Polycystic ovarian syndrome in adolescents

Knowledge on PCOS among the Nursing Students of a Selected College, Mangaluru

Polycystic ovarian syndrome (PCOS) is an endocrine disorder commonly affecting the adolescent girls. Globally, the prevalence rate is around 4 to 12% and it affects 5 to 10% women in their reproductive age group. The study was conducted to assess the knowledge on PCOS among the student nurses. This was a questionnaire-based cross-sectional study among 350 adolescent girls of a selected nursing college recruited using stratified random sampling. A predesigned, pretested, semistructured 16-item questionnaire containing two components—basic knowledge on PCOS (8) and treatment and prevention of PCOS (8), was used for data collection and the results were analyzed. Results revealed that all the adolescent girls (350; 100%) belonged to the age group of 18 to 20 years. It was noted that 306 (87.4%) of students had inadequate knowledge, whereas 44 (12.6%) students had adequate knowledge on PCOS. Significant association was found between primary source of information (p = 0.012) and knowledge on PCOS at 0.05 level of significance. The study concluded that conduction of planned teaching programs is necessary to increase comprehensive knowledge with regard to detection of presenting symptoms and foster early diagnosis and treatment of the syndrome thereby promoting overall health.

Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases

This review provides the reader with the up-to-date evidence-based basis for prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis); metabolic diseases (obesity, hyperlipidemia, metabolic syndrome, polycystic ovarian syndrome, type 2 diabetes, type 1 diabetes); cardiovascular diseases (hypertension, coronary heart disease, heart failure, cerebral apoplexy, and claudication intermittent); pulmonary diseases (chronic obstructive pulmonary disease, asthma, cystic fibrosis); musculo-skeletal disorders (osteoarthritis, osteoporosis, back pain, rheumatoid arthritis); and cancer. The effect of exercise therapy on disease pathogenesis and symptoms are given and the possible mechanisms of action are discussed. We have interpreted the scientific literature and for each disease, we provide the reader with our best advice regarding the optimal type and dose for prescription of exercise.

A comparison of bone mineral density in normal weight and obese adolescents with polycystic ovary syndrome

STUDY OBJECTIVE

To evaluate whether there are any differences in bone mineral density (BMD) between normal weight and obese adolescents suffering from polycystic ovary syndrome (PCOS) with oligo/amenorrhea.

DESIGN

Prospective cohort study.

SETTING

Adolescent gynecology clinic in a general service hospital.

PARTICIPANTS

Subjects consisted of adolescents between 16 to 18 years of age presenting with oligo/ amenorrhea with ultrasound morphology of polycystic ovaries ± evidence of hyperandrogenism over 24 months. Controls consisted of consecutive eumenorrheic patients within the same age group.

INTERVENTIONS

All underwent full hormonal profile assessment, and dual energy X-ray absorptiometry and peripheral quantitative computed tomography scans.

MAIN OUTCOME MEASURES

Areal and volumetric BMD parameters.

RESULTS

Of 37 adolescents with PCOS, 12 (32%) were obese with BMI ≥25, of which 9/12 (75%) were hyperandrogenic. The control group consisted of 40 normal weight eumenorrheic girls. The PCOS group overall had lower lumbar spine BMD values as compared to the controls (0.91 vs 0.97 g/ cm(2), P = 0.033). The normal weight PCOS group had lower BMD at the spine (0.90 vs 0.97 g/ cm(2), P = 0.027), trochanter (0.66 vs 0.71 g/ cm(2), P = 0.039) as well as volumetric distal tibial core sites (268 vs 296 mg/ cm(3)) as compared to eumenorrheic controls, but there were no significant BMD differences between the obese PCOS group and the eumenorrheic controls.

CONCLUSIONS

Normal weight PCOS adolescents with oligo/amenorrhea have marginally lower BMD values than controls, but obese PCOS adolescents have BMD values compatible with eumenorrheic adolescents.

Adolescent hair loss

PURPOSE OF REVIEW

Hair loss, or alopecia, may occur as a primary skin disorder or because of an underlying health problem. It may be upsetting to patients, particularly adolescents who are experiencing physical, emotional, and psychological transitions. Understanding the impact of alopecia is important for care providers who see adolescents.

RECENT FINDINGS

The most common forms of alopecia in adolescence are telogen effluvium, androgenetic alopecia, and alopecia areata. Telogen effluvium may present suddenly or insidiously secondary to a variety of triggers. Androgenetic alopecia may begin in adolescence, and topical minoxidil is effective at retarding further hair loss. It may be a sign of underlying androgen excess, particularly polycystic ovary syndrome in women. Alopecia areata is less common, but may be distressing, especially if hair loss is extensive. Because treatments for alopecia are not curative, helping affected patients cope by offering support and nonpharmacologic techniques to help appear more like their peers should be part of care.

SUMMARY

Physicians need to be skilled in evaluating the most common forms of alopecia presenting in adolescence and should be aware of potential treatments, including the value of psychosocial support.