Adolescent friendly health services: perceptions and practice of medical professionals

Background: Introduction Adolescence is a period of intricacies, with a wide range of adolescent health problems, such as depression, eating disorders, drug and alcohol use, unplanned pregnancy, chronic illness, and suicide due to unfavorable social conditions and risk taking behaviors. Not many studies are there to assess problems related to providing health services to adolescents. Our study analyzed the views about perception and practice of adolescent health among doctors of the different groups of medical discipline.Methods: A total of 44 doctors, 12 from ayurveda, 10 from siddha, 10 from homeopathy and 12 from allopathy, were included in the study who filled in questionnaire containing 17 questions on perceptions and practice of adolescent health.Results: Response rate was 100%. Overall the doctors understanding on adolescent health was good. Majority of the doctors (90%) felt that adolescents are not comfortable in the present available setting to bring out their problems. Only 3 of our doctors had received formal training in adolescent health and are informed about adolescent friendly health services. There was no separate forum to render adolescent health services.Conclusions: Effectively planning, implementation and also evaluation of health programs in adolescent health is required to change attitude of adolescents, the health providers and also that of the setting where adolescents are addressed. Health professionals have their credibility towards adolescents, and the advice they give may be important for teenage behavior

Effect of educational program on premenstrual syndrome in adolescent school girls

Background: Premenstrual syndrome is a difficult problem in adolescence as the psychological changes that occur during the adolescent period are often complex and stressful.In this study, we aimed to study the prevalence and severity of premenstrual symptoms in adolescent girls and how effective an educational program is in decreasing the symptom severity in these girls.Methods: An educational program was conducted in two rural and two urban secondary schools of Pondicherry in girls suffering from premenstrual symptoms. We assessed the symptom severity before conducting the educational program (pre-test) and three months following the program (post-test) by using a self-administered semi structured questionnaire.Results: 40.9% of the urban girls and 51.6% of the rural girls were suffering from premenstrual symptoms. We noted a significant decrease in the total PMS scores and all the subscale scores (PMS - A, C, D, H and others) of the students three months after the educational program when compared to the scores before the program.Conclusions: Women with PMS commonly present to their doctor with a self-diagnosis, only when the symptoms severely hamper their day to day activities. We suggest that health education programs regarding PMS and other menstrual problems must be included in the curriculum of secondary schools to bring down the prevalence of such problems

The plasma nitric oxide and homocysteine levels and their association with insulin resistance in South Indian women with polycystic ovary syndrome

Background: Women with polycystic ovary syndrome (PCOS) exhibit features of the metabolic syndrome apart from low-grade chronic inflammation and endothelial dysfunction and may be at increased risk for cardiovascular disease (CVD). The Nitric oxide (NO) and Homocysteine (Hcy) are important plasma markers of endothelial dysfunction, an early marker of atherosclerosis. There are no Indian studies on NO and Hcy levels in women with PCOS and their association with Insulin Resistance (IR). Therefore the present study is to estimate plasma levels of NO and Hcy in south Indian women with PCOS and association with insulin resistance.Methods: 104 women with PCOS and 95 healthy age matched control subject were enrolled in the study. Standard physical methods and Chemiluminescent Immunoassay technique were employed for estimation of Anthropometric parameter and plasma sex hormones respectively. Fasting insulin, glucose, NO and Hcy were measured by standard methods. Insulin resistance was evaluated by using Homeostasis Model Assessment for Insulin Resistance (HOMA- IR)Results: Women with PCOS had significantly higher insulin resistance (P<0.01), Hcy (p<0.05) and lower NO levels (P<0.05), IR was positively correlated with Hcy (r= 0.610, p<0.01) and negatively correlated with NO (r= -0.285; p<0.01)Conclusions: Our data revealed that South Indian women with PCOS had elevated IR and homocyeteine and lowered NO levels

Evaluation of complications of abdominal and vaginal hysterectomy

Background: Hysterectomy is one of the most common surgical procedures performed by the gynaecologist.  It can be performed by vaginal and abdominal route. Gynaecologic surgeons worldwide continue to use the abdominal approach for a large majority of hysterectomies that could be performed vaginally despite well-documented evidence that vaginal hysterectomy has better outcome. Aim of our study is to compare vaginal route versus abdominal route of hysterectomy in terms of intra operative and post operative complications.Methods: A retrospective study was done in 229 women who had undergone hysterectomy (176 abdominal hysterectomies and 53 vaginal hysterectomies) from January 2010 to July 2012. Information on the indications, operative procedures, and complications were extracted and analysed.Results: The mean duration of surgery in VH group was 79.6 min and that of TAH group was 99.2 min. The mean blood loss was also more in case of TAH group than that of VH group (215ml vs. 167ml). Bladder injury occurred in 1 case in VH (1.9%) and in 4 cases in TAH (2.3%). Ureter injury occurred in 1(0.6%) case in TAH group. Wound infection developed in 10 cases of TAH group whereas only one case in VH group developed vault infection.Conclusions: Vaginal hysterectomy is associated with quicker recovery, early mobilization, shorter hospitalization, less operative and post operative morbidity when compared to abdominal hysterectomy

E-learning as a tool to impart knowledge of surgical procedures in the undergraduate medical teaching

Background: E-learning is in a budding stage in developing countries. As present-day students are gadget-friendly, introducing a surgical e-learning module may create interest and help in understanding the surgeries easily. This study aimed to determine the effectiveness of E-learning in improving the knowledge component of surgical procedures for undergraduate students and to analyze students’ feedback regarding its usefulness. Methods: This quasi-experimental study was conducted among 67 final-year MBBS students, who had completed 1 week of operation theatre (OT) posting in obstetrics and gynecology. Recording of videos for must-know surgeries in gynecology was done. Video editing and audio description of surgical steps were done. A YouTube channel was created and surgical videos were uploaded. Links to 2 surgical videos and additional teaching materials were uploaded to the college learning management system daily for 2 consecutive weeks. A telegram group was formed for posting questions daily. Pre-test and post-test were conducted and the results were analyzed. Results: The mean marks obtained in the pre-test were 6.567±1.9 and the post-test was 15.22±2.5 (Paired t test p=0.0001). Students mentioned that combining OT posting with an e-learning module helped them to build their knowledge of surgical procedures. Telegram quizzes helped them to increase their understanding of surgeries. 34 students wanted e-learning module to be conducted on other topics also. Conclusions: E-learning is highly effective in improving knowledge component of surgical procedures for undergraduate students. E-learning can be made more effective by adding formative assessment. Combining surgical e-learning module with operation theatre posting can enhance knowledge and understanding

Adolescent friendly health services: perceptions and practice of medical professionals

Background: Introduction Adolescence is a period of intricacies, with a wide range of adolescent health problems, such as depression, eating disorders, drug and alcohol use, unplanned pregnancy, chronic illness, and suicide due to unfavorable social conditions and risk taking behaviors. Not many studies are there to assess problems related to providing health services to adolescents. Our study analyzed the views about perception and practice of adolescent health among doctors of the different groups of medical discipline.Methods: A total of 44 doctors, 12 from ayurveda, 10 from siddha, 10 from homeopathy and 12 from allopathy, were included in the study who filled in questionnaire containing 17 questions on perceptions and practice of adolescent health.Results: Response rate was 100%. Overall the doctors understanding on adolescent health was good. Majority of the doctors (90%) felt that adolescents are not comfortable in the present available setting to bring out their problems. Only 3 of our doctors had received formal training in adolescent health and are informed about adolescent friendly health services. There was no separate forum to render adolescent health services.Conclusions: Effectively planning, implementation and also evaluation of health programs in adolescent health is required to change attitude of adolescents, the health providers and also that of the setting where adolescents are addressed. Health professionals have their credibility towards adolescents, and the advice they give may be important for teenage behavior

A study of the hypo-osmotic swelling test of spermatozoa in both fertile and infertile male subjects and its relationship with the standard spermiogram

Objective: To compare the hypo-osmotic swelling test (HOST) of spermatozoa with the standard spermiogram in both fertile and infertile male subjects. Materials and Methods: The HOST was performed on 50 men of proven fertility and 51 infertile men. The results from both the groups were compared with the standard spermiogram. Study Design: Prospective case-control study. Analysis: The statistical analysis was done using the Karl Pearsons coefficient of correlation. Results: The HOST values were higher in the fertile group. The correlation between hypo-osmotic swelling and semen variables was higher in the infertile group than in the fertile group. 2 patients in the infertile group with greater than 50% hypo-osmotic swelling got their spouses pregnant during the study period. Conclusion: The HOST is inexpensive, easy to per-forrn and can be used to evaluate sperm tail function. It can also be used to predict the fertilizing potential of the semen sample

Determinants and treatment modalities of uterovaginal prolapse: A retrospective study

Introduction: Prevalence of uterovaginal prolapse is increasing with increase in life expectancy of women. The reported prevalence of uterovaginal prolapse is different in different countries. Various studies have been reported on the prevalence, determinants, clinical manifestations and treatment modalities of uterovaginal prolapse. Objectives: Determine the prevalence of uterovaginal prolapse, identify determinants of uterovaginal prolapse, its clinical manifestations and describe different treatment options. Study Design: Retrospective study done on uterovaginal prolapse at Indira Gandhi Medical College and Research Institute in Puducherry in India from January 1, 2014 to December 31, 2014. Results: The mean age of the patients in our study was 57.5. 87.3%belonged to the Hindu religion. 77% of women with prolapse were post-menopausal. 86.2% of women were multiparous. The predominant presenting complaint was history of mass protruding out of vagina. Non-surgical treatment was offered for 33.7%. Vaginal hysterectomy with pelvic floor repair was the predominant surgical treatment offered. Conclusion: Prolonged labor and vaginal delivery involving sphincter and vaginal tear are the main determinants of uterovaginal prolapse. Modifiable risk factors warrant health programs to develop interventions targeting the prevention of uterovaginal prolapse

The plasma nitric oxide and homocysteine levels and their association with insulin resistance in South Indian women with polycystic ovary syndrome

Background: Women with polycystic ovary syndrome (PCOS) exhibit features of the metabolic syndrome apart from low-grade chronic inflammation and endothelial dysfunction and may be at increased risk for cardiovascular disease (CVD). The Nitric oxide (NO) and Homocysteine (Hcy) are important plasma markers of endothelial dysfunction, an early marker of atherosclerosis. There are no Indian studies on NO and Hcy levels in women with PCOS and their association with Insulin Resistance (IR). Therefore the present study is to estimate plasma levels of NO and Hcy in south Indian women with PCOS and association with insulin resistance.Methods: 104 women with PCOS and 95 healthy age matched control subject were enrolled in the study. Standard physical methods and Chemiluminescent Immunoassay technique were employed for estimation of Anthropometric parameter and plasma sex hormones respectively. Fasting insulin, glucose, NO and Hcy were measured by standard methods. Insulin resistance was evaluated by using Homeostasis Model Assessment for Insulin Resistance (HOMA- IR)Results: Women with PCOS had significantly higher insulin resistance (P&lt;0.01), Hcy (p&lt;0.05) and lower NO levels (P&lt;0.05), IR was positively correlated with Hcy (r= 0.610, p&lt;0.01) and negatively correlated with NO (r= -0.285; p&lt;0.01)Conclusions: Our data revealed that South Indian women with PCOS had elevated IR and homocyeteine and lowered NO levels

Knowledge, attitude, and practice of exercise during pregnancy among antenatal mothers

Introduction: Safe maternity with improved neonatal outcomes is predicated on proper antenatal health care services. Regular exercise is promoted for its overall health benefits. The American Congress of Obstetricians and Gynecologists, recommends that pregnant women can exercise moderately for 30 min on most days of the week. Methodology: A total of 200 antenatal mothers were included in the study, who filled in the questionnaire. The questionnaire comprised of 25 questions (21 on knowledge, 3 on attitude and 1 on practice). For knowledge items categorical responses (yes, I don′t know and no) were applied with an item score of ′2′, ′1′, ′0′ respectively for positive knowledge. For attitude and practice the answers were either yes, no. Data were analyzed using Statistical Package for Social Sciences (SPSS). Results: Response rate was 100%. The age range of the study group was 18-35 years with a mean age of 25 ± 4.51 years. The majority of the study population were Hindus (81%), had undergone primary education (63%) and were homemakers (74%). The total mean knowledge score was 20.53 ± 2.08. 51% felt it was necessary to do exercise during pregnancy. 18% were practicing exercise in pregnancy. Conclusion: The knowledge of our women on exercise during pregnancy was less than average, and their attitude was favorable. However a very few were actually practicing exercise in pregnancy