Dr. Swati Ravziani

Ultra sound is commonly known as sonography. It is a process of reproducing ultrasound images of soft tissues of a particular body part and other organs on the computer screen with the help of the echoes of the sound waves produced by the transducer, a high-frequency generating instrument.
Ultra sound is commonly used during the different stages of pregnancy to denote the foetal health, date of delivery, birth defects etc. However, in recent times, the ultra sound has also been associated with the diagnosis of other body parts such as the eyes, heart, gall bladder, liver, ovary, uterus, kidney, uterus, testicles, and ovaries. Ultra sound has also been useful in conducting biopsies for suspecting cancer patients, although not all of the cancers are detected by this imaging process. 3D & 4D ultrasound imaging are useful for looking at a particular body portion with much more precision and in slow motion respectively.

The advantages of ultra sound are:
1. The process of ultrasound imaging is a painless and a fast one. It does not require any insertion of needles or similar objects to denote the problems of the concerned body part.
2. The process is more convenient as compared to other similar imaging processes like MRI, mammogram and x-rays as they can capture images of the soft tissues, blood flow & cysts more clearly than the other processes.
3. The process is free of any harmful effects as there are no chances of exposure to radiation as compared to similar processes such as CT scans or X-rays. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

जिगर शरीर में सबसे बड़ा ग्रंथियों वाला अंग है और शरीर को विषाक्त पदार्थों और हानिकारक पदार्थों से मुक्त रखने के लिए विभिन्न महत्वपूर्ण कार्य करता है। पेट के दाहिने ऊपरी चतुर्भुज मंर स्थित है, पसलियों के ठीक नीचे। लिवर पित्त के उत्पादन के लिए जिम्मेदार है, जो एक पदार्थ है जो आपको वसा, विटामिन, और अन्य पोषक तत्वों को पचाने में मदद करता है। यह ग्लूकोज जैसे पोषक तत्वों को भी स्टोर करता है और दवाओं और विषाक्त पदार्थों को तोड़ता है। 

लिवर कैंसर, जिसे हेपेटिक कैंसर भी कहा जाता है, एक कैंसर होता है जो लिवर में शुरू होता है। जब कैंसर लिवर में विकसित होता है, तो यह लिवर कोशिकाओं को नष्ट कर देता है और सामान्य रूप से कार्य करने के लिए लिवर की क्षमता में दखल देता है। लिवर कैंसर के दो प्रकार होते हैं। प्राथमिक लिवर कैंसर, जो लिवर की कोशिकाओं में शुरू होता है। जबकि, कैंसर जो कि कहीं और से शुरू होता है और अंततः जिगर तक पहुंच जाता है, उन्हें जिगर मेटास्टेसिस या द्वितीयक लिवर कैंसर कहा जाता है।

प्राथमिक लिवर कैंसर के विभिन्न प्रकार
विभिन्न प्रकार के प्राथमिक लिवर कैंसर लिवर के विभिन्न कोशिकाओं से उत्पन्न होते हैं। प्राथमिक लिवर कैंसर लिवर में एक गांठ के रूप में, या एक ही समय में लिवर के भीतर कई स्थानों में शुरू हो सकता है।

1. हेपैटोसेलुलर हेपैटोसेलुलर:
हेपेटोसेल्यूलर कार्सिनोमा (एच.सी.सी), जिसे हेपेटामा भी कहा जाता है, सबसे सामान्य प्रकार का लिवर कैंसर है। एचसीसी मुख्य प्रकार के लिवर कोशिकाओं में शुरू होता है, जिसे हेपोटोसेल्यूलर कोशिका कहा जाता है। एचसीसी के अधिकांश मामले हेपेटाइटिस बी या सी, या शराब के कारण जिगर के सिरोसिस के संक्रमण का नतीजा है। 

2. फाइब्रोलैमेलर एचसीसी:
फाइब्रोलामेरेलर एचसीसी एक रेअर प्रकार का एचसीसी है, जो आम तौर पर अन्य प्रकार के लिवर कैंसर की तुलना में उपचार के लिए अधिक संवेदनशील होता है।        

3. कोलेंजियोकार्सिनोमा:
कोलेंजियोकार्सिनोमा, जिसे आमतौर पर पित्त नली के कैंसर के रूप में जाना जाता है, लिवर में छोटे, ट्यूब जैसे पित्त नलिकाओं में विकसित होता है। पाचन में मदद करने के लिए, ये नलिकाएं पित्ताशय में पित्त को ले जाने के लिए जिम्मेदार हैं। जब कैंसर लिवर के अंदर नलिकाएं के खंड में शुरू होता है, तो इसे इंट्राहेपेटिक पित्त नलिका कैंसर कहा जाता है। यद्यपि, जब लिवर के बाहर नलिकाओं के अनुभाग में कैंसर शुरू होता है, तो एक्स्ट्राहेपाटिक पित्त वाहिका कैंसर कहलाता है। 

4. एंजियोसारकोमा:
एंजियोनेसकोमा लिवर कैंसर का एक रेअर प्रकार है जो लिवर के रक्त वाहिकाओं से शुरू होता है। इस प्रकार का कैंसर बहुत तेज़ी से प्रगति करता है, इसलिए यह आमतौर पर एक और अधिक उन्नत चरण में डिटेक्ट किया जाता है।

5. हेपेटोब्लास्टोमा:
हेपोटोब्लास्टोमा एक अत्यंत असामान्य प्रकार का लिवर कैंसर है। 

लिवर कैंसर के लक्षण
ज्यादातर लोगों के प्राथमिक जिगर कैंसर के शुरुआती चरणों में लक्षण नहीं होते। जिसके परिणामस्वरूप, लिवर कैंसर बहुत देर से डिटेक्ट किया जाता है। लिवर कैंसर के लक्षणों में शामिल हैं:

1. पीलिया
2. भूख में कमी
3. वजन घटना
4. एबडोमीनल पेन
5. बुखार
6. मतली और उल्टी
7. सामान्य खुजली
8. हेपटेमेगाली (बढ़े हुए जिगर)
9. बढ़े हुए स्प्लीन

चूंकि लिवर कैंसर के लिए कोई व्यापक रूप से अनुशंसित नियमित स्क्रीनिंग टेस्ट नहीं हैं, इसलिये बीमारी के परिवार के या अन्य जोखिम कारकों के इतिहास वाले लोगों को उनके डॉक्टर से बात करनी चाहिए ताकि वे अपने जोखिम को मॉनिटर करने या कम करने के लिए सही कदम उठा सकें।

लिवर कैंसर के जोखिम कारक
प्राथमिक लिवर कैंसर के खतरे को बढ़ाने वाले कारकों में शामिल हैं:

1. मधुमेह
2. अफ्लाटॉक्सिन
3. उपचय स्टेरॉयड्स
4. आर्सेनिक
5. धूम्रपान
6. सिरोसिस
7. कम प्रतिरक्षा और मोटापा

Breast cancer, is a type of cancer, which is common to women, where cancer cells grow on the breasts or the female mammary gland. It starts out with the formation of a small lump in your breast and can spread out to your other organs very rapidly. It generally affects women above forty years of age. Breast cancer can be classified into two types. They can either start forming on the inner linings of your milk ducts ( known as Ductal carcinoma) or in the lobules which supply milk (known as Lobular carcinoma).

There are many causes responsible for breast cancer they are mentioned below: 

• Obesity or post-menopausal obesity (Learn more about Heart Diseases Post Menopause)
• Exposure to frequent radiation (X-ray)
• Consumption of alcohol
• Being taller than average
• Start of periods at an early age
• Late menopause
• Hormone replacement therapy
• Consumption of birth control pills

The most common symptoms of breast cancer are as follows: 

1. Formation of a lump in your breast
2. Swelling or shrinking of your breast
3. Change of size, shape and color of your nipple
4. Blood or milk discharge from the nipple
5. Breast pain
6. Itching sensation
7. Appearance of rashes (Learn more about to maintain the skin health)

Breast cancer if not diagnosed and treated at an early stage may turn out to be fatal. Ayurveda offers promising cures for breast cancer.

A few of the Ayurvedic remedies are mentioned below: 

1. Include foods, which are well supplied with vitamin D in your diet. Researches show that women with less amount of vitamin D in their bodies are more likely to develop breast cancer. Consider including foods like eggs, orange juice, dairy products and fish like salmon in your diet.
2. Drink more of green tea as it has anti cancer properties.
3. Exercises like walking, yoga, meditation and certain breast exercises can help you to relax the pain sensation, reduce stress and also get cured.
4. Incorporate bitter gourd in your diet. Researches show that bitter gourd can kill those cancer cells, which cause breast cancer.
5. Ayurvedic herbs like Ashwagandha, tulsi, curcumin have certain properties that can destroy cancer cells.

Since, breast cancer has less survival rates, it is absolutely essential for you to visit an Ayurvedic practitioner if you wish to get cured through Ayurvedic treatment.

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Cerebral ischaemia or brain ischemia is a medical condition that restricts the flow of blood to the brain, resulting in an unmet metabolic demand. This leads to limited oxygen supply in the brain, which could result in death of brain tissues, cerebral infarction or an ischemic stroke. Thus, a cardiorespiratory arrest, a stroke, and irreversible brain damage are few possible consequences of cerebral ischaemia.

People with compressed blood vessels, low blood pressure, congenital heart defects or sickle cell anaemia have a high risk of developing cerebral ischaemia, since compressed blood vessels or very low pressure can lead to restricted blood flow. Also, sickle-shaped cells have a greater tendency to clot, causing obstructed blood flow.

Patients with cerebral ischaemia experience a host of symptoms, such as weakness in the body, problems in coordination and movement, vision and speech impairment and unconsciousness.

Cerebral congestion, on the other hand, refers to excessive quantity of blood in the brain vessels, causing pressure on the cerebral substance. Cerebral congestion is of two types. It is termed as active when there is too much arterial blood flow and passive when there is undue quantity of venous blood in the veins of the brain. Both conditions cause symptoms, such as severe headache, insomnia, irritability and unconsciousness. The patient gets little sleep and is disturbed, often followed by dreams. When awake, the patient’s mental activity in the brain is very high.

Homeopathy is now a well-established school of medicine backed with years of research and practice. Gone are the days when homeopathy was considered no more than an extension of herbal home remedies. Homeopathic laboratories around the world produce large number of medicines covering almost all ailments. The benefits of homeopathic treatment are now well established due to its holistic approach and minimal side effects. Homeopathy is undoubtedly a ray of hope for patients with cerebral ischaemia and cerebral congestion, as it delivers a comprehensive treatment plan designed to target the signs and symptoms of the disease and address its non-occurrence.

The medications deal with mild to severe symptoms, including inflammation of the brain, headache, vomiting, insomnia, stroke/convulsions and seizures. The stramonium drug, for example, deals with seizures. Belladonna is an effective remedy for sharp shooting headaches, a common symptom of cerebral congestion. Ferrum is believed to be a valuable remedy for brain ischaemia. Few drugs deal with the symptoms of both ischaemia and congestion—nux is a suitable drug for the treatment of ischaemia as well as for passive cerebral congestion. Similarly, phosphorus can be used to treat brain ischaemia and congestion. Zincum metallicum is a highly recommended drug for chronic cases of ischaemia.

The treatment is comprehensive and long term and shows substantive results. Regular follow-ups and consultation with a homeopath specialist is the key to an effective treatment.

Our spinal disk resembles a jelly donut, wherein the softer insides are protected by the hard exterior. Sometimes, as a result of some injury or an accident the jelly slips out, leading to an extremely painful condition which in medical parlance is known as herniated disc. The pain that you are subjected to, during herniated disc, occurs as the nerves nearby are damaged due to the concussion.

Apart from pain, herniated disc is preceded by other symptoms, some of them are:

1. Pain in the arm or the leg: Depending on which part of the body you have suffered the herniated disc, in the neck or in your lower back, this condition is succeeded by intense pain either near the buttocks or near the shoulders. It goes without saying that this pain increases sharply with movement.
2. Numbness: That part of the body where the nerves are damaged due to herniated disc often becomes numb and has no sensation whatsoever.
3. Weakness: Due to herniated disc, the muscles become weak that considerably impairs and curbs mobility.

However, there are various ways by which you can prevent a herniated disc. Some of them are:

1. Exercise: Exercise in any form and even for a short while yields several benefits. Your body invariably gains momentum and agility. If you exercise daily, your spine becomes more stable and strong, thereby preventing a possible herniated disc.
2. Maintaining the right and good posture: A lot depends on the way you sit and walk, in fact more than you can imagine. If you sit badly, it exerts a pressure on the spine and the discs. Subsequently, a good posture does the very reverse and curbs chances of a herniated disc in the future.
3. Keep a tab on the weight: It is always healthy to maintain the right weight, the one that keeps you away from the onset of various diseases. If you are overweight, it puts more pressure on the spine disk, thereby increasing the risk of developing a herniated disc.

What is Bone cancer?

Bone cancer is malignant tumour of the bones which can spread to lungs or other parts of the body. It may have arisen primarily from the bone itself (primary bone cancer) or more commonly, may have spread to the bones (secondary bone cancer) from cancer of some other body organ like Breast cancer, Prostate cancer etc.

Symptoms:

Primary bone cancer usually occurs in growing children and young adolescents, whereas, secondary bone cancer usually occurs in older age group. Usually, the patient experiences pain in the affected area, which over the time, gets worse and continuous. There may also be swelling in the involved region. It can cause weakening of bones resulting in fracture. Some patients may attribute these symptoms to any prior antecedent trauma. Unintentional weight loss may also be seen. Sometimes, these patients are wrongly being treated for infection, thus delaying the correct treatment which may have a bearing on the final outcome.

How common is bone cancer?

Secondary bone cancer is the most common type of bone cancer with bone being the third most common site of cancer spread (metastasis) from other organs. However, primary bone cancers are rare accounting for less than 1% of all cancers.

Causes of bone cancer?

There are no known environmental or other hereditary factors which cause bone cancer, however, certain patients are at a greater risk for bone cancer which include:

• Patients who have received prior radiation therapy
• Patients with a history of Paget’s Disease
• Patients with hereditary retinoblastoma - a type of eye cancer that most commonly affects very young children
• Patients with Li-Fraumeni syndrome - a rare genetic condition

How is it diagnosed?

A patient suspected with bone cancer needs to be investigated thoroughly with blood tests, Xrays, MRI to look for local extent of disease. Since bone cancer can spread to lungs and other bones, staging of the disease is done either with whole body PET CT or a bone scan with CT Chest. Alongwith that, a biopsy (usually with a needle) is required to establish the diagnosis. It’s important to do biopsy from the correct site since wrong biopsy site can be detrimental in limb salvage and can result in amputation (cutting the limb). Therefore, it’s recommended that the biopsy should always be done by the surgeon (Orthopaedic Oncologist) who will be doing the final surgery for bone cancer.

Treatment

Treatment of bone cancer is a multidisciplinary approach requiring an Orthopaedic Oncologist (Bone & Soft tissue tumour specialist), Medical Oncologist (Chemotherapy Specialist), Radiation Oncologist (Radiotherapy specialist) and Pathologist (Specialist in tissue diagnosis).

Usually in primary bone cancers, chemotherapy is given to the patient followed by surgery to remove the diseased bone which is further followed by adjuvant chemotherapy. Limb salvage surgery is possible nowadays for bone cancers in which the part of the bone involved with tumour is removed surgically (rather than cutting the whole limb) and the defect is reconstructed with artificial joint, thereby saving the limb. In some cases, the cancerous bone so removed is given very high dose of radiation so as to kill all the cancer cells and the sterilised bone so formed is fixed back to the parent bone with the help of plates and screws, a technique commonly called as Extra Corporeal Radiation Therapy (ECRT). In children, since the artificial joint will not grow as the child grows leading to unequal limb lengths over a period of time, the defect can be reconstructed with expandable joint which can be lengthened as the child grows which allows to maintain limb length equality at the time of skeletal maturity.

Is cure possible in bone cancer?

With the current chemotherapy regimes and advanced surgical technology, cure is possible in upto 70-75% patients with primary bone cancer. In patients with secondary bone cancer, cure can still be achieved depending upon the primary cancer and the extent of disease. In advanced cases also, a lot can be done to control the disease and give a quality of life to the patient.

Is it possible to prevent bone cancer?

Since the exact cause of bone cancer is not known, as of now it’s not possible to prevent bone cancer.

Whom to consult?

First chance is the best chance when it comes to curing bone cancers. So, it’s advisable to seek treatment from a trained Orthopaedic Oncologist when confronted with a bone cancer to achieve maximum beneficial outcome.

Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.

Here's what you should look for:

Breasts that are their usual size, shape, and color

Breasts that are evenly shaped without visible distortion or swelling

If you see any of the following changes, bring them to your doctor's attention:

Dimpling, puckering, or bulging of the skin

A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)

Redness, soreness, rash, or swelling

Step 2: now, raise your arms and look for the same changes.

Step 3: while you're at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).

Step 4: next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.

Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.

Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage.
 

Step 5: finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 4.