In recent years, rape has become a very disturbing issue. Rather, it has become an epidemic. It is a considerable blot on the Indian Society, the society which has great claims to have nurtured human behavior with good human values. Children were raised with moral codes and values, by the parents as well by the society in a very controlled manner. Whereas now all those checks and balances have lost sight. In such a progressive society, in the name of freedom, the controlling social forces are getting lost in oblivion, instead aggression is emerging. Some of younger people’s behavior is getting out of control, rather it is becoming perverted.

Background: India is one of the fastest growing countries and is home for more than 243 million adolescents. Adolescent gynecological problem needs careful and important attention as it has immense implication on future reproductive and personal health of women. Objective(s): To study the profile of adolescent girls, seeking in patient treatment for emergency gynecological problems. Method(s): A total of 294 adolescent girls admitted for inpatient treatment for their emergency gynecological problems. Meticulous history taking, examination and investigations were done. Results: 294 adolescent girls attended emergency for in- patient treatment in the study period (July 2014 – December 2014). Patients with pregnancy related complications [230, (78%)] outnumbered the patients having gynecological problems [64 (22%)]. Among pregnancy related complications, incomplete abortion [104, 35%] was the single most common cause for hospital admission, seeking inpatient treatment whereas among gynecological causes, menorrhagia [18, 6%] was most common cause. Conclusion: Adolescent gynecology needs increased awareness and greater attention in order to protect and promote the health of teenagers with the help of specialized adolescent clinic. Measures should be taken to prevent teenage pregnancy and unwanted pregnancy

Adolescents and youths pose a number of reproductive and sexual health (RSH) challenges. Addressing their needs is a challenge that goes well beyond the role of health services alone. Adolescent friendly health Services (AFHS) should be extended beyond health institutions. Various programs have been implemented at various levels for improving health conditions of adolescents and youths.

Background: Oral hygiene is one of etiologies which determine the morbidity due to oral conditions like periodontitis, dental caries, etc. It might be often neglected in a district with low literacy rate like the one in which this study was conducted. Aims: To assess oral hygiene status and its socio-demographic determinants among children and adolescents below 19 yrs in a large school of a district. Methods: It was a cross sectional study conducted by Department of Community Medicine and Department of Dentistry of a Govt. Medical College in a large purposively selected school. All the school children from classes first to twelfth were enrolled and screened during the year 2012-13. Clinical data were collected on self-designed, pre-tested and semi-structured schedules by conducting dental examinations by a dentist. The socio-demographic data of the students were collected from their school records with the help of respective teachers. Proportions, chi square test, with and without Yate’s correction, and t test were used as statistical tools for the analysis. Results and Conclusions: Oral hygiene index-Simplified (OHI-S) was estimated to be poor, fair, and good among 210/1118 (18.8%), 441/1118 (39.4%), and 467/1118 (41.8%) study participants respectively. Children with poor OHI-S need be focused and targeted for oral hygiene education programs.

Background: Bullying and being bullied causes adverse psychological and sociological effects on the health of young adolescents. Understanding the parenting and relationship adolescents share with their parents is thus important as it helps us identify the origin of the behavior and also to verify if there is any connection at all. This study considers parents’ viewpoint in understanding how they perceive this relationship as. Aim: The current study explores the nature of parent-adolescents relationship among early adolescents characterizing bullying and victim behavior Methods: Qualitative research design method was utilized. Semi-structured interviews were conducted on 12 Indian parentsresiding in Bangalorewhose children characterize bullying and victim behavior [6-Group A parents (bullying) and 6-Group B parents (victim)]. A semi-structured interview schedule was created to assessthe nature ofthisrelationship. The interviewsweretape-recorded.The interview transcripts were analyzed using deductive content analysis process. Six dimensions of this relationship were studied thoroughly. Those are, Communication, Involvement, Discipline, Attachment, Encouragement and Psychological Autonomy. Results: The data revealed interesting findings which are also supported by the previous studies. Preference in using punitive methodsfor discipline, inability to express warmth and love to the child, conversationsrevolvingmostly around study related or behaviormodificationtopics,and lessfreedom given to take decisions was observed in the case of Group A (parents of bullying adolescent), whereas in the case ofGroup B (parents of victimadolescents) parental over protectiveness was predominant. Low level of awareness and knowledge about adolescent’s day-to-day activities and ‘Lack of understanding’ of his/ her emotional needs, bordering on emotional deprivationwere commonacross these two groups. Conclusion: Findings of the study can be significantly beneficialfor understanding thenatureofparentadolescent relationship and also will provide a base for future research work and counseling/ interventions programs.

Adolescence is a transitional stage of physical and psychological human development that generally occurs during the period from puberty to adulthood. The period of adolescence is a period of intense growth, second only to infancy. Thus, similar to infancy, overall nutrient needs are high in orderto support optimum growth and development. Iron is one nutrient that is in particularly high demand. It is estimated that roughly 20% of adult height is gained during adolescence. 1 During adolescence, (i.e. 10-19 years of age), anemia is estimated to be the greatest nutritional problem.

Menarche is a landmark pubertal event for most females. Puberty is a process of maturation of the sexual and secondary sexual characteristics, with menarche (onset of menstrual bleeding) as a step within that process. Menarche has occurred at a younger age during the last century. This may be due to improved nutrition in the population. The average age of menarche is 13 years, but it can be as early as 8 years and as late as 18 years and still be normal. The present article is critically reviewed based on growth, development and risk factors at the age of menarche. The first sign of puberty (i.e. either breast or pubic hair development) appeared between the ages of 8.5 years and 13 years in 95% of girls.

Menarche, an important marker of puberty and a milestone in a girl’s reproductive life is studied in this review. There are global as well as national studies reporting the overall factors contributing to this important phenomenon. As we look at the overall determinants of age at menarche, following factors are prominently reported: dietary intake, body composition, physical activity, psychosocial stress, etc. Most of them share a relationship with each other and influence the process of menarche. Studies show that higher intake of proteins and fats in the diet in peri pubertal period results in earlier menarche. Higher body fat percentage which is an important component of body composition and reduced physical activity may also have a contributory role in an early onset of menarche. Girls growing up in homes without their biological fathers undergoing a considerable amount of psychological stress tend to go through puberty earlier than their peers. Thus various factors influencing the process of menarche display the complexity of it. Determinants of age at menarche is extensively studied in developed countries whereas there are less reported studies in India and thus there is a lot of scope for the researchers to further explore this area.

Background: Adolescent risk taking behaviors are common throughout the world. However, such data is scarce in rural areas. Objective: To assess the prevalence of health risk behavior among the adolescents in rural Goa. Method: This community based cross sectional study was conducted in the schools and colleges under rural area of sub center Mandur among 904 adolescents. Youth Risk Behavior Surveillance System was utilized to study the prevalence of health risk behavior in adolescents. Result: Overall health risk behavior was more common among boys; particularly in 16-19 years age group. Inadequate consumption of fruits and vegetables (71.8%) and inadequate physical activity (53.1%) were the commonest risk behaviors among the adolescents in the present study. The prevalence of road risk behavior was found in 33.9% of adolescents. Among substance use, alcohol consumption (15.3%) was more common, despite the health education delivered to the schools during school health program. Smoking was reported among 2.8% of the adolescents and only 0.2% reportedly used drugs. Violence related behavior was in 4.2% of adolescents. Depression, suicidal behavior and bullying were observed in 2 – 2.6% of the study participants. A high percentage (55.3%) was unaware about at least 2 correct methods of prevention of HIV/ AIDS. 35.2% were unable to mention at least 2 correct modes of HIV transmission. Conclusion: Many health risk behaviors are prevalent in the study population. Efforts to control the problem in this age-group should target their parents and other family members, by means of media and through Parent-Teacher Associations. Effective enforcement of the laws regarding tobacco and alcohol restriction is also required. Repeat surveys would help in monitoring the health risk behavior in school adolescents.

Background: Sleep hygiene is defined as “the controlling of all behavioral and environmental factors that precede sleep and may interfere with sleep”. Sleep hygiene is very important for predicting the quality and quantity of sleep in adolescents. Lack of sleep in adolescents can affect academic achievement and can cause decreased alertness and concentration. Objective: To assess sleep hygiene practice and its associated factors among rural school going adolescents aged 10 to 19 years. Methodology: A cross sectional study was conducted at a government high school in Solur, Ramanagara District of Karnataka during March to April 2014, after obtaining necessary permission. A pretested semi structured questionnaire was administered to the students of class V to X, which included Adolescent Sleep Hygiene Scale (ASHS), socio- demographic details and beliefs and attitudes about sleep hygiene. Results: Of the 135 adolescents who participated in the study, majority 104 (77%) were mid adolescents (14 -16 years). 12 (8.9%) were found to have systemic illness. The study revealed that 98.5% of the adolescents had good sleep hygiene. Sleep hygiene was found to be significantly higher with increasing age of the subject and parent’s education. The Sleep Environment Factor Score among adolescents with educated parents was found to be significantly higher (p<0.05). Conclusion: The adolescents in this study were found to have adequate sleep hygiene. School curriculum should include information about the importance of sleep and sleep hygiene to improve attitudes towards sleep hygiene.

Introduction: There are about 350 million adolescents comprising about 22% of the population in the countries of the South- East Asia Region (SEAR). Hygiene related practices of adolescent girls have health impact in terms of increased susceptibility to reproductive tract infections (RTIs) which affects productivity of young adolescents. Objective: The study was conducted to find out the magnitude and awareness of reproductive tract infections among adolescent girls in villages under the Comprehensive Rural Health Services Project (CRHSP), Ballabgarh, Haryana. Methodology: A community based cross sectional study was done among adolescent girls aged 14- 19 years. Using simple random sampling technique, 274 girls were interviewed using semi structured interview schedule. Analysis was carried out in Stata version 11. Results: All 274 participants had attained menarche and the mean age at attainment of menarche was 14.2 ±1.4 years. Almost half of the participants (47.1%) were not aware about the causes of RTIs. Seventy one girls (25.9%) reported symptoms of reproductive tract infections. Also, almost half of them did not seek any treatment for RTI. Conclusions: There is a concern that prevalence of untreated reproductive tract infections among adolescent girls is significant especially in rural India. Therefore, proper menstrual hygiene and correct perceptions and beliefs can protect the women from this suffering.

Introduction: Adolescence is a transitional phase between childhood and adulthood, characterized by a number of cognitive, physical, emotional and attitudinal changes. Their development through the stages of puberty in early adolescence is associated with change in body mass, leading to change in body image, and higher levels of drive for fitness and looking good. Studies suggest that adolescents who are dissatisfied with their bodies are more likely to perceive their health as fair or poor and more likely to show low self-esteem. Objective: To assess the Self Body Image and Perceived Health in adolescents of 13- 17 years attending Urban Health Centre, East Delhi and to study the relationships between Body Image and Perceived health in adolescents. Method: A cross sectional study was conducted in the outpatient department of Urban health centre, Kalyanpuri area located in East Delhi, from July to September 2013. A semi structured, pretested, proforma was administrated to collect data. Sample size of the study was 203 (98 boys and 105 girls), taken by non-probability (convenient) sampling. Proforma included questions related to the Perceived Health, Body Image, Body Satisfaction and anthropometric measurements of study subjects. Data was compiled and analyzed by SPSS version 12. Results: Girls were more likely to report bothersome health issues than boys and the probability of having issues found to be increasing with age. 21.8% of boys ‘do not feel healthy’ as compared to 56.8% that of girls. Proportion of boys who ‘do not feel healthy’ was decreasing with age as compared to that of girls. An average 53% of boys were found to be satisfied with their body as compared to 40.6% in girls. Concern for physical appearance was found to be increasing with age in both boys and girls. Older age groups more often in girls tend to follow certain diets and seem to be more dissatisfied with their weight and appearance. Subjects who were unsatisfied with their body/ physique perceived their health as ‘not good’ and the difference in the two groups was found to be statistically significant Conclusion: Adolescence being a very influential phase in life, perception about body image has a role to determine the health. Access to correct information about growth, development and all other issues corroborate with their healthy behaviors. Counseling and personalized health care services would help them to deal with their perceived issues of body image.

One in every 10 births occurs to a teenager mother because 3/4th of the women become sexually active during this period in most of the countries. Awareness about emergency contraceptives among younger population is poor. Around one tenth of abortions worldwide occur among women aged 15-19 years and 40% of these are unsafe leading to infections and severe complications. Adolescents particularly migrants, street children and unemployed are at high risk of sexually transmitted diseases

Cancer in adolescent is not a rare phenomenon. Despite higher incidence and modest survival improvement compared to pediatric patients, adolescents have not been categorized as a separate “special” group in the frame of medical oncology. Moreover, there is lack of awareness about adolescent cancers among our physicians. So there is a need to disseminate knowledge about adolescent cancer. We carried out extensive research about this topic on Google, Google scholar and Pub Med to collect data on this topic. Worldwide, the range of adolescent cancer rates is 90-300 per million in males and among females, it is 88-270 per million. Cancer in this age group does not have only adverse health impact but also have adverse psychosocial and financial impact not only on patient but also on family members. Similar to geriatric and pediatric oncology, we call for the intensification of treatment, support and research multidisciplinary efforts in order to better fulfillthe increasing demands of this patient group. In this article, we have tried to discuss various issues related to adolescent cancer and certain recommendations towards improvement in this field.

Background: Adolescent risk behavior is a major concern. Objectives: The study assessed the effect of school background, personal, social and other deviant behavior on school going adolescent sexual behavior. Material and Methods: The sample covered 3069 randomly selected adolescents (students) from 9 th to 12th standard in various governments, private and missionary run schools from two districts namely; Aizawl being state capital and Champhai being distant under developed district. Summary: School background, leisure and entertainment practices, influence of taking alcohol, tobacco, drug, peer influence were found to be the major risk factor for indulgence in unsafe sex practices among adolescents. About 10% accepted involvement in premarital sex and majority of them (70%) of them had premarital sex between age group 15-19 years. The schools lacked in organizing awareness program and counseling activities on consequences of adolescent sex. The ARSH Program needs to synergize with school health program for desired results. Conclusions: Adolescent sexual risk behavior is a part of overall deviant behavior and can be managed in holistic manner.

Objective: To determine the status of knowledge and menstrual hygiene practices among adolescent school girls. Design: Cross sectional study. Setting: 3 schools in South Chennai, Tamil Nadu, India. Participants/ Subjects:Adolescent girlsin the age group 13-18 yearsfrom std IX to XIwhohadattained menarche. Method: The subjects were administered a pre designed and validated questionnaire on various components of menstrual hygiene practicesincluding a) usage of pads with respecttoabsorbentused, changing frequency; b) bathing during menstruation c) hygiene of external genitalia including frequency of cleaning, method of cleaning and care of pubic hair; d) access to covered toilets; e)Normal age of menarche; f) Duration of normal flow; g) Normal interval between the menstrual cycles; h) Knowledge about premenstrualsymptoms; i) Source of informationregardingmenstruation and hygiene practices. The data was analyzed using SPSS software. Results: 1522 girls participated in the study. The average level of menstrual hygiene practices was <50% in 1226 (80.6%)subjects, 50-75% in 296 (19.45%) and none practiced >75 % ofpropermenstrual hygiene. Factor analysis on menstrual hygiene showed highest scores on frequency of changing the pad, bath during menstruation, absorbent used and access to water. Average level of hygiene practiceswas comparativelymore among girls who belonged to highersocio-economic groups(Pvalue = 0.003) and those who had access to a covered toilet (P value = 0.000). Conclusion: There is deficiency in menstrual hygiene practices among adolescent school girls. It is importantthattheremust be intense education reinforcing allthe components ofmenstrual hygiene practices. Strategies such as access to water and sanitation may play a major role in adopting safe practices.

Background: The World Health Organization defines adolescents as those belonging to the age group of 10-19 years old. Nevertheless, adolescence should be considered a phase rather than a fixed age group, with physical, social, psychological and cultural dimensions. This is indeed a transition period between childhood and adulthood where special attention is required. Due to unawareness, peer pressure and misinformation they become confuse and indulge in high risk behaviors. Theobjective of this study isto determine the knowledge and perception of sexual behavior and sexuality education among adolescents and also to determine the association between knowledge regarding HIV/ AIDS and selected variables. Methods: A cross sectional study was conducted among 420 students of class X-XII from fourschools of Imphal and undergraduate 1st year MBBS, BDS and Nursing students of RIMS, Imphal, Manipur during 3rd - 24th April 2014. Data was collected through self administered questionnaire and analyzed by SPSS version-16. Descriptive statistics like mean, percentages were used. Chi-square test was used for analysis where P-value of <0.05 was taken as significant. Results: Out of 420 undergraduate MBBS, BDS, Nursing and Class X-XII school students, 221 (52.6%) were males and mean age was 16±1.6 years. Only 23.8% of the respondents had adequate knowledge about HIV/ AIDS. There was significant increase in the knowledge with increase in age (P=0.00). Significant increase in knowledge was found among the undergraduate MBBS, BDS, Nursing students as compared to school students(P=0.00). 18 (4.3%) respondents had experienced sexual intercourse. Conclusion: More than 2/3rd of the students had inadequate knowledge about HIV/ AIDS. Higher age and education of the students were significantly associated with knowledge about HIV/ AIDS.

Background: Hypertension,the silent killer, is one ofthemajorrisk factor of cardiovascular and other non-communicable diseases which is currently responsible for 2/3rd of global mortality. Obesity is a good predictor of hypertension and is a risk factor for cardiovascular disease. Objective: To find out the prevalence of hypertension and obesity among high school students of Mysore, Karnataka. Methodology: A cross sectional study was conducted from June 2014 to July 2014. Multistage samplingmethod was adopted to select 3000 students. The required sample size was collected from 8 th , 9 th , and 10th standard students equally after doing gender stratification in each class. Anthropometrics measurements and blood pressure was measured according to WHO guidelines. Results: In our study most of the children belong to the age group of 13-14 years, mostly were boys and were studying in 10th standard, belonged to Hindu religion and nuclear family. In our study, we found that 22.4% of children had a family history of hypertension and 13.7% of children had a family history of obesity. In our study, we found that the prevalence of overweight was 4.97%, obesity was 1.47% and prevalence of hypertension was 0.3%. Conclusion: The prevalence of hypertension was 0.3% and obesity was 1.47%.

Background: Child and adolescent mental health is an essential component of overall health. Mental health problems among adolescents are fairly common. Collaboration between families, schools, communities & health care institutions can improve not only the mental health of adolescents but also their access to mental health services. Study was carried out to assess the mental health status of school going adolescents as part of introducing life skills education. Methods: Cross sectional study was carried out among adolescent students (10-19 years) in rural schools of Anand district of Gujarat, using a pre-tested and validated self reported ‘Strengths & Difficulties’ Questionnaire (SDQ) in Gujarati language. Results: 605 (62.6%) boys and 361 (37.4%) girls participated in the study. The mean age was 14.2 years (Standard deviation: 1.46). Majority of students 820 (84.9%) attended day schools (9am-5pm). 171 (17%) students attended tuitions also. Only about 37% had normal self reported SDQ scores. 30% had borderline and 33% had abnormal scores. Highest level of abnormal score was seen in peer problem score (45.9%) and least in pro-social behavior score (1.1%). The abnormal SDQ score were statistically more among girls, Muslim students, students in primary school, those with problematic families and those attending morning schools. Conclusions: The SDQ can be easily administrated in rural Indian setting by trained non professional personnel including teachers. The high prevalence of abnormal SDQ scores calls for integrating mental health issues and Life skill education in the existing school health programs.