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Dr. Nirmla Phadke

Gynaecologist, Mumbai

500 at clinic
Dr. Nirmla Phadke Gynaecologist, Mumbai
500 at clinic
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I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage....more
I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage.
More about Dr. Nirmla Phadke
Dr. Nirmla Phadke is an experienced Gynaecologist in Andheri East, Mumbai. She is currently associated with Phadke Nursing Home in Andheri East, Mumbai. Don’t wait in a queue, book an instant appointment online with Dr. Nirmla Phadke on Lybrate.com.

Find numerous Gynaecologists in India from the comfort of your home on Lybrate.com. You will find Gynaecologists with more than 28 years of experience on Lybrate.com. You can find Gynaecologists online in Mumbai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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8 Modern Town, Off Mahakali Caves Road,Andheri East. Landmark:-Next To Takshashila, MumbaiMumbai Get Directions
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I have the pain in both breast on the tip of the breast if it is any dangerous to health. Please advise.

DGO, MBBS
Sexologist,
Breast pain is a common problem if it occurs before periods, because it happens due to hormonal changes, however if the pain stays all through the month or if you can feel some lump/swelling then you may need to do ultrasound examination of breasts. For pain you can take paracetamol tablets, also wearing a well fitting bra and taking less water may help. But if there is discharge from nipple then you need to do serum prolactin and ultrasound examination of breasts.
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There is pain in my back and leg due to secret abortion and my mom doesn't know about that. I am in problem.

MBBS, MS - Obstetrics & Gynecology, Fellowship in Infertility (IVF Specialist)
Gynaecologist, Aurangabad
There is pain in my back and leg due to secret abortion and my mom doesn't know about that. I am in problem.
Hi Ash, it could be due to iron deficiency and your body is under recovery phase after abortion. Please get hemoglobin tested Have a diet rich in protein, calcium and iron.
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I am 32 years old having 2nd gravida completed 38 Weeks and 2 days. Avg fetal wt is 3.3 kg. HC#32.67 cm. Doctor suggested induced labor. Please suggest. B) is epidural analgesia is good for above condition as I was having too much pain in first delivery 5 years back.

MBBS, MD - Obstetrtics & Gynaecology, FMAS, DMAS
Gynaecologist, Noida
I am 32 years old having 2nd gravida completed 38 Weeks and 2 days. Avg fetal wt is 3.3 kg. HC#32.67 cm. Doctor sugge...
Hello, If there are no complications then pregnancy can be allowed to continue till 40 weeks an induction is started only when there is a maternal of foetal riskfatcors.
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DNB (Dermatology), MBBS
Dermatologist, Delhi
Adhesive bandages can be put on the nails to stop yourself from biting them.
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First Vaccine Again Dengue

M.B.B.S,C.C.A,D.C.A,AASECT,FPA,AAD,M.I.M.S
General Physician,
First Vaccine Again Dengue

Dengvaxia - First vaccine against dengue:

Dengvaxia is a vaccine used to help protect adult or children against dengue disease caused by dengue virus serotypes 1, 2, 3 and 4. Dengvaxia is given to adults, adolescents and children 9 through 45 years of age living in endemic areas.

 

Read more:-

Dengue symptoms and what to do if you think you have denguedengue fever - remedies using papaya leaf juice

 

Full prescribing info - dengvaxia

Contents

Dengue tetravalent vaccine (live, attenuated).

Indications / uses

Dengvaxia is a vaccine used to help protect adult or children against dengue disease caused by dengue virus serotypes 1, 2, 3 and 4. Dengvaxia is given to adults, adolescents and children 9 through 45 years of age living in endemic areas.

Dosage / direction for use

The patient will receive 3 injections of 0.5 ml each at 6-month intervals.

The first injection will occur at the chosen or scheduled date; the second injection, 6 months after the first injection; and the third injection, 6 months after the second injection. Dengvaxia should be used according to the local vaccination schedule.

If the patient forgot an injection of dengvaxia: if the patient missed a scheduled injection, the physician will decide when to give the missed injection.

It is important that the patient follows the instructions of the physician, pharmacist or nurse regarding return visits for the follow-up injection. If the patient forgets or is not able to go back to the physician, pharmacist or nurse at the scheduled time, ask the physician, pharmacist or nurse for advice.

Administration: dengvaxia is given by the physician or nurse as an injection underneath the skin (subcutaneous route) in the upper arm.

Contraindications

Do not use dengvaxia if the patient is allergic (hypertensive) to the active substances or any of the other ingredients of dengvaxia listed in description (see description); has developed an allergic reaction after prior administration of dengvaxia. Signs of an allergic reaction may include an itchy rash, shortness of breath and swelling of the face and tongue; is suffering from a disease with mild to high fever or acute disease. In this case, the physician will postpone the administration of dengvaxia until the patient has recovered; has a weakened immune system, for example due to a genetic defect, hiv infection or therapies that affect the immune system (for example, high-dose corticosteroids or chemotherapy); is pregnant; is breastfeeding.

Use in pregnancy lactation: Dengvaxia must not be given to pregnant or breastfeeding women.

If the patient is of child-bearing stage, the patient should take the necessary precautions to avoid pregnancy for 1 month following administration of dengvaxia; is pregnant or breastfeeding, the patient thinks may be pregnant or is planning to have a baby, ask the physician, pharmacist or nurse for advice before receiving dengvaxia.

Special precautions

Inform the physician, pharmacist or nurse before receiving dengvaxia if the patient is taking an immunosuppressive treatment (prednisone or equivalent to 20 mg or 2 mg/kg for 2 weeks or more). The physician will postpone administration of dengvaxia until 4 weeks after the treatment is discontinued; has experienced any health problems after prior administration of any vaccines. The physician will carefully consider the risks and benefits of vaccination.

As with all vaccines, dengvaxia may not protect 100% of persons who have been vaccinated. Vaccination with dengvaxia is not a substitute for protection against mosquito bites. The patient should take appropriate precautions to prevent mosquito bites, including the use of repellents, adequate clothing, and mosquito nets.

Fainting, sometimes accompanied by falling, can occur (mostly in adolescents) following, or even before, any injection with a needle. Therefore inform the physician, pharmacist or nurse if the patient fainted with a prior injection.

Adults above 45 years of age: adults above 45 years of age should not receive the vaccine.

Driving and using machines: no data are available on the effects of dengvaxia on the ability to drive or use machines.

Use in children: Children less than 9 years of age should not receive the vaccine.

 

Side effects:

Like all medicines, dengvaxia can cause side effects, although not all patients get them.

Serious allergic reactions: If any of these symptoms occur after leaving the place where the patient received an injection, consult a physician immediately: difficulty in breathing, blueness of the tongue or lips, a rash, swelling of the face or throat, low blood pressure causing dizziness or collapse.

When these signs and symptoms occur they usually develop quickly after the injection is given and while the patient is still in clinic or physician's surgery.

Serious allergic reactions are very rare (may affect up to 1 in 10,000 people), after receiving any vaccine.

Other side effects: The following side effects were reported during clinical studies in children, adolescents and adults (from 9 to and including 60 years of age). Most of the reported side effects occurred within 3 days after the injection of the vaccine: very common (may affect more than 1 user in 10): headache, muscle pain (myalgia), generally feeling unwell (malaise), feeling of weakness (asthenia), injection site pain, fever.

Common (may affect up to 1 user in 10): Injection site reactions: redness (erythema), bruising (hematoma), swelling, and itching (pruritus).

Uncommon (may affect up to 1 user in 100): Infections of the upper respiratory tract, dizziness, sore throat (oropharyngeal pain), cough, runny nose (rhinorrhea), nausea, skin eruption (rash), neck pain, hardening of skin at the injection site (injection site induration).

Additional side effects in adults (from 18 to and including 60 years of age): Uncommon (may affect up to 1 user in 100): swollen glands (lymphadenopathy), migraine, joint pain (arthralgia), flu-like symptoms (influenza-like illness).

Additional side effects in children and adolescents (from 9 to and including 17 years of age: Uncommon (may affect up to 1 user in 100), Itchy rash (urticaria).

Reporting of side effects or any suspected adverse event: If the patient experiences any side effects after vaccination, advised to seek immediate medical attention.

By reporting side effects, it can help provide more information on the safety of the vaccine.

 

Interactions:

Using other medicines and dengvaxia: Dengvaxia may not have an optimal effect if it used at the same time as medicines that suppress the immune system such as corticosteroids or chemotherapy.

Inform the physician, pharmacist or nurse if the patient is taking or has recently taken any other vaccines or any other medicines, including medicines obtained without a prescription.

 

Caution for usage:

Before administering any biological, the person responsible for administration must take all precautions to prevent allergic or other reactions. As with all injectable vaccines, appropriate medical treatment and supervision must always be readily available in the event of an anaphylactic reaction following the administration of dengvaxia.

Epinephrine (1:1000) and other appropriate agents used to control immediate allergic reactions must be available to treat unexpected events such as anaphylaxis.

Dengvaxia must not be mixed with other medicinal products in the same syringe.

Dengvaxia must not be administered by intravascular injection under any circumstances.

Syncope (fainting) can occur following, or even before, any vaccination as a psychogenic response to injection with a needle. Procedures should be in place to prevent injury from falling and to manage syncopal reactions.

Separate syringes and needles, separate injection sites and preferably separate limbs must be used if any other vaccine (s) or medicinal product (s) is/are concomitantly administered.

Dengvaxia is reconstituted by transferring all the solvent (0.4% sodium chloride solution) provided in the blue-labeled pre-filled syringe into the vial of freeze dried powder with a yellowish green flip off cap. The pre-filled syringe is fitted with a sterile needle for this transfer. The vial is then gently swirled. After complete dissolution, a 0.5 ml dose of reconstituted suspension is withdrawn into the same syringe. For injection, the syringe should be fitted with the new sterile needle.

The suspension should be visually inspected prior to administration. After reconstitution, dengvaxia is clear, colorless liquid with the possible presence of white to translucent particles (of endogenous nature).

After reconstitution with the solvent provided, dengvaxia must be used immediately.

Any unused dengvaxia or waste material should be disposed of, preferably by heat inactivation or incineration, in accordance with local regulations.

Do not throw away any medicines via wastewater or household waste. Ask a pharmacist on how to throw away medicines that no longer use. These measures will help to protect the environment.

 

Storage

Store in a refrigerator (2°c-8°c). Do not freeze. Keep the vaccine in the outer carton in order to protect it from light.

 

Description

After reconstitution, one dose (0.5 ml) contains 4.5-6.0 log10 ccid50* of each serotype of the cyd dengue virus** (1, 2, 3 and 4).

* ccid50: 50% cell culture infectious dose.

** produced in serum-free vero cells by recombinant dna technology.

The powder is a white, homogenous, freeze-dried powder with possible retraction at the base, and may form a ring-shaped cake.

The solvent (0.4% sodium chloride solution) is a clear, colorless liquid.

After reconstitution with the solvent provided, dengvaxia is a clear, colorless liquid with the possible presence of white to translucent particles.

Excipients/inactive ingredients: essential amino acids including l-phenylalanine, non-essential amino acids, l-arginine hydrochloride, sucrose, d-trehalose dihydrate, d-sorbitol, trometamol, urea, sodium chloride, water for injections.

 

Mechanism of action:

Dengvaxia contains dengue virus serotypes 1, 2, 3 and 4 that have been weakened. Dengvaxia works by stimulating the body's natural defenses (immune system), which produces its own protection (antibodies) against the viruses that cause dengue disease.

Dengue is a viral infection transmitted to humans through the bite of an infected aedes mosquito. Dengue is not transmitted directly from person-to-person. Nevertheless the virus which replicates in an infected individual can be transmitted to other humans through mosquito bites for 4-5 days (maximum 12 days) after the first symptoms appear.

Dengue disease results in a wide range of symptoms including fever, headache, pain behind the eyes, muscle and joint pain, nausea, vomiting, swollen glands or skin rash. Symptoms usually last for 2-7 days. Dengue disease can also be asymptomatic.

However, occasionally dengue can be severe and potentially lead to hospitalization and in rare cases to death. Severe dengue is characterized by high fever and any of the following symptoms: severe abdominal pain, persistent vomiting, rapid breathing, severe bleeding, bleeding in stomach, bleeding gums, fatigue, restlessness, coma, seizure and organ failure.

Source:- http://www.mims.com/philippines/drug/info/dengvaxia

More information about dengvaxia - First vaccine against dengue

Sanofi awaits govt approval to launch dengue vaccine in india

 

Sanofi pasteur - Dengue vaccine frequently asked questions

You found this helpful

I am 29 years old. My menstrual cycle lasts for 24 days. I got married on 17th July 2016. My LMP started on 2nd July. I had due date on 27july but I missed my periods that are regular. I thought I am pregnant but since morning I am observing spotting and abdominal cramps. What can it be? Kindly help.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Pune
I am 29 years old. My menstrual cycle lasts for 24 days. I got married on 17th July 2016. My LMP started on 2nd July....
Spotting is also observed some times in pregnancy too. So, please use a pregnancy kit to detect if you are pregnant or not. Further medicine will depend on the result.
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I'm 17. My breasts become sore an they hurt alot and half before my periods and the soreness lasts till my periods start. Is it okay?

MS-General Surgery, MBBS
General Surgeon, Hyderabad
I'm 17. My breasts become sore an they hurt alot and half before my periods and the soreness lasts till my periods st...
It is normal. It happens in most girls due to hormone changes. Take some simply pain killer. If problem persists then consult a general surgeon.
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Irregular periods problems. And what are the precautions taken. And to maintain health and hygiene during periods time. Thank you.

MS - Obstetrics and Gynaecology
Gynaecologist, Agra
Irregular periods problems. And what are the precautions taken. And to maintain health and hygiene during periods tim...
Are you married or unmarried? in early years mc may be irregular. In your case get and ultrasound done along with blood test in form of abo rh, cbc esr, tsh, and hormonal profile (for pco)
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Pickle vs Chutney - Which Is Healthier?

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Kanpur
Pickle vs Chutney - Which Is Healthier?

The primary difference between pickle and chutney lies in the fact that pickles are meant to be preserved for months together while chutneys are devoid of preservatives and are required to be consumed very soon. Both of these food items proffer a host of health benefits including an optimum supply of all the needful minerals and vitamins along with the antioxidants. Some of the ingredients present in the pickle and chutney help in controlling high blood pressure, diabetes, improves digestion and immunity.

Pickles and the process of preparing the pickles
The process of making pickles is known to have originated in India, and it was the most viable way of preserving food items so that it can be stored for future usage. The process started as a means of preserving those food items, which are not available all through the year. The conventional means of preparing pickles in oriental style incorporates the usage of ingredients like oil, salt, chilli powder along with other condiments. The ingredients are mixed as per the set proportions, and there are many health benefits of eating pickles on a regular basis.

As per the reports of NSDA, pickles contain moisture, energy, fat, protein, carbohydrates, fibres, vitamins and sugar. The long list of vitamins includes Vitamin A, Vitamin B, Vitamin B-12, Vitamin C, Vitamin E, Vitamin K, riboflavin, niacin, thiamin, and folate. Indian pickles abound in phosphorus, iron, magnesium, sodium and potassium. The health benefits of pickles include the supply of necessary antioxidants, probiotics which are the gut-friendly antibiotics, helps in digestion, improve haemoglobin levels in anaemic people. There are some pickles which aid in controlling blood pressure levels and have hepatoprotective properties.

Chutney and their health benefits
Chutneys are a ubiquitous component of Indian cuisine, and some of the most common flavours added to the chutneys include ginger, garlic, onion salt, sugar and tamarind among others. Homemade chutneys prepared in almost all Indian households can be preserved for about a week in the refrigerator. Chutneys are filled with vitamins along with other nutrients, and less usage of oil makes it fat-free. They are rich in antioxidants, and sometimes fresh leaves are added to ensure inclusion of chlorophyll.

Just like pickles, chutneys also offer a wide range of advantages for one’s health. It provides the body with the needful amount of antioxidants which are the micronutrients that aid in protecting the body from the free radicals. These free radicals are a type of unstable chemicals being generated at the time of cellular metabolism and react with the cells and cause damage to the DNA. The DNA then becomes unstable and gives way to the production of more free radicals which can be controlled by the consumption of antioxidants. The chutneys also supply the body with all the vitamins, minerals and other micronutrients which are necessary for sustaining healthy living.

To conclude, both pickles, as well as chutneys, are a significant part of the Indian food habits. Both of these items have a great taste and offer a wide variety of health aids which testifies to their consumption on a regular basis. If you wish to discuss about any specific problem, you can consult an ayurveda.

5602 people found this helpful

Her periods end on 29 June Then when I do intercourse which can she get pregnant? ?

BHMS
Homeopath, Kaithal
Her periods end on 29 June
Then when I do intercourse which can she get pregnant? ?
Ok. Fertility period starts from 1 week after periods finishes, so I recommend you to have sex any day after 6th to 15th. For any other help regarding homoeopathic treatment contact me.
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MD(HOM), BHMS
Homeopath, Ludhiana
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We had sex first time with my fiancé and it was unprotected. We didn't have sex for very long only a couple minutes because I was scared, night my periods I just wanted to know what I should think/know abt I vil get pregnant if I take pill any side affects who to now need helps.

MBBS, MD - Obstetrtics & Gynaecology, FMAS, DMAS
Gynaecologist, Noida
Hello, If menses have not arrived, and its been a week, then get a serum beta hcg test done to rule out pregnancy first. If its just 72 hrs, then take an emergency contraceptive pill.
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Last month my menstruation date has came on 24 and this month it was on 15 is it the reason for dropslets after having flow of periods normally generally it will flow for 4 to 5 days but for the first time I have seen drops only after normal continue flow of my dates.

DGO, MD, MRCOG, CCST, Accredation in Colposcopy
Gynaecologist, Kolkata
Last month my menstruation date has came on 24 and this month it was on 15 is it the reason for dropslets after havin...
Don't worry too much . Keep a menstrual calendar for the next three months. If this trend persist then I would advice a Pelvic USG and thyroid function tests. If normal consider combined pills for the next 6 cycles to regularise your periods.
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I am 30 year old man. And my wife is 29 year old. We r trying. For child but my wife left side uterus is bloked nd doctor say still we ll have child. It gone 3.5yrs of my marriage. My count is ok also. Please give me such suggestions

MBBS, MD Obs & Gynae, FNB Reproductive Medicine
Gynaecologist, Jalandhar
If u want conception by natural methods she needs laparoscopy to look at the status of the tubes and tests for tuberculosis. Depending on the findings further treatment plan will be made. If pregnancy has not occurred she needs further evaluation.
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My wife is having irregular periods and abdominal pain for 1 years. He has been advice for weight loss and some regular medicine for 3 months. But she has done everything but nothing much helped. What should I do doctor? Thank you. She is 23 and weight 43 kg and height 5.2 ft.

MD - Obstetrtics & Gynaecology
Gynaecologist, Mumbai
My wife is having irregular periods and abdominal pain for 1 years. He has been advice  for weight loss and some regu...
You do blood test on 2nd to 5th day of period, f. S. H, l. H, t. S. H, prolactin, dht, pelvic u. S. G.
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May I know the reasons for occurrence of pregnancy. After having sex if we have doubt about pregnancy what to do to remove it? Medicines for removal of that?

MBBS, DNB (Obstetrics and Gynecology), MD - Obstetrtics & Gynaecology
Gynaecologist, Delhi
If you have not taken post coital pill in 72 hours, wait for oeriods, if overdue for 4-6 days do a oreg test, if pregnant a medical abortion may be done by a gynaecologist.
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Hi sir. I am newly marriage couple doing intercourse my partner cause irritation. After completed sex also long time irritation in there. What is the problem tell me.

MD-Ayurveda, Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Sexologist, Haldwani
Hi sir. I am newly marriage couple doing intercourse my partner cause irritation. After completed sex also long time ...
Hello, Internal lubrication of your partner is not secreting properly,which is causing pain, burning and irritation during sex. Use artificial lubrication during sex,use condom as its surface reduces the friction and hence minimise the pain. These are symptomatic solutions. For permanent relief start ayurvedic medicines and avoid excess of spicy and fast foods for you wife.
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Treating Chronic Lower Back Pain

BPTh/BPT
Physiotherapist, Ghaziabad
Treating Chronic Lower Back Pain

About 80 percent of people all across the globe experience lower back pain at some stage in their lives. It is one of the most common reasons why people miss their work and appoint a physiotherapist. But lower back pain is an ailment that can be avoided with proper knowledge and some back exercises. In case your lower back pain is not under control and you have been neglecting it, you are susceptible to acute pain, sciatica, nerve pain and pain in other regions caused from a pinched nerve. Long-term pain in the back portion can lead to permanent ailments like degenerative disc disease or spinal stenosis.

Probable causes of lower back pain: Severe pain in the lower back region can be caused due to a herniated disc, back muscle pain, ligament strain or any other non-specific pain. An individual may also suffer from lower back pain due to systemic conditions like rheumatoid arthritis, fibromyalgia or ankylosing spondylitis. Though these causes are very common in most people suffering from lower-back pain, the diagnosis varies from person to person and to ensure the best care to alleviate the pain, you must consult a responsive musculoskeletal physiotherapist.

Stages for assessing and treating lower back pain: Managing the back pain is the primary objective of physiotherapy. In reality, back pain is the final symptom that is developed and the first thing that must be addressed.

  • Stage I: Back pain relief: The physiotherapist is going to use different types of tools and items to help the pain subside along with the inflammation. These include electrotherapy, acupuncture, ice application, soft-tissue massage and deloading taping techniques. Sometimes the physiotherapist may also recommend an anti-inflammatory drug if the pain is intolerable.
  • Stage II: Restoring normal strength: With the settling of pain and inflammation, you are more susceptible to injury because though your pain has subsided, your ligaments and muscles are weak. Your doctor will aim at restoring normal motion of lumbar spine, muscle endurance and strength, proprioception, balance and walking abilities.
  • Stage III: Restoring full body function: Depending on your daily chores and activity, your physiotherapist will aim at restoring the function of your back portion to keep you safe while performing the chosen activities. For some, it may be taking a slow walk around the park while for others it may mean taking part in some sports activity.
  • Stage IV: Preventing recurrence: Your physiotherapist will rehabilitate you to prevent further occurrence of this excruciating pain by suggesting proper postures, exercise and core muscle workout.

Each of these stages are important to help you get rid of severe back pain and with daily exercise, you can regulate your body and spare yourself from recurrence of this lower back pain.

3230 people found this helpful

Is condom 100% avoid pregnancy? And why people speaks condoms are not 100% safe to avoid pregnancy?

Minimal invasive surgery in gynaecology, MD - Obstetrtics & Gynaecology, DNB, MBBS
Gynaecologist, Mumbai
Is condom 100% avoid pregnancy? And why people speaks condoms are not 100% safe to avoid pregnancy?
It's not 100% effective because of some chance of slippage and breakage. In fact nothing is 100%. Each method has its own failure rate
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When I do sex with my wife, I am not able ejuculate while doing sex instead I need take my penis out and masturbate for few mins/sec to ejuculate and as soon as I feel to ejuculate I insert my penis in vagina. Will this help to get baby. Is this normal?

MBBS
General Physician, Faridabad
When I do sex with my wife, I am not able ejuculate while doing sex instead I need take my penis out and masturbate f...
it will help to get baby. you go on doing, do not masturbate . its a habit try this or consult. thanks
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