Lybrate.com has a number of highly qualified Homeopaths in India. You will find Homeopaths with more than 43 years of experience on Lybrate.com. You can find Homeopaths online in Mumbai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.
Book Clinic Appointment
Treatment Of Erectile Dysfunction
Skin Care Treatment
Treatment of Migraine Treatment
Treatment of Neurological Problems
Weight Management Treatment
Piles Treatment (Non Surgical)
Sexually Transmitted Disease (Std) Treatment
Cysts Removal Procedure
Treatment Of Pregnancy Problems
Well Woman Healthcheck
Thyroid Problems Treatment
Corn Removal Procedure
Submit a review for Dr. Kaushal B. ShahYour feedback matters!
Last month I got my period on 17th july and ended up around 20 july then had unprotected sex with my bf on 24th july (did not ejaculated inside) though after the sex there was no discharge since then I counted days and took a pregnancy test after 14 days of sex and it is negative which was on 7th aug will take another on 14th aug though I am not feeling any symptoms of pregnancy my breasts are normal no abnormal abdomen pain no fatigue or nausea m rather energetic every day no abnormal discharge thus theres no white discharge. Discharge is really less n transparent n bit stretchy type like I use to get before my periods its like a symptom for my period but on 8th I noticed a small n tiny dot like spot but not pink or brown was like period and again on 10th it is so small that it can get ignored (i keep on fingering to check for any abnormalities I admit that the area also became bit dry. But no cramp no headache. I am a pcos. So I always get period symptoms like nipple pain or cramps before 4 days of period (do not know if this information can help) though I feel I am not pregnant and will get my periods as expected may be around 17 or 18 this month (at may I got periods o 24 at june on 18 and at july it was 17) but bit worried about that small n tiny dot like spot. Please help or give any suggestions it will be really kind of you.
I'm 25 year old Im in love with my cousin sister (younger), I'm not able to understand what's happening to me and I want to convey this to her. I know that this is very bad, but im not able to control my feeling towards her. I'm in depression please help me out doctor.
Having Green Tea in empty stomach is good or bad for women? If having which one will be add with this is sugar or honey?
I had total thyroidectomy due to Thyroid cancer, Rai of 100 mcg done. 4 Parathyroids were preserved. Currently on Calcium supplement of 2000 mg, my recent Calcium level is 7.2 mg/DL Couple of weeks ago the level was 7 mg/DL. At time of discharge my Calcium level was 8.3 mg/DL, even though my recent level is decreased I have no symptoms of low calcium, I had vitamin D deficiency since long time. The calcium supplement has vitamin D3 as well, my worry is why the level decreased? My albumin level is 4.2gms/DL which is normal. Is my low calcium caused by low Vitamin D issue? Do I need to undergo any blood tests?
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.
Race-, sex-, and age-related demographics
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.