by Womanaari | Jan 1, 2024 | Uncategorized
When it comes to prioritizing your health, especially women’s well-being, finding the best gynaecologist is paramount. In the bustling city of Dubai, Dr. Talakere Usha Kiran stands out as a beacon of excellence, offering a comprehensive range of gynaecological services with a personal touch. Explore why she is regarded as the “Best Gynaecologist in Dubai”.
A Trusted Name in Women’s Health:
Dr. Usha Kiran’s reputation as a trusted gynaecologist in Dubai is built on a foundation of expertise, compassion, and a commitment to providing top-notch healthcare for women. With a wealth of experience spanning the UK and Dubai, her practice reflects a dedication to ensuring the well-being of every woman under her care.
Specialized Services Catered to You:
As a UK Certified (CCT) Consultant Gynaecologist, Dr. Usha Kiran brings a unique set of skills and services to her practice. From Scarless Surgery to Advanced Minimally Invasive Laparoscopic Procedures, she offers a comprehensive suite of services tailored to meet the diverse needs of women in Dubai. Whether you require Uterovaginal Prolapse surgery, treatment for Urinary Incontinence, or Cosmetic Gynaecological Procedures, Dr. Usha Kiran is your trusted partner in women’s health.
International Expertise, Local Care:
With 15 years of experience in the UK and a subsequent tenure as Unit Head and Associate Professor in Mumbai, Dr. Usha Kiran brings a global perspective to her practice in Dubai. Her international expertise is seamlessly woven into the fabric of local care, ensuring that you receive the best of both worlds – cutting-edge medical knowledge and personalized attention.
Accessible Excellence Across Prominent Hospitals:
Dr. Usha Kiran’s commitment to accessibility is reflected in her association with Prime Hospital, Emirates Speciality Hospital, International Modern Hospital, and Clemenceau Medical Center Hospital in Dubai. This strategic presence across renowned healthcare institutions ensures that quality gynaecological care is within reach for women across the city.
Why Choose Dr. Talakere Usha Kiran?
Holistic Care: Dr. Usha Kiran believes in treating not just the symptoms but the whole person, addressing your unique concerns and health goals.
Innovative Techniques: Embracing the latest advancements in gynaecology, including Scarless Surgery and Advanced Minimally Invasive procedures, for a more comfortable and effective experience.
Patient-Centric Approach: Your comfort and well-being are at the forefront of Dr. Usha Kiran’s practice. Expect an empathetic, and supportive environment.
Conclusion:
For those searching for the “Best Gynaecologist in Dubai,” Dr. Talakere Usha Kiran emerges as the epitome of excellence. With a commitment to personalized care, a wealth of international experience, and a comprehensive range of services, Dr. Usha Kiran is your trusted partner on the journey to optimal women’s health in the heart of Dubai. Schedule your appointment today and experience healthcare that truly puts you first.
by Womanaari | Aug 8, 2023 | Uncategorized
‘breastfeeding is a natural instinct?’ Maybe in the animal kingdom, not for humans anymore.
Maybe our ancestral women had more time on their hands, had more children, and learned more from their mothers and relatives about breastfeeding. But in this modern era where we women are always multitasking, breastfeeding is weighing heavy on our hearts and minds as neither does it come naturally nor is it easy to learn.
Some fortunate ones do it very easily and spontaneously. However, not everyone is that lucky.
After my own experience and seeing some of my patients go through this with a considerable amount of confusion and stress, I decided to write about the difficulties that women face rather than the benefits of breastfeeding (which I do not dispute).
For those who have or are experiencing difficulties, I would like to reassure and say ‘Do not feel guilty, you are not alone.’
1. Soon after the delivery, I was expecting to feel an intense desire to feed the baby, but I did not, Am I normal?
We are often given the impression that as soon as you give birth, you will experience this overwhelming motherly love and wanting to feed the baby.
Believe me, it is not so, and a majority of the women will agree with me on this. I looked at my baby and all I could think of was ‘How am I going to feel anything for this blob covered in liquor and blood.’
That was 15 years ago, and today, words are not enough to express what I feel for my children. So give it time. I am not saying 15 years! But at least 15 minutes or a couple of hours.
The feeling of bonding is the result of a hormonal milieu created by various hormones in the brain such as Oxytocin, Dopamine, etc.; Research has shown that 30% of women do experience delayed bonding which might be due to exhaustion, pain, or any other factor.
It is proven that if enough Oxytocin is injected, you can bond with anyone not just your baby!
So do not despair, it will kick in, and you will feel the ‘tug,’ Just hang on.
2. I have very small breasts, do you think I will be able to breastfeed?
Do not worry, the size of the breasts does not make any difference. Size varies depending on the fat content in the breast and fat is not what is producing the milk for your baby.
3. There is very little milk coming; I don’t think this is enough for my baby as he/she is hungry all the time and keeps waking up every 10 minutes to feed.
This is a common problem faced by first-time parents. The anxiety that your baby is not getting enough milk is normal. But believe me, the baby doesn’t need a lot of milk in the first two days.
In addition to this, the size of a newborn stomach is tiny and can hold only a teaspoon full of milk at a time which means it can feed only a tiny quantity at a time. However, by day 3 or 4, this capacity increases by four times and that is when you start noticing that your baby is sleeping a bit more between feeds. By this time the baby’s suckling reflexes also get better with practice.
4. Is it wrong to bottle-feed my baby?
There is nothing wrong or right about this. If for some reason, you are unable to breastfeed, there is nothing wrong with bottle-feeding your baby. You can’t let the baby starve, Can you ?!
However, before you decide to bottle feed, you need to be aware of a few things.
a. Bottle feeding doesn’t always equate to formula feeding. You can bottle-feed your baby with expressed breast milk (especially in premature babies who can’t suck and are in neonatal intensive care). This will provide all the benefits of breastfeeding. However, the expression of breast milk either manual or by the pump is not as stimulating as a baby suckling at your breast. So the establishment of milk production and maintenance is not effortless. So unless you did not have a choice (as in preterm or ill baby), it might be easier to breastfeed than bottle feed after the initial teething difficulties are overcome.
b. Bottle feeding with formula feeds although might be less tiring and troublesome and makes you feel like a normal sane person, doesn’t have all the benefits of breastfeeding (such as ideal composition for baby’s needs, gentle on the stomach, antibodies, less chance of infection plus lower risk of breast cancer for yourself to name a few )
5. My baby keeps vomiting and passing stools as soon as I finish feeding.
This again is quite normal. As soon as the milk enters the stomach, there is a reflex that makes the baby pass stools. As long as the stools are not greenish and the baby is passing enough urine and feeding and playing well, you needn’t worry. Vomiting or regurgitation is more common in babies who are bottle-fed as the baby ingests air while sucking through a bottle which is lesser while breastfeeding. It is important to keep the baby in an upright position for a while or until it burps to prevent this.
6. I was told not to feed the baby lying down, but my stitches in the perineum hurt.
There is nothing wrong with feeding a baby lying down as long as your position is correct. The reason mothers are advised not to do so is because of the risk of suffocation if the mother goes off to sleep while doing so. So be careful that you do not fall asleep while doing so and hence definitely do not feed lying down at night.
7. Can I take medicines to produce more milk?
There is no need for it. The main stimulus comes from the baby suckling. So if you want to increase your breast milk, just feed the baby more frequently. Drink lots of water and fluids (such as juice and milk which have the nutrients).
Consult your doctor if you are not getting enough milk despite this.
8. I feel like a failure as my baby doesn’t want to feed from me as it feeds well from the bottle but cries when I try to breastfeed.
Babies do not have any such feelings towards you. They are just doing what is easy for them. Milk flows more easily from the bottle, but the baby needs to do a workout to get it out of his breast. So once they know this trick they just cry until they get the bottle.
9. Am I a bad mother if I do not want to breastfeed my baby?
Despite everything you have heard and read, some of you might just not want to breastfeed at all.
Honestly, that is ok. No need to beat yourselves for it. Like everything else you do in life, you do have a choice despite what everyone around you says. So do not feel guilty about it.
10. Will my baby bond with me if I do not breastfeed?
Fathers do not breastfeed!
Breastfeeding is not the only way to bond with your baby. There are many more ways of bonding with your baby. Your baby will bond and love you as much even if you do not breastfeed.
Bonding is not a one-time event anyway; it is a lifetime process.
Good luck whether you decide to breastfeed or not.
by Womanaari | Aug 8, 2023 | Uncategorized
Recurrent vulvovaginitis is on the rise.
Although it is not a serious condition, it can affect the quality of a woman’s life to a large extent.
I am not going to write a complete essay on how to manage recurrent vulvovaginitis as I am sure most of my fellow gynecologists are very versed with it.
The reason for writing on this topic is to share some of the salient points in the management and add a few rarer things which some of you might or might not be used in the management of this highly uncomfortable ailment.
- History and Examination
Getting a detailed history of the color, consistency, smell of the discharge and its timing in relation to the menstrual cycle is imperative to clearly diagnose the causative agent which could range from fungal to bacterial to dermatological condition or hormonal imbalance
It is mandatory that vaginal swabs are taken for culture at the first visit when a woman presents with vaginal discharge, as this forms a baseline later to ‘test for the cure’ after completion of the treatment.
- Is your patient on Antibiotics or hormonal contraception?
Do not forget to check if your patient is on antibiotics or hormonal contraception. If she is, counsel her that your efforts might not yield the same results.
- Is she a diabetic?
I am sure you are all ruling out diabetes in these women. Please do a GTT, not just random sugar as they might be impaired glucose tolerance and not overtly diabetic.
- What treatment are you advising her ?
Depending on the causative organism, she will need treatment with Metronidazole/Clindamycin for Bacterial vaginosis/Trichomoniasis and Fluconazole for fungal infection.
However, it is important to note here, local treatment alone has lesser cure rates than combined oral and local treatment.So it is preferable to prescribe both oral and local treatment.
This removes the colonization in the bowel and hence chances of reinfection.
- Test for cure
It might be beneficial to follow up with your patient after the treatment course is completed and recheck vaginal swabs to test for a cure. This way, the risk of incomplete treatment and emergence of resistant strain is reduced.
- Long term treatment
All those who have a persistent or recurrent infection after the initial treatment should be treated with once a week oral Fluconazole and Metronidazole for at least 3 to 6 months.
Consider post-coital or post-menstrual prophylaxis if symptoms coincide with coitus or menstruation.
- Treating the partner
In recurrent vulvovaginitis, it is essential to advise the woman to follow safe sexual practices and to treat the partner as well with long-term oral Fluconazole and Metronidazole.
- Is it Candida Glabrata infection?
The majority of the yeast infections are due to the common Candida Albicans species. However, recently there is an increased emergence of resistant species such as Candida Glabrata.
Routine Fluconazole may not be effective in such cases. Either higher Azoles such as Teraconazole or Itraconazole might help.
In those with resistance to all Azoles, local Boric acid application for 7-14 days might be beneficial.
If no relief with even this, higher anti-fungal drugs such as Amphotericin or Flucytosine might be considered but with caution.
In this day and age of resistant species what other life style measures can we advise our patients to prevent getting these infections.
- Have you heard of the Anti Candida diet?
Did you know that diet rich in sugars and starchy foods can predispose women to recurrent candidiasis?
Likewise, diet rich in probiotics (such as probiotic yogurt) can reduce the recurrence rates.
- Have you asked the Wiping habits of your patient?
Wiping from back to front can increase the chances of reinfection of the vagina with bacteria or fungus as these could have colonized in the bowel.
- Is your patient routinely douching herself?
These days women have developed a trend of douching themselves on a regular basis. I do not blame them. Pharmacological company adverts are partly responsible for this.
Counsel your patient that normal body odors are acceptable. Only if they are excessive and foul-smelling, she needs treatment and even that after consulting her gynecologist.
Routine douching is not only unnecessary but can even harm the vaginal epithelial cells and alter the vaginal milieu, hence increasing her risk of vaginitis, This applies to repeated washing the area with soap as well.
- Does Coconut oil help?
There is some evidence to suggest either oral or local coconut oil can help combat and prevent vaginal infections. It contains fatty acids such as lauric acid/capric/caprylic acid which have both fungicidal and antibacterial properties.
- Do not ignore the hormonal imbalance or dermatological condition.
For all you know her symptoms might not be due to infection at all. So make sure that she is not suffering from a dermatological condition that is causing vaginitis-like symptoms.
In addition to this, perimenopausal or postpartum women might be more prone to vaginal infections due to relative or absolute estrogen deficiency. A short course of topical estrogen might be considered in such cases with caution.
by Womanaari | Aug 8, 2023 | Uncategorized
With the beginning of Ramadan and working in a specialty that deals with pregnant women, I thought it is time to write about fasting in pregnancy. Maybe, I should have written this before Ramadan started.
Of course, it is clearly stated in the Quran that if a pregnant/nursing mother is not strong enough to fast or if she fears for the health of her baby, she is exempt from fasting. She can either forego the whole month of fasting or do just the number of days she feels safe and strong enough to do. The lost days of fasting can be made up at a later date. There is also an alternative option of feeding a needy person for the number of days of missed fasting.
Nonetheless, a considerable number of women continue to fast during pregnancy as they find fasting later on after the month of Ramadan much more difficult as they are on their own doing it.
Besides, the option of ‘Fidya’ (donate food or money to feed the needy) is not favored either as it is felt that they are missing out on the holy gains by doing so.
With this background, I would like to answer a few questions that might be on your mind whether you have decided to fast or not.
1. Is fasting during Ramadan safe?
This is not an easy question to answer. The reason being the effects of fasting during Ramadan in pregnancy are influenced by a multitude of factors, such as the month of Ramadan (summer or not), mothers body weight, stage of pregnancy, the type of job you do, any other associated conditions during pregnancy, etc.,
So if you are of good weight and health, in the middle of your pregnancy (not too far or not too early) do not have any associated problems during pregnancy, not working or do light and less stressful work, then it might be entirely safe for you to fast.
On the other hand, if your weight is not up to the mark, have busy and physically tiring work, have associated complications in pregnancy and Ramadan is in summer, you might not be able to cope with fasting during the month.
2. What are the effects of fasting on my baby?
There are conflicting reports on whether the growth of the baby is affected or not due to fasting in the second and third trimesters, as some studies show a significant difference and some do not.
There is some evidence to say that the glucose and fat levels decrease during fasting which is expected and in some cases, this can lead to decreased growth and weight of the baby.
A decreased intake of water can reduce blood supply to the baby and hence decreased liquor (water around the baby).
Are these changes significant enough to affect the baby?
By and large, the majority of studies have demonstrated that fasting in a healthy pregnant mother doesn’t have significant adverse effects on the baby. This includes Ramadan during the summer months as well.
A healthy pregnant mother is the Key.
3. Can Pregnant women with Diabetes fast?
This is a relevant question, as Diabetes (Mellitus ) is all about your blood sugar level maintenance.
Advice regarding this again varies, the reason being, there are different types/grades of diabetes in pregnant women.
The commonest one that we come across these days is Gestational diabetes. This is very similar to Type 2 diabetes but a milder one usually. This is in fact a pre-diabetic stage that has manifested just in pregnancy and warns us of future risk of Type 2 diabetes.
Due to the modern-day lifestyle, this is much more common in women these days, especially more so among Asian women.
As this is a milder form, the majority of women are well controlled with a bit of alteration in the diet and addition of exercise.
So, if a pregnant mother with gestational diabetes decides to fast during the holy month, she might be able to do so provided she takes certain precautions (mentioned later on).
If a pregnant mother was already diabetic before pregnancy and was on either oral medications or insulin, it is an entirely different matter.
Her carbohydrate and fat metabolism which was already defective is further altered by pregnancy and if fasting is added to it, it gets further deranged.
The baby might find it hard to handle the alternating episodes of high and low sugars levels.
4. Can women with blood pressure problems or kidney disease fast ?
Pregnant mothers with chronic kidney disease are advised not to fast as it can worsen their kidney problem.
Women with a mild form of preeclampsia and blood pressure problems, who do not need more than once or twice medication can fast as long as they feel fit and fine.
If your medical problems are much more serious, then fasting is not advisable.
Key factors to be considered regarding fasting for a pregnant mother during Ramadan
- Stage of pregnancy:
- Fasting in the first trimester may cause a drop in the baby’s birth weight
- Fasting towards end of pregnancy might be safe but difficult to cope
- Number of days of fasting: This is the most important parameter of all
- Fasting for 10 days at a stretch is safe. Majority of adverse effects appear after 20 days of continuous fasting.
- Alternate day fasting might be the best way to fast or stretches of 5-10 days with a break of a few days.
- Summer month poses an additional difficulty to fasting. It is imperative that enough fluid is consumed at Ifthar and Suhoor
- Type and Quantity of food: Eating the right quantity and type of food can minimize the adverse effects. This specially applies to those with diabetes.
- Do not eat single large meal but breakit into smaller multiple meals.
- Make sure your meals consist of complex carbohydrates, enough protein and fat in addition to fruits, nuts and vegetables. which will minimize fluctuation of blood sugar levels
- Monitor for warning signs:
- Make sure you keep a watch on the baby’s movements and at any point of time if you feel it is moving less or not moved at all for a few hours, seek medical advice. Ideally your baby should move at least 10 times a day and should not be quiet for more than 3 to 4 hours.
- If you are feeling ill, have headaches, dizziness, pain or bleeding seek medical advice
- Keep repeated checks of your blood sugar if you are a diabetic. If sugar level drops to 80, consider breaking the fast and if it drops to 60, break the fast and seek medical advice.
- If you are passing very less urine or not passed urine at all for more than 6 hours, seek medical advice
- Medical consultation:
- Always consult your doctor before starting your fast, so he/she can assess your condition and advise accordingly.
- Be in touch with your doctor throughout your fasting period.
- Have more frequent consultations to check your pregnancy during the fasting period.
Whether you decide to fast or not, we are here to support you at Prime Hospital. Contact us for any further advice.
Happy Ramadan.
