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Dr. Kulkarni Pratibha N

Gynaecologist, Pune

250 at clinic
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Dr. Kulkarni Pratibha N Gynaecologist, Pune
250 at clinic
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Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; a......more
Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; as a health provider being ethical is not just a remembered value, but a strongly observed one.
More about Dr. Kulkarni Pratibha N
Dr. Kulkarni Pratibha N is a trusted Gynaecologist in Sadashiv peth, Pune. She is currently associated with Asha Clinic in Sadashiv peth, Pune. Book an appointment online with Dr. Kulkarni Pratibha N and consult privately on Lybrate.com.

Lybrate.com has top trusted Gynaecologists from across India. You will find Gynaecologists with more than 27 years of experience on Lybrate.com. You can find Gynaecologists online in Pune 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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Asha Clinic

2 A Nilayam Society, Off Paud Rd, Lokmanya Nagar-Sadashiv Peth,Landmark:-Near Kinara Hotel, PunePune Get Directions
250 at clinic
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Hello mai 5mth pregnant hu abhi mene ultrasound karvaya he jisme bataya he ki AFI 5.22 cm he to mujhe please sahi slaha dijiye me kya karu.

MBBS
General Physician, Chandigarh
Hello mai  5mth pregnant hu abhi mene ultrasound karvaya he jisme bataya he ki AFI 5.22 cm he to mujhe please sahi sl...
You have to keep a check on the progress by repeated ultrasound and then decide according to the report one single report is not confirmatory.
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DYSPHAGIA (SWALLOWING PROBLEM) IN BRIEF AND IT'S MANAGEMENT

Master of Hospital Administration, Bachelor of Audiology & Speech Language Pathology (B.A.S.L.P)
Speech Therapist, Gurgaon
DYSPHAGIA (SWALLOWING PROBLEM) IN BRIEF AND IT'S MANAGEMENT

What are some signs or symptoms of swallowing disorders?

Several diseases, conditions, or surgical interventions can result in swallowing problems.

General signs may include:

 

  •     Coughing during or right after eating or drinking
  •     Wet or gurgly sounding voice during or after eating or drinking
  •     Extra effort or time needed to chew or swallow
  •     Food or liquid leaking from the mouth or getting stuck in the mouth
  •     Recurring pneumonia or chest congestion after eating
  •     Weight loss or dehydration from not being able to eat enough

As a result, adults may have:

 

  •     Poor nutrition or dehydration
  •     Risk of aspiration (food or liquid entering the airway), which can lead to pneumonia and chronic lung disease
  •     Less enjoyment of eating or drinking
  •     Embarrassment or isolation in social situations involving eating

Most swallowing problems can be treated, although the treatment you receive will depend on the type of dysphagia you have.

Treatment will depend on whether your swallowing problem is in the mouth or throat (oropharyngeal, or 'high' dysphagia), or in the oesophagus (oesophageal, or 'low' dysphagia).

The cause of dysphagia is also considered when deciding on treatment. In some cases, treating the underlying cause, such as mouth cancer or oesophageal cancer, can help relieve swallowing problems.

Treatment for dysphagia may be managed by a group of specialists known as a multidisciplinary team (mdt). Your mdt may include a speech and language therapist (slt), a surgeon, and a dietitian.

High (oropharyngeal) dysphagia

High dysphagia is swallowing difficulties caused by problems with the mouth or throat.

It can be difficult to treat if it's caused by a condition that affects the nervous system. This is because these problems can't usually be corrected using medication or surgery.

There are three main treatments for high dysphagia:

 

  •     Swallowing therapy
  •     Dietary changes and
  •     Feeding tubes

Swallowing therapy

You may be referred to a speech and language therapist (slt) for swallowing therapy if you have high dysphagia.

An slt (speech language therapist) is a healthcare professional trained to work with people with feeding or swallowing difficulties.

Slts use a range of techniques that can be tailored to your specific problem, such as teaching you swallowing exercises.

Dietary changes

You may be referred to a dietitian (specialist in nutrition) for advice about changes to your diet to make sure you receive a healthy, balanced diet.

An slt can give you advice about softer foods and thickened fluids that you may find easier to swallow. They may also try to ensure you're getting the support you need at meal times.

Feeding tubes

Feeding tubes can be used to provide nutrition while you're recovering your ability to swallow. They may also be required in severe cases of dysphagia that put you at risk of malnutrition and dehydration.

A feeding tube can also make it easier for you to take the medication you may need for other conditions.

There are two types of feeding tubes:

  1.     A nasogastric tube - a tube that is passed down your nose and into your stomach
  2.     A percutaneous endoscopic gastrostomy (peg) tube - a tube that is implanted directly into your stomach

Nasogastric tubes are designed for short-term use. The tube will need to be replaced and swapped to the other nostril after about a month. Peg tubes are designed for long-term use and last several months before they need to be replaced.

Most people with dysphagia prefer to use a peg tube because it can be hidden under clothing. However, they carry a greater risk of complications compared with nasogastric tubes.

Minor complications of peg tubes include tube displacement, skin infection, and a blocked or leaking tube. Two major complications of peg tubes are infection and internal bleeding.

Resuming normal feeding may be more difficult with a peg tube compared with using a nasogastric tube. The convenience of peg tubes can make people less willing to carry out swallowing exercises and dietary changes than those who use nasogastric tubes.

You should discuss the pros and cons of both types of feeding tubes with your treatment team.

Low (oesophageal) dysphagia

Low dysphagia is swallowing difficulties caused by problems with the oesophagus.

Medication

Depending on the cause of low dysphagia, it may be possible to treat it with medication. For example, proton pump inhibitors (ppis) used to treat indigestion may improve symptoms caused by narrowing or scarring of the oesophagus. 

Botulinum toxin

Botulinum toxin can sometimes be used to treat achalasia. This is a condition where the muscles in the oesophagus become too stiff to allow food and liquid to enter the stomach.

It can be used to paralyse the tightened muscles that prevent food from reaching the stomach. However, the effects only last for around six months.

Surgery

Other cases of low dysphagia can usually be treated with surgery.

Endoscopic dilatation

Endoscopic dilation is widely used to treat dysphagia caused by obstruction. It can also be used to stretch your oesophagus if it's scarred.

Endoscopic dilatation will be carried out during an internal examination of your oesophagus (gastroscopy) using an endoscopy.

An endoscope is passed down your throat and into your oesophagus, and images of the inside of your body are transmitted to a television screen.

Using the image as guidance, a small balloon or a bougie (a thin, flexible medical instrument) is passed through the narrowed part of your oesophagus to widen it. If a balloon is used, it will be gradually inflated to widen your oesophagus before being deflated and removed.

You may be given a mild sedative before the procedure to relax you. There's a small risk that the procedure could cause a tear or perforate your oesophagus.

Find out more about gastroscopy.

Inserting a stent

If you have oesophageal cancer that can't be removed, it's usually recommended that you have a stent inserted instead of endoscopic dilatation. This is because, if you have cancer, there's a higher risk of perforating your oesophagus if it's stretched.

A stent (usually a metal mesh tube) is inserted into your oesophagus during an endoscopy or under x-ray guidance.

The stent then gradually expands to create a passage wide enough to allow food to pass through. You'll need to follow a particular diet to keep the stent open without having blockages.

Congenital dysphagia

If your baby is born with difficulty swallowing (congenital dysphagia), their treatment will depend on the cause.

Cerebral palsy

Dysphagia caused by cerebral palsy can be treated with speech and language therapy. Your child will be taught how to swallow, how to adjust the type of food they eat, and how to use feeding tubes. 

Cleft lip and palate

Cleft lip and palate is a facial birth defect that can cause dysphagia. It's usually treated with surgery. 

Narrowing of the oesophagus

Narrowing of the oesophagus may be treated with a type of surgery called dilatation to widen the oesophagus. 


Gastro-oesophageal reflux disease (gord)

Dysphagia caused by gastro-oesophageal reflux disease (gord) can be treated using specially thickened feeds instead of your usual breast or formula milk. Sometimes medication may also be used.
 

I have a problem of irregular menstruation. In a year I get only 3/4 times menstruation but I don't feel any pain during menstruation time. How can I get my menstruation regular? Can you suggest me?

Advanced Aesthetics
Ayurveda, Gulbarga
I have a problem of irregular menstruation. In a year I get only 3/4 times menstruation but I don't feel any pain dur...
1. m2tone syrup 5ml 2times after food 2. ashokarista 3spoon 3times a day its helpfull to regulate ur periods take for minimum 3monthd...
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My partner got pregnant 2 weeks ago, Bt she want to avoid pregnancy right now. So what will she do now. quickly please.

MBBS
General Physician, Mumbai
My partner got pregnant 2 weeks ago, Bt she want to avoid pregnancy right now.
So what will she do now. quickly please.
First get an ultrasound done and with the report meet a gynaecologist and ask for oral abortion pills.
2 people found this helpful
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Sir after taking (Misoprostol Mifepristone) on 25 July I started heavy bleeding with clotting I feel cramp and bleeding happen till 9 days but I am not seeing any symptoms of pregnancy I am fine but when my periods will start and my abortion happen or not please guide me sir.

M.B.S.(HOMEO), MD - Homeopathy
Homeopath, Visakhapatnam
Sir after taking (Misoprostol Mifepristone) on 25 July I started heavy bleeding with clotting I feel cramp and bleedi...
Most of the side effects when using this early abortion option are caused by the second medication, misoprostol. Side-effects may include heavy bleeding, headache, nausea, vomiting, diarrhea, and heavy cramping. Vaginal bleeding with medical abortion could be extremely heavy. Mifepristone blocks the hormone progesterone needed to maintain the pregnancy. Because this hormone is blocked, the uterine lining begins to shed, the cervix begins to soften and bleeding may occur. With the later addition of the second medication, misoprostol, the uterus contracts and the pregnancy is usually expelled within 6 to 8 hours. Aftercare a follow-up exam is scheduled for two weeks later to make sure the process is complete. If you have not yet miscarried, we will perform a aspiration abortion. A very small percentage (5%) of women do not pass the pregnancy tissue and need a suction procedure to complete the process. Side effects most of the side effects when using this early abortion option are caused by the second medication, misoprostol. Side-effects may include heavy bleeding, headache, nausea, vomiting, diarrhea, and heavy cramping. Risks vaginal bleeding with medical abortion could be extremely heavy. In rare situations it could require a aspiration abortion and very rarely, a blood transfusion. You will be given our 24-hour hotline number to call if you have any problems. Medical staff are on call at all times to answer your medical questions and concerns. If pregnancy is continued after taking these medications, there is a high risk of fetal deformities. Aftercare a follow-up exam is scheduled for two weeks later to make sure the process is complete. If you have not yet miscarried, we will perform a aspiration abortion. A very small percentage (5%) of women do not pass the pregnancy tissue and need a suction procedure to complete the process. Side effects most of the side effects when using this early abortion option are caused by the second medication, misoprostol. Side-effects may include heavy bleeding, headache, nausea, vomiting, diarrhea, and heavy cramping. Risks vaginal bleeding with medical abortion could be extremely heavy. In rare situations it could require a aspiration abortion and very rarely, a blood transfusion. You will be given our 24-hour hotline number to call if you have any problems. Medical staff are on call at all times to answer your medical questions and concerns. If pregnancy is continued after taking these medications, there is a high risk of fetal deformities.
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I am 38 yr old. My follicle is not grown up to 18 mm. What is the solution for this?

International Academy of Classical Homeopathy, BHMS
Homeopath,
Since how many months u r having this condition ? needs detail. U can take puls303 hrly for 9 days inform me after usg. T. C.
1 person found this helpful
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During pregnancy if mom is not lying on bed then fetus is not having food properly inside the womb. If pregnant mother use to lying on bed it will help the baby to get food from her mother. Is it true?

MBBS, DGO
Gynaecologist, Mumbai
During pregnancy if mom is not lying on bed then fetus is not having food properly inside the womb. If pregnant mothe...
ya it's true..preferable to lie on left lateral position..never lie in supine position..it obstructs major blood vessels partially.
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WHAT YOU MUST KNOW ABOUT ACNE

DNB (Dermatology), Fellowship in Dermatological Laser Surgery, Fellowship In Cosmetic Dermatology, Diploma in Venerology & Dermatology (DVD), MBBS
Dermatologist, Mumbai
WHAT YOU MUST KNOW ABOUT ACNE
Hi lybrate-user, I would like to enlighten you about acne/pimples in brief.

What is acne?
Acne is a chronic inflammatory disease of the pilo sebaceous follicles (i. E. Hair with oil producing glands attached to hair) characterized by comedones (blackheads and whiteheads), papules, pustules, nodules and ultimately leading to scars.

Who gets acne?
Close to 100% of people between the ages of twelve and seventeen have at least an occasional whitehead, blackhead or pimple regardless of race or ethnicity. Acne starts between the ages of ten and fifteen years of age and usually lasts till twenty years of age; however, acne can persist into the late twenties or thirties or even beyond. Some people get acne for the first time as adults and this is known as adult acne.

What are the causes of acne?

Bacteria: bacteria that normally live on the skin play a role in acne development. The bacteria are known as propionibacterium acnes (p. Acnes). The bacteria content can increase in people whose faces are not clean.

Hormones: during the teen years increased levels of sex hormones cause the oil glands of the skin to produce increased amount of oil. These excess skin oils tend to bind with cellular debris causing a blockage and producing a fertile environment for the bacteria to grow. The bacteria cause inflammation, pus, swelling and redness. In adult acne, excessive hormones produced due to polycystic ovaries and other hormonal imbalances cause excess oil production and inflammation, which lead to acne.

What are the factors that precipitate or aggravate acne?

Stress- stress is frequently implicated in aggravation of acne while acne itself induces stress.

Sweat- sweating in a hot and humid environment causes deterioration in 15% of acne patients.

Menstruation- pre menstrual flare of acne occurs in 70% of female acne patients.

Friction and pressure- friction and pressure from helmets, backpacks and tight collars can induce blackheads and papules. Pressure from face massages or facials can aggravate acne.

Pregnancy- pregnancy has an unpredictable effect on acne. Pre-existing acne may aggravate or remit during pregnancy.

Diet- high glycemic load foods (sugar loaded and starchy foods), oily foods may aggravate acne.

Drugs- oral contraceptives, anti tuberculosis medication, oral steroids, anti depressants may aggravate acne.

Treatment for acne:
Treatment for acne needs to be individualized as per the type of acne and type of your skin.
For comedones (white and black heads), we recommend comedone extraction procedure.
For red papules (bumps), we recommend topical creams, chemical peels and oral antibiotics as per severity.
For nodules [big red swelling], intralesional steroid injections works fastest and are safe.
For acne scars, there are various procedures like dermaroller[microneedling], subscision, deep chemical peels and lasers.

Total duration of treatment for acne varies from 2 to 4 months for complete cure and for acne scars varies from 8 to 12 months. I recommend you to consult qualified dermatologist to prescribe you correct treatment that suits you the best after examining your skin.
1 person found this helpful

I am a married men, I need to ask about pregnancy. I am working in abroad. Last year I went to my country in my vacation on june that time we had a sex with my wife. My wife had a sex with another person. A month before I arrived. And she got a last menstruation on june 25th. After she was pregnant. I want to know after sex how many day will be take to pregnant. Was that child mine?

MBBS, MD - Social & Preventive Medicine / Community Medicine, Fellowship of european union of sexual medicine, Fellowship in diabetes
Sexologist, Chandrapur
I am a married men, I need to ask about pregnancy. I am working in abroad. Last year I went to my country in my vacat...
You can not know whether the child is your or not except dna testing or wait for the baby to be born and see if it resembles Best of luck.
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I am gaining weight after marriage in 8 months I have gained 13 kgs nd even I want to get pregnant that's why I am not going any gym or anything. please tell me whether Increasing weight is d prob. That I am not able to conceive.

MBBS
General Physician, Faridabad
I am gaining weight after marriage in 8 months I have gained 13 kgs nd even I want to get pregnant that's why I am no...
try to reduce your wt as it may cause problem, try if your cycle is regular then take chance on mid of cycle,. say your cycle start on 1st then try help between 12-17.during this period you have maximum chance. but it may happen at any time. it will. welcome.
1 person found this helpful
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