Dr. Batra's Clinic

Hello!

I am Dr. Chandra Mohan Batra. I am a senior consultant Endocrinologist. I am going to talk to you about Erectile Dysfunction in men. Erectile dysfunction is the inability of a man to get and keep an erection for enough time in sexual intercourse. If erectile dysfunction is present in once in a while then it can be just psychological and you should not be worried about it but if you have a consistent problem then you should start worrying about it because it can cause a lot of stress, can cause a lot of relationship problem with your wife, it can be a marker of serious medical disease like heart disease, kidney disease, liver disease. So it should be taken seriously if it is consistent. When we take the history of patient of erectile dysfunction we ask him whether he has a desire to have sex which is called libido. Lack of libido is a serious problem.

It means that the patient has some hormonal deficit or some serious problem which is causing erectile dysfunction. Whereas lack of erection also signifies cardiac problem or a neurological problem or a vascular problem which is causing him not to have an erection and lack of discharge or a premature discharge usually concludes a psychological problem. So once you have the history of the patient then you ask him about the drugs he is taking because drugs form a very important cause of erectile dysfunction. Drugs like antidepressants and antipsychotics- they are very important causes of erectile dysfunction. So drugs have to be ruled out. Then we have to ask the patient whether he is suffering from any psychological problem or not. If he is suffering from the psychological problem then that can be the cause of his erectile dysfunction. So what are the causes of erectile dysfunction?

The causes of erectile dysfunction can be a hormonal problem, can be a vascular problem, it can be a psychological problem, it can be a neural problem or neurogenic problem. So in all cases, these things have to be taken into consideration to examine the patient. When we examine the patient, we will look for all the pulses to look out for the vascular problem. We do all the reflexes and we see the jerks to see if there is any neurological problem existing. If there is a neurological problem we address it. If he doesn't have all these problems then we think of a psychological problem and ask him about the history or whether he can sleep properly at night, whether he is depressed all the time, if he has a psychological problem then we can address that.

Treatment of erectile dysfunction depends on its cause. The causes hormonal, we give testosterone therapy. The cause is a psychological, we send the patient to a psychiatrist for psychological counseling and psychiatric therapy. If the cause is either neurologic or vascular we try Sildenafil. Sildenafil is a drug which is also called as Viagra. Viagra acts by increasing the blood supply of the penis causing it to become rigid. If that also fails then we have other therapy called vacuum pump and prosthesis available. The prosthesis can be of two forms- rigid and flexible type.

Thank you!

Hello!

My name is Chander Mohan Batra. I am a senior consultant. I will be talking to you today about Hirsutism. Hirsutism is a name given to extra hair in the females on the face, body, chest, the upper arms, lower arms etc. The causes of this Hirsutism or extra hair is excessive male hormones called androgens. These androgens are secreted from the adrenal glands or the ovaries in the female. The ovaries in the female can become big and can become cystic and produce a disease called Polycystic Ovarian Disease, PCOD. In this disease, extra male hormones are produced. Or there can be tumors in the ovary called ovarian tumors which can produce extra androgens which causes this. In the adrenal gland also, there could be an adrenal tumor which can produce extra androgens. The third cause which is found in many patients is neither the ovarian hormones nor the adrenal hormones are excessive.

There is no extra hormone production but the skin is extra sensitive to the normal amount of hormones that are present in the body. The treatment of this disease Hirsutism depends on the cause. If you have ovarian cause called PCOD- it depends on what the patient wants. If the patient wants children then we induce ovulation by some drugs. If the patient wants to get rid of abnormal periods and get rid of extra hair we have certain drugs which are called as anti-androgen drugs which do the needful. If the cause is an ovarian tumor or an adrenal tumor then the answer is surgery. Besides these options, there is always the option of removal of unwanted hair. The cosmetic methods like waxing threading and the best method are laser treatment. With the use of the Laser, you can get rid of hair for as long as 1-2 years and this is the best method available. The other methods threading and waxing are useful and less costly but they are painful and not effective in the long run.

Thank You!

Hi,

I am Dr. CM Batra. I am senior consultant endocrinologist in Apollo Hospital, Delhi. I will be talking to you today on bone disorders in endocrinology i.e. the hormonal disorder. Hormonal diseases that cause disease in the bone. The 3 bone disorders which are there in endocrinology in which hormones play the effective role. They are: osteomalacia, hyperparathyroidism, osteoporosis. All 3 presents with bone pain. Pain in the legs, body and increased chances of fracture. Osteomalacia is due to the deficiency of vitamin-D.

In this bone becomes weak and brittle and there are small fractures with severe pain. And the treatment is given with the vitamin-D and calcium supplements. 2nd disease: hyperparathyroidism, in this glands behind the neck becomes large and produces the a lot more hormones and causes PTH. PTH destroys the bones. This again represents with the bone pain and fractures. It is also represented as a renal calculi i.e. kidney stones. The treatment is to locate the tumor and remove it. 3rd is called osteoporosis. In this bones become weak and usually it is seen in post menopausal woman or man above the age of 50 years old. The diagnosis is done by bone mineral densitometer. With this patient can be scanned and we can see that how much bone density is there. The treatment is very simple in the form of drugs.

Thank You.

I’m Dr. C.M.Batra. I’m consultant senior consultant endocrinologist at Indraprastha Apollo Hospital New Delhi.

I will be talking to you today about thyroid disorders. What is thyroid disorders? The thyroid gland is in the center of the neck. It is a middle line structure and it is over line the windpipe or the trachea, on the esophagus i.e. the food pipe. And its function is to produce hormones i.e. T3 and T4. And due to this whore production of hormones or underproduction of hormones i.e. the hormones being less or hormones being more, they are disorders.

The thyroid gland itself can become a large without any hormonal disorder and thus produce problems also. So let me talk to you first about disorders caused by enlargement of thyroid gland itself. The thyroid gland can become very big and compress the windpipe i.e. the trachea and the food pipe i.e. the esophagus and thereby it causing problems. The problems will be shortness of breath, difficulty in eating and this will be increased at night, because when the patient lies down it increases.

And the treatment is very simple just you have to remove the thyroid gland which is obstructing or which is causing the problems. The thyroid gland can function more than it should be or less than it should. And if it adds its function more it is called thyrotoxicosis i.e. it produces more hormone than it should. In that case the person will have weight loss, will feel very uncomfortable, will have palpitation, will have tremors, will be having bulging eyes, might have a thyroid gland enlargement which we called Goitre.

This will how do you diagnose a person with thyrotoxicosis or having excess of thyroid hormone, simple blood test is a trick. The blood test is named free T3 T4 and TSH. And the thyroid scan and radioactive iodine uptake is another test. If you have these two tests you can make the diagnosis of the thyrotoxicosis. Once you made the diagnosis what you do? You start treating it with tablets, they are called neomercazole or methimazole and the other options available are radioiodine and you can even operate the enlarged thyroid and get rid of the excess thyroid hormones.

In person thyroid gland functions less is called hypothyroidism in which the person becomes slow sluggish easily fatigue exhausted, has slow pulse rate, skin becomes dry, the thyroid gland can become enlarge i.e. the goiter can happen and how do you make a diagnosis? A simple blood test T3 will be or T4 will be low TSH will be high. The treatment is simple i.e. the thyroxin tablet can be given and that within three to four weeks the patient becomes alright. But these tablets have to continue throughout life in most cases.

The next disorder of thyroid is thyroiditis in which it is a simple inflammation or swelling of the thyroid gland that causes pain in the thyroid region or the neck region that can cause thyrotoxicosis or excess of thyroid hormone or decreased in thyroid hormones called hypothyroidism and the treatment is usually simple. You don’t have to do anything except just give analgesics and some drugs and mostly the thyroid disease disappear itself. If you are having problems of this type with the thyroid gland you are most welcome to visit me at Indraprastha Apollo Hospital or my clinic, Sarita Vihar.