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Dr. Suchitra Samir Dalvie

Gynaecologist, Mumbai

600 at clinic
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Dr. Suchitra Samir Dalvie Gynaecologist, Mumbai
600 at clinic
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I'm a caring, skilled professional, dedicated to simplifying what is often a very complicated and confusing area of health care....more
I'm a caring, skilled professional, dedicated to simplifying what is often a very complicated and confusing area of health care.
More about Dr. Suchitra Samir Dalvie
Dr. Suchitra Samir Dalvie is an experienced Gynaecologist in Dadar West, Mumbai. She is currently practising at Shushrusha Hospital in Dadar West, Mumbai. You can book an instant appointment online with Dr. Suchitra Samir Dalvie on Lybrate.com.

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Street No 698-B, Ranade Road, Dadar West, Landmark : Nera Shivaji ParkMumbai Get Directions
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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 done hysterectomy on 22-12-2014. Last 45 days , i have little/moderate vaginal bleeding . By usg it revealed vault hematoma of size 6.5 mm x 2.5mm size. Please advice. How long it will cure.

MBBS, MD - Obstetrtics & Gynaecology, DNB, Fellowship in Infertility
Gynaecologist, Mumbai
Vault haematoma needs to be managed conservatively it will get liquify or organised.. just prevent infection. repeat a sonography after 3 months.
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I am 32 yr. My period cycle was 4th March. I had unprotected sex in evening of 24 March. I have taken i-pill on 26 March in evening. Again I had unprotected sex on 28 March evening. Can I get pregnant in that case? If yes than how I can avoid that as my son is very small so wanted to avoid. Pl reply.

MD - Obstetrtics & Gynaecology, MBBS
Gynaecologist, Kolkata
I am 32 yr. My period cycle was 4th March. I had unprotected sex in evening of 24 March. I have taken i-pill on 26 Ma...
You had first exposure on 20th day. In normal 28 days cycle, the egg ruptures on 14th day and can result in pregnancy till the 17th day. So if you were in a regular cycle your chance for pregnancy would be low. But quite often egg ruptures can get delayed, and this usually results in accidental pregnancy. The i-pill best works if taken within 12 hours and effect lasts for next 4-5 days. You were very much covered by safety period provided by i-pill, but unfortunately the drug has 20-30% failure rate. If pregnancy happens in spite of i-pill, you have to wait at least 7 days delayed period before you can test for pregnancy. In future it would be safer to use a regular pill.
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Ceaserian delivery ke baad kya unprotected sex kar sakte hai? Delivery ke baad menses nahi aye aur breastfeeding b continue hai toh kya hum bina protection ke sex karna chahiye?

MRCOG, Laparoscopic Suturing Skills in Surgical Disciples, Medical Writing Course, Laparoscopic Training, Diploma in Gyanecology Endoscopy, Diploma in Minimal Access Surgeries, MD - Obstetrtics & Gynaecology, Fellowship in Basic Endoscopy Training, FOGSI Ethi Skills Course, Training Course in Ultrasound-Obstetrics & Gynaecology, MBBS
Gynaecologist, Delhi
After delivery you are safe for 3 months only if you are breastfeeding. After 3 months you should use contraception.
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Calcium Tablets - Can They Be Bad For You?

MBBS, MD - Internal Medicine, Post Graduate Program in Diabetology
General Physician, Delhi
Calcium Tablets -  Can They Be Bad For You?

For many people, popping a calcium tablet is something which has benefits, but at the same time does no harm. After all, who does not want to have strong bones and healthy teeth? The unfortunate part is that things are not so simple and a lot of research has debunked this.

Take, for example, the findings that when an old woman has calcium, the fracture rates are not all that different as compared to one who has not had calcium supplements. In addition to this, it was also found as part of a study that there is no positive impact on the mineral density of the hip.

As a matter of fact, calcium tablets and supplements can pose a significant risk, as well. While it is true that calcium does help in the effort of getting heart disease, an amount which is greater than the dietary limit does not. Actually, the excess calcium may increase the risk. This is true when it comes to calcium from supplements and not calcium which is absorbed by the way of food. So, what sort of additional risk is there? A study found that people who receive calcium from a tablet or another similar source have about a 140% greater chance of a heart attack!

How much is too much?

A thousand milligrammes of calcium in excess of the requirement on a daily basis is said to increase the risk of death from CVD or cardiovascular disease by about a fifth. Not a trivial amount, by any measure.

But why does this happen?

The key to answering this question comes from how the calcium is absorbed by the body. When calcium from food is eaten, the rate of it being released is a lot slower as compared to calcium from tablets. Also, when there is excess calcium, it is not absorbed and kept in reserve by the body but is excreted in the form of urine. So, this calcium going through the kidneys can cause some trouble there, as well!

Yes or No?

So, what is to be done in order to make sure one is having a sufficient amount of calcium? Well, there are a lot of sources and consuming things such as dairy products and fish, along with dark leafy vegetables are some great ways to get natural calcium. Only if a person has very low calcium levels should calcium tablets be consumed? It is well worth remembering that too much of a good thing is a bad thing! If you wish to discuss about any specific problem, you can consult a General Physician.

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Sir/madam please tell me, sex with pregnant lover. It is safe or not. My wife have 1st month pregnancy. Please tell.

BHMS
Homeopath, Faridabad
Sir/madam please  tell me, sex with pregnant lover. It is safe or not. My wife have  1st month  pregnancy. Please tell.
Hi, congratulations! it's always better to avoid sex during 1st trimester (i. E. First 3 months of pregnancy) and last trimester (last 3 months of pregnancy) as chances of abortion or miscarriage are more. You can ejaculate outside to prevent that. Let your wife have safe and stress-free pregnancy! all the best best! and take care.
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I am not getting bleeding in mensuration what food I have to eat for natural bleeding? Please advise.

DGO, MD, MRCOG, CCST, Accredation in Colposcopy
Gynaecologist, Kolkata
I am not getting bleeding in mensuration what food I have to eat for natural bleeding? Please advise.
If you are getting scanty periods please get a hb done first. If low take iron rich foods like green leafy vegetables, citrous fruits like oranges and chicken/ fish that are rich in iron.
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I am day time sleep every day. As I will sleep at night 11 pm & wake up at 7 am. At work time I get automatically sleep. This cycle is continuously 4 to 5 times in day.

DHMS (Hons.)
Homeopath, Patna
I am day time sleep every day. As I will sleep at night 11 pm & wake up at 7 am. At work time I get automatically sle...
Hello, lybrate user, you need to go for a sugar test. You are under weight, causing weakness, litharzicity, sleepy mood, aversion to talk to people. Accumulation of carbondioxide in body, may cause sleepy mood all d time. You should follow the under noted tips. * go for a walk in d morning to burn the fats ant circulate oxygen to nourish your body. * go for meditation to reduce your stress and to nourish your brain to ease your problem. * tk plenty of water to hydrate your body and to regulate metabolism. * your diet be easily digestible on time. Tk care.
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I am 23 year old female. About to. Get married in next 3 years. I am. Planning for twins desperately. Will clomid be helpful and safe. And what else I can do?

DGO, MBBS
Sexologist,
Though clomid can increase chances of multiple pregnancies, but you may not get desired twins. Most often it results in single pregnancy. Ivf can give multiple pregnancies.
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My friend have disease" polycystic ovarian syndrome" I want to know about this disease. And what are the symptoms of this disease? What problem may face from this disease? And is proper treatment is available to vanish this?

PGDHHM, MBBS
General Physician, Delhi
Polycystic ovarian disease causes irregular menstrual cycles, excessive body or facial hair and polycystic ovaries and infertility. It is due to hormonal imbalances. Treatment-- healthy diet and regular exercise is recommended for all women with pcos. If overweight, reduce your weight. Medications includes-birth control pills to regulate menstruation, insulin-sensitizing medications, ovulation induction to treat infertility or androgen-blocking medications. Hope I answered your query.
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