Welcome to Twachaa-the Skin & Laser Clinic

At Twachaa- The Skin Clinic, our mission is to provide a high level of innovative skin care services. Each treatment is unique to you and customized for your skin, to help you achieve and maintain your healthiest possible skin.

We are committed to advancements in the procedures & we offer the highest quality services for our clients. Over the course of our relationship we will help you to create and maintain a radiant complexion. Through regular visits to our clinic we will guide you every step of your tailor made skincare routine, offering advice and support as your skin goes through the different phases on the road to recovery. We will always strive to make your experience fulfilling and serene.

Dr. Megha Modi
Dermatologist In Vasundhara, Vaishali and Indirapuram
Dr.Megha Modi is a practicing Dermatologist in Delhi and received her medical degree from Baroda Medical College. She went on to specialize in dermatology and attained her MD in Skin-VD from the same college. She has to her credit the enviable distinction of being a gold medalist at both the undergraduate as well as post graduate levels.

Professionally Dr. Megha Modi has been a consultant at the Dermatech Clinic in North Delhi and brings to the table a rich experience in the field of Cosmetology and Dermatology. On an academic front, she has won numerous accolades and citations for her stellar contributions for her paper presentations at State and National Level conferences. Concurrently Dr. Modi has numerous publications in indexed journals which are standing evidence of her prowess in the specialty.

Dry Eyes Treatment In Ghatkopar
A dry eye is an uncomfortable and painful condition. It can be understood as an inadequate production of tears leading to dryness of eyes. Dry eyes make you more susceptible to bacterial infections and trauma due to reduced lubrication over the cornea. As tear film is very thin, reading, writing and watching becomes very uncomfortable.



Role of tears
Blinking makes your eyes moist every time and keeps the corneal surface smooth and clean. Tear film contains a combination of oil, water and mucous. Outermost layer is made up of oil as it prevents tear from drying. Second layer (water) comes from lacrimal gland and made up of mostly water as main content. Water washes away any dirt and unwanted particles from the eye to keep it clean. Inner most layer is made up of mucus and formed in conjunctiva, due to this layer tears don’t stick to eyes. In general we see with any irritant, our eyes protective response is to produce tears but in few local and system medical conditions, tear formation is reduced and that hampers with the vision.



Why do I get dry eye condition?
We produce tears all the time, not only when we are emotional but with every blink. Dry eye can be because of various reasons:
Altered composition of tears or tears dry up too fast – imbalance is oil, water and mucous content may result in dry eyes.
Inflammation or trauma to the eye (lacrimal gland, conjunctiva) – dry eyes may result as a consequence to damaged tear producing apparatus.
Medical conditions for less production of tears – autoimmune diseases like lupus, scleroderma, rheumatoid arthritis, Parkinsons disease.
Vitamin A deficiency may result in poor eye health
Disease like diabetes or radiation exposure also affects eye status.
Hormonal imbalance like pregnancy or menopause also reduces tear production.
Drugs like Antihistamins, antidepressants may result in dry eyes.
Corneal nerve desensitivity caused by contact lens or nerve damage by laser eye surgery.
As an aging process.
Other medical conditions can lead to dry eyes, such as the following:
Keratoconjuctivitis - It refers to the inflammation of the surface of your eye, called the cornea or the conjunctiva

Keratitis is another condition that’s caused by irritation or swelling of your cornea when your eyes are dry for too long

Keratoconjuctivitis Sicca – This term is used to describe an autoimmune condition when you aren’t able to produce enough tears and develop an infection or inflammation.



How do I know that I have dry eyes condition?
Symptoms experienced by patients suffering from dry eyes are:

Fatigued and heavy eyes
Sore and itchy eyes
Burning and dryness sensation
Red eyes with blurred vision
Difficulty in wearing contact lenses
Difficulty in night driving
Sensitivity to light and stringy mucous around the eyes
Eyelids sticking together when waking up after sleep
Double vision
How diagnosis is made?
Ophthalmologist conducts a thorough eye examination and certain tests to reach to a final conclusion and design the treatment plan.

Detailed Medical and drug history of systemic diseases may help in diagnosis.
History of trauma and family occurrence can be related to present condition.
Schirmer test – this test is performed to see the volume of your tears, blotting strips of paper are placed under your lower eyelids. After five minutes your doctor measures the amount of strip soaked by your tears.
Phenol red thread test - In this test, a thread filled with pH-sensitive dye (tears change the dye color) is placed over the lower eyelid, wetted with tears for 15 seconds and then measured for tear volume.
Special dyes are used for your eye doctor to check the evaporation of your tears. As tear composition has oil content in it, so if it is reduced, it may lead to quick drying of your tears.
Tear osmolarity test can be done to measure the composition of particles and water in your tears.
Special Tear markers for dry eye disease like matrix metalloproteinase-9 or lactoferrin.
Complications
Often people with dry eyes experience poor quality of life as it’s very difficult for them to read, write or watch anything for long period of time. Tears serve as protective coating, without them you are prone to eye infections. If left untreated, dye eye may lead to damage to corneal surface and permanent vision impairment may happen in severe cases.

Prevention
As an aging process, tears production will eventually go down, but still precautions may help to avoid dry eyes discomfort.

Add humidifier to your room in winters
At high altitudes or extreme winters, take care of your eyes as dry winds may be traumatic to your eyes and tear producing apparatus.
If you are a person spending more time on computer or phone, take short brakes during your tasks as your eyes get tired by long focus and radiation exposure.
Use sunglasses while going outdoors
Use of ointments instead of drops
Frequent washing of your eyes also serves a natural way for eye moisture and cleaning.
Mild soap use to reduce the irritation.
Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult eye doctor about your specific condition. Only a trained, experienced board certified eye doctor can determine an accurate diagnosis and proper treatment.

Diabetic Retinopathy Treatment In Ghatkopar
Diabetic retinopathy is a form of eye disease caused by chronically high or variable blood sugar that is associated with diabetes. If left untreated, diabetic retinopathy can lead to vision loss and blindness. The condition develops slowly throughout many years; therefore, it is essential to undergo regular eye tests when you have Diabetes. Retinopathy is basically impaired blood vessels in the retina which is the thin inner light-sensitive layer situated in the back of the eyes. In some cases, these vessels will swell up (macular oedema) and leak fluid into the rear of the eye. In other cases, abnormal blood vessels will grow on the surface of the retina.

Diabetic retinopathy occurs in three stages:
Background retinopathy - Background retinopathy is said to occur if you have developed microaneurysms on your retina. Microaneurysms are when there is a swelling of the capillaries (very small blood vessels) that feed the retina. It is an early warning sign that your diabetes has lead to some damage of the small blood vessels of your retina.
Diabetic maculopathy - The macula is the part of the eye that helps to provide us with our central vision. Diabetic maculopathy is when the macula sustains some form of damage. One such cause of macular damage is from diabetic macular oedema whereby blood vessels near to the macula leak fluid or protein onto the macula.
Proliferative retinopathy - If a significant number of blood vessels on the retina become damaged, your body will respond by releasing a growth hormone known as Vascular Endothelial Cell Growth Factor (VEGF). The growth hormone stimulates the growth of new blood vessels. However, these new blood vessels are particularly weak and prone to leaking. Proliferative retinopathy is the body’s attempt to save its retina but it can often lead scarring of the retina and can cause the retina to detach, leading to blindness.
Symptoms
You might not have any signs of diabetic retinopathy until it becomes serious. When you do have symptoms, you might notice:

Loss of central vision, which is used when you read or drive
Not being able to see colors
Blurry vision
Holes or black spots in your vision
Floaters, or small spots in your vision caused by bleeding
Poor night vision
Risk factors
Anyone who has diabetes can develop diabetic retinopathy. Risk of developing the eye condition can increase as a result of:

Duration of diabetes — the longer you have diabetes, the greater your risk of developing diabetic retinopathy
Poor control of your blood sugar level
High blood pressure
High cholesterol
Pregnancy
Tobacco use
Being African-American, Hispanic or Native American
Detection and diagnosis of diabetic retinopathy
Diabetic retinopathy can be detected by undergoing a comprehensive eye examination that emphasizes on the evaluation of specifically the retina and macula. Such a test may include:

Visual acuity measurements – measuring a patient’s ability to see at different distances.
Patient history – to determine the presence of diabetes, vision impairments and other general health issues that may affect vision.
Tonometry – Measuring pressure within the eye.
Refraction – to establish whether a prescription for new glasses is required.
Pupil dilation – evaluation of eye structures, including assessment of the retina and optic nerve through a dilated pupil.
Supplementary testing may be required which include:
Retinal tomography or photography – In this test retina’s current status is documented.
Fluorescein angiography test - During this test, your doctor will inject a dye into your arm, allowing them to track how the blood flows in your eye. They’ll take pictures of the dye circulating inside of your eye to determine which vessels are blocked, leaking, or broken.
An optical coherence tomography (OCT) exam - It is an imaging test that uses light waves to produce images of the retina. These images allow your doctor to determine your retina’s thickness. OCT exams help determine how much fluid, if any, has accumulated in the retina.
Treatment
Treatment of diabetic retinopathy depends on the extent of the disease.

Eye Injections - Eye Medications called vascular endothelial growth factor (VEGF) inhibitors can be used to help stop the growth of new blood vessels and improve vision. Most people who receive these injections will need to get them for at least three months. Over time, some people may need to get them less often or may no longer need them at all, but others will need to continue in order to protect their vision.
Focal laser surgery - This surgery attempts to stop or reduce the leaking of blood or fluid into the eye by burning and sealing the damaged blood vessels.
Photocoagulation - This is usually done in your doctor’s office as an outpatient procedure during a single session. The procedure may or may not restore your vision to normal, but it should prevent your condition from worsening.
Scatter laser surgery - This surgery uses lasers to burn the damaged blood vessels so that they shrink. This procedure may require more than one application, and your vision may be blurry for a day or more after each session. You may also experience loss of peripheral vision or night vision after the procedure.
Vitrectomy - This surgery is done under general anesthesia and involves making a tiny incision in the eye to remove blood from the vitreous fluid, as well as any scar tissue that may cause retinal detachment.
Complications
Diabetic retinopathy involves the abnormal growth of blood vessels in the retina. Complications can lead to serious vision problems:

Vitreous hemorrhage - The new blood vessels may bleed into the clear, jelly-like substance that fills the center of your eye. If the amount of bleeding is small, you might see only a few dark spots (floaters). In more-severe cases, blood can fill the vitreous cavity and completely block your vision. Vitreous hemorrhage by itself usually doesn't cause permanent vision loss. The blood often clears from the eye within a few weeks or months. Unless your retina is damaged, your vision may return to its previous clarity.
Retinal detachment - The abnormal blood vessels associated with diabetic retinopathy stimulate the growth of scar tissue, which can pull the retina away from the back of the eye. This may cause spots floating in your vision, flashes of light or severe vision loss.
Glaucoma - New blood vessels may grow in the front part of your eye and interfere with the normal flow of fluid out of the eye, causing pressure in the eye to build up (glaucoma). This pressure can damage the nerve that carries images from your eye to your brain (optic nerve).
Blindness - Eventually, diabetic retinopathy, glaucoma or both can lead to complete vision loss.
How can I reduce my risk of Retinopathy?
You can reduce your risk of developing diabetic retinopathy, or help prevent it getting worse, by:

Controlling your blood sugar, blood pressure and cholesterol levels
Taking your diabetes medication as prescribed
Attending all your screening appointments
Getting medical advice quickly if you notice any changes to your vision
Maintaining a healthy weight, eating a healthy, balanced diet, exercising regularly and stopping smoking
Important Reminder: This information is only intended to provide guidance, not a definitive medical advice. Please consult eye doctor about your specific condition. Only a trained, experienced board certified eye doctor can determine an accurate diagnosis and proper treatment.

Cataract Surgery In Ghatkopar

Cataract surgery is replacing the faulty lens with an artificial lens. It’s a common and safe procedure done by ophthalmologist when you are having cloudy vision. Decision to undergo cataract surgery depends on the level of difficulty; a patient is facing on daily routine activities.

What is Cataract?
Cataract is progressive in nature and develops with time you grow older. Cataract affects most of people and becomes prominent with age. It can be described as blurry, cloudy or opaque vision. Natural eye lens focuses light on the retina to form clear and undistorted image. Clouding of this lens results in blurred and distorted image. It commonly affects both eyes but in few cases one eye cataract might advances rapidly. If not treated on time, may result is complete loss of sight.

Causes of Cataract
Cataract can be seen in children as a hereditary defect, while eye trauma, smoking, diabetes, excessive use of alcohol, prolonged exposure of sunlight or ultraviolet rays, extended use of corticosteroids are few causes of cataract occurring in elderly people.

Eye Examination
Cataracts can be diagnosed with simple eye exam. The eye exam contains a vision test and an examination of your eyes using a slit lamp microscope. The pupils are dilated with special eye drops to provide a better view of the back of the eye, where the retina and optic nerve are located.

Symptoms of cataract
Ask yourself few questions

Do you feel difficulty in seeing at night?

Is reading or watching television becoming difficult for you?

Driving at night or seeing in bright light has become difficult?

Do you need assistance for finding ways while walking, cooking, shopping or daily activities of your visi

Are you opting for alternate ways to substitute your vision problems?

Glare or sensitivity to light is another symptom of cataract. Diplopia or double vision is also seen in cataract patients. It also affects color vision, leading to yellowish or brownish tint to your eyesight. Patients often need frequent changes in their eyeglasses.

Cataract Treatment in Ghatkopar
Cataract develops as a result of thickened eye lens and treatment is to replace faulty lens with a new lens. Cataract removal is a routine treatment procedure at opthalomogist clinic and carried out across the globe with rarely any accompanying complications.

To prepare you for surgery, your doctor calls you for eye checkup (a week before), to choose which eye lens is best for you.

On the day of surgery, it’s recommended not to eat for 12 hours before surgery.

Recovery
Usually it is a complication free procedure, but it is recommended to be in contact with your surgeon after the surgery. Initially, an eye drop is given to reduce inflammation and prevent infection. You will need frequent visits to the doctor to monitor any complications. Cataract removal procedure doesn’t need night stay, as it’s a small daycare surgery. Most people observe an improvement in their visual function within few days of the surgery, enabling them to restart most of their daily activities including work.

Majority of people regain full activity after a few days of getting the procedure. Your doctor might fit you with a pair of glasses (if needed) once your vision is stabilized. This also depends upon the type of intraocular lens implanted in your eye.

For more information = https://www.mumbaieyecare.com/

Cerebral Venous Sinus Thrombosis In Pediatric Nephrotic Syndrome



A 2-year-old girl presented to the emergency room with recurrent seizures. The child had been diagnosed with nephrotic syndrome in the previous 2 weeks (serum albumin, 1.5 g/dl; serum creatinine, 0.4 mg/dl) and had been convulsing on and off since the week before presentation. Oral prednisolone (2 mg/kg per day) had been started for 2 weeks with no response. There was no metabolic cause of seizures with normal serum ammonia, blood gas, and serum electrolyte levels.
About Dr.

Dr. Sidharth Kumar Sethi
Kidney & Urology Institute
He was trained as a Fellow (International Pediatric Nephrology Association Fellowship) and Senior Resident in Pediatric Nephrology at All India Institute of Medical Sciences and Division of Pediatric Nephrology and Transplant Immunology, Cedars Sinai Medical Centre, Los Angeles, California. He has been actively involved in the care of children with all kinds of complex renal disorders, including nephrotic syndrome, tubular disorders, urinary tract infections, hypertension, chronic kidney disease, and renal transplantation. He has been a part of 8-member writing committee for the guidelines of Steroid Sensitive Nephrotic Syndrome and Expert committee involved in the formulation of guidelines of Pediatric Renal Disorders including Steroid Resistant Nephrotic Syndrome and urinary tract infections. He has more than 30 indexed publications in Pediatric Nephrology and chapters in reputed textbooks including Essential Pediatrics (Editors O.P. Ghai) and “Pediatric Nephrology” (Editors A Bagga, RN Srivastava). He is a part of Editorial Board of “World Journal of Nephrology” and “eAJKD- Web version of American Journal of Kidney Diseases”. He is a reviewer for Pediatric Nephrology related content for various Pediatric and Nephrology journals.


For more information = http://www.pediatricnephrologyindia.com/