Puberty is delayed when there is no sign of pubertal development in boys by 14 years and in girls by 13 years. The first sign of puberty in girls is breast enlargement. It is mostly visible and sometimes mildly painful. In boys, the first sign of puberty is enlargement of the testes. This is usually not noticeable. However, most boys are brought to the endocrinologists only when parents fail to notice pubic hair growth.
But pubic hair growth can be present even in people with pubertal delay.
Of the various medicines available for osteoporosis, the endocrinologist can decide the best choice based on the risk of fractures for the patient, the BMD, age, cause for osteoporosis and safety of the medicines.
This will be an informed decision made in discussion with you. In general, your doctor will use medicines that add bone when you have very poor BMD or you have had fractures in the past. This includes medicines like Teriparatide. Otherwise he may use drug classes like bisphosphonates or denosumab. Sometimes, the doctor may use a combination of drugs.
Osteoporosis is a treatable medical condition. Treating osteoporosis can strengthen the bone and prevent fractures. Depending on the severity of osteoporosis, we can use various drugs.
Medicines that prevent bone destruction
Medicines that build bones
Osteoporosis is one of most common chronic disease. Everyone should be aware of the risk factors for osteoporosis. Being a metabolic disease of bone, osteoporosis is primarily managed by endocrinologists. They do tests to understand the reason for osteoporosis and treats it. Osteoporosis is strongly associated with arthritis and is also treated by rheumatologists. Many people with osteoporosis patients will never know that they have the disease till they sustain the first fracture. They will be treated by orthopaedic surgeons.
Your bone density test results are reported using T-scores.
Osteoporosis is usually diagnosed by using DXA (Dual Energy Xray Absorptiometry)for
measuring Bone Mineral Density (BMD). It is a non invasive test and is not painful. It involves checking your spine, hip and wrist for bone thinning. Other tests include qCT ( quantitative CT ) and ultrasound based screening for osteoporosis.
Once osteoporosis is diagnosed, we need to look into the reasons why it has occurred.
The reasons can be very diverse from calcium and vitamin D deficiency to malignancies like multiple myeloma or hormonal diseases like hyperparathyroidism.
You are at risk of osteoporosis if you have any of the following risk factors.
We know that the common signs of corona virus infection are fever, cough, shortness of breath, running nose and sore throat. However, coronavirus may cause some medical issues which are less commonly recognised
1. Eye infections: conjunctivitis
2. Skin problems: skin rashes (hives to measles like rash), bluish discolouration of the toes /fingers, vasculitis, purpuric rashes etc
3. Gastric symptoms: includes poor appetite and diarrhoea
4. Cardiac: cardiac injury (myocarditis), coronary artery disease, venous thromboembolism, arrythmias
5. Neurological: hyposmia/anosmia (reduced sense of smell), ageusia/hypogeusia (reduced taste) , headache, loss of consciousness, dizziness, neuralgic pain and muscle injury
Although anyone can develop corona virus infection, some people are at increased risk of corona virus infections. If you have the following medical conditions you are at excess risk 1. Age more than 65 years 2. Diabetes mellitus 3. Any heart disease 4. Kidney disease 5. Asthma and Chronic Pulmonary Disease 6. Anyone on oral/injectable steroids 7. Cancer and cancer chemotherapeutic agents. Take extra precautions in case you have any of these conditions.
Always remember that you can contract the infection only if you are in close contact with someone with infection. Following all precautions can prevent you from having a corona virus infection.
Certain concerns have been raised about certain drugs used in hypertension and diabetes to increase the risk of COVID infection. As of date there are no scientific proof to discontinue these medicines. In fact, there is some science that discontinuing drugs like ACEI (e.g. ramipril) and ARB (e.g. Telmisartan, Losartan) can in fact be harmful. Many professional organisations including the American and European Society of Cardiology recommends that you don’t discontinue any medicines that you are on without consulting your doctor.
It seems so. One of the reasons people with diabetes are prone to viral respiratory infections is due to the increased blood glucose. Having high blood glucose reduces immunity and also promotes some mechanisms by which the COVID-19 virus attacks the lungs. Keeping the blood glucose under check can help reduce the risk of COVID 19 infections
Since the virus spreads mostly by aerosols, we should avoid contact with people who have COVID 19 infection. This is especially true of people with cough, fever, sore throat and running nose. But during the carrier stage people may not have any signs of infection, but can still spread the virus. So, it is important to practice hygiene at all times. To avoid COVID infection 1. Wash hands regularly 2. Avoid touching face, nose, mouth and eyes repeatedly 3. Avoid contact with people who are sick. Avoid everything except essential travel including travel for non-emergency medical care.
