Endocrinology in Haryana: 50 years of statehood, 15+ years of service.

Sir,

Haryana, a small but dynamic state of Northwest India, completed 50 years of statehood on November 1, 2016. The past half-century has been marked by sustained and significant growth in all fields. Both public and private sectors have worked hard to transform Haryana from a little-known dusty state to one of the engines of growth of the country. Health care in general and the superspecialty of endocrinology in particular have contributed to this story of growth as well.

The first documentation of an endocrine medicinal preparation is from Haryana. The twin Ashwin Kumars, who were Raj Vaidya (Royal Physicians) to Devas during Vedic times, invented and created this formulation for Chyawan Rishi at his Ashram on Dhosi Hill near Narnaul in Haryana.[1] Chyawan was able to reverse old age and become young with this endocrine tonic. The nutraceutical, known even today as Chyawanprash, is used as an anabolic and pro-longevity drug.

Full-time modern endocrine services, however, began in Haryana on March 1, 2000, at Mahabir Dal Hospital, Karnal. These services evolved into the first independent endocrine clinic of the state on May 25, 2001, and the first endocrine center with admitting facilities on February 24, 2002, in the same city.

Part-time endocrine clinics later opened in Faridabad (2001) and Gurgaon (2004). Endocrinologists gradually settled in Gurgaon (2006), Panchkula (2007), and Rohtak (2007), bringing quality endocrine services to all parts of the state. The services at Pt BDS, PGIMS, Rohtak, were strengthened in 2013 with the arrival of a second endocrinologist who further enhanced endocrine services by adding 2 days more per week of endocrinology clinics and collaborating with the Biotechnology Department at PGIMS, Rohtak, to initiate genetic analysis of endocrine patients.

Perhaps the largest endocrine department in the private sector in India today, the Endocrinology Department at Medanta Hospital began operations in December 2009 and currently boasts nine consultants, including one diabetologist and one pediatric endocrinologist. The department is approved for training Diplomate of National Board postgraduates in endocrinology since 2014.

Endocrinologists are also rendering yeoman service in Yamunanagar (2014) and Faridabad (2015). Full-time qualified pediatric endocrinologists are at work in Gurgaon (2009) and Ambala Cantt (2016). Many towns such as Mullana (Ambala), Kurukshetra, Sonipat, and Kaithal host endocrine clinics run by visiting endocrinologists at weekly or fortnightly intervals. Haryanvi endocrinologists also work outside the state, in locations as diverse as New Delhi, Chandigarh, United Arab Emirates, and the Maldives.

Haryana's endocrinologists have matched their peers from across the country in every sphere. Dr. Ambrish Mithal, who has served as the President of the Endocrine Society of India and the Indian Society of Bone and Mineral Metabolism, sits on the Board of the International Osteoporosis Foundation. The Indian Journal of Endocrinology and Metabolism was led by an editorial team from Haryana for 6 years (2011–2016), while Thyroid Research and Practice, the Journal of Indian Thyroid Society, is currently edited from Haryana. The data used for the Indian risk engine for osteoporosis in the FRAX tool are obtained from research conducted in Rohtak by Dhanwal et al.[2]

As of today (November 1, 2016), there are 20 qualified Doctorate of Medicine endocrinologists in Haryana, including 12 in Gurgaon, 2 in Rohtak, and 1 each in Faridabad, Karnal, Panchkula, and Yamunanagar. Two qualified pediatric endocrinologists, located at Ambala Cantt and Gurgaon, add weight and value to this list.

The burden of endocrine disease in the state, however, is much heavier than this. According to the National Family Health Survey (NFHS-4),[3] the prevalence of “high blood sugar” in Haryana is 8.2% in adult men and 6.6% in women. Studies carried out by endocrinology-led teams have found a higher prevalence of diabetes. Large-scale epidemiological surveys in Sonipat district,[4] conducted as part of Project Uday, reveal a diabetes burden of 16.7%, which is much greater than thought earlier. In a rural-based study, the prevalence of newly detected diabetes has been shown to be 7.3%, whereas the overall prevalence of known and newly detected diabetes is 13.3%.[5] Karnal city in Haryana has a relatively high prevalence of type 1 diabetes mellitus (31.9/100,000 population),[6] while Rohtak reports a 13.9% community prevalence rate of gestational diabetes mellitus,[7] thought to be a surrogate for prevalence of prediabetes.

In the NFHS-4, 20% men and 21% women are found to have a body mass index >25.0 kg/m2.[8] This is a sharp rise over the figures of 10.8% and 17.4% reported by NFHS-3, conducted in 2005–2006.[3]

The prevalence of hypothyroidism in pregnancy is reported to be 19.4% in Haryana. This is higher than that observed in any other state, except Jammu and Kashmir.[9] The prevalence of other endocrine and metabolic disorders probably mirrors that seen in other parts of the country.

At 15+, the endocrinologists of Haryana are working hard to meet the clinical needs and demands of its population, contribute to Indian research, and keep India's flag flying high in their chosen field.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.