Lybrate.com has top trusted Gynaecologists from across India. You will find Gynaecologists with more than 43 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.
Book Clinic Appointment
Endometrial Ablation Procedure
Treatment of Treatment of Breast Cancer
Management of Abortion
Hormonal Replacement Therapy Treatment
Caesarean Section Procedure
Treatment of Gynae Problems
Gynecology Laparoscopy Procedures
Treatment Of Female Sexual Problems
Treatment Of Menopause Related Issues
Treatment Of Menstrual Problems
Treatment of Mirena (Hormonal Iud)
Pap Smear Procedure
Polycystic Ovary Syndrome Treatment
Treatment of Uterine Bleeding
Antenatal And Postnatal Exercise
Submit a review for Dr. Kundan V IngaleYour feedback matters!
My girlfriend has not got periods since 1 month. This has happened before too. What could be the reason?
Ovulation study day 16 Endometrium size : 9.0 mm Left ovary: 16*1 Right ovary : msf It is possible to get pregnant with this dimensions.
I am having pain in both the legs and knee when I stand or walk from last 6 month. L took gemcal for 2 months and gemcal plus for additional 1 month but I didn't find much relief. Can I take calcirol sachet 60000 IU and gemcal. When and how should I take it.
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.
Hello I have a question my wife is just 21 and I am 24 she want to intercourse with her daily and also she is very seductive and also she want to force me do rough sex is there is any problem if I doing these things.
I am 24 weeks pregnant. My cervical length at 19 weeks 2 days was 4.1 cm. And now at 24 weeks cervical length is 3.2 cm. Am I at risk. What measures can I take to increase the length.
I had sex on 27 the day of period. I took an ipill the same day. I had very light bleeding after 5 hrs of the pill. What does it mean.
I am trying to conceive I just turn to 33 years please help me I am taking gestofit 100 mg as doctor suggested to insert inside vagina from 17th day to 15 day and check pregnancy test, my cycle is regular on 27th day, if I conceive I be very happy but if not then when will get my date coz I heard many saying gestofit delay periods please tell me. But my cycle is always in time, please tell me when the date of mine will come or it will come in 27 day of cycle please help me.
My periods are 20 days late .I did a home pregnancy test from prega news pregnancy test kit 5 days back but it came negative. I took an I pill last month on 21 sept and had my last period on 6 September. What can b done so that I get my periods.
I am pregnant nd right now in the starting of 2nd tri semester, so I can travel in domestic flight from Srinagar to Jammu and the duration of this flight is about 50 minutes.
Bread is a very versatile food variant and finds its place on most breakfast platters. Be it white, brown or whole grain, mass produced quality or home-baked artisan kind, bread is almost indispensable in modern Indian household. There has been incessant debate over which carries the most health benefits and nutritional value, read on to explore…
Why brown or whole wheat bread is good for you?
1. Whole wheat grain
Flour is prepared from wheat berries made out of the bran, the germ and the endosperm they in combination are filled with nutrients. Whole grain or wheat bread intake decreases LDL, or the bad cholesterol, it also helps you retain a healthy body weight due to low carbohydrate content and has a lower glycaemic index that keeps your blood sugar steady.
2. Smooth bowel movements
The fibrous quality provides you relief from irritable bowel syndrome. The bran and germ improves your bowel by increasing the bulk of stools, making it easier to pass through the intestines. If you are prescribed laxative medications all you need to do is have enough brown or wheat bread.
3. Nutrients and vitamins
Breads labelled whole grain contain a large amount of nutrients. One of the most important features of brown bread is that it contains most of B vitamins -including riboflavin, thiamine and niacin -- that helps your body acquire energy from food. Whole wheat breads are also rich in vitamins E, K, pantothenic acid and folate.
Tip – With only a slight difference in taste and texture, wheat bread adds as a great accompaniment with any dish. You can even double it up as a healthy sandwich by adding fresh veggies and cottage cheese, with only minimal preparation.
Why white bread is bad for you?
1. Low fibre content
White bread is low in fibre, an essential in lowering your levels of bad cholesterol and checks the smooth functioning of your gastrointestinal tract. An average slice of white bread consists only 0.5 grams of fibre with the whole wheat bread providing up to 2 grams of fibre.
2. Refined grains
The whole grain is stripped of all its bran and germ for it to be refined where it loses all elements that hold fibre, magnesium, zinc, vitamins and minerals. White bread is made from these refined grains. Even though bread-makers attempt to add some vitamins back in, fibrous whole grains prove to be the clear winner.
3. High glycemic index
This index measures how rapidly food affects your blood sugar and insulin levels compared to pure glucose. White bread has a high glycaemic index due to which it gets rapidly absorbed during digestion, causing sharp spikes in blood sugar and insulin levels. A diet comprising of high-glycaemic foods increases your chances of weight gain, type-2 diabetes and heart problems.
Replace the white bread with the equally tasty, wheat-made variant to score high on the fitness meter!
If you would like to consult with me privately, please click on 'Consult'.