Causes of Visiting Teenagers in the Pediatric and Adolescence Examining Room

Adolescence is the transitional period between childhood and adulthood. Depending on female gonads’ function and on hypothalamic-pituitary-ovarian axis activation, results in teenager’s body growth, in secondary sex characteristics’ development and finally in their reproductive potential. In adolescence, the negative feedback of gonadal steroids on gonadotropins is disturbed. Teenagers presenting with dysfunctional bleedings are usually suspected of hemorrhagic ovarian cysts or endometriosis and require gynecologic examination, evaluation, and hormone therapy. It is of great importance both for teenagers and their parents to understand that hormone therapy is the first line treatment for bleeding disorders in these ages. A detailed medical history is necessary to determine the appropriate treatment plan. Primary care includes the detection of adolescents with acute or chronic pelvic pain that may be associated with endometriosis or other pathologies like mullerian duct abnormalities, imperforate hymen, ovarian teratomas, ovarian torsion, and vaginal absence or atresia. Mullerian duct abnormalities are associated with increased rates of unexplained infertility, spontaneous abortions, and pathological conditions of pregnancy. Specialists, should help teenagers in getting familiar to their bodies, to their sexuality, inform them about the sexually transmitted diseases, and safety options including vaccination and guide them in contraception issues

Depigmentation’s Disorders of the Vulva, Clinical Management

The cancer of the vulva is a rare disease with a positive association to poor developing countries. However, the incidence of vulvar cancer in situ nearly doubled in the last two decades and remained relatively stable. The main reason for this increased incidence of vulvar intraepithelial neoplasia (VIN) in women younger than 45 years is due to changes in sexual behavior, first intercourse at early age, multiple sexual partners, and sexually transmitted diseases that were increasing progressively. Furthermore, it is strongly associated with smoking and the increased incidence of HPV infection. The occurrence of early symptoms of VIN-like pruritus vulvae, pain, and lichen sclerosus led to early diagnosis to perform the adequate treatment. VIN tends to appear multifocal, while most invasive cancers are unilateral located and appeared with well-circumscribed lesions

Thrombophilia and Pregnancy: Diagnosis and Management

Thromboembolic disease during pregnancy is a significant cause of maternal morbidity and mortality involving venous or arterial thrombosis and possible clinical manifestations like clinical symptoms of antiphospholipid antibody syndrome and hyperhomocysteinemia. For diminishing the prevalence of thromboembolic disease, the early identification of pregnant women with various risk factors for thrombosis without clinical symptoms is of great importance. However, the optimal management for asymptomatic pregnant women who have inherited thrombophilia is uncertain and recognized only due to pregnancy complications such as recurrent pregnancy loss and preeclampsia. The clinical approach to thromboembolism is the same in pregnant women with or without thrombophilia. Based on family history, clinical symptoms should begin with simple reliable inexpensive laboratory tests like prothrombin time and activated thromboplastin time to test the status. Early diagnosis and appropriate use of thromboprophylaxis lead to increasing better maternal and perinatal outcomes. Conclusively, it is important to recognize these patients in order to prevent all pregnancy complications

Comparative Evaluation of Arabin Pessary and Cervical Cerclage for the Prevention of Preterm Labor in Asymptomatic Women with High Risk Factors

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Abortions in First Trimester Pregnancy, Management, Treatment

The miscarriages’ investigation should include a familiar history, gynecological examination and a full laboratory testing including hormonal control, as well as karyotype, maternal immune control and thrombophilia testing. If the physician suspects the cause of abortions is chromosomal due to heredity, a special blood test (karyotype) for the pair is recommended. Chromosomal abnormalities are the most common reason for first trimester abortions, and are impossible to be prevented. Based on the above data, abortion and the subsequent possible infertility should not be considered as a personal failure for the woman and the treating physician. Nowadays, medical advancement provides many options combined with psychological support can actually reduce the miscarriages’ risk

Abortions in First Trimester Pregnancy, Management, Treatment

Tujuan dari penelitian: 1. Mendeskripsikan penerepan pendekatan Client Centered dalam mengatasi kepribadian introvert pada siswa kelas XI IPS MA Al Hidayah Kudus Tahun Pelajaran 2016/2017. 2. Mendeskripsikan kepribadian introvert pada konseli siswa kelas XI IPS MA Al Hidayah Kudus setelah diberikan konseling dengan pendekatan Client Centered. Pendekatan client centered adalah pendekatan yang berpusat pada diri klien, yang mana seorang konselor hanya memberikan konseling serta mengawasi klien pada saat mendapatkan pemberian konseling tersebut agar klien dapat berkembang atau keluar dari masalah yang dihadapinya. Introvert merupakan tipe kepribadian individu yang mempunyai kecenderungan menutup diri dari dunia luar. Jenis penelitian yang digunakan adalah peneltian kualitatif studi kasus. Penelitian dilakukan di MA NU Al Hidayah Kudus Tahun Pelajaran 2016/2017, dengan dua subjek penelitian (ABS, DAS). Metode pengumpulan data yang digunakan: 1. Wawancara, 2. Observasi, 3. Dokumentasi dan 4. Home Visit. Analisis data yang digunakan adalah: analisis sistem Bacon. Hasil penelitian: 1. Konseli I (ABS) faktor yang menyebabkan memiliki kepribadian intovert: 1. Tidak percaya diri. ABS yang berusia 16 tahun dan saat ini tengah duduk di kelas XI IPS MA NU Al Hidayah Kudus merasa kurang percaya diri dengan bentuk kaki yang dimiliki membuat ABS menjadi pibadi yang tidak percaya diri dalam pergaulan, sehingga membuat konseli sering mendapatkan perlakuan yang tidak menyenangkan dari siswa-siswi lain. Konseli memang terlahir dengan keadaan yang tidak sempurna karena cacat fisik pada salah satu kakinya atau yang biasa disebut sebagai (Clubfoot) atau kaki pengkor. 2. Perlakuan diskriminasi. Karena bentuk fisik yang dimiliki oleh konseli yang berbeda, konseli mendapatkan perlakuan diskrinasi dari siswa-siswi lain. 2. Konseli II (DAS) faktor yang menyebabkan konseli memiliki kepribadian introvert: 1. Rendahnya kemampuan interaksi konseli. Konseli sering berpindah tempat tinggal sejak usia sekolah dasar membuat kemampuan interaksi DAS kurang. Di sekolah, konseli banyak diperhatikan oleh siswa-siswi di sekolah karena secara fisik DAS merupakan siswa yang berpenampilan menarik. Tetapi kurang interaksi sosial, konseli lebih banyak memilih menyendiri dan tidak terlihat aktif dalam hubungan pertemanan yang sering terjalin pada anak usia sekolah atau remaja awal. 2. Perceraian kedua orang tua konseli. Perceraian yang ditimbulkan karena keuangan keluarga yang memburuk membuat konseli harus bekerja keras untuk membiayai sekolahnya semakin membuat konseli tidak memiliki waktu untuk bersosialisasi dengan teman sebayanya. Setelah pelaksanaan tiga kali konseling client centered terhadap kedua konseli diperoleh keterangan bahwa, konseli I (ABS) telah mampu menerima kekurangan dirinya yang memiliki keterbatasan pada kakinya. ABS telah percaya diri dan mampu bersosialisasi dengan baik. Konseli II (DAS) telah menyadari bahwa kehidupan yang ia alami harus tetap berjalan, dan DAS juga telah memahami bahwa makna kehidupan adalah terus bekerja dan bahagia atas apa yang dimilikinya sekarang. Berdasarkan kesimpulan di atas peneliti dapat memberikan saran: 1. Kepala sekolah: Dalam penelitian ini menunjukkan bahwa konseling individual sangat membantu siswa dalam memberikan mengatasi perilaku introvert siswa. Sehingga diharapkan kepala sekolah dapat mendukung adanya layanan konseling indivual ini dengan memfasilitasi guru pembimbing dalam memberikan layanan konseling individual. 2. Guru bimbingan dan konseling: Diharapkan guru bimbingan dan konseling dapat menjadikan hasil penelitian sebagai acuan dalam memberikan pelayanan konseling individual dengan konseling client centered. 3. Siswa: Diharapkan siswa dapat bergaul dengan baik dan semakin meningkatkan hubungan interpersonal. 4. Penelitian selanjutnya: Diharapkan peneliti selanjutnya dapat mengembangkan penelitian yang sejenis dengan menggunakan layanan konseling yang lebih varatif, sehingga didapatkan komparasi yang berbeda dengan penelitian ini

Vein Thrombosis Risk in Women and Travel

Deep vein thrombosis (DVT) of the lower limbs is a serious condition that can lead to pulmonary embolism (PE) in about 15–24% of cases. If it is not diagnosed/treated timely, nearly 15% of these PE are lethal. The relationship between travel and staying in the same position for a long time is well-known since World War II. Generally, it is more frequent in air flights. It is also associated with the economic downturn in airplanes because passengers have limited space and have greater difficulty of moving. It is estimated that approximately 1–6% of long-haul passengers arrive at their destination with a clot in their veins, but most DVT are asymptomatic

Cervical Length and Perinatal Outcome

Prematurity nowadays has taken on significant dimensions. It is a complex medical issue with socio-economic consequences. The estimation of cervical length, assessed during the second trimester of pregnancy, using transvaginal ultrasound, may help to reduce rates of prematurity. By predicting the risk of preterm birth and identifying women who are at high risk of preterm birth, certain practices could be implemented, such as the use of progesterone or cerclage placement. Nonetheless, it remains unsolved the question of certain strategies, such as the use of progesterone in pregnant women with shortened cervical lengths. This work examines the relationship of cervical length during pregnancy to the perinatal outcome

Emergency Contraception. Literature Review. Experience in a Greek Center. Greece Used Methods

The sexual liberation of women can now be taken for granted, and access to information is particularly easy, but even today there is still many lack of information about contraceptive methods. No method of contraception has a 100% guaranteed result as success depends on many factors such as faithful adherence to the instructions of family planning centers, age of the woman, the frequency of the sexual act, and of course the type of contraception. Emergency contraception refers to any method of contraception used after intercourse and before implantation. It differs from the medical termination of pregnancy, which has 75–89% effectiveness and copper IUDs. Contraception is used to stop the sperm from fertilizing the egg or to stop the fertilized egg from implantation in the uterus. All contraceptive methods require educational awareness and emergency contraception should not be used as normal contraceptive treatment. It does not fall into the sphere of moral dilemmas if it is taught correctly at the levels of primary and secondary education and in the family sphere. Undoubtedly, the organization of family planning centers for women of reproductive age as well as for teenagers is deemed necessary and should become a priority of every government

Vaginal Seeding in Term Cesarean Section Is a Mandatory Condition for Improvement of Neonatal Health

The human vaginal microbiota is an important component of the defense system to fight microbial and viral infections. During pregnancy, a significant decrease in overall diversity is observed in the vaginal flora, and there is an increase in stability as the composition of the vaginal flora changes gradually. These alterations are linked to a decrease in vaginal pH and an augmentation in vaginal secretions. The composition of the vaginal microbiome changes according to gestational age, with its composition in advanced weeks of pregnancy resembling that of nonpregnant women. There is supporting evidence for the existence of differences in the neonate’s microbiome between those born via C-section and those delivered vaginally. The evidence suggests that this difference is a result of the changes that occur in the mother’s microbiome, particularly in the vagina. The vaginal microbiome serves as a crucial barrier between the external environment and the intra-amniotic cavity. The vaginal microbiome appears to play a significant role as an additional defense mechanism of the mother and, consequently, the fetus. Any abnormalities in this microbiome can potentially impact the pregnancy and perinatal outcome