|| Small testis || Absent genital development || Small Genital & Genital enlargement ||
  || Less beard & moustache || Hypogonadism || Testosterone deficiency || Andropause || Male Infertility ||
|| Breast enlargement in male ||  Male hormone Disorders || Less Body muscles and under weight ||

What is Gynecomastia? Breast enlargement in boys called gynecomastia (also known as gynecomazia). It may start any time from childhood to 35 years of age.  It may start as small breast nodule then grow further to large size. It causes lot of embarrassment to boys. It leads to inferiority complex & lack of concentration in study or work.  Sometimes breast enlargement may be associated with decreased development of secondary genital characters like less beard & moustache, less body hair, soft skiin as found in girls, soft voice like females, less muscular development i.e. less manly body. Due to all this patient may have decreased confidence on himself & may even sometimes may have nervousness in talking to others. The body energy may also become less so that patient feels tired all the time. There memory also may be less. Sometimes all above disorders can lead to severe anxiety & even frank depression may occur.

Why Breast Enlargement Occurs? All boys have very little undetectable breast tissue in childhood. In some boys due to any of below mentioned causes either male hormones decreases or female hormone as estradiol & other hormone either increase in amount or their effect increases in the body. These hormones changes lead to increased concentration of female hormones in the breast tissue. These hormones then act on the various sensors (called receptors) in the breast tissue. After the interaction of hormones & receptors certain changes occurs in the functioning of cells of breast tissue so that breast cells starts growing in thickness & size & more & more fat starts depositing in the breast . Thus breast size gradually starts increasing. Simultaneously it also increases the blood supply to breast tissue leading to more availability of growth factors to the breast tissue resulting in faster growth of breast tissue. These hormones & growth factors become particularly in high concentration during peak of secondary genital characters development i. e. puberty leading to persistent stimulation of breast tissue for next two to three years leading to further breast enlargement. In some boys breast size keeps on increasing for many years where as in other growth stops after few years.  

Causes of Gynecomastia:  Breast enlargement in male can occur due to any of the following causes as:

1) Deficiency of male hormones: It can be due to decreased production of male hormone (Testosterone & other male hormones) from testis either due to defect in testis or due to deficiency of trophic hormones from the pituitary gland.   

 a) Primary Testicular Disorder: Viral orchits, trauma, castration, granulomatous disease, varicocele, Congenital anorchia, Klinefelter syndrome, Noonan syndrome, Viral orchitis, Mumps Orchitis, Leprotic Orchits, other Testicular disorders, primary leydig cell dysfunction, XX male gonadal dysgenesis 

b) Deficiency of Trophic Hormones: Hypothalamic – pituitary deficiency: Idiopathic GnRH deficiency, Kallman syndrome, Prader-Willi syndrome, Laurence-Moon-Biedl syndrome , Hypothalmic deficiency, pituitary hypoplasia, Trauma, post surgical, postiradiation, Tumour (Adenoma, craniopharyngioma, other), Vascular (pituitary infraction, carotid aneurysm), Infiltrative (Sarcoidosis, histiocytosis, tuberculosis, fugal infection, hemochromatosis), Autoimmune hypophysitis, Isolated gonadotropic deficiency with or without anosmia, Fertile eunuch syndrone, Idiopathic hypopituitarism, CNS disorders  : tumors, infections, pituitary agenesis or hypoplasia, hydrocephalus, Septooptic dysplasia, CNS radiation for leukemia or brain tumor, Prader-Willi and Laurence-Moon-Biedly Syndrome, Thalassemia major

c)      Defects in androgen synthesis.

2) Excess female hormone production from Adrenal Glands: Increased female hormone estrogen in body due to excess production from testis, HCG-producing tumor , testicular tumor, True hermaphorditism, Estrogen-producing adrenal tumor, Increased production of female hormone in other body parts as in Adrenal disease, liver disease , thyrotoxicosis.

3) Excess female hormone production from testis: due to many disorders ovaries start producing more female hormones. This may occur due to Alcoholic Liver Disease, Hyperthyroidism, Obesity, Androgen-Insensitivity syndrome ,Familal aromatase excess  

4) Idiopathic Gynecomastia: In this disorder breast tissue is more sensitive  to even small amount of female hormone in the body . It can also due to abnormally increased sensitivity of breast tissue to tiny levels of female hormones so that they over-react & grow large.

5) Drug  Induced: There are many drugs which when used wrongly may lead to enlargement of breast as  phenothiazine, methyldopa, reserpine, trycyclic antidepressant, metochlopramide, estradiol, diethylstilbestrol, digitalis, HCG, clomiphene,  ketoconazole, alkylating agents, spironolactone, cimetidine, aminoglutethimide, flutamide, cypoterone. Others : amiodarone, busulfan, captropril, ethionamide, isoniazid, D-penicillamine, phenytoin, diazepam, marijuana, heroin, omeprazole, rantidine, enalapril, niledipine, verapamil, Cytotxic drugs

6) Androgen Receptor defects: Defects in the structure or function of androgen receptors, Complete testicular feminization syndrome, Partial androgen insensitivity syndrome(Reifenstein syndrome)

7) Genetic i.e. hereditary causes

8) Postreceptor transduction abnormalities

9)    Increase in peripheral aromatase activity

10)  Physiological Pubertal Gynecomastia

Investigations & Diagnosis: We take detail history to pinpoint the possible causes of this problem. After this we do certain of below mentioned tests to diagnose the possible cause of breast enlargement in that particular patient. At our diabetes & thyroid center we have most advance state of the art laboratory with all the modern facility for all above tests. After these tests we reach the final diagnosis.

Various tests needed are as follows:

Complete male hormone profile: This profile includes all the male hormone tests which controls all the male features & does not allows breast to enlarge.

Thyroid test

Serum testosterone is either below normal range or on the lower side of normal. Similarly free testosterone is either low or on lower side of normal.

SHBG

Adrenal Hormones

Female hormone tests

HCG

Mammography

USG breast

USG of testis or abdomen or for some other part

Chromosomal analysis is done to see the genetic structure of testis, because there are many chromosome disorders lead to hypogonadism.  
Capacity of generation of active testosterone i.e. DHT is tested. This DHT generation test is abnormal in some cases of hypogonadism.  

Molecular genetic studies done in some special cases.  
Serum estrogen increased whenever testicular function decreased.  
Serum DHT is low in some conditions when generation of dihydrotestosterone is decreased.  
Assessment of androgen receptor is due when needed, dynamic tests as HCG test, response to antiestrogen & gonadotropin releasing hormone tests.

Treatment: There are many drugs which cure gynecomazia in six months to one year time. All above drugs or procedures have no side effects.

A) Drug treatment: various treatments are:

1) Antiestrogens as tamoxifen& clomiphene is very effective. These drugs block the effect of female hormone on the breast cells. After few week of treatment breast size starts shrinking. In many cases few month of therapy may completely cure the gynecomastia leading to absolutely flat chest.  

2) Danazol also decreases the gynecomastia and is also very effective. The effects starts in three months & breast enlargement is cured in six months. 

3) DHT gel local application: Local application of D.H.T. gel is new preparation for male hormone replacement. By binding to breast cell receptors it leads to shrinking & finally disappearance of breast enlargement. It is   very effective for gynecomastia treatment & in most cases of cure of breast development in boys.

4)  Male Hormone Replacement: Treatment with male hormone testosterone is available as oral tablets,  skiin patch, skiin gels or injection is  given with very good results.

The various preparation of testosterone & route of administration are: 

a)     Oral preparation that is available in capsule form. It needs to be given one to three capsules daily. These have no side effects. 

b) Transdermal Testosterone given as testosterone gel preparations.  It need to be applied any part of skiin once a day. It is very effective & has no side effects. 

c). Transdermal Testosterone scrotal patch are also available which are very effective even if used in small doses.. It is very effective & has no side effects.

d)   Sublingual Testosterone cyclodextrin is now available which is very fast acting & very effective is fast & better effective.  It is used as one tablet daily to be kept under the tongue for few minutes. It has no side effect and it is very effective.

e)   Local application of D.H.T. gel available is a new preparation for male breast treatment. 

f)  Injection Testosterone esters these includes Testosterone enanthate & testosterone cypionate given  every 10 to 14 days. 

g)   Long acting testosterone as testosterone bucilate given once in 4 months. 

h)   Testosterones implants are now available which once injected remain effective for up to six months. 

5) Liposuction: In this technique with the help of needle all fat & breast tissue. In this no admission required. It is painless. Patient need to stay at the centre just for few hours.

6) Localized fat dissolving devices

B) Surgical treatment:  is done by our surgeon. This procedure is called Reduction mammoplasty. This surgery is a minor surgery takes 15 to 30 minute under local anaesthesia.

Why doctors don’t take this problem seriously: The problem of breast enlargement is psychologically very painful for the patient who is suffering with this problem.  It makes them feel less manly among the friends. This creates lot of mental stress in the patients. Unluckily majority of doctors do not take this problem seriously, because they think it to be more of cosmetic problem. Many patients come to our center from different corner’s of Indian cities including many from abroad too, all patient complained to us that majority doctors did not give much importance to their problem. Most doctors do not take this problem seriously, because they are not aware of the proper treatment of this case. At our center because we are specialize in exclusive treatment of breast  enlargement & other hormone disorders, we take this problem as seriously as any other hormone disease.

Response of treatment: At our center we have treated successfully thousands of patients breast enlargement from different states of India & other parts of world. After start of treatment breast size starts decreasing in approximately 3 months time. In next six to nine months almost all breast size disappears in most patients. 

Side effects of treatment: The treatment has no side effects.

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|| Home || Less beard & moustache || Small testis || Absent genital development || Hypogonadism ||
|| Testosterone deficiency || Andropause  || Breast enlargement in male  || Male Infertility ||
||  Male hormone Disorders || Other Hormone Disorders  || Contact Us || How to Consult Us ||

We get patients from all major cities in India & Abroad . In the following cities all the facilities for investigation & treatments including medicines are available as Delhi (North, South, East, Central, West, New Delhi), Ghaziabad, Faridabad, Noida, Gurgaon, Meerut, Saharanpur, Dehradun, Ferozepur , Aurangabad, Manesar, Rewari, Pataudi, Rohtak, Bahadurgarh,Bombay,  Bhiwani, Karnal, Panipat , Ambala, Ludhiana, Amritsar, Batala, Gurdaspur, Jalandhar, Patiala, Chandigarh, Calcutta,  Ferozepur Simla, Manali, Jammu, Udhampur, Poonch, Rajouri, Srinagar, Kargil, Aligarh, Mathura, Etawah, Lucknow, Kanpur, Allahabad, Varanasi, Kashi, Faizabad, Bareilly, Moradabad, Rampur., Dehradun, Uttarkashi, Meerut, Sitapur, Mathura,  Madras, Pilibhit, Nainital, Almora, Agra, Ferozabad, Jhansi, Alwar, Jaipur, Dausa, Ajmer, Beawar, Pali, Bhilwara, Chittorgarh, Kota, Dholpur, Churu, Ratangarh, Sikar, Bikaner, Jodhpur, Jalore, Rajkot, Porbandar, Jamnagar, Dwarka, Junagadh, Surendranagar, Bhav Nagar, Ambala, Ahmedabad, Gandhi Nagar, Godhra, Vadodara, Surat, Bilmora, Navasari, Mumbai, Sonapur, Kalbadevi, Girgaon, Dadar, Mahim, Dharavi, Juhu, Andheri, Kurla, Sahar, Pune, Thane, Palghar, Panaji, Panvel, Solapur, Pandharpur, Ahmednagar, Satara, Kolhapur, Ichalkaranji, Kalyan, Nasik, Dhule, Bhir, Nagpur, Bhandara, Amraoti, Khandwa, Indore, Ujjain, Ratlam, Mandsaur, Bhopal, Vidisha, Sagar, Guna, Shivpuri, Gwalior, Jabalpur, Bhilai, Raipur, Hyderabad, Zahirabad, Suryapet, Guntakal, Chittoor, Tirupati, Tirumala, Nandyal Vijayawada, Guntur, Goa,  Tenali, Nellore, Visakhapatnam, Vellore, Bangalore, Banglore, Ulsoor, Mysore, Srirangapatna, Hassan, Mangalore, Udupi, Manipal, Davanagere, Shimoga, Dharwad, Hubli, Bellary, Hospet, Bijapur, Belgaum, Chennai, Chengalpattu, Pondicherry, Tiruvannamalai, Kumbakonam, Thanjavur, Tiruchirappalli, Palani, Madurai, Sivakasi, Tirunelveli, Ambasamudram, Tenkasi, Nagercoil, Kanchipuram, Salem, Erode, Tirupur, Coimbatore, Pollachi, Kanyakumari, Ernakulam, Trivandrum, Calicut, Kottayam, Calcutta, Howrah, Purulia, Darjeeling, Siliguri, Gangtok, Bhubaneswar, Puri, Rourkela, Guwahati, Shillong, Imphal, Kohima, Agartala, Patna, Gaya, Bokaro, Jamshedpur, Ranchi, Madhubani.

We also get patients from following major cities of the world as Aalborg, Abadan, Abidian, Abudhabi, Abuja, Acapulco, Addis,  Ababa, Adelaide, Agadir, Agana, Ahvaz, Akueryai, Al Ain, Al Khobar, Alaska, Aleppo, Alexandria,       Alexandroupolis, Algiers, AlicanteAll, Areas, All Parts, All parts, Alma-Ata, Almada, AlofiAmatitlan, Ambato, Amman, Amsterdam, Andorra, Andrup, Ankara, AntanarivoAntigua, Antwerp, Apia, Aqaba, Areqioca, Arusha, Ashghabat, Asmara, Assab, Assuncion, Atbara, Athens, Auckland, Augra  Do Heroism Bacolod, Badalona, Baghdad, Baku, Bamako, Bander seribegaw, Bangkok, Barcelona, Barranquilla, Basseterre, Bedzin, Beijing, Belfast, Belgrade, Belize, Bengui, Benha, Benina, Bergen, Berlin, Bern, Bethlehem, Bhutan, Bimini, Birmingham, Bisho, Bissau, Bizerta, Bobo Dioulasso, Bogra, Bonaire, Bonn, Boras, Brasilia, Bratislava, Brazov, Brazzavila, Bremen, Bridgetown, Brisbane, Bristol, charest, Budape  st Buenos Aires, Bujumbura, Bulawayo, Bundung, Burgas, Buzau, Caacupe, Cairo, Cali, Canberra, Cap Haitien, Cape Town, Carecas, Castries, Cebu, Chengdu, Chicago, Chiclayo, chittagong, Christchurch, Christmas Island, CocosKeeling Island, Cologne, Colombu, Conakry, Conception, Contonou, Copenhagen Cordaba,  Cork, Coroval, Corprivertion, Craiova, Cuenca, Cumana, Curacao, Dacca, Dakar, Damascus, Damman, Dangregia, Dar Es Salaam, Defeera, Derbrecen, Dewaniya, Diego Suarez, Diriamba, Djibouti, Doha, Dramman, Dubai, Dublin, Durban, Dushanbe, Dusseldort, El Salvador, Entebbe, Erevan, Equitorial Guinea, Fade N'Gorma, Falun, Faroe Islands, Fes, Franarantsoa, Frankfurt, Freeport, Freetown, French Guiana, Frunze.Ft de France, Fujairah,  Gaborone, Garbrovo, Genda, Geneva, George Town, Georgetown, Ghent, Gibraltar, Glasgow, Gonaives, Gondomar, Granada Grand Beirut, Graz,Guadalajara, Guautemala City, Guayaquil, Gyongyas, Hajja, Hamar, Hamburg, Hamilton, Havana, Halsinki, Ho Chi Milk City, Hodeidah, Homs, HongKong, Honiara, Honolulu, Houston, Hyvinkaa, Ibadan, Ikeja, Incheon, Industira, Invercargill, Isfahan, Islamabad, Island tuvalu, Istanbul, Jakarta, Janawa, Jeddah, Jerusalam, Jimma, Jinia, Johannesburg, Jaba, Kaduna, Kampala, Kaoshiung, Karachi, Karor, Kathmandu, Khartoum, Khon Kean, Khulna, Kiev, Kigalibad, Kingston, Kingstown, Kismayo, kitwe, Kobe, Kolding, Kosice, Koudougou, Kowloon, Kristianstav, Kula Belait, Kuala Lumpur, Kuantan, Kumasi, Kuwait, Kyoto, La Paz, Lady Ville, Lea, Lagos, Lahore, Lahti, Larissa, Las Palmas, Lattaquieh, Leeds, Leipzig, Librevilla, Lima, Limassol, Linden, Lisbon, Liverpool, Ljubl-iana, Lome, London, Los Angeles, Luanda, Lubumbashi, Lugazi, Lungi, Lusaka, Luxembourg, Macao, Madani, Madrid, Majuro, Maldonado, Male, Malmo, Managua, Manama, Mancheter, Manila, Mansoure, Manta, Maputo, Maracay, Marrakech, Maseru, Mashad, Mayotte, Mbabane, Mbale, Medan, Medlin, Melbourne, Mendoza, Mexico city, Miami, Micronesia, Milano, Misrata, Mmabatho, Mogadiscio, Mombassa, Monrovia, MonteCarlo, Monterrey, Monte-video, Montreal, Moscow, Mosule, Mulanje, Mumbai, Muscat, Mutare, Mwanza, Nabeul, Naestved, Nagozi, Nairobi, Najat, Nanjing, Nassau, Nastriya, Nazareth, Ndjamena, New Amsterdam, New-York, Niamey, Nicosia, Norrkoping, Nottingham, Nouakehott, Noumea, Nukualofa, Oklahoma City, Omdurman, Oradea, Orodtheab, Oruro, Osaka, Oslo, Ostrava, Ottawa, Ouagadougu, Oulu, Panama-City, Paralimni, Paramaribo, Paris, Paysandu, Perth, peshawar, Philadelphia, Pingtung, Piraeus, Piura, Pl Villa, Plazen, Plovdiv, Plymouth, Poneloya, Port Au Prince, PortSaid, Port-Sudan, Potosi, Prague, Praia, Pretoria, Pt Lousi, Pt of Spain, Pt.Stanley, Pte Apitre, Pusan, pyongyang, Rabat, Ramalla, Rarstonga, Rawalpindi, Reykyavik, Riga,Rio De Janeiro, Riyadh, Road Town, Rodriquez Islands, Rome, Rosario, Roseau, Rota, Rotterdam, Rzeszow, Saba, Sabh, Sailburg, Salta, Samoa-American, San Francisco, San Jose, San Marcos, San Marino, San pablo, Sandnes, San-Jaun, Sanna, Senta Cruz(Graciosa), Santa Cruz, Santiago, Santo Doming, Sao Paulo, SaoTome Island, Semarang, Seoul, Serrekunda, Sert, Sfax, Shangai, Shariah, Singapore, Skopie, Sofia, Sopot, ST.Denis, St.Georges, St.Helena, St.Johns, St.Pitterbuze, Stockholm, Strydom Airport, Stuttgart, Suphanburi, Suva, Sydney, Szekesfehervar, Taegu, Taichung, Tainan, Taipei, Taiz, Tallinn, Tamatave, Tampere, Tanga, Tashkent, Tavira, Tbilisi, Tegucigalpa, Tehran, Tel-Aviv, Tema, Temburong, Teneriffe, The Hague, The Valley, Thessaloniki, Thohoyandou, Thomwood, Thonbiri, Thyolo, Timisoara, Tirane, Titograde, Tokyo, Toronto, Tripoli, Tsumeb, Tunisi, Turks Caicos, Tutong, Ulan-Batar, Vaduz, Valetta, Valparasio, Vancouver, Vatican City, Victoria, Victoria Falls, Vienna, Vientiana, Vigo, VilaDOporto, Villa Nueva, Villarica, Vilua, Vina Del Mar, Volgagrad, W.Berlin, Wallis & Futuna Island, Warsaw, Washington Dc, Wellington, Windhoele, Yaounde, Yaren, Yokohama, Yundum, Zagreb, Zahle, Zurich.

 At these places all the facilities for investigation & treatments are available.

At our center / centre / clinic / clinics / hospital / hospitals doctors are dedicated for latest & scientific treatment of these diseases.

Carbamazepine (Tegretol), serum, Cardiac Anhydrase III, Cardiac injury profile, Mini (LDH, CPK (Total & MB), SCOT), Cardiac Injury Profile, Max! (Includes CK-MB, FABP, Glycoqen Phosphorylase, Myoglobin, Troponin-l ), Cardiac screen (CBC.Urine rt,ESR,FBS,Cholesterol,SGOT, LDH, CPK), Cardiac risk profile (Homocysteine, Lp(a), D-dimer, hsCRP, LDL direct and Apolipoproteins A1/b), Cardiolipin +Beta2 glycoprotine 1-lgG (Phospholipid), Cardiolipin +Beta2 glycoprotine 1-lgM (Phospholipid), Cardiolipin Antibody-IgG, serum, Cardiolipin Antibody-lgM. Serum, Catecholamines (Adrenaline+Nor Adrenaline), Cathepsin D for Immunohistochemistry, CCP-Ab to cyclic citrulinated Peptide, CD15Rscell, CD154, CD16, CD16b, CD20, CD20 B cell, CD21, CD22, CD25, CD3 T cell, , CD3/CD16/CD56 (Natural Killer Cells), CD3/CD4/CD8 Counts, blood, CD30 RS cell, CD31, CD33, CD34, CD4 count, blood, C04/C08 Counts, blood, CD40, CD43, CD52, CD120a, CD120b, CEA-Carcino Embryonic Antigen, Cell count, CSF, Centromere Antibody, serum, C-Er-B2 (Her-2/Neu) by Immunohistochemistry, Ceruloplasmin (Copper Oxidase), serum, CH-50 (Complement, total), serum, Chemistry-15 (FBS, Ca, P, Cholesterol, Uric acid, Bilirubin-Direct, Creatinine, Alkaline phosphatase, CPK, SCOT, SGPT, LDH, Proteins and Trialyerides), Chlamydia Pneumoniae, lgM Antibodies, Chlamydia Trachomatis-lgA Antibodies, Chlamydia Trachomatis-IgG Antibodies, Chlorides, Cholesterol (Total), Cholinesterase (Pseudo), serum, Chromagranin A by Immunohistochemistry, Chromium, Chromosomal Analysis (Giemsa banding) (G banding) (For numerical and structural chromosomal abnormalities), Chromosomal analysis - High resolution banding, Chylomicron Qualitative, Chyluria, urine, CIC-IgM antibodies to circulating immune complex CK10 (High Molecular weight) by Immunohistochemistry  Ckit (CD117) by Immunohistochemistry, CK-MB (MB fraction of Creatinine Kinase), serum, Clot retraction test (For walkins), Clozapine, serum, CMV-Avidity test, serum, - CMV-IgG Antibodies to Cyto Megalo Virus, CMV-IgM Antibodies to Cyto Megalo Virus, CNS Markers Profile (GFAP, Neurofilament), Coagulation (DIC) profile (CBC, BT, CT, PT, PIT, Fibrinogen, D-dimer) Cobalt, Cocaine, urine (Qualitative), Cocaine, urine (Quantitative), Cold agglutinin, Colorectal Marker profile (CEA, CA 19.9), Complete blood count, blood, Congo Red & Methyl Red stain for histopathology, Coomb’s test (Direct), blood, Coomb’s test (Indirect), serum, Copper, Copper, Copper Oxidase (Cerulopiasmin ), serum, Cortisol, Coxsackie antibody-IgG, Coxsackie antibody-IgM, C-Peptide, serum (Fasting sample), C-Peptide, serum (Glucagon Stimulation test) (Fasting and post glucagon-1mg IV at 5,10,15 minutes interval), C-Peptide, serum (Insulin Suppression test) (Fasting & post insulin (0.1 U/Kg of body wt) samples at 10,20,30,40,50,60 Minutes), CPK - Creatinine Phospho Kinase (Total), serum, Creatinine, Creatinine Clearence Test, CRP-C Reactive Protein, serum, CRP-high sensitivity, serum, Cryoglobulins, serum (Qualitative), Cryptococcus Antigen, Quantification, Cryptococcus Antigen, Quantification, Crystals, Synovia! Fluids, CSF, Routine examination, CSF electrophoresis, Culture, Mycobacterim Tuberculosis, Culture Acid fast bacilli, Culture and sensitivity, Culture for aerobic bacteria with identification by, conventional manual culture plate method and manual sensitivity, Cyanocobalamin (Vitamin B12), serum, Cyclospora, stool,

Different Hospitals in india are: Moolchand Health Care, St. Stephen’s Hospital, Dr. Ram Manohar Lohia Hospital, G.B Pant Hospital, Lok Nayak Hospital, RG Stone Urological Reasarch Institue, Sir Ganga Ram Hospital, Jeevan Hospital, Deen Dayal Upadhyaya Hospital, Orthonova Hospital, Batra Hospital, Sahi Hospital, Indraprastha Apollo Hospitals, Holy Faimly Hospital, Jeevan Mala Hospital, Jaipur Golden Hospital, Lady Harding Hospital, Smt. Sucheta Kriplani Hospital, Mata Chanan Devi Hospital, Safdarjung Hospital, Mohindra Hospital, M.P Heart centre Hospital, Bara Hospital, Hindu Rao Hospital, Holy Angels Hospital, Shankar Hospital, Holy Family Hospital, Chopra Hospital, Escorts Hospital St. Stephen's Hospital, Vardaan Hospital, Visitech Eye Hospital, Vardhman Mahavir Medical College, Safdarjung Hospital, Lok Nayak Jai Prakash (LNJP) Hospital, Private Hospital, Guru Teg Bahadur Hospital, Kalra Hospital,  Bangalore Baptist Hospital, Bowring Hospital, B W Lions Eye Hospital, Bangalore Hospital, Bangalore Children's Hospital, Genesis Hospital, Lakeside Hospital, M G A Hospital, Mallya Hospital, Manipal Hospital, Sindhi Charitable Hospital, Yellamma Dasappa Hospital,  Sir Harkisandas Narottamdas Hospital, Prince Alikhan Hospital, Saifee Hospital, Breach Candy Hospital, Jaslok Hospital, Habib Ismail Hosptal, Kalajyot Hospital, Motiben Dalvi Hospital, Bombay Hospital, Corwest Jain Clinic Group of Hospitals, D.S. Kothari Hospital, Lotus Hospital, Elizabeth Hospital, Bhatia Hospital, The Bomanji Dinshaw Petit Parsee Hospital, Cumbala Hill Hospital, Noor Hospital, K.B. Haji Bachoali Charitable Ophthalmic & ENT Hospital, Bai Jerbai Wadia Hspital, Nawroji Wadia Maternity Hospital, Wadia Hospital, Yerla Medical Trust Hospital, Tarachand Bappa Hospital, Dhanwantari Hospital, Shri Samasta Parajiya Suvarna Hospital, Smt.B.C.J. General Hospital, Smt.B.C.J. General Hospital, Holi Spirit Hospital, Lilavati Hospital, The Bandra Holy Family Hospital, Raheja Hospital, Gurunanak Memorial Hospital, Ramakrishna Mission Hospital, Radhibai Watumull Global Hospital, BSES Hospital, Sushrut Hospital, LH Hiranandani Hospital, Maganlal Popatlal & Sarvoday Hospital, Rajawadi Municipal General Hospital, Shatabdi Hospital, KBB Hospital, V.N. Hospital, Dr.K.B. Babha Hospital, Cooper Hospital, Bhagwati Hospital, Sion Hospital, K.E.M. Hospital Nayar Hospital, Kama Hospital, G.T. Hospital, J.J. Hospital, Sr.George Hospital, Aliganj Hospital, Blue Cross Hospital, Getwell Hospital, Krishna Lok Hospital, Lucknow Hospital, Medwin Hospital and Health Centre, Vivekanand Hospital, G.M.Associate Hospital, Dufferin Hospital, Civil Hospital, Communicable/Infectious Diseases Hospital Lifeline Hospital and Heart Centre, Lucknow Hospital, Shalimar Hospital, Rajendranagar Hospital Tuberculosis Hospital, Lucknow Rajpoot Hospital, Nishat Hospital, Z A Chartable Hospital, Indira Gandhi Eye Hospital, Sitapur Eye Hospital, Awadh Hospital and Heart Centre, Balrampur Hospital, Cantonment General Hospital, Civil Hospital, Dr.Shyama Prasad Mukherjie Hospital, Fatima Hospital, G.M.Associate Hospital, K.K.Hospital, Veerangana Jhalkari Bai Female Hospital, Shekhar Hospital, Queen Mary Hospital, Osmania General Hospital, Gandhi Hospital, Government Maternity Hospital, Nilofar Hospital, Cancer Hospital, T.B. Hospital, Hospital for Mental Diseases, Sarojini Devi Hospital, Sundram Medical Foundation, Chennai. MIOT Hospital, Chennai. Apollo Hospital, Madras. Malar Hospital Limited, Gandhi Nagar Adyar, Chenni. Calcutta Medical College Hospital. N.R.S. Medical College & Hospital, Calcutta. R.G. Kar Medical College & Hospital, Calcutta. Calcutta National Medical College & Hospital, Instt. of Postgraduate Med. Education & Research, Calcutta Seth S.K.M. Hospital, Calcutta. Sambhu Nath Pandit Hospital, Calcutta. Lady Dufferinvictoria Hospital, Calcutta. Howrah General Hospital, Howrah, Hoogly Sadar Hospital, Hoogly, Chittaranjan Seva Sadan & Chittaranjan Cancer Hospital,  Ramakrishna Mission Seva Pratishthan General Hospital, Calcutta.

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Diet Reinfarction Trial Daunorubicin, effects endocrine function values, Dave, Harish P.G., Davis, Faith B., Davis, Paul J., Dawn phenomenon, elderly diabetics, DAX-1 gene, mutations , DAZ genes, deletions , db gene, Mics, db / db appetite regulation, DCCT. Diabetes Control Complications Trial D cell(s) (Gama cells) gastric, diffuse neuroendocrine system, intestinal, diffuse neuroendocrine system, pancreatic, diffuse neuroendocrine system, embryology , fetal development , numbers , secretory characteristics , secretory granules , somatostatin , staining , ultrastructure , somatostatin production , DDAVP. Desmopressin acetate o, p’ DDD. Mitotane ddI. Didanosine DDT insulin secretion, toxic effects , Deafness. Hearing, loss Alport syndrome, gonadal dysgenesis, lysosomal storage disease with, osteogenesis imperfecta, sensorineural, hypoparathyroidism , 1-Deamino-(8-D-arginine)-vasopressin. Desmopressin acetate Death, sudden. Sudden death Decadron. Dexamethasone, therapy with Decadron-L.A. Dexamethasone acetate Decadron Phosphate. Dexamethasone sodium phosphate Decadron W / Xylocaine. Dexamethasone sodium phosphate with lidocaine Deca-Durabolin. Dexamethasone sodium phosphate Decaject-L.A. Dexamethasone acetate Decapacitation factors, Decidua, Decidua basalis, Decidua capsularis, Decidualization, Decidua parietalis, Declomycin. Demeclocycline hydrochloride Deconvolution, Decoy receptor(s), Deep tendon reflexes hypothyroidism, thyroid function , Deep venous thrombosis oral contraceptives , risk , pregnancy, Defeminization, with Sertoli-Leydig tumors, Deferoxamine, aluminum accumulation, Deficiency states, Defronzo, Ralph A., Dehydration anorexia nervosa, elderly, hypernatremic, hyperthyroidism, pseudohypoaldosteronism type 1, Dehydration tests, Dehydroascorbic acid, 7-Dehydrocholesterol, dermal synthesis , age , vitamin D synthesis, Dehydroepiandrosterone (DHEA) adrenal, adrenarche, circulating during menstrual cycle, polycystic ovarian syndrome, elderly, females adrenal tumors , depression , normal serum levels, fetal, half-life , hCG synthesis, , immune response, inappropriate uses , mean blood production rate , adrenal contribution , menopause , metabolism , ovarian, plasma protein binding by, plasma / serum level adults, age-related changes , androgen-producing neoplasm, anorexia nervosa, 3vita-hydroxysteroid dehydrogenase deficiency, hypothalamic chronic anovulation, infancy childhood, normal, polycystic ovary syndrome, premature pubarche, puberty female, male, reference values , regulation , secretion age-related patterns , rhythms , steroidogenesis , pathways , synthesis , T helper cells, therapy with, anorexia nervosa, Dehydroepiandrosterone sulfate (DHEAS) adrenarche, athletic performance, clearance , cord blood, elderly, females adrenal, adrenal tumors , circulating, polycystic ovarian syndrome, hair growth, menopause , normal values, ovarian, polycystic ovarian syndrome , fetal, immunostimulatory properties , inappropriate uses , mean blood production rate , adrenal contribution , metabolism , maternal-fetal-placental unit, plasma protein binding by, plasma / serum level , adults, age-related changes , children, critical illness, clevation , infancy childhood, premature pubarche, puberty female, male, reference values , regulation , secretion age-related patterns , dopamine , fetal, synthesis , Dehydroepiandrosterone sulfate (DHEAS) loading test, evaluation fetal-placental unit, 3vita-Dehydrogenase deficiency, male hypogonadism, 3vita-ol-Dehydrogenase-isomerase deficiency, late-onset, 24-Dehydroprovitamin D, de Kretser, David M., Delatestryl. Testosterone enanthate oil Delayed extinction, vasopressin , Delayed puberty. Puberty, delayed del Castillo syndrome, Sertoli-cell-only syndrome germ-cell failure , Delestrogen. Estradiol valerate oil Deletions, chromosomal, de Morsier syndrome, ovarian maintenance, pathologic physiologic effects , Delirium, endocrinopathy, Delphian node, Hashimoto thyroiditis, papillary thyroid carcinoma, thyroid cancer, Delta cells. D cell(s) Delta-D. Cortef. Prednisolone, therapy with Delta-D. Cholecalciferol Delta sleep-inducing peptide (DSIP) central nervous system effects , phosphorylated, central nerous system effects , Deltasone. Prednisone, therapy with Deltorphin, central nervous system effects , Delusions, endocrinopathy, De Maria, Nicola, Demeclocycline hydrochloride (Declomycin). Tetracycline actions , adverse effects side effects , diuretic effects , dosage administration , effects endocrine function values, indications , as vivo marker bone formation, nephrogenic diabetes insipidus caused by, nephrotoxicity , preparations , Dementia AIDS-related, primary polydipsia , cerebrotendinous xanthomatosis, endocrinopathy, Hashimoto thyroiditis, de Morsier syndrome, clinical findings , eitology , genetics , neuropathology , primary hypothalamic / pituitary insufficiency , Dempster, David W., Demser. Metyrosine Demulen, acne, hirsutism, Demyelinating disorder(s), adrenal insufficiency caused by, Dendritic cell(s), cytokine expression by, definition , T-cell deletion, Dengue fever, kinins , Densitometry, bone. Bone densitometry Dental abnormalities bulimia, endocrine / metabolic causes , Dental caries hypopituitarism, hypothyroidism, juvenile myxedema, osteopetrosis, Dental heatlh, fluoride , Dental maturation, evaluation , Dental treatment Addison disease, hyperadrenocorticism, hyperthyroidism, hypothyroidism, multiple endocrine neoplasia, parathyroid disease, pheochromocytoma , Dentinogenesis imperfecta, osteogenesis imperfecta, Deoxyadenosine, excess , adenosine deaminase deficiency, Deoxycorticosterone excess , children, glucocorticoid excess, hypertension caused by, mineralocorticoid excess, plasma / serum level , pregenancy, 11- Deoxycorticosterone, actions , mean blood production rate , adrenal contribution , metabolism , mineralocorticoid activity , plasma / serum level  11vita-hydroxylase deficiency, 17alfa-hydroxylasse / 17,20-lyase deficiency, measurement , diagnosis congenital adrenal hyperplasia, normal, reference values , synthesis , urinary, measurement , diagnosis congenital adrenal hyperplasia, 11-Deoxycortisol mean blood production rate , adrenal contribution , metabolism , plasma / serum level adults, children, 11-Vita-hydroxylase deficienty, infancy childhood, measurement , diagnosis congenital adrenal hyperplasia, metyrapone , normal, reference values , steroidogenesis , pathway , urinary, measurement , diagnosis congenital adrenal hyperplasia, 21-Deoxycortisol, amnionic fluid level , prenatal diagnosis congenital adrenal hyperplasia, 2-Deoxyglucose, vasopressin secretion, Deoxycorticosterone, excess , purine nucleoside phosphorylase deficiency, Deoxycorticosterone (DPD), as biomarker bone resorption, immunoassay , urine, reference values , technical characteristics , tissue distribution , urinary excretion , Deoxyribonucleic acid. DNA Deoxyribonucleotides, 8 DepAndro. Andro. Testosterone cypionate oil Dephosphorylation, Depigmentation. Vitiligo inherited disorders amino-acid metabolism, depMedalone. Methylprednisolone acetate Depo-Estradiol Cypionate. Estradiol cypionate oil DepoGen. Estradiol cypionate oil Depoject. Methylprednisolone acetate Depo-Medrol. Methylprednisolone acetate Depo-Provera. Methylprednisolone acetate Depotest 100/200. Testosterone cypionate oil Depot medroxyprogesterone acetate. Methylprednisolone acetate Depression atypical, CRH hyposecretion , bipolar disorder, bone mineral density , central neuropeptide systems , classic (melancholic), corticosteroid-induced, cortisol secretion , Cushing syndrome. definition , diabetic adolescent, diabetic patient, eating disorders, endocrine findings , endocrine rhythms, endocrinopathy, estrogens , glucocorticoids , growth hormone , Hashimoto thyroiditis, hypercalcemia-related, hypothalamic dysfunction , oral contraceptives , with pancreatic cancer, phase-advance hypothesis , pineal function , from postmenopausal estrogen replacement therapy, postpartum, thyroid , primary hyperparathyroidism, progestin-only implants , pseudo-Cushing syndrome, psychogenic amenorrhea with, seasonal, CRH hyposecretion , genital distribution , unipolar, Deprivational dwarfism, Deprivation syndrome, clinical presentation , diagnosis , growth curve , growth curve with, prognosis , treatment , Depopred. Methylprednisolone acetate de Quervain thyroiditis. Thyroiditis, subacute Dermal capillary(ies), Dermatitis chronic, inherited disorders amino-acid metabolism, eczematoid, zinc , exfoliative, with sulfonylurea therapy, Dermatitis herpetiformis clinical features , with Graves disease, thyroid disease, Dermatofibrosis lenticularis disseminata, Dermatographism hyperthyroidism, mastocytosis, pregnancy, Dermatosis, perforating, diabetes, Dermis, eicosanoids , Dermopathy, diabetic, Dermorphin, central nervous system effects , Derry disease. Gangliosidosis, GM1, type 2 DES. Diethylstilbestrol Desensitization, Rauwolfia derivatives Desiccated thyroid. (Thyroid U.S.P., Armour Thyroid, Thyrar, S-P-T, Thyroid Strong), dosage administration , De Simone, Luca, Desiprramine. Tricyclic antidepressants effects endocrine function values, Deslanoside, Digoxin 17,20-Desmolase deficiency , characteristics , male hypogonadism, mode inheritance , pseudohermaphroditism, 20,22-Desmolase. Cytochrome P450, CYP11A deficiency , 1136f adrenal hyperplasia , characterisitcs , male hypogonadism, mode inheritance , pseudohermaphroditism, Desmopressin acetate (DDAVP, Stimate) administration , contraindication , type IIB von Willebrand disease, diagnosis diabetes insipidus, dosage aministration , structure , studies learning, therapy with diabetes insipidus, , pregnancy, hemophilia A, nephrogenic diabetes insipidus, type 1 von Willebrand disease, type IIA von Willebrand disease, Desogen, acne, hirsutism, Desogestrel, dosage administration , estrogen-progestin pill, endometriosis, oral contraceptives, risk thromboembolism, therapy with acne, hyperandrogenic women, thromboembolic disease, Detection antibody, immunoassays, Determined osteoprogenitor cells, Detrusor instability, Development normal infant child, prenatal, glucocorticoids , Developmental endocrinology, DEXA. Dual x-ray absorptiometry Dexacen-4. Dexamethasone sodium phosphate Dexameth. Dexamethasone, therapy with Dexamethasone. Glucocorticoid(s) adverse effects side effects , anorectic response , arachidonic acid metabolism, depression , effects endocrine function values, equivalent glucocorticoid dose , glucocorticoid potency , half-life , melatonin production, mineralocorticoid activity , prenatal therapy with efficacy , 21-hydroxylase deficiency, maternal complications , safety , structure , therapy with (Decadron, Dexameth, Dexone, Hexadrol) ACTH deficiency, actions , adverse effects side effects , congenital adrenal hyperplasia, fetus, Cushing disease / syndrome, dosage administration , eye disease, hirsutism, indications , mineralocorticoid excess, preparations , triiodothyronine production, Dexamethasone acetate (Cortastat-L.A., Dalalone D.P. / L.A., Decadron-L.A.., Decaject-L.A., Dexasone-L.A., Dexone L.A., Solurex L.A.,) actions , adverse effects side effects , dosage administration , indications , preparations , Dexamethasone / CRH test, drug effects , expected response , intraindividual variation , method , physiologic factors affecting, special considerations / interpretation , substance measured , Dexamethasone receptor(s), renal, Dexamethasone sodium phosphate (Cortastat, Dalalone, Decadron Phosphate, Hexadrol Phosphate, Decadron Phosphate, Decaject, Dexacen-4, Dexasone, Dexone, Hexadrol Phosphate, Solurex) actions , adverse effects side effects , dosage administration , indications , preparations , Dexamethasone sodium phosphate with lidocaine (Decadron W/ Xylocaine) actions , adverse effects side effects , dosage administration , indications , preparations , Dexamethasone suppression test, children, corticortropin-realising hormone (CRH) test, combined (CRH/DST). Dexamethasone/CRH test Cushing disease, Cushing syndrome, drug effects , expected response , factors affecting, high-dose, hyperandrogenism, interpretation , difficulties , intraindividual variation , low-dose, method , normal results , physiologic factors affecting, renal failure, special considerations / interpretation , substance measured , Dexasone. Dexamethasone sodium phosphate Dexasone-L.A. Dexamethasone acetate Dexchlorpheniramine. Antihistamines Dexone. Dexamethasone, thearpy with; Dexamethasone sodium phosphate Dexone L.A. Dexamethasone acetate Dextran 40, effects endocrine function values, Dextran 70. Dextran 40 Dextrose, enteral / parenteral nutrition, dosage administration , Dextrothyroxine sodium, effects endocrine function values, Dezocine, effects endocrine function values, DHA. Docosahexaenoic acid DHEA. Dehydroepiandrosterone DHEAS. Dehydropiandrosterone sulfate DHPG. Dihydroxyphenylglycol DHT. Dihydrotachysterol DiaBeta. Glyburide Diabets Control Complications Trial (DCCT), Diabetes-deafness syndrome, Diabetes insipidus, adults, clinical features , anorexia nervosa, AVP-resistant hyperaldosteronism, pregnancy, causes , children, clinical features , clinical features , craniopharyngioma patient, definition , diagnosis , plasma vasopressin , differential diagnosis , dipsogenic, causes , hyperosmolar syndromes, differentiation , hypopituitarism with, hypothalamic (cranial, central, neurogenic), causes , clinical features , diagnosis , plasma vasopressin , familial, granulomatous disease, , idiopathic, posttramuatic, thirst , treatment , tumors causing, hypothyroidism, infants, clinical features , infundibular disease , Langerhans cell histiocytosis, with metastatic cancer pituitary, nephrogenic, acquired, causes , congenital, definition , with demeclocycline, diagnosis , plasma vasopressin , familial, , hyperaldosteronism, hypercalcemia, hypercalcemia, hyperuricemia , treatment , X-linked, ocular manifestations , otolaryngologic considerations , pathogenesis , pathophysiology , with pituitary abscess, pituitary apoplexy , postoperative, postpartum, posttraumatic, triphasic response injury , pregnancy, acute fatty liver pregnancy with, with sellar aneurysm, transient, pregnancy, treatment , Diabetes mellitus. Brittle diabetes; Infants diabetic mothers acromegaly, Addison disease, adhesive capsulitis , adolescence, management , psychosocial factors , adynamic bone , age at onset , alcohol intake , amputation , amyloid , anemia , anorexia nervcsa , antioxidants , asymptomatic elderly, atherosclerosis , autoimmune experimental (animal models ), pathogenesis , biliary colic , biliary colic , biliary lipid secretion , bone loss , borderline, Buschke scleredema with, carbohydrate intake , cardiac disease , cardiomyopathy , cardiomyopathy , cardiovascular complications , epideminology , hematogenous factors , hormones , hyperglycemia , metabolic factors contributing , pathology , smooth muscle cells , carpal tunnel syndrome , cataracts , causes death , celiac disease, cerebral effects , cheiroarthropathy , chemical, cholecystectomy , indications , cholecystitis , cholelithiasis , chromium , classification , clinical heterogeneity , complications cardiovascular. Diabetes mellitus, cardiovascular complications distribution , esophageal, gastric, Diabetic gastroparesis gastrointestinal, pathogenesis , glycemic control , hyperglycemia , late, pediatric patients, preention , intensive therapy , small bowel, congenital lipoatrophic, hirsutism , constipation , coronary artery disease , incidence , mortality rate , costs , cow’s milk proteins , cumulative incidence , delayed gastric emptying , delayed puberty , dental / orofacial abnormalities , diagnosis age at, life expectancy, early, importance , elderly, procedures , diagnostic criteria , dietary therapy , alcohol , carbohydrates , childhood adolescenece, fat , fiber , historical prespective , meal planning , pregnancy, prescription , principles , drug-induced, , Dupuytren contracture , dysphagia , early diagnosis , importance , eicosanoids , elderly, asymptomatic, clinical presentation , complications , diagnostic criteria , dietary therapy , epidemiology , exercise , glycemic control , insulin therapy , Diabetes mellitus (continued) oral hypoglycemic agents , pathogenesis , progression , factors , treatment , emphysematous cholecystitis , endothelial dysfunction , enteroviruses , environmental factors , epidemiology , dysfunction , esophageal complications , exercise , therapeutic effects , eye disease , familial combined hyperlipidemia, familial dysbetalipoproteinemia, fatty liver , histology , obesity , prevalence , fecal incontinence , fiber intake , flexor tenosynovitis , foot problems . Diabetic foot fructosamine assay , gallbladder disease , gallstones , obesity , gangrene foot / limb. Diabetic foot gallbladder, gastric complications , Diabetic gastroparesis gastrointestinal complications , pathogenesis , genetics , glaucoma , glucagon , with glucagonoma, glucose homeostasis , glycemic control . Diabetes mellitus, metabolic control with Graves disease, growth hormone secretion , gynecomastia, hepatic manifestations , , drug-induced, HLA associations, hyperosmolar hyperglycemic nonketotic coma , hypertension , hypertriglyceridemia , hyphema , hypoaldosteronism, hypoglycemia , unfant child, hyporeninemic hypoaldosteronism, hypouricemia , IGF-I abnormalities , IL-1 , immunology , immunotherapy , incidence , adolescents, age-specific, children, cumulative, elderly, geographic variation , secular trend , infant child emotional support , exercise program , hypoglycemia , management , microvascular complications , psychosocial factors , treatment , advances (future directions ), infections , oral, skiin, urinary tract bacterial, fungal, treatment , insulin action , defects , insulin level , insulin-like growth factors , insulin resistance , insulin-resistant, cutaneous manifestations , insulin therapy . Insulin thearpy interferon , islet cell antibodies , islet transplantation immune attack , rejection , joint disease , J-type, juvenile-onset. Diabetes mellitus, type 1 (insulin-dependent) kidney transplantation , lactic acidosis , lactoferrin inactivation , latent, limited joint mobility , lipid abnormalities , dietary therapy , exertise , nonpharmacologic management , treatment , lipid metabolism , lipoprotein abnormalities , liver disease , lymphocyte dysfunction , lysozyme inactivation , macroangiopathy , insulin-like growth factors , magnesium deficiency , major hostocompatibility complex , malignatn (necrotizing) external otitis , maternal. Diabetes mellitus, pregnancy; Gestational diabetes blood glucose , infant mortality, neonatal effects , maturity-onset. Diabetes mellitus, type 2 (non-insul ).

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