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Dr. Srinivas Desai

MBBS

Radiologist, Mumbai

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Dr. Srinivas Desai MBBS Radiologist, Mumbai
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I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage....more
I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage.
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Dr. Srinivas Desai is an experienced Radiologist in Mumbai, Mumbai. He is a qualified MBBS . You can meet Dr. Srinivas Desai personally at Dr. Srinivas Desai@Breach Candy Hospital in Mumbai, Mumbai. Save your time and book an appointment online with Dr. Srinivas Desai on Lybrate.com.

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Facts Of Human Brain

M.B.B.S,C.C.A,D.C.A,AASECT,FPA,AAD,M.I.M.S
General Physician,
Facts Of Human Brain

The human brain is the most complex and least understood part of the human anatomy. There may be a lot we don’t know, but here are a few interesting facts that we’ve got covered.

Nerve impulses to and from the brain travel as fast as 170 miles per hour. Ever wonder how you can react so fast to things around you or why that stubbed toe hurts right away? it’s due to the super-speedy movement of nerve impulses from your brain to the rest of your body and vice versa, bringing reactions at the speed of a high powered luxury sports car.

The brain operates on the same amount of power as 10-watt light bulb. The cartoon image of a light bulb over your head when a great thought occurs isn’t too far off the mark. Your brain generates as much energy as a small light bulb even when you’re sleeping.

The human brain cell can hold 5 times as much information as the encyclopedia britannica. Or any other encyclopedia for that matter. Scientists have yet to settle on a definitive amount, but the storage capacity of the brain in electronic terms is thought to be between 3 or even 1, 000 terabytes. The national archives of britain, containing over 900 years of history, only takes up 70 terabytes, making your brain’s memory power pretty darn impressive.

Your brain uses 20% of the oxygen that enters your bloodstream. The brain only makes up about 2% of our body mass, yet consumes more oxygen than any other organ in the body, making it extremely susceptible to damage related to oxygen deprivation. So breathe deep to keep your brain happy and swimming in oxygenated cells.

The brain is much more active at night than during the day. Logically, you would think that all the moving around, complicated calculations and tasks and general interaction we do on a daily basis during our working hours would take a lot more brain power than, say, lying in bed. Turns out, the opposite is true. When you turn off your brain turns on. Scientists don’t yet know why this is but you can thank the hard work of your brain while you sleep for all those pleasant dreams.

Scientists say the higher your i. q. The more you dream. While this may be true, don’t take it as a sign you’re mentally lacking if you can’t recall your dreams. Most of us don’t remember many of our dreams and the average length of most dreams is only 2-3 seconds–barely long enough to register.

Neurons continue to grow throughout human life. For years scientists and doctors thought that brain and neural tissue couldn’t grow or regenerate. While it doesn’t act in the same manner as tissues in many other parts of the body, neurons can and do grow throughout your life, adding a whole new dimension to the study of the brain and the illnesses that affect it.

Information travels at different speeds within different types of neurons. Not all neurons are the same. There are a few different types within the body and transmission along these different kinds can be as slow as 0.5 meters/sec or as fast as 120 meters/sec.

The brain itself cannot feel pain. While the brain might be the pain center when you cut your finger or burn yourself, the brain itself does not have pain receptors and cannot feel pain. That doesn’t mean your head can’t hurt. The brain is surrounded by loads of tissues, nerves and blood vessels that are plenty receptive to pain and can give you a pounding headache.

80% of the brain is water. Your brain isn’t the firm, gray mass you’ve seen on tv. Living brain tissue is a squishy, pink and jelly-like organ thanks to the loads of blood and high water content of the tissue. So the next time you’re feeling dehydrated get a drink to keep your brain hydrated.

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

DNB (Radiodiagnosis), DMRD, MBBS
Radiologist, Bangalore
Hi, thanks for writing in to us. It is possible that the disc bulge might have increased in severity recently. Please get a repeat mri scan done and discuss the findings please. It is possible that you might get relief through physical therapy or mild pain relief medications. If there is no relief with medicines then there is the option of steroid injection and radio frequency nerve block procedure. Surgery is the last resort and done only in extreme cases. Please do not worry. Regards,
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My mother is suffering from disc extrusion in L5, is surgery necessary? Or something other will be helpful.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
My mother is suffering from disc extrusion in L5, is surgery necessary? Or something other will be helpful.
avoid surgery do physiotherapy treatment for few days and spine stretching and strength exercise. avoid long sitting toward bending lifting weight. posture correction must
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Age 51 years male. Slip disc happened jan'2010 and get to normal after 4 years doing only exercise till now and used lumbo scrarol belt when out of home. Due to filling uneasy during walking, a tmt brace protocol suggested. Is it ok to do the test.

dnb orthopaedic surgery
Orthopedist, Jaipur
Lumbar brace support is not recommended for you. Stop immediately to used it otherwise it will weaken your back muscles. And consult with spine surgeon.
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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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Hi I'm from South Africa. I need to have a hysterectomy done .What are cost of hospital fees, Dr. and anesthetic ,theatre fees etc awaiting your response kind regards Mariam Patel.

MBBS, MD - Obstetrics & Gynaecology
Gynaecologist, Noida
Hi Mariam, cost of hysterectomy depends upon the method of surgery. I suggest you to consult me privately to share relevant information.
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Abnormal Uterine Bleeding - How Best to Diagnose It?

Fellowship and Diploma in Laparoscopic Surgery, FOGSI Advanced Infertility Training, Royal College of Obstetricians and Gynaecologists (MRCOG), MS - Obstetrics and Gynaecology, MBBS
Gynaecologist, Gurgaon
Abnormal Uterine Bleeding - How Best to Diagnose It?

It is perfectly normal for women to experience the periodic monthly bleeding cycle. However, if a woman experiences uterine bleeding which is abnormal and dysfunctional, it could be a symptom of infection. Other causes of abnormal uterine bleeding include hormonal imbalance, infection in cervix and cancer of the uterus. Many women can also experience abnormal uterine bleeding during first trimester of pregnancy.

The following are considered to be abnormal or dysfunctional uterine bleeding:

  1. A menstrual cycles occurs between 21 to 35 days, anything shorter or longer than this is abnormal
  2. No period for 3–6 months (amenorrhea) is abnormal
  3. Spotting or bleeding between periods
  4. Spotting or bleeding after intercourse
  5. Bleeding that is heavier or lasts longer than usual
  6. Spotting or bleeding after menopause

What can cause such a situation?

Some of the common causes leading to abnormal bleeding are as follows:

  1. Miscarriage
  2. Ectopic pregnancy
  3. Pregnancy
  4. Cervical or uterine infections
  5. Fibroids
  6. Hormonal imbalances
  7. Problems with blood clotting
  8. Polyps
  9. Polycystic ovaries
  10. Endometrial hyperplasia
  11. Cancer of the reproductive tract

How to Diagnose it?

Most women tend to ignore abnormal bleeding, taking it as something to do with age or hormones. A detailed physical examination and history is done to understand menstrual cycle patterns and family history. In addition, the following would be used.

  1. Ultrasound: The pelvic organs are examined through sound waves to locate the problem area
  2. Hysteroscopy: Through a thin device that is inserted into the vagina, the doctor takes a look at the inside of the organs and identify the cause for the bleeding
  3. Endometrial biopsy: The uterine lining tissue is removed and examined under microscope to look for tissue changes that could be causing the bleeding

How Best to Treat It?

This would depend on the reason for the abnormal bleeding. However, in most cases, combinations of the following are useful in treatment.

  1. Hormone replacement can be done depending on the age and gynecological history, the type and the dose of the hormone would be decided upon. These could be in the form of tablets, vaginal creams, injections, or through an intrauterine device
  2. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are useful in reducing bleeding and controlling cramps during excessive menstrual bleeding.
  3. Antibiotics may be useful if there is infection of the pelvic organs.
  4. Polyps, cysts, cancers, and other growths can be removed via hysteroscopy and sent for biopsy to confirm they are not cancerous.
  5. Endometrial ablation where the endometrial tissue is treated with heat can be used to control bleeding permanently.
  6. Hysterectomy would be done if other forms of treatment have failed. This could depend on their gynecologic history and other considerations as she cannot get pregnant after this.

Do not ignore if you see a change in the pattern of your uterine bleeding. It definitely calls for medical attention and if identified early, can be managed in much simpler ways.

3 people found this helpful

Am 24 years old and facing disc bulge from past 4 years (L4, l5, l6) I have taken treatment with exercises, massages and Physio therapy. Which is best way to cure in a quick time.

MBBS, MS - Orthopaedics, DNB (Orthopedics)
Orthopedist, Mumbai
Continue your physiotherapy and avoid bending forward and lifting heavy weights, do regular back and core strengthenin exercise, take a healthy diet of calcium and vitamin d usually slipped discs regress on their own in a period of 6 to 8 months.
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She has a desk job and feeling pain in right leg the mri shows reduced space in intervertebral disc.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
She has a desk job and feeling pain in right leg the mri shows reduced space in intervertebral disc.
Maintain your pelvic sit straight equal balance sciatica pain take ultrasonic therapy and swd then start stretching exercise is confirmation.
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My wife is suffering from slip disc in spine after mri doctor diagnosis that she also suffering bone tb with unbearable pain in lower portion. Now as per doctor advice completely she is in bed rest. Now she cannot able to stand. Kindly advice.

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. I would like to examine her personally as soon as possible.
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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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I am 45 years of age, there are ligament disorder in my left side knee & slip disc problem too in both side feel heavy pain you are requested to advice me for better treatment & earlier relief in the same.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Kindly show me a photograph of the affected part. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 4-5days, contact me again. Do not ignore. It could be beginning of a serious problem. Once you are better with back, then send details of knee problem.
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I have disc bulge and getting pain in my left leg. I have MRI report my nerve is compressed of left leg.

MS - Orthopaedics, MBBS
Orthopedist, Hyderabad
I have disc bulge and getting pain in my left leg. I have MRI report my nerve is compressed of left leg.
If it's small disc bulge then it's treated with medication, exercises, physiotherapy. If no much relief then needs epidural steroid injection. Last resort with no improvement then needs discectomy.
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Sir I have a problem of slipped disc in cervical spine. I am a dance choreographer so I should do my profession or I should stop it.

Fellowship in Shoulder and Upper Limb, Fellowship in Joint Replacement, MS - Orthopaedics, MBBS
Orthopedist, Mumbai
If the problem is recent and correctly diagnosed you should take rest for a couple of weeks and then start gradually with neck physio. Once your neck muscles are strong then you can gradually restart your dance activity.
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Does Knuckle breaking at neck at regular intervals when I'm feel stressed, will that leads to an disk injury or any problems in future. Usually I keep doing that when I work out in gym.

MBA (Healthcare), MRCPsych UK, MBBS
Psychiatrist, Bangalore
Does Knuckle breaking at neck at regular intervals when I'm feel stressed, will that leads to an disk injury or any p...
Try to sleep without pillows-it helps your neck and shoulder muscles to relax properly and maintain a good spine posture.
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Breast Cancer - Know More to Say 'No' More!

MBBS, DGO, MD - Obstetrics & Gynaecology, MRCOG
Gynaecologist, Delhi
Breast Cancer - Know More to Say 'No' More!

Cancer is the abnormal, uncontrolled growth of cells in a particular body part. With continued growth, pieces of this tissue travel through the blood to different body parts and continue to grow in the new area. This is known as metastases. Breast cancer is one of the most common forms of cancer and affects about 1 in 8 women in the USA. Read on to know more details of breast cancer – breast anatomy, causes, symptoms, risk factors, detection, prevention, and of course treatment.

Anatomy: The main function of the breast is lactation through its milk-producing tissue that are connected to the nipple by narrow ducts. In addition, there is surrounding connective tissue, fibrous material, fat, nerves, blood vessels and lymphatic channels which complete the structure. This is essential to know as most breast cancers develop as small calcifications (hardened particles) in the ducts or as small lumps in the breast tissue which then continues to grow into cancer. The spread can happen through lymphatic or blood flow to other organs.

Warning signs/symptoms: The following are some symptoms that need to be watched out for if you have a predisposition to breast cancer.

  1. A lump in either of the breasts or armpits
  2. Change in size, shape, or contour of either breast
  3. Redness of your breast or nipple
  4. Discharge of clear or bloody fluid
  5. Thickening of breast tissue or skin that lasts through a period
  6. Altered look or feel of the skin on the breast or the nipple (dimpled, inflamed, scaly, or puckered)
  7. One area on the breast that looks very different from the other areas
  8. Hardened area under the breast skin

Either one or a combination of these should be an indication to get a detailed checkup done. Early diagnosis results in controlling the disease with minimal treatment and reduced complications.

Causes and risk factors: The exact cause for breast cancer is yet to be pinned down. However, risk factors are clearly identified, and women with risk factors need to watch out for warning signs.

  1. Family history: Of all the risk factors, the family history is the most important. Breast cancer runs in families, and if there is a first-degree relative with the breast cancer, the chances of developing it are almost double. Two genes BRCA1 and BRCA2 are the carriers of the disease, and this testing can be done in women to identify if they are at risk.
  2. Family history of other cancers: Even if there is no breast cancer, if there are other cancers that run in the family, watch out.
  3. Age: Women over 50 are at higher risk of developing breast cancer.
  4. Race: Caucasian and Jewish women are at higher risk of breast cancer than African-American women.
  5. Hormones: Greater exposure to the female hormone estrogen increases the chances of developing breast cancer. Women who use birth control pills for contraception and hormone replacement after menopause are at a higher risk of developing breast cancer.
  6. Gynecologic milestones: Women who have abnormal menstrual milestones need to watch out. These include those who attain menarche before 12 years of age, get pregnant after 30, attain menopause after 55, and have menstrual cycles shorter than 26 days or longer than 29 days.
  7. Obesity and alcohol abuse are also likely to increase a woman’s chances of developing breast cancer.

Stages: Starting from stage 0, higher stages indicate advanced disease.

  1. Stage 0: The growth which has begun in the milk-producing tissue or the ducts has remained there (in situ) and not spread to any other area, including the rest of the breast.
  2. Stage I: The tissue slowly becomes invasive and has begun to affect the surrounding healthy tissue. It could have spread to the fatty breast tissue and some breast tissue may be found in the nearby lymph nodes.
  3. Stage II: The cancer at this stage grows considerably or spreads to other parts. There are chances that cancer may grow and also spread.
  4. Stage III: It may have spread to the bones or other organs but small amounts are present in up to 9 to 10 of the lymph nodes in the armpits and collar bones which makes it is difficult to fight.
  5. Stage IV: The cancer is widespread to far-flung areas like the liver, lungs, bones, and even the brain.

Screening: This is one of the most effective ways to identify the disease in its early stages. This will help in controlling cancer from spreading with minimal treatment.

  1. Self-examination: A thorough self-examination to look for changes in terms of shape, size, colour, contour, and firmness should be learned by all women. Watch for any discharge, sores, rashes, or swelling in the breasts, surrounding skin, and nipple. Examine them while standing and when lying down.
  2. In most women, annual screening mammograms are advised after the age of 40. However, in women who have a strong family history or genetic makeup, it is advisable to have screening mammograms starting at age 20 every 3 years and then annually from the age of 40.
  3. Women in high-risk categories should have screening mammograms every year and typically start at an earlier age.
  4. Ultrasound screening can also be given in addition to mammograms.
  5. Breast MRI is another way to screen for breast cancer if the risk is greater.

Breast Cancer Prevention: Now that there is so much awareness about causes and risk factors, there are definitely ways to prevent or delay the onset of the disease.

  1. Exercise and a healthy diet with reduced amount of alcohol are definitely effective in minimising the chances of developing cancer.
  2. Tamoxifen is used in women who are at high risk for breast cancer.
  3. Evista (raloxifene) which is used to treat osteoporosis after menopause. It is also widely used in preventing breast cancer.
  4. In high-risk women, breasts are surgically removed to prevent the development of cancer (preventive mastectomy).

Treatment: As with all cancers, treatment would depend on the stage at which it is identified and include a combination of chemotherapy, radiation, and surgery. As noted earlier, if you are at risk, look out for warning signs as early diagnosis is the key to maximum recovery.

2622 people found this helpful

MPT
Physiotherapist, Mumbai
Herniated disks or bone spurts in the vertebrae of the neck may become the reason behind severe neck pan. They sometimes take too much space and compress the nerves branching out from the spinal cord.
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Dear sir. My mother is suffering from pain in waist and legs unable to stand for sometime and unable to walk due to L5 L6 displaced and make pressure on nerve. I don't want to operate for this . Is any other solution.

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi , This is Dr Akshay from Fortis Hospital. Kindly upload her x ray and MRI images so that i can see and opine accordingly. Thanks & Regards Dr Akshay Kumar Saxena
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I am suffering from severe backache problem. From last three days. Like slip disk. What should I do? suggest please.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I am suffering from severe backache problem. From last three days. Like slip disk. What should I do? suggest please.
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. You may have to use a spinal belt for some time.
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