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Please meet Dr. Ayman El-Hattab – Consultant Clinical Genetics.

 

Highly trained and educated, with more than 10 years of experience in the field of genetics as he worked in USA (Baylor College of Medicine and University of Missouri), Saudi Arabia (King Fahad Medical City), and the United Arab Emirates (Tawam Hospital).

 

At Genesis Dr. Ayman will provide healthcare for children and adults with confirmed or suspected genetic diseases, or with family history of genetic diseases. We provide clinical evaluation, perform genetic tests, advise on management and do genetic counseling for patients and families on the following genetic and inherited conditions:

 

  • Fetal malformations and suspected genetic diseases in fetus 
  • Recurrent miscarriages
  • Birth defects and congenital malformations
  • Infertility
  • Intrauterine fetal death
  • Developmental delay, intellectual disability, and behavioral disorders
  • Growth failure
  • Down syndrome and other chromosomal and genetic syndromes
  • Inborn error of metabolism (metabolic disorders) and mitochondrial disorders
  • Familial hereditary cancers
  • Inherited and genetic neurological, endocrine, cardiovascular, pulmonary, renal, gastrointestinal, skeletal, dermatological, immunological, and hematological diseases
  • Inherited and genetic hearing impairment and eye diseases
  • Genetic counseling for carriers of genetic diseases 
  • Genetic counseling for prevention of inherited genetic diseases

19th April 2019 at Le Meridien Hotel, Airport road, Dubai.

Dr. Deemah Salem will be joining Genesis Perinatal Care Clinic in March!

Dr. Deemah was born in Chicago, Illinois, USA. She received her Bachelor’s degree from Saint Louis University in the USA in 1999 with the highest recognised honor, Summa Cum Laude. She then graduated from Saint Louis University School of Medicine with honors in 2003, after which she did her residency training in Obstetrics and Gynaecology at one of the top nationally ranked hospitals in the USA, William Beaumont Hospital in Michigan. She then joined a prestigious OBGYN medical center for seven years where she gained outstanding experience in general and high risk obstetrics and gynaecology.

She relocated to Dubai with her husband and children in 2014. She performs deliveries and surgeries at Mediclinic City Hospital in Dubai.

Dr. Deemah has a warm bedside manner and advocates women’s preventative healthcare. She speaks both English and Arabic fluently. She has a rich diverse background and caters to the cultural needs of patients.

Her passion is to educate and empower her female patients with information about their health and provide them with the best healthcare.

She is a fellow of the American College of Obstetrics and Gynecology and is board certified by the American Board of Obstetrics and Gynecology.

Martie Clayton is a qualified Registered Nurse and Midwife for the last 28 years, South African trained.
In 2006 she completed a honors degree in Nursing Education and administration.
Martie relocated to Dubai in 2008. She worked as Head Nurse – Maternity Manager at Mediclinic City Hospital for 9 years. During this period her team received numerous accolades and recommendations including passing the JCIA accreditation with excellent comments for the care given to parents and newborn babies.
In 2011 Martie completed International Breastfeeding Lactation Consultancy Course (IBCLC). She is a certified ALSO/NRP/BLS instructor and actively participates in giving lectures on breastfeeding, Obstetric Emergencies, Neonatal Resuscitation and Basic life Support. This keep her updated on International best practices in Obstetric.
“I am enjoying my new work experience as part of the Genesis Perinatal Care Clinic family with Dr. George and the team. We all have the same goal a healthy mom and healthy baby/babies and a family that know we care for them. 
I am a reflective practitioner who enjoy and love what I do hence, I value the importance of having personal engagement with parent to share knowledge and ideas during their journey to parenthood and post delivery as a family.
As a midwife my role will be to provide Antenatal Classes in preparation for our parents to parenthood as well as Breastfeeding Education prior delivery as well as breastfeeding support after delivery.
Wishing all a blessed day and keep smiling!” – Martie says 🙂

Carrier screening for genetic diseases Preconception, Early pregnancy test Genesis Perinatal Care Clinic 

Carrier screening in early pregnancy.Advances in genotyping technology resulted in the fast and affordable sequencing of the human genome (genetic information). Conditions like cystic fibrosis (1/25 risk of being a carrier) and spinal muscular atrophy (1/47 -1/90 risk of being a carrier) thalassemias (almost 7% of women are carriers ) are relatively common conditions with a significant impact on the life of the affected individual. Expanded carrier screening can identify not only common recessive conditions but also rare ones. This was till recently offered only as a preconception test. However as Carrier screening can now be completed at a very fast pace it is an option to be considered as an early pregnancy test. 

What is carrier screening?

Carrier screening is a type of genetic test that can tell you whether you carry a gene for certain genetic disorders. When it is done before or during pregnancy, it allows you to find out the chances of having a child with a genetic disorder

What is a carrier; 

For some genetic disorders in order for the child to be affected, it needs to inherit the abnormal gene from both parents (autosomal recessive). Individuals who have one abnormal gene are most of the time asymptomatic meaning they do not have the disease or have a very mild form. However, they can pass the abnormal gene to their children. these individuals are called Carriers.  For example, for Cystic fibrosis, the carrier is usually completely symptomatic while for B thallasemia the carrier might have mild anemia. 

Who should have carrier screening?

It is currently recommended for women to consider  having screening for cystic fibrosis, hemoglobinopathies and spinal muscular atrophy if they are planning to get pregnant 

How is the testing done?

Usually, a sample of blood is required although some test uses saliva for swab taken from the mouth.  The test comes as positive (you have an abnormal variant) or negative (you don’t). If you are found to be a carrier then your partner should be tested to determine his status 

Normally you do not need to repeat the test in the future for the same mutation

Should everyone have carrier screening?

Carrier screening in most settings is a voluntary decision. The same applies to the extent of screening you will have. Meaning whether you will opt for a targeted screening or expanded

What is expanded carrier screening? 

Current tests offer the option to test for more than 200 conditions. They usually focus on conditions that although rare are expected to have a major impact on the person’s quality of life 

How accurate are the tests?

The tests are not perfect. There is a small risk of both false positive and false negative results. A negative – normal test does not guarantee that there no chance for genetic disorders because; 1 does not test for everything 2. there may be a variant mutation that is not detected by the test but still cause problems

What the test providers are trying to calculate for you is the residual risk; meaning the risk after you have a negative test 

the following table gives an example for cystic fibrosis  

 Gregg et al  Expanded Carrier Screening Obstet Gynecol Clin N Am 45 (2018) 103–112

At Genesis Perinatal Care Clinic we are offering the most comprehensive carrier screening tests; The test can be scaled from the relatively common diseases to an expanded test that covers more than 270 serious diseases. We have built the proper setting to discuss, counsel and perform both screening and follow up diagnostic tests for genetic conditions

Dr George Michailidis, MRCOG 

Fetal &Maternal Medicine Consultant

Obstetrician & Gynaecologist 

20 Sep 2017

WORKSHOP “BASIC ULTRASOUND”

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We are happy to announce the ‘GENESIS’ was granted an Educational Permit by Dubai Healthcare Regulation, what gives us a great opportunity to organize medical events where we can  talk about different topics related to:

  • Maternal and Fetal Medicine
  • Obstetrics and Gynecology
  • Management of high risk pregnancies
  • Basic and advanced prenatal ultrasound scans
  • 3D/4D scans
  • And many more…

A good breastfeeding guide for mothers Breastfeeding questions Breastfeeding questions 2

25 Mar 2016

NICU guide

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nicu-welcome-guideThis is  fantastic work from a group of mothers who aim to share their experience in the NICU at Mediclinic City Hospital.
It is full of the emotion and sincerity of the parents who have been there and had a first hand experience.
The full NICU Survival Guide can be found at the following link www.nicudubai.wordpress.com
Dr George Michailidis, Fetal Medicine Consultant, Obstetrician & Gynecologist

 

Zika virus and pregnancy in Dubai

What is Zika virus ?

How is Zika virus transmitted ?

Aedes_aegypti Zika virus is spread by the yellow fever mosquito Aedes aegypti . The specific mosquito can carry a number of other viruses as well like denque fever yellow fever. It is recognised by the white markings on its legs and a specific mark that resemble the music instrument lyra on it thorax . The mosquito has originated in Africa and now is spread in most subtropical regions throughout the word

 

 

 

 

 

 

How do I know if I am infected ?

Symptoms of Zika virus infection in pregnancy

 

 

109px-Zika.Virus.Rash.Arm.2014symptoms are fever, rash eye irritation ( conjactivitis). Muscle and joint pains as well as headaches are frequent symptoms as well

  • It is a self limiting infection that usually lasts a few days
  • Only one in 5 people who are infected with the virus do actually become ill

 

Diagnosis of Zika virus infection

  • Diagnosis is not easy and is based on a very high index of suspicion
  • Symptoms are very similar to those from dengue fever or chinkungunya . Both these viruses are transmitted from the same species of mosquitoes as Zika
  • Travel history during pregnancy in areas where zika virus is prevalent is important. CDC is regularly updating its travel information and this can be found online at http://wwwnc.cdc.gov/travel/notices/
  • Blood tests can help the diagnosis

Treatment for the pregnant mother with Zika virus infection

  • There is no specific medication or vaccine to treat or prevent Zika virus infection during pregnancy
  • Ensure good hydration
  • Paracetamol is safe to take during pregnancy in mothers with Zika virus infection to relieve some of the symptoms
  • In pregnant mothers with laboratory evidence of zika virus disease during pregnancy follow up by a fetal medicine specialist is recommended. Ultrasound scans are performed in 3-4 weeks interval looking for specifically for evidence of microcephaly or cerebral calcifications

Pregnancy advice and Zika virus

Pregnant women considering travelling in an area affected by Zika virus 

  • Pregnant women should be advised against travelling to areas known to be affected by zika virus. There are no vaccines or medication that can be used in pregnancy to prevent Zika virus.
  • The mosquitos responsible for transmitting Zika virus are most active during the day so appropriate measures to avoid mosquito bites should be taken . Wearing long sleeve shirts and long sleeve pants as well a appropriate use of insect repellants is strongly advised

Testing of pregnant women with a possible infection by Zika virus

  • zika virus interim guidance cdcTo date there is no commercially available test specific for Zika virus . Blood test utilising reverse transcription polymerase test can be used in symptomatic patients . In the US this is facilitated by the local health care departments

Effect of Zika virus to the baby

There is increasing evidence linking Zika virus infection during pregnancy and fetal microcephaly.

microcephaly-comparison-500pxWhat is microcephaly? The term microcephaly is used to describe a fetal head size that is smaller than expected at a certain gestational age. Different cut of points are used but most will take 3 standard deviations from the mean. This means that the circumference  of the fetal head is less than the 0.3 % expected for the gestation

The size of the fetal head is mostly dependent on the growth of the fetal brain. Most cases of microcephaly are due to genetic factors. However acquired microcephaly is well described due to infections like toxoplasmosis and rubella. Zika virus has been associated with the increased rate pregnancies affected by fetal micropcephaly in Brazil .

What is the treatment for microcephaly. There is no treatment for microcephaly as this is the result of the damage that has already happened to the fetal brain.

 

Dr George Michailidis

Fetal and Maternal Medicine Consultant

Obstetrician Gynaecologist

Genesis Perinatal Care Clinic Dubai
www.genesis-dubai.com

drgeorge@genesis-dubai.com

 

Further updated information 

Centers of Disease Control and Prevention – Zika virus 

http://www.cdc.gov/zika/index.html

Interim Guidelines for Pregnant Women During a Zika Virus Outbreak — United States, 2016

Interim Guidelines for Pregnant Women During a Zika Virus Outbreak — United States, 2016

http://www.cdc.gov/mmwr/volumes/65/wr/mm6502e1.htm

 

Image acknowledgment

“Aedes aegypti” by Muhammad Mahdi Karim (www.micro2macro.net) Facebook Youtube – Own work. Licensed under GFDL 1.2 via Commons – https://commons.wikimedia.org/wiki/File:Aedes_aegypti.jpg#/media/File:Aedes_aegypti.jpg

 

“Zika.Virus.Rash.Arm.2014” by FRED – Own work. Licensed under CC BY-SA 3.0 via Commons – https://commons.wikimedia.org/wiki/File:Zika.Virus.Rash.Arm.2014.jpg#/media/File:Zika.Virus.Rash.Arm.2014.jpg

gestational-diabetes-diet-planGestational diabetes has a major impact in pregnancy care especially in Middle East. Lifestyle and diet interventions can help improve outcomes for baby and mother. Furthermore the set the foundations for a long term healthier lifestyle. The following is from the OBGYNnet referring to a recent publication from Diabetes Care ;

Best Diet for Gestational Diabetes | OBGYN.Net: Clinicians should prescribe a low glycemic index diet to women with gestational diabetes mellitus, according to new data from a meta-analysis.

The analysis found that a low glycemic index diet was associated not only with reducing insulin use but also with lower birth weights for the babies. Published in Diabetes Care, the analysis was based on data from nine randomized controlled trials.
Key Points:

– Physicians should recommend that women with gestational diabetes choose foods with a low glycemic index.
– Adhering to a low glycemic index diet will likely improve the health of women with gestational diabetes.
– Although associated with decreased need for insulin and reduced birth weight in infants, a low glycemic diet did not affect maternal weight gain or c-section rates.
A previous Cochrane review found no significant dietary benefit of a low glycemic index diet. However, this latest analysis included more trials that the Cochrane analysis, the authors said.
Total dietary restriction and low carbohydrate diets did not have similar impact on maternal or newborn health, the researchers found. However, a low glycemic index diet reduced the proportion of patients who needed insulin (relative risk, 0.767 [95% CI 0.597, 0.986]; P = 0.039).
“The less frequent use of insulin means that 13 out of 100 patients with GDM will not need to use insulin if they adopt a low GI diet during pregnancy,” the authors reported.
In addition, the average birth weight of babies born to pregnant women with gestational diabetes who consumed a low GI diet was 161.9 g less than that of babies born to women in the control diet group (95% CI: −246.4, −77.4; P = 0.000).
Using a glycemic index scale from 0 to 100 according to the extent to which a food raises blood glucose levels after eating, the authors categorized foods with a glycemic index of less than 55 as low glycemic index foods. Pumpernickel bread, oatmeal, muesli, sweet potato, corn, yam, lima beans, peas, lentils, most fruits, and carrots are among foods deemed to have a low glycemic index, according to the American Diabetes Association.
A low glycemic diet, however, did not affect maternal weight gain or c-section rates, the authors noted.
See more at: http://www.obgyn.net/gestational-diabetes/best-diet-gestational-diabetes


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