Dr. Rachna Garg

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.

Uterine cancer is also known as endometrial cancer. It is a cancer which begins in the lining of the uterus. The uterus is the part of a woman's body where the fetus develops. Uterine cancer is one of those rare cancers in India, which can be diagnosed in its early stages. This is because excessive vaginal bleeding occurs, thus making it a very serious and an apparent symptom. It is also one of the few forms of cancer which can be cured as removing the uterus is often more than enough to cure the patient of uterine cancer.

Here are the causes, diagnosis and treatment of uterine cancer:

Causes:

The exact cause of uterine cancer is not yet known, however, there is a theory on what causes uterine cancer. Hormones in a woman's body have been thought to increase the chances of getting uterine cancer. This is because it has long been thought that having high levels of estrogen is the cause of uterine cancer. Increased estrogen thickens the endometrium and thus, increases the likelihood of uterine cancer.

Diagnosis:

1. Pelvic exam: This is an examination in which the vagina, bladder, rectum and uterus are scanned for lumps. If they are found, it might be due to uterine cancer.
2. Pap test: A pap test is a special test designed to scan for uterine cancer.
3. Transvaginal ultrasound: A transvaginal ultrasound uses high-intensity sound waves so that pictures of the uterus can be taken.
4. Biopsy: During a biopsy, the doctor will remove tissue from the endometrium and it will then be analyzed for cancerous growths.

Treatment:

1. Surgery: This is the most common treatment as it removes the entire uterus and prevents the spreading of the cancer.
2. Chemotherapy: Chemotherapy involves giving drugs which kill cancerous cells. They are given through either an intravenous line or even in pill form.
3. Hormone therapy: This is a therapy in which either progesterone levels are increased or estrogen levels are decreased.
4. Radiation therapy: In this treatment, high energy laser beams are used to destroy cancerous cells. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

Breast Cancer - What exactly is it?
‘Breast cancer’ is a term that is used to refer to a malignant tumour, which has developed from cells present in the breast. Generally, all tumours can be divided into two categories i.e. benign and malignant and it is the malignant tumour that is responsible for causing cancer. Breast cancer generally originates in the cells the  milk producing glands of the breast's or the passage, which carries milk from the glands to the lobules. Additionally, breast cancer can also originate in the stromal tissues, including the fibrous and fatty connective breast tissues.

Breast Cancer: Treatment Options
Treatment for breast cancer depends upon two things: the exact type of the cancer and how advanced the cancer is. Treatment options for breast cancer can thus be broadly divided into two categories as Local treatments and Systemic treatments.

Local Treatments
Treatments that target the tumour without having any effect on the rest of the body are called local treatments. The following types of local treatment options are available for treating breast cancer:

1. Surgery: Surgical breast cancer treatment involves removal of the malignant cancerous tumour in an operation. Smaller tumours can be removed using a surgical process referred to as ‘lumpectomy’, wherein the tumour along with a small amount of healthy tissue surrounding the tumour is removed. For larger tumours, removal of the entire breast becomes mandatory, in a surgical process known as ‘mastectomy’. Women who undergo mastectomy can choose to undergo reconstructive plastic surgery for reconstruction of the removed breast(s).
2. Radiation Therapy: This basically involves using radiation to kill cancer cells present in the body. Radiation therapy is a long-drawn process that usually involves a set number of treatments administered over a long period of time. Radiation therapy is also generally the follow-up procedure after a lumpectomy, or more rarely, a mastectomy.

Systemic Treatments
Treatments involving drugs that are administered via either the mouth or direct injection into the bloodstream are called systemic treatments. These include:

1. Chemotherapy: This includes using drugs to destroy the cancer cells present in the body by stopping the cancer cells from growing and dividing. Chemotherapy can be administered using either an IV (intravenous) tube or via pills that can be swallowed.
2. Hormone Therapy: This treatment option is used for treating tumours which have tested positive for progesterone or oestrogen receptors. Blocking hormones that fuel the tumour’s growth is the basis of this therapy.
3. Targeted Therapy: This targets specific proteins and genes which contribute to growth and survival of the cancer cells. Targeted therapy is an extremely focused treatment, and is very effective in blocking the growth and division of cancer cells, as well as minimizing damage to surrounding healthy cells.

Blockage in heart is a common term used for narrowing of coronary arteries. Coronary arteries are vessels, which supply blood and thus oxygen and food to continuously working heart muscles. Heart muscles, which are not tired working from the birth till death, however, cannot sustain long without blood supply.

A reduction in blood supply gives rise to ischemia of heart muscles commonly manifested as chest discomfort or angina. A sudden complete shutdown of blood supply leads to heart attack leading to permanent damage to heart (if blood flow not reestablished promptly).

But what causes these arteries to block? Sedentry lifestyle is the most primary reason of these blockages. Cigarette smoke increases the rate of atherosclerosis in the arteries of the heart, legs, and the aorta -- the largest artery in the body. Also, there is an increase in the risk of heart attack if a first-degree relative (parent or sibling) has had a heart attack or stroke. That is mainly seen when the relative has had a heart attack before the age of 45 if they are male, 55 if they are female. 

High levels of ''bad'' cholesterol, or low-density lipoprotein (LDL), are also the major contributors to arterial plaque formation. Having high blood pressure also increases the rate at which arterial plaque builds up. It also hastens the hardening of clogged arteries. LDL a normal component of blood (upto certain limit) starts depositing in arteries as early as 10 years of age!

Deposition of billions of LDL molecules over several years on inner surface of arteries gives rise to visible narrowings in these arteries. Flow ahead of these narrowings is reduced in proportion to the narrowing. At a level of 70 % narrowing the flow is reduced to give ischemia (and angina) during exercise. Gradually increasing degree of narrowing reduces the exercise needed for ischemia and angina; a narrowing of more than 90 % can give symptoms at rest. A sudden clot formation at any of these stages can block the flow suddenly giving a heart attack.

If LDL is a normal component of blood, why it is deposited in the arteries at first place?
LDL above a certain limit in blood starts depositing in the arteries. Diabetes, Hypertension, smoking, less exercise and genetics makes it more sticky thus making narrowing faster. This is why these risk elements need to be properly attended for prevention from heart disease. For treatment medicines are important for stopping the progression of narrowings; angioplasty is a method of fast resolution of blockage; and bypass surgery is the method of creating a whole new blood supply for the affected part of the heart. If you wish to discuss about any specific problem, you can consult a Cardiologist.

The lower part of uterus, which eventually leads into the vagina in the female reproductive system in humans is called the cervix uteri or in simple words, cervix. The inflammation of this part of the reproductive system is called Cervicitis.

Causes

Inflammation in the cervix is caused due to irritation, infection or injury to the cells, which align the cervix. Any one of a number of infections, mainly sexually transmitted diseases can cause cervicitis, of which the most common are chlamydia , mycoplasma , ureaplasma and gonorrhea. Chlamydia accounts for almost 40% of the total cases. Less common causes of cervicitis are Trichomoniasis (Trichomonas vaginalis) and Genital herpes. Other than STDs, causes for Cervicitis include allergies, bacterial imbalance, injury or irritation resulting from pessaries, tampons, hormonal imbalance and even cancer or its treatment (radiation therapy).

Symptoms

Some cases of cervicitis in women can be symptomless. However, in most cases, symptoms are present, and they include:

1. Persistence of gray or white vaginal discharge that may or may not smell

2. Vaginal bleeding under certain conditions eg. in between periods or after sex

3. Pain during intercourse

4. Backache

5. Difficulty or pain during urination

6. In rare cases, fever or pain in the abdomen

Treatment

Cervicitis has no typical form of treatment. Treatment may not be needed in cases where the cause is not a sexually transmitted infection. On suspicion of an infection, the main objectives of the treatment are the removal of the infection and obstructing its spread to the fallopian tubes and uterus, or in case of pregnancy, to the baby.

The medical prescription issued by your doctor would depend on the organism, which is causing the infection. It may include Antibiotics, Antifungal medications or Antiviral medications. Cryosurgery, a process, which freezes the abnormal cells in the cervix using freezing temperatures, may also be performed by your doctor. In severe cases, where there is damage to the cervical cells, your doctor can apply silver nitrate (destroys abnormal cells).

Recommendations from your doctor may also ask your partner to be treated so as to prevent recurrence of the disease and to avoid intercourse as long as the treatment is in process. Treatment is mandatory if you are tested to be HIV positive. Moreover, having cervicitis makes you more prone to receive the virus from a HIV positive partner. If you wish to discuss about any specific problem, you can consult a gynaecologist.

Breast Cancer can be detected at various stages. Some women might feel a difference in their breast area, with a lump or kind of a skin rash around the nipple or they could see that their nipple has become inverted, so then the treatment procedures would be different. The different stages of cancer and their respective treatment procedures are discussed below:

Stage I Breast Cancer - Treatment
In this case, breast cancers are at their nascent stage, either they have not spread to the lymph nodes or might have spread to only a small area. Treatment options are as follows:

• Surgery: The main treatment for breast cancer in stage I is surgery. These types of cancers get treatment with either breast-conserving surgery or mastectomy. There are some cases when breast reconstruction can also be done along with the surgery to get rid of cancer.
• Radiation therapy: When doctors feel the need to do a breast construction surgery, then radiation therapy is normally given after surgery. This helps in lowering the chance of cancer getting relapsed. Older women, aged close to 70 years, should go for breast reconstruction surgery without radiation therapy, provided the following conditions are true:
  • The lump was 2cm or less across and it has been completely removed.
  • None of the lymph nodes removed contained cancer.
  • The cancer is either ER or PR-positive and hormone therapy is conducted.
• Chemotherapy and other drugs: Women who have either ER or PR-positive hormone receptor, doctors would recommend them to go for hormone therapy. The therapy is given for 5 years. In case the tumor is larger than 1cm across, adjuvant chemotherapy is recommended.

Stage II Breast Cancer-Treatment
This is the stage when cancer has spread to some nearby lymph nodes. The treatment methods followed are:

• Surgery and radiation therapy: This second stage of cancer gets treated with breast-conserving surgery or mastectomy. The lymph nodes nearby get checked either with a sentinel lymph node biopsy or an axillary lymph node dissection. Women, on whom BCS have been conducted, get treated with radiation therapy after surgery.
• Neoadjuvant and adjuvant systemic therapy: This is another method followed for treating stage II cancer. It is a good option for women with large tumors as they shrink the tumor before conducting surgery. Chemotherapy, HER2 targeted drugs and Hormone therapy all form part of treatment in this stage II.

Stage III Breast Cancer – Treatment
In stage III breast cancer, the size of a tumor is more than 5 cm, with cancer spreading on to the nearby lymph nodes. The treatment procedures followed are:

• Neoadjuvant therapy: Generally the stage III cancers are treated with neoadjuvant chemotherapy. Radiation therapy is also given after surgery, followed by breast reconstruction surgery.
• Starting off with surgery: Another treatment option for this stage is to get started off with surgery. The tumors are quite large and they even grow on to nearby tissues, which means women need to get a mastectomy. Women having large breasts can even go for Breast Reconstruction Surgery, in case cancer has not spread on to the nearby tissues.

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