Study of adolescent clinic: holistic approach for women health with dual client methodology

Background: The study is done to understand the gynaecological problems in adolescent girls. Do counseling, imparting knowledge for the girl and her mother, hence creating a holistic approach towards the women health in the family by dual client approach.Methods: 400 adolescent girls attending the clinic were studied (prospective observational study). Hb%, S.TSH was done for all the girls. Ultrasonography abdomen and pelvis was done on patient basis. Treatment was given. Mothers were counseled regarding their gynecological issues and screening tests (pap smear, self breast examination) was done after taking consent.Results: 70% girls had menstrual disturbances, 20% had complains of vaginal discharge. 44% had anemia (4% had severe anemia). Subclinical hypothyroidism was detected in 8% of cases. Ultrasonography was done in 52% of cases in which 81 patients had features suggestive of polycystic ovaries. 85.5% of the adolescent girls were accompanied by their mothers. 12% girls took HPV vaccination and 52% mothers underwent pap smear.Conclusions: Teenage problems need to be dealt very sensitively. Counseling is an integral component of treatment strategies. At present, adolescent gynaecology remains an area to which increased awareness and greater attention should be given to promote the health of teenagers and incult healthy lifestyle practices. In the same set up even the mothers of girls can be given counseling and address their gynaecological issues as majority of times mothers are the accompanying person creating the dual client approach in one setting. Hence adolescent clinic should aim for holistic, dual client approach for improvement of overall women health in the family

Breast feeding knowledge, attitude and perspective in immediate postnatal mothers

Background: The aim of the study is to understand the knowledge, attitude and practice of breastfeeding among postnatal mothers and optimize the breast feeding practices and overcome various factors that hinder and influence the full realization of benefits of breast feeding.Methods: The study was conducted in the postnatal ward of Rajarajeswari medical college and hospital, Bangalore. 500 postnatal mothers were included. A structured interview schedule was prepared to collect sociodemographic data, perceptions, knowledge, attitude and practices of mothers regarding breastfeeding. Data was collected by interviewing mothers (in their own language) using proforma.Results: About 100% of mothers and newborn infant have skin to skin contact within one hour of an uncomplicated vaginal delivery. Majority of the mothers knew about the importance of breast feeding for babies and herself. Only 17% of the mothers were working in our study and majority of them had resigned from their work as there was no option of maternity leave and baby friendly work environment at their working places. 69% intended to breastfeed up to 6 months. 23% mothers discarded colostrum and 11% gave prelacteal feeds to their babies.Conclusions: The mothers should be encouraged and reinforced about the benefits of breastfeeding for both baby and herself. The workplace condition has to be improved and make it more breast feeding friendly. The study also will assist the health care providers and community workers to understand the attitude and practice in the area and help them to prioritize and focus on these aspects and decrease the incidence of suboptimal feeding practices

Thrombocytopenia in hypertensive disorders of pregnancy

Background: Thrombocytopenia is defined as a platelet count of less than 150×103 μl. It is commonly diagnosed and has attracted more interest from researchers during recent years, especially in Hypertensive disorders of pregnancy. This study was done to estimate the incidence of thrombocytopenia in pregnant women diagnosed with hypertensive disorders of pregnancy and to correlate its severity with the degree of thrombocytopenia.Methods: In the study 150 women admitted in the OBG Department at Rajarajeswari Medical College and Hospital, Bengaluru during August 2015-August 2016 were included. Hypertensive disorders of pregnancy cases were classified into: Gestational hypertension, mild preeclampsia, severe preeclampsia, haemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome and eclampsia. The incidence and severity of thrombocytopenia along with maternal and foetal complications encountered in the five groups were analysed. Data were arranged in Microsoft Excel version 2010, and statistically analysed by SPSS version 23.Results: Preeclampsia- mild (29.25%) and severe (22.5%), accounted for most of the cases followed by eclampsia (3%) and gestational HTN (1.5%). Among these hypertensive patients, mild thrombocytopenia was noted in 60 cases (40%), moderate thrombocytopenia 48 (32%), severe thrombocytopenia 12 (8%), and normal platelet counts 30 (20%) were noted. Poor maternal outcome was seen 10.67% cases due to HELLP syndrome and postpartum haemorrhage. Poor foetal outcome was seen in 16% cases due to intrauterine growth restriction and perinatal mortality.Conclusions: Hypertensive disorders of pregnancy is recognized as a major cause of gestational thrombocytopenia. Careful follow up during and after pregnancy is recommended

Thrombocytopenia in hypertensive disorders of pregnancy

Background: Thrombocytopenia is defined as a platelet count of less than 150×103 μl. It is commonly diagnosed and has attracted more interest from researchers during recent years, especially in Hypertensive disorders of pregnancy. This study was done to estimate the incidence of thrombocytopenia in pregnant women diagnosed with hypertensive disorders of pregnancy and to correlate its severity with the degree of thrombocytopenia.Methods: In the study 150 women admitted in the OBG Department at Rajarajeswari Medical College and Hospital, Bengaluru during August 2015-August 2016 were included. Hypertensive disorders of pregnancy cases were classified into: Gestational hypertension, mild preeclampsia, severe preeclampsia, haemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome and eclampsia. The incidence and severity of thrombocytopenia along with maternal and foetal complications encountered in the five groups were analysed. Data were arranged in Microsoft Excel version 2010, and statistically analysed by SPSS version 23.Results: Preeclampsia- mild (29.25%) and severe (22.5%), accounted for most of the cases followed by eclampsia (3%) and gestational HTN (1.5%). Among these hypertensive patients, mild thrombocytopenia was noted in 60 cases (40%), moderate thrombocytopenia 48 (32%), severe thrombocytopenia 12 (8%), and normal platelet counts 30 (20%) were noted. Poor maternal outcome was seen 10.67% cases due to HELLP syndrome and postpartum haemorrhage. Poor foetal outcome was seen in 16% cases due to intrauterine growth restriction and perinatal mortality.Conclusions: Hypertensive disorders of pregnancy is recognized as a major cause of gestational thrombocytopenia. Careful follow up during and after pregnancy is recommended