguishing it from non-invasive changes such as ductal carcinoma in situ.

Another form of biopsy used for the diagnosis of breast cancer is called vacuum assisted biopsy or mammotome biopsy. In this process, a needle gets attached to a suction tube, which helps in obtaining the sample and for clearing the bleeding. 

Uterine Fibroids: 5 Surgeries that are Done to Treat them

MBBS, MD, Registrar, DNB, MNAMS
Gynaecologist, Delhi
Uterine Fibroids: 5 Surgeries that are Done to Treat them

Uterine fibroids, also known as leiomyoma or myoma, are benign growths on the uterus, occurring mostly during the years of childbearing. Few of the common symptoms of fibroids are leg pain or backache, constipation, difficulty in emptying the bladder, frequent urination, pain or pressure in the pelvic region, menstrual periods stretching over a week and excessive menstrual bleeding.

Causes:

  1. Certain genetic changes of the uterus which are different from the ones normally present in the muscle cells of the uterus can cause this disorder.

  2. Certain hormones such as progesterone and estrogen that prepare the body for pregnancy are even responsible for triggering the development of fibroids.

  3. Substances which help the body maintain its tissues trigger fibroid growth as well.

  4. Family history, excessive consumption of alcohol and red meat while going low on foods such as dairy products, fruits, green vegetables and vitamin D, obesity, usage of birth control pills and early onset of the menstruation cycle are other factors that may escalate the risks of one suffering from fibroids.

Treatment:

  1. Be careful and take a closer look: Fibroids are fundamentally non-cancerous and they hardly interfere with pregnancy. Often, they do not exhibit notable symptoms and are prone to shrinkage after menopause. Hence giving them and yourself some time might be the best option.

  2. Medications generally aim at the hormones controlling the menstrual cycle and treating symptoms such as pelvic pressure and excessive menstrual bleeding. However, they do not treat fibroids completely but work towards contracting them. They include-

    • Gonadotropin-releasing hormone (Gn-RH) agonists to block estrogen and progesterone production

    • Progestin-releasing intrauterine device (IUD) to alleviate severe bleeding caused due to fibroids

    • Tranexamic acid to ease excessive menstrual periods

    • Progestins or oral contraceptives to regulate menstrual bleeding

    • Nonsteroidal anti-inflammatory drugs (NSAIDs) to ease pain associated with fibroids

Surgeries to Treat Fibroids:

Depending on symptoms and whether medical therapy has failed, the patient may have to undergo surgery. The following surgical procedures may be considered:

  1. Hysterectomy: removing the uterus. This is only considered if the fibroids are very large, or if the patient is bleeding too much. Hysterectomies are sometimes an option to prevent fibroids coming back.

  2. Myomectomy: fibroids are surgically removed from the wall of the uterus. This option is more popular for women who want to get pregnant.

  3. Endometrial ablation: removing the lining of the uterus. This procedure may be used if the patient's fibroids are near the inner surface of the uterus; it is considered an effective alternative to a hysterectomy.

  4. UAE (Uterine artery embolization): this treatment cuts off the fibroid's blood supply, effectively shrinking the fibroid.

  5. Magnetic-resonance-guided focused ultrasound surgery: an MRI scan locates the fibroids, and sound waves are used to shrink the fibroids.

2810 people found this helpful

Breast Cancer Treatment - What Type Of Nutrition Should You Intake?

MBBS Bachelor of Medicine and Bachelor of Surgery, MS - General Surgery
Oncologist, Pune
Breast Cancer Treatment - What Type Of Nutrition Should You Intake?

Maintaining a nutritious diet is always a necessity and the need is more so during breast cancer treatment. Cancer being a dreadful disease, the treatment procedures put a lot of stress on any person. As it is, a person affected by cancer tends to become weak and add to that the rigorous methods of treatment. As these aspects make one thing clear from a patient’s perspective, which is to have a balanced, healthy and nutritious diet during treatment. Only then will the body have necessary strength to heal itself completely after getting treated. Good nutrition would help women to stay strong and feel good. Each cancer patient would have unique nutritional needs as per their weight, extent of the disease and their ability to intake food.

Benefits Of Good Nutrition During Breast Cancer Treatment

  • There are quite a number of benefits to maintain good nutrition during cancer treatment. Some of them are detailed below:
  • Cancer makes you weak, hence intake of good nutritious food enables you to combat fatigue.
  • Helps to maintain your body’s store of nutrients and your weight. It ensures that you don’t lose weight due to weakness.
  • Good nutrition would result in decreasing the risk of getting infected and also allow you recover faster.

What type of diet should you follow?
Now we take a look at the nutritious diet, which cancer patients must ensure to take during cancer treatment:

  • Eat less but have frequent meals throughout the day: Avoid eating too much as weight gain would be a menace in this phase. So, eat small meals frequently and that would ensure your body is getting the required protein, calories and nutrients to tolerate treatment. This would also help in reducing the side-effects related to the treatment, such as nausea.
  • Take protein-rich foods: Taking foods which are rich in protein, is a necessity as protein allows the body to repair tissues and cells. Protein also helps in building immunity. So, take items like chicken, fish, eggs, low fat dairy products in the form of milk, cheese, yogurt, nuts, beans, soyabeans. These would give you the strength to bear treatment.
  • Eat a whole lot of fruits and vegetables: Fruits and vegetables should be there in your diet as they provide antioxidants to the body, which can be of great help in fighting cancer. For patients, who are going through treatment and have weak immune system, fresh fruits and vegetables should be cooked and include them in their daily diet.
  • Drink water: It’s important for patients to drink enough water during treatment so that there is no chance of getting dehydrates. Caffeinated beverages should be avoided.
  • Go for sources of healthy fat: Fried, fatty and greasy foods should be completely avoided at all costs. Rather, choose boiled, baked or grilled foods. Healthy fats would include:
  • Intake of sweets should be limited: Sweets should be kept away from the diet of a cancer patient receiving treatment. Along with it, avoid items having high content of added sugar.

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

2747 people found this helpful

Breast Cancer - Tips To Prevent It!

MS, MBBS
Gynaecologist, Noida
Breast Cancer - Tips To Prevent It!

One of the things that Shannen Doherty and Rita Wilson, the wife of Tom Hanks, have in common, apart from their fame is that both were affected by breast cancer. No matter how normal a person may seem, breast cancer can strike anyone. In fact, it usually strikes one in eight women. So, it makes good sense to know what it can appear as!

Breast cancer makes up a rather big amount of the general cancer cases as 15% of the cancer cases which are reported on a yearly basis are usually breast cancer cases. That being said, there are quite a few things which can be done in order to reduce a person’s risk to breast cancer.

Prevention is Prudent-

  1. Get Fit: The first thing which should be done is that a reasonable level of fitness should be maintained. Many studies have found that if a person is significantly heavier than her recommended weight, she is at a far great risk to develop all sorts of cancer and breast cancer, in particular, than a person who is able to keep her weight in check. The difference in cancer risk rates is about 40%. This is because a greater amount of fat leads to more estrogen being produced, which increases the risk of breast cancer.

  2. Quit Smoking: While most people associate smoking as something which increases the risk of cancer to the lungs and are not aware that it increases the risk of breast cancer, too. So, the best solution is to kick the habit!

  3. Get Off the Pill: Once a woman crosses past her mid-thirties, she should try to avoid relying on birth control pills to reduce the risk of pregnancy. This is because these pills have an effect which increases the risk of breast cancer, which heightens as a woman gets older. As long as the woman cuts out the use of the pill, the risk quickly gets cut, as well.

  4. Get Regular Check Ups: While screening for breast cancer by making use of mammograms does not cut the risk of it, the screening helps detect breast cancer early if it does exist. As a result, a woman has a much better chance of fighting breast cancer. So, a woman who is past the age of forty should try to have a mammogram on an annual basis with the frequency of the same increasing as she gets older. However, it is to be kept in mind that going for a mammogram too often is also not a good idea as the tests themselves pose risks of DNA changes.

Women all around the world are susceptible to breast cancer. While there isn’t a 100% chance of avoiding it, taking care of yourself and leading a fit and active lifestyle can significantly cut down your risk of contracting this condition. Remember, your health is in your hands, so the earlier you start, the better! In case you have a concern or query you can always consult an expert & get answers to your questions!

2673 people found this helpful
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