Private obstetrician Ashok Kumar is adept at ultrasound scanning for early pregnancy complications and then dealing with acute emergencies during labour such as shoulder dystocia (abnormal or difficult childbirth), cord prolapse (when the umbilical threatens to cut off oxygen and blood supplies to the fetus), eclampsia (includes seizures and coma that happen during pregnancy but are due to preexisting or organic brain disorder), and abruption of placenta (when the placental lining has separated from the uterus of the mother; the most common cause of late pregnancy bleeding as well as breech births (baby enters the birth canal feet first rather than head first).
This is a doctor with considerable experience in risk management in the hospital setting. He’s updated the Junior Doctors’ Departmental Handbook at Northwick Park Hospital in Harrow, focusing on measures to manage early pregnancy complications, hyperemesis gravidarum (a severe form of morning sickness, that prevents adequate intake of food and fluids), abdominal pain in early pregnancy and labour ward management.
London Obstetrician Mr Kumar has designed departmental and clinical guidelines for the management of pregnancy complicated by diabetes, asthma as well as for the management of pre-eclampsia/eclampsia (includes seizures and coma that happen during pregnancy but are due to preexisting or organic brain disorder), preterm labour, the spontaneous rupture of membranes at term and pre term (less than 37 weeks) and perinatal (the time around the birth, after 22 weeks) management of hypertension.
Following a diagnosis of Autism Spectrum disorder, “What do I do next?” is the question that has certainly been asked by every parent of a child with an autism spectrum disorder (ASD).
London based Dr Chelvi Kukendrarajah a leading Consultant Paediatrician at the Portland Hospital states in many cases, it comes after the “What is autism?” and “How did it happen? ” Unfortunately, just as with the first two questions, the answer isn’t very satisfying. Although many treatments and therapies are proposed to help, few have been studied enough to know whether they really do (or don’t) work, and for which children. This reality is frustrating and confusing for families and professionals caring for children with ASD.
Consultant pediatrician Dr Chelvi who practices at the Portland Hospital says many studies have shown that ASD and similar behavioural interventions can improve intelligence test scores, language skills, and academic performance of young children with ASD. Some studies have also shown some measure of improvement in behaviour or personal and social skills, while others have not. One issue has been generalization – that is, there has not been much evidence to show that children can transfer the skills they have learned through behavioural interventions to contexts outside the setting in which skills are acquired.
Many children taking part in these autism treatment programs make significant strides. It is clear at this point, however, that such interventions do not result in a great number of affected children achieving “normal” developmental status, as was once claimed.
Beyond the specific nature of any one approach of treating autism in children, there are many other factors that may influence the outcomes of early intervention programs, such as location (home-based vs. centre-based), duration and intensity of therapy, the experience of the provider, and the involvement of parents. In addition, characteristics of the child (such as age, symptoms, and severity of the disorder) also affect the potential benefits of therapy. Despite the many unknowns, most care providers believe that the earlier the child begins intensive intervention, the better the outcome. Dr Kukendrarajah requests nursery/school report or questionnaires for teachers and/or parents or carers, as well as reports from previous assessments (such as those from psychologists or therapists). Sometimes parents prefer not to involve the child’s school and she understands there can be difficult situations. However, it is important to say that without another independent opinion of the child (even if there are conflicting viewpoints!) it might be difficult to arrive at a firm diagnosis on the first appointment.
As an autism consultant she will aim to give my expert opinion as a senior clinician as to the diagnosis and appropriate options for helping. Her assessment is based on asking a large number of structured questions in a fairly straightforward conversational way. She usually see child and parents together so if they feel comfortable, the child can contribute and She can unobtrusively observe them at play or interaction over an extended time. Parents are understandably wary of talking about their child’s problem in front of him/her but she finds that in general, children and young people can offer valuable insight and find the process helpful and positive. It may be helpful to explain to your child that she is a doctor who will try to find out why they are having difficulties and how we can together help make things go better. There will be no tests or needles involved!
With appropriate intervention, many behaviour associated with ASD can be positively changed. Research does indicate that with early and intensive intervention, many children make substantial gains and enter preschool programs with varying levels of support. Research has shown that a structured, specialised education program that emphasises communication and social interaction skills designed for the individual child will produce positive results. Family members must also consider their role in the program when evaluating effectiveness. Questions such as “How much time and resources will be necessary from the family in order to implement a specific approach?” should be considered. The approaches found to be the most effective include a coordinated program involving the child and the family. Programs must be reflective of family concerns, priorities, and values, and consistently implemented by all providers, including family members.
There are some interventions available for children with ASD (such as Attention Autism mainly focus on Attention and listening skills by Gina Davis, positive behaviour approaches, social stories, ABA, visual support, therapeutic listening and sensory diet for sensory processing disorders etc.
Children with ASD also have other co existing conditions such as ADHD, Anxiety, sleep problems that are managed with pharmacological intervention (medication) along with behavioural approaches.
Besides doctor-to-patient interaction, video clip conferencing is likewise permitting healthcare facilities to develop networks to supply each various other with assistance and also consults. By conveniently sharing their experience outside their very own organizations, medical professionals could use extraordinary worth to their clinical coworkers as well as those coworkers’ individuals. A number of online doctor apps have recently launched like DktrGo in the UK.
Video clip conferencing could be an unbelievably efficient device in the work of remote telemedicine. Its usages are numerous, as well as array from tracking and also subsequenting with released individuals, to helping with interaction to track an individual’s recuperation, to preliminary examination with clients in places where in-person visits with a wanted expert could not me a choice.
Video clip conferencing has a lot to use health care specialists as well as individuals alike. GlobalMed deals a range of electronic cameras, extents, telemedicine carts, and also software program that enable specialists to deal with individuals from anywhere without the requirement for traveling.
Using video-conferencing modern technology when relevant, medical care professionals and also clients could lower the prices related to normal workplace brows through. Physicians could be anywhere keeping track of as well as gathering individual info while the individual stays in the convenience of his/her house. Along with minimizing unneeded prices and also take a trip times, this could be specifically useful to individuals with flexibility concerns or ecological worries for which it would certainly not be optimal to check out a health center or center.
What are they? Uterine Fibroids are the most every now and again analyzed noncancerous tumors of the female pelvis. They are smooth muscle or connective muscle developments in the dividers of the uterus. Once in a while, a fibroid is appended to the outside of the uterus by a stalk. Fibroids may develop as a solitary knob or in bunches. They extend in size from as little as a pea to as substantial as an orange or little melon. Once in a while fibroids develop sufficiently huge to fill the whole guts or pelvis.
What causes fibroids? Gynecologist London Dr Mahantesh Karoshi states the reason for fibroids is obscure. Fibroids are the most widely recognized in ladies ages 30-40, yet they can create at any age. An expected 20-30% of all ladies create fibroids. The female hormone estrogen appears to expand their development. Fibroids may increment in size or show up amid pregnancy since levels of estrogen are expanded. Since estrogen levels fall amid menopause, fibroids settle amid this time. Fibroids are analyzed 2-3 times more as often as possible in dark ladies than in white ladies.
What are the manifestations? Most fibroids don’t create any indications. At the point when indications do happen, there is a substantial range including: Changes in the menstrual cycle increment in draining longer and more incessant periods cramping draining or spotting between periods amenia from blood misfortune Pain in the stomach or lower back which can run from dull to sharp amid sex Pressure trouble while urinating or an expansion in recurrence of pee clogging, rectal torment, or trouble with a solid discharge felling of completion in your lower belly Problems with pregnancy, work, and conveyance unsuccessful labors inconvenience getting pregnant untimely birth breech birth (child’s position is other than head down) How are they analyzed? Amid a routine pelvic exam, your specialist might have the capacity to distinguish the primary indications of uterine fibroids. There are a few tests which help affirm your specialist’s conclusion: Ultrasound makes a photo of the uterus or pelvic organs utilizing sound waves.
Hysterscopy utilizes a thin instrument to help the specialist see the fibroids inside your uterus which is embedded through your vagina.
Hyersterosalpingography (HSG) is a X-beam which may recognize changes in the size and state of the uterus and fallopian tubes which are strange.
You’re 14 and haven’t saw any progressions from pubescence
You’re 16 and haven’t had a period
You’re having extreme menstrual issues or some other pelvic agonies
Your period is additional overwhelming, bizarre or keeps going over a week
You have vaginal tingling, redness, bruises, swelling, bizarre smell or release
You may be pregnant
You have to talk about safe sex
You’ve been having periods for over a year and have sporadic periods
You’ve missed more than three periods (You can hold up three months on the off chance that you are sure that you are not pregnant, but rather if there is a shot that you might be pregnant, you ought to see your specialist immediately.)
You encounter a blazing sensation while urinating
You encounter visit pee
You’ve harmed your pelvic range
You’ve had non-consensual sex
You trust that you’ve been presented to a sexually transmitted illness
You see an adjustment in the consistency of your periods
We’ve all observed the ghastliness stories of what awful plastic surgery can do. These photographs get spread all around magazines and news stories, and, while plastic surgery can have stunning triumphs and make emotional change that leave patients radiating, tragically there are specialists out there who you truly should know about.
A considerable lot of us need to adjust our picture or change parts of our bodies that we are uncomfortable with so severely this can frequently prompt to rushed choices that at last hurt us.
Along these lines, we need to instruct whatever number individuals as could reasonably be expected and help you have the capacity to promptly recognize the notice signs, so you don’t turn into a casualty of terrible plastic surgery.
You would be astounded at what number of facilities work without accreditation – driving numerous willing patients now requiring extra operations and surgeries to amend their oversights.
As the main center in Durham, our family here at CARE Plastic Surgery thought we would share a couple tips to remember when you are picking your plastic specialist.
1. Search for Board Certification – Make beyond any doubt your specialist is board-guaranteed with the American Board of Plastic Surgery (ABPS). The purpose behind this is on the grounds that individuals from the ABPS should dependably be a la mode in the most recent innovations and strategies. Click here to see whether your specialist is ensured.
2. Meet with Multiple Physicians – Don’t pick the main doctor you go to. Become acquainted with your specialist and discover how they are with you amid the discussion. It is safe to say that they are warm and caring? Do they make inquiries and truly hear your answers? Is it true that they are hurrying you? It is safe to say that they are pushing you to get strategies you didn’t request or need? Is it accurate to say that they are giving you sensible desires and speaking the truth about what’s in store? Is it true that they are pushing you to begin? Utilize your own particular impulses and judgment without settling on an enthusiastic choice.
3. Do Your Research: Check every doctor’s records for past misbehavior cases or warnings. Take a gander at how long they’ve been in the business, furthermore investigate their experience and tutoring. These are all vital components when searching for the correct specialist for you.
4. Never Bargain Shop – When it goes to your body, this is not an ideal opportunity to search for the best deal. Getting a look-a-like Louie Vuitton is a certain something, yet with regards to plastic surgery and modifying your body, you don’t need an unpracticed specialist offering similar administrations however at a much lower cost. Less expensive isn’t generally better. You have to settle on strong choices while picking your plastic specialist.
5. Costly isn’t Always Better Either: The same is valid here as well. Because a specialist is higher valued than all the rest does not imply that specialist is a superior and more experienced specialist. We understand cost is a variable, however there are numerous more imperative elements here that you should know about first. There are numerous choices for installment today and you can even fund your strategies or hold up somewhat longer to spare. Over the long haul you are in an ideal situation holding up, else you truly pay later in the event that you settle on the wrong decision.
6. Be Honest with Your Physician – Your therapeutic history is absolutely critical with regards to plastic surgery. Be straightforward with your doctor while revealing yours. Likewise, speak the truth about your way of life. Lying about smoking, drinking, or your action levels can be conceivably life debilitating while experiencing your methodology. Your doctor is not there to judge you; they are here to give you the most ideal care and additionally comes about.
7. Make inquiries – Ask a ton of inquiries regarding the technique or methodology you are occupied with. What are the dangers, what should you expect after the surgery is over and additionally what will the outcomes be. Additionally, look through each shape you are given before you sign and make inquiries wherever something does not bode well. It is constantly best to be very much educated about the methodology, how frequently the specialist plays out that specific strategy, and every one of the points of interest of pre and post-operation. The more you know and comprehend the more certain you will feel about your decision.
8. Request Referrals – It’s imperative to request referrals and see what different patients are saying in regards to your specialist. You can likewise request that read any tributes they have. You can truly take in an incredible arrangement from what different patients are saying in regards to the practice you’re talking.
9. Search for Social Proof: With today’s web-based social networking stages and online audits, it makes it much less demanding for patients to discover warnings and rapidly. Check the specialist’s web-based social networking profiles and hope to check whether they are dynamic via web-based networking media, how would they draw in with their fans, what do their audits say. This is an incredible approach to see what your specialist is truly similar to.