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Varicose veins – best treatment options

Varicose veins – best treatment options

Varicose veins are a relatively common and painful condition, with over 10 million cases in India each year. Scientifically referred to as varicose or varicosities, this condition is caused by your veins becoming swollen, dilated, and overloaded with blood.

To the naked eye, varicose veins may look bluish-purple, and sometimes red. The most common cases of varicose veins are in the lower parts of your legs. This is because they are the furthest from your heart, and gravity prevents the blood from automatically flowing upwards.

Causes of Varicose veins

The primary cause of varicose veins is a problem with the way your veins function. The blood in your veins flows in one direction, controlled by valves. The function of this process is to ensure your blood is pumped effectively through the body. But in some cases, the valves stop working. This causes the blood to enlarge the appearance of your veins by collecting in them.

This condition could be brought up by other changes in your body that put a lot of pressure on your abdomen or legs. It could also be a result of your lifestyle or certain habits that you practice. Some of these have been mentioned below:

  • Pregnancy
  • Menopause
  • Work that involves standing for long periods
  • Little to no physical exertion
  • Obesity

An increase in age can also cause varicose veins, especially in individuals who are over 50 years old, as veins can weaken with age. You are likely to get varicose veins if there is a family history of the condition. 

Symptoms of Varicose veins

The most common symptoms of varicosity are the appearance of the veins. The enlarged veins are almost always superficial veins that lie just below the surface of your skin. In addition to the veins looking bluish, enlarged capillaries in the vicinity give the appearance of a spider web. This condition is known as spider veins.

In some cases, although quite rare, the affected vein could be one of the interior ones of the leg, causing more pain than usual.

Since this condition is most common in the legs, it may also be accompanied by swollen ankles and itchy skin. 

Prevention of Varicose veins

In the case of mild varicose veins, you need not visit a doctor. You can try the following tips for the prevention and treatment of varicose veins:

  • Move around more, so the pressure on your legs is relieved. Avoid standing in one place for a long time.
  • Monitor your weight carefully to ensure you are at a healthy weight. As we have mentioned, obesity can be a cause of venous diseases.
  • Incorporate exercise in your daily routine as a varicose treatment. This will improve your blood circulation and reduce the chances of you developing varicose veins.
  • Use compression socks or stockings to reduce the pressure on your legs and allow blood to flow more freely to the heart.
  • When you are sitting, keep your legs at an elevated level.

If you see that these methods are not working for you, it may be time for you to consult a vein doctor.

Varicose veins treatment options

The vein specialist will provide several procedures to treat varicose veins. The three most common varicose veins treatment methods are as follows:

1. Surgery

Varicose vein surgery is one of the main ways to address the condition if the previously suggested remedies don’t work and if varicose veins lower your overall functioning.

Endoscopic vein surgery involves blocking off the vein through an invasive process. A scope is inserted via an incision, which then blocks off the vein.

Since surgery is an invasive way to treat the condition, over time, this has been replaced by less invasive methods.

2. Sclerotherapy

This method involves injecting a solution into the vein to cause the blood vessels therein to collapse and the blood to clot. Over time, this fades into scar tissue and is no longer painful or a cause of varicose veins.

Sclerotherapy is considered a more useful way to deal with the problem of varicose or spider veins. A small Indian study found that ultrasound-guided foam sclerotherapy proved to be more effective in treating primary varicose veins than surgery.

However, it is vital to inquire about the sclerotherapy cost before choosing to go with it.

3. Endovenous Ablation therapy 

Endovenous ablation therapy can help you deal with the irritation and pain that comes with varicose veins, in a less invasive manner than surgery. In this process, the doctor burns and closes each varicose vein. This is done using radiofrequency or light energy and leaves almost no scars.

4. Transilluminated Powered Phlebectomy

Although this process is invasive, it is not as invasive as surgery. A special light known as an endoscopic transilluminator is placed under the skin using a small incision. This light is then used to cut off the problematic vein, which is removed using suction. You may have some bruising for a few days following this procedure; however, this will fade with time.

When to consult a doctor

In the case that you feel or see any of the following symptoms, you should make an appointment with a trained medical professional who can advise you on the best course of treatment.

  • Your ankles or lower parts of your legs swell up
  • Your veins cause intense pain when you are standing or walking
  • The pain does not decrease with compression stockings
  • The swelling, itchiness, colour change in your veins drastically increases suddenly
  • A ‘pulling’ feeling in your calf, along with pain and redness. If this is also accompanied by a warmth when you touch, it could indicate a blood clot that you should address immediately
  • Sores on or near the varicose veins
  • Thicker, differently coloured skin near your ankles and calves or where the varicose veins are most present

Keep in mind that not treating venous diseases in the initial stages can cause serious problems in the long run. 

Conclusion

It is in the interest of the patient to keep an eye out for any varicose veins beginning to stand out. If you just see varicose veins form, the home remedies suggested may help you control it at the outset. However, if the varicose veins interfere with your daily activities, book an appointment at the vein centre closest to you for varicose veins pain relief.

Breast pain: 10 reasons your breasts may hurt

Breast pain: 10 reasons your breasts may hurt

Breast pain, also known as mastalgia or mastodynia, is a common condition. About 60-70% of women experience breast pain at some point in their life. However, only 10-20% of these cases require medical attention.

The severity of breast pain may vary, ranging from mild breast tenderness to burning sensation or stabbing pain in the breast. Similarly, you could experience pain in both breasts or pain in one breast alone, such as pain under the left or right breast.

Breast pain causes

There are several breast pain causes; some of these include:

1. Poorly-fitted bra

One of the most typical breast pain reasons is a poorly-fitting bra. About 80% of women wear the wrong bra size.

Bras that are either too big or old and stretched out will do a poor job at supporting your breasts. Consequently, it can cause discomfort and soreness not only to your breasts but also to your neck, shoulders, and back. Conversely, tight bras can compress your chest and result in breast sensitivity.

2. Breast cysts

Breast cysts are yet another common reason for breast pain. The filling up of fluid in the lobules or ducts can result in cyst formation, which, although asymptomatic, can be rather painful during your periods.

Cysts that are closer to the surface are softer, whereas the deeper cysts are hard lumps in the breast that hurts relatively more. Hereditary could put some women at higher risk of developing breast cysts.

However, if you notice the formation of new lumps or worsening in pain, consider consulting your doctor.

3. Hormone medication

Breast tenderness and pain is a side effect of medication, hormone supplements, and replacements. Several oral contraceptives contain reproductive hormones like estrogen and progesterone, which could cause breast soreness. Thus, if you are on birth control pills or are undergoing infertility treatment or hormone replacement therapy, the medication could be the reason behind breast pain.

4. Chest wall pain

Have you noticed a sharp pain in your right breast that comes and goes as you carry out household chores or lift heavy things? The chances are that you are experiencing pain in your breast bone.

Muscular strains, characterised by sharp, shooting pain in breast, leads to sternum pain. In this case, the source of the pain is your pectoral muscles. The pecs are located beneath and around your breasts. Hence, any strain to these muscles could make it appear that you have breast pain.

Typically, this kind of pain is limited to pain in one breast.

5. Costochondritis

Costosternal syndrome, also known as Costochondritis, is an inflammatory disease of the cartilage that connects the breastbone to the rib. Women aged 40 and above are more susceptible to this syndrome. 

Those suffering from Costochondritis may also experience a burning sensation in their breast, in addition to pain in the breastbone. This condition often co-exists with autoimmune diseases like arthritis. However, it can also occur due to an injury or physical strain.

6. Fibrocystic breast changes

Fibrocystic breast changes are also known as cyclic mastalgia due to its periodic nature. It results in lumpy and swollen breasts due to the buildup of fibrous tissues and fluid-filled cysts. These cysts may enlarge before the onset of your period. The breast pain or tenderness before periods appears on the upper and outer areas of the breasts, and you may also notice nipple discharge.

Fortunately, this condition is harmless. More than 50% of women have experienced fibrocystic breast changes at some point in their lives. Further, it is more common for women between the ages of 20 and 50. 

7. Mastitis

An infection of the breast tissues can lead to mastitis. This painful condition is most common among breastfeeding women and is a result of clogged milk ducts. However, it can happen to anyone. Mastitis typically affects only one breast.

Symptoms of mastitis include swollen breasts, redness, breast tenderness, fever, fatigue, burning sensation in the breast, and chills. When left untreated, mastitis can develop an abscess. Hence, consult your physician immediately.

8. Breast Cancer

Interestingly, breast pain is rarely an indicator of cancer, as most breast cancers do not cause any pain. However, in the case of inflammatory breast cancer, the tumours can cause mastodynia and general discomfort.

If you notice painful lumps in the breast that do not subside even after menstruation, then you must immediately contact your doctor. Also, talk to your physician if you notice persistent breast pain without any known cause.

9. Menstruation

Some women experience breast pain before the start of their period. On the other hand, some develop sore breasts due to hormonal changes during the menstrual cycle. The release of hormones like estrogen and progesterone increase the size and number of milk ducts, which causes breast tenderness. In some cases, breast pain may radiate towards the armpit, arm, and back. The pain, swelling, and tenderness go away once your period ends.

10. Breast surgery

If you have undergone breast surgery, especially for cancer removal, you may experience breast pain of varying intensity. The pain could be due to the formation of scar tissues, inflammation, or nerve damage.

Patients report sharp pain in the breast for the initial days, followed by moderate pain after some passage of time. Some individuals may continue experiencing mild, persistent pain even six months after surgery.

Conclusion

Breast pain could be a common occurrence and not a cause of grave concern. Start by getting fitted for an appropriately-sized bra for extra support.

At the same time, several women experience cyclical breast pain that starts with their period and ends once their period is over. Similarly, women of reproductive age may also experience breast tenderness at some point before they reach menopause. Pregnancy and breastfeeding also lead to swollen breasts, which can cause breast pain.

Clearly, most of the breast pain causes are natural and unavoidable.

However, if you have been experiencing mastalgia for prolonged durations, new lump formations, blood discharge from nipples, and other symptoms, it is time to see a doctor.

Schedule a breast examination appointment with expert Breast cancer doctors as soon as possible.

Abnormal uterine bleeding: symptoms, causes, diagnosis and treatment
May 28, 2020|Dr. Aruna Kalra

Abnormal uterine bleeding: symptoms, causes, diagnosis and treatment

According to a nationwide, doctor-centric research study, abnormal uterine bleeding affects 10 – 30% of women in India. The research suggests that females within the reproductive group (ages 15-49) account for 82.9% of the total cases reported by doctors. As such, abnormal uterine bleeding is ubiquitous because it affects the physical, mental, socio-economic, and quality of life of an individual.

Considering the fact that it affects so many women, demystifying the condition will raise awareness and increase prevention. This article seeks to expound on some causes and patterns of abnormal uterine bleeding, its symptoms, and the diagnosis and treatment of the condition.  

What Is abnormal uterine bleeding? 

Abnormal Uterine Bleeding (AUB), formerly known as Dysfunctional Uterine Bleeding, is excessive bleeding from the uterus. Excessive bleeding occurs either during your menstrual period (heavy flow) or between monthly cycles. A normal menstrual cycle lasts for about 5 to 7 days, whereas unusual uterine bleeding can last for a long duration.  

Common causes of abnormal uterine bleeding 

To determine the causes of abnormal uterine bleeding, you have to factor in the reproductive ages of those affected. The following are some of its reasons: 

  1. Fibroids – Small or large non-cancerous muscle tissue that develops in and around the uterus
  2. Polyps – Abnormal growths which take on round or oval shapes and develop within the uterus lining and cervix
  3. Hormonal Imbalance –  When the endocrine system releases too much estrogen or too little progesterone into the bloodstream
  4. Uterine Cancer – Cancer that affects the uterus
  5. Cervical Cancer – Cancer that affects the cervix
  6. Hypothyroidism – In severe hypothyroidism, the thyroid gland cannot produce enough thyroid hormone

Apart from the causes of abnormal uterine bleeding mentioned above, here are a few others explained: 

Endometriosis

Endometriosis entails abnormalities of the lining of the uterus. In some women, this tissue that generally grows in the uterus grows outside of it. This lining settles over the ovaries, and may even find its way to the Fallopian tubes and pelvic region.

Polycystic Ovary Syndrome (PCOS) 

PCOS is a hormonal abnormality that affects 10% of women of their reproductive age. The condition is characterised by the overproduction of testosterone. Polycystic ovaries are enlarged and comprise many small follicles that do not mature. The result may sometimes lead to menstrual irregularity and unusual uterine bleeding.  

Also, Read: Meal Plan For Polycystic Ovary Syndrome Patients

Perimenopause

Perimenopause is a term used to define your transition into menopause. In most cases, women experience conflicting bleeding patterns during perimenopause. But if you are experiencing irregular or heavy bleeding more often than not, you have chances of suffering from abnormal uterine bleeding.

Abnormal uterine bleeding: signs and symptoms 

Although the signs of excessive uterine bleeding may differ from one person to another, a few of the symptoms include:  

  1. Menorrhagia – A condition wherein your bleeding is excessively heavy, or you suffer from abnormally long-period cycles
  2. When your menstrual cycles are irregular for a prolonged period
  3. Secondary Dysmenorrhea – Severe abdominal cramps experienced at the time of your monthly period, which may even continue after menses
  4. Bleeding between cycles, after intercourse, during menopause and perimenopause

When it comes to the diagnosis of abnormal uterine bleeding, your doctor will be able to understand the symptoms correctly. Do not hesitate to talk to your gynaecologist if you notice any of these signs.

Diagnosis of abnormal uterine bleeding 

Your doctor may suggest a series of tests to diagnose you. The diagnosis of excessive uterine bleeding depends on your age, situation and history. Based upon these factors, your healthcare provider may ask you the following questions:

  • A complete list of symptoms you are experiencing
  • What instigates the bleeding, and how heavy is it?
  • Are you pregnant?
  • What is your age?

The tests involved in concluding a diagnosis are as mentioned below:

  1. A pregnancy test
  2. A blood count check (to ensure that you don’t have a low blood count on account of the blood loss)
  3. A pelvic exam (an ultrasound of your pelvic area that could point out the cause of your bleeding)
  4. An endometrial biopsy (a sample of the uterine lining will be tested for cancer or a change in cells)
  5. Hysteroscopy (for a view of the inside of the uterus to look for abnormalities)
  6. An exam of the cervix
  7. A thyroid function test (to understand whether your ovaries are functioning)

Abnormal uterine bleeding: treatment and surgical procedures

The treatment options of unusual uterine bleeding depend on the causes of your bleeding. You must also consider age and whether you’re looking to get pregnant. This will help determine how best your doctor can help you.

Some of the standard treatment options women opt for: 

  • Birth Control Pills – Your doctor may prescribe birth control pills to stop your uterus lining from getting thick. The pills can also regulate your period cycle and significantly reduce your cramps.
  • Intrauterine device (IUD) – An IUD is a device used for birth control that is inserted into a woman’s uterus.  Doctors use a certain IUD known to release hormones to reduce unusual uterine bleeding considerably.
  • Dilation and Curettage (D&C) – A Dilation and Curettage procedure will ensure that the thick lining of your uterus is scraped away. The process involves opening up your cervix just enough to insert a surgical tool into your uterus. The subsequent lining sample is sent to the lab to check for abnormal tissue.
  • Hysterectomy – A hysterectomy involves the surgical removal of the uterus. The procedure will stop you from having your periods and getting pregnant. The surgery is usually considered as a last resort to stopping abnormal uterine bleeding.  

Prevention of excessive uterine bleeding  

Preventive measures for the dysfunctional uterine bleeding centre around several factors such as age, history and other underlying conditions. A few of the measures are: 

  • Sustaining a healthy weight
  • Taking your birth control pills regularly and as prescribed by your gynaecologist
  • Make sure you take your regular dose of hormone replacement therapy as suggested by your doctor

Conclusion 

As it turns out, you may experience abnormal heavy bleeding due to several reasons. But still, it is wise to rule out any signs of abnormal or dysfunctional uterine bleeding. You can schedule an appointment with a gynaecologist or obstetrician if you recognise any of the above symptoms.

5 Common cancers affecting women

5 Common cancers affecting women

Overview

After cardiovascular disease, cancer is the second-highest common cause of death in India. In cancer, the cells in our body grow and divide uncontrollably. The ailing cells have the potential to form tumours, impair the immune system and cause other changes. These changes hinder the body in functioning in a regular, healthy way.

The mortality rate of cancer is largely affected by late diagnosis. In recent years, several companies have developed new screening devices to tackle this problem.

As per a report published in Cancer India, the top five cancers in women account for 47.2 per cent of all cancers in India. 

The hopeful part is that most of the cancers can be cured if detected and treated at an early stage. Realising the early signs and symptoms of the disease and possible risk factors will help you stay informed and alert about your health.

The five most common cancers in women in India are:

1. Breast cancer

Breast cancer is the most common type of cancer in women in India and worldwide. The prevalence rate of breast cancer is 25.8 per 100000 women in India. This figure may rise to 35 per one lakh women in 2026, according to the Indian Council of Medical Research (ICMR)

Most breast cancers appear in the ducts that carry milk to the nipple. Some cancers start in the glands that make breast milk. After initial self-examination, you can detect breast cancer via ultrasound, mammogram, MRI or a biopsy.

If you haven’t already been screened for breast cancer, remember: early detection is the key to a successful treatment. Thus, it is important to be aware of all possible signs and symptoms of breast cancer, along with the potential risk factors.

Signs and symptoms

  • A mass or lump in or near your breast or armpit
  • Pain in the breast, nipple or armpit
  • Breast skin dimpling (like an orange peel)
  • Red, inflamed or thickened breast skin
  • Change in breast size or shape
  • Sunken or inverted nipple
  • Nipple discharge

Causes and possible risk factors

  • Personal or family history of breast cancer
  • Having dense breast tissue
  • Early age menstruation and late menopause
  • Older women, generally over 50 years
  • Obesity combined with low physical activity
  • Having your first child after 30 and not breast-feeding

Also, Read: What to Expect When You Are Diagnosed With Breast Cancer

2. Cervical cancer

When cancer develops in the cervix of a female, it is termed as cervical cancer. The cervix is the lower part of the uterus, which connects the body of the uterus to the birth canal (vagina). In India, it is the second most common cancer in women. Rural women are at a higher risk of developing cervical cancer than their urban counterparts.

The majority of the cases of cervical cancer are attributed to the HPV (human papillomavirus) infection. It is a sexually transmitted infection which is usually preventable with a vaccine.

Cervical cancer often goes undiagnosed for extended periods in Indian women, delaying cancer treatment. It is important to consult a doctor on experiencing any of the following symptoms associated with cervical cancer.

Signs and symptoms

  • Vaginal bleeding between menstrual periods
  • Vaginal discomfort or bleeding after sex
  • Foul-smelling or blood-stained vaginal discharge
  • Painful urination
  • Abdominal and pelvic pain

Causes and possible risk factors

  • Early marriage and sexual activity
  • Multiple sexual partners
  • Taking birth control pills for a long period
  • Frequent childbirths
  • Reproductive tract infection
  • Weakened immune system

Also, Read: Cervical Cancer – All You Need To Know

3. Oral cancer

Oral cancer is among the leading cancers in females in India. It is defined as a cancer of the lips, mouth and tongue. On the whole, oral cancer accounts for around 4 per cent of all the cancers diagnosed annually. Approximately 80 per cent of this cancer is owing to tobacco use.

If you experience difficulty in swallowing or soreness around the throat for more than two weeks, then immediately visit a doctor for proper diagnosis. Other signs and symptoms of oral cancer are:

Signs and symptoms

  • Any sore or ulcer in the mouth that does not heal within 14 days
  • Discolouration of soft tissues of the mouth
  • Tenderness or lump anywhere in the mouth or lips
  • Any abnormality in the mouth that easily bleeds when touched
  • Unexplained bleeding or numbness in the mouth
  • Chronic sore throat and husky voice
  • Difficulty in speaking or moving the jaw or tongue

Causes and possible risk factors

  • Smoking (Tobacco users are 50 times more likely to develop oral cancer)
  • Excessive consumption of alcohol
  • Excessive sun exposure
  • Family history of cancer
  • Human papillomavirus (HPV)

Get HPV Vaccinated at the CK Birla Hospital Now!

4. Ovarian cancer

The female reproductive system contains two ovaries – one on each side of the uterus. Ovarian cancer is found in the ovaries. It is the fifth most common cancer in women.

The majority of ovarian cancers are diagnosed late due to no or fewer symptoms in the initial stages. 

Let’s learn some possible early ovarian cancer symptoms that will help in early detection of this cancer.

Signs and symptoms

  • A feeling of fullness in the abdomen
  • Urgent or frequent need to urinate
  • Abdominal bloating
  • Pelvic discomfort

Causes and possible risk factors

  • Family history of cancer
  • Older age
  • Inherited gene mutations
  • Early age menstruation and late menopause
  • Obesity

5. Lung cancer

Lung cancer has been on an increasing trend among females in recent decades. Though smokers are at the greatest risk of developing lung cancer, surprisingly, it has also been rising among young, non-smoking women. 

As per a report in Biospectrum India, lung cancer accounts for 8.4 per cent of all common female cancers. To detect the disease as early as possible, you need to be aware of the symptoms of lung cancer.

You should consult a doctor when you show any of the following symptoms:

Signs and symptoms

  • A persistent cough that gets worse
  • Shortness of breath with activity
  • Coughing up blood
  • Wheezing
  • Chest, arm or shoulder pain
  • Extreme fatigue and tiredness
  • Frequent pneumonia-like symptoms

Causes and possible risk factors

  • Smoking (cigarettes, beedis, e-cigarettes, cigars, hookahs)
  • Workplace exposure to cancer-causing chemicals like asbestos, chromium
  • Indoor burning of coal
  • Air pollution
  • Radon gas
  • Personal/family history of cancer

In closing

Cancer is a fatal disease which often gets unnoticed in the early stages, especially among women. Women tend to bear and ignore the mild pains and symptoms their bodies experience as a normal work-related strain. Thus, it becomes increasingly important to be vigilant towards your health to identify this deadly disease in its initial phase. 

The bottom line is to gain knowledge about the initial symptoms of cancer that will help in early diagnosis. Additionally, knowing about the possible causes and risk factors of common cancers in females will help in preventing them to some extent. Further, treatment options like chemotherapy, surgery, radiation therapy are available and decided by the oncologist, depending on the stage and type of cancer.

Stay informed; stay healthy!

Everything you need to know about ACL injury, its diagnosis and treatment
May 27, 2020|Dr Debashish Chanda

Everything you need to know about ACL injury, its diagnosis and treatment

An ACL or Anterior Cruciate Ligament injury occurs due to activities that involve sudden and jerky movements in the knees. These injuries are highly common among teenagers that are into high-intensity sports activities. Female athletes are three times more susceptible to this injury than male athletes due to factors like genetics, strength, and anatomy. This is why it is important to study the causes, symptoms and ACL tear treatment before it leads to something severe and possibly life-long.

What Is ACL?

The anterior cruciate ligament is one of the key ligaments that help connect your thighbone and your shinbone at the knee. It is one of the four crucial knee ligaments that stabilise the knee when it rotates. When this ligament is overstretched, it can lead to a tear and eventually, an injury. 

Also, Read: Things To Know About ACL Injury

Causes of ACL Injury

Some major causes of ACL injury can include sudden knee movements that cause a ligament tear. Some of these movements include:

  1. A sudden change of direction while running
  2. Landing in an uncomfortable or wrong way on your knees after jumping, leading to the twisting of the knee or the knee bending backwards
  3. A direct injury to the knee due to a collision or hitting of an object
  4. Overstretching the knee joint
  5. Movement of knee away from the leg due to a very harsh injury
  6. Landing on one leg after jumping, like in games such as volleyball or basketball
  7. Loosening of the ligament due to repeated stretching and stress

Symptoms of ACL injury

Some major symptoms of an ACL injury include:

  1. Hearing of a popping sound in the knees
  2. The inability of the knees to take heavyweights
  3. Pain and swelling in the knees
  4. Feelings of grinding in your kneecaps
  5. Shooting pain in your knees accompanied by the inability to carry out tasks
  6. A loss in the mobility of the knees

Risk Factors for ACL injury

The people who fall under any of the following categories are at high risk for ACL and should look at possible knee ligament tear treatments and prevention for the same.

1. Previous History of ACL Injuries

The repeated occurrence of ACL is 15% higher than the development of a new case in a normal knee. The first year after the first ACL injury is the most crucial and has the highest chance of re-occurrence. If you are someone who has previously contracted this injury, you should consider proper ligament tear treatment to prevent re-occurrence.

2. Sex

As mentioned above, due to factors like strength, mobility, genetics, and muscle conditioning, female athletes are more vulnerable to this injury than their male counterparts. Research on rats suggests that a lack of testosterone in women may explain their increased susceptibility to ACL tears.

3. Sports activities

People that play sports are also vulnerable to ACL injuries. Some of these sports activities include volleyball, basketball, football, lacrosse, skiing, and tennis. These activities involve sudden, jerky knee movements and can increase the chances of ligament tears.

4. Age and lifestyle

Other factors such as age and lifestyle matter too when it comes to being a high-risk patient for ACL injuries. People with a more active lifestyle tend to develop this injury between 15-45 years of age and also due to participation in different sports activities.

How can an ACL injury be diagnosed?

If you are displaying any of the above symptoms of ACL, it is necessary to consult your doctor or a medical professional. After doing so, the doctor will check the range of motion of your knee. Depending on their observation, they could either get an X-ray done or perform an MRI if nothing stands out.

The physical exam includes checking for any swelling or pain points. There is another way of diagnosis called Lachman’s sign test. In this test, the patient is asked to lie on their back. The examiner then holds the leg and supports the thigh and calf. The knee is bent to an angle of 30 degrees, and the calf is pulled in a forward, upward motion. This test is performed on both knees, and if the affected knee shows a greater range of motion than the other knee, the ACL has probably been torn.

ACL injury treatment 

There are many anterior cruciate ligament tear treatments available, including surgical and non-surgical options. They are:

  1. Wearing a knee brace can help restrict large and rapid movements of the knee and result in a progressive ligament injury treatment.
  2. Taking non-steroidal and anti-inflammatory drugs like Ibuprofen (Advil) or Naproxen for your torn ligament in leg treatment
  3. Try going to a physiotherapist for treatment wherein they will help you in your knee ligament injury treatment with the help of exercises. Physical therapy is recommended for people with less activity, and the main aim is to restore strength while letting the ligament heal naturally.

If you seek ACL tear treatment without surgery, you can try these options before opting for surgery. If after examination, your doctor concludes that surgery is the only way to go, the following is some information on the same.

Surgical procedures

A doctor determines whether or not you require surgery for treatment for knee ligament damage based on three prime factors:

  • Age
  • Level of everyday activity
  • Medical history

Only after considering these can the doctor decide if surgery is the best option for you.

It is also important to have an informed discussion with your doctor or surgeon before you go into surgery. Educate yourself about the various post-surgery treatments and any long-term risks.

The ligament treatment is done by reconstructing the ligament with the help of grafts. These can be developed surgically or obtained from a donor. The latter is highly preferred among doctors and surgeons. These grafts act as a scaffold for your ligament tissues to grow on.

Synthetic grafts are also available in various materials. Check with your doctor and select one that is best for you since all materials have their advantages.

Conclusion

A timely diagnosis of ACL is exceptionally crucial and can benefit you in the long term if you are an athlete or heavily involved in sports activities. ACL is curable and can be treated with proper treatment while also being calm and patient. Be in touch with your doctors and other medical specialists to know better about your condition and prevent it in the future.

 

Foot and ankle pain: everything you need to know
May 27, 2020|Dr. Anuj Chawla

Foot and ankle pain: everything you need to know

As we age, joint and muscle pain become a part of our daily lives. Many older people suffer regularly owing to discomfort and immobility caused by illness in different areas of the body. One of the most universally experienced types of pain, however, is in the foot and ankle. Foot and ankle pain is exceptionally inconvenient as this restricts a basic need – walking. 

Dr Anuj Chawla (FAS) is a distinguished foot and ankle specialist in Delhi, with all the information you need about unease in your feet. This article will bring to your notice all the common causes of pain in your feet and ankle. 

A small overview on foot and ankle pain 

Throughout the years of our life, our feet undergo a lot of pressure. All the weight of our body concentrates on the surface of our feet. This puts tremendous pressure on the muscles, tissue, and bones of our legs, ankle-down. 

Over the years, our body’s mobility reduces due to several factors. These factors can either be systemic, i.e., involving blood vessels, nerves, etc. or they could be local, which includes wear and tear of joints, weak bones, deformities, etc. The wear and tear of joints in a person’s body can result in cartilage damage, which can be detrimental. 

Therefore, if you experience any signs of pain in your feet, you should consult a doctor right away and deal with the problem right at its root.

Here are some common causes of foot and ankle pain in the elderly: 

Corns / calluses 

Calluses refer to areas of thickened skin on the sole of the foot as a result of unbalanced pressure. By nature, the thick skin on our toes and heels are designed to withstand our body weight. But with time, the skin becomes prone to wear and tear. With increased pressure and decreased ability to bear it, calluses start appearing.

A callus can also hint towards underlying deformities in the feet. In some cases, it could also point towards an ulcer in a diabetic patient. It is strongly recommended that patients get their calluses checked by a foot and ankle specialist to address the problem in due time. 

Just like calluses, corns are thickened areas of the skin caused by uncomfortable footwear such as ill-fitting shoes. They are commonly seen on the outer part of the little toe and on the top skin of the small toes. Wearing well-fitting footwear is the only preventive measure one can take in this case.

Medical intervention is imperative in case corn or callus appears on the foot of a diabetic. Remedies such as corn caps and salicylic acid cream are available on the market. However, these are not recommended for people with diabetes or poor blood flow.  

Ingrown toenails 

Toes are that region of our body, which we generally neglect when it comes to hygiene. Keeping them cut and clean is fundamental to avoiding nail disorders. However, as we age, the flexibility in the joints, proper hand-eye coordination, and good vision is lost. As such, the elderly predispose themselves to nail disorders.

An ingrown nail is one such nail disorder that occurs when the side of a nail keeps growing underneath your skin. This is very painful and causes inflammation and redness. Ingrown nails can also intensify and lead to swelling and pus discharge. 

You can try some household remedies for ingrown toenails: 

  1. Soaking feet in warm water
  2. Cutting toenails straight
  3. Pushing away from the skin around the toe with a cotton ball
  4. Using over the counter medications or creams

A medical intervention involves taking oral or topical antibiotics. In the worst-case scenario, patients may have to undergo a surgical procedure to remove the nail.

Bunion 

A bunion is a deformity in the big toe where it aligns itself towards the second toe. Although it affects only the big toe, the pain can spread up to the third toe. The primary reason for bunions is the development of arthritis of the bones. However, wearing narrow-toed shoes in adulthood can also lead to the condition.  

Some remedies to relieve the pain caused by bunions are:

  1. Wearing proper shoes
  2. Exercising
  3. Equipment such as bunion pads, inserts, and arch supports

In extreme cases, the patient needs to get surgery to align the toe, where some tissue or bone from the toe might also be removed. These surgeries don’t take too long, and the patient can walk immediately afterwards with a particular shoe. 

Flat feet 

With age, the arch of the foot (tibialis posterior) stretches out and reduces the arch height. This condition is termed Adult Acquired Flat Foot (AAFD). It is also known as Posterior Tibial Tendon Dysfunction (PTTD) as it occurs due to weakness in the posterior tibial tendon.

This causes several reasons for unease, as patients experience pain in the inner and outer regions of their ankle, accompanied by swelling. In some cases, patients note a change in the shape of their feet. This causes the heel and/or front of their foot to deviate outwards. These conditions are termed heel valgus and forefoot abduction, respectively.

This condition can result in

  1. Sprains
  2. Overpronation
  3. Pain in the lower body
  4. Loss of stability

The treatment of flatfoot requires specialized knowledge in the biomechanics of the lower body region.

Flat feet are often treated with non-surgical methods at first, which includes using heel wedges, arch supports, and employing physiotherapy to strengthen the muscles of the foot. However, if these methods fail, heel shift procedures and tendon transfers are the opted methods.  

Arthritis/ osteoarthritis 

Arthritis is a condition that occurs due to wear and tear of the joints. Arthritis leads to inflammation, which can cause pain, loss of mobility in joints, and swelling. The big toe, subtalar joint, and ankle joint are the commonly hit areas, impairing the patient’s ability to walk with ease. 

Osteoarthritis entails the wearing away of the cartilage which protects the joints. While osteoarthritis is the most common, patients report cases of rheumatoid arthritis, gout, psoriatic arthritis, and post-traumatic arthritis. According to medical research, about half of the population above 60 years of age suffer from arthritis affecting their feet. 

While there is no research-based prevention measure for keeping arthritis at bay, there are some measures one can take to reduce its symptoms. These steps include:

  1. Wearing comfortable shoes
  2. Regular exercise
  3. Weight loss
  4. Massages
  5. Surgery (in some cases)

Surgical procedures involve cleaning of the joint (debridement), fusion (arthrodesis), and replacement (arthroplasty). 

Also, Read: All You Need to Know About Shoulder Arthritis and Shoulder Osteoarthritis

Conclusion 

Pain should not interfere with our quality of living, especially in this day and age of modern medicine. However, we must remain cautious of the causes of these diseases and take preventive measures to keep them away. 

If you are looking for a foot and ankle doctor in Delhi, book an appointment with Dr Anuj Chawla (FAS). He has long-standing experience in this field and is the best medical professional in the region for tackling these issues. 

10 Signs of Breast Cancer During COVID-19

10 Signs of Breast Cancer During COVID-19

Under normal situations, oncology professionals recommend women between the ages of 50 and 74 with an average risk for breast cancer to undergo annual mammogram screenings. 

But the times you’re living in are far from normal. 

Ideally, if you do not witness the warning signs, you would do well to delay your mammogram test until the COVID-19 pandemic is under control. Do not let this perilous circumstance limit your ability to check if you require immediate medical help.

But a lump in the breast is not the only telltale for developing malignant tissue. Keep an eye open for the following ten symptoms to secure the help you need.

1. Development of breast lumps

This is the most frequently spoken of breast cancer symptom, and one that you might be aware of. But not all the lumps are cancerous. 

A malignant lump in your breast would be soft and small. It can appear like a hard knot in the developing tissue. You can feel thickening within your chest or in your underarm area. 

When you distinguish these alarming lumps, be sure to connect with your medic.

2. Changes in the breast skin

It is a point of concern if you notice changes to the skin texture or the appearance of your breast. When a tumour develops in your breast, the lymph nodes will get blocked. This would cause itching and tingling across the skin of your chest.

In inflammatory breast cancer, your skin can assume a swollen and dimpled look. Your breast skin might even turn red. 

While it’s common for you to assume the colour changes in your breast for a bruise, if it doesn’t fade away soon, then it might be more serious. 

3. Swelling in Breast, Arm, and Underarm

Despite having cancerous cells in their earlier stages, your breast would look perfectly normal. But as the cancer advances, your breast swells. 

Additionally, if you’re developing a tumour in your right breast, your right sidearm and the underarm area will also swell, and vice versa. This condition occurs when the lymph nodes in your breast and arms become cancerous. 

These lymph nodes block your body fluids and alter the way they flow in your body. Therefore, if you discover any inflammation, you must schedule a consultation.

4. Discharge from nipples

If you notice any discharge other than milk from your nipples, that’s a warning sign. 

The nipple discharge could be yellow, resembling pus, or be as red as blood. It might appear as though blood pockets are floating in mucus. If the consistency of the discharge is either too runny or too thick, it could be a sign of danger. 

Since pain may or may not accompany these discharges, don’t underplay it. 

5. Excruciating pain in the breast

As the tumour in your breast develops, you will naturally experience pain as pressure is applied to different parts of your chest. So, even while feeling the mildest pain, see your doctor.

Prolonging your consultation would give room for the tumour to grow. It can reach the skin to afflict you with skin abrasions and painful ulcers.

6. Difficulty in sleeping

Of the various signs and symptoms of breast cancer, insomnia is the most neglected one. Paired with anxious thoughts and stabbing pains in your breasts, you could find great difficulty in falling asleep. 

Don’t take it lightly if you’re unable to sleep easily with zero pains. It’s always best to seek guidance when alarmed. 

7. Experiencing extreme fatigue

Irrespective of patients in their early stages of cancer or undergoing chemotherapy, feeling fatigued and lethargic is a common symptom of breast cancer.

Chemotherapy exerts a paramount of fatigue to the one undergoing the treatment. But aside from this, if you face extreme tiredness coupled with other symptoms of breast cancer, it’s time to have a word with your doctor.

8. Having stomach troubles

All forms of cancer are known to cause stomach-related ailments such as constipation, diarrhoea, vomiting, and stomach upsets. 

Ideally, patients with this symptom avoid certain kinds of food as a proactive measure to relieve digestive troubles. This leads to a lack of fibre and calcium intake in their diet. As a result, other maladies can cause greater pain and discomfort in their stomach areas. 

While medications can temporarily ease the discomfort, you must take counsel from your medic to address the malignant issue. 

9. Encountering shortness of breaths

Doctors associate generalised shortness of breath with breast cancer. This is because, as the tumour in your breast grows in size, its position against the wall of your chest can make it difficult to breathe. 

Further, if it has spread to the lungs, you can experience a shortness of breath in accompaniment with dry coughs or wheezing. 

You’re not at risk of breast cancer solely with this symptom. However, if you detect warning signs in conjunction with shortness of breath, book an appointment with your doctor. 

10. Finding difficulty in walking  and sitting

As breast cancer spreads, a variety of symptoms would surface, and one of them is finding difficulty in walking and sitting postures. 

Since the easily affected part of your body besides your breasts is your bones, you could experience pain with differing motions in your spine, pelvis, arms, and legs. This makes sitting down or walking around laborious.

When should you see your doctor?

Bear in mind that the last five warning signs might be an indication of other ailments. For this reason, it’s best not to assume that you have breast cancer when you discover only one symptom from the latter half of this list. 

Then, when should you be alarmed?

  • Formation of lumps in the breasts
  • Changes in the appearance and texture of the breasts
  • Swelling of the breasts, arms, and underarms
  • Unusual discharges from the nipples
  • Excruciating pain in the breasts

Should you feel any of these symptoms, seek medical help at the earliest or book an appointment with the best doctor near you.

A quick guide to routine antenatal scans done during Pregnancy [2020]
May 14, 2020|Dr. Astha Dayal

A quick guide to routine antenatal scans done during Pregnancy [2020]

Pregnancy is notoriously associated with dramatic physiological changes!  As your hormones steadily shift during this phase, you may realize that your weight, mood, eating habits, and even sleeping patterns seem to be going haywire. Understandably, many of these changes can be somewhat uncomfortable. Some of these changes are, however, both normal and essential for the development and health of your unborn child.

Given that every woman’s pregnancy experience is unique, the changes you experience during pregnancy can range from mild to severe and even life-threatening illnesses. Therefore, getting early and regular prenatal care becomes essential to determine if the symptoms you are experiencing are normal or not.

The World Health Organization (WHO) recommends that all pregnant women should get at least four antenatal care (ANC) assessments done by a qualified doctor or skilled attendant. But the proportion of women receiving the minimum of four antenatal assessments in India has only modestly increased from 37% to 51.2% between 2006-2016.

John Hopkins Medicine underlines that most pregnancies may progress without any complications. However, approximately 8 per cent of all pregnancies can involve some complications which, if left untreated, can harm the mother or the baby. You must, therefore, prioritise your routine antenatal scans.

Prenatal care may involve blood tests, imaging tests, and ultrasound exams, among others. These methods can help monitor your baby’s development in the womb as well as identify any ongoing health problems or existing health risks that you may have.

This article discusses some of the routine antenatal scans done during pregnancy.

Routine Antenatal scans in pregnancy:

You can schedule your first antenatal visit with your doctor as soon as your pregnancy has been confirmed. Your first appointment is likely to take place between eight and twelve weeks of your pregnancy. Throughout your pregnancy, your doctor may suggest several tests to check if both you and your baby are in good health.

Some of these tests will be a part of your routine prenatal checkups. Other tests may be voluntary and only done if your doctor thinks it may be appropriate for you to get tested. The following are the routine antenatal scans that you may experience during pregnancy:

1. Height, weight and blood pressure

During your first booking appointment, your doctor will note down your height and weight measurements to calculate your Body Mass Index (BMI). Obesity can put you at risk for complications such as preeclampsia, blood pressure, and blood clotting. Thus, if you are overweight, your doctor may advise you to lose some weight.

Additionally, your doctor will check your blood pressure on every visit. Your blood pressure can be comparatively lower in the middle of your pregnancy. But, if your blood pressure is high later in pregnancy, it could be a sign of pregnancy-induced hypertension.

2. Blood tests

On your first prenatal visit, you may have to give a blood sample. This blood sample helps determine your blood group, your rhesus status, and your HCG levels. Blood tests also check your immunity to certain diseases like HIV, Hepatitis B, and syphilis (unless you have specifically requested not to be tested for these diseases).

Apart from this, your blood sample may also be evaluated for conditions such as:

  • Thalassemia
  • Sickle cell anaemia
  • Cystic fibrosis
  • Tay-Sachs
  • Other genetic conditions

3. Urine tests and pap smear

A urinalysis helps your doctor check for potentially dangerous complications associated with pregnancy. These include urinary tract infection, preeclampsia or high blood pressure and gestational diabetes. If your doctor suspects a serious problem, he or she may send your urine sample to a lab for more in-depth testing.

A pap smear is a routine part of your first-trimester antenatal screening and will check for abnormal cervical cells. If any abnormality is suspected, your doctor may perform a second test called colposcopy.

4. Ultrasound exams

Your doctor may perform ultrasound exams at any point during your pregnancy. If you have a healthy pregnancy, however, you may only need to get two antenatal ultrasound scans done.

Your first ultrasound exam is likely to be scheduled when you around 11 to 14 weeks into your pregnancy. During this first antenatal scan, your doctor will give you the estimated date of delivery and will also identify and rule out any significant abnormalities.

A detailed ultrasound will be done again in the second trimester to look at the anatomy of the whole fetus. This antenatal growth scan is usually done around 18 to 20 weeks of pregnancy.

5. Nuchal translucency ultrasound

The Nuchal Translucency (NT) Ultrasound is an optional antenatal scan in pregnancy. This specialised ultrasound serves the purpose of screening for chromosomal abnormalities such as open neural tube defect, Down Syndrome and Trisomy 18.

The scan may be done sometime between 11 and 14 weeks of your pregnancy and is often combined with two other tests:

  • Noninvasive prenatal Test (NIPT)
  • Quad screen (also called Maternal Serum Screen, multiple marker screen, AFP, triple test or triple screen).

If any of these antenatal anomaly scans indicate that your baby is at a higher risk for certain congenital conditions, your doctor may recommend more invasive diagnostic tests such as chorionic villus sampling (CVS) or amniocentesis.

6. Glucose screening 

A glucose screening is done at approximately 26 to 28 weeks of pregnancy. This test determines your risk of gestational diabetes. Based on the results, your doctor may also recommend a glucose tolerance test.

7. Group B streptococcus

This test, done around 36 to 37 weeks of pregnancy, checks for bacteria that can cause pneumonia or other serious infections in your newborn. A swab will be used to take cells from your vagina and rectum for testing purposes.

Conclusion

Routine antenatal scanning can ensure that you have a healthy pregnancy as well as a healthy baby. All mothers-to-be are encouraged to have these scans done as recommended by your doctor from time to time.

You can make an appointment with your doctors for your care during pregnancy. Ensure that you are fully informed about all the necessary tests and treatments. Discuss all your concerns with your medical professional openly to receive the best care possible.

All you need to know about inguinal hernia | Symptoms and treatment

All you need to know about inguinal hernia | Symptoms and treatment

Do you feel pain in your lower abdomen or groin area when you bend, cough, or lift something heavy? Or, do you feel a noticeable bump around the pubic or groin area, especially when you stand up or cough?

If you answered in an affirmative to either of the above, you might have developed an inguinal hernia, and you must visit a doctor to prevent any further complications. 

To help you out, we have compiled all the information you need to recognize the symptoms of inguinal hernia and when to seek help.

What is an Inguinal Hernia?

A hernia is a common condition, which occurs when a part of an internal organ or tissue bulges through a muscle. An inguinal hernia involves a part of the small intestine or fat bulging through the lower abdominal wall into the inguinal canal or the groin area. 

Both men and women have inguinal canals – which is a passage in the lower abdominal wall that contains nerves and blood vessels. In males, it also holds the spermatic cord and the testes descend through the canal before birth. For women, the inguinal canal is the passage for the ligament that supports the uterus.

As mentioned before, a hernia in this passage can lead to a noticeable bump and may be painful during movement.

Types of Inguinal Hernia

Two types of inguinal hernia are identified, that is:

  • Indirect inguinal hernia caused by a birth defect in the abdominal wall
  • Direct inguinal hernia, which occurs due to weak abdominal wall muscles, caused by heavy lifting or straining over time

Direct inguinal hernias are most common in older adults. According to an article published by Cleveland Clinic, male adults over the age of 40 are more likely to develop an inguinal hernia. Another study conducted in India reveals that groin hernias are 20 times more common in men than women.

Health experts also agree that smoking, abdominal surgery and a family history of inguinal hernias may put individuals at a higher risk. 

When to seek help?

If you feel a noticeable bump in the groin area or experience pain during movement, it is best to get checked for an inguinal hernia. On the whole, an inguinal hernia is not a serious or fatal condition. Still, medical intervention is necessary to prevent complications such as incarcerated hernia or strangulation.

Incarceration occurs when a part of the fat or small intestine from the abdomen gets stuck in the groin area, and cannot go back into the stomach. If this condition remains untreated, the blood supply to the small intestine can be cut off (strangulation), which can have serious consequences. 

Symptoms of Inguinal Hernia

Symptoms of an inguinal hernia include:

  • A bulge in the groin area, which will be more noticeable if you stand or sit erect, cough, or strain the abdominal muscles.
  • You may feel pain or itching in the bulge at times, or mild discomfort when lifting heavy things, coughing, exercising or bending over.
  • A feeling of weakness, pressure, heaviness or burning in the groin area
  • Some men may also experience swelling in the scrotum
  • In infants, a hernia may only be visible while crying, coughing or straining during a bowel movement. The infant may be irritable and suffer from a low appetite.

Causes of Inguinal Hernia

There isn’t any single cause for hernia, but weak abdominal and groin muscles can be major contributors. Other risk factors for a hernia include family history, premature birth, chronic cough, constipation, obesity, etc.

As you can see, you cannot control many factors on this list. However, it is in your hands to eat a healthy, high-fibre diet and maintain a healthy weight. It is also advisable to not lift heavy weights and quit smoking to reduce your chances of developing an inguinal hernia.

Inguinal Hernia diagnosis 

If you or your child experience swelling, bumps or pain or pressure in the groin, it is advisable to seek immediate medical attention. 

Your doctor will ask you a few questions about your family history and lifestyle, before conducting a physical examination to feel the bulge. The doctor may ask you to sit erect, cough or strain to see if the bulge comes out.

In some instances, an X-Ray may be recommended to determine the state of the hernia, according to which your healthcare provider will prescribe the treatment.

Inguinal Hernia treatment

All hernias in the inguinal canal do not require surgery. Sometimes, a healthcare provider may ‘push’ a small inguinal hernia back into the abdomen – which can resolve the issue for good. 

However, if this approach does not work, surgery may be required for inguinal hernia repair.

Inguinal hernia repair, also known as herniorrhaphy, is of the following types:

  • Open hernia repair: In this case, an incision is made in the groin to push back the hernia into the abdomen. The abdominal wall is strengthened using mesh or stitches, to prevent the problem in the future.
  • Laparoscopic hernia repair: This is a less invasive surgical procedure using a laparoscope to repair the hernia through small incisions. It results in faster healing and recovery post-surgery. Robotic hernia repair using a laparoscope is also being undertaken at many hospitals currently.

Conclusion

Do not feel shy or afraid to discuss bumps in your groin area or pelvic region with your doctor. An inguinal hernia is a common problem, and more prevalent in male adults. Fortunately, it isn’t a serious problem and, in most cases, can be quickly taken care of by a medical professional. 

However, it is strongly recommended to contact a healthcare practitioner if you:

  • Feel any sudden pain or pressure in your groin
  • Notice a bulge in your pelvic area
  • Experience discomfort in the groin while moving or working out

Call up your doctor to discuss your symptoms openly or book an appointment at CK Birla Hospital for instant expert care.