This document provides information about Dr. Jyoti Agarwal and her presentation on adolescent health. It includes: 1) Details of Dr. Agarwal's background and positions, including being an alumnus of Lady Harding Medical College and director of multiple centers. 2) The presentation is dedicated to her mentor, Dr. Sharda Jain. 3) The presentation provides an overview of adolescent health, discussing the needs, concerns and challenges faced by adolescents. It covers topics like physical changes during puberty, mental health, nutrition, and sexuality. 3) The presentation aims to address common questions adolescents have and provide guidance on maintaining good health and hygiene during puberty

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. Adolescent HealthAdolescent Health
‘An overview’‘An overview’
‘‘Needs ,Needs ,
concerns andconcerns and
challengeschallenges’’
Dr. Jyoti AgarwalDr. Jyoti Agarwal
Dr. Sharda JainDr. Sharda Jain

3. This Presentation is dedicated to
my
MENTOR
&
LIGHT HOUSE
Dr. Sharda Jain

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. India is the youngest country in the world
Adolescent population : 250 - 260 million

6. Adolescents are resources to
be developed……..
………not the problems to be fixed !

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. 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. We can not ignore adolescents !!We can not ignore adolescents !!

11. Adolescence
10-19 years
Youth 15-24
Years
Young people
10-24 Years
WHO defines
‘No longer a child but not yet an adult’

12. Adolescents are ‘Special’

13. 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

15. Peers are more importantPeers are more important
than parents !than parents !

16. Is it normal to be
attracted to boys ?
What is
Growing Up
All About?

17. TO BE ABLE TO CHOOSE THE
RIGHT PATH….
Reassuranc
e
Support
Guidance
TUMULTOUS
PERIOD

20. Wish to stand out !!

21. Want to become one of the
‘special performers’

23. What is Body Image?What is Body Image?

24. 24
Image is Everything
Kareena Kapoor
syndrome
Hritik Roshan Syndrome:

25. Way we picture
our body
Ingredient of
our self concept
Accept or
reject ourselves
Idealized
or realistic idea
Directly related
to self esteem

27. Questions ??
What are the
changes in
my body?
What are
normal periods?

28. Address their
menstrual concerns
very patiently and
with care

29. 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

31. Good Perineal Hygiene and
cleaning habits
antiseptic liquids excessive
soap
tissue paper anti-
perspirants
deodorants talcum
powder
tight nylon undergarments

32. 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.

33. Hygiene in Boys
-Take Bath Daily
-Cotton clothes
-Use personal
razor
-Clean smegma
after retracting
prepuce

34. Questions ??
Why do
I get
moody? Why do I
get
pimples?

35. 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

36. 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

37. 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
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A
A
a
A
a
A
a
a
a

38. 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

39. Stunted 22- 33 %

40. Eating Disorders

41. 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

42. 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.

43. 43

44. India-RCH Survey (2002- 2003)
Anaemia among adolescent girls
MILD MODERATE
SEVERE NO ANAEMIA
43 Percent
28 Percent24 Percent
5 Percent

45. 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%

46. Anaemia though
preventable
yet a major problem

49. 49
Anaemia drains all our energy
&
makes us “Lazy Race”

50. EFFECT A ADOLESCENT GIRL
-↓Second growth spurt
- ↓ School
performance
-↓ capacity to do work
- inadequate preparation for
Motherhood

51. 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

52. Eat a
Rainbow
Diet !

54. 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

55. Lets Pledge to make
Anaemia Free India
Anamia Free School
Anaemia Free
Family
Anaemia Free
Children
I LOVE MY INDIA

56. It is Doable
&
We Can Do it

57. Incidence of obesity

59.
““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

60. 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%

61. – 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

62. Obesity
“An Emerging Menace”
Overweight = Underweight
2.1 billion 2.1 billion
First time in human
history !
Aug 2005

63. 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

64. 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

65. Burden of co-morbidities in an
obese

66. Diabesity
India would be the diabetic
capital of the world by 2020

67. Most frequent endocrine
problem in this age group
.

68. =

69. 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

70. 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

71. 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

72. 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

73. YOGA
“Yoga is a discipline of life.”
Yoga is a powerful tool to re energize oneself

74. Questions ??
Is it normal
to get
attracted to
boys ?

75. Dear diary,
One more day has passed ; and I still don’t have a boy
friend !!

76. 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 ?

77. 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 !!

79. 79
India Today 2003
• Nearly 32%
Urban teens have
alcohol
• 25% smoke (SG)
• 40% smoke
(NSG).
Health risk behaviour and violence

81. CONCEALING INFORMATION
DOES NOT HELP…..

83. Treat the adoloscent with
respect
At home
In school
At work
At government level
At NGO level
Listen to their silent
protests

84. My wonderful moments ….
Role of ParentsRole of Parents

85. 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’

86. 86Ringmaster approach will not

87. 87
Why don’t you listen to me ??

88. 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

89. AT THE CLINIC
• Treat them as adults
• Listen patiently
• Maintain confidentiality
• Do not reprimand
• Give sound, friendly advise
• See them frequently
for counseling

90. Knowledge and attitude alone don’t help
to modify unsafe behavior
Life Skill Development & Scholastic Achievements

91. Life skills Education
Life skills need to be
imparted
-Communication
-Assertiveness
-Negotiation
-Critical thinking
-Coping skills
-Empathy etc.
Adolescent health workshop

94. 94
… make life less Complicated

95. 95
More organised and Focused
Comprehensive & Convenient

97. Bad patches are temporary
Failure is good - for growth

98. Thank You