Medical and Legal Aspects of Child Sexual Abuse : A Population-Based Study in a Hungarian County

Background: Very few studies focus on childhood sexual abuse in middle European countries. Aim: The purpose of our study is to describe the medical and legal characteristics of children who experience sexual abuse and explore common features that may result in strategies for prevention. Methods: Between 2000 and 2015, 400 girls and 26 boys under the age of 18, suspected of being sexually abused, visited one of the four hospitals in a Hungarian county. Results: Mean age at onset was 10.81 years for boys, 13.46 years for girls. In 278 cases (65.3%), the perpetrator was known to the victim, and a stranger was suspected in 148 cases (34.7%). In 79 cases (30.7% of boys and 17.7% of girls), a family member was the accused perpetrator. In more than one-third (boys) and in one-fifth (girls) of cases, sexual abuse had occurred on multiple occasions. In the case of boys, child and adolescent sexual abuse (CSA) included oral genital, genital touching and genital to genital contact in 14 cases (53.8%) and anal intercourse in 12 (46.2%) cases. In case of girls, sexual abuse included coitus in 219 (54.8%), oral genital, genital touching, genital to genital contact in 164 (41.0%), anal abuse in 14 (3.5%) cases, physical injury was incurred in 15 cases. Legal proceedings followed the CSA in 205 (48.1%) cases. Conclusion: The results highlight the urgent need to address the issue of sexual abuse in Hungary and minimize its impact. Prevention requires a systematic and lifelong approach to educating children about personal space safety and privacy to reduce vulnerability and is the responsibility of parents and professionals

Tranexamic Acid (TXA) for the Hemostatic Treatment of Post-Partum Hemorrhage (PPH): What Key Points Have We Learnt After All These Years?

Post-partum bleeding or post-partum hemorrhage (PPH) is often defined as the loss of more than 500 mL of blood after vaginal delivery or 1000 mL of blood after cesarean section following the delivery of a child [...]

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

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

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

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

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