European Journal of Cardiovascular Medicine

Introduction: The cerebellar mutism syndrome is a neurological condition which has been seen in children and only rarely described in adults after surgery of the posterior fossa. It usually appears as a consequence of posterior fossa surgery in children with cerebellar or fourth ventricle tumors. Objectives: It is a case report of an adolescent girl from Bangladesh presenting with postoperative cerebellar mutism. Case: The 15-year-old young, student initially presented with headache of raised intracranial pressure due to obstruction. She developed mutism on the second postoperative day following Surgery for astrocytoma of fourth ventricle. By the second and third post- operative day, her responses to query had almost stopped, but to persistent queries she gave a single word response and it was restricted to either ‘yes’ or ‘no’. She remained silent and kept her eyes closed most of the time and cried for any attempts to wake her. She had mood instability with sudden unprovoked laughter followed by cry. She ate what she was fed and did not have any difficulty swallowing. Conclusion: To the authors’ best knowledge, this is first case report of the cerebellar mutism in Bangladesh which would help the clinicians to deal with syndrome

Background : The dual forms of malnutrition is characterized by the coexistence in a population of underweight and overweight. In India evidence suggests presence of both forms of malnutrition not only in adults but also in adolescents. The present study was done in Ghaziabad with an aim to gauze the presence of both forms in adolescent going to schools. Methodology - The present cross-sectional survey was conducted among 1128 school-going adolescent students (10–19 years) in Ghaziabad district of Uttar Pradesh. Multistage sampling technique was used to study 1128 study population. Anthropometry and a structured questionnaire were used as study tool. Results- The most frequently reported dietary deficiency was underweight at 21.6 percent, followed by overweight at 10.7 percent and obese at 9.5 percent. (3.6 percent).We had 620 boys and 508 girls as participants in our study sample.We found 35% of adolescents as having both forms of malnutrition. Conclusion- Our study highlights the presence of both forms of malnutrition among adolescent school going population. Our study also reinforces the latest trend in adults in country which might be a continuation of the features of malnutrition in both forms found. Adolescence is the future also for coming adults in country and if we have more number of adolescents malnourished we will have more problems due to the number of health and other issues malnutrition poses at all ages

Introduction: The face extends on each side to the auricle, superiorly from an adolescent portion of the hairline and inferiorly to the chin and the base of mandible. The facial appearance determines the well being of the human psyche and self-regard. Diseases on the face have become misery, as in most societies, face is the natural body part that is visible. The facial skin differs markedly from the skin of the other regions of the body, which makes the significant reasons for the unique nature of facial dermatoses. This makes the facial dermatoses stand apart from both in terms of the clinical presentation as well as a therapeutic approach

Introduction Asthma is a long-term condition affecting children and adults. The air passages in the lungs become narrow due to inflammation and tightening of the muscles around the small airways. This causes asthma symptoms such as cough, wheeze, and shortness of breath and chest tightness. It can be difficult to coordinate breathing using an inhaler, especially for children and during emergency situations. The assessment of asthma control has become pivotal in the management of asthma. However, several surveys in developed nations have shown that the majority of patients with asthma do not enjoy adequate asthma control. This is not because asthma control is unrealistic and not achievable; the multicentre, multinational study of asthma management, the Gaining Optimal Asthma control (GOAL) study, has shown that well-controlled asthma is achievable in the majority of patients.  Materials and Methods: This is a descriptive and cross-sectional study to assess the levels of asthma control among adult patients attending Tertiary Care Teaching Center. The study used those (physician-diagnosed asthma patients) participants who volunteered. There is a causality department where patients presenting with acute asthma attack are managed. Complicated cases of asthma including status asthmaticus are managed in the high dependency unit. Results: Prevalence of bronchial asthma in adolescents was 13.1% (n = 110) of which 10.2% had episodes in the past 1 year. Prevalence was higher among males (6.23%) compared to females (3.94%). About 79.1% of total asthmatics were newly diagnosed cases. Prevalence was significantly higher among those having pets at home (P < 0.001), belonging to higher socioeconomic status (P = 0.021), using smoke producing fuel at home (firewood/cow dung/kerosene; P = 0.021), and with history of smoking among family members (P = 0.027). Among current asthmatics, 71.8% reported cold/rhinitis (51.3% in March–May duration), 59.1% nocturnal dry cough, 48.2% sleep disturbances, and 42.7% speech disturbances in the past 1 year. Discussion: In our study we found, there is significant increase in weight, BSA, BMI, where as significant decrease in DBP of diabetic group compared to Non-Diabetics & there is significant increase in FBS, HbA1C levels of Diabetic group significant decrease in LH levels of Diabetics compared to Non-Diabetics. However T3 levels of Diabetic and Non-Diabetic group were almost same, where as T4, Oestradiol and progesterone levels of diabetic group non-significantly increased and FSH and TSH levels non-significantly decreased in Diabetics. There is frequent co-existence of thyroid dysfunction and diabetes mellitus among post menopausal diabetic women. Conclusion: We estimated the global prevalence of ACO based on population-based studies and found that 2.0% of the general population is affected. However, the prevalence of ACO depends on its diagnostic criteria. Therefore, there is a vital need to better define the ACO diagnostic criteria, management and treatment. It is worth noting that the limitations of the present study include lack of studies in some region of the world and small number of studies included in the subgroup analyses

Background: The number of adolescents in India are 250 million and are a significant proportion to the Indian population. Increase in the addictions, both in terms of behavioral and non-behavioral addictions leading to lot of changes in the attitudes of the adolescents resulting in aggressive and some times violent behaviour which is detrimental to the future of the individual and also to the societies as a whole. Methodology: It is an institution-based study in southern part of India, conducted among 500 adolescents in the schools and colleges of Rajahmundry city, East Godavari district, Andhra Pradesh. The Aggression scale and socio demographic details and other factors are obtained from the adolescents Results: 26 (5.2%) members showed aggression and factors like gender, type of school or college, residential status and Socio-economic status were significantly associated with Aggressive behaviour

Background: This prospective study aimed to assess the clinical and demographic profile of adolescent poisoning cases admitted to the Department of Pediatrics at HIMS Hassan, India. Methods: A total of 105 patients aged between 10 and 17 years were included in the study, with data collected regarding their clinical-demographic profile and consumption details.  Results: The majority of cases were female (79%) and from a rural area (63.8%). In terms of socioeconomic status, the largest proportion of cases were from the upper lower class (32.3%). Insecticide (26.6%), rat paste (13.3%), acid (11.4%), and tablet consumption (24.7%) were the most common poisons consumed by the adolescents. Suicidal consumption accounted for 85.7% of cases, while 14.2% were accidental. Regarding treatment, 80% of patients received supportive and symptomatic management, while 20% received a specific antidote. Conclusion: The study provides valuable information about the clinical and demographic profile of adolescent poisoning cases in India, which can be used to inform prevention and management strategies.

Background In this study, we wanted to assess the menstrual awareness among urban and rural adolescent girls and compare the menstrual hygiene practices among them. Methods This was a hospital based cross-sectional study conducted among 170 adolescent girls attending the OPD of Gynaecology, Paediatrics and General Medicine at Government Medical College, Thrissur District, Kerala. It was carried for a period of one year after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. They were provided with a validated questionnaire to assess menstrual awareness hygiene practice among them. Results Majority (89.4%) from the urban area of residence believed that it was physiological, while majority (54.1%) from the rural areas didn’t know the actual cause for menstruation. This difference between the rural and urban areas on awareness about the cause of menstruation was found to be statistically significant. More than half of the subjects used sanitary pads during menstruation. The frequency of changing pads at school was less in both urban and rural groups. The reusage of pads was almost similar among rural and urban study subjects with around 23.5% and 22.4% of them reusing the pads respectively in both the groups. Awareness regarding menstrual cup was more in urban group compared to rural. But restrictions during menstruation was practised more in rural group that is 70% compared to urban group which was roughly 52%. Conclusion Menstrual health forms the most important stepping stone to women’s sexual and reproductive health. One third of the study population was not at all aware of the cause of menstruation. There was significant difference in various menstrual hygiene practices among urban and rural girls. Many restrictions were practiced during menstruation more in rural group. A concerted effort from parents, educational institutions and existing healthcare institutions along with media may ensure safe and secure reproductive health prospects for adolescents in the region.

Background: Alopecia areata is a common cause of non-scarring alopecia of hair characterized by single or multiple patches of hair loss.  It is an autoimmune disease with an unpredictable course and has a profound impact on the psychosocial well-being of the patients. Aims: Our present study aimed to assess the demographic pattern, clinical patterns, and associations with diseases in a tertiary care teaching hospital in Bihar. Materials & methods: All patients diagnosed with alopecia areata visiting dermatology opd and fulfilling the inclusion criteria were included in the study. A detailed history-taking and clinical examination was conducted and recorded in a predefined performa. All routine blood and radiological investigations, dermoscopic and histopathological examination in doubtful cases. All data were recorded and analyzed with Descriptive statistics and Chi-Square Test. Analyses of collected data were done by SPSS software, version 18.0. Results: A total of 82 patients suffering from alopecia areata were included in our study. 53(64.6%) patients were male and 35(29%) were female. The male-female ratio was 1.5. Classical alopecia areata was the commonest (87.8%) variant noted. Alopecia totalis (6.1%), alopecia universalis (3.6%), and ophiasis pattern (2.4%) were also identified. Scalp (67.3%) was the commonest site involved. Majority of our patients presented to us within 6 months of disease onset. 23 patients (28%) had nail involvement. In our study, Atopy was the most common condition associated condition seen in 10.8 % of cases followed by vitiligo in 4(4.8%), leucotichia in 2(2.4%), lichen planus in 3(3.6%), androgenic alopecia in 4(4.8%) and verruca in 3 (3,4%) cases. Ocular changes were present in 11(13.4%) cases. Conclusion: Alopecia areata mainly affects young and adolescent age group patients. Poor prognostic factors are extensive involvement, early age of onset, and positive family history. The scalp region is most commonly involved. The most common associated condition noted was atopy.

Background. ECG is a simple non-invasive tool for assessing prognosis in the Adult Sickle cell anaemia patient as pathological changes occur early in adolescents. It is suggested that ECG should be done annually for SCA   patients and those with LVH should be placed on primary prophylaxis. Aims and Objective: This study was undertaken with an aim to ascertain the electrocardiogram analysis in adult patients with sickle cell anemia and without sickle cell anaemia Methodology. In this case control, cross sectional study 60 sickle cell patients from study and control group attending the medicine OPD were confirmed by HPLC analysis by using D-10TM Dual HbA2/F/A1c 220-0201kit. Anthropometric parameters like age, weight, height, BMI, sex and medications of all patients were taken. A 12 lead ECG was recorded on all subjects, speed of a paper was 25 mm/sec and standardized at 0.1mv/mm. A single observer was analysed the ECG. The Heart rate, Cardiac Axis, PR interval, QRS duration and QTc interval were measured. The dispersion of P-wave, QRS and QTc intervals were measured manually. ST-segment was taken as the interval between the j point (or end of the ORS complex) and the beginning of the T wave. Elevation or depression of the ST-segment by 2mm or more the isoelectric line was considered abnormal. The Data was analysed by using EPI Info 7. Result. HPLC analysis confirmed 60 adult patients with Hb SS SCA had a mean age of 20±4.6. The SCA patients matched the control group in and sex, with a higher preponderance of males of 62% in both groups. SCA patients had body surface area and BMI compared with control patients of 1.19±0.01 versus 1.53±0.03 (p less than 0.01) and 20.2±1.5 versus 26.4±2.7 (p less than 0.001), respectively. The biochemical analysis in the SCA group compared with the control group are Ferritin 382.38±94.4 versus 84.1±9.3 ug/L, Hemoglobin 7.5±0.9 versus 12.19±1.6 g/dL, Reticulocyte 4.34±0.6 versus 2.52±0.3%, Vitamin D3 44.6±4.9 versus 75.3±7.1 and LDH 272.9±50.97 versus 154.5±41.6 0.1 mmol/L for each 5 g/L (p less than 0.01).  The mean QTc interval of SCA patients was 0.38±0.035 seconds and controls 0.37±0.02 seconds (p=0.123). The mean PR interval of SCA was 0.186±0.06 seconds and controls 0.169±0.036 seconds (p=0.369). the mean QRS duration of SCA was 0.07±0.09 and controls 0.043±0.14 seconds (p=0.055). Conclusion. Sickle cell anaemia is associated with significant electrocardiographic abnormalities.  Cardiac abnormalities particularly pulmonary and diastolic left ventricular dysfunction have been to be risk factors in sickle cell anaemia. The study should stimulate the use of ECG to assess adult SCA patients for early intervention to prevent cardiac events.

Background: Type I Diabetes Mellitus is the most common endocrine-metabolic disorder of childhood and adolescent. Diabetic ketoacidosis is a potentially life-threatening complication among children, characterized by triad of hyperglycemia, ketosis and academia, accounting for majority of hospital admissions and deaths related to Diabetes in children.  Early diagnosis and prompt management substantially reduces the mortality. Objectives: This study was done to evaluate clinical profile, severity, complications and immediate outcome of patients admitted in PICU with Diabetic Ketoacidosis. Results: Out of 30 children included in our study, 70% were females(n21) and 30% were males(n9). Newly diagnosed diabetics accounted for 17 (56.5%) of the patients. The common presenting complaints of DKA in our study was altered sensorium (100%), rapid breathing (93%), vomiting (80%) and abdominal pain (73%) followed by polyuria (63%), polydipsia (60%), weight loss (50%) and fever (40%). Amongst all 30 cases, 20 patients (66%)had moderate dehydration meanwhile 10(33.3%) had severe dehydration. Complications like Hypokalaemia (20%), other electrolyte imbalance (16%) like hypocalcaemia, hyponatremia, superadded infection (26%) like upper and lower respiratory tract infection, acute febrile illnesses were commonly encountered in our study and 11(36%) cases of DKA were not associated with any complications. Out of 30, 5 (16%) children had mild DKA, 13(43%) children had moderate DKA and 12 (40%) children have severe DKA. In our study, all patients recovered and were shifted to ward with mortality of 0%. Conclusion: DKA was most prevalent in newly diagnosed IDDM cases. Infections was the most common precipitating factor. No lethal complications were recorded in our study.

Background: Cannabis is the generic word for all psychoactive preparations of the Cannabis sativa plant. Delta-9 tetrahydrocannabinol (THC) is the main psychoactive component in cannabis. Cannabis is one of the most often used illegal substances in the world. Cannabis is the fourth most prevalent psychoactive substance in the world, behind coffee, nicotine, and alcohol, with an estimated 200 to 300 million regular users. Objectives: 1. To evaluate sociodemographic profile among persons abusing cannabis. 2. To evaluate problematic domains among persons abusing cannabis. 3. To evaluate withdrawal symptoms among persons who abstain from cannabis. 4. To estimate the distribution of psychiatric comorbidity among persons abusing cannabis. 5. To estimate sociodemographic variables and psychosocial attributes between adolescent and adult-onset of cannabis use. Material & Methods:Study Design:  Hospital based prospective cross-sectional study. Study area:Manasa Psychiatry Hospital, Secunderbad, Telangana. Study Period: August 2022 – August 2023. Study population:  Participants were patients diagnosed with cannabis use disorders who came to the Psychiatry Department. Sample size: Study consisted a total of 40 subjects.  Sampling Technique: Convenience sampling. Study tools and Data collection procedure: After obtaining the written consent from the participants as required by the international ethics committee the following questionnaire was given to all subjects 1. Semi-structured proforma 2. Marijuana problem scale 3. The Cannabis withdrawal scale 4. MINI PLUS structured clinical interview. Results: In our study, those who seek cannabis-related problems were predominantly male i.e. 100%. No females registered for cannabis-related problems during our study period. 75% of people were below 10th standard. 80% of individuals with CUDs were unmarried. 30% were unemployed among persons who presented with CUDs. 92.5% of patients belong to low socioeconomic status. 90% of patients belong to Hinduism. 72.5% of patients belong to urban areas. In our study statistically significant difference in marital status and religion i.e., most of the adolescent-onset cannabis users were unmarried and Hindus. But occupation, place, SES there was no significant difference between these 2 groups. Conclusion: Psychiatric comorbidity is widespread in people who are addicted to cannabis, especially those who seek treatment. Cannabis withdrawal symptoms worsen as the length of cannabis addiction grows. The most common associations with cannabis abusers are comorbid other substance use and a family history of substance use. Adolescents who start using cannabis have lower levels of psychosocial characteristics such as impulsivity, drug-using peer relationships, drug availability in the neighbourhood, and skipping school or job than those who start using cannabis in early adulthood.

Background: Menstrual hygiene is a crucial aspect of adolescent health, impacting the well-being and dignity of school girls. In central Haryana, where a significant population of adolescent girls resides, there is a need to understand the knowledge, attitudes, and practices of school girls regarding menstrual hygiene. This study, conducted among 200 adolescent school girls, aims to fill this gap by assessing these factors and providing insights for targeted interventions. Methods: A cross-sectional study was conducted among 200 adolescent school girls aged 10-18 in central Haryana from 2020 to 2021. A self-designed questionnaire was administered to collect data on socio-demographic characteristics, knowledge, attitudes, and practices related to menstrual hygiene. SPSS version 24 was used for data analysis, employing the Chi-square test to identify associations between variables. Results: The study revealed that, among the 200 adolescent school girls in central Haryana, 68.3% considered menstruation a normal process, while 46.7% had good knowledge scores. However, concerning percentages, 30.8% were uncertain about menstrual blood hygiene, and 53.3% were categorized as having poor knowledge. Addressing these knowledge gaps is crucial for promoting menstrual hygiene and the well-being of school girls in the region. Conclusions: The findings emphasize the importance of addressing the knowledge gaps and misconceptions surrounding menstrual hygiene among school girls in central Haryana, where this study involved 200 adolescent participants. Targeted educational programs involving mothers and teachers as key influencers are essential to improving girls understanding and promoting better menstrual hygiene practices. This research serves as a foundation for empowering school girls with knowledge and promoting their overall well-being.

Menstrual hygiene is a topic that has long been shrouded in silence and stigma, but in India, it has emerged as an urgent public health concern that demands our immediate attention. The lack of access to proper menstrual hygiene management not only affects the well-being of millions of Indian women and girls but also has far-reaching consequences for their health, education, and overall quality of life.¹Menstruation is a naturally unfolding biological process that takes place in adolescent girls and women of reproductive age.²

In a country as diverse as India, where cultural norms, traditions, and socioeconomic disparities vary widely,³ addressing menstrual hygiene requires a multifaceted, integrated approach. Here, we shed light on the critical aspects of this issue and the imperative need for a unified strategy to combat the menstrual hygiene crisis in India.

Background: The skin over the the external genitalia is a common site for rashes, itching, and minor infections as the skin  of this area has homeostasis around the ano-genitalia and also this area is warm, moist, and occluded, and it is frequently exposed to irritating urine, feces, and vaginal secretions. Genital dermatoses pose serious diagnostic and therapeutic challenges due to privacy persistant checkups, embarrassment, and the inability of necessary investigations. Hence this study has been undertaken to know the distribution and  determination of associated epidemiological factors of Nonvenereal Genital Dermatoses among the children & adolescents in our setup. Research Question: What is the distribution and determination of associated risk factors of Non venereal Genital Dermatoses in our set up? The setting of the study was at department of DVL, Government General Hospital, Government Medical College, Ongole, Andhra Pradesh. A one year observational study was conducted during the period from December 2022 to November 2023 on about 200 patients of various Non venereal Genital Dermatoses attending DVL OPD & Paediatrics OPD during the above period by studying their socio-demographic profiles, Type of skin lesions, clinical pattern and associated epidemiological factors etc. Results: The Non venereal Genital Dermatoses problem was more distributed among adolescents 9-18 years(36%) followed by School children 6-9 years (29%), Preschool children 3-5years(20%) toddlers 1-2years(15%) respectively with the mean Mean age = 7.4, Mean + 2SD = 3.54 – 18.34,  P < 0.01 and in this study males were more in number (71.5%) significantly when compared to females (28.5%). Among the total study subjects Infective Genital Dermatoses accounted for 80% and Non-Infective Dermatoses accounted for 20%. And among all the Infective Dermatoses Scabes occupies the major position (50.2%) followed by Fungal infections (26.5%), Bacterial infections (19%) and Viral infections (4) respectively. And among Non Infective Genital Dermatoses Phrynoderma (40%) was the most common one followed by Vitiligo Vulgaris (22.5%), Eczema (10%), Drug eruptions (7.5%), P.alba (5%), Fordyce spots (2.5%) Lichen Planus (2.5%), Lichen Striatus (2.5%), Haemangioma (2.5%), Phimosis (2.5%) and Traumatic ulcer (2.5%) respectively. And more number of study subjects were belongs to middle & lower class of SES. And furthur it was also observed that among both the Genital Dermatoses more number of  study subjects were belongs to Rural area (60.5%) followed by Sub urban (26.5%) and Urban (13%) significantly. About 34.5% of study subjects were residents of Hostels among the total study group..In adition to the above findings it was observed significantly that Genital Dermatoses was more observed  among the study subjects who wear under garments (90.5%).

Background:   Smartphones are the new generation of mobile phones that provide integrated communication and entertainment services. With a rapid rise in its use, a new kind of health disorder called “smartphone addiction (SA)/abuse/misuse” has now emerged as a challenging public health problem among adolescents. Aim: To study on Physical activity and lipid profiles to understand the impact of smartphone usage on adolescents in Malawa region, Indoor MP. Methods: This cross-sectional study was conducted in the Department of Physiology, Index Medical College, Hospital and Research Centre Indore MP, India. The study participants from primary, higher secondary, and intermediate schools located in rural and urban areas of Madhya Pradesh; of either sex adolescents (10 to 19 years) of age group were enrolled in this study. Anthropometric parameters (age, height, weight, and BMI), physical inactivity, and lipid profile screening (such as total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, and very low-density lipoprotein) were recorded. Results: The mean age of the study participants, was 15.9±2.5years, with a minimum of 10 to maximum 19 years. The mean weight, height, and BMI of the study participants were 57.1±10.8 kg, 158.0±7.7 cm, and 22.9±4.9 kg/m2 respectively. All participants were eating chips, Kurkure, magi, burgers, pizza, sweets, and using cold drinks. Our study also noted that 73.0% of children were using the smartphone while eating. 64% of participants reported using a smartphone for more than 2 hours each day. When we compared indoor physical activity with lipid profile, then we noted that indoor physical activity everyday duration of was insignificant associated with lipid profile (p>0.05). Lower total cholesterol levels and higher HDL levels were significantly associated with outdoor physical activity greater than 60 minutes (<0.05). Outdoor physical activity and total cholesterol level were positively significantly associated (p<0.05). Lipid profile (total cholesterol, triglycerides, and LDL) was positive and HDL was negative and significantly associated with the use of a smartphone every day (p<0.001). Conclusions: Children with smartphone addiction were less likely to walk for each day. Namely, smartphone addiction may negatively influence physical health by reducing the amount of physical activity, such as walking, and increasing lipid profile (fat mass).

Purpose- Obesity is a fast growing problem not only in developed countries but also in developing countries like India¹. Obesity is a risk factor in development of short stature, school teasing, precocious puberty, hypertension, diabetes, gall bladder disease and coronary heart disease, certain type of cancers and other comorbidities even at early age than usual². Understanding the prevalence trend and factors contributing in developing obesity in adolescent children will be helpful in prevention of obesity and developing comorbidities in later life.

Methods- A cross sectional analytical study conducted in 6 different schools of identified district of western India from 1st July 2022 to 31st June 2023 including school going adolescent children, of age between 10 to 16 years after taking necessary consent. Information regarding various predictors of obesity were taken by predesigned questionnaire, filled by participant along with his/her parentsand  relevant anthropometric measurements were recorded. Detailed analysis of predictors which were present in obese and non- obese group was done and results interpreted.

Results-Incidence of obesity in present study is 12.6%. Most common age of obesity is 16 years (46%) and most common age group is mid-adolescent (90.4%). Obesity and overweight is most common in upper middle class and in urbanc area. Positive correlation had been observed between adolescent obesity and parental obesity, calorie intake >2000kcal/day, eating >2 times snacks/day, >2 times junk food/week, sleeping > 8hrs/day and watching TV for >60 min, physical activity <30 min and light grade of physical activity.

Conclusion-Restricting the calorie intake, food behavioural changes like restricting junk food and snacks consumption, daily physical activity could limit the development of obesity in adolescent age group.

Introduction: Any situation that necessitates adjustment can lead to stress. While a certain level of stress can be beneficial, excessive stress can negatively affect performance. Individuals vary in their perceptions, interpretations, and coping mechanisms regarding stress. The human body responds to stress with changes in biological functions, particularly in autonomic functions. 1st M.B.B.S. students likely experience significant stress during their first-term internal examinations. This study aims to investigate the effects of exam stress on cardiac autonomic functions in these students and to observe the differences in their individual responses to such stress. Methods: A total 33 students of 1st M.B.B.S included in the study. Written informed consent obtained. Detailed history, which included age, sleeping and reading habits of last 1 week. Depending on sleeping hours, students were divided into 2 groups, students in group I had no afternoon sleep and group II had afternoon sleep. Resting pulse rate (PR) & blood pressure (BP) were recorded after 5 min of rest in sitting position and with handgrip & Valsalva maneuver allowing at least 5 min gap between measurements. All the recordings were taken 1 hour before exam and immediately after the exam. Mean and SD values of age, sleeping time, pulse rate & blood pressure were determined. Statistical significance of the data was measured by applying paired & unpaired t test appropriately. p < 0.05 was considered statistically significant. Results: The data compares two groups of adolescents: Group I (n=14) with an average age of 17.71 years and Group II (n=19) with an average age of 17.73 years. Group I reported an average total sleep of 4.85 hours, significantly lower than Group II's average of 6.3 hours, indicating a notable difference in sleep duration between the two groups. Overall, the results indicate a notable cardiovascular stress response during exams, characterized by decreased heart rates and variations in blood pressure. Conclusion: Individuals exhibit varying responses to stress, as evidenced by their sleep patterns and autonomic responses. Students who demonstrate a sustained blood pressure response should be monitored regularly to assess their risk of developing hypertension in the future.

The purpose of this study was to compare the respective contributions of psychosocial stressors and neuropsychological deficits to the prevalence of borderline pathology in children. Method: For psychiatric day treatment, 86 school-age adolescents (75 boys and 11 females) were the subjects. 35 of the kids fulfilled the requirements for borderline pathology. Based on parent and child conversations, reports from schools and social service organizations, and information from a questionnaire filled out by members of the child's clinical team, data on psychosocial risk factors were compiled for each child. Computerized versions of the Wisconsin Card Sorting Test and the Continuous Performance Test were used as neuropsychological assessments. Results: The variation in borderline pathology was significantly and independently influenced by both executive function deficits and psychological stress. A model that included both groups of risk factors and explained 48% of the variance in borderline diagnoses was the result. Conclusions: To comprehend the etiology of borderline pathology in children, it is important to consider both environmental hazards and neurobiological susceptibility.

Background: Complications of hypertension are the third leading cause of pregnancy relaed deaths, superseded only by hemorrhage and embolism. Pre-eclampsia is associated with increased potential risks of placental abruption, acute renal failure, cerebrovascular and cardiovascular complications, disseminated intravascular complication and maternal death. Consequently, early diagnosis of pre-eclampsia and close observation and timely drug intervention is needed. Labetalol is generally considered to be more effective than methyldopa for treating pre-eclampsia and pregnancy-induced hypertension (PIH) and Labetalol is quicker and more effective at controlling blood pressure and causes fewer side effects than methyldopa. Drowsiness is a common side effect of methyldopa. And also, Labetalol has a beneficial effect on renal function, ripening effect on the uterine cervix, decreases proteinuria/preeclampsia and decreases fetal/newborn death compared with methyldopa.1 Methyldopa is the medicine of choice for hypertensive conditions in pregnancy in several countries. Despite this, there is little proof of its safety in early pregnancy. So far, most methyldopa safety studies have focused on therapy during the second and third trimesters2,3,4. Thus this study was planned to know the efficacy of the two commonly used drugs comparatively in our set up. Research Question: What is the efficacy of the drugs Labetalol Vs Methyldopa on obstetric outcome in women with pre-eclampsia? The setting of the study was at department of Obstetrics and Gynaecology, Government Medical College, Machilipatnam. A one year observational study was conducted during the period from March ,2023 to February, 2024 on about 200 Pre-eclampsia patients admitted during the above period in the department of Obstetrics and Gynaecology by studying their socio-demographic profiles, type of hypertensive disorders, mode of delivery & preterm or term delivery, maternal complications and evaluation of efficacy of the drugs Labetalol and Methyl Dopa comparatively etc ; Results: The disease was more among the pregnant women  between 21-25 years of age group (49.5%) and the Mean age was 52 years and very few about 3% was observed among >31 years of age group. And most of them are primigravidae. And also, majority of the study subjects were belonging to low socioeconomic group & early marriages (adolescent marriages) were also high in number. There was a significant reduction of Blood Pressure noticed by both the drugs but the more significant reduction was seen among those treated by Labetalol. And also, significantly (P<0.05), about 32% of spontaneous vaginal deliveries happened with Labetalol users when compared to 20% among Methyldopa users & 25% induced deliveries with Labetalol as against 21% with Methyldopa and also significantly 43% LSCS with Labetalol as against 59% LSCS with Methyldopa but totally among both the groups LSCS was little bit more happened among the study subjects. Further it was observed that Preterm deliveries were only 23% with Labetalol as against 40% with Methyldopa which was highly significant (P >0.001). With reference to Birth weight LBW babies were more among Methyldopa users (55%) when compared Labetalol users (50%).

Background: Excessive screen time among adolescents is a growing public health concern, particularly in developing countries like India. This study aimed to determine the prevalence of screen time among adolescent school children in rural Telangana, India. Methods: A cross-sectional study was conducted between June and August 2023, involving 200 adolescent students from two schools in rural Telangana. Data was collected using a structured proforma and analyzed using SPSS version 23. Results: The study found that 13.5% of participants exceeded the recommended screen time of two hours per day. The majority (86.5%) reported screen time of 2 hours or less, while 11% reported 3-4 hours, and 2.5% reported 5 hours of daily screen time. Most participants were aged 13-15 years and from 8th and 9th grades. 62.5% belonged to joint families, and the largest socioeconomic group (34%) fell into the middle class category. Conclusions: While the prevalence of excessive screen time was lower than in some recent studies, it still indicates a significant portion of rural adolescents exceeding recommended limits. This emphasizes the need for continued awareness, education, and interventions to promote healthy screen habits among rural adolescents in India.

Background: Adolescence is a period where there is rapid physical as well as mental growth and development. Obesity and Hypertension (HTN) are emerging as major health problems among adolescents in urban areas. The prevalence of Obesity among adolescents in India varies between 3.6% to 11.7%.¹ Similarly, the prevalence of HTN among Indian adolescents varies between 0.46% to 15% as per studies conducted in different regions of the country.² Obesity is not just a risk factor for developing HTN, but also contributes to emergence of many non-communicable diseases. Hypertension is often asymptomatic and an under-diagnosed problem among adolescent. Since limited data are available on the prevalence of obesity and HTN among adolescents of eastern Odisha, this study was carried out with an aim to estimate the Prevalence of Obesity and Hypertension among adolescents of an urban slum of Cuttack city and suggest remedial measures on basis of the study findings. Materials and methods: A total of 152 adolescents were selected randomly from 4 wards of the urban field practice area of SCB MCH, Cuttack from November 2023 to January 2024. A pre-designed, pre-tested, semi-structured schedule was validated from the experts of Department of Community Medicine. Socio-demographic, anthropometric and other relevant data from study respondents was collected using epicollect5. Body mass index (BMI) and Blood Pressure (BP) greater than 95^th percentile for age and gender were considered Obese and Hypertensive respectively. Data analysis was done using SPSS version 17.0. Results: Prevalence of HTN, Pre-HTN, obesity and overweight in the study were 7.2%, 5.3%, 10.5% and 31.6% respectively. Majority of the males 14 (15.5%) were obese as compared to females 02(3.2%). BMI, sleep duration, consumption of carbonated drink, fast and processed food consumption, academic stress, gadget use (in hrs) was found to have significant association with Hypertension (p value <0.05). Discussion: Prevalence of Hypertension in this study (7.2%) was consistent with the findings in a study by Anand T et al. (7.6%).³ Prevalence of Obesity and overweight in the present study was 10.5% and 31.6% respectively. However, study by S Seema et al.⁴ found that 6.8% of adolescents were obese and 17.1% were overweight. Conclusion: Obesity, Overweight and Hypertension are rising health problems among Adolescents. Early detection, dietary and lifestyle modification and regular health check-up of adolescents is required for prevention of emergence of chronic diseases later. There is also a need for community participation and implementation of health promotion measures and disease preventive programs for adolescents.

Introduction: Anemia remains a significant public health concern in India, particularly affecting children and adolescents. This study aimed to assess the prevalence of anemia and associated factors among children aged 6-59 months visiting the outpatient department (OPD) of a tertiary care hospital in Hyderabad, India. Methods: A cross-sectional study was conducted on 360 children aged 6-59 months visiting the OPD. Sociodemographic data were collected using a structured questionnaire, and venous blood samples were obtained for hemoglobin estimation. Anemia was defined according to WHO criteria. Statistical analysis was performed to identify factors associated with anemia. Results: The overall prevalence of anemia was 48.5%, with a higher prevalence in females (55%) compared to males (42%). The mean hemoglobin level was 12.15 g/dL, with females having significantly lower levels (11.8 g/dL) than males (12.5 g/dL). Nutritional status and maternal education were significantly associated with anemia prevalence. Children from lower socioeconomic backgrounds exhibited higher anemia rates, although this association was not statistically significant. Discussion: The study reveals a high prevalence of anemia among children in Hyderabad, consistent with national trends reported in recent surveys. The gender disparity in anemia prevalence aligns with previous studies and highlights the need for targeted interventions. Despite ongoing national programs, the persistence of high anemia rates underscores the necessity for more effective implementation of existing initiatives and the development of comprehensive strategies addressing nutritional deficiencies, maternal health, and socioeconomic disparities

Background: Teenage pregnancy poses significant health risks for both mothers and neonates, and it is associated with higher rates of maternal and neonatal morbidity and mortality. This study compares the maternal and perinatal outcomes between teenage primigravidae (15–19 years) and adult primigravidae (20–29 years) in a hospital setting.To assess and compare maternal and perinatal outcomes between teenage and adult primigravidae. Methods: A prospective hospital-based study was conducted at the Department of Obstetrics and Gynecology, KIMS, Amalapuram, from December 2019 to September 2021. The study included 80 teenage and 160 adult primigravidae. Data were collected on sociodemographic characteristics, antenatal care, complications, delivery outcomes, and neonatal health. Statistical analysis was performed using descriptive methods and p-values were considered significant at <0.05. Results: Teenage primigravidae had significantly higher rates of antenatal complications (71.3% vs. 16.3%) compared to adults. Common complications included anemia (71.3%), pre-term labor (26.2%), and pregnancy-induced hypertension (17.5%). Hemoglobin levels were significantly lower in teenage mothers (9.56 g%) than in adults (11.12 g%). The cesarean section rate was higher among teenage mothers (45%) compared to adults (20.6%), with fetal distress as the main indication. Teenage mothers also had higher rates of pre-term births (27.5% vs. 6.3%) and low birth weight babies (42% vs. 15.4%). Neonatal morbidity, including birth asphyxia, NICU admissions, and hyperbilirubinemia, was also more common in the teenage group. Conclusion: Teenage pregnancies are associated with higher maternal and neonatal risks, including more complications during pregnancy, labor, and delivery. Enhanced antenatal care and educational interventions are essential for improving outcomes for adolescent mothers.

Malignant Peripheral Nerve Sheath Tumors (MPNSTs) are one of the most rare high grade malignancies which usually affect extremities or trunk. Incidence is 1/Lac population per year. Intra-cranial MPNSTs (affecting commonly Cranial Nerves VIII &VII) are even rarer and only few case reports or short case series are found in literature. Orbital region intra-cranial MPNSTs are rare to the extent that only few case reports are described. In Henderson’s series of 764 Orbital region tumors only 2 were MPNSTs while in Kennedy’s series of 820 cases no MPNSTs was found. Intra-cranial MPNSTs are usually sporadic arising de novo. The second most common mode of origin is from pre-existing schwannomas whereas malignant transformation from pre-existing benign neurofibroma is extremely rare. As per the largest review of all reported cases of intra-cranial MPNSTs by Benedicte L’ Heureux and IssamSaliba, out of 60 cases 36 were sporadic, 16 arose from Schwannoma, only 06 arose from pre-existing benign Neurofibroma and there were only 4 cases of intra-cranial MPNSTs in association with NF-1. Moreover, only 3 cases are reported in literature where MPNSTs arose from benign neurofibroma in the orbital region. To describe the rarity of our case, as per the literature search, it is only the fourth reported case of malignant transformation of benign Neurofibroma in the orbital region and only the fifth case of NF-1 associated intra-cranial MPNSTs. Usual age of occurrence is around 50 years whereas incidence of affecting before 20 years is 1/Million population per year. We present  an extremely rare case of NF-1 affected  16 years old boy with large orbital region MPNSTs arising from pre-existing benign neurofibroma of the V CN with no prior history of irradiation. Complete excision should be the goal of Surgery which is the mainstay of treatment. However, due to the tenacious nature of tumor and intimate relation with critical neurovascular structures, this may not always be feasible. The reported incidence of gross total resection in intra-cranial MPNSTs is 15-20 %. When such tumors cannot be excised completely, high dose radiation is a useful adjunct

Background: Iron deficiency anemia (IDA) remains a significant public health issue among adolescent girls in rural India, impacting growth, cognitive development, and overall health. Socioeconomic conditions play a pivotal role in the prevalence and severity of anemia. This study aims to estimate the prevalence of IDA and assess its association with socioeconomic determinants among adolescent girls in rural settings. Materials and Methods: A cross-sectional study was conducted over a period of six months among 400 adolescent girls aged 10–19 years from five rural villages in India. Hemoglobin levels were estimated using the Sahli’s method. A structured questionnaire collected data on socioeconomic factors including family income, parental education, dietary habits, and access to healthcare. Data were analyzed using SPSS v25 with chi-square tests and logistic regression to identify predictors of anemia. Results: The overall prevalence of iron deficiency anemia was found to be 62.5%. Among these, 40% had mild anemia, 18% had moderate anemia, and 4.5% had severe anemia. A significant association was observed between anemia and low family income (p<0.01), maternal illiteracy (p=0.02), and poor dietary diversity (p<0.001). Girls from families earning below INR 5,000/month were 2.8 times more likely to be anemic compared to those from higher-income groups (OR=2.8; 95% CI: 1.9–4.1). Conclusion: Iron deficiency anemia is highly prevalent among adolescent girls in rural India, with socioeconomic disadvantages acting as key contributing factors. Interventions focused on improving nutritional awareness, female education, and economic support are crucial for effective anemia control in rural populations.

Background: Anemia is a major public health problem worldwide, especially among adolescents who face increased nutritional needs during their critical growth years. In India, anemia rates among teenagers remain worryingly high, though the situation varies widely from one region to another. Unfortunately, there’s very little research on how much adolescents actually know about anemia or whether they eat enough iron-rich foods—particularly in rural areas of the Gaya district in Bihar. This study aims to fill that gap by evaluating anemia awareness and dietary habits, specifically iron consumption, among 14- to 17-year-old students attending government schools in five villages of the Gaya district, Bihar. Materials and Methods: We conducted a cross-sectional study among 300 school-going adolescents aged 14 to 17 years from five villages in the Gaya district, Bihar. Written consent was obtained from parents and assent from participating students. The study included students enrolled in grades 7 to 12 who were willing to participate, while excluding those absent or unwilling. Data were collected through face-to-face interviews using a structured questionnaire. Collected data were entered into Microsoft Excel, and the statistical analysis was performed using GraphPad version 8.4.3, with P-values < 0.05 considered significant. Results: Our study indicated that a majority of adolescents were aware of anaemia (61%). However, only a smaller percentage considered it a health issue (48%). In the past year, just 14% of adolescents had taken Iron-Folic Acid (IFA) tablets, while a significantly larger proportion, 71%, had used deworming tablets in the previous six months. The study found that adolescents consumed roti or rice daily (98%), pulses weekly (51%), and dark green leafy vegetables (DGLV) weekly (59%). Fruits were primarily eaten weekly by 48%, with a notable 37% consuming them infrequently. Fried foods and carbonated beverages were consumed regularly. These results suggest that the National Iron Plus Initiative (NIPI) program is not being adequately implemented. Conclusion: This study highlights significant gaps in anemia awareness and dietary practices among adolescents in Gaya, despite their satisfactory hygiene habits. The low level of knowledge regarding the causes of anemia and available screenings, combined with challenges in implementing the I-NIPI program, emphasizes the need for gender-sensitive interventions. Strengthening nutrition education in schools, launching health campaigns, and initiating targeted awareness programs could effectively reduce the prevalence of anemia and improve health outcomes for adolescents in the region

Background: Air pollution is a major environmental health concern, particularly affecting lung development in adolescents. Urban populations are often more exposed to higher levels of air pollutants compared to their rural counterparts. This study aims to evaluate and compare pulmonary function in adolescents residing in urban and rural regions with varying air quality indices (AQI). Materials and Methods: A cross-sectional observational study was conducted involving 120 adolescents aged 13–18 years, with 60 participants each from urban and rural areas. Participants underwent spirometry to measure Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), and FEV1/FVC ratio. AQI levels were monitored over a 3-month period in both regions. Exclusion criteria included known respiratory illnesses, smoking, and recent infections. Statistical analysis was performed using unpaired t-tests and ANOVA. Results: The mean FEV1 among urban adolescents was 2.48 ± 0.42 L, significantly lower than the rural group (2.91 ± 0.37 L, p < 0.001). Similarly, FVC was reduced in the urban group (3.12 ± 0.45 L) compared to rural participants (3.45 ± 0.39 L, p = 0.004). The mean FEV1/FVC ratio was also lower in urban subjects (79.4%) versus rural (84.3%), indicating early signs of obstructive airway changes. Average AQI in urban areas was 186 (moderate to poor), while rural areas recorded an average AQI of 72 (good). Conclusion: Adolescents living in urban areas with higher air pollution levels demonstrate significantly reduced pulmonary function compared to their rural counterparts. These findings highlight the need for improved air quality monitoring and public health interventions to protect vulnerable age groups.

Background: NAFLD is a global public health problem with more than 10% of fat accumulation in the liver cells and Prevalence is 18% in adolescents and young adults. There are no studies in Indian scenario regarding health education among adolescents with focus group discussion technique on NAFLD, so study was conducted to assess awareness on Fatty Liver Disease, risk factors, its prevention and management. Methods: A Quasi Experimental - Pre and Post evaluation study conducted from Septemer 2022 to March 2023 among degree college students in Ongole, Prakasam District, Andhra Pradesh. Total 12 Mentors with good communication, training and moderating capabilities were identified and selected, and a introduction was given to them about the objectives and purpose of this study. They were trained regarding conducting and moderating a focus group discussion Results: Total 111 First year Degree College students were participated in the focus group discussion on Non Alchoholic Fatty Liver Disease (NAFLD ) and out of them, 42.3% were males and 57.7% were females ,36.7% were heard about NAFLD. A significant improvement was noticed on awareness of prevention and management regarding weight loss goal (22.9% to 50.5%), anti-diabetic drugs (24.8% to 90.8%), statins (35.8% to 95.4%),vitamin E (36.7% to 95.4%) and anti oxidants (37.6% to 95.2%) with focus group discussion (P<0.01). Conclusions:Health Education awareness programme on NAFLD need to be strengthened initially for Medical fraternity followed by general population . Specific Health intervention tools need to be used for prevention, early detection, and treatment .

Background: Adolescents experience significant changes in sleep patterns, often leading to insufficient or poor-quality sleep. Emerging evidence suggests a strong association between sleep parameters and mental health outcomes in this age group. Understanding these relationships is critical for developing targeted mental health interventions for adolescents. Materials and Methods: A cross-sectional population-based study was conducted among 800 adolescents aged 13–18 years, randomly selected from 12 schools in an urban district. Sleep duration and quality were assessed using the Pittsburgh Sleep Quality Index (PSQI). Mental health status was evaluated using the Strengths and Difficulties Questionnaire (SDQ). Data on sociodemographic characteristics, screen time, and academic stress were also collected. Statistical analysis included Pearson correlation, independent t-tests, and multiple linear regression models to explore associations between sleep variables and mental health outcomes. Results: The mean sleep duration was 6.2 ± 1.3 hours per night, with 63.5% (n = 508) of participants reporting poor sleep quality (PSQI >5). Adolescents with poor sleep quality had significantly higher total SDQ scores (Mean = 19.8 ± 5.7) compared to those with good sleep quality (Mean = 14.3 ± 4.1; p < 0.001). A moderate negative correlation (r = –0.42, p < 0.001) was observed between sleep duration and emotional symptoms subscale scores. Regression analysis revealed that shorter sleep duration, greater screen time, and higher academic stress were significant predictors of emotional distress and peer relationship problems (adjusted R² = 0.31, p < 0.001). Conclusion: The findings indicate a high prevalence of poor sleep quality and reduced sleep duration among adolescents, both of which are significantly associated with adverse mental health outcomes. Public health programs must prioritize sleep education and lifestyle modifications to improve adolescent well-being

Background: Inadequate cobalamin levels (VB12D) within the Indian subcontinent constitute a meaningful dietary health issue, largely resulting from poor public health prioritization, dietary patterns, and limited intake of animal products. This synthesis of pooled evidence integrates results from 20 key Indian studies to assess VB12D frequency and distribution in demographic groups. Objectives: We reviewed the literature and also synthesized the pooled evidence that came from 20 selected Indian studies published between the years 2001 and 2023. Our purpose was to determine the pooled frequency with which levels of inadequate cobalamin occurred in the Indian population. Twenty peer-reviewed studies were selected according to predefined inclusion criteria focusing on Indian populations. These studies included antenatal screening as well as community-based and hospital-based cohorts. A calculation used a variance-accommodating approach. The result was a pooled frequency of occurrence. Subgroup analyses used age group, gender, geographic location, and physiologic status, like pregnancy. Results: In the 20 chosen articles, including 18,750 participants, the pooled frequency of inadequate cobalamin levels occurred in 51% (95% CI: 44%–57%). Vegetarians in 65% of cases, females in 55% of cases, adolescents in 49% of cases, and pregnant women in 67% of cases showed a higher frequency of occurrence. This was notably seen among vegetarians as well as among pregnant women. Differences existed that were inconsistent in rural and urban areas. The data reveal inadequate cobalamin levels burdening the Indian subcontinent, especially women, vegetarians, and youth. These findings support health strategies being critically necessary, so programs must supplement, fortify food, and screen routinely in maternal health.

Introduction: reproductive and sexual health is one of the topics which is scarcely discussed in india. Increasing age gap between the age of puberty and marriage, early sexual activity and inadequate knowledge might lead to risk of STD and unwanted pregnancy Objective – this study was done to know the extent of awareness about reproductive health, contraception and STD’s  among adolescent girls aged between 11-19yrs  Methods- it’s a prospective observational study carried out among 400 girl students between age 11-19yrs using a structured pre designed multiple choice questionnaire , analysis was done using spss software Results- among 400 participants 26.5% were sexually active , 62%knew about condoms, more than 2 methods of contraception was known to 22% of girls. In our study 47.5% of girls didn’t have an idea about routes of transmission of STD’s. among all participants who were having knowledge of STD’s HIV was most commonly known.in our study 72.25% didn’t have an idea of HPV vaccine Conclusion- poor knowledge in girls about reproductive health contraception and STD’s is of serious concern. Therefore, education about contraception should be incorporated in the curriculum which should be given through teaching, interpersonal communication, television, health camps and specialists.