Tag: Biopsy

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Diagnonistic Test

Liver Biopsy

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In a liver biopsy (BYE-op-see), the physician examines a small piece of tissue from your liver for signs of damage or disease. A special needle is used to remove the tissue from the liver. The physician decides to do a liver biopsy after tests suggest that the liver does not work properly. For example, a blood test might show that your blood contains higher than normal levels of liver enzymes or too much iron or copper. An x ray could suggest that the liver is swollen. Looking at liver tissue itself is the best way to determine whether the liver is healthy or what is causing it to be damaged.

Preparation
Before scheduling your biopsy, the physician will take blood samples to make sure your blood clots properly. Be sure to mention any medications you take, especially those that affect blood clotting, like blood thinners. One week before the procedure, you will have to stop taking aspirin, ibuprofen, and anticoagulants.

You must not eat or drink anything for 8 hours before the biopsy, and you should plan to arrive at the hospital about an hour before the scheduled time of the procedure. Your physician will tell you whether to take your regular medications during the fasting period and may give you other special instructions.

 

Procedure
Liver biopsy is considered minor surgery, so it is done at the hospital. For the biopsy, you will lie on a hospital bed on your back with your right hand above your head. After marking the outline of your liver and injecting a local anesthetic to numb the area, the physician will make a small incision in your right side near your rib cage, then insert the biopsy needle and retrieve a sample of liver tissue. In some cases, the physician may use an ultrasound image of the liver to help guide the needle to a specific spot.

You will need to hold very still so that the physician does not nick the lung or gallbladder, which are close to the liver. The physician will ask you to hold your breath for 5 to 10 seconds while he or she puts the needle in your liver. You may feel pressure and a dull pain. The entire procedure takes about 20 minutes.

Two other methods of liver biopsy are also available. For a laparoscopic biopsy, the physician inserts a special tube called a laparoscope through an incision in the abdomen. The laparoscope sends images of the liver to a monitor. The physician watches the monitor and uses instruments in the laparoscope to remove tissue samples from one or more parts of the liver. Physicians use this type of biopsy when they need tissue samples from specific parts of the liver.

Transvenous biopsy involves inserting a tube called a catheter into a vein in the neck and guiding it to the liver. The physician puts a biopsy needle into the catheter and then into the liver. Physicians use this procedure when patients have blood-clotting problems or fluid in the abdomen.

Recovery
After the biopsy, the physician will put a bandage over the incision and have you lie on your right side, pressed against a towel, for 1 to 2 hours. The nurse will monitor your vital signs and level of pain.

You will need to arrange for someone to take you home from the hospital since you will not be allowed to drive after having the sedative. You must go directly home and remain in bed (except to use the bathroom) for 8 to 12 hours, depending on your physician’s instructions. Also, avoid exertion for the next week so that the incision and liver can heal. You can expect a little soreness at the incision site and possibly some pain in your right shoulder. This pain is caused by irritation of the diaphragm muscle (the pain usually radiates to the shoulder) and should disappear within a few hours or days. Your physician may recommend that you take Tylenol for pain, but you must not take aspirin or ibuprofen for the first week after surgery. These medicines decrease blood clotting, which is crucial for healing.

Like any surgery, liver biopsy does have some risks, such as puncture of the lung or gallbladder, infection, bleeding, and pain, but these complications are rare.

For More Information:
American Liver Foundation (ALF)
75 Maiden Lane, Suite 603
New York, NY 10038
Phone: 1–800–465–4837
1–888–443–7872
or 212–668–1000
Fax: 212–483–8179
Email: info@liverfoundation.org
Internet: www.liverfoundation.org

National Digestive Diseases Information Clearinghouse
2 Information Way
Bethesda, MD 20892–3570
Phone: 1–800–891–5389
TTY: 1–866–569–1162
Fax: 703–738–4929
Email: nddic@info.niddk.nih.gov
Internet: www.digestive.niddk.nih.gov

Sources:http://digestive.niddk.nih.gov/ddiseases/pubs/liverbiopsy/index.htm

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Device For Your Heart

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Shabina Akhtar on a new instrument that records the heart‘s functioning and shows exactly what goes wrong during a fainting spell .
CLICK & SEE THE PICTURE

When V.S. Prasad, 58, lost consciousness for about half a minute in his bathroom last September, none of the doctors he went to initially could fathom why. They thought it was a case of syncope  simply temporary loss of consciousness. All the usual tests failed to give any indicationsEven the 24-hour Holter monitoring(an ambulatory electrocardiography device for monitoring the heartbeat  round the clock) failed to indicate any underlying heart disorder. The Tilt test (to detect syncope of neurological origin), too, was negative because of which the neurologist ruled out epilepsy,” says Arunangshu Ganguly, consultant interventional cardiologist at the Apollo Gleneagles Hospital, Calcutta.

Prasad’s case is not uncommon; cardiologists worldwide are often faced with such tricky situations. Dr Emilio Vanoli, associate professor at the Dipartimento di Cardiologia Policlinico of Monza, Italy, says: Syncope is a symptom that a doctor needs to interpret. Unfortunately, in more than 40 per cent of cases, it goes unregistered.” Lack of awareness — even among doctors — makes things difficult, he adds. Patients who complain of fainting spells are often treated as epileptics and the cardiac problem, if any, goes undetected. Similarly, epileptics are sometimes wrongly implanted with pacemakers.

Prasad was, however, more fortunate. Says Dr Ganguly: “I suspected some electrical problem in his heart. But none of the tests backed my intuition. Then I advised him to get an Insertable Loop Recorder (ILR) implanted. The device records the heart’s functioning, providing evidence of what goes wrong during a fainting spell.”

So when Prasad fainted again in December, he pressed the activator button on regaining consciousness. This, to store data about how his heart had behaved during the episode.

When Dr Ganguly analysed the data, he found that Prasad’s heart had stopped beating for nearly 20 seconds. The doctor then concluded that Prasad was suffering from an abnormally low heart beat rate — less than 60 beats a minute is a cause for worry — and needed a pacemaker.

Launched in India in October 2007, the ILR has been on the US market for some years now. It costs around Rs 35,000 to get the thumb-sized device inserted through a non-invasive procedure under local anaesthesia. It has a battery life of 14 months, during which it can continuously record the user’s heart beat.

The ILR promises to be of great use to many. “About 1.5 million people worldwide suffer from unexplained syncope. In almost 10 per cent of cases syncope has a cardiac cause, in 50 per cent a non-cardiac cause, and in the remaining 40 per cent of cases the cause remains unknown. The recorder is of great help as the fainting occurs suddenly and for a very brief duration. Moreover, there is no definite pattern of repetition, which makes documentation very difficult. We cannot perform an electrocardiograph (ECG) right then and the ECGs before and after are usually normal,” explains Dr Vanoli.

With the number of patients complaining of unexplained loss of consciousness increasing, unfortunately, there are instances where pacemakers are implanted without proper documentation of the cause, says Dr Ganguly. Not all cases of loss of consciousness are due to cardiological reasons; neurological, metabolic and other factors too could be at play.

The heart, explains the doctor, is an electromechanical pump which uses its muscles to continuously pump blood to the body system. The valves in it ensure a uni-directional blood flow. A mechanical failure of the organ doesn’t lead to syncope except when there is a critical obstruction in the outflow valve or when there is an uncoordinated contraction of the heart muscles. All other causes of loss of consciousness attributed to a cardiological reason are due to a power failure in the electrical supply to the heart. This electrical supply originates in a generator (Sinus node) and is carried through a nerve to a distribution box (AV node) from where it reaches the heart by means of three nerves (one right bundle and two left bundles). Now when the generator or distribution point or any of the wires becomes incapable of providing uninterrupted power flow to the heart, the heart stops functioning and the brain — on not getting its blood supply — switches off, and the person faints. A stoppage of more than three seconds is fatal. And that is where you need an inverter to back you up, which is a pacemaker.
………………………………

The ILR has helped us provide evidence-based treatment rather than fall back on presumptive management,” says Dr Ganguly. However, the cost could pose a problem for some, he feels.

Nonetheless, it comes as a huge relief to many people, sparing them the travails of presumptive management of their disease.

Sources: The Telegraph (Kolkata, India)

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Ailmemts & Remedies

Breast Lumps

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Alternative Names : Breast mass

Definition :
A breast lump is a swelling, protuberance, or lump in the breast.
Breast lumps are a common problem. many women notice generalized breast lumpiness, especially when the breasts enlarge during puberty and pregnancy and before menstruation. this generalized lumpiness can usually be regarded as a variation in normal breast development and does not increase the risk of breast cancer. discrete breast lumps may cause concern, but in fact only 1 in 10 breast lumps is due to cancer.
Click to see the pictures…...(01)..….(1).……..(2)……..(3)..……..(4).………..(5)

Considerations :
Normal breast tissue is present in both males and females of all ages. This tissue responds to hormonal changes and, therefore, certain lumps can come and go.

Breast lumps may appear at all ages:
Infants may have breast lumps related to estrogen from the mother. The lump generally goes away on its own as the estrogen clears from the baby’s body. It can happen to boys and girls.
Young girls often develop “breast buds” that appear just before the beginning of puberty. These bumps may be tender. They are common around age 9, but may happen as early as age 6.
Teenage boys may develop breast enlargement and lumps because of hormonal changes in mid-puberty. Although this may distress the teen, the lumps or enlargement generally go away on their own over a period of months.
Breast lumps in an adult woman raises concern for breast cancer, even though most lumps turn out to be not cancerous.

Causes :Generalized lumpiness in the breasts, often with associated breast tenderness, is thought to be related to the hormonal changes that occur during the menstrual cycle. The lumpiness usually becomes worse just before a menstrual period, and this worsening may be due to oversensitivity of the breast tissue to female sex hormones at this time.

A discrete lump is often a fibroadenoma. This noncancerous lump is caused by the overgrowth of one or more breast lobules. Breast cysts are fluid-filled sacs in the breast tissue. one or more cysts may be present, and both breasts may be affected. occasionally, a breast lump is caused by an infection that has developed into an abscess. A breast abscess may develop if mastitis, which is mot common in women who are breast-feeding, is not treated.An abscess may be associated with inflammation and localized pain. A lump in the breast may also be a symptom of breast cancer.

Lumps in a woman are often caused by fibrocystic changes, fibroadenomas, and cysts.

Fibrocystic changes can occur in either or both breasts. These changes occur in many women (especially during the reproductive years) and are considered a normal variation of breast tissue. Having fibrocystic breasts does not increase your risk for breast cancer. It does, however, make it more difficult to interpret lumps that you or your doctor find on exam. Many women feel tenderness in addition to the lumps and bumps associated with fibrocystic breasts.

Fibroadenomas are non-cancerous lumps that feel rubbery and are easily moveable within the breast tissue. Like fibrocystic changes, they occur most often during the reproductive years. Usually, they are not tender and, except in rare cases, do not become cancerous later. A doctor may feel fairly certain from an exam that a particular lump is a fibroadenoma. The only way to be sure, however, is to remove or biopsy them.

Cystsare fluid-filled sacs that often feel like soft grapes. These can sometimes be tender, especially just before your menstrual period. Cysts may be drained in the doctor’s office. If the fluid removed is clear or greenish, and the lump disappears completely after it is drained, no further treatment is needed. If the fluid is bloody, it is sent to the lab to look for cancer cells. If the lump doesn’t disappear, or recurs, it is usually removed surgically.

Other causes of breast lumps include:

  • Milk cysts (sacs filled with milk) and infections (mastitis), which may turn into an abscess. These typically occur if you are breastfeeding or have recently given birth.
  • Breast cancer,detectable by mammogram or ultrasound, then a biopsy. Men can get breast cancer.
  • Injury — sometimes if your breast is badly bruised, there will be a collection of blood that feels like a lump. These tend to resolve on their own in a matter of days or weeks. If not, the blood may have to be drained by your doctor.
  • Lipoma — a collection of fatty tissue.
  • Intraductal papilloma — a small growth inside a milk duct of the breast. Often occurs near the areola, the colored part of the breast surrounding the nipple, in women between the ages of 35 and 55. It is harmless and frequently cannot be felt. In some cases the only symptom is a watery, pink discharge from the nipple. Since a watery or bloody discharge can also be a sign of breast cancer, this must be evaluated by your doctor.

What might be done?
You should check your breasts regularly so that you become familiar with their normal appearance and texture. Always consult your doctor if you notice a new lump or a change in an existing lump. he or she will perform a physical examination of your breasts and may arrange for ultrasound scanning or mammography to investigate a breast lump. Your doctor may also take a sample of cells from the lump to look for cancerous cells.

Most noncancerous breast lumps do not treatment. generalized lumpiness tends to decrease after menopause, but may continue if you take hormone replacement therapy. However, breast cysts are usually treated by draining. modern screening techniques and treatments mean that breast cancer can often be diagnosed early and treated successfully. If a tumor is found in your breast, you will be referred to a specialist.

Home Care
Treatment of a breast lump depends on the cause. Solid breast lumps are often removed surgically, or at least a biopsy is taken. The biopsy is to check whether it is cancerous or not. Cysts can be drained. Breast infections require antibiotics.

For fibrocystic changes, birth control pills are often helpful. Other women are helped by:

  • Avoiding caffeine and chocolate
  • Taking vitamin E, vitamin B complex, or evening primrose oil supplements
  • Limiting fat and increasing fiber in the diet

If breast cancer is diagnosed, most women receive a combination of surgery, radiation, chemotherapy, and hormonal therapy. These options would be carefully assessed and thoroughly discussed with your doctor.

When to Contact a Medical Professional :

Call your doctor if:

  • You find a new breast lump during your monthly self-exam
  • You have bruising on your breast but did not experience any injury
  • You have nipple discharge, especially if bloody or pinkish (blood tinged)
  • The skin on your breast appears dimpled or wrinkled (like the peel of an orange)
  • Your nipple is inverted (turned inward) but normally is not inverted

Also call if:

  • You are a woman, age 20 or older, and want guidance on how to perform a breast self-examination
  • You are a woman over age 40 and have not had a mammogram in the past year

Prevention :
Breast cancer screening is an important way to find breast cancer early, when it is most easily treated and cured.

  • If you are over age 20, consider doing a monthly breast self-exam. See: Breast self exam
  • If you are over age 20, have a complete breast exam by your provider at least every 3 years — every year if you are over 40.
  • If you are over age 40, get mammogram once a year. If you are high risk, experts say you should start getting a mammogram at age 30.

Having fibrocystic breast tissue, mastitis, or breast tenderness related to PMS does NOT put you at greater risk for breast cancer. Having fibrocystic breasts does, however, make your self-exam more confusing since there are many normal lumps and bumps.

To prevent breast cancer:

  • Exercise regularly
  • Reduce fat intake
  • Eat lots of fruits, vegetables, and other high fiber foods
  • Do not drink more than one or one and a half glasses of alcohol a day

Click to learn latest news about Breast Cancer

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

.Resources:
http://www.nlm.nih.gov/medlineplus/ency/article/003155.htm
http://www.charak.com/DiseasePage.asp?thx=1&id=236

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Breast cancer strikes younger women too.

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How to spot signs of trouble: In November 1999, Jennifer Johnson seemed to be living her dream. She was 27 years old, happily married to her college sweetheart and expecting her first child. Johnson also tried to give back to her community by volunteering for the Susan G. Komen Breast Cancer Foundation. Because of that work, she understood the importance of monthly breast self-exams. Though breast cancer is unusual in young women, she was vigilant about the task. And that was how, one day in the shower, she found what she describes as a “rock” in her left breast. It was a devastating discovery  and it also saved her life.

A biopsy revealed that Johnson had invasive ductal carcinoma, which means that malignant cells had formed in a milk duct and then spread. Her tumor measured 3.5 centimeters (about 1.4 inches), she says. Once she had gotten over the initial shock of her diagnosis and begun treatment, Johnson met and joined forces with three other young women fighting breast cancer: Patti Balwanz, Jana Peters and Kim Carlos. They formed their own private support group, meeting regularly for lunch at the Nordstrom’s store near their Kansas City homes. The friendship inspired their moving new book, “Nordie’s at Noon,” published this month by Da Capo Press. “We felt such comfort in being able to talk to each other and share our stories,” says Carlos. “We felt there weren’t enough resources out there for young women.”

Breast cancer is generally considered an older women’s disease; the median age of diagnosis is 63. But younger women are not immune. In fact, according to the National Cancer Institute, one in 229 women in their 30s will be diagnosed with a malignancy in their breasts. Young women also have special concerns that don’t affect older breast cancer patients. If they haven’t had children, they worry that chemotherapy or radiation will send them into early menopause. If they  are single and dating, they may have to contend with feeling less attractive after surgery. Breast cancer in younger women tends to be more aggressive, which makes early diagnosis all the more critical. But getting that early diagnosis is often difficult. In general, women with no special risk factors for breast cancer don’t start getting mammograms, the most widely used screening, until they’re in their 40s. (Before then, younger women’s denser breast tissue makes mammograms less reliable.)

Even if women do notice something suspicious during a self-exam, doctors don’t always take their complaints seriously. “The doctor will say, ‘Oh, let’s just watch that lump for three or six months or a year and see what happens’,” says Carlos. That often means that young women are diagnosed at a later stage and face a grimmer prognosis. In fact, breast cancer is the leading cause of cancer deaths among women aged 15 to 54, according to the National Cancer Institute. However, if the tumor is detected early enough, the odds are good: 83 percent of women under 45 whose cancers are found early will survive for at least five years.

Without mammograms, what’s the best tool for spotting signs of trouble? All four of the Nordie’s authors found lumps themselves. But among breast cancer groups, there is disagreement over whether self-exams should be included in screening recommendations; studies have not proven that the exams reduce deaths. However, no one disputes that self-exams help you become aware of the geography of your breast so you can detect any abnormalities early on. “The most important thing is to understand what kind of lumps or bumps are normal for you and if something is different, you need to consult a doctor,” says Randi Rosenberg, a founding member and former president of the Young Survival Coalition, a network of young breast cancer survivors(www.youngsurvival.org) (For tips on how to check your breasts, go to the Komen Foundation site,www.komen.org   and click on the breast-self exam link.)

(As published in the Newsweek)

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