Welcome to EndocrinologyNepal

Endocrinology is a branch of internal medicine which deals with disorders related to hormonal imbalance. It includes not only diabetes and thyroid disorders but also deals with various diseases like hypogonadism, erectile dysfunction, infertility, hirsutism, gynecomastia, PCOS, pubertal disorders, obesity, short stature, tall stature, pituitary disorders, Cushing's syndrome, Pheochromocytoma, parathyroid disorders and metabolic bone diseases.

Endocrinology भनेको हर्मोन को गडबडीबाट हुने रोग सम्बन्धि क्षेत्र हो I हर्मोनको गडबडीका कारण निम्न समस्याहरु हुन सक्छन :
१. मधुमेह (Diabetes)
२. सुगर कम हुने रोग (Hypoglycemia)
३. थाईराइद रोग (Thyroid disorders)
४. महिनाबारीमा गडबड र निसन्तान (Infertility)
५. महिलाहरुको शरीरमा धेरै रौँ उम्रने (Hirsutism)
६. स्तनबाट दुध चुहिने (Galactorrhea)
७. पुरुषहरुमा स्तन बढ्ने (Gynaecomastia)
८. शरीरको उच्चाई नबढी पुड्को हुने (Short stature) वा धेरै अग्लो हुने (Tall Stature)
९. लिङ्ग वा अन्दकोश सानो हुने (Hypogonadism)
१०. यौन इच्छामा कमि आउने वा सम्भोग गर्न गार्हो हुने (Erectile Dysfunction)
११. यौबन अवस्था चांडो देखिने (Precocious puberty) वा ढिलो गरि देखिने (Delayed puberty)
१२. हड्डी बारम्बार टुट्ने , हड्डी बंगिने (Rickets), हड्डी सुन्निन्ने वा हड्डी खिइने (Osteoporosis)
१३. शरीरको मोटोपना बढ्ने(Obesity)
१४. बारम्बार मिर्गौलाको पत्थरी हुने(Kidney stones)
१५. सानो उमेरमा नै रक्तचाप बढ्ने वा रक्तचाप अचानक बढेर टाउको दुख्ने , बान्ता हुने र पसिना आउने
१६. लिङ्ग निर्धारण गर्न गार्हो हुने (Disorders of sexual development)

About Dr Ansu Mali Joshi

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Kathmandu, Nepal
I am an endocrinologist, practising at Kathmandu, Nepal. I did my DM Endocrinology from the prestigious All India Institute of Medical sciences, New Delhi in 2011. DM Endocrinology is a 3 year superspecialized degree which is done after doing 3 years of MD Internal Medicine. Currently I work at KATHMANDU DIABETES & THYROID CENTER PVT LTD (01-5521969).

Monday, March 5, 2012

New NAMS Guidelines Back Hormone Replacement Therapy(HRT) for Menopausal Symptoms

North American Menopause Society (NAMS) has updated its 2010 position statement on the use of estrogen therapy (ET) and estrogen-progestogen therapy (EPT) (published online February 27, 2011 in Menopause: The Journal of The North American Menopause Society).

Highlights of the specific recommendations include:
1.The most effective treatment for menopausal vasomotor symptoms and associated quality of life is Estrogen Therapy or Estrogen+Progesterone Therapy.

2.Heightened risk for breast cancer associated with more than 3 to 5 years of Estrogen+Progesterone Therapy (EPT) use limits the duration of safe EPT use. For Estrogen Therapy(ET), the benefit–risk profile is more favorable. Because risk for breast cancer does not appear to increase during an average of 7 years of ET use, there is more flexibility in duration of ET treatment.

3.HRT use is associated with a lower fracture risk, but a higher risk for ischemic stroke, venous thromboembolism (VTE), and ovarian cancer.

4.Compared with ET, EPT is associated with a higher risk for coronary artery disease.

5.Women with premature or early menopause and no contraindications to HRT may use HRT until age 51 years, which is the average age of natural menopause, or longer if needed to control symptoms.


Take Home Message:
Hormone Replacement Therapy can be used judiciously for menopausal vasomotor symptoms.It should not be solely used for prevention of osteoporosis or cardiovascular disease. In fact, it may increase cardiovascular disease.

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