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Dr. A K Bhatnagar

Pediatrician, Delhi

700 at clinic
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Dr. A K Bhatnagar Pediatrician, Delhi
700 at clinic
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I pride myself in attending local and statewide seminars to stay current with the latest techniques, and treatment planning....more
I pride myself in attending local and statewide seminars to stay current with the latest techniques, and treatment planning.
More about Dr. A K Bhatnagar
Dr. A K Bhatnagar is one of the best Pediatricians in Vasant Vihar, Delhi. He is currently practising at Holy Angels Hospital in Vasant Vihar, Delhi. Save your time and book an appointment online with Dr. A K Bhatnagar on Lybrate.com.

Lybrate.com has an excellent community of Pediatricians in India. You will find Pediatricians with more than 34 years of experience on Lybrate.com. You can find Pediatricians online in Delhi and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Holy Angels Hospital

P No-B, Behind Priya Cinema, Basant Lok, Vasant Vihar, Landmark:-Lok Commercial Central, DelhiDelhi Get Directions
700 at clinic
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Know About Delayed Puberty

MD - General Medicine, DM - Endocrinology, MBBS
Endocrinologist, Delhi
Know About Delayed Puberty

Puberty results from activation of gonads (testes in boys/ ovaries in girls) by pituitary hormones LH and FSH. Activated gonads produce sexual hormones (testosterone in boys and estrogen in girls ) which are responsible for gender specific physical changes at puberty along with behaviour changes. Testosterone in boys is responsible for hair growth over pubic area and face with maturation of genital organs, breaking of voice, development of muscular and skeletal system. Similarly, estrogen in girls is responsible for breast development, maturation of genital organs with feminisation of body. Bone maturation with rapid height gain is seen at puberty both in boys and girls. Various systemic and hormonal disorders can result in either late or early puberty. 

LATE PUBERTY - 

Most of the boys show signs of puberty latest by age of 14 years and most girls start showing signs of puberty latest by age of 13 years. The earliest sign of puberty in boys is enlargement of testes and in girls is height spurt/breast development. When boys older than 14 years and girls older than 13 years don't have any signs of puberty it is called delayed puberty. 

CAUSES OF DELAYED PUBERTY - 

  1. Constitutional delay is most common cause of delayed puberty. The constitutional delay means child is not having any illness and he is going to develop puberty spontaneously at later age. But diagnosis of this condition can be made only after physical examination and investigations so that other causes of delayed puberty are ruled out. 
  2. Functional hypogonadotropic Hypopogonadism - Delayed but spontaneous puberty develops. This condition can be seen in systemic illnesses like chronic infections, poor nutritional status etc. 
  3. Hypogonadotropic Hypogonadism - Disorders of pituitary gland result in low LH and FSH so that testes/ovaries are not stimulated and sex hormone is not produced. This can be caused by various genetic disorders, brain tumours, head injury, brain radiation etc. 
  4. Hypergonadotropic Hypogonadism - In this scenario, LH and FSH levels are normal but gonadal are not able to produce sex hormones resulting in delayed puberty. 

CONSEQUENCES OF DELAYED PUBERTY - 
The absence of age specific pubertal changes cause anxiety and distress in children and their parents. These children may develop low self-esteem and are teased by their peers. Along with the poor development of physical signs of puberty, fertility is also affected in hypogonadism. And most importantly, delayed puberty can be the symptom of serious underlying illness like intracranial tumours etc. These children deserve medical attention to get best results. 

INVESTIGATIONS - 
Serum testosterone/estradiol with LH and FSH is done to find out where is defect i.e. whether at the level of pituitary gland or at the level of testes/ovaries. Further investigations depend on levels LH, FSH, estradiol/testosterone. Other useful investigations include prolactin, T4, TSH, ray hand for bone age, ultrasound pelvis, MRI pituitary gland etc. 

TREATMENT - 
After diagnosis is established, Testosterone/estrogen replacement should be started to boys older than 14 year and girls older than 13 years respectively. Hormone replacement is very effective and usually safe. In adulthood those with hypogonadotropic hypogonadism can be treated with LH and FSH to produce sperms/ eggs so that they can achieve fertility. If you wish to discuss about any specific problem, you can ask a free question.

2952 people found this helpful

My son is 11 years old doesn't feel hungry at all and he complains all the time about head pain and back pain I am giving him liv 52 he is pale all the time not so active and got 2 white patches on skin.

BSC (Home), cerificate course in child care, diploma course in hospital administaration, master in food service management
Dietitian/Nutritionist, Vadodara
Weight is quite low 4 kg you can give pediasure in water 3scoob in 150 ml of water 2 times in a day.

My baby is suffering from fever due to urinary track infections. He is having antibiotics and paracetamol but fever is not going away. What should I do?

MD - Paediatrics, MBBS
Pediatrician, Jaipur
My baby is suffering from fever due to urinary track infections. He is having antibiotics and paracetamol but fever i...
Sponge whole body for around 30 minutes & give paracetamol orally. Get routine, culture sensitivity of urine & treat with appropriate antibiotics. Add urinary alkaliser to get better results.

My daughter is 23 days old as I feed him she demands more milk want to know whether I have sufficient breast milk or not n if no please suggest me how I can increase breast milk.

C.S.C, D.C.H, M.B.B.S
General Physician, Alappuzha
To know whether you have sufficient breast milk or not you have to weigh the baby every month as see weight is increasing as per standards

Hello, My son of 3 years old keeps falling ill twice a month And runs high fever so every time doctor suggest a course of antibiotic. Like azithral cefixime and zenflox. We recently did his cbc, ultrasound of abdomen, urin test and everything comes normal. Is taking so many medicines safe. Are there any health concerns in the long run. Should we introduce pediasure or any supplement.

Diploma in Child Health (DCH), F.I.A.M.S. (Pediatrics)
Pediatrician, Muzaffarnagar
Hello,
My son of 3 years old keeps falling ill twice a month And runs high fever so every time doctor suggest a cours...
You have not mentioned range and duration of temp. Fever twice in a month relapse after a fortnight which may be due interrupted treatment for a definite cause of fever as various antibiotics used may not have been for sufficient time. Antibiotics are not safe if used unnecessary. I suggest, next time, to maintain temperature chart of 4 time for three to four days without medicine. If temp is > 101 degree f, give him 10 ml paracetamol. You may get back after that. House hold foods are better than pedisure.

5 Foods That'll Help Increase Your Child's Height Naturally

Diploma in Child Health (DCH), MBBS
Pediatrician, Noida
5 Foods That'll Help Increase Your Child's Height Naturally

Did you know that there are certain foods that increase your child's height naturally? Foods that are rich in essential nutrients such as Vitamins, Calcium, Zinc, Magnesium etc can prove to be highly instrumental in adding extra inches to your child's height. Read on...

1. Whole Grains - Whole grains are rich sources of Zinc, Magnesium and Vitamin B, which play a very vital role in promoting your child's growth during his/her budding years. Additionally, whole grains also contain calories and carbohydrates, which ensure the maintenance of proper weight in your child, imparting him/her with the requisite energy to go on throughout the day. Feed your child whole-grain breads, cereals and pastas to make him healthier and taller.

2. Milk - Milk contains calcium and Vitamin D, which help in bone development during the growing years of a child, besides increasing his/her physical strength. Milk also helps in assimilating different proteins making it one of the best foods to be consumed by your child for attaining a good height. Three servings of milk, or milk products such as cheese or yoghurt, each day will suffice your child's Vitamin D and calcium requirement.

3. Fruits and Vegetables - Fruits are excellent sources of Vitamin A, which is instrumental in ensuring an enhanced rate of bone growth in your child, consequently making him/her taller. You can include carrots, mangoes, sweet potatoes, spinach etc. in your child?s diet to aid his/her height growth. It's advisable to provide him/her with 3 to 5 servings of fruits and vegetables every day.

4. Eggs - To ensure that your child grows taller naturally, providing him/her with a protein rich diet is very crucial. Eggs contain ample amount of protein needed to keep your child energetic throughout the day and help him/her grow taller. One to two eggs per day is considered to be the ideal intake amount for a child.

5. Soybeans - Soybeans are rich sources of protein and help in enhancing the growth of bones and muscles of your child, which in turn adds to his/her height during the budding years. You can cook various soybean dishes or you can add ground soybean powder to the dough while making rotis to make soybean a part of your child?s diet.

Although a child's height is also dependent on his/her genes, a well balanced diet containing these super-foods will increase your child's chances of growing to the fullest to attain a good height.

'Consult'.

5718 people found this helpful

I have a kid of 4 years old suffering from trout problem, could not take any food. What shall I give him? As morning I gave Combiflam syrup.

MBBS
General Physician, Mumbai
Antibiotics (Amoxicillin) with anti inflammatory medication (combiflam) should be helpful after clinical examination.
1 person found this helpful

My daughter is 5 years old, getting increase abdominal portion since 6 months. Not taking much more fatty food yet her weight is 27 kgs, height 3'7" Is it normal for this age of a growing child OR should she has to go for a complete medical check up. Please advise.

MBBS, Diploma in Child Health (DCH)
Pediatrician, Kanpur
Her height is ok, but weight is more. If she healthy and active stop giving her fatty things and ask her to do more outdoor games and physical activities. If she is having mild fever or lethargy and inactive consult a doctor.
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