Department of Endocrinology

About the Department

History:

The Department of Endocrinology, TNM College & BYL Nair Charitable Hospital, was started in these institutions on 17^th June 1962. Dr. Smt S.M. Shahani was the pioneering spirit behind this endeavor. She made a modest beginning by starting an outdoor clinic and setting up a laboratory. In late 1962, the department got a tremendous boost by the offer of a $ 1,25,000/- grant from the Ford Foundation which allowed the purchase of sophisticated laboratory equipment.
Dr. M.S. Kenkre and Dr. S.K. Bhansali from the departments of Pharmacology and Surgery began the Thyroid OPD in 1967. The Nuclear Medicine Services supported the clinic with thyroid hormone assays, thyroid scans and uptakes, and radio ablation for hyperthyroidism.

Dr. Mrs. K.D. Nihalani was responsible for beginning the Diabetes Clinic in 1971. The Diabetes Clinic was a part of the Department of Medicine. Dr. S.D.Mehtalia (Hon Professor) and Dr. P. S. Menon were associated with the Clinic. The department had a Medical Nutrition Therapist and a Social Worker attached to it from its inception and is fully geared for appropriate follow-up for patients with all sorts of complications. In 1987, the Thyroid Clinic and the Diabetes Clinic were integrated with Endocrinology Department.

Since then the department has grown steadily and is today recognized both at the national and international levels.

Currently the department laboratory offers specialized hormonal investigations with state-of-the-art modern technology at nominal rates and has 2 DM Endocrinology training seats per year.

CLIA for Different Endocrine Hormones.

(FSH, LH, Prolactin, Cortisol, Testosterone, T3, T4, FT3, FT4, TSH, Anti TPO Antibodies, Vit.D, Insulin, C Peptide, PTH).

Biochemistry pertaining to Endocrinology & Diabetes

(Blood Glucose/OGTT, Glycated Haemoglobin, Urine pH Serum osmolality, and Urine Osmolality)

PATIENT CARE:

The Department is responsible for patient care in the specialty of Endocrinology.
This comprises clinical evaluation of patients, specialized laboratory investigations, specialized treatment modalities, and long-term follow up which is extremely important in the branch. Referrals are made to this specialty from within the city and state and at times from other parts of India. The department has 30 beds for indoor patients where patients are admitted for diabetes management, pre/post-op care for surgical endocrine problems.

The department conducts the following OPDs :

Diabetes and Diabetes Foot OPD: The Diabetes Clinic runs OPDs on Monday and Thursday from 8.00 a.m. to 11.30 am. Patients are examined in detail. 
Blood Glucose values are repeated every three months and dosages of drugs are adjusted according to these reports in well-compliant, well-adjusted patients. Less compliant or less well-adjusted patients are evaluated at frequent intervals. Patients are also evaluated for any specific problem they may have and are treated accordingly. Hba1c tests are done in the Endocrine laboratory at a very concessional rate. Special care is taken for patients with Type 1 diabetes and pregnant women with diabetes.
The department also manages all the patients suffering from diabetes and undergoing surgery in the hospital.
We have Podiatry Services wherein patients are evaluated for neuropathy using a Bioesthesiometer and Vascular insufficiency using a portable Doppler.
Preventive measures are recommended for patients with a high-risk foot in terms of off-loading, specialized footwear, etc.
We arrange for new technological measures like Self-Monitoring of Blood glucose, Continuous Glucose monitoring Ambulatory Blood Pressure Monitoring, and Insulin Infusion pumps for needy patients.

Thyroid and Obesity OPD: It is run on Wednesdays and Fridays. This is geared toward diagnosing and managing all thyroid disorders, be they Goiters, Nodules, Multinodular Goiters, Hypothyroidism, Thyrotoxicosis, or Malignancy. The Pathology Department by virtue of FNAC and Histopathology of Surgical Specimens also contributes to the workup of patients with thyroid disorders. Radio Isotope scanning for the thyroid gland and whole body scans on cases of suspected malignancy could be carried out in the Isotope Unit. Radio- Iodine Therapy can be administered in the Nuclear Medicine Department for patients with Thyrotoxicosis. We follow up on patients with thyroid malignancies in the Special Care Clinic. Patients with obesity are assessed and evaluated for complications and causes. They are then managed with a multidisciplinary approach with the help of dieticians and other relevant departments as per the complications.

ENDOCRINOLOGY CLINIC AND GROWTH CLINIC: Is run on Tuesdays and Saturdays every week. Endocrine OPD patients with hypothalamic-pituitary disorders, secondary hypertension, adrenal disease, reproductive disorders including hirsutism, parathyroid disorders, Metabolic Bone Disease, Obesity, Lipid Disorders, and genetic/chromosomal disorders are evaluated and managed.
The Puberty and Growth Clinic evaluate patients with short stature and pubertal disorders.
Patients' socioeconomic status is ascertained by the social worker, who helps patients by arranging for drugs or any other help which is needed. Eligible patients are also enrolled in the MJPJAY scheme for their evaluation and treatment.

Faculty

Dr. Nikhil M. Bhagwat

Professsor and Head

Dr Prema Varathakavi

Emeritus Professor

Jugal Gada

Associate Professor

Dr. Sukirti Misra

Assistant Professor

Research and Publications

Sr. No	Citation in PUBMED NLM format
1	Dalwadi PP, Bhagwat NM, Tayde PS, Joshi AS, Varthakavi PK. Pituitary dysfunction in traumatic brain injury: Is evaluation in the acute phase worthwhile? Indian journal of endocrinology and metabolism. 2017 Jan; 21(1):80.
2	Bhagwat NM, Tayde PS, Dalwadi PP, Sorabjee J, Varthakavi PK. Mikuliczs Disease with hypophysitis a new IgG4-mediated disorder. Endokrynologia Polska. 2016;67(6):622-6
3	Tayde PS, Bhagwat NM, Sharma P, Sharma B, Dalwadi PP, Sonawane A, Subramanyam A, Chadha M, Varthakavi PK. Hypothyroidism and depression: Are cytokines the link? Indian journal of endocrinology and metabolism. 2017 Nov;21(6):886
4	Ali MK, Singh K, Kondal D, Devarajan R, Patel SA, Shivashankar R, Ajay VS, Unnikrishnan AG, Menon VU, Varthakavi PK, Viswanathan V. Effectiveness of a multicomponent quality improvement strategy to improve achievement of diabetes care goals: a randomized, controlled trial. Annals of Internal Medicine. 2016 Sep 20;165 (6):399-408
5	Joshi A, Ghagre R, Varthakavi P, Dalwadi P, Bhagwat N. Case of TSH secreating pituitary adenoma (TSHOMA) where course was modified by coexistant autoimmune hypothyroidism. In19th European Congress of Endocrinology 2017 May 3 (Vol. 49). BioScientifica.
6	Thakur DS, Bhagwat NM, Bhide MM, Yerawar CG, Ghanekar GA, Sonawane AB, Chadha MD, Varthakavi PK. Clonidine stimulation test: Is single best time point, convenient yet efficacious? Indian Journal of Endocrinology and Metabolism. 2018 Jul;22(4):511
7	Thakur DS, Yerawar CG, Phiske M, Bhagwat NM Clitoromegaly: beyond testosterone Case Reports 2018; 2018: bcr-2018-225350.
8	Joshi AS, Bhagwat NM. The relation of the non-modifiable (destiny) and modifiable (free will) factors in metabolic derangements. Indian J Endocr Metab 2018;22: 722-3.
9	Neonatal diabetes mellitus: remission induced by novel therapy. Dalwadi P, Joshi AS, Thakur DS, Bhagwat NM.BMJ Case Rep. 2019 Jun 25; 12(6):e228806. doi: 10.1136/bcr-2018-228806.PMID: 31243025
10	Munshi RP, Kumbhar DA, Panchal FH, Varthakavi P. Assessing the Effectiveness of Panchatikta Ghrita, a Classical Ayurvedic Formulation as Add-on Therapy to Vitamin D3 and Calcium Supplements in Patients with Osteopenia: A Randomized, Open-Labeled, Comparative, Controlled Clinical Study. The Journal of Alternative and Complementary Medicine. 2019 Oct 1; 25(10):1044-53.
11	Singh K, Ali MK, Devarajan R, Shivashankar R, Kondal D, Ajay VS, Menon VU, Varthakavi PK, Viswanathan V, Dharmalingam M, Bantwal G. Rationale and protocol for estimating the economic value of a multicomponent quality improvement strategy for diabetes care in South Asia. Global health research and policy. 2019 Dec 1;4(1):7.
12	Shah MK, Kondal D, Patel SA, Singh K, Devarajan R, Shivashankar R, Ajay VS, Menon VU, Varthakavi PK, Viswanathan V, Dharmalingam M. Effect of a multicomponent intervention on achievement and improvements in quality of care indices among people with Type 2 diSouth Asia: the CARRS trial. Diabetic Medicine. 2019 Sep 3.
13	Current Status of Diagnosis and Management of Functioning Pituitary Tumors: Part II. Gada JV, Sanamandra P, Barasara SA, Chauhan YV, Bhagwat NM.Neurol India. 2020 May-Jun;68(Supplement):S20-S27. doi: 10.4103/0028-3886.287672.PMID: 32611888
14	A Lean Lady With Acanthosis Nigricans and Uncontrolled Diabetes Mellitus. Rao G, Chauhan YV, Varthakavi PK, Bhagwat N.Cureus. 2020 Nov 4;12(11):e11330. doi: 10.7759/cureus.11330.PMID: 33304668
15	A study of glycemic variability in patients with type 2 diabetes mellitus with obstructive sleep apnea syndrome using a continuous glucose monitoring system. Khaire SS, Gada JV, Utpat KV, Shah N, Varthakavi PK, Bhagwat NM.Clin Diabetes Endocrinol. 2020 Jun 5;6:10. doi: 10.1186/s40842-020-00098-0. eCollection 2020.PMID: 32518676
16	Unrecognized Primary Hypothyroidism As a Possible Cause of Hyperreactio Luteinalis. Chauhan YV, Dalwadi PP, Gada JV, Varthakavi PK, Bhagwat N.Cureus. 2021 Feb 26;13(2):e13573. doi: 10.7759/cureus.13573.PMID: 33796422
17	Khaire SS, Gada JV, Varthakavi PK, Bhagwat NM. Prevalence and predictors of abnormal glucose tolerance and its resolution in acromegaly: Single Centre retrospective study of 90 cases. Growth Horm IGF Res. 2021; 59(101394):101394.  https://doi.org/10.1016/j.ghir.2021.101394

Academic Activity

M.B.B.S.

The Endocrine department is allotted lectures for undergraduate students by the Department of Medicine.




POSTGRADUATE STUDENTS: 

P. G. Lectures and Seminars are allotted for Medicine Postgraduates to the faculty members in Endocrinology.


We also interact with allied departments in their teaching programs e.g. seminars, clinical meetings, and conferences.




DM ENDOCRINOLOGY: 


The MCI has recognized the Department of Endocrinology, for the DM degree course in Endocrinology. The Department is recognized for TWO DM Endocrinology registration/year.


The teaching sessions for DM students comprise:

• Discussions on cases/ topics pertaining to Diabetes are carried out in the Diabetes Clinics.
• Other Endocrine topics are covered in discussions twice a week. The discussions may be in the form of a review of topics allotted or a journal review.
• A Collaborative Discussion of Thyroid patients and Topics related to thyroid is carried out with nuclear medicine, histopathologists and surgeons
• Inter and Intra collegiate Clinical Meetings. Every month all the Endocrinologists in Mumbai, meet for an Intercollegiate Clinical meeting where interesting cases are presented and discussed.
• We participate in the clinical meetings of the other departments in the hospital where cases with Endocrinologic diseases are presented.
• Clinico Radiologic discussion is held with the Department of Radiology, where interesting radiology (Plain, USG, CT, and MRI) are discussed.
• Journal Review: Reference articles from standard medical Journals are reviewed thrice a week.
• CPC/Death Conferences are held as and when there is a death in the department.
• The Department has organized UpdatesICMES and lectures on a regular basis for Endocrinologists, Postgraduates, Physicians, and paramedical personnel.
• The members of the department are actively involved in patient education on an inpatient and outpatient basis.
• Perioperative management on a case-to-case basis in association with operating surgeons.
• Laboratory techniques in endocrinology with a training programme either in our laboratory or if permitted in places where these courses are conducted (NIN/BRIT).
• The PG Academic Committee conducts a research methodology workshop in hospitals for newly registered postgraduates.

Awards and Achievements

ESICON 2016 3rd Prize : Poster presentation on Prevalence of macro TSH in Subclinical Hypothyroidism

ESICON 2017 2^ndPrize : Poster presentation on Optimising clonidine stimulation test in growth hormone deficiency

ESICON 2017 : National Intercollegiate quiz 3rd prize

Endocrine Enrichment Programme Title of Hawk Eye 2018 3rd Prize.

Gallery

Location