Recent Advances in Adolescent Health Dilip Kumar Dutta, Roza Olyai
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1RECENT ADVANCES IN ADOLESCENT HEALTH
“Knowledge is as wings to man's life, and a ladder for his ascent. Its acquisition is incumbent upon everyone. The knowledge of such sciences, however, should be acquired as can profit the people of the earth, and not those which begin with words and end with words…”
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3RECENT ADVANCES IN ADOLESCENT HEALTH
Editors Roza Olyai MS MICOG FICMCH FICOG National Chairperson, Adolescent Health Committee, FOGSI (2009-2011) National Trainer, Adolescent Health, FOGSI-IMA-IAP and WHO WHO Consultant, Expert Panel ASRH, WHO – Geneva (2010) Convener, Adolescent Friendly Health Centers, India Olyai Hospital, Hospital Road, Gwalior, Madhya Pradesh, India Dilip Kumar Dutta MD PhD MAMS FICOG FIMCH MAAGL MAFS Dip in High High Risk Pregnancy (USA), Dip in Pelviscopic Surgery (Germany) Vice President, FOGSI (1997-98) Chairman, Safe motherhood committee, FOGSI (1998-2002) Chairman, Adolescent Committee, ISOFERB (2005-2007) Director, GICE Hospital Kalyani, Nadia, West Bengal, India Foreword Hamid Rushwan
------------A FOGSI Publication------------
4Published by
Jaypee Brothers Medical Publishers (P) Ltd
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4838/24, Ansari Road, Daryaganj, New Delhi 110 002, India
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Recent Advances in Adolescent Health
© 2011, Federation of Obstetric and Gynaecological Societies of India
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher.
This book has been published in good faith that the material provided by contributors is original. Every effort is made to ensure accuracy of material, but the publisher, printer and editors will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only.
First Edition: 2011
9789350252277
Typeset at JPBMP typesetting unit
Printed at
5Dedicated to
Late Prof Dr (Mrs) Perin Olyai
Professor Emeritus Ex Head of the Department of Obstetrics and Gynecology Gajra Raja Medical College, Gwalior, Madhya Pradesh, India For her genuine love and dedication towards service to humanity
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7CONTRIBUTORS
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Foreword
I am delighted to introduce the superb work Recent Advances in Adolescent Health, a publication from the Adolescent Health Committee of FOGSI.
It provides the very latest update on this critical and highly topical issue, of enormous relevance to gynecologists and obstetricians worldwide.
The International Federation of Gynecology and Obstetrics (FIGO), of which I am the Chief Executive, recognizes that the area of Adolescent Sexual and Reproductive Health (ASRH), especially in low- and middle-resource countries, is a matter of concern for all those working within our profession.
FIGO has long been involved in highlighting the complexities and challenges of ASRH; its specially commissioned studies have been the inspiration behind several recent ground-breaking FIGO ASRH Workshops, funded by the United Nations Population Fund (UNFPA), including one held in Bengaluru, India last April. These popular, highly successful events have been bringing together committed representatives from numerous countries for an opportunity to focus and collaborate on how national professional organisations and national member associations can contribute effectively in the promotion of ASRH.
The eventual findings have provided much food for thought: It is clear that there are notable health and social challenges facing youth of all countries, and it is time to improve our understanding of them, and to focus our energies on the alleviation of these problems. Obstetricians and gynecologists, through their national associations and through FIGO at the international level, have an important role to play in the advancement of ASRH services.
FOGSI's production of this succinct and timely publication ensures that the Society—a longstanding and important FIGO member, is at the very forefront of professional analysis and debate. The launch at the prestigious All India Congress will ensure that the book's contents receive a wide and appreciative audience. I have no doubt that it will be an invaluable point of reference in the future for everyone connected to, and interested, in this fascinating area of health.12
Dr Roza Olyai (Chairperson of FOGSI's Adolescent Health Committee) and Dr Dilip Kumar Dutta; in their respective roles as Editor and Co-Editor, have done a commendable work in bringing this valuable project to fruition.
My very best wishes.
Hamid Rushwan md, frcog
Chief Executive
International Federation of Gynecology and Obstetrics (FIGO)
United Kingdom
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Message from the desk of President, FOGSI
Adolescence is a period of transformation from childhood to adulthood and is a phase which demands specific attention and intervention. The conventional medicine curriculum has not been able to provide as yet with a specific reference to this particular age group and many a clinician is found wanting for a ready reckoner for understanding the reproductive needs of this age group.
Targeting this age group with awareness and early corrections of matters related to Adolescent Sexual Reproductive Health issues would help us yield a healthy society and empowered youth ready to face the challenges of life further on. I congratulate Dr Roza Olyai for her efforts in bringing out this book which I am sure will help the reader profoundly in clinical practice. I wish this endeavor a great success and may it fulfill the goals for which it was created.
Dr Sanjay Gupte
President FOGSI
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Message from the Desk of Secretary General, FOGSI
It is indeed a matter of pride for FOGSI that the much-awaited book “Recent Advances in Adolescent Health” is being published under its banner. If you are looking for complete information on various physiological and pathological aspects of an adolescent, here is one. It is a complete package of knowledge on Adolescent health put together for the reader. Adolescent health is an important topic especially in a country like ours where not much is discussed or written about it in depth.
I congratulate Dr Roza Olyai, Chairperson of Adolescent health committee of FOGSI and editor of this publication as well as Dr Dilip Kumar Dutta, co-editor of this work, for bringing out an interesting and informative book for not only obstetricians and gynecologists but also for all interested in improving the health of younger generation of the world.
Dr PK Shah
Secretary General
FOGSI
15Preface
It gives us great pleasure to share with you the book, Recent Advances in Adolescent Health.
Adolescents experience many challenges in their sexual and reproductive lives, therefore, appropriate and timely specialist advice and care can do much to alleviate problems and misconceptions, and enable young people to move forward with their lives in confidence. Not many doctors are familiar with the delicacy and sensitivity an adolescent girl needs to be treated with as she needs special attention and a quiet, friendly environment.
The Adolescent Health Committee of FOGSI aims to achieve this task by establishing Adolescent Friendly Health Centers. Our mission is to sensitize the youth of our country, through various projects we will be dealing in different aspects of health, i.e. physical, mental, social, spiritual, reproductive and sexual health and well-being, throughout their lives.
We aim to “help young people form a strong moral identity in their early adolescent years and empower them to contribute to the well-being of their communities…”
Disseminating knowledge and helping our adolescents to be empowered has been the goal of the Adolescent Health Committee, FOGSI and one such endeavor would hopefully reach to our colleagues through this book. We have selected different topics related to ASRH for the interest of our readers who will invariably face the dilemma of counseling the young adolescents and relieving them of the stress related with their normal pubertal changes. The preventive health section covers the social aspect of health as not many doctors will be well-versed in treating difficult adolescents, peer pressure and introducing life skills to them.
Teenage pregnancy has its own complications and knowledge about contraception is lacking amongst the adolescents which is a major cause of concern globally with complications of unsafe abortion.
Premarital counseling, vaccines and knowledge about STDs are important aspects of reproductive sexual health. Menarche at early age and ovarian tumors are cause of concern not only to the adolescents but to their mothers as well, hence a special section will deal with this area. To update our knowledge and learn about laparoscopic and robotic surgery will be a delight for our readers as these are upcoming recent trends in adolescent gynecology.
For further enhancement of knowledge on adolescent issues, you may kindly visit the website: http://adolescenthealthindia.org/
Roza Olyai
Dilip Kumar Dutta
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17Acknowledgments
We are specially honored that Prof Hamid Rushwan, Chief Executive, International Federation of Gynecology and Obstetrics (FIGO), UK has graciously consented to write the foreword.
We are thankful to Dr Sanjay Gupte, President FOGSI and Dr PK Shah for their support and encouragement by sharing their message with our readers.
We would like to thank all our contributors for their generous contribution towards this book. We have selected contributors from different parts of India and from abroad from various specialties and organizations.
We are very grateful to Jaypee Brothers Medical Publishers (P) Ltd for publishing this book and help spread the message. We would also like to thank Mr Narendra Katore for designing the cover page.
Last but not least, we are greatly indebted to our parents who have given us the courage to face challenges of the world by inculcating good attributes in us, to our spouses and children for their tolerance and understanding of the time away from them during our own careers and in editing this book and being the backbone to our progress.