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Dr. Usha Seth

Radiologist, Mumbai

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Dr. Usha Seth 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.
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Dr. Usha Seth is one of the best Radiologists in Mumbai, Mumbai. You can visit her at Dr Seth Clinic in Mumbai, Mumbai. Book an appointment online with Dr. Usha Seth and consult privately on Lybrate.com.

Lybrate.com has a nexus of the most experienced Radiologists in India. You will find Radiologists with more than 35 years of experience on Lybrate.com. Find the best Radiologists online in Mumbai. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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I am 43 years old and I have taken scan and in my report there is a small fibre on the both wall of the uterus, can you please tell me whether it is danger or not.

BHMS
Homeopath, Chennai
Homeopathy is much more effective in treatment of uterine fibroids. Out of all possible alternatives, Homeopathy is the best non surgical treatment for fibroids. The homeopathic medicines slowly but surely retard the growth of fibroids. Over a period of time, the fibroids disappear completely. This is a far more effective and the most convenient treatment of fibroids.
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Brain Aneurysms - Key Treatments That Can Help With It!

MCh - Neurosurgery, MBBS
Neurosurgeon, Chennai
Brain Aneurysms - Key Treatments That Can Help With It!

Are you experiencing excruciating headache? you probably didn't know but you could be suffering from brain aneurysms. It is described as bulge formation in the blood vessel in the brain. It is a totally asymptomatic condition as one does not display any symptoms until the bulge vessel ruptures which may result in blood releasing in the skull which may further lead to a stroke. The bulge is often formed in the gaps between the tissues covering the brain and brain itself.

Most common treatment options for ruptured aneurysm
There are two common treatment options for a ruptured brain aneurysm endovascular coiling and surgical clipping. Both these procedures have certain risk factors, therefore it is best to discuss the details with a neurologist. The endovascular coiling is a less invasive process where the surgeon inserts a hollow tube or catheter into an artery and threads it through the body to reach an aneurysm. Then a guide wire is sent to push a soft platinum wire through the catheter. This coils up and disrupts the flow of blood into the aneurysm and leads to blood clotting. The clotting is essential in sealing off the aneurysm from the artery.

The surgical clipping is a process used for closing off the aneurysm, and a section of the skull is required to be removed for assessing the affected part. It also helps in locating the blood vessel that is responsible for the problem. Finally, a metal clip is placed on the neck of the aneurysm to stop the flow of blood. Though endovascular coiling is less invasive and said to be safer, adequate post-treatment care is necessary to minimize risks.
To treat larger aneurysms, a treatment called flow diverters may be useful. Since, the treatment is decided based on the size, location, apperance and your health condition, your doctor will be the best person to take the final call.

Other procedures to treat symptoms
Other than the surgical procedures several treatments might be prescribed to treat the symptoms and to manage complications. A few commonly advised treatments are:

  1. Pain relievers: To manage headaches
  2. Calcium channel blockers: One of the most common complications that may arise with an aneurysm is calcium entering the walls of blood vessels which may result in narrowing of walls. Calcium channel blockers are medications may be prescribed by the doctors to deal with the complication
  3. Anti seizure medications: Medications such as levetiracetam, phenytoin, valproic acid, and others are prescribed to treat seizures associated with aneurysms
  4. Procedures to prevent stroke: An insufficient blood flow may result in a stroke and to prevent it, the drug vasopressor is injected intravenously, or angioplasty is performed.
  5. Rehabilitative therapy: Damage to the brain may require the patient to undergo several physical and occupational therapy.

If you suffer from the condition, it is advised to keep a check on the blood pressure and quit smoking as they can help in reducing the risks associated with aneurysms. 

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

3671 people found this helpful

Brain Surgery - What You Need To Know About It?

MCh, MBBS, MRCS (UK)
Neurosurgeon, Chennai
Brain Surgery - What You Need To Know About It?

Brain surgery involves several medical procedures, which incorporate fixing issues with the brain, including changes in the tissues of the brain, cerebrospinal fluid and brain blood flow. Brain surgery is quite a complicated method of surgery and the type of surgery to be conducted depends on the underlying conditions.

Reasons for Brain Surgery:
Brain surgery is performed for the correction of physical brain abnormalities. These abnormalities could occur because of diseases, birth defects and injuries. A brain surgery is required when the following conditions arise in the brain:

  1. Abnormal blood vessels
  2. Aneurysm
  3. Bleeding
  4. Blood clots in the brain
  5. When the protective tissue or dura is damaged
  6. Epilepsy
  7. Due to nerve damage
  8. Parkinson's disease
  9. Any kind of pressure after an injury
  10. Abscesses
  11. Skull fractures
  12. In case of stroke and tumors

A surgery may not be required for all the above mentioned conditions, but in case of many, a brain surgery is very important as the conditions may worsen health problems.

Types of brain surgeries:

  1. Craniotomy: During this open brain surgery, an incision is made in the scalp, and a hole is created in the skull, near the area, which is being treated. After this process is complete, the hole or bone flap is secured in its place using plates or wires.
  2. Biopsy: This form of brain surgery helps in the removal of a small amount of brain tissues or tumors. After removal, the tissues or tumors are examined under a microscope. The creation of a small incision and a hole in the skull is indicated as a part of this process.
  3. Minimally invasive endonasal endoscopic surgery: This form of brain surgery enables the removal or lesions and tumors via the nose and sinuses. Private parts of the brain can be accessed without creating an incision. An endoscope is utilized in the process which is used to examine tumors all across the brain.
  4. Minimally Invasive neuroendoscopy: This process is similar to the minimally invasive endonasal endoscopic surgery. This method also involves the use of an endoscope for removal of brain tumors. Small, dime sized holes may be made in the skull to access some brain parts.

Risks:
Brain surgeries may be associated with several risks. They may be:

  1. Allergic reactions to anesthesia
  2. Bleeding
  3. Blood clot formations
  4. Swelling of the brain
  5. A state of coma
  6. Impairment in speech, coordination and vision.
  7. Problems in memory
  8. Strokes and seizures
  9. Infections in the brain

A brain surgery is a serious and very complex surgery. There are different kinds of brain surgeries, which are conducted depending on the condition and severity of the disease. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.

3475 people found this helpful

I have L5-S1 disc extrusion condition from a year resulting in severe pain in the right leg. Is surgery the only solution?

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I have L5-S1 disc extrusion condition from a year resulting in severe pain in the right leg. Is surgery the only solu...
Apply hot fomentation twice daily. Avoid bending in front. Postural correction- sit tall, walk tall.
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Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

MBBS, MD, FIMSA, FIPP
Pain Management Specialist, Delhi
Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

  • Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
  • Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
  • High risk of primary or consequential damage to neural, bony or disc element
  • Increased wedging, deformity & increase incidence of adjacent VB
  • Chronic pain of altered spine mechanics
  • Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
  • Cost of surgery and hospital treatment
  • Cost of implants
  • Phobia of surgery
  • Prolonged recovery period & Extensive rehabilitation
  • Changed spinal mechanics & transition syndrome
  • Major surgery & anesthesia with its own complications

Results / Outcome

  • PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
  • Different studies show an immediate pain relief in (85 – 90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
  • PVP does augment height of VB but ideal would be kyphoplasty
  • Patient is either off medicine or on reduced doses.
  • Patient feels so well that he almost forgets if he had VB
     

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are  Metastatic VB,  Multiple myeloma VB, VB haemangioma,  Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF)   which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis.  Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient  back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

  • Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
  • Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
  • GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
  • High risk of primary or consequential damage to neural, bony or disc elements.
  • Increased wedging, deformity & increase incidence of adjacent VB
  • Chronic pain of altered spine mechanics.
  • Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.

Morbidity and complication of spinal surgery 

  • Cost of surgery and hospital treatment
  • Cost of implants
  • Phobia of surgery
  • Prolonged recovery period & Extensive rehabilitation
  • Changed spinal mechanics & transition syndrome
  • Major surgery & anesthesia with its own complications

Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

  • Cementing of fragments.
  • Thermal neurolysis of VB nerve ending due to heat of polymerization.
  • Washing away of nociceptor chemicals.
  • Neurolytic action of liquid monomer.
  • By allowing early ambulation decreasing pains of immobility & bed rest.

Complications 

  1. PVP is generally safe with low risk.
  2. Ectopic cement leak is frequent but generally inconsequential.

Outcome 

  1. PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
  2. Different studies show an immediate pain relief in (85 – 90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
  3. PVP does augment height of VB but ideal would be kyphoplasty.
  4. Patient is either off medicine or on reduced doses.
  5. Patient feels so well that he almost forgets if he had VB

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

4342 people found this helpful

My mother is on ventilator now she has stage 4 breast cancer and she is unable to breathe she is uncouysus now please give me suggestion.

M.Ch - Oncology, MS - General Surgery, M.B.B.S., F.I.A.G.E.S.
Oncologist, Bhopal
Get opinion of intensivist treating at present. At this point of time and this critical condition it is not possible and recommended to control disease by chemotherapy.
2 people found this helpful
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All About Bone Cancer

M.Ch - Orthopaedics, Fellowship in Arthroscopy & Sports Medicine, MS - Orthopaedics, MBBS
Orthopedist, Delhi
All About Bone Cancer

Cancer that originates in the bones of a human body is referred to as bone cancer. Any bone could come under the threat of this disease, but generally the longer bones of your body, so to say the bones of your limbs, are at a greater risk. 

A few factors that might push you an inch closer to bone cancer are:

  1. Genes could jinx your health: A few typical genetic syndromes could increase a person's chances of contracting bone cancer. These syndromes could have been active in any person belonging to your lineage. One such syndrome is Li-Fraumeni.
  2. Treatment for one kind of cancer can make you prone to some other kind: Radiation affects your bones adversely. A patient of breast cancer might be undergoing radiation therapy that further increases his or her risk of contracting bone cancer in future.  
  3. Paget's disease can have unfavorable implications: Paget's disease is a disease that affects elderly people. This condition, if left untreated, can turn into bone cancer at a later stage. 

Several symptoms of bone cancer can be found below:

  1. Sudden loss of weight: If you lose a considerable amount of weight in a few weeks time without having made any effort at all, you should probably be worried about the health of your bones. Bone cancer can result in sudden and unintentional weight loss
  2. Unexpected bone fracture or breakage: Cancer of the bones is known to gnaw at the strength of your bones. Weakened and diseased bones can break or get fractured very easily. An unexpected fracture should not be overlooked so as to prevent chances of anything more harmful.
  3. Long spans of unyielding exhaustion: Constant fatigue and sleepiness might be hinting at a more serious underlying problem. The bones in your body hold you together; cancerous bone cells can make you feel exhausted without much exertion as your bones lose their inherent potency.
  4. Persistent pain in the bones: Excruciating cramps or pangs of stinging pain in a person's bones either continuously or at odd hours, could be indicative of bone cancer. Such instances require the advice and guidance of an experienced oncologist.
  5. Bone swelling: The area affected by bone cancer can grow big and tender or the bone itself can swell up.
3245 people found this helpful

Is homeopathic medicine helpful for disc extrusion (L5-S1) neurosurgeon is saying surgery is must otherwise you may loose control over foot movement and urine, please HELP.

Fellowship in Interventional Pain management , Diploma in Anesthesia, DA, MBBS
Pain Management Specialist, Jaipur
disc problems are mechanical one due associated with ur action like weight lifting. jumping.riding. forward flexion.etc. prognosis is depending entirely on radiological finding as well as clinical presentation too. a single criteria shouldn't be implement in every case. as in my opinions up to certain extent conservative management be institute. afterwards six week to six months. if ur ur bowl.bladder or motor powers affected. immediately go for minimal invasive technique. avoid open surgery. because its associated with failed back surgery syndrome in 30%case worldwide.
3 people found this helpful
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