Dr. Ameet Kishore - Best ENT Doctor in india
Dr (Prof) Ameet Kishore is a graduate of the AFMC (Pune) and was awarded the medal for ENT. He obtained his higher surgical training in ENT Surgery in the UK and attained Fellowships of the Royal College of Surgeons of Edinburgh as well as the Royal College of Physicians and Surgeons of Glasgow.

He has received special training and experience in Microscopic Ear surgery, Neuro-Otology, Cochlear Implants, Endoscopic Sinus Surgery and in Paediatric ENT at various centres in UK, Europe and USA.

He was trained at the National Centre for Cochlear Implantation (UK) since 1995 and thus has extensive experience in management of deafness and in cochlear implantation. He set up and is the lead surgeon for the cochlear and hearing implant programme (for children and adults) at Apollo Hospitals. He has over 1800 cochlear implant recipients in this programme.

His team is particularly experienced in management of complex cochlear situations and is the only active programme in North India for Auditory Brainstem Implantation.

This programme also provides Bone Anchored Hearing Aids (BAHA), Bonebridge and Vibrant Soundbridge middle ear implants as options for patients with hearing loss.

Dr Kishore has large experience in endoscopic nasal and sinus surgical procedures like Functional Endoscopic Sinus Surgery (FESS) and Balloon Sinuplasty. Also performs advanced endoscopic procedures such as orbital decompression, optic nerve decompression, dacryocystorhinostomy (DCR), endoscopic closure of CSF leaks and endoscopic pituitary tumour surgery.

He was trained at the Royal Hospital for Sick Children, Glasgow in the Paediatric ENT, and is competent in the management of the child with common ENT problems as well as complex conditions that affect the paediatric ear, nose, throat and airway.

Is experienced in the management of conditions and lumps of the head and neck, salivary and thyroid gland. Well versed in microlaryngeal surgery and phonosurgical techniques for hoarseness.

He held the post of Consultant and Sr Lecturer at the Glasgow Royal Infirmary University Hospital for a number of years before returning to India, having spent over 15 years overseas.

His academic profile includes 6 book chapters, over 30 articles in peer reviewed journals and numerous presentations at National and International Conferences.

With over 25 years of ENT experience, he is Sr Consultant in ENT & Neurotology at Indraprastha Apollo Hospital, New Delhi and the Founder Director & Lead Consultant of Adventis ENT, Head Neck & Cochlear Implant Clincs.

Hypospadias Surgery In Delhi

What is hypospadias?
Hypospadias is a birth defect in boys in which the opening of the urethra is not located at the tip of the penis. In boys with hypospadias, the urethra forms abnormally during 8-14 weeks of pregnancy. The abnormal opening can be anywhere, from just below the end of the penis to the scrotum. Depending on the site of the opening they are classified as distal (minor type)and proximal (major type).

Types of Hypospadias:
The types of hypospadias a boys has depends on location of the opening of the urethra:

Subcoronal: The opening of the urethra is located somewhere near the head of the penis.
Midshaft: The opening of the urethra is located along the shaft of the penis.
Penoscrotal: The opening of the urethra is located where the penis and scrotum meet.
Understanding the normal penis and urethra
The normal urethra is a tube through which that urine flows out of the bladder. It passes through the penis. The opening of the urethra (meatus) is normally at the end of the penis, partly covered by the foreskin.

What is the penis like in hypospadias?
The main problem is that the urethra opens on the underside of the penis instead of at the end of the penis. The opening can be anywhere from just below the normal position (mild) to as far back as the base of the scrotum (severe).

Hypospadias may also include the following:

A hooded appearance of the foreskin. This is because the foreskin does not develop on the underside of the penis.
Tightening of the tissues on the underside of the penis (called ‘chordee’). This pulls the penis down and it cannot fully straighten. This is commanly seen in severe hypospedias

What problems can hypospadias cause?
Problems are likely to occur if hypospadias is left untreated. The further back the opening of the urethra is, the more severe the problems are likely to be.

Passing urine is different to normal. A baby in nappies will have no problem. However, when older, the urine stream may not be able to be directed forward into a urinal. When going to the toilet the urine is likely to ‘spray’ backwards. Sitting on a toilet may be needed to pass urine without mess.
Chordee causes bending of the penis. This is more noticeable when the penis is erect. Sexual intercourse may be difficult or impossible in severe cases.
Psychological problems about being ‘different’ to normal are common.

How common is hypospadias and what causes it?
About 1 in 300 boys are born with some degree of hypospadias. It seems to be getting more common. The reason why the penis does not develop properly is still not clear. The development of the penis while the baby is growing in the womb (uterus) is partly dependent on the male sex hormones such as testosterone.

What is the treatment for hypospadias?
If the hypospadias is mild, with the opening of the urethra just a little down from normal and with no bending of the penis, no treatment may be needed. However, in most cases an operation is required to correct the hypospadias. This can usually be done in one operation. However, if the hypospadias is more complicated, two operations may be necessary. The operation is usually done when the child is around 6-18 months old. The goals of treatment are:

For urine to be passed in a forward way.
For the penis to be straight when erect.
For the penis to look as normal as possible.
The position of the opening of the urethra is altered. Also, if chordee is present then this is corrected to allow the penis to straighten. The foreskin is usually used during the operation to make the new urethra so it is important that a circumcision is not done before the corrective surgery is performed.depanding on the surgery of hypospedias surgeryes

The success of the operation and the ‘normality’ that can be achieved depends on the severity of the hypospadias done in single as two stage

What happens after the operation?
Your son will be brought back to the ward to recover. He will be able to eat and drink after 3 hours He will have a dressing on his penis and a tube draining away the urine. The patients are usually kept for 2 days in the hosptial and then discharged. The dressing and tube need to stay in place for 10 days, then you will need to come back to the Hospital to have them removed.

What are the risks of hypospadias repair?
All surgery carries a small risk of bleeding during or after the operation.

For about one in ten boys, the original hole opens up again, so that your son passes urine through two holes. This can occur at any time after the operation. If this happens, your son will need the operation again. Occasionally, the new hole at the tip of the penis is too small, so your son will need another operation to make the hole larger. The drainage tube can irritate the inside of the bladder, which is painful. This is called ‘bladder spasm’. To reduce this, your son will be given ‘bladder spasm medicine’ as well as pain relief.

When you get home
Your son will go home with the catheter and dressing in place. Staff on the ward will give you full details of how to care for these at home.

You should encourage, to drink plenty of water/fluids.
Your child may need some pain relief when you get home.
You should not have a bath or shower until after the dressing comes off.
Putting your son in two nappies at a time can protect the area from accidental knocks.
Your son should not ride a bicycle or any sit-on toy until the area has healed.
Try to avoid getting the dressing dirty when nappy changing. If this happens, dab any faeces off with a damp cloth.
As there is a small risk of infection, your son will need to take antibiotics until he returns for his outpatient appointment.

Chemical Peeling In Dwarka
Chemical Peeling is the most commonly used dermatologic procedure that can be carried out on an OPD basis, it helps in promoting the effect of other medicines and thus is highly recommended by dermatologists.

A chemical peel is a technique used to remove the outermost layers of the skin (in a controlled manner) with the help of a chemical solution.

The nature of the chemical used determines the depth of the peeling and also decides the indication of that peeling agent.

Most common indications of chemical peels are Acne, Acne Marks & Scars Hyperpigmentation problems like Melasma, Tanning and Freckles.

Dermaheal has developed its own peeling mechanism where different peeling agents are combined to give best results to our patients according to their skin problems. These have been designed specially for the Indian skin type.

Peeling for Acne
According to the severity and chronicity of the Acne, Acne Marks & Acne Scars for a particular patient, we use a 3 to 4 step sequential peeling mechanism to give desired results. Peels used for this indication are -

Black Peels (Theraderm Inc. Imported from South Korea)
Salicylic Peels
Pyruvic Peels
Retinol (Yellow) Peel
The aforementioned peels can be used in different combinations or solitarily depending on the severity of Acne, Acne Marks & Scars and Patient skin type.

Peeling for Hyperpigmentation (Melasma)
In Indian skin the most common hyperpigmentation problem is Melasma, which occurs in the butterfly region of the face surrounding the nose, most commonly observed in the females of reproductive age group. This condition is very resistant to conventional medical treatment. Peels have come a long way to help Melasma patients to improve their quality of life and their social interaction by acting on the deeper layers of the skin where most creams and lotions can't penetrate. Peels used for this indication are -

Pyruvic Peels
Phenol-TCA Combination Peels
Glycolic Peels
Retinol (Yellow) Peels
Lactic Peels
The aforementioned peels can be used in different combinations or solitarily depending on the patient skin type and ongoing treatment protocol.

Vitiligo Treatment In Dwarka
What is Vitiligo
Vitiligo is a form of a chronic skin disorder which can easily be diagnosed by its characteristic appearance of white patches on the skin as the skin begins to lose its pigmentation.

These blotches can occur on any part of skin, however most common areas are face, neck, hands, eyes, mouth and foot.

Vitiligo can be treated by medications, phototherapy, laser and in certain cases surgical transplantation (tissue grafting and cellular grafting) is also advisable.

What causes vitiligo?
Melanin is the pigment which determines the color of our skin and hair.
The cells responsible for producing melanin (Melanocytes) are unable to function in case of Vitiligo thus causing loss of color of skin.
These white areas can either be localized or can continue to grow and are easily noticeable.
Melanocytes can be reintroduced to the affected areas via various methods to treat vitiligo.

Impact Of Vitiligo On Patients
Though vitiligo does not cause any serious impact on patient’s overall physical health and life expectancy, it can adversely affect patient’s psychological well-being.
Patient’s often feel insecure and anxious about their appearance which results in the development of antisocial behavior.
Younger patients are under constant emotional stress.
Mixed emotions of shame and fear often leads to depression.


Role Of Phototherapy
Derma heal Skin and Hair Clinic offers its patients the latest and best possible treatment modalities
We are equipped with a Narrowband UV-B (NB-UVB) chamber which works on whole body upto a great extent in cases of Generalized Vitiligo.
NB-UVB is an upright in-office booth which has a number of lamps that emit ultraviolet light thereby inducing re-pigmentation.
This device can be used in cases of both adults as well as children and does not cause any major side effects.
This treatment procedure is safe for both adults as well as children and generally requires 2-4 sessions weekly.
Phototherapy when combined with medications yield satisfactory results. Usually, prolonged treatments are required to attain better results.

Benefits Of Phototherapy
Significant improvement in the quality of life has been observed in the patients of generalized vitiligo undergoing phototherapy when combined with medications.
With phototherapy going on, the required doses of medicines gradually decreases thus decreasing the chances of long term side effects of medicines.
Patients experience a boost in their self-esteem as they keep on witnessing better results per session.
Phototherapy aids to prevent the formation of new patches thereby helping patients regain the confidence to face the world.

EXCIMER THERAPY
Excimer Therapy is an advanced technology that helps to treat skin diseases like vitiligo, atopic dermatitis and psoriasis which are usually difficult to treat conditions as there are very limited treatment options available for such skin conditions. This therapy is gentle as well as effective when followed with strict continuation.

The Excimer laser delivers a concentrated beam of UVB light through a hand piece directly to the white patches on the patient’s skin.

Laser Hair Reduction In Dwarka
Gone are the days of waxing, threading, epilating and hair removal creams, Laser hair removal is the latest and most advanced method of hair reduction and offers several benefits over the other methods



How it works?
Laser emits a concentrated beam of light which is absorbed by melanin (pigment present in the hair).

This light energy further converts into heat energy resulting in the destruction of hair follicles thereby preventing the growth of hair in future. However multiple sessions along with maintenance sessions are required as only the hair in their growth phase are actively targeted by the laser at a time.

About the Procedure
Triple wavelength diode laser used at Dermaheal is U.S. FDA (United States Food and Drug Administration) approved, to ensure better results in fewer sessions.
A diode laser with 810nm is the gold standard for hair reduction.
After shaving and marking the area to be treated, cooling gel is applied before giving laser shots
There may be a warm sensation in some areas and pin-prick sensation in others where the hair is thick and coarse. Cooling the skin again after laser shots, further makes the sessions more comfortable.
The time required for the treatment depends on the size of the area to be treated.
The intervals between each session depends on the growth of hair (ranging from a few weeks to a few month).
As the number of sessions progress, the gap between each session keeps on increasing.

What to expect?
Around 80-90% hair reduction is expected after 6-8 sessions, especially in female patients.
More sessions are required in male patients.
Every subsequent session results in delayed hair growth and reduced density of hair.
Laser hair reduction can be done either on small sections or on full body on both men and women.
Coarse hair decrease in number and even if some of them remain, they turn fine and thin which are easily bleachable.
Maintenance sessions may be required varying from case to case.

At Dermaheal Skin and hair clinic
Get rid of unwanted hair with laser hair reduction and say hello to your hair free skin.
To enquire in detail about Laser Hair Reduction and other cosmetic treatments best suited for your individual needs, schedule an appointment with our trusted and experienced dermatologist Dr. Navjot Singh Arora at Dermaheal Skin and Hair Clinic, Dwarka Sector 7, Delhi.