Women tend to put themselves second to the family at the expense of their health. Societal stigma plays a role in developing countries like Pakistan. The fair sex hesitate to speak openly about health concerns regarding their own anatomy, a recent story by BBC highlighted. 

For these women and others, being educated on the self-examination techniques of their own breasts could empower them. Although self-examination cannot provide the medical accuracy of a mammogram, it does help in the early detection of major lumps and abnormalities that appear on the breasts. 

Thoroughly examining one’s breasts needs no medical expertise, and can be performed in the privacy of one’s home environment. A few days after the period cycle ends is the opportune time to perform the self-examination since hormonal changes alter the breasts mid-cycle.

What better time to start than in the month of October, marked as breast cancer awareness month. Here are the five steps to follow. 

Step 1 – Place your arms at your side, near the hips, and stand topless in front of a mirror then begin noticing if there are changes in your breast. You need to check for changes in breast size, shape and symmetry. You should also be looking for dimpling and puckering of the breast skin. At first glance, inverted nipples and redness are also easy to spot. So, watch out. 

Step 2 – Lift up your arms and examine the breasts to identify these same issues. 

Step 3 – Next, look for any discharge from the nipples, either from one or both. They could be yellow fluid, watery and even milky. Be alert to anything dripping out of the nipples.  

Step 4 – Lie down and use the opposite hand to check each breast: left hand for right breast, right hand for left breast Instead of using the tips of your fingers, join the fingers and use the finger padding below in a flattened position. 

Rotate these fingers in small concentric circles, covering the whole breast including the nipple. The pattern can follow the increasing width of the circles formed with the fingers, until the entire breast has been studied. Also, pinch the nipples gently. 

Step 5 – Repeat the same movements with the fingers while sitting or standing upright. If it makes it easier to do this when taking a bath, when the skin is wettened, the same self-examination can be completed in the shower. 

This is not enough. For all women above 20 years of age, doctors advise going in for an annual breast exam. Younger women with a family history of breast cancer and associated risk factors should consider doing a mammography in consultation with their physician. All women above the age of 40 should have routine annual breast examinations. 

The post Breast Self-Examination: A Guide On How To Detect Breast Cancer Early On appeared first on MyMedicPlus.

BHOPAL: A national surgical workshop was organised on the occasion of 5th anniversary of Divya Advanced ENT Clinic, on Tuesday.

The workshop was attended by eminent experts across country that performed various surgeries. About 16 surgeries were performed in this workshop including Pituitary Tumour Surgery, Acoustic Neuroma Surgery and surgery of CSF Rhinorrhea by the expert from Jaipur Dr Satish Jain.

Another expert from Pune Dr Virendra Ghaisas performed Rhinoplasty surgery (Nose Job).

Dr Satyaprakash Dubey, expert from Bhopal performed Cochlear Implant Surgery of the children who were deaf since birth and also performed cochlear implant surgery done in adult patient who has acquire deafness because of discharging ear.

This is the first time in MP that cochlear implant surgery was conducted in discharging ear. Director of the course, Dr Satyaprakash Dubey said, “This is the ninth surgical workshop of the Divya Advanced ENT Clinic in the last five years. All the operations from Divya Advanced ENT were broadcasted live to more than 100 ENT specialist surgeons from different parts of the country.”

The occasion of fifth successful year of the Divya Advanced ENT Clinic was graced by the chief guest of was Narmada Speaker of MP Legislative Assembly, Prasad Prajapati. He said, “Such events give an excellent opportunity to the new doctors and physicians to learn more and the exchange of knowledge leads to the development of medicine and treatment.”

Special guest of the program was Minister of Minority Affairs and Backward Classes, Arif Aqueel. He said that the Divya Advanced ENT Clinic has done remarkable job in the treatment of deaf and dumb children in the last five years.

Special guest Minister of Public Health and Family Welfare, Tulsi Silavat appealed the private doctors to treat the backward class and underprivileged sector people of the society. He also said that regular diagnosis of deafness in the infants will also be done in other cities of the state alike it is currently being done in Indore. City doctors and administrative officers were also present in the workshop.

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In the last 10 years, incidents of skin cancer have gone up by more than 50 percent nationwide – which means Dr. David Kelly is a pretty busy physician.

The Gilbert resident is a plastic and reconstructive surgeon who deals with the ravages of skin cancer.

The job can be challenging for Kelly, one of the partners of the Center for Dermatology and Plastic Surgery – which has grown to nine clinics across the Valley, including Chandler and Gilbert, since he joined the practice in 2015.

“I do a lot of skin cancer reconstruction on the head and neck, nose, eyelids, ears,” he said, recalling how one of his more challenging surgeries involved the reconstruction of an ear.

“It basically was the entire ear,” he said. “All the earlobe was completely gone…I had to replace the cartilage in the ear and then also the skin on the front and back of the ear. So that required about three different surgeries to reconstruct the ear, rebuild it and put new cartilage in the ear to help support the ear.”

He sees a lot of the damage that unprotected skin can suffer from exposure to the sun. And the age range of patients is virtually limitless.

The sun generally inflicts most of its damage on people before they turn 30, but skin cancer can take decades to develop. Moreover, when older patients were that young, sunscreen products were not nearly as effective as they are today.

Consequently, “We definitely have a lot of patients 60, 70, 80,” Kelly said. 

“But being in Arizona, we see a fair amount of younger people in their 30s and 40s with some pretty significant skin cancers,” he added. “I see a lot of pediatric patients that pediatricians and dermatologists send me.”

Of the 19 different medical providers at the Center for Dermatology and Plastic Surgery, Kelly is one of three different types of physicians.

Besides dermatologists, the center also has Mohs micrographic surgeons.

Named after Dr.  Frederick Mohs, the founder of micrographic surgery, the procedure removes cancerous tissue while removing as little of the healthy tissue as possible.

They usually are the physicians whom patients see before Kelly, who has two Mohs surgeons on his team, in the hope that radical reconstructive surgery might be averted.

“Most patients will come in and they have a spot that’s not healing,” Kelly said. “So we’ll biopsy it and once we determine it actually is skin cancer, then I normally work with a Mohs surgeon.

“They’ll look at the skin underneath the microscope immediately and make sure all the skin cancer is completely gone.”

But what happens if the Mohs surgeon removes enough tissue to create disfigurement? That’s why Kelly and the Mohs surgeons coordinate their schedules with patients.

“I work hand in hand with them,” he said, explaining, “Nobody wants to have half their ear missing and wait a week or so to see another doctor. So, when that patient is done with having a skin cancer removed, I can do” reconstructive surgery if needed.

“It’s in my same office. I meet patients, evaluate them, talk about what we need to do, how we need to fix this, and then we try to do that the same day. That way it’s just easier for the patient.

“That makes a big difference, and that’s one of the things that attracted me to this practice.”

A Utah native, Kelly did his post-graduate medical training in North Carolina and Kentucky.

He recalled how in North Carolina, “most patients have to wait one to two weeks to get to see a plastic surgeon, so they have a bandage on their nose or the ear for a week or so. That’s just not the best way to handle things.

“It increases the risk of infection, doesn’t have as good of an outcome. So, the way it is here, it’s nicer for the patient. We can evaluate immediately.”

Kelly, whose brother is an oral surgeon and a longtime Gilbert resident, had an lifelong ambition to become a doctor – partly because his father is a pediatrician.

“Ever since I was a kid, I wanted to be a surgeon, but I didn’t know what kind of surgeon,” he recalled.

But then he had the chance to go to Africa and Guatemala, where he helped doctors treat children and adults with significant burn injuries and birth deformities. 

And those transformations he helped work on led him to plastic and reconstructive surgery.

“I liked the concept of plastic surgery, that we basically operate on like the entire body,” he explained. “We can operate on adults, children. We kind of run the gamut.

“When I was a medical student and resident, I just loved the skin cancer aspect of it – taking care of patients with large skin cancers on their face and helping them. There’s an immediate sense of satisfaction in reconstructing the nose or the ear or the eyelid or whatever. 

“So that’s what attracted me, the variety. Every day is something different….If the patient has a skin cancer on the nose, I don’t know if it’s going to be a small skin cancer or if it’s their entire nose that I have to reconstruct. So, it’s challenge. You kind of have to use your creative skills trying to figure out how to reconstruct and how to solve their problem.”

And the potential for challenges is always there, especially since post-cancer reconstructive surgery accounts for 60 percent of reconstructive and plastic surgery that the Center for Dermatology and Plastic Surgery handles.

The rest is cosmetic, such as face and neck lifts, eyelid and breast enhancements and what Kelly called “mommy makeovers.”

Kelly – who with his wife of 18 years, Ashley, has four children ranging in age between 3 and 12 – doesn’t let the skin cancer part of his work dissuade him from hiking and running.

“That’s one of my favorite things about living here is being able to be outside most of the year,” he said.

But Kelly takes no chances and thinks everyone should follow suit – meaning a nearly slavish attention to wearing protective clothing and good sunscreen at virtually any time under the sun and getting a skin cancer checkup every year.

The Center for Dermatology and Plastic Surgery has nine locations, including Chandler, Sun Lakes, Scottsdale and Glendale. 

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Middle ear infections are one of the most common reasons for visits to the pediatrician. However, because the middle ear is hidden from view by the ear drum, physicians must diagnose based on symptoms and a limited physical exam — and when patients have ambiguous or borderline symptoms, accurate diagnosis can be challenging.

PhotoniCare’s TOMi Scope uses near-infrared light waves to provide 3D views beyond the ear drum into the middle ear, allowing physicians to visualize and better diagnose middle ear infections.

Co-founder and CEO Ryan Shelton, Ph.D. answered a few of our questions about his company’s beginnings, its technology, and what he expects for his firm’s future.

Cici Zhou, Medgadget: Tell me about the founding team members. How did PhotoniCare start, and what was the inspiration?

Ryan Shelton: I founded the company with Stephen Boppart [Professor and Head of the Biophotonics Imaging Laboratory at the University of Illinois at Urbana-Champaign], and Ryan Nolan, an engineer and clinical trial specialist. I was doing postdoctoral research in Dr. Boppart’s medical imaging lab leading a project on an imaging technology with Ryan N. We were exploring a few potential clinical indications and during this same time my oldest son, Jack, now 7 years old, was going through his first year of life. He had 10 office visits with multiple rounds of antibiotics before finally getting a referral to an ENT for surgery. I got to experience first-hand the challenges and frustrations that accompany the current standard of care for ear infections. That experience certainly drove my passion for using our technology platform to improve care for this extremely common disease.

Medgadget: In plain terms, how does the TOMi Scope technology work? Are there studies showing that it is better at helping with diagnosis than traditional otoscopes?

Shelton: The TOMi Scope contains two important imaging modes in one familiar handheld package. It provides a high-quality video otoscope with capabilities for digital export and real-time sharing with parents & patients. It also provides a depth imaging mode that uses near-infrared light to image through the eardrum and directly visualize the contents of the middle ear. Current otoscopes misdiagnose the presence of fluid 50% of the time and give little or no indication of the type of fluid, yet proper diagnosis of both the presence and type of fluid are extremely important for ensuring patients receive proper treatment.

We have several publications on the technology showing the ability to detect and characterize fluid in the middle ear. We have a manuscript currently under review that shows 90%+ sensitivity and specificity for detecting fluid through the eardrum in the pediatric population. The biggest shortcoming for other technologies trying to address this problem is that nearly all of them measure the eardrum in some way. We believe that is the wrong approach. The disease lives in the middle ear, so the middle ear is what we need to assess to make an accurate diagnosis. Unlike competing technologies, we directly visualize the middle ear contents. We are not measuring the eardrum as a proxy for middle ear health.

Medgadget: At what stage is the company today?

Shelton : Today, the company has finalized development of the device and we are in the regulatory process. We keep a lean team of around 5 [full time employees]. We’ve raised less than $2M of private capital (along with $4.5M in grant funds) to get where we are now and should be closing a commercial-stage financing soon. The device has been piloted at 4 clinical sites and we have a long waiting list of additional providers that would like to participate in our upcoming beta program.

Medgadget: What are some of the biggest challenges facing the team, whether it’s on the technology or business side?

Shelton: The team is preparing for a growth phase, so making sure we attract the right team members during that phase will be critical. The team makes and breaks any enterprise, and we are always looking for stellar team members that have a passion for improving healthcare at the front lines. One ever-present hurdle in our industry, and especially in primary care, is market access. We have been working hard to ensure that we have the proper channel partners (we closed a distribution deal in Japan earlier this year) and value proposition to effectively access the market, but that will always be a challenge we are devoting mind power and resources toward.

Medgadget: Looking to the next 5 years, what are the biggest goals for PhotoniCare?

Shelton: We are incredibly excited about the next 5 years. Five years from now we expect to be seen as the next standard of care for ear health in primary care, urgent care, and retail settings. We expect to have additional clinical trials completed and published, and we expect to have changed outcomes for millions of children and adults in [the] US, Japan, and EU. Additionally, one of the great things about our technology platform is that it truly is a platform… We have shown the ability to image the eye, skin, teeth, and oral mucosa in addition to the ear, so we are incredibly excited about the future as we grow our platform and make an enormous impact on efficiency and outcomes at the front lines of medicine.

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32 year old woman in Hanoi with the weigh of nearly 90 kilogram admitted that she bumped into difficulties and was ashamed of her weight.
Therefore, she went to the infirmary for treatment of obesity where physicians decided to conduct the bariatric surgery after examination and diagnosis. Military surgeons and their Korean peers performed the difficult surgery because positions of the woman’s organs were reversible; for instance spleen is normally in one’s left but the woman’s spleen in the right whereas liver in the opposite side. Nevertheless, the operation was a success; two months after the operation, she lost 19 kilogram feeling better than before. Surgery Department Deputy President Colonel Nguyen Anh Tuan said that the Department has carried out such kinds of surgeries on six obese patients from March, 2019; one of them weighing 130 kilograms and they were all in good condition after the operation. According to the Ministry of Health, the number of obese people in Vietnam increased substantially in adults and children. As per the National Nutritional Institute’s report, obese people aged from 25 to 64 account for 16.3 percent of the whole country’s population. Worse, the rate of obese people has gone up by ages and more female become fat than male and city dwellers are fatter than their peers in countryside. Factors are attributable to obesity are high-fat diet, eating in fast food, less exercise and alcohol abuse. The obesity epidemic is driving up the burden of several non-communicable diseases (NCDs) such as cancers, heart disease and diabetes. Fat people should take regular exercise and take heed of their diet. In cases that exercise and less fat diet prove no effectiveness, bariatric surgery can help very overweight people who have tried but failed to lose weight and face serious medical problems. Patients undertaking the surgery will be under physicians’ monitor. Globally, obesity is increasing quickly. Statistically, around 1.9 billion overweight people in the world and 609 obese people. It is estimated that 57.8 percent of the world population will be obese by 2030 leading to high medical cost.

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