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Adolescent health an overview dr. jyoti agarwal

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Adolescent health an overview dr. jyoti agarwal

  1. 1. Dr. Jyoti Agarwal Alumini of Lady Harding Medical College (Gold Medalist) Presently Director of :- Lifecare Centre : - Lifecare IVF - Consultant : Pushpanjali Crosslay Hospital - Secretary of East Delhi Gynaecologist Forum - Treasurer Delhi Gynaecologist Forum - Member of WOW India - Member Adolescent committee AOGD - Special interest in Infertility & Ultrasound
  2. 2. Adolescent HealthAdolescent Health ‘An overview’‘An overview’ ‘‘Needs ,Needs , concerns andconcerns and challengeschallenges’’ Dr. Jyoti AgarwalDr. Jyoti Agarwal Dr. Sharda JainDr. Sharda Jain
  3. 3. This Presentation is dedicated to my MENTOR & LIGHT HOUSE Dr. Sharda Jain
  4. 4. Why should we talk about Adolescents? •They are 1/5th of the world’s population •85% of them live in Developing Countries. •23% of the Indian population are adolescents ( census 2000 )
  5. 5. India is the youngest country in the world Adolescent population : 250 - 260 million
  6. 6. Adolescents are resources to be developed…….. ………not the problems to be fixed !
  7. 7. Adolescence is a time for opportunity and risk • Adolescent population is our demographic force. • They are our economic force. • They are the future health. • They have a right to participate. Adolescent health need to be rightfully addressed
  8. 8. Habits and behaviors initiated in adolescence have life long impact Important to have a healthy , energetic and enthusiastic The society reaps what it sows in its adolescents…..
  9. 9. We can not ignore adolescents !!We can not ignore adolescents !!
  10. 10. Adolescence 10-19 years Youth 15-24 Years Young people 10-24 Years WHO defines ‘No longer a child but not yet an adult’
  11. 11. Adolescents are ‘Special’
  12. 12. Understanding Adolescents In hesitation they do not discuss it with their parents or elders and seek information from all other sources further adding to their confusion This leads to myths and
  13. 13. Peers are more importantPeers are more important than parents !than parents !
  14. 14. Is it normal to be attracted to boys ? What is Growing Up All About?
  15. 15. TO BE ABLE TO CHOOSE THE RIGHT PATH…. Reassuranc e Support Guidance TUMULTOUS PERIOD
  16. 16. Wish to stand out !!
  17. 17. Want to become one of the ‘special performers’
  18. 18. What is Body Image?What is Body Image?
  19. 19. 24 Image is Everything Kareena Kapoor syndrome Hritik Roshan Syndrome:
  20. 20. Way we picture our body Ingredient of our self concept Accept or reject ourselves Idealized or realistic idea Directly related to self esteem
  21. 21. Questions ?? What are the changes in my body? What are normal periods?
  22. 22. Address their menstrual concerns very patiently and with care
  23. 23. When should I see a doctor? • Must see a doctor if – has not started periods by the age of 15 years – has started before the age of 10 years – are delayed or early – are heavy (with clots) or scanty – are very painful – if she is unable to attend school
  24. 24. Good Perineal Hygiene and cleaning habits antiseptic liquids excessive soap tissue paper anti- perspirants deodorants talcum powder tight nylon undergarments
  25. 25. 32 Golden Rule ‘‘Front to Back”Front to Back” • after urination or bowel movement, aafter urination or bowel movement, a girl should wash area from front togirl should wash area from front to back & pat dry.back & pat dry.
  26. 26. Hygiene in Boys -Take Bath Daily -Cotton clothes -Use personal razor -Clean smegma after retracting prepuce
  27. 27. Questions ?? Why do I get moody? Why do I get pimples?
  28. 28. What can I do about it? • Hormonal changes occur which may affect your emotions and moods. • It is normal and many girls go through it about 10 days before their period. • These symptoms can be reduced by eating a well- balanced diet, avoiding coffee, sugar, and supplementing the diet with
  29. 29. Acne are not related to sexual thoughts or activity It is best not to squeeze acne so as to avoid scarring Frequently wash your face with warm water
  30. 30. GrowingGrowing UpUp 3-5yrs 6-9yrs 10-14yrs Above 20yrs Growing Up – Changes in *Height & weight *Body proportion *Facial features *Body structure *Fat deposition Aaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaa A A a A a A a a a
  31. 31. Ht of a child = Mid Parental HtHt of a child = Mid Parental Ht Mother’s ht(cm) + Father’s ht (cm)- 6.5cm Girls = 2 Mother’s ht(cm) + Father’s ht(cm) + 6.5cm Boys = 2
  32. 32. Stunted 22- 33 %
  33. 33. Eating Disorders
  34. 34. Eating disorders ASPIRATIONS TO BECOME A Ramp scorcher Air hostess Film actress FOOD FADS Period of rapid growth & development Dietary inclination towards ready-to-eat foods, processed foods & junk foods. STRONG LIKES AND DISLIKES Use of steroids for body building Consumption of Slimming
  35. 35. Watch Out for – Anaemia ! • One in every two adolescent girls suffer from Anaemia • When girls first start their periods they can get this condition because of not having enough iron in their blood. • Iron from food helps to form Hemoglobin which is present in Red Blood Cells • Oxygen from the air enters the body through the lungs, gets attached to hemoglobin and circulates throughout the body. • If there is less hemoglobin there is less Oxygen in the body leading to poor health, repeated infections and tiredness. Eat an iron rich diet to avoid this – foods like meat/dal/green leafy vegetables and beans. Eat an iron rich diet to avoid this – foods like meat/dal/green leafy vegetables and beans.
  36. 36. 43
  37. 37. India-RCH Survey (2002- 2003) Anaemia among adolescent girls MILD MODERATE SEVERE NO ANAEMIA 43 Percent 28 Percent24 Percent 5 Percent
  38. 38. 9 out of 10 Adolescent girls in Delhi are Anaemic 90% of Delhi university girls who volunterred for blood donation were rejected – Hb of < 12.5 gm%
  39. 39. Anaemia though preventable yet a major problem
  40. 40. 49 Anaemia drains all our energy & makes us “Lazy Race”
  41. 41. EFFECT A ADOLESCENT GIRL -↓Second growth spurt - ↓ School performance -↓ capacity to do work - inadequate preparation for Motherhood
  42. 42. 51 CHINA Role Model Once they brought “one child norm” • their children have become much healthier • Their heights have increased • Their I. Q. levels are much higher If they can do it in china We surely can do it in india
  43. 43. Eat a Rainbow Diet !
  44. 44. Remember 5 A’s • Ask what is your Hb • Ask when was it done last • Ask what is the normal Hb • Ask to get it done right away • Advise : Diet : Tablet : Deworming
  45. 45. Lets Pledge to make Anaemia Free India Anamia Free School Anaemia Free Family Anaemia Free Children I LOVE MY INDIA
  46. 46. It is Doable & We Can Do it
  47. 47. Incidence of obesity
  48. 48.                                                                                                                                                                           ““Ye dil mange more”Ye dil mange more” lifestylelifestyle Tobacco/ Alcohol Excess dietary FAT         Lack of vegetables & fruits Sedentary habits Sexual behavior/ poor genital hygiene
  49. 49. Obesity Prevalence • World – 12% in the world (World Health Statistics, WHO, 2012) • India – Women: 15%; Men: 12% (Source: NFHS 3; Delhi Fact Sheet) –Girls: 18.3% –Boys: 20.6%
  50. 50. – Women: 33%; Men: 24% Source: NFHS 3; Delhi Fact Sheet • Adolescents – Total: 24% – Public schools: 29%; – Govert schools: 11.3% Source: Misra et al, 2011 Delhi
  51. 51. Obesity “An Emerging Menace” Overweight = Underweight 2.1 billion 2.1 billion First time in human history ! Aug 2005
  52. 52. Prevalence of Obesity ( 1986 – 2000 ) 1. BMI > 30 kg / m2 - doubled 2. Morbid Obesity > 40 kg /m2 quadrupled 3. Super Obesity > 50 kg /m2 – five fold Increase Buchwald et al Surg for obesity & realated diseases(2005) 371-381
  53. 53. Fueled by the parents failing to recognize the risk to their children FUELED An obese child is a healthy child. In an effort to keep child “healthy", he/she is fed in excess. Obesity epidemic
  54. 54. Burden of co-morbidities in an obese
  55. 55. Diabesity India would be the diabetic capital of the world by 2020
  56. 56. Most frequent endocrine problem in this age group .
  57. 57. =
  58. 58. Role of weight lossRole of weight loss Ref : Kathleen M et al Fertility & Sterility 2004 5-7% wt. Reduction effective in restoring normal menses and fertility
  59. 59. Balance between Food & Exercise • Be physically active for at least 30 minutes most days of the week • About 60 minutes a day of physical activity is needed to prevent weight gain • For sustaining weight loss at least 60-90 minutes a day of physical activity is required
  60. 60. Exercise Is Important • Improves strength and endurance • Helps build healthy bones and muscles • Helps control weight & menstrual problems • Reduces anxiety and stress and increases self- esteem Gives you a great
  61. 61. Don’t Overdo It How much is enough? Benchmarks to follow daily: – Walking 2 miles/30 min. or running 1.5 miles in 15 minutes – Bicycling 5 miles/30 min. or 4 miles/15 min – Dancing fast for 30 minutes or jumping rope for 15 minutes – Playing basketball 15-20 min. – Swimming for 30 min
  62. 62. YOGA “Yoga is a discipline of life.” Yoga is a powerful tool to re energize oneself
  63. 63. Questions ?? Is it normal to get attracted to boys ?
  64. 64. Dear diary, One more day has passed ; and I still don’t have a boy friend !!
  65. 65. Issues in Sexuality How to talk about Sex ? How to talk about Sex ? How to avoid pregnancy ?How to avoid pregnancy ? How to stay healthy ? How to stay healthy ? How to make the right choices? How to make the right choices? How not to get hurt by diseases ? How not to get hurt by diseases ?
  66. 66. Teenage Pregnancy • One of the most traumatic experiences for Adolescents – Each year, 2.0 to 2.4 million adolescents resort to abortion (WHO,2001) – Dangers of unsafe abortions – Infections, Bleeding, Chronic Pelvic Pain, Infertility • Speak to a Qualified Gynecologist Prevention is the best method !! Prevention is the best method !!
  67. 67. 79 India Today 2003 • Nearly 32% Urban teens have alcohol • 25% smoke (SG) • 40% smoke (NSG). Health risk behaviour and violence
  68. 68. CONCEALING INFORMATION DOES NOT HELP…..
  69. 69. Treat the adoloscent with respect At home In school At work At government level At NGO level Listen to their silent protests
  70. 70. My wonderful moments …. Role of ParentsRole of Parents
  71. 71. Encourage children – Positive Self Esteem • Tell them – “We love them” • Treat them with kindness & Respect • Must Discipline - but be gentle • Listen and then teach decision making • Praise v/s criticism • Responsibility and trust • “Thanks” - ‘Count the blessing’
  72. 72. 86Ringmaster approach will not
  73. 73. 87 Why don’t you listen to me ??
  74. 74. BE A FRIEND TO YOUR TEENAGER • Turn your life clock back to your teens • Keenly observe his/her activities, Interests, protests • Don’t be too strict • Involve a reliable mediator for communication
  75. 75. AT THE CLINIC • Treat them as adults • Listen patiently • Maintain confidentiality • Do not reprimand • Give sound, friendly advise • See them frequently for counseling
  76. 76. Knowledge and attitude alone don’t help to modify unsafe behavior Life Skill Development & Scholastic Achievements
  77. 77. Life skills Education Life skills need to be imparted -Communication -Assertiveness -Negotiation -Critical thinking -Coping skills -Empathy etc. Adolescent health workshop
  78. 78. 94 … make life less Complicated
  79. 79. 95 More organised and Focused Comprehensive & Convenient
  80. 80. Bad patches are temporary Failure is good - for growth
  81. 81. Thank You

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