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Learn About Acute Myeloid Leukaemia

Acute myeloid leukaemia (AML) is a type of blood cancer that starts in the bone marrow or the soft, internal section of a bone. As a vital part of the skeletal system, the bone marrow or soft tissue within the bones produces three types of blood cells: platelets, white blood cells, and red blood cells. White blood cells help the body fight infections, but in people with AML, these white blood cells fail to grow properly and subsequently transform into cancer cells called myeloid blasts. These then move from the bone marrow into the bloodstream, affecting various other body parts. If acute myeloid leukaemia symptoms are left untreated, the cancer can spread to the brain, lymph nodes, liver, spleen, skin, and cerebral spinal fluid. Symptoms of Acute Myeloid Leukaemia There are different stages of acute myeloid leukaemia: M0: Undifferentiated AML M1: AML that is less mature M2: AML that is more mature M3: APL or acute promyelocytic leukaemia M4 EOS: Acute myelomonocytic leukaemia with eosinophilia M5: Acute monocytic leukaemia M6: Acute erythroid leukaemia M7: Acute megakaryoblastic leukaemia In its early stages, the signs of acute myeloid leukaemia can be the same as flu, and you might suffer from fatigue and fever. Other common symptoms of AML include: Frequent nosebleeds Bone pain Easy bruising Swollen and bleeding gums Shortness of breath Excessive sweating, especially at night Unexplained weight loss Fatigue Fever Heavier than normal periods in women Headaches Dizziness Weakness Feeling cold all the time Joint pain Vomiting Schedule an acute leukaemia panel or a bone marrow test today to ensure you can prevent or diagnose, manage and treat acute myeloid leukaemia. Causes of Acute Myeloid Leukaemia The main cause of acute myeloid leukaemia is DNA mutations in the bone marrow's stem cells. These mutations cause the stem cells to produce more white blood cells. Since these cells are immature, they do not have infection-fighting capabilities. As they keep increasing in number, the platelets and red blood cells decrease in number, resulting in the onset of acute myeloid leukaemia. Doctors do not know what triggers the genetic stem cell mutations and why certain people suffer from this condition. But certain factors might increase your risk of developing this condition. These risk factors include the following: Being exposed to radiation of a considerable level can increase your risk of developing AML. But this usually requires exposure at the highest levels. As such, people who have undertaken radiotherapy as part of previous cancer treatment have higher chances of contacting AML. Exposure to chemicals like benzene can also increase your chances of getting AML. Benzene is commonly found in the rubber industry, petrol, and cigarette smoke, so doctors recommend quitting smoking to avoid developing AML. The ingestion of certain chemotherapy medicines for an earlier, unrelated cancer can also increase your chances of developing AML, even after several years have passed since the treatment. These medicines include mitoxantrone, melphalan, cyclophosphamide, and doxorubicin. Individuals suffering from blood disorders like myelofibrosis, myelodysplasia, and polycythemia vera are at an increased risk of developing AML. Genetic conditions like Fanconi's anaemia, Down's syndrome, Li-Fraumeni syndrome, and neurofibromatosis type 1 can also increase a person’s chances of developing acute myeloid leukaemia. Genetic predispositions can also cause AML. Treatment for Acute Myeloid Leukaemia The treatment of acute myeloid leukaemia depends on factors such as the age of the patient, the subtype of the condition, the overall health of the patient, and their preferences. There are two phases of general treatment available for the condition. These are: Remission Induction Therapy The first phase of treatment is remission induction therapy, where the objective is to kill leukaemia cells within the blood and bone marrow. However, this generally does not wipe out all of the leukaemia cells; therefore, further treatment is needed to prevent a relapse occurring. Consolidation Therapy In consolidation therapy, also known as post-remission therapy or maintenance therapy, the objective is to destroy the remaining leukaemia cells, so the condition does not return.  There are different treatments used in these treatment phases, including: Chemotherapy: It is one of the most important types of remission induction therapy, where doctors use chemicals to kill cancer cells in the body. Chemotherapy can also be used in consolidation therapy for AML treatment. Patients must stay in the hospital during chemotherapy because the treatment destroys normal blood cells as well as the leukaemia cells. The chemotherapy can be repeated if it does not cause remission. Targeted therapy: This acute myeloid leukaemia treatment focuses on certain abnormalities in the cancer cells. Targeted therapy involves using drugs to block these abnormalities, causing the death of the cancer cells. A doctor might test a patient's leukaemia cells to find out if targeted therapy might be helpful for them. This therapy can either be used alone or in combination with chemotherapy. Bone marrow transplant: This process is also called a stem cell transplant and is used for consolidation therapy. It helps re-establish a colony of healthy stem cells by replacing unhealthy bone marrow with stem cells to regenerate healthy bone marrow. Before a bone marrow transplant, high doses of radiation therapy or chemotherapy are used to destroy the leukaemia-producing bone marrow. Next, the patient receives stem cell infusions from a compatible donor. A patient can even use their own stem cells for a transplant if they have had healthy stem cells harvested before the cancer began. Clinical trials: These include different types of experimental treatments and combinations of known therapies that AML patients enrol in. Alternative medicine: There are no alternative treatments available for AML, but certain complementary solutions can relieve the signs of this condition, such as massage, acupuncture, meditation, exercise, and relaxation activities, like tai chi and yoga. Bottom Line Approximately 2 out of 3 patients suffering from AML go into remission following chemotherapy. Remission means the patient does not exhibit any symptoms of the disease anymore. Patients who have yet to achieve remission fall in the acute myeloid leukaemia ICD 10 class,a medical classification for patients who have not yet achieved remission. In such patients, there are detectable cancer cells in the bone marrow, and the normal healthy cells cannot grow properly. Visit a doctor today to schedule an acute leukaemia panel or a bone marrow test to ensure you can prevent or diagnose, manage and treat acute myeloid leukaemia.

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Disease

ESR Blood Test: Possible Reasons For High ESR Levels

Erythrocyte Sedimentation Rate (ESR) tests are frequently carried out as part of routine blood panels. An ESR test is a type of test that measures how fast the red blood cells (RBCs) in your blood settle down inside a test tube. RBCs typically have a slow settling rate. However, if your tests show a high settling rate, i.e., high ESR levels, they may indicate a diseased state in your body, which appears as high ESR symptoms.  Before we understand what causes high ESR levels, let’s know what an ESR test is and how it is useful. What is an ESR Test? ESR is an abbreviation for “Erythrocyte Sedimentation Rate.” ESR blood test is also commonly called a “Sed rate test.” ESR tests calculate how fast the erythrocytes, or red blood cells, in your blood settle down in a test tube. It indirectly measures the level of specific proteins that facilitate the settling down of blood cells. These protein levels provide information about the state of inflammation in your body. What Do High ESR Levels Mean? When the body is diseased or infected, the immune system triggers a response to fight the infection, and in doing so, the level of these proteins increases in the body. As these proteins increase, they cause clumping of the RBCs together, which increases their settling rates. (Tishkowski, K. et al., 2022) Therefore, high levels of ESR usually mean that the body is currently fighting a disease or infection. For certain chronic disorders, like  Inflammatory diseases Autoimmune diseases Chronic kidney diseases Arthrits,  ESR tests are used to monitor the stages of disease and development. However, the Erythrocyte Sedimentation Rate/ESR test is not diagnostic for any specific disease. It is combined with other tests and symptoms to determine whether there is increased inflammation in the body and, consequently, disease. When Does The Doctor Recommend an ESR Test? If your doctor suspects you have an infection, they may recommend the ESR test. However, ESR tests are typically part of routine blood panel screenings, so they do not need to be ordered separately. What are The Symptoms of High ESR Levels? Since ESR levels are determinants of disease and infection, high ESR symptoms typically show up in following as symptoms associated with symptoms & illnesses such as: Headache Fever Joint/muscle pain or stiffness Loss of appetite Abnormal weight loss/weight gain Anaemia  This list of symptoms is not exhaustive. High ESR symptoms can appear different and are best evaluated by a physician.  What is The Normal Range for ESR Levels? High ESR levels correspond to high protein levels in the blood that cause faster clumping of RBCs.  The ESR test measures in millimetres (mm) the distance between the clear liquid (plasma) at the top of the tube and your red blood cells after an hour. The normal range is: 0 to 15 mm/hour in men whose age is <50 years 0 to 20 mm/hour in men >50 years of age 0 to 20 mm/hour in women <50 years of age 0 to 30 mm/hour for women above 50 years of age What Can Cause High ESR Levels? High ESR levels can be due to several conditions. Most of them are inflammatory diseases, which heighten the immune system’s response and cause high ESR symptoms. Some of them include: Inflammatory infections that have invaded the blood, i.e., systemic inflammatory infections. These include infections affecting the bone, heart, skin, lungs, etc.  Tissue injury or ischemia (tissues suffering from lack of blood supply) Traumatic events or accidents Certain types of cancer like leukaemia, myeloma, lymphoma, etc. Diabetes Heart disease  Kidney disease Vascular diseases like atherosclerosis, high blood pressure, etc. Obesity Thyroid disease Rheumatic fever Autoimmune disorders like lupus, arthritis, etc. This list of conditions is not exhaustive. High ESR symptoms can also be caused by other conditions depending on gender, medical history, and overall health.  Medicines like birth control pills, vitamin A supplements, cortisone, methyldopa, quinine, and theophylline may also affect your ESR test results.  Some conditions, like pregnancy, advanced age, and even anaemia, can result in high ESR levels. Therefore, it is not always necessary that high ESR symptoms are due to any disease or infection.  What Do I Do if I Have High ESR Levels? The best thing to do after receiving a report showing high ESR levels is to wait for your physician to make an accurate diagnosis based on your other tests, gender, age, and overall health. Just because you have high ESR levels is not an accurate assessment of an underlying disease or condition in your body.  For the doctor to make an accurate assessment, it is imperative to provide correct information about your medical history and any medicines you are on - as certain supplements can affect your ESR levels. The normal range of ESR levels is subject to change based on the labs, the tested person, and gender.  Not just that, a moderate ESR level may be an indicator of pregnancy or menstruation rather than an inflammatory disease, making it necessary for the physician’s diagnosis rather than just the ESR levels. Your physician may also consider ordering more tests to make an accurate diagnosis.

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Disease

Breast Cancer: Early Warning Signs You Must be Aware of

Breast cancer happens to be the most common cancer among women globally. Though it may affect both men and women, breast cancer is more common in women. According to the epidemiological studies, the global burden of BC is expected to cross almost 2 million by the year 2030[2]. Even in India, the newly reported cases of breast cancer have significantly increased. Despite multiple campaigns and efforts by the Government and private organizations, the awareness around breast cancer remains low, especially in sub-urban and rural India. It is critical to understand that cancer can be defeated if diagnosed at early stages. Take a look at some of the early symptoms of breast cancer    Mutations in BRCA1 and BRCA2 genes are associated with breast cancer. A BRCA 1 and 2 profile test is ordered in Individuals with a strong history of breast or ovarian cancer.   Early Symptoms of Breast Cancer: The most common symptoms of breast cancer include:  Changes on breast skin, such as swelling, redness, or other visible differences in one or both breasts A lump or a mass or nodes felt on or inside of the breast or armpit An increase in size or change in shape of the breast(s) (not linked with puberty in young girls) Discharge other than breast milk from nipples Pain or ulceration in/on any part of the breast  Inward pulling of the nipple or pain in the nipple area Not all women with breast cancer experience the same symptoms. They can vary to some extent from person to person. A study has reported that women aging above 40 with high cholesterol were 45% less likely to develop breast cancer than those without high cholesterol. Track your cholesterol levels from time to time.   Early Detection Saves Lives It is common for women to ignore a doctor visit owing to the privacy concerns and stigmas associated. Do not hesitate to consult a doctor if you notice any early warning sign. What Can Put You at Risk of Breast Cancer? Risk factors that cannot be changed (non-modifiable risk factors) Advancing age: Most breast cancers are diagnosed after age 50. The risk for breast cancer increases as a woman gets older. Reproductive history: If a woman got periods before age 12 and had menopause after age 55, this exposes her to hormones for a longer period, that can increase the risk of getting breast cancer. Dense breasts: Women with dense breasts are more likely to get breast cancer. Family history of breast or ovarian cancer: The risk of getting breast cancer for a woman goes up if her first-degree relative (mother, sister, or daughter) has breast or ovarian cancer. Risk Factors that can be controlled (modifiable risk factors) Sedentary lifestyle: Women who are not physically active have a higher chance of getting breast cancer. Being overweight: Unhealthy weight or obesity increases women's risk of getting breast cancer than those who have maintained a normal weight. Reproductive history: Having the first pregnancy after age 30 and not breastfeeding can raise breast cancer risk. Alcohol consumption and smoking: Several studies have shown that drinking alcohol and/ or smoking increase a  woman’s risk for breast cancer. Tips to Cut Down The Risk of Breast Cancer Get involved in physical activity. Exercise regularly Maintain a healthy weight Limit alcoholic drinks and quit smoking, one step at a time If you have a family history of breast cancer or inherited changes in your BRCA1 and BRCA2 genes, talk to your doctor about other ways to lower your risk. A simple habit to keep yourself safe from breast cancer A breast self-exam is a simple check-up which women can do at home to look for changes or problems in their breast. This method requires a woman to look at herself and feel each breast for possible lumps, distortions or swelling.  Here is How You Can Perform Self-Breast Examination: Step 1 Undress from the waist up and stand straight with your hands on your waist in front of a large mirror in a well lighted room. Take your time and observe your breasts. Look for any changes in shape, size or position, or any change in skin around it. Check if there is any puckering, dimpling, sores or discoloration. they might not be equal in size or shape and that’s perfectly okay. If you notice any change, bulging of the skin, visible distortion or swelling, you should bring it to the notice of your doctor. Check your nipples, examine them carefully for any sores, peeling or change in their direction- a nipple that has changed position or has redness, rash or swelling. Step 2 Raise your arms high and look for the same changes in the mirror. See if there is any sign of fluid coming out of any nipple,  it can be watery, milky or yellowish fluid or even blood. Step 3 Lie down on a bed and then touch your left breast with your right hand and vice versa. With the fingertip pads of your hand check your breast using a firm smooth circular motion. Examine the entire breast from top to bottom, side to side- from your collar bone to the top of your abdomen, from your armpit to your cleavage. Follow a pattern so as to cover the whole breast area. Start from the nipple, moving in larger and larger circles until you reach the outer edge of the breast. Or as more women prefer, you can also move your finger pads up and down vertically, in rows like while you are mowing a lawn. Be sure to check all the tissues from the front to the back of your breast Step 4 Feel your breasts while standing or sitting. Cover your entire breast, using the same movements described in the previous step. Do not panic if you feel a lump or something unusual while you are self-examining yourself. There can be a number of causes behind the changes, not just cancer. It might be due to hormonal changes, a benign breast condition or an injury. Consult a doctor and clear any doubts.   Breast Cancer Screening One should not depend only on self-exam to rule out cancer. No single test can detect all breast cancer early but breast cancer organizations believe that performing a breast self-exam along with other screening methods can increase the odds of early detection. Regular physical examination by a doctor, mammography and if necessary ultrasound or MRI; all or any might be needed. Apart from breast self-examination, certain imaging tests can help learn more about your breasts and detect any disease even before it gives symptoms: Mammogram. This detailed X-ray gives doctors a better view of lumps and other problems. Magnetic resonance imaging (MRI). This body scan helps create detailed images of the insides of your breasts. Biopsy. For this test, the doctor removes tissue or fluid from your breast and looks at it under a microscope to check for cancer cells and, if they’re there, learn which type they are. Common procedures include: Fine-needle aspiration Core-needle biopsy Surgical (open) biopsy Lymph node biopsy Image-guided biopsy Remember, breast cancer can be treated. The key to treatment is early detection and timely adequate care. Just take care of yourself and stay aware of warning signs.  

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Disease

Liver Cirrhosis: Symptoms, Tests and Treatment

Liver is one of the major abdominal organs in humans performing the important function of metabolism of carbohydrates, proteins and fats along with detoxification of harmful substances and toxins from the body by production of bile. It also functions as a major site for production of proteins and clotting factors. It also serves to store glycogen reserves for the body as well as storage of important vitamins and minerals. Keep an eye on your liver health with a liver function test.   Here, we have discussed late-stage liver disease called liver cirrhosis, a condition in which the normal architecture of the liver is replaced by fibrotic tissue. Usually after cirrhosis sets in, it is irreversible. As the normal functions of liver are hampered due to fibrosis in liver over time, multiple complications arise, and the most important and troublesome of it is portal hypertension, where blood coming from portal vein (draining blood from entire GIT) toward liver faces excessive resistance due to fibrosis in the liver. Clinically patients with portal hypertension are identified by presence of low blood platelet count and enlarged spleen. Symptoms of Liver Cirrhosis The clinical signs and symptoms in cirrhosis mimic the level of fibrosis in the liver. The early signs usually include feeling tired or weak, loss of appetite, unintentionally losing weight, nausea, vomiting, mild pain or discomfort in the abdomen. Other features associated with loss of normal liver functions are development of jaundice coagulation disorder, encephalopathy, etc. While any liver insult can ultimately lead on to cirrhosis unless intervened in time, the most common causes are chronic alcohol use, chronic viral infections affecting liver like hepatitis B and C viruses, biliary cirrhosis, autoimmune liver inflammation and rarely some inherited liver disorders. Overall chronic alcohol consumption remains to be a major cause for cirrhosis in India and worldwide. The accurate diagnosis of alcohol causing liver cirrhosis requires accurate history regarding the amount and duration of intake along with corroborative symptoms like vague upper abdominal pain, nausea, vomiting, diarrhoea and even malaise. Meanwhile a few patients may present straight away with complications of cirrhosis like abdominal distension, edema and even gastrointestinal variceal haemorrhage. Test for Liver Cirrhosis Laboratory investigations may reveal signs of acute blood loss as in anemia along with nutritional deficiency with low platelet counts commonly. Liver function tests may show signs of mild increase in serum bilirubin as fibrosis in liver hampers its elimination along with elevation in levels of liver enzymes in blood, both ALT and AST are elevated but AST levels higher than ALT approximately in a ratio of 2:1 are typical of alcoholic liver disease and cirrhosis. Coagulation profile may show increased PT time. Pathological confirmation of cirrhosis can be obtained with the help of liver biopsy. For patients with suspected viral cause for cirrhosis blood tests may be done for detecting HCV RNA, HBsAg, HBeAg and Anti HBe levels along with quantitative HBV DNA levels. For autoimmune causes of cirrhosis, blood levels of antinuclear antibody (ANA) or anti-smooth-muscle antibody (ASMA) may be done. Anti-Mitochondrial auto-antibodies (AMA) are present in patients developing cirrhosis due to biliary cause along with other signs of cholestasis. Fibroscan may help detect the level of fibrosis in the liver and the need for liver transplant in future. For patients who have risk factors associated with development of cirrhosis it is prudent to rule out development of portal hypertension at the earliest. One should be vigilant for development of ascites and features of hypersplenism like low platelet counts (thrombocytopenia) and low WBC counts (leukopenia).  It is important to rule out variceal bleeding in suspected patients at onset of cirrhosis with the help of endoscopy. Ascitic fluid study may be done to rule out other causes for it. Apart from these radiological investigations like CT scan or MRI abdomen should be done to evaluate the level of cirrhosis and portal hypertension. Treatment for Liver Cirrhosis   Management of people with cirrhosis primarily revolves around 2 main components- first managing the etiology causing it and other managing the complications arising due to cirrhosis. All the complications arising due to cirrhosis require specific management. In general, the main treatments include reducing salt from your diet and taking a type of medicine called a diuretic. For people developing liver cirrhosis due to excessive consumption of alcohol abstinence is the cornerstone of therapy. Patients who are unable to abstain from alcohol are shown to have significantly low 5 year survival. Occasionally patients with alcoholic cirrhosis have been shown to benefit from the use of glucocorticoids or oral pentoxifylline (drug causing decrease in pro inflammatory cytokines). For patients developing cirrhosis due to viral etiologies antiviral drugs have shown to benefit. For Hepatitis B virus Entecavir or tenofovir are useful, and for patients with cirrhosis due to Hepatitis C Virus direct antivirals have replaced the use of pegylated interferon and ribavirin. For patients developing cirrhosis due to autoimmune inflammation of the liver, immunosuppressive therapies are useful. UDCA is shown to help cirrhotic patients with etiology of biliary stasis. Managing complications arising due to cirrhosis revolves around managing complications of portal hypertension. The measures revolve around managing portal hypertension and ascites. In people with advanced cases of liver cirrhosis, a liver transplant may be the only treatment option as the liver may not be functional. Make sure to follow your doctor's advice and get all tests done as advised.

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Disease

Kidney Biopsy : Procedure, Test, and Report

Kidney biopsy is a procedure to procure tissue samples from the abnormal kidney with an aim to identify the pathology. This test is also called renal biopsy test. It helps to correctly diagnose the various diseases, as well as help healthcare professionals to plan treatment and foretell associated prognosis. During the procedure, the tissue samples will be collected by your health care professional and then marked and labelled for identification before sending it to a pathologist for careful assessment under microscope. The reporting usually takes around 5 to 7 days depending on available laboratories and logistics. Make sure to get your kidney biopsy test report analyzed through an expert. Who needs a kidney biopsy? Kidney is your main excretory organ and helps the body to eliminate a variety of toxins from the body by producing urine. It also helps the body to maintain normal levels of various electrolytes in the body. The kidneys produce an average of around 2 litres of urine per day in a healthy adult. While most kidney problems are identified with simpler investigations like routine urine examination, urine gram stain and culture sensitivity, some people may need to undergo ultrasound of kidneys and on rare occasions require radiographic CT and special X Ray images. However at times when these investigations are not enough to correctly diagnose the pathology, a kidney biopsy is planned. Some of the indications of a kidney biopsy are as follows Blood (haematuria) or protein (proteinuria) in the urine Abnormal blood test results suggesting a kidney cause Acute or chronic kidney diseases where other investigations have not yielded fruitful results Nephrotic syndrome (a condition involving excessive leakage of proteins in urine) Glomerular disease (condition affecting the filtering units of the kidney) To determine the results of ongoing treatment like if the patient is improving or deteriorating In people with deteriorating kidney functions post-transplant, it helps to identify a specific cause and even save the transplanted kidney at times. In diagnosis of suspected kidney tumor. Other unusual or special conditions. How do you prepare yourself for a kidney biopsy? The risk of kidney biopsy though very small is not negligible and the same should be understood from the doctor before signing the consent for it. You are advised to disclose all your medical history to your doctor in advance like any history of other diseases like diabetes, high blood pressure, thyroid problems or any disease pertaining to heart or breathing or even a history of stroke. Any history of bleeding disorders must be told to your doctor. Disclose all the medications you are presently consuming especially if you are on blood thinners, non-steroidal anti-inflammatory drugs (NSAIDS) and aspirin. The most common complication is bleeding which may require blood transfusion or even surgery at times. For patients on aspirin medication should be stopped a week before surgery to avoid increased risk of bleeding. Medications to control high blood pressure may be taken till the morning of the procedure. Blood work up before the biopsy is done to rule out any pre-existing bleeding disorder, blood infection and low haemoglobin. You may also be advised to undergo investigations like chest X-Ray, ECG, Ultrasound and some routine blood work up prior to the procedure to determine the safety of anaesthetic agents You are advised to disclose any allergies if any specifically to contrast agents. The biopsy procedure may involve general anaesthesia, so patients are advised to have 6 to 8 hours of fasting before the procedure. Kidney biopsy test price may vary from lab to lab. Always book your test through a trusted lab partner. How is kidney biopsy done? Kidney biopsy is usually performed by a nephrologist or a radiologist. There are various methods to obtain a biopsy sample from the kidneys. The most commonly used approach is a percutaneous approach, however other approaches which can be employed to secure a tissue sample are laparoscopic, open and rarely trans-jugular. A laparoscopic approach involves the use of a thin biopsy needle through your skin to acquire samples of your kidney tissue. The procedure is usually completed within an hour. The patients are advised to lie prone with a firm support under the belly unless biopsy is indicated in a transplanted kidney. Special circumstances like obesity or pregnancy may require lying down, seated, or other comfortable positions. Procedure requires intravenous (IV) or local sedatives to help you stay comfortable during the procedure. Radiological assistance may help guide the location, depth and angulation of biopsy needles to secure adequate biopsy samples. Finally the desired puncture site is cleaned with an antiseptic solution to avoid infection. The health care professional might ask you to withhold your breathing during the biopsy to avoid damaging blood vessels and normal organs. The procedure does not require any stitches and just a normal dressing is sufficient at the puncture site. Post kidney biopsy care and risks Post procedure the patients are observed for signs of bleeding with continuous monitoring of vitals. Typically patients are advised bed rest for a duration of 12 to 24 hrs. Patients are advised to refrain from heavy lifting, strenuous exercise and competitive sport for a couple of weeks post procedure. While minimal amounts of blood in urine post biopsy is expected, passage of blood in urine beyond 24 hrs of biopsy is unusual and requires urgent attention from your concerned doctor. Pain at the site of biopsy is mild and usually lasts only for a few hours post procedure, however continuous worsening of pain requires thorough evaluation. Other red flag signs are unable to pass urine, high fever or have loss of consciousness post biopsy. Pain, redness, swelling and oozing of tissue fluids from the biopsy site indicate infection. The biopsy report takes around 5 days however you may have a provisional report in a couple of days.

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When Should You Get a Mammogram for Breast Examination

  What is a mammogram? A mammogram is an X-ray of the breast used by doctors as a screening tool for breast cancer and to detect abnormalities in breast tissue. A mammogram is considered a useful test to identify breast cancer early, even before symptoms develop.  In a few cases up to three years before they can be felt or detected. This is called a screening mammogram. While a diagnostic mammogram is advised by a healthcare professional in case you develop any new symptom, such as a lump, pain, nipple discharge or breast skin changes. Breast cancer is the most prevalent cancer worldwide and is one of the leading causes of death in women. Although treatment approaches for breast cancer continue to improve, early diagnosis with the help of screening mammograms has significantly reduced the cancer-related deaths and impacted the survival rates of these patients. Please note that not all breast lumps are breast cancers. Your doctor can ask for specific tests to differentiate between a cancerous and a noncancerous mass. Why is a screening mammogram different from a diagnostic mammogram? A screening mammogram is a routine, in most cases done annually to check for signs of breast tissue abnormalities before you have symptoms. It typically includes at least two pictures of each breast taken at different angles, from top to bottom and from side to side. However, you can undergo a diagnostic mammogram if your screening mammogram detects an abnormal tissue in your breast. It includes extra views and utilizes additional imaging techniques which are supervised by the radiologist at the time of the study. Who all should undergo a mammogram? Various organizations such as American College of Obstetricians and the American College of Radiology, recommend an annual screening mammogram, starting at age of 40 years for all women with an average risk of developing breast cancer.  The American Cancer Society recommends the following: Women with age 40 to 44 years should have the option to start annual breast cancer screening with mammograms. Women with age 45 to 54 years should undergo mammograms every year. Women who are 55 and older can choose to get mammograms every 2 years, or can continue yearly screening. Screening mammograms should be continued if a woman is in good health and is expected to live 10 more years or longer. All women should be aware with the benefits, limitations, and potential harms associated with breast cancer screening.    Occasionally, males who are at high-risk of developing breast cancer because of their family history may also get screening mammography. However, about 1 out of 100 males develop breast cancer.   Besides, your healthcare provider may ask you to take annual screening mammograms if you have any of the following risk factors: Family history of breast or ovarian cancer Personal history of breast cancer Inherited genetic mutations Certain noncancerous breast diseases such as atypical ductal hyperplasia or lobular neoplasia Dense breasts. How is a mammogram done? A mammogram is a special X-ray designed to check only breast tissues. You will stand in front of the machine and a technician will place your breast on a plastic plate Another plate, known as paddle will firmly press your breast from above which will flatten it, you might feel some pressure at this moment These two plates will hold the breast still while the X-ray is being taken The machine creates X-rays that pass through your breast to a detector located on the opposite side The detector transmits electronic signals to a computer to form a digital image These steps are repeated to capture side views of the breast for both breasts. How can you prepare yourself for a mammogram? Although getting a mammogram is not usually an uncomfortable procedure for most women, it takes only a few moments and any discomfort, if present gets over soon. You will be required to remove all clothing and jewellery from your waist up for the imaging procedure. Points to consider while scheduling your appointment for mammogram: If you have been recently vaccinated for COVID-19, and are due for a mammogram, ask your healthcare provider for how long you should wait after vaccination to get your mammogram done Avoid scheduling your mammogram the week before you get your period or during your period as your breasts may be tender during this time, which could make it uncomfortable Try to inform your doctor if you are breastfeeding, pregnant or suspected to be pregnant If you have breast implants, do not forget to mention it to your healthcare provider. There are certain guidelines that you are required to follow on the day of your mammogram: Follow your normal routine including regular medicines You should remember to not apply the following substances as they can appear as white spots on the image and will interfere with the accuracy of mammogram: Deodorants Body powders Perfumes Ointments or creams on your breasts or underarms. How safe are mammograms? Although mammograms expose your breasts to small amounts of radiation, its benefits outweigh any potential harm from the radiation exposure.   Do you feel pain during mammograms? A mammogram experience can be different for different people. The level of discomfort that you feel depends on the following factors, such as: The size and density of your breasts The compression your breasts need while capturing the image If you are having or about to get on your period as your breasts may be more tender and sensitive to compression The skill of the radiology technician You will feel less discomfort if you are relaxed and position yourself in the best way for good images. What does the result of mammogram signify? If your mammogram is normal, continue to get mammograms according to recommended time intervals. Screening mammograms are most beneficial when a radiologist can compare them to your previous mammograms to analyse the changes in your breasts. If your mammogram is abnormal, and shows one or more suspicious regions, it does not necessarily mean that you have cancer. You will be advised to undergo additional mammogram views, other imaging tests including a breast ultrasound, or a breast biopsy. In nutshell, mammography is a fast and safe procedure. A mammogram can save your life as early detection of breast cancer reduces your risk of dying from the disease by 25-30% or more. Consult your doctor about your need for mammograms, so you can make sure to start screening as early as possible. When did you have your last health check up? Book one now.

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Disease

Kidney Cancers: Symptoms, Diagnosis and Treatment

Kidney cancers are predominantly a disease of old age with most patients diagnosed beyond 60 years of age. Kidneys are a pair of excretory organs located in the abdomen. Apart from their role in removal of toxic metabolic by products from the body they are also critical in maintaining the body electrolyte levels and blood pressure. Who may get it? The disease is seen to be related with carcinogenic exposure like smoking and is frequent in people employed in the dry cleaning industry having exposure with gasoline, solvents and heavy metals. The risk is also high among obese and hypertensive patients with long history of exposure to diuretic therapy and NSAIDs (pain killers). Apart from this patients with other benign kidney diseases and those having prolonged history of dialysis are also at increased risk of developing kidney cancers. As per some experts, the risk of Kidney Cancer is gradually growing due to a change in lifestyle and unhealthy food habits in urban cities.   Symptoms of Kidney Cancer Kidney cancers are most commonly localised to the kidney at diagnosis however they have a potential for spread via blood and lymph to various organs with lungs, bone, brain and liver being the most common sites of spread. Classically patients with localised kidney cancers present with symptoms of flank mass, pain and bleeding with urination. In a person presenting with cancer being spread to other organs (metastatic disease), the symptoms may vary from persistent pain in back to headache, vomiting, blurring of vision, seizures and difficulty in breathing.   Diagnosis of Kidney Cancer Usually, a physical examination along with medical history can provide a lot of information to your doctor. He or she will enquire about signs of kidney cancer and other health problems. Many times, an abnormal lump is felt when the doctor examines the belly. Most patients are diagnosed with the help of radiological imaging tests which require use of pre and post contrast CT and MRI images. Kidney biopsy and non-contrast Diffusion weighted MRI are useful in certain clinical scenarios. While most patients with radiological enhancement are correctly diagnosed as kidney cancers, as many as 20% of them are wrongly diagnosed making radiological diagnosis unreliable. Doctors usually recommend a complete blood count for preliminary investigations. People with kidney cancer can have anemia (having too few red blood cells) very commonly, some may have too many red blood cells (called polycythemia) as well. Other lab tests include kidney function and urine analysis. These results become important for further imaging tests or if surgery is planned. The most common benign kidney lesions confused with malignant disease radiologically are fat containing lesions of the kidney. While increasing tumor size on radiological imaging increases the likelihood of kidney cancer, a certain diagnosis requires kidney biopsy. It is majorly done for a certain group of people, those having advanced kidney cancer where the tumor has already spread.   Treatment of Kidney Cancer Fortunately, most kidney cancers are diagnosed as localised disease as small renal masses. Historically these localised kidney cancers were treated with radical nephrectomy which required complete removal of kidneys but recently the treatment guidelines have evolved with acceptance for partial nephrectomy as well as active surveillance in selected patients. Partial nephrectomy requires complete removal of the tumor with maximum preservation of normal functioning kidney tissue on the affected side. For larger localised kidney cancers where complete removal of tumor anyway results in unacceptable residual functioning of kidneys on the affected side, the radical nephrectomy is preferred over partial nephrectomy. Generally localised tumors beyond 7 cms are considered unsuitable for kidney preservation via partial nephrectomy. For advanced metastatic disease, maximum removal of tumor tissues via nephrectomy and even removal of tumor from metastatic sites followed by systemic therapy is an accepted approach. Kidney cancer is a very vascular tumor and hence most systemic therapy in kidney cancers are targeted to block the generation of new blood vessels which are required for facilitating spread of kidney cancer. Overall localised kidney cancers have good prognosis post treatment however for metastatic disease prognosis depends on factors like general well being of the patient, anaemia, high blood calcium and high blood WBC & platelet cell counts at the time of diagnosis. After treatment, it is advised to visit and consult your doctor for follow-up check ups or routine examinations.  

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