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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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My daughter is 2.5 years old and doesn't know how to chew. Pls advise as she is not able to eat solids.
My son is 3 years 11 months old, and have been suffering from high diabetes 600+, though no member in our family or my wife's have diabetes. Doctor's saying his body is not generating insulin and he will have to keep taking insulin 2 times a day daily lifelong. Is there any cure, please advice.
A 4 months old baby weighing 7.5 kg having constipation from last 3 days and crying a lot with pain and fowl smelling flatulence. Please recommend the best advice.
My baby boy completed 3 month on 9 august. He breast feeding normally. But last 5 days he intake his hand in mouth. Can I give him cow milk. Powder milk due to gas problem he does not drink.
There are two different types of pneumonia vaccines are available for the children. 1 is almost double the price of other. Which one should be preferred and why?
Hello doctor, since last 1 week at evening and night time after giving food sometimes he completely vomited. At evening we give him fruits juice like mango, papaya, Apple and evening give navadhanya, Ragi powder, banana powder. Morning he is OK eat properly. We tried to feed Rice. Idly.and all these things he vomiting. Now 14 months completed and feeding him 3 times a day along with brest feeding. Please suggest what we have to do in this situation.
I have 2 months baby and she is getting puss from navel I consulted many doctors but not getting well give me suggestion.
Hello Dr. my baby boy is 2 and half month old jab wo sota hai to aksar uske hands or legs kanpte hai aisa kyu hota hai please tell the reason urgently.
My baby is one and half month old she had a vaccine today she is crying badly pls tell me any way and medicine for relief.
My daughter is 6 months old and weighs 10 kg. She is in good health since birth. Feeding on mother's milk. Have started solid food 2weeks back. Does her weight need any concern? Also tell me if we should give her any kind of supplements.
My son is 2.5 years old. He has weak digestion and lost of appetite. Can I give him Liv-52 syrup? Or any thing else you suggest , what I should follow.
Hi doctor. My son is 6 months old and his weight is 6.30 kg. He was born as pre term at 7 and half months. My concern is that he is getting cement colour or sometime palak colour motion from last 1.5 months. He was admitted in hospital in may month as he got pneumoniae for 10 days and also 2 weeks before he was suffering from cough issue whom medicines were given by Doctor. He is ok now with cough and cold issue but this motion thing is still not sorted. Is this any issue? Kindly suggest.
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.