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Dr. Rakesh Panja

Gynaecologist, Mumbai

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Dr. Rakesh Panja Gynaecologist, Mumbai
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My experience is coupled with genuine concern for my patients. All of my staff is dedicated to your comfort and prompt attention as well....more
My experience is coupled with genuine concern for my patients. All of my staff is dedicated to your comfort and prompt attention as well.
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Dr. Rakesh Panja is a renowned Gynaecologist in Mumbai, Mumbai. You can meet Dr. Rakesh Panja personally at Manav Kalyan Kendra in Mumbai, Mumbai. Book an appointment online with Dr. Rakesh Panja and consult privately on Lybrate.com.

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Manav Kalyan Kendra

Address: 1 Govind Nandanvan, Sv Road, Dahisar, SV Rd, Parbat Nagar, Borivali, Mumbai, MumbaiMumbai Get Directions
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Fasting For Eid - Know How You Can Break It The Healthy Way!

Bachelor of Unani Medicine and Surgery (B.U.M.S)
Unani Specialist, Gaya
Fasting For Eid - Know How You Can Break It The Healthy Way!

People across the planet observe fasting from dawn to dusk during the holy month of Ramadan, the ninth according to the Islamic calendar. The fasting is observed throughout the month to commemorate the first revelation that was made of the Holy Quran to Prophet Muhammad, and people remind themselves to abstain not only from food, but also from negative thoughts.

However, the fasting is observed from dawn until the onset of twilight. The most important part of this fasting ritual is breaking the fast, the consumption of the iftar.

Care needs to be taken when breaking a fast so as not to overburden your digestive system. Though fasting is a healthy regimen for both the mind as well as the body, the natural body cycle is challenged by reversing the normal food cycle and can affect metabolism.

Break the Eid fast in a smarter way

The most nutritious and easy-to-digest foods should be ingested to break a fast, gradually adding more diversity over time. You can try dates and honey, which are not only a part of the tradition, but also help and prepare the digestive system and being sweet in flavor they prevent you from overeating.

Eating heavy food can better be avoided while breaking the fast as they may create a sudden imbalance in the system. You may start with fruit juices and eat light food that is easy to digest. Fruit and vegetable juices, bone broths and even yogurt are good for that initial "breaking" of the fast.

Among these, fruits are the most popular and easiest. But whatever you do, rehydrate yourself with a couple of glasses of water and continue to take sips through the evening.

Not full yet, try these

Lettuce and spinach (you can use plain yogurt as a dressing and top with fresh fruit), cooked vegetables and vegetable soups, raw vegetables, well-cooked grains and beans, nuts and eggs, and milk products are recommended.

The body undergoes minor internal changes, like enzymes usually produced by the digestive system, have ceased to be produced or have been diminished greatly while observing the fast, so introducing food slowly allows the body to re-establish the enzyme production.

Also, try making healthy choices, for instance, grilled meats instead of fried, light sauces instead of creamy ones and limited portions of white rice and bread. Fiber and protein rich diets should be preferred choice.

Put a vigil on your wandering hands

While fasting the mucus lining of the stomach momentarily is reduced, making the stomach walls more vulnerable to irritation until it returns to normal. Gentle introduction of foods, beginning with the simplest and easy-to-digest foods supports this process. Coffee and spicy foods like haleem or beef must be avoided, as it can cause irritation to the system, during the fast.

Also limiting sugary syrups and fizzy drinks can help you keep your weight and blood sugar levels in check. The same goes for fatty foods, preservatives, and soft drinks. Avoid vinegar and chili, for instance.

To conclude, after fasting for long hours, while breaking the fast, small meals are preferred as the digestion will be slow and also avoid food that is spicy and heavy. Introduce nutrient-rich ingredients in the meal and have proteins and essential vitamins and minerals in your diet. And last, but not the least, keep yourself well hydrated.

This Eid, break the fast the healthy way! If you wish to discuss about any specific problem, you can consult a doctor.

4774 people found this helpful

Effective Ways To Deal With Hereditary Heart Disease!

DM - Cardiology -, MD - General Medicine - , MBBS, FSCAI, MHRS, FACC, FESC , Fellowship in Interventional Cardiology & EP, Interventional Cardiology & EP and Devices, Senior Specialist( Interventional Cardiology), Fellow of southeast Asian Interventional Cardiology Society, International Award of Excellence in Cardiology
Cardiologist, Delhi
Effective Ways To Deal With Hereditary Heart Disease!

Ever wondered why you needed to share your family’s health history at a doctor’s clinic? Specific questions regarding health issues of your immediate family or close blood relatives give your doctor an insight into various health risks you might have now or in future. Those are medical conditions inherited by parents or grandparents through genes. Genes are passed from parents to children in DNA of eggs or sperms. Even a single mutation (fault) in gene can influence body systems and may lead to disorders. If any of the parents have a faulty gene, there are 50:50 chances of the child inheriting it.

Hereditary heart diseases are also a result of mutation in one or more genes and tend to run in families. Genes control almost all aspects of cardiovascular system including strengthening blood vessels, pumping capacity or communication of cells in the heart. A single genetic variation is enough to alter cardiovascular processes increasing the risk of developing a heart disease, attack or a stroke. Some of the most common hereditary cardiac disorders include; Arrhythmias, congenital heart diseases and cardiomyopathy. A family history of heart attack or stroke is also an established high-risk factor for the family members. High blood cholesterol, medically known as familial hypercholesterolemia also tends to run in families.

Unfortunately, many of these conditions cannot be prevented since they are acquired through genes. But there are many ways in which these could be managed before they become complicated or fatal.

Let’s look at some ways by which we can deal with hereditary heart diseases and increase a patient’s chances of survival:

  1. Early Diagnosis And Treatment: When one person in the family is diagnosed with a heart disease, it is strongly advisable for other family members to go in for screening. An early diagnosis can help in better treatment and management of the disease and impacts positively on patients’ life. Medical screening of siblings is highly recommended in case a person suffers a sudden cardiac death especially at a young age.

  2. Watch out for these symptoms at a young age: Abnormal heart rhythm, asthma that does not get better with inhaler, seizures that do not improve with medication, extreme fatigue or shortness of breath are warning signals and need immediate medical attention.

  3. Genetic Testing: Family members may opt for genetic testing to check if they carried genes of an inherited disorder.

  4. Genetic Counselling: Genetic counselling deals with problems like anxieties and fear of attacks, confusion over disease and emotional difficulties in accepting the situation.

We may not be able to change the family history but we can surely change our environment, lifestyle and habits. Eating healthy and following an active lifestyle does help in prevention and management of such diseases.

2 people found this helpful

Me and my lover had unprotected sex before the first day of her period. Is there any chance of pregnancy during safe period?

MD - Obstetrtics & Gynaecology
Gynaecologist, Faridabad
Me and my lover had unprotected sex before the first day of her period. Is there any chance of pregnancy during safe ...
Unlikely as it was just a day before period and she got her periods later on. However following safe period has its failures, consider regular contraceptive. Consult a gynaecologist for detailed advice.
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My gf periods has not come this month. We had sex last month. Is this any symptoms of pregnancy of her?

BHMS
Homeopath, Faridabad
My gf periods has not come this month. We had sex last month.
Is this any symptoms of pregnancy of her?
Write down the date of her last menses and the expected date for the coming month, her menstrual cycle and the duration, everything!
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We have been having unprotected sex for around a month and my girlfriend is facing problem like regular urination. Help me how to diagnose if she is pregnant or not . N how to terminate pregnancy.

BDS, Certification in hypnotherapy, Certification in N.L.P, Certification in Gene and behavior, Psychology at Work
Psychologist, Gurgaon
We have been having unprotected sex for around a month and my girlfriend is facing problem like regular urination. He...
This looks like some urine infection. Get her urine routine test done and consult a physician if there is a problem. To rule our pregnancy buy a pregnancy kit from a medical store, it is cheap, accurate and easy for self use in future, try using condom and maintain your pubic hygiene.
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I had my c sec last month (sep 17) and gave birth to twin girls. Bleeding did not stop till now. Bleeding is on and off. Is this normal. Also my breast milk is less. Can I use manual pump? Or any ways to increase my breast milk. Thanks in advance.

MBBS
General Physician, Mumbai
I had my c sec last month (sep 17) and gave birth to twin girls. Bleeding did not stop till now. Bleeding is on and o...
Get an ultrasound pelvis done to rule out any pathology and we should concentrate on stopping the bleed and I will suggest you to eat nutritious home made food with adequate fluid intake and take physical rest.
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Msc- food and nutrition
Dietitian/Nutritionist,
Go for a five meal daily plan

It is ideal for you to eat small quantities of nutritious food regularly to reduce your weight. It is ideal for you to include at least 30 to 45 minutes of exercise every day to see visible differences in weight.

Have a breakfast by 8: 30 am in the morning and limit it to 250 to 300 calories.
Have a handful of nuts as a mid morning snack at 10: 30 am
Have your lunch at 12.45 pm and make sure it is only a diet full of veggies and fruits.
At 2: 30 pm have your afternoon snack that could be carrot sticks or apple with low fat peanut butter?
At 6 pm have the last meal of the day that includes a cup of vegetables before the meal? then drink water and follow it with a cup of rice and lean meat.

She is four week pregnant, our doc took first hcg test which came around 305, so I need to know is it normal? We underwent 2nd hcg test also whose report we will get on monday. So is it compulsory tht hcg should double after 48 hours. Our gynac also recommended to take hcg injection. So it viable to take that.

MBBS, MD - Obstetrtics & Gynaecology, FMAS, DMAS
Gynaecologist, Noida
She is four week pregnant, our doc took first hcg test which came around 305, so I need to know is it normal? We unde...
Hello, yes it is necessary for hcg levels to increase by 65% to double in 48 hrs as this confirms the viability of the foetus whether the foetus shall survive/ grow further or not.
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I had miscarriage this month. And I want to conceive again. Now I want to know when I can plan to conceive next? And what precautions I should take to have a successful pregnancy?

Diploma in Obstetrics & Gynaecology, MBBS
General Physician, Delhi
I had miscarriage this month. And I want to conceive again. Now I want to know when I can plan to conceive next? And ...
You should know about the cause of miscarriage if you are not anemic, plan next baby anytime be careful about getting tested for 5 types of infections responsible for miscarriages. It's called torch test if any infections is positive, get treatment, wait for 6 months if tests are negative, plan next baby at earliest.
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I am 25 year old I was plan for child. So what will I do. I period coming on this moth 12/2/16 so what should I do. I have completed 9month for marriage? Please suggest me the good thing?

MD - Obstetrtics & Gynaecology
Gynaecologist, Delhi
I am 25 year old I was plan for child. So what will I do. I period coming on this moth 12/2/16 so what should I do. I...
You can continue as your normal life and routine intercourse if no any problem you may conceive the most chances of your conceive is around 26-28 feb.
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My girlfriend is 24 years old I had sex with her she took i pill within 24 hours but after 7 days bleeding started what happens please help me.

Fellowship In Minimal Access Surgery, MS - Obstetrics and Gynaecology, MBBS
Gynaecologist, Hyderabad
My girlfriend is 24 years old I had sex with her she took i pill within 24 hours but after 7 days bleeding started wh...
Hi lybrate user, this bleeding can be due to ipill, as ipill is not 100%effective in preventing pregnancy, wait till her periods, if she misses her period do a urine pregnency test and confirm.
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I am 25 year old girl and having irregular period from starting (45-50days cycle), but now my periods time is increasing day by day, this time it takes 4.5 months. I am taking yasmin tablet also as per doctor suggestion, Is it ok?

MD, Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Pune
You need ayurvedic tablets to restore the balance of hormones. Taking just yasmin is not sufficient.
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Hello Doctor, Please Help me with this. I had only entered very little amount of my penis inside her vagina. And had 2-3 stokes only. Is there chances of pregnancy? What should I do? Please help.

MBBS, DNB - Obstetrics & Gynecology
Gynaecologist, Mumbai
Hello Doctor, Please Help me with this.
I had only entered very little amount of my penis inside her vagina. And had ...
Hi chances of pregnancy are very less. Nonetheless, unprotected intercourse is always risky, even precum can also make female pregnant. Use of condom is ecommended.
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My girl friend is telling me to do sex with hr but hr vagina shod not brake like dt she tlng me to do sex how can we do like dt.

C.S.C, D.C.H, M.B.B.S
General Physician,
It is not possible to do sex without entering vagina and in that process they hymen will break. Instead of sex you can do foreplay and enjoy
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All you need to know about premenstrual dysphoric disorder

DGO, MBBS
Gynaecologist, Delhi
All you need to know about premenstrual dysphoric disorder

Premenstrual dysphoric disorder (PMDD) is a severe and more dangerous form of premenstrual syndrome (PMS). Premenstrual syndrome describes symptoms a woman may have a few days before her menstrual cycle. The most common ones include tender breasts, bloating, cramps, mood swings, and headaches. The symptoms of PMDD are similar to those of PMS but are severe enough to interfere with your routine work, social activities, and relationships.

What causes PMDD?

The exact cause behind this medical condition is unknown but most doctors and researchers believe that the disease is caused due to the bodily changes that you undergo due to the rapidly changing hormones in your body.

What are the most common symptoms associated with it?

The symptoms of PMDD show a very close resemblance to the symptoms of PMS, and they are mostly the same but differ in terms of intensity and severity. The most common symptoms of the condition include the following:

  • Mood swings
  • Depression or feelings of hopelessness
  • Unnecessary anger resulting in increased interpersonal conflicts
  • Tension and anxiety
  • Decreased interest in everyday activities
  • Difficulty in concentrating
  • Fatigue
  • Change in dietary patterns
  • Sleep problems
  • Physical problems such as bloating, breast tenderness, swelling, headaches, joint or muscle pain

How can PMDD be treated?

A host of effective and efficient treatments are available for the treatment of PMDD. However, this condition is diagnosed by a doctor only when the symptoms of the disorder are identified. The common measures to treat the PMDD disease are as follows:

- Good nutrition
- Exercise
- Medications
- Counseling

'Consult'.

Related Tip: 6 Reasons To Avoid Aerated Drinks During Your PMS

Boerhaave Syndrome

md general phisician
General Physician, Hyderabad
Boerhaave Syndrome

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%.
 

Pathophysiology
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. [3] a 1986 summary by bladergroen et al described 127 cases. [4] 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.
Mortality/morbidity

Prognosis
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.
 

Morbidity/mortality
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.
 

Complications
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.

I am 31 years old and I am trying for pregnancy for 2 yrs. I have done all the tests as Doctor said and have all the results positive. So doctor asked me to try normally and have not given any medicine. What should I now.

DNB (Obstetrics and Gynecology), DGO, MBBS
Gynaecologist, Hyderabad
I am 31 years old and I am trying for pregnancy for 2 yrs. I have done all the tests as Doctor said and have all the ...
Pcos hi if you want to become pregnant and you are not getting success since 2 years than please do following tests first for you - s lh, s fsh, s prolactin. S etradiol, hsg-hysterosalpingogram usg pelvis for husband- semen analyisis if everything comes normal than you should go for ovulation induction with t clomiphene/t letrozole from 2nd to 7 th day of cycle along with follicular study from 10th day to see how follicle is growing for at least 5-6 cycle and if you not succeed with that than next is iui/ivf technique. Happy to help you thanks.
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