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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:
- Abnormal blood vessels
- Blood clots in the brain
- When the protective tissue or dura is damaged
- Due to nerve damage
- Parkinson's disease
- Any kind of pressure after an injury
- Skull fractures
- 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:
- 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.
- 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.
- 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.
- 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.
Brain surgeries may be associated with several risks. They may be:
- Allergic reactions to anesthesia
- Blood clot formations
- Swelling of the brain
- A state of coma
- Impairment in speech, coordination and vision.
- Problems in memory
- Strokes and seizures
- 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.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Breast cancer begins when cells in the breast(s) start to grow out of control. It is understood as being the most common cancer, seen predominantly in females, globally. It is reasonably treatable and often curable.
1. Type: Adenocarcinomas constitute more than 95% of breast cancers with infiltrating ductal carcinoma (IDC) being the most common form of invasive breast cancer.
Frequently occurring breast cancers present as one of the following types mainly
1. Ductal Carcinoma In Situ (DCIS): Is the most common type of non-invasive breast cancer and is confined to the milk ducts of the breast. There is no invasion in the basement membrane. Pure DCIS metastasizes rarely. Non comedo cribrioform carcinoma is the most common DCIS found which, when compared to the comedo type, is mostly non-aggressive.
2. Infiltrating Ductal Carcinoma (IDC): Represents majority (about 3/4th) of the breast cancers, and is known to metastasize commonly to bones, lungs and liver.
3. Lobular Carcinoma In Situ (LCIS): Develops in multiple lobules of the breast (bilaterally). LCIS is less commonly seen, compared to DCIS.
4. Infiltrating Lobular Carcinoma (ILC): Represent about a tenth of all breast cancers and tends to metastasize to other regions of the body.
Less commonly occurring breast cancers such as
5. Inflammatory Breast Cancer: Is relatively uncommon and are caused probably owing to viral infections. The breast is warm, red and swollen.
6. Paget’s disease of the nipple: Is a rare form of breast cancer. It begins in the milk ducts and spreads to the nipple and areola.
7. Medullary Carcinoma
8. Mutinous Carcinoma
9. Tubular Carcinoma
10. Phylloides tumor etc all.
2. Gender: Affects the female populace predominantly. However, a small percentage of breast cancer is attributable to the male populace as well.
3. Etiology: No definite cause is known. However, diet, lifestyle, environment, hormonal/ reproductive factors, personal or family history of breast cancer especially in first degree relatives and also any benign breast disease history etc all are known to increase the risk of breast cancers. Specifically, excessive fatty diet, obesity, type 2 diabetes mellitus, benign breast disease, heredity/ inheritance of mutated breast cancer genes 1 (BRCA1) and 2 (BRCA2), smoking, alcohol intake, infertility, estrogen therapy/ hormone replacement therapy (long term) in post menopausal women, delayed age at first pregnancy, nulliparity (not having child), early menstruation, delayed onset of menopause, lactating mothers not breast feeding, exposure to ionizing radiation, sedentary lifestyle, depression, exposure to MMTV virus etc all can potentially increase the risk for breast cancer.
4. Features: Signs & symptoms, of breast cancer, manifest majorly in the following ways
Lump/ nodule in the breast that gets attached to the skin of the breast over time. The lump / nodule could be hard and painless with irregular edges or it could also be soft, rounded, tender and painful.
Enlarged lymph nodes in the axilla which are palpable.
Swelling of whole or a part of a breast. This is even if there is no distinct lump felt.
Retraction or thickening of the nipple(s).
Pain in the breast or nipple.
Discharge from nipple other than breast milk.
Irritation/ scaliness of skin over the breast.
Redness of nipples
Rarely, red, swollen and tender breast.
5. Screening: Is generally recommended for asymptomatic populations goal of which, as usual, is to be able to detect & diagnose breast cancer at an early stage which is potentially curable. It is mostly radiologic with mammography/ USG being instrumental in raising suspicions for further diagnostics (i.e. biopsy) that help detect breast cancer, if any, early.
6. Diagnosis: A self-examination/ clinical exam of the breast(s)/ axilla that reveals a palpable mass prompts the following diagnostics. Abnormal blood test results may be indicative of malignancy, but a follow up imaging/ biopsy is always the gold standard for accurate diagnosis.
- Blood: ER/ PR/ HER2/neu, uPA, PAI-1, CA15-3, CA27.29 etc all tumor markers are helpful.
- Imaging: Mammography/ USG Scan usually, as relevant. Again, CT Scan of abdomen & pelvis and chest, PET CT scan, bone scan etc all help detect metastasis, if any, for cancers in stage III & above.
- Biopsy: either excisional, incisional, fine needle aspiration (FNA) or core biopsy technique, as contextually appropriate, is frequently employed and a histopathological examination (HPE) thereof clinches the diagnosis and the nature of the disease.
7. Treatment: Conventional treatment includes surgery, radiotherapy, hormone therapy/ chemotherapy as deems appropriate. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as would be feasible contextually.
8. Prognosis: Preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage breast cancer are more. The cure/ recovery chances are influenced by the type, grade, stage of cancer, recurrence and the patient’s general health & vitality etc all. Above-mentioned apart, age, menopause status, lymph node status, ER/ PR/ HER-2/ neu status, size & extent of breast cancer etc all also influence the treatment outlook in breast cancer. The five year survival rate is strongly correlated with the stage of breast cancer.
9. Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an increased focus on protective factors and avoidance of the risk factors can be of help. An adherence to a Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising (for at least 30 minutes daily), de-stressing and relaxation is highly recommended for reducing the risks of breast cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. It is advisable to limit milk/ dairy, preferably of low fat content, to 1 to 2 servings max daily. Although alcohol is optional and is not for everyone, the consumption of the same, if any, has to be strictly in moderation, and is best avoided. Smoking is to be avoided as well. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly or are best avoided too. Limiting dosage/ duration of hormone therapy, if any, especially to counteract post menopausal symptoms and also avoiding exposure to radiation and environmental pollution can help reduce the risks of breast cancer. Apart from the above-mentioned, for high risk cases, a prophylactic oophorectomy, prophylactic radical mastectomy, long term hormone therapy etc all can help reduce the chances/ risks of developing breast cancer significantly. Breastfeeding is known to confer protection against breast cancer risk too.
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:
- 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.
- 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.
- 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:
- 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.
- 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.
- 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.
- 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.
- Bone swelling: The area affected by bone cancer can grow big and tender or the bone itself can swell up.
Sir slip disk ka koi treatment hai without operation kyu ki mujhe slip disk ka problem hai 4 months ho gaye hai dawai khate khate par koi aram nai hai.
Cancer is the one of the biggest threat to the young Indian population because of the factors that cause cancer, but also due to late detection. However, certain bad habbits and the factors increase the risk of cancer in India.
Causes of cancer in India:
- Overpopulation and the problem of nutrition: As per records, India is the world's third most populous country. However, it lacks in resources to feed the multiplying number of mouths. Nutrition plays a key role in deciding the quality of a person's life. Nutrition has therefore emerged as an essential branch of research and medical care in the last few decades. Lack of nutrition directly results in weakened immunity. Your body becomes prone to diseases, some of which can be fatal. To fight off cancer cells, one must have a strong immune system that comes from the right kind of nutrition.
- Smoking is a recurrent habit among children and adults: Smoking can cause cancer. Every cigarette packet reads the same warning messages but it doesn't actually deter smokers in any way. Smoking is prevalent among people of all age groups in India. From poor children to conscious educated adults, all are seen smoking.
- A Tropical country and its woes: Tropical countries are known to face the wrath of the sun. While most places in central, western, partly eastern and southern India experience extremes of temperature in summer, other places with moderately hot summers are not exempted from the harmful UV rays. Ultraviolet rays can be very harmful for one's skin, as it can cause skin cancer. Indians have a high amount of melanin, which protects them against sun rays, but the threat exists nonetheless.
- The concept of fast food: A global economy has opened avenues awaiting your attention in the realm of food. To suit the tones and moods of a fast life, fast food has been made available to you. We take pride in consuming things that can be prepared in an instant: instant noodles, soups and even curries. Packaged food and junk food are sources of cancer cells.
- Lack of awareness regarding the most common types of cancer: Breast and cervical cancer are the two most common types of cancer eating away the health of Indians. The problem lies in being unaware about the root causes, symptoms and treatment procedures related to these kinds of cancer. Social repression turns health concerns into matters of insignificance. Women fear social alienation after coming in the open with their problems.
Renal cancer is also known as hypernephroma, renal cell carcinoma (RCC), kidney cancer or renal adenocarcinoma. The kidneys are organs in your body that dispose off waste, while additionally regulating fluid balance. There are small tubes in the kidneys called tubules. These filter the blood, help in discharging waste, and make urine. RCC happens when cancer cells start to grow out of control in the lining of the tubules of the kidney. Renal cancer is a progressive disease that spreads to the lungs and the organs around it.
Medical experts do not know the exact cause behind renal cancer. It is most commonly found in men between the ages of 50 and 70. There are some risk factors and signs that indicate one’s possibility of having renal cancer and these are as follows
- Family history of renal cancer
- Dialysis treatment
- Hypertension or high blood pressure
- Smoking cigarettes
- Polycystic kidney disease (a condition that causes cyst formation in the kidneys)
At a point when renal cancer is in its initial stages, patients might not see any symptoms. The symptoms are mainly seen in the later stages. Some of the most common symptoms are as follows:
- Blood in urine: Blood in urine is called hematuria. As indicated by the Renal Cancer Association, hematuria is the most widely recognized indication of kidney cancer. In case you have blood in your urine, you may see pink, rust or even a red staining.
- Lower back pain: The vast majority does not encounter pain until cancer is in later stages. Pain from renal cancer is felt on one side of the flank, the region over the pelvis, and beneath the ribs in the abdomen. This pain can go from a dull yearn to a sharp wound, frequently leaving the area blue. In case you have any sudden pain that continues for more than a couple of days, you need to see a specialist.
- A mass or lump: A mass or protuberance in the abdomen can be an indication of renal cancer. Kidney knots might be hard to feel since they are somewhere down in the abdomen. Once a bump is found, your specialist may arrange symptomatic tests such as an ultrasound or a CT scan. These tests may diagnose what your knot might be.
- Iron deficiency and fatigue: Weakness and a fall in your iron levels are the most common symptoms of any type of cancer. Cancer exhaustion is not quite the same as simply feeling tired.
- Weight reduction, loss of appetite and fever: Another normal side effect of cancer is sudden and startling weight reduction. This happens quickly without any excessive workouts or dieting. A person diagnosed with cancer can also face a loss of appetite. In fact, even their most loved food items can get to be unappealing. Frequent fever is yet another common symptoms among most cancer patients.
In case your specialist suspects that you may have renal cancer, they will take some information about your and family’s medical history. They will then do a physical exam. Discoveries that can show renal cancer include swelling or irregularities in the stomach area. In case of men, augmented veins in the scrotal sac (varicocele) may be found. In case you have a concern or query you can always consult an expert & get answers to your questions!
I have slip disc l4, l5 Should I avoid carrying weights. More over what are the exercise I must follow?
1. What are the symptoms of liver disease? When to see a doctor?
Most of the liver diseases present with similar symptoms with some variations. Some of the common symptoms can be loss of appetite, nausea and vomiting, vomiting of blood, jaundice(yellowish discoloration of the eye), abdominal pain, itching, distension of abdomen( accumulation of fluid- ascites), swelling of lower limbs, weight loss, altered sensorium, confusion, and in a late stage- coma.
2. Can liver disease be prevented?
Liver is a crucial body organ which is responsible for processing essential nutrients from the food you eat, synthesizing bile and most importantly removing harmful toxins from the system. To ensure that your liver keeps performing its functions, you need to follow a healthy lifestyle.
Some of the liver diseases are metabolic and hence inherent at the time of birth and manifest later. However, some of the more common liver diseases are preventable like alcohol induced liver disease, fatty liver induced liver disease (NAFLD), Hepatitis A, B and C.
3. What is liver transplantation? What is the average cost of liver transplantation?
Liver transplantation is the treatment for end stage liver disease in both adults and children. In this operation, the diseased liver is removed and replaced by a healthy one. The success rate for the operation is high and terminally ill patient can return to normal lives.
The average cost of liver transplantation is Rs 18 to 20 Lakhs at Sahyadri specialty hospital, Pune Maharashtra. The cost of investigations of the donor and recipient is Rs 90,000. When patients are too sick and require prolonged stay following liver transplantation, the cost of treatment can escalate; hence it is advisable to patients to have the liver transplantation before they develop complications secondary to the liver disease (Cirrhosis).
Most of the patients seek help at a very late stage or referred late to a Surgeon. It is advisable for patients to seek the opinion of a Surgeon at a very early stage of the disease. The patient needs to take medicines for the rest of his life to prevent rejection of the new liver. The cost of medicines and the investigations in the first year is approximately Rs 10-15000/-. The number of medicines and the frequency of blood investigations are much less after the first year of liver transplantation.
The cost of liver transplantation in India is one-twentieth when compared to USA, UK and other European Countries.
4. When should a liver transplant be performed?
When a person’s liver is severely damaged and cannot function properly or complications may develop and liver transplantation should be considered. Conditions like hepatic coma, massive upper gastrointestinal bleeding, and liver cancer is the best treated by complete removal of the liver (cirrhotic liver).
In general, when a patient needs a new liver, the earlier the operation, the higher the success rate is.
Urgent liver transplantation is recommended in patients who have acute liver failure and this could be due to many reasons. The common conditions are Hepatitis B, Hepatitis A, Hepatitis E and drug induced. In such patients, liver transplantation is urgently needed in order to save the life of the individual.
5. What are the advantages/benefits to the recipient of getting a living donation vs cadaver?
A new liver can come from either of the two sources: A living donor or a brain-dead deceased donor.
Living donor transplantation:
It is technically feasible to remove part of the liver from a living person and transplant it to a patient who needs a new liver. The operation has now been done since 1989. Depending on the size matching of the donor and recipient, either the left side (about 35-40%) or the right side (60-65%) of the liver will have to be removed. The liver remnant in the donor will grow to its original size in 6-8 weeks time.
This process helps in an earlier transplantation before the recipients’ conditions deteriorates. It is a planned procedure whilst cadaver liver transplantation is an emergency procedure. It avoids the risk of death while waiting for a deceased donor liver graft(40% overall and 75% for patients in Intensive care units). The survival rate of a living donor transplant is over 90%.
There are risks like complications of the investigations and surgical procedures but the possibility of donor death rate is of 0.2-0.5%. Seventeen donor deaths have been reported in Brazil, France, Germany, Egypt, Hong Kong, Japan, USA and India.
This is well established in the Europe and USA. Unfortunately, the availability of deceased donor liver is not very often in India. Depending on your blood group, you may have to wait for 0 to 6 months before you get a new liver.
During this waiting period, you may develop complications like spontaneous bacterial peritonitis (infection of the fluid in the abdomen) which, if repetitive may produce severe adhesions in your abdomen rendering liver transplantation difficult if not impossible.
It is important for everyone to register for organ donation, so that when we die, this noble act will help many people to lead normal lives. In the Western world the organ donation rate is between 15-18/million population where as in Indi it is less than 1/million.
6. Who can be a suitable living donor?
The most important criteria is that the donation of portion of the liver is done voluntarily. The donor has to be less than 50 years of age, body mass index of less than 25 and is a near relative of the recipient. Both the donor and the patient should have the same Blood group or O Blood group.
Besides, the potential donor should understand clearly that
- The donor operation carries complication rate of 10-15%.
- The recipient is successful in 90-95%, which means that there is 5-10% chance of dying.
- The donation is done out of his/her own wish and without any coercion.
- There is no financial gain related to the act of donation.
- The donor has the right to withdraw at any time without the need of giving any reasons to do so.
7. Which patients are excluded from liver transplantation procedure?
Patients who have cancer in another part of the body, active alcohol or illegal drug abuse, active or severe infection in any part of the body, serious heart, lung or neurological conditions or those who are unable to follow doctors’ instructions are excluded generally.
8. What are the risks to the recipient from the surgery?
The overall success rate of liver transplant is over 94% and the majority of recipients can return to normal activities and achieve 95% of their quality of life which they had prior to liver disease. Since the recipients’ body may reject the new liver, it is essential for them to take immunosuppressive medications and continue follow up at the liver transplant clinic. They will need to continue these medications for life, at a reducing dosage.
The risk for the recipient is the return of the original problem that necessitated the liver transplant in the first place, e.g. hepatitis C, recidivism (return to alcoholism), noncompliance of medications. The other complications that can arise are thrombosis of blood vessels going into or out of the liver, primary or delayed graft non-function, bile duct complications, renal failure and other infections.
9. What are the side effects of having a liver transplant?
After a successful liver transplantation (95% of patients) – the patient is advised to take care of infections and to take anti-rejection medicines for life. The patient can return to normal quality of life and can return back to work in three months time. The patient has to regularly follow up with the surgeon in the first year and later at regular intervals as advised by his doctor. He will require blood tests to determine that his liver functions and to adjust his medications in the beginning and later the tests are infrequent. The patient is advised not to take any herbal or alternative drug treatment.
The transplant patient is assessed regularly for various complications like rejection, infection, narrowing of blood vessels etc., and appropriate treatment is initiated. Post transplantation, he is under the guidance of his doctor throughout his life. Any health problems that do come up have to be investigated and treated, though they are infrequent.
In case you have a concern or query you can always consult an expert & get answers to your questions!