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Diagnostic X- Ray
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Interventional Diagnostic Procedures
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Sir I am FROM CHENNAI having back pain when mri scanned impression as follows Early lumbar spondylosis. Mild disc bulge with focal posterocentral and bilateral postrtolateraldisc at l3_ 4 disc level causing thecal sac ibdentation and bilatrral mild beural foranimal narrowings (L>R) MILD ligamentum flavum hypertrophy at L3_4 & L4_5 disc level causing mild posterior thecal sac indention Disc desiccation in L4_5 & L5_ S1 DISC LEVEL AS LOSS OF HYPERINTENSE SIGNAL ON T2W1 PLEASE HELP I REPLY ME POSITIVELY
What is ECMO?
Like dialysis for unfunctional kidney, Ecmo for unfunctional lung.
Ecmo stands for extracorporeal membrane oxygenation. It is a method of giving oxygen for the body when icu pateint lungs and/or heart are not able to supply oxygen on their own.
Why ICU pateint put on ECMO?
Doctors place ICU patients on ECMO when patients are not able to supply oxygen to the body.
When a patient’s lungs fail, he/she first is intubated (breathing tube) and hooked up to a ventilator (breathing machine).
However, sometimes lungs are so damaged that providing oxygen through intubation is not enough.
This is when doctors turn to v-v ecmo.
A heart can fail for many reasons including heart attack, pulmonary embolism, bad valve disease, or worsening heart failure. When a heart fails, doctors try to fix the underlying problem. They may also start medications (called ionotropes) to help improve the pump function of the heart. If medications are not enough, doctors will turn to v-a ecmo.
How long can someone stay on ecmo?
That is a complicated question. Due to the risks of ecmo discussed above, doctors try to keep patients on ecmo for as short a time as possible. Often patient will be on ecmo for several days up to 1-2 weeks. Every day, several blood and imaging tests are done to determine if a patient is ready to come off ecmo. As the technology of ecmo improves, hopefully side effects will decrease and patients can remain on ecmo for longer periods of time.
What is the difference between ecmo and a ventilator (breathing machine)?
Both ecmo and a ventilator aim to provide oxygen to the body when the patient’s own lungs and breathing are failing. The ventilator assists the patient’s own lungs by pushing oxygen with pressure into the lungs. Ecmo instead provides oxygen directly via a catheter placed in a patient’s vein or artery. We almost always try oxygenating a patient with a ventilator first. However, when a patient’s lungs are too sick for this, we turn to ecmo to assist in providing oxygen to the body. V-v ecmo provides oxygen through a vein. This blood then has to travel to the heart and be pumped around the rest of the body through arteries. Therefore, with v-v ecmo or with a ventilator, a patient must have a well-functioning heart to get the oxygen pumped throughout the body. V-a ecmo has the additional advantage of pumping blood directly to arteries. This “by-passes” the heart and is therefore the method of ecmo we use when a patient’s heart is failing.
Different methods to treat Disc problems
Hello friends, I am Dr Gaurav Khera. I am an orthopaedic surgeon, doing joint replacements and spine surgeries at the Access healthcare. Now today I will be talking about the lumbar degenerative disc disease. Now it sounds very big, but it is not as complicated as it sounds. It basically is what you people commonly know as a disc disease. So it is a fairly common problem that is seen in our population today. In fact about 30 or 40% of the patients who come to our OPD have lower back pains, some have other disc problems and very commonly seen after 40 years of age and this incidence gradually increases up to 60-70 years of age. The other ecological factors which are associated with this are, first of all smoking, secondly it is, mild to moderate trauma, thirdly its seen in people who lift heavy weights, fourth is obesity, especially central obesity, that is if you have a very heavy waistline.
Now what is Lumbar degenerative disc disease? Now, our spine is composed of multiple bones, which are starting from your neck and they come all the way down to your hip, divided into the cervical, dorsal, lumbar and sacral spine. And between these bones, there are these small pieces of discs, which act as cushions. When your body walks, these act as shock absorbers between your body’s bones. Now this discs, when these come out of their normal place, it gives or presses against the nerves which are passing through these areas and it causes pain. This is what happens in the disc disease. Basically, in the patient it will come as a lower back pain, and this pain will be travelling down to the hip, and it will also be coming down to the legs. Some people complain that as they walk, the pain increases.
They also complain of tingling numbness. They complain that sometimes their fingers or their toes are feeling numb. These are some of the very common symptoms which are being seen. Few people may have only lower back pain, and these are the people who do not have very significant disc disease. Now there are two main causes of the disc disease. First is an inflammatory reaction that occurs in the disc, and second is the micro motion instabilities that occur. Inflammatory reactions may occur as a result of some small traumas which may occur such as when you may injure your back. Such inflammatory reactions occur in the form of small swellings in the body. And micro motion instabilities are when the body ages, the disc which has an outer fibrous thick layer, that degenerates, and as it degenerates, the pulp which is there at the centre, of the discs, tends to degenerate. What I mean is it comes out of its normal space. And as it comes out of the normal place, it comes and tends to press on the nerves and these are the two most common causes.
All disc patients are not to be operated. When we get these patients, the first and foremost investigation that we do is a X-Ray. And if required, we go in for a MRI. Frankly MRI is the known standard to diagnose the disc disease. The findings of a MRI are always coordinated with the clinical findings. Once we have diagnosed that it is a disc problem, we have to establish that what the compression on the nerves is. If the nerve compression is a lot, and if we think that we cannot do anything other than surgery, then we take the patient for a surgery.
If not, we take the patient fro physiotherapy, lifestyle changes and few medications. These medications may carry on for few weeks to few months. And a lot of exercise has to be carried on regularly. Lifestyle changes such as weight loss, stoppage of smoking is very important. And if you can achieve this, then your problems are very easily solved. If you have any queries regarding your disc problems or back pains, then you can get in touch with me for the same.
You can reach me in my clinic, which is there in Indrapuri, by the name of Dr Khera’s Wellness Clinic or you can also contact me through Lybrate for the same. Thank You.
Collectively grouped under the Ewing sarcoma family of tumors, Ewing's sarcoma is the second most common form of bone cancer, which is commonly seen in children and adolescents. Very rarely is it experienced in adults above the age of 30.
Typically forming in the bones of the chest, pelvis, head, back or trunk and in the long bones of the arms and legs, Ewing's sarcoma is believed to originate in certain kinds of primitive cells. When it begins to affect similar kind of cells found outside the bone, it is usually called an extraosseous Ewing's sarcoma.
1. Similar to all types of Ewing tumors, Ewing's sarcoma is generally caused by an alteration in a certain cell compelling a gene named EWS found on chromosome no. 22 to move over to a DNA section on any one of the surrounding chromosomes resulting in the activation of the EWS gene.
2. While it is not a hereditary condition, it usually occurs after childbirth, but no substantial evidence has been found as to why it happens so.
Symptoms of Ewing's sarcoma may include:
1. Swelling and pain especially in the arms, legs, back, chest or pelvis
2. Swelling accompanied by joint immobility
3. A bone breaks having no apparent cause
4. Swelling which may or may not be accompanied by a warm, tingling sensation
5. Fever resulting from unknown causes
6. Lumps or bumps which do not subside over time
7. Abnormal weight loss
8. High levels of fatigue
9. Tumors which have spread over to the lungs may cause shortness of breath
10.Tumors spread over to the spine may cause weakness or even paralysis.
Because the symptoms of Ewing's sarcoma can hardly be distinguished from symptoms caused by other infections or injuries, an early diagnosis is absolutely necessary for a successive treatment. If you wish to discuss about any specific problem, you can consult an oncologist and ask a free question.
Ayurveda is a form of medicine that has been practiced for thousands of years and has many effective cure for some of the most complex diseases. Cancer, in this day and age, is one such complex disease and its incidence is increasing rapidly. It is always recommended to consult a Ayurveda specialist for severe cancer. Some of the common ingredients for treatment of uterine cancer through Ayurveda are mentioned here.
- Turmeric: Already a staple spice in many Indian dishes, turmeric as a herb in raw form and as a spice in powdered form, is touted the new wonder herb all across the world. It has been used as a traditional healing herb in India since ages. It has also been seen to be a very effective anti-inflammatory agent and thus it is very effective in stopping the growth of cancer cells.
- Green tea from the Camellia Sinensis plant: Green tea has been known to be effective in treating multiple types of cancer, aid in weight loss and also facilitate detoxification. Regular consumption of green tea from the Camellia Sinensis plant is known to fight the growth of cancer cells within the body; thus is a very effective in treating uterine cancer as well.
- Ashwagandha: This herb is not only used in Ayurveda, but has also been adopted by homeopathy as conventional medicine to make extracts. Ashwagandha is an adaptogen, which means it can adapt to the requirements of the body and then make the changes to provide support to the necessary areas. It is also very good at preventing the growth of cancer cells.
- Garlic: This spice is known to be good for multiple forms of cancer as it contains allicin, which is being hailed as one of the best fighters of inflammatory diseases. It also contains other types of phytochemicals and thus helps in detoxifying the body. It is very effective in fighting cancer cells and can arrest the growth of cancer within the body.
- Ginger: Ginger is extremely effective in the treatment of many ailments, if consumed regularly in controlled amounts. It has been known to be very effective in the treatment of colon cancer. Due to its properties, it is also known to be effective in the prevention of uterine and many other forms of cancer.
Ayurveda, an enigmatic yet enthralling science offers numerous treatment methods for uterine cancer. Here are a few:
- Matra Basti: Matra Basti is a special treatment in traditional ayurveda for chronic constipation, low back pain, rheumatoid arthritis, obesity, and various neurological disorders like multiple sclerosis, epilepsy, dystrophy and atrophy of nerves and muscle. In this treatment, certain herbal oils and herbal extracts are applied through the rectum on a daily basis. Matra Vasti has a lubricating, balancing, nourishing, strengthening and pacifying effect. It also works as rejuvenator, immune-modulator and nutrient and subdues elevated vata dosha. The treatment lasts for a period of 3 to 7 days.
- Pichu Dharanam for Soothing at Advance Stages of Uterine Cancer: It is a special treatment modality in Ayurveda where sterile medicated cotton swab is kept inside the vagina for a specific period of time. This comes under local treatment modalities specific to gynaecological diseases in females and is also done in ante natal care. Pichu means “cotton ball”. Yoni pichu is the application of a sterile cotton swab soaked in medicated oil or ghee in the vagina.
- Abhyanham: Abhyanga is a form of Ayurvedic medicine that involves massage of the body with large amounts of warm oil. It’s a complete body massage and really effective. The Abhyangam massage therapy is very beneficial and prevents degeneration and ceases the aging process. This therapy needs more positions to massage and comparing to other massage therapy, Abhyangam is very special. It usually involves oils prepared with specialized Ayurvedic herbs and essential oils for lymph drainage, detox, and relaxation. It has seven positions and it treats the whole body. It assures new healthy physical changes.
- Nasyam: Nasyam or errhine therapy is an Ayurvedic treatment excellent remedy for chronic sinusuitis, headache, throat diseases, epilepsy, catarrh, migraine, voice constraint, eye diseases and cervical spondylitis. In Ayurveda, the application of medical oils or powders through the nostrils is called Nasya. It is said in classical texts that the nostrils are the doorway to the brain. Nasya is an important method of treatment for illnesses of the cranial region. Nasya treatment - the forehead and neck regions of the patient are gently massaged with a suitable oil to induce sweating. Thereafter the patient is made to lie down on his back with his head bent slightly back. Warm oil is then dripped into both nostrils which the patient draws in.
Hi sir my mother 72 year old she is suffering slip disk problem mri report conclusion/impression- Mr. Imaging reveal degenerative changes affecting lumbar spine with disc bulge-herniation at l1-2, l3-4, l4-5 and l5-si levels, more at l2-3, l3-4, l4-5 and l4-s1 level (protrusion), together with ligamentum flavum hypertrophy and facetal arthropathy are producing secondary canal stenosis with narrowing of bilateral neural foraming. Canal stenosis is most sever at l4-5 level.
Breast Cancer is one of the most common types of cancer among women. In US, it is the second most common cancer to affect women, the first one being skin cancer. The disease has been such a dreadful one that the first thing which crops up on the minds of those diagnosed with the same, is whether they would survive. Nowadays, medical science has made such rapid progress in diagnosing the disease and then coming up with various treatment options, that ones who are diagnosed with cancer have high chances of survival as compared to those, who had to bear the brunt of the dreaded disease and lose their battles due to lack of advanced medical treatment.
Now, we take a look at some of the most frequently asked questions on breast cancer:
1. Which age group of women is most likely to get breast cancer?
Breast Cancer most often occurs in women who are above 40 years and risk tends to increase with age. There are certain risk factors, some of which can be controlled, which are related to lifestyle, environment, diet, while some factors cannot be controlled, top of which is age.
2. What are the signs and symptoms?
Outward signs of breast cancer are very rare. In case any outward sign does occur, the most probable ones include a lump, area around the nipple having a thickened feeling or skin around the nipple having rashes. Still, even if you come across these signs, they don’t always necessarily mean you have breast cancer, so it is always advisable to consult a doctor as and when you come across these signs.
3. Can breast cancer be prevented?
Unfortunately there is no sure way to prevent breast cancer but precautions on the part of women can definitely reduce the risk of getting engulfed by the disease. Lifestyle and environmental factors play huge role in influencing cancerous cells within a person’s body. So, maintaining healthy lifestyle and staying away from alcohol and fatty, spicy foods would go a long way in ensuring that you do not invite the risk of cancer.
4. How often should I do a breast self exam?
Breast Self Exam should be done at least once a month. You can look for any changes in the tissue, changes related to size, shape or a feeling of lump, inversion of nipple, reddish tinge on the breast skin.
5. Is breast cancer inherited?
All kinds of cancers involved changes in a person’s genes. If a woman’s mother, sister or daughter had suffered from cancer, then there is always a chance that the woman would also suffer from the same.
6. Is there a link between oral contraceptives and breast cancer?
Use of birth control pills for more than five years lead to an increased risk of breast cancer, though due to the low amount of hormones in pills nowadays, the risk is comparatively small.
7. What is preventive mastectomy?
Preventive Mastectomy refers to the removal of one or both breasts so that risk of getting breast cancer is reduced. Women who are at a high risk of breast cancer go for this option.
Liver transplantation or hepatic transplantation is the second most carried out transplant procedure in the world. It is a potentially difficult surgery that is performed by a team of two to four surgeons along with the help of anesthesiologists and nurses. It takes around 10 to 12 hours to complete the procedure as there are many anastomoses, sutures, reconnections, and disconnections, which are to be performed under the liver bed which is necessary for the transplant to be a success.
Tests required before a transplant is planned
- Computed tomography, or CT scan which employs X-rays and a computer to create pictures of the liver, showing its size and shape. CTs and chest X-rays are also recorded to evaluate your heart and lungs.
- Laser Doppler flowmetry: to check if the blood vessels to and from the liver are normal.
- Echocardiogram to check the status of heart function.
- Pulmonary function test or lung capacity test to study and determine the lungs' ability to exchange oxygen and carbon dioxide.
- Blood tests are performed to determine the patient's blood type, clotting ability, and biochemical status of blood, and to determine liver function.
The liver transplant procedure
- After an admission at the hospital, an Intravenous line is started in the patient's arm or hand. Other tubes (catheters) are put in their neck and wrist, or their collarbone or the area between the belly and the thigh (the groin). These are used to check heart and blood pressure, and to get blood samples.
- The patient is placed on the back, over the operating table.
- If there is too much hair at the surgical site, it may be shaved.
- A catheter is placed into the bladder to drain urine.
- After the patient is sedated, the anesthesiologist will insert a tube into the lungs. This is done so that the breathing can be helped with a ventilator. The anesthesiologist will keep checking the heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
- The skin at the surgical site will be cleaned with a sterile (antiseptic) solution.
- The doctor will make a cut (incision) just under the ribs on both sides of the belly.
- The doctor will carefully separate the diseased or the injured liver from the nearby organs and structures.
- The attached arteries and veins are then clamped to stop the blood flow into the diseased liver.
- The diseased liver will be cut off from the blood vessels and then removed.
- The surgeon will check the donor liver before implanting it into the body.
- The donor's liver is placed in the patient's body.
- The incision will then be closed with sutures or surgical staples.
In case you have a concern or query you can always consult an expert & get answers to your questions!
The sciatic pain caused due to a lumbar herniated disc can radiate down your legs and may make you immobile. It is quite common for a herniated disc to press against a nearby nerve and inflame, leading to pain radiating along the length of the affected sciatic nerve. For getting relief from lumbar herniated disc pain, you need to become active. Daily hamstring stretches are considered to be an effective way to tackle such pain if you do them regularly.
Here are three important hamstring stretches which will help you in strengthening your hamstring muscles:
- Seated chair stretches: This stretch is perfect for people whose mobility is limited or for those who have unusually tight hamstrings. It is carried out in a sitting position. While performing this stretch, you have to sit on a chair with another chair placed across. By resting one foot on the ground and the other on the second chair, you need to straighten your back and lean forward over the leg which is extended. Once you feel a stretch in the upper and rear thigh, you should be in that position for at least 30 seconds. You should switch legs and repeat the stretching exercise thrice for each leg.
- Towel hamstring stretch: If you like stretching while lying down, this stretch is an ideal option for you. For performing a towel hamstring stretch, you have to lie down on the floor and keep one leg flat. Tighten your abdominal muscles while you lift the other leg and keep it straight. You should wrap a belt around the elevated leg’s instep and use it for pulling back the leg towards you. Hold the position for around 30 seconds when you feel a stretch.
- Wall hamstring stretch: This stretch is for people who find the towel hamstring stretch hard to execute. For such people, extra stability can be attained by taking help of a solid surface such as a door jamb or a wall. You can rest the raised leg against the wall for support. You need to lie on the floor near a wall corner and leave one leg straight while placing the other against the wall. Your hips should be on the floor.
While you do stretches of any kind, you should only stretch as far as you are comfortable. You must not stretch to a point which causes pain. These hamstring stretches are quite safe, but you should avoid them in case of any sudden, acute pain. In case you have a concern or query you can always consult an expert & get answers to your questions!