Physician Directory

As you learn what baby milestones your newborn is likely to achieve this year, keep in mind that this is only a guideline. Each child is unique and develops at her own pace. There’s a wide range of what’s considered normal and you probably don’t need to be concerned unless you notice one of the red flags described below.

Two Months

What most babies do at this age:
Begin to smile at people.

Can briefly calm themselves (may bring hands to mouth and suck on hand).

Try to look at parent.

Coo, make gurgling sounds.

Turn their heads towards sounds.

Pay attention to faces.

Begin to get bored (cry, fussy) if activity doesn’t change.

Can hold head up and begin to push up when lying on tummy.

Make smoother movements with arms and legs.

Begin to follow things with eyes and recognize people at a distance.

Talk to baby’s pediatrician if (s)he:

Doesn’t respond to loud sounds.

Doesn’t watch things as they move.

Doesn’t smile at people.

Doesn’t bring hands to mouth.

Can’t hold head up when pushing up when on tummy.

Four Months

What most babies do at this age:

Like to play with people and might cry when playing stops.

Copy some movements and facial expressions, like smiling or frowning.

Begin to babble with expression and copy sounds.

Cry in different ways to show hunger, pain, or being tired

Let you know if they are happy or sad,
and respond to affection.

Able to see and reach for toys; involves hand-eye coordination.

Follow moving things with eyes from side to side.

Laugh.

Recognize familiar people and things at a distance.

Hold head steady, unsupported.

Push down on legs when feet are on a hard surface.

May be able to roll over from tummy to back.

Can hold a toy and shake it and swing at dangling toys.

Bring hands to mouth.

When lying on stomach, push up to elbows.

Talk to baby’s pediatrician if (s)he:

Doesn’t watch things as they move.

Doesn’t smile at people.

Can’t hold head steady.

Doesn’t coo or make sounds
.

Doesn’t bring things to mouth.

Doesn’t push down with legs when feet are placed on a hard surface.

Has trouble moving one or both eyes in all directions.

Six Months

What most babies do at this age:

Know familiar faces and begin to know if someone is a stranger.

Like to play with others, especially parents.

Respond to other people’s emotions and often seem happy.

Like to look at self in a mirror.

Respond to sounds by making sounds.

String vowels together when babbling (‘ah’, ‘eh’, ‘oh’) and like taking turns with parent while making sounds.

Respond to own name,
makes sounds to show joy and displeasure.

Begin to say consonant sounds (jabbering with ‘m’, ‘b’).

Look around at things nearby.

Bring things to mouth.

Show curiosity about things and try to get things that are out of reach.

Begin to pass things from one hand to the other.

Roll over in both directions (front to back, back to front).

Begin to sit without support.

When standing, support weight on legs and might bounce.

Rock back and forth, sometimes crawling backward before moving forward.

Talk to baby’s pediatrician if (s)he:

Doesn’t try to get things that are in reach.

Shows no affection for caregivers.

Doesn’t respond to sounds.

Has difficulty getting things to mouth.

Doesn’t make vowel sounds (‘ah’, ‘eh’, ‘oh’).

Doesn’t roll over in either direction.

Doesn’t laugh or make squealing sounds.

Seems very stiff, with tight muscles.

Seems very floppy, like a rag doll.

Nine Months

What most babies do at this age:

May be afraid of strangers.

May be clingy with familiar adults.

Have favorite toys.

Understand ‘No’.

Make a lot of different sounds like “mamamama” and “bababababa”.

Copy sounds and gestures of others.

Use fingers to point at things.

Watch the path of something as it falls.

Look for things they sees you hide.

Play peek-a-boo.

Put things in their mouth.

Move things smoothly from one hand to the other.

Pick up things like cereal O’s between thumb and index finger.

Stand, holding on.

Can get into sitting position.

Sit without support.

Crawl.

Talk to baby’s pediatrician if (s)he:

Doesn’t bear weight on legs with support.

Doesn’t sit with help.

Doesn’t babble (‘mama’, ‘baba’, ‘dada’).

Doesn’t play any games involving back-and-forth play.

Doesn’t respond to own name.

Doesn’t seem to recognize familiar people.

Doesn’t look where you point.

Doesn’t transfer toys from one hand to the other.

One year

What most babies do at this age:

Are shy or nervous with strangers.

Cry when caregiver leaves.

Have favorite things and people.

Show fear in some situations.

Hand you a book when he wants to hear a story.

Repeat sounds or actions to get attention.

Put out arm or leg to help with dressing.

Play games such as peek-a-boo and pat-a-cake.

Respond to simple spoken requests.

Use simple gestures, like shaking head ‘no’ or waving ‘bye-bye’.

Make sounds with changes in tone (sounds more like speech).

Say ‘mama’ and ‘dada’ and exclamations like ‘uh-oh!’

Try to say words you say.

Explore things in different ways, like shaking, banging, throwing.

Find hidden things easily.

Look at the right picture or thing when it’s named.

Copy gestures.

Start to use things correctly; for example, drinks from a cup, brushes hair.

Bangs two things together.

Put things in a container, takes things out of a container.

Let things go without help.

Poke with index (pointer) finger.

Follow simple directions like “Pick up the toy”.

Get to a sitting position without help.

Pull up to stand, walks holding on to furniture (cruising).

May take a few steps without holding on.

May stand alone.

Talk to baby’s pediatrician if (s)he:

Doesn’t crawl.

Can’t stand when supported.

Doesn’t search for things they see you hide.

Doesn’t say single words like ‘mama’ or ‘dada’.

Doesn’t learn gestures like waving or shaking head.

Doesn’t point to things.

Loses skills he once had.

Cancer is a word that nobody wants to hear; it is often referred to as the ‘vicious disease’ since it is considered the second leading cause of death worldwide after heart disease. Breast cancer ranks as the second worldwide cause of cancer-related death in women.

What a pessimistic start to an article, but believe me it will get better.
Questions that often pop in people’s minds are: Have the cases of breast cancer increased these days? What can we do about that? And how can we protect ourselves?
The answer to those questions is easy: Early Detection.
Breast cancer awareness campaigns and new technologies for early detection have elevated the percentage of newly diagnosed patients and consequently offered a cure to more women. Yes, you heard right, more women are getting cured from breast cancer these days.

In this article, I want you to pay attention to these five important messages:
1- Know your risk factors;
2- Follow a healthy lifestyle;
3- Know the shape of your breasts well;
4- Beware of the early warning signs;
5- Get your annual check-ups as recommended.

Can someone be more prone to getting breast cancer than others? Well, of course, but you have to know that one of the major risk factors is being a female. Men also get breast cancer, but at a lower rate. Other risk factors that have to be known and taken care of include your family history with cancer, age and exposure to excess hormones.

If a mother, aunt and/or sister had breast or ovarian cancer, this indicates a genetic susceptibility that runs in the family. Moreover, if the genetic testing was positive for the gene mutation, the chance of getting breast cancer ranges from 40-85 % and for getting ovarian cancer ranges from 16-60%, depending on which genes are affected.

Do we have genetic testing in Egypt? The answer is yes. What happens if a lady has positive genes for breast cancer? First of all, she must never panic! Secondly, she will be given the appropriate prophylactic measures to prevent the cancer from developing or to catch it in its earliest stage.
As for the age factor, the older someone gets, the more likely he/she gets sick because the body is less capable of fighting diseases, one of which is cancer.
Exposure to hormones is not limited to oral contraceptive pills; scientists doubt its role in causing cancer these days due to the new generation pills with very low doses of hormones. Another point to consider is that the earlier one gets her first period (menarche) – before the age of 12 – and the later she gets her menopause – after the age of 55 – is a risk factor in itself since the ovaries may secrete estrogen for a longer time during her life. Estrogen is also used as hormone replacement therapy to help with the post menopausal symptoms.
Leading a healthy lifestyle is certainly an important factor in lowering your risk of cancer. Eating organic fruits and vegetables, playing regular sports, maintaining an ideal weight, refraining from smoking and drinking alcohol. People still don’t believe that laughter is the best medicine, well, having high morals and good spirits increases your immunity and hence the ability to fight diseases.

For a wholesome and healthy lifestyle, try some of these tips:
1- Read the list of ingredients on everything you buy.
2- Go back to nature; eat raw vegetables and fruits, ideally organic.
3- Cut out white, brown and refined sugars from your diet. Cancer cells love them.
4- Replace sugar with honey or stevia (a natural source of sugar from stevia plant)
5- Reduce carbohydrates, especially those made from white flour. White bread, pasta, pastries and cakes are some examples.
6- Wear natural fabrics as the first layer that touches your skin; cotton, viscose, linen and wool.
7- Never heat food in plastic containers.
8- Never leave your water bottle in the sun and then drink it.
9- Avoid long-life shelf products like canned fruits and vegetables, as well as milk and juices in cartons. The artificial additives and colors are very harmful and the carton invites fungus.
10- Start buying paraben and sodium lauryl sulfate (SLS) free shampoos, creams and deodorants. Those substances have been identified in breast cancer tissues.

Knowing the shape of your breasts is crucial since you are the only one who would instantaneously notice any change that is troublesome and needs to be checked by an expert oncologist. Some women are born with a retracted nipple, others have one breast lower than the other, especially after breast feeding, etc. At least, once a month, and 10 days after your period ends, you should stand in front of a mirror and do the self breast examination (SBE).
1- Stand with arms aside and look at your breasts in the mirror. Are they the same?, Can you see any abnormalities?

2- Put your hands above your head and inspect for any change in the under surface of the breasts.

3- Put your hands on your waist and squeeze to contract your chest muscles and look.

4- Now, imagine that you have divided each breast into four quadrants, with the tip of your three middle fingers and in a circular motion start examining each quadrant without leaving the surface of the skin.

5- Do it once lightly and a second time, more deeply.
6- After finishing the four quadrants, don’t forget to check under the armpits (axilla) and above the collar-bone for any small lumps that are called lymph nodes.

7- Repeat from Step 4 while you are lying down so that your breasts fall to the sides and reveal anything deep and difficult to detect while standing.

Practicing SBE every month is a positive step towards early detection of small suspicious lumps/masses.
What do you look for during the breast examination? You look for the early warning signs of breast cancer which can be summarized as follows:
1- A breast lump/mass.
2- Enlarged lymph nodes
3- Changes in the shape of either breast.
4- Changes in the skin, such as dimpling or redness.
5- A retracted nipple.
6- Nipple itching, scaling, redness or discharge.
7- Continuous pain in the same location, regardless of your period timing.
If any of these signs are detected, you should immediately go to an oncologist for a check up.
An annual mammography for women over the age of 40 is highly recommended. The check up can be made more frequently if she has a family history of breast cancer at a similar age.
A breast ultrasound is used for women under 35 since younger breasts are usually firmer in texture, unless they have already breastfed, which means the breasts are softer and more lax.
Unfortunately, we are seeing younger breast cancer patients these days, therefore it is recommended that girls over 20 years old have a clinical breast examination at the oncologist every three years, in addition to her monthly SBE.

Dr. Wafaa Abdel-Hadi, MB BCH, MSc
Clinical Oncology Specialist, Cairo University
Founder & CEO of Aware clinic
Oncologic Nutritional support, Arizona, USA
Breast Cancer educator & supporter, Texas

 

Vaginal discharge is normal secretion that occurs in every female, and functions to clean and protect the vagina.

Fluid is produced and secreted by glands inside the vagina and cervix, which carries away dead cells and bacteria.

Normal vaginal discharge is clear and watery and is increased during aggressive exercise.

The amount, odor and color may vary depending on the time in your menstrual cycle.

For example, there will be more discharge if you are ovulating, breastfeeding, or are sexually aroused.

The smell may be different if you are pregnant or you haven’t been diligent about your personal hygiene.

None of these changes is cause for alarm.

What is abnormal discharge?

Vaginal discharge that has an unusual odor and/or appearance, or is associated with itching and/or pain, may be a sign that something’s wrong.

What causes abnormal discharge?

Disturbance of the vaginal flora’s natural balance leads to abnormal discharge.

Examples of abnormal discharge causes:

• Antibiotic or steroid use.
• Infections such as:
  • Bacterial Vaginas, a bacterial infection more common in pregnant women or women who have multiple sexual partners.
  • Yeast Infection
  • Chlamydia
• Birth Control Pills.
• Vaginal atrophy.
• Diabetes
• Douches, scented soaps or lotions, bubble bath.

How can abnormal discharge be prevented?

• Keep yourself clean and dry.
• Keep the vagina clean by washing regularly with a gentle, mild soap and warm water.
• Never use scented soaps and feminine products or douche. Also avoid feminine sprays and bubble baths.
• After going to the bathroom, always wipe from front to back to prevent bacteria from getting into the vagina and causing an infection.
• Avoid clothes that hold in heat and moisture. Nylon underwear, tight jeans, pantyhose without a cotton panel and non-breathable gym shorts and leggings, can lead to yeast infections.
  • It is best to wear 100% cotton underpants, and to avoid overly tight clothing.

When to go to your gynaecologist?

• If you develop abnormal discharge, notice itching, swelling, or soreness around or outside of your vagina, it is time to visit your gynaecologist.
• Other signs include a burning sensation while urinating and discomfort during sex.

Written by :

Dr. Omaima Idris

Prof. of Obs. & Gyn.

There are several different types of vaccines available and some vaccines can be harmful to a baby, so mothers need to be very careful before getting any immunization. However, there are some vaccines that are recommended before and during pregnancy.

Why should pregnant women get vaccinated?

Firstly, an immunized pregnant woman will transfer her immunity t the baby. Also, immunization helps the mother avoid serious complications due to her naturally decreased immunity during pregnancy.

What vaccines are recommended before pregnancy?

If you are planning to get pregnant, it is recommended that you get the vaccine for chickenpox, HPV and measles, mumps and rubella (MMR).

Which vaccines are safe during pregnancy?

• Hepatitis ‬B: Pregnant women who are at high risk for this disease and have tested negative for the virus can receive this vaccine. It is used to protect the mother and baby against infection both before and after delivery. A series of three doses is required to have immunity. The second and third doses are given one and six months after the first dose.

‬‬ • ‬Influenza‬ (Inactivated): This vaccine can prevent serious illness to the mother during pregnancy. All women who will be pregnant (any trimester) during the flu season should be offered this vaccine.

‬• ‬Tetanus‬/Diphtheria/Pertussis (Tdap): Tdap is recommended during pregnancy, preferably between 27 and 36 weeks’ gestation, to protect the baby from whooping cough.

‬‬ Which vaccines should pregnant women avoid?

The following vaccines can potentially be transmitted to the unborn child and may result in miscarriage, premature birth or birth defects.

• Hepatitis A: The safety of this vaccine hasn’t been determined, so it should be avoided during pregnancy. Women at high risk for exposure to this virus should discuss the risks and benefits with their doctors.

• Measles, Mumps, Rubella (MMR): Women should wait for three months to become pregnant after receiving these live-virus vaccines.

• Varicella: This vaccine, used to prevent chicken pox, should be given at least one month before pregnancy.

• Pneumococcal: Because the safety of this vaccine is unknown, it should be avoided in pregnancy.

• Oral Polio Vaccine (OPV) and Inactivated Polio Vaccine (IPV): Neither the live-virus (OPV) nor the inactivated-virus (IPV) version of this vaccine is recommended for pregnant women.

• HPV Vaccine: To prevent the human papillomavirus virus (HPV), the vaccine is best taken before pregnancy.

Written by :

Dr. Omaima Idris

Prof. of Obs. & Gyn.

Seeing more cases diagnosed with endometriosis in Cairo, mostly among adolescent girls and young women, we decided to give focus to this disease by writing an article that’s purpose is to increase health awareness among the high-risk group.

What is Endometriosis?

Endometriosis is a disease that affects adolescent girls and young women; it is characterized by the migration of the inner lining of the womb (medically known as the endometrium) to be located outside the uterus. In the average cycle of a non-pregnant female, every month the endometrium sheds causing menstrual blood. However, patients afflicted with endometriosis experience an endometrium that partially sheds into the fallopian tube and into the pelvic cavity, known as retrograde menstruation.

The result of this type of menstruation is the formation of small implants on the surface of the pelvic organs, articularly the surface of your ovaries. With each menstrual cycle, the abnormally located endometrium produces regular cyclic bleeding (internal menstruation) – similar to that of the menstrual cycle – except the bleeding inside the pelvic cavity causes adhesions and blood cyst formation on the surface of the ovaries and other pelvic organs. Endometrium causes the fixation of pelvic organs that have adhesions (the ovaries, the uterus, bowel and vagina), which results in severe pain during each menstrual cycle and may compromise your fertility later if not treated.

Who is Susceptible to Endometriosis?

The mean age are women between the ages of 20-30 years. However, more recently we are seeing more adolescent girls affected.

• Nulliparous and single women.
• Women who reach menarche at an early age (the first menstrual period).
• Women with short menstrual cycles.
• Women with heavy menstrual flow.

 What are the Symptoms of Endometriosis?

Although some women with endometriosis are asymptomatic, the most common symptoms are infertility as well as pelvic and menstrual pain. Up to 87% of women with chronic pelvic pain (one that occurs below the belly button and lasts for at least six months) are often diagnosed with endometriosis. Forty to sixty percent of patients with severe menstrual pain, where strong analgesics are required, are also believed to have endometriosis.

Other symptoms may include:

• Abdominal cramps or back pain during menstruation.
  
• Very painful menstrual cramps.
• Painful bowel movements.
• Painful urination, especially during menstruation.
• Abnormal or heavy bleeding during periods.
• Painful sex.

How to Detect Endometriosis?

If you think you have symptoms of endometriosis, contact your gynecologist for a check up. After thoroughly studying your medical history, he or she will perform a routine physical and a pelvic exam.

How to Prevent Endometriosis?

Greater parity and cumulative lactation have been shown to protect against the development of endometriosis.

Can Endometriosis be Treated?

Endometriosis without symptoms, or with mild symptoms, usually does not require medical treatment. However, your doctor may choose to bring you in for frequent examinations. When necessary, treatment may vary depending on whether you are being treated for pain or infertility secondary to the endometriosis. 

Written by :

Dr. Omaima Idris

Prof. of Obs. & Gyn.

Why do we need dental care?

1. 59% of children between ages from 5 to 17 suffer from tooth decay.
2. More than 1/3 of the population has untreated tooth cavities.
3. Adults lose 164 million hours of work annually due to oral problems.
4. 90% of systemic diseases have oral signs that are hidden by poor oral health.

 How can we care for our teeth?

Caring for our teeth is achieved through Basic Dental Care and routine checkup at the dentist every 6 months.

How can we achieve Basic Dental Care?                                    

1. By picking the proper toothbrush and paying attention to its condition.
2. By choosing the proper toothpaste.
3. Through proper brushing technique and frequency.

Picking the proper toothbrush and when to replace it?

Choose a soft toothbrush not hard or medium and preferably with a tongue scrubber. 

When to replace my toothbrush?

You should change your toothbrush every 3 months.                                                                

Why?                                                                                                                                                  

1.) Studies show that after three months of normal wear and tear, toothbrushes are much less effective at removing plaque from teeth and gums compared to new ones.

2.) The bristles break down and lose their effectiveness in getting to all those tricky corners around your teeth.

• It is also important to change toothbrushes after you’ve had a cold, the flu, a mouth infection or a sore throat. That’s because germs can hide in toothbrush bristles and lead to re-infection. Even if you haven’t been sick, fungus and bacteria can develop in the bristles of your toothbrush another reason to change your toothbrush regularly.

Choosing the right toothpaste?

Use toothpaste instead of gel as it has a better cleansing action, use Gel only in cases of gum inflammation or bleeding.

The amount of Paste or Gel used on a toothbrush should not exceed the size of a pea; any increase reduces the cleansing effect.

What is the proper brushing technique and frequency?

Brushing your teeth at least twice a day is recommended, while three times a day is the best, Brushing should last at least 2 minutes, if you can achieve 3 minutes even better, while most people consider 2-3 minutes is a long time you can incorporate it with a little TV.

To properly brush your teeth, use short, gentle strokes, paying extra attention to the gum line, hard-to-reach back teeth and areas around fillings, crowns or other restoration.

Concentrate on thoroughly cleaning each section as follows:

• Clean the outer surfaces of your upper teeth, then your lower teeth.
• Clean the inner surfaces of your upper teeth, then your lower teeth.
• Clean the chewing surfaces
• For fresher breath, be sure to brush your tongue.

Caution

• Excessive brushing could expose the root of the tooth to irritation, and that could in turn irritate the gums. Brushing vigorously can also erode tooth enamel. The trick is to brush very gently for two to three minutes.
• Rinsing the toothbrush after you brush will help remove any leftover toothpaste; Bacteria can grow on an un-rinsed toothbrush.