Lybrate.com has an excellent community of Gynaecologists in India. You will find Gynaecologists with more than 31 years of experience on Lybrate.com. You can find Gynaecologists online in Delhi and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.
Book Clinic Appointment with Dr. Abha Narain
Management of Abortion
Caesarean Section Procedure
Treatment Of Female Sexual Problems
Termination Of Pregnancy Procedure
Treatment Of Pregnancy Problems
Well Woman Healthcheck
Treatment Of Female Sexual Problems
Treatment Of Medical Diseases In Pregnancy
Treatment Of Menstrual Problems
Intra-Uterine Insemination (IUI) Treatment
Medical Termination Of Pregnancy (Mtp) Procedure
Gynecology Laparoscopy Procedures
Pap Smear Procedure
Submit a review for Dr. Abha NarainYour feedback matters!
I'm newly married and we don't want children immediately, but we did sex thrice in past three days, will that lead to pregnancy ?
I am 28 year old mother of 1 child. My Doctor recommended Cerazette tablet to take and I'm taking this pill from last November but since February 2018 I haven't got my periods. Do I need to worry? Will there be any complications in future? Please help me here.
I do sex with my girlfriend. And I use condom. BT daut fully I gave her unwanted 72 within half an hour. Now my gf. Period delay. Now six day over for her MC but period not come. Please give me suggestions what I do.
A healthy mind is responsible for a healthy and relaxed body and both are imperative for attaining better orgasms during intercourse. Orgasmic dysfunction, or inhibited sexual excitement, or simply anorgasmia, is a condition whereby, a woman fails to attain orgasms even when sexually aroused. This can prove to be a major sexual problem and is the cause of disputes and conflicts in a relationship because of the lack of sexual intimacy and satisfaction.
In order to be sexually excited, both mind and body are involved in a series of complex processes, which finally result in a peak sexual response. Thus, both need to be functioning well in order to stimulate an orgasm.
Causes that may lead to orgasmic dysfunction:
- Boredom or lack of interest in sexual indulgences
- Hormonal disorders or changes brought on by menopause
- Chronic illnesses that affect sexual interest
- Acquired negative attitudes (usually from childhood or adolescence) towards sex
- Previous traumatic experiences relating to rape or sexual abuse
- Certain prescription drugs like antidepressants
- Stress or high fatigue
- Medical conditions affecting the nervous system around the pelvis
- Medical conditions causing chronic pelvic pain
Symptoms of orgasmic dysfunction may include:
- Inability to attain orgasms
- Taking longer than normal to reach an orgasm
- Not having satisfying orgasms
It is important to note that when treating problems associated with orgasmic dysfunction, you must maintain a healthy attitude towards sex, in addition to having sufficient knowledge pertaining to sexual stimulations and responses. Learning how to communicate and how to express your needs and desires clearly is another important step in the treatment of anorgasmia. Here are a few other ways to improve your sex life:
- Eat well and get enough rest
- Reduce your consumption of alcohol, drugs, or smoking
- Engage in Kegel exercises which involve tightening and relaxing the muscles of the pelvis
- Use birth control methods that both you and your partner agree to
- Engage in other sexual activities apart from sexual intercourse
- Educate yourself more about reaching orgasms by focusing on clitoral stimulation or directed masturbation
- Take up sexual counseling to learn helpful exercises
If you wish to discuss about any specific problem, you can consult a sexologist.
My wife is pregnant .i am unable to go near her .we have sex only 8 days after marriage. Now again we sex after 3 or 4 months .is there any problem to my baby due to long sex gap. Or anything else.
It is 2 months now. After my cesarean and I didn't use a belt around my waist. I'm 5'4" in height and 76 in weight while pregnant and 66 at present. What precautions should I take in order to keep my weight under control and please suggest which exercises I can do.
For the benefit of couples suffering from infertility, modern medical science has introduced several innovative procedures. Some of the popular procedures are In-vitro Fertilization (IVF), Intra Uterine Insemination (IUI), Gamete Intrafallopian Transfer (GIFT), Intracytoplasmic Sperm Injection (ICSI), donor eggs and embryos and so on. In addition to these, there are several drugs and surgical procedures that help the couple in getting rid of infertility. Among all these procedures, IUI has gained popularity in the field of gynaecology and infertility treatment procedures. The IUI treatment is also popularly called as artificial insemination procedure. Although this is a popular procedure, it is appropriate that you should also understand its pros and cons.
IUI procedure in brief:
In simple terms, the IUI procedure involves placing the sperm inside the womb or uterus, which in turn would assist in fertilization of the egg. As a result of this procedure, the sperm reaches the fallopian tube, which enhances the chances or rate of egg fertilization.
Conditions precedent of IUI Procedure:
Before initiating the IUI procedure, the fast moving eggs are separated from the slow moving eggs. This separation is done in the laboratory. Further, in order to undergo IUI procedure, the women should be less than 40 years of age. On the other hand, apart from healthy fallopian tube, the women should also have higher ovarian reserves. Also, the sperm should have minimum mortality rate. However, IUI procedure is adopted only if the fallopian tube is healthy. IUI procedure is suggested in case the couple is having difficulty in vaginal intercourse, either because of psychosexual reasons or for reasons of physical disability.
The IUI procedure can be performed either with the husband's egg or with the donor’s egg. Some of the other important aspects of IUI procedure are briefly discussed here:
- The IUI procedure is a short duration procedure and it can be completed within a few minutes. This procedure does not cause any discomfort or pain. The procedure does not require any hospitalisation or administration of anesthesia. Further, the procedure also does not cause any side effects. In fact, compared to the IVF procedure, IUI is cost-effective.
- In order to enhance the level of success, the gynaecologist may suggest IUI procedure every month. In some cases, the gynaecologist may also prescribe a few medicines to simulate the ovulation procedure. Except this, IUI may not involve extensive medication.
You may undergo the IUI procedure under the supervision of sufficiently experienced gynaecologist. Further, you may also ensure the hospital is equipped with modern state of art machineries for carrying out the IUI procedure.
Got my period on 29th May and missed next menstrual cycle which likely to start between 28 june to 1st July as I used to have 28 to32 days cycle. On 7th July I got a negative pregnancy report on preg card. I stopped to take pill four months ago. Can I start the pill now without waiting for next period.
I have had severe back acne and acne marks in the back for a very long time now. I have pcos because of which initially there were a lot of breakouts on my face too but now they have completely gone except the back acne. Please suggest the treatment for it.
Boerhaave first described the spontaneous rupture of the esophagus in 1724. It typically occurs after forceful emesis. Boerhaave syndrome is a transmural perforation of the esophagus to be distinguished from mallory-weiss syndrome, a nontransmural esophageal tear also associated with vomiting. Because it often is associated with emesis, boerhaave syndrome usually is not truly spontaneous. However, the term is useful for distinguishing it from iatrogenic perforation, which accounts for 85-90% of cases of esophageal rupture.
Diagnosis of boerhaave syndrome can be difficult because often no classic symptoms are present and delays in presentation for medical care are common. Approximately one third of all cases of boerhaave syndrome are clinically atypical. Prompt recognition of this potentially lethal condition is vital to ensure appropriate treatment. Mediastinitis, sepsis, and shock frequently are seen late in the course of illness, which further confuses the diagnostic picture.
See can't-miss gastrointestinal diagnoses, a critical images slideshow, to help diagnose the potentially life-threatening conditions that present with gastrointestinal symptoms.
A reported mortality estimate is approximately 35%, making it the most lethal perforation of the gi tract. The best outcomes are associated with early diagnosis and definitive surgical management within 12 hours of rupture. If intervention is delayed longer than 24 hours, the mortality rate (even with surgical intervention) rises to higher than 50% and to nearly 90% after 48 hours. Left untreated, the mortality rate is close to 100%.
Esophageal rupture in boerhaave syndrome is postulated to be the result of a sudden rise in intraluminal esophageal pressure produced during vomiting, as a result of neuromuscular incoordination causing failure of the cricopharyngeus muscle to relax. The syndrome commonly is associated with overindulgence in food and/or alcohol. The most common anatomical location of the tear in boerhaave syndrome is at the left posterolateral wall of the lower third of the esophagus, 2-3 cm proximal to the gastroesophageal junction, along the longitudinal wall of the esophagus. The second most common site of rupture is in the subdiaphragmatic or upper thoracic area. [1, 2]
Although likely underreported, the incidence of boerhaave syndrome is relatively rare. A 1980 review by kish cited 300 cases in the literature worldwide.  a 1986 summary by bladergroen et al described 127 cases.  of these, 114 were diagnosed antemortem; the others were diagnosed at autopsy. Overall, boerhaave syndrome accounts for 15% of all cases of traumatic rupture or perforation of the esophagus.
Cases have been reported in all races and on virtually every continent, affecting males more commonly than females, with ratios ranging from 2: 1 to 5: 1.
Boerhaave syndrome is seen most frequently among patients aged 50-70 years. Reports suggest that 80% of all patients are middle-aged men. However, this condiction has also been described in neonates and in persons older than 90 years. Although no clear explanation exists for this, the least susceptible age group appears to be children aged 1-17 years.
Prognosis is directly contingent on early recognition and appropriate intervention. Early diagnosis of boerhaave syndrome allows prompt surgical repair. Diagnosis and surgery within 24 hours carry a 75% survival rate. This drops to approximately 50% after a 24-hour delay and approximately 10% after 48 hours.
The mortality rate is high. Esophageal perforation is the most lethal perforation of the gi tract. Survival is contingent largely upon early recognition and appropriate surgical intervention.
Overall, the mortality rate is approximately 30%. Mortality is usually due to subsequent infection, including mediastinitis, pneumonitis, pericarditis, or empyema.
Patients who undergo surgical repair within 24 hours of injury have a 70-75% chance of survival. This falls to 35-50% if surgery is delayed longer than 24 hours and to approximately 10% if delayed longer than 48 hours.
Cases of patients surviving without surgery exist but are rare enough to warrant case reports in the medical literature.
Esophageal rupture may lead to the development of septicemia, pneumomediastinum, mediastinitis, massive pleural effusion, empyema, pneumomediastinum, or subcutaneous emphysema.
If the esophageal rupture extends directly into the pleura, hydropneumothorax is expected. In adults, this occurs more commonly on the left side of the pleura. In neonates, esophageal rupture usually occurs on the right side.
After esophageal rupture, free air enters the mediastinum and also may spread to the adjacent structures, resulting in mediastinal abscess or superimposed secondary infection.
Other complications include acute respiratory distress syndrome, pneumomediastinum, pneumothorax, and hydrothorax.