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Treatment of Child and Adolescent Problems
Thyroid Problems Treatment
Thyroid Disorder Treatment
Paediatric Critical Care
Treatment of Childhood Infections
Child Nutrition Management
Growth And Development Including General Paediatri
Management of New Born Care
Preimplantation Genetic Diagnosis (Pgd)
Congenital Ear Problem Treatment
Treatment of Polycystic Ovary Syndrome In Adolesce
Treatment of Thyroid Disease in Children
Cleft Lip Treatment
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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 -
- 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.
- Functional hypogonadotropic Hypopogonadism - Delayed but spontaneous puberty develops. This condition can be seen in systemic illnesses like chronic infections, poor nutritional status etc.
- 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.
- 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.
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.
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.
My son is two months old. He was born with forceps delivery. Because of this one hand was not moving fully in the beginning. Now there are improvements on the hand. He is moving better now. Whether it will be alright slowly or we need to consult doctors? His head is also tilted due to this . Whether this will correct on its own after hand is healed ?pls advise. We are very much worried.
My son faces some learning difficulties, lack of concentration & minute dyslexia as per our observation since last 2-3 yrs. He is 6 yrs old & will be going to class 1 in dwarka, Delhi, Need guidance & suggestions for ensuring that my son get over this issue as earliest as possible.
My 2 months baby suffering from cold since one week, Dr. prescribed wikoryl AF n rhinoclear drops ,my baby crying for nose drops, I am giving steam too, she making sounds tru throat ,she vomiting frequently due to cold. Hw to get rid of cold n frequent vomit.
Hi, I had boy baby on 2/11/2016. Just one month over now. I want to apply oil for body massage. Which oil is the best to apply. And also which is the best powder and soap. Kindly tell me.
I had ectopic pregnancy last September 2015. Hsg show my both tube open. We have been trying for baby last 6 month. N 2 iui cycle not succeed. Doctor advise me for laparoscopic surgery for seeing is there any infection in tubes. Pls suggest me other alternative except ivf n laparoscopy.
My baby' s feets are normally little hot at day and night. He is 1 year and 4 months old. Is it normal?
My 8 months old girl baby refusing to drink cows milk and not eating any solid foods and sleeping properly. What to do for these problems?
My daughter is 12 months old, last ten days she is suffering from cold with running nose. She dont have fever. Kindly suggest me is this serious or normal condition. Also kindly suggest some medicines or home treatment method. Am staying in saudi arabia. Waiting for your kind response.
My daughter was born premature by 20 days and her birth weight was 2.4 Kgs. She suffered from Jaundice after 3 days of birth & was given phototherapy for 1 day. Her weight reduced to 2.1 kg. After 5.5 months, Her weight gain has reached till only 5 Kgs. Her vaccination till 6 months are completed. Question 1 :- Doctor has suggested only Vitamin D3 & Ferris drops. But he has not suggested Calcium drops. Whether this is required or not. We are continuing Pro Nan -1 & we have started little upper diets like cereal water etc. Question 2 :- What else shall we do to raise her weight exponentially, which according to us is less than shall be as actual. Awaiting your valuable feedback, Regards,
My daughter is 8 years old and weighs only 20 kgs. She is never interested in eating, be it anything. Capacity of food intake is very low and so she is not that much energetic & active as she should be in this age. Kindly suggest what to do in this as supplements and tonics will do the needful or any other way so that can eat properly own her own and deficiencies can be done away with.
Hello. I'm 24 years old and I have given birth to 2 months baby girl. Still I'm under weight 40 kg. Done with C section only. I'm vegetarian too. Need to put on weight.
My baby is born with brachial plexus birth injury. Now she is 6 months old, we have consulted few orthopedics n neurologists all they have said is go for surgery. Is that problem wont recover with physioteraphy? if we go for surgery also will there be any side effects for baby in future? kindly advise.
Hi, our relatives baby has hydrocephalus and placed a stunt from head to stomach almost 3 years back. Now she is nearly 3.6 years old. What would be the next step and how world be her health in future. Now she is very active and doing well. Please let us know the consequences and about her health problems in future. Thanks,
भोजन के बाद फ्लोराइड टूथपेस्ट से कम से कम हर दिन दो बार ब्रश करे |
रात को सोने से पहले मुँह में अच्छे से फ्लॉस करे |
अपने दांतो की स्वच्छता के लिए नियमित रूप से चिकित्सक के पास जाएं |
खाने के लिए अच्छी तरह से संतुलित आहार विशेष रूप से अपने नियमित खाने में शामिल करे |
ज्यादा से ज्यादा पानी पिए |