Adolescent Pregnancy

Adolescent pregnancy in ninety nine percent of the cases is unwanted and is the major consequence of adolescent sexual activity, other than STDs. This issue has affected youth, families, educators, health care professionals, and government official. A study on the high school adolescents has concluded that forty eight percent of the males and forty five percent of the females are sexually active. One fourth of the high school students had sexual contact by fifteen years of age. The average age of boys is sixteen and a girl is seventeen, who have had intercourse. Ninety percent of adolescents, in the age range of fifteen to nineteen, say their pregnancy is unintended.

Seventy four percent of females above fourteen years and sixty percent of females below fifteen years have reported to have involuntary sex. Fifty percent of the adolescent pregnancies are within the time period of six months after the initial sexual intercourse. More than nine hundred thousand teenagers are reported to have become pregnant every year in the United States. Fifty one percent of the adolescent pregnancies result in live birth, thirty five percent result in induced abortion and fourteen percent result in stillbirths or miscarriages. Four out of ten adolescent females get pregnant, before they turn twenty, at least once. Twenty five percent of adolescent deliveries aren’t the mother’s first child. When a teenager gives birth to her first child, she increases the risk of begetting another child. One third of the adolescent parents are themselves result of adolescent pregnancies.

There are many reasons why adolescents choose to become sexually active at an early stage in life. The reasons can be early pubertal development, poverty, sexual abuse in childhood, lack of parent’s attention, lack of career goals, family and cultural patterns of early sex, substance abuse, dropping out from school and poor school performance. Factors which discourage an adolescent to become sexually active are stable family environment, parental supervision, good family income, regular prayers, connectedness with parents and living with complete family and both the parents. The factors which are responsible for the consistent use of contraceptive among adolescents are academic success, anticipation for successful future, and involvement in a stable relationship.

There are many medical risks associated with adolescent pregnancies. Adolescents who are less than seventeen years are at a greater risk of developing medical complications, when compared to adult females. The risk is even more in teenagers below seventeen. The weight of the child, given birth by an adolescent, is very low in these pregnancies. It is usually below 2.5 kilogram. The rate of neonatal birth is also three times greater in adolescents, when compared to adults. Other problems caused by adolescent pregnancies are prematurity of the child, birth of underweight child, poor maternal weight gain, poor nutritional status, anemia, STDs and hypertension induced due to pregnancy.

Although there is an increase in the use of contraceptive methods by adolescents during their first sexual contact, only sixty three percent of the high school students have said to use condom while having sex previously. Adolescents, who use prescription contraceptives, delay their doctor’s visit until the time they become sexually active for over a year.

According to a research, youngsters who have participated in sex education programs which gave them knowledge about contraception methods, abstinence, sexually transmitted diseases and youngsters who involved in discussions in order to get a clear picture, used contraceptives and condoms effectively without any increase in sexual activity. The Center for Disease Control & Prevention has said that the solution for unwanted adolescent pregnancies and STDs are barrier contraceptive use and abstinence.

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Sprains and Strains in Adolescents

Sprains and strains are among the majority of the injuries caused while playing sports. Sports injuries can be caused by small trauma which involves ligaments, muscles and tendons including bruises, sprains and strains. The body part which is most commonly involved in spraining or straining is the ankle. The 3 ligaments that are involved during ankle sprain or strain include anterior talofubular ligament, posterior talofibular ligament and calcaneofibular ligament.

An injury caused to the soft tissue as a result of a direct force like fall, kick and blow is called a contusion or a bruise. A sprain is nothing but a ligament injury which is wrenched or twisted. Sprains usually affect knees, wrists and ankles. On the other hand a strain is an injury caused to a tendon or muscle which usually results from force, stretching and overuse.

Sprains/Strains are usually diagnosed by a physician after a physical examination. The physician asks for thorough medical history of the adolescent and asks various questions that lead to the cause of the injury. Various diagnostic procedures are also available which also helps in evaluating the problem. X-ray is one of the oldest and common diagnostic tests done to know the extent and exact location of the injury. An x-ray uses electromagnetic waves to get photos of internal tissues, organs and bones onto a film. MRI scan is one of the recently evolved diagnostic procedures which also help in evaluating a physical injury. This procedure actually called Magnetic Resonance Imaging makes use of bug magnets, computer and radio frequencies to get detailed pictures of structures and organs inside the body. Another diagnostic procedure called Computed Tomography Scan or CT scan is also used to evaluate the extent and location of injury. This procedure uses a blend of computers and x-rays to get cross sectional pictures in horizontal and vertical alignment. It shows thorough pictures of any part of the body like muscles, bones, fat and organs. They provide more information than conventional x-rays.

There are various symptoms of strain and sprain depending on each teen’s physical condition and they may vary accordingly. One of the symptoms includes pain in and around the area injury. There could also be a swelling around the injured area. Some teens also experience difficulty when they use or move the area of the body that is injured. Some teenagers also undergo bruises or redness in the area that is injured. Many times the symptoms of sprains and strains may look similar to other medical conditions and a doctor’s advice is the best option in this scenario.

Depending on various factors the treatment of sprains and strains will be prescribed by the teenager’s physician that include teenager’s age, overall health of the teenager, and medical history of the adolescent. To what extent the teen is injured is also a factor in determining the nature of treatment. A teenager’s level of tolerance to certain medications, therapies and procedures is also taken into consideration before opting for a particular method of treatment. The treatment also depends of what expectations one has and also preference and opinion.

Various options available for treatment include things like restriction of the activity after the injury, application of cast/splint on the injured spot, crutches or wheelchair, physical therapy which involves stretching exercises to give strength to the muscles, tendons and ligaments that are injured and last but not the least is the surgery which is opted for in worst case scenario.

In the long-term scenario bruises, sprains and strains heal pretty quickly in kids and teenagers but it is important that the adolescent sticks to the restrictions imposed during the treatment and healing process like restriction of activity and regularly attending physical therapy sessions if any. It is noted that majority of the sports related injuries results either due to traumatic injury or excessive use of muscles and joints. But, they can be avoided and prevented with right training, by wearing right protective gears and by using right equipment for training.

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Eating Disorders in Adolescents

Since the adolescence is the age where bones are sprout and grow rapidly, well nourished food must be given to the adolescent to facilitate normal growth & development. The nutritional intake must be monitored regularly and modified depending upon the growing needs. Teenagers tend to develop eating disorders which affect their nutritional health. The eating behavior must be corrected as early as possible as it can lead to the development of complex illnesses. Eating disorder is the third common chronic illness, especially in adolescent females and the number has been increasing rapidly from the past thirty years.

There are two subcategories of eating disorders, anorexia nervosa and bulimia nervosa. Anorexia nervosa is the restrictive form, where the intake of food is limited severely. In bulimia nervosa is the eating disorder where the adolescent binges on food and then tries to minimize the effects by forcibly vomiting, fasting, and catharsis or over exercising. When handling adolescence eating disorders, they must be handled differently from adult eating disorders. Adolescents face problems such as growth retardation, suppressed height, abnormal weight, pubertal delay, menstrual periods absence, and menses unpredictability. When the adolescent is growing there will be critical tissue components loss like loss of body fat, muscle mass and bone mineral.

Nutritional imbalance is also caused which reflect abnormalities in the levels of vitamins, mineral and other trace elements. The problem is that these abnormalities cannot be recognized clinically. But since protein and calories are essential to the growth of the adolescent, it is important to trace their abnormalities. Because of the problems, healthy adulthood is not a possible thing. Because of all these reasons, it is important to diagnose adolescence eating disorders as early as possible. Eating disorders give rise to peak bone mass impaired acquisition in case of adolescents. When they turn into adults, this problem aggravates to osteoporosis. Even internal organs get affected due to eating disorders. All this can be prevented by early intervention so as to limit, prevent and ameliorate medical complications, which can turn become life threatening.

Adolescents who practice unhealthy weight control practices and are obsessive about figure, weight, food or exercise should be treated clinically. Not only should the symptoms be checked, but their duration, intensity and frequency should also be checked. Although most of the physical complications caused due to eating disorders get solved with the help of nutritional rehabilitation some of the conditions become irreversible and the long term consequences of this are very dangerous. It is best if the eating disorders are recognized in the early stages as it won’t result in irreparable damage. The medical monitoring should be pursued till the adolescent returns back to appropriate psychological and medical health.

Eating disorders not only result in physical abnormalities, but also psychological abnormalities. Adolescents with eating disorders take onto social isolation, low self esteem, affective disorders, low self concept, substance abuse, anxiety, and depression. Usually adolescents switch to unhealthy eating habits because of depression and lack of knowledge about affective techniques to lose weight. So the patients who are being treated for eating disorders must also be treated for psychiatric illness, if they have any. Even if the habits doesn’t fit the strict criteria, adolescents who limit food intake, binge, vomit or purge accompanied with or without harsh weight loss, should be monitored because of the involvement of risk of even death. Early treatment will have an improved outcome. But the level of intervention in adolescents should be less when compared to adults.

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Infectious Mononucleosis

Also known as mononucleosis or mono Pfeiffer's disease or glandular fever, infectious mononucleosis can be identified by inflamed lymph glands and constant fatigue. The disease is named so as the amount of mononuclear leukocytes which belong to white cells increase in number. The cause of the disease is EBV (Epstein - Barr virus) or in some cases cytomegalovirus. Both these viruses belong to the family of herpes simplex. According to statistic majority of the adults in the United States are exposed to the virus Epstein – Barr, a very widespread virus. Although the virus does not show any visible affects in children but it does in adolescents which can lead to infectious mononucleosis in nearly fifty percent of cases of exposure to the virus.

The other virus called cytomegalovirus which also belongs to the family of herpes simplex causes the cells to become enlarged. According to statistics, about eighty percent of adolescents infected with this virus generally don’t see any further symptoms. Although EBV has potential to develop infectious mononucleosis in adolescents the virus could make throat and blood cells its home for the lifetime. The virus has the capability to bounce back and reactive from time to time but the consolation is that it would reactivate without symptoms.

The condition usually lasts for 1-2 months. The symptoms may vary from one adolescent to other but may include inflamed lymph glands in areas such as groin, neck and armpits, fever, continuous fatigue, enlarged spleen, sore throat as a result of tonsillitis that can make things difficult to swallow and last but not the least minor liver damage that can lead to short-term jaundice. Some adolescents may also experience symptoms such as abdominal pain, petechial hemorrhage, muscle ache, headache, depression, loss of appetite, skin rash, weakness, dizziness, enlarged prostrate, dry cough, swelled genitals and puffy and swollen eyes. Some parents are puzzled by the symptoms of mononucleosis as it may be similar to other medical conditions. It is safe to consult a doctor in such cases.

The viruses are usually transmitted to other people through saliva (the reason why it is also called kissing disease), blood, sharing drinks and sharing utensils. The symptoms usually lasts for 4-6 weeks and do not cross 4 months. The disease is diagnosable but requires a though medical history of the adolescent. The diagnosis also involves physical examination of the adolescent and is based on symptoms reported to the physician. The diagnosis is further supported by laboratory test like blood test, antibody test and test to count white blood cells.

A rest of about a month is generally advised and normal activities can be resumed after acute symptoms disappear. Also care should be taken to avoid physical activities which are heavy in nature and also activities or sports involving physical contacts should also be avoided. Care must also be taken to avoid eating sweet things in excess for few months.

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Scoliosis in Adolescents

Normally, a spine when viewed from rear should appear straight but if the spine is lateral or curved or sideways or rotated then it is affected by scoliosis. It gives an appearance as if the person has leaned to a side. According to Scoliosis Research Society the definition of scoliosis is the curving of the spine at an angle greater than 10 degrees on an x-ray. Scoliosis is a kind of spinal deformity and shouldn’t be confused to poor posture. Usually there are 4 common kinds of patterns of curves experienced in Scoliosis which are: Thoracic wherein the right side has ninety percent curves, lumbar wherein left side has seventy percent curves, thoracolumbar wherein right side has eighty percent curves and double major where both right and left sides have curves.

In majority of the cases, as high as eight to eighty five percent, the cause of the deformity is unknown, this is also known as idiopathic scoliosis. It is observed that females have scoliosis more commonly than males. According to some established facts 3 to 5 children per 1000 has chances of developing spinal curves which is a number big enough requiring medical treatment. There are three types of scoliosis that can develop in children namely congenital, neuromuscular and idiopathic. Congenital scoliosis is seen in 1 out every 1,000 births which is caused due to vertebrae’s failure in normal formation, vertebrae is absent, vertebrae is formed partially and vertebrae is not separated. Neuromuscular scoliosis is linked with various neurological conditions and particularly in children who don’t walk like cerebral palsy, muscular dystrophy, spina bifida, tumors in spinal cord, paralytic conditions and neurofibromatosis. The cause of third type of scoliosis called Idiopathic scoliosis is still unknown. It is further divided into infantile, juvenile and adolescent scoliosis. Infantile scoliosis occurs up to the age of 3 years from birth wherein the vertebrae curve is towards left and is more frequently observed in boys. The curve takes normal shape with the growth of child. Juvenile scoliosis is common in children of age three to nine. Adolescent scoliosis is common in kids of age ten to eighteen and this is also the most common form of scoliosis occurring more in girls than boys.

The other possible causes of the deformity include hereditary reasons, different lengths of legs, injuries, infections and tumors. There are numerous symptoms attributed to scoliosis which can vary from individual to individual. The symptoms are: Difference in heights of the shoulders, off-centered head, difference in the height or position of the hip, difference in the position or height of shoulder blade, different arm lengths in straight standing position and lastly different height back sides when the body is bent forward. Other symptoms include leg pain, back pain and change in bladder and bowel habits do not belong to the symptoms of idiopathic scoliosis and require medical checkup by a doctor. The symptoms may be similar to other problems related to spinal cord or other deformities or could result from an infection or injury and consulting a doctor is the best bet in this situation who may conduct diagnosis to know what exactly it is.

The diagnosis of scoliosis requires thorough medical history of the teenager, diagnostic tests and also physical examination. The doctor asks for entire prenatal history, birth history and also would want to know if anyone in the family has scoliosis. The doctor may also ask for the milestones related with the development of the teenager since some kinds of scoliosis are known to be related to neuromuscular disorders. The delay in development may need additional medical evaluation. Doctor may also prescribe x-ray, CT scan and MRI scan of the back to measure the degree of curvature in the spinal. There are various treatments available for scoliosis which is decided by the physician depending on teenager’s age, medical history and health in general. The method of treatment also depends on the extent to which disease has reached. The tolerance of the teenager to certain medicines, therapies and procedures are also taken into consideration. Expectations and opinion of the parents or teenager is also the criteria in deciding the type of treatment. The main aim of the treatment is stop the curve from progressing and avert deformity. The treatments include observation and repetitive examinations, bracing and surgery to correct the defect.

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Eye problems and injuries in Adolescents

Every year more than one million people get eye injuries, out of which ninety percent are preventable if safety eyewear is used. One hundred and twenty five thousand eye injury cases are caused by household products.

It is a good habit to wash hands regularly, especially after handling household chemicals. When using detergents and hazardous solvents, the handler must wear chemical safety goggles. Also, no children must be around while handling chemicals. While spraying, the nozzle must be turned away from the face. Fertilizers, pesticides and paints must be stored away from reach. While doing household activities proper protective gears such as goggles, gloves, boots and helmet should be worn, if required. The house must be illuminated adequately to avoid accidents in the dark. Stairs should also be illuminated and the rails must also be installed. The instructions for opening the tops of bottles must be read carefully to avoid them from popping and injuring other people. Children and adolescents should read instructions before handling operating equipment before playing games. All power equipment must be installed with guards. While playing outside, the eyes must be protected by UV protective goggles and it is a bad idea to look at the sun directly.

Precautions should not only be taken indoors, but outdoors too. This is because; more than forty thousand people get eye injuries outdoors. Ninety nine percent of the injuries are caused while playing sports. So it is necessary for the youngsters to wear protective eyewear while playing sports or when involved in outdoor recreational activities. A special helmet is designed with wire shield or polycarbonate face mask which is not only safe, but comfortable, too. Protective eyewear should also be worn while performing experiments in science lab. Fireworks must only be handled by adults.

Because of increasing use of computers, more and more youngsters are getting eye strains. The symptoms of eye strain caused by computer are red & watery eyes, focusing problems, aching & tired eyelids, eye muscle spasm, backache and headache. In such an environment, eye exercise must be done regularly. The eyes must be made to focus on distant objects and should be rotated from side to side. It is extremely important to give ample rest to the eyes. Glasses with UV shield must be worn when looking at the computer screen. Eye strain can be avoided by increasing the distance from the monitor.

Eye hazards are also caused when cosmetics are used improperly by contact lens wearers. Some of the adverse reactions are injury, eye irritation, allergy, dryness, infection, and lens deposition. That is the reason why adolescents must be made aware of the risk they will face when opting for contact lens. Girls should understand that they should buy hypoallergenic cosmetics and especially the non-scented variety, manufactured by big brand names. Cosmetics should not be shared with anything else. The applicator brushes must be washed regularly and old mascara must be disposed and not refilled. Eye shadows which are glittery, pearlized, frosted or iridescent contain ground tinsel or oyster shell, which should be always avoided. Eyeliner should not be applied in the inner lid edge. Loose powder should be avoided. Cream should not be applied near the eyes. The wearer should wash hands while handling contact lens. No crying, washing of face or bathing should be done with the contact lens on.

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Asthma in Adolescents

Most of the teenagers who have asthma are also allergic to many things. The asthma can get severe even if the people with asthma are exposed to allergens of low grade. Allergies play an important role in asthma cased which are undiagnosed. Other factors that also trigger childhood asthma include upper respiratory infections like colds, second hand smoke, and certain climate conditions like cold air and due to emotional physical expressions like laughing, crying or yelling. However, it is not the end of the road for asthmatics as they can live active and healthy if they manage asthma properly by avoiding asthma triggers, regular intake of prescribed medications, being alert of the warnings and be aware of the ways to deal with an asthma attack.

There is a great consensus among the parents whether their children would outgrow asthma as they grow up. But the truth is it depends from child to child. While some children experience improvement in their teens others see asthma becoming even more severe. But almost half of the children who have asthma outgrow asthma as they grow although some symptoms may come back later.

Many parents have questions like whether their children can take part in sport activities. The answer is both yes and no. Some kids may get an asthma attack when they participate in exercises like running. But with proper management a teenager suffering from asthma can actively participate in sports. Special aerobic exercises can improve airway function. This strengthens the breathing muscles. Some of the ways that one can participate in sports is to follow the regimen of stretching the muscles prior to and after exercising, nose-breathe instead of breathing through the mouth and make sure that humidified air passes through the airways. Also parents should make sure that the adolescent has taken all prescribed medication supposed to be taken before they begin exercising. Carrying a reliever is a must for asthmatic teens which would come handy if asthma attack occurs. Asthmatic teenagers should make sure that they wear something over their mouth and nose to stop cold air from entering.

It is not easy for adolescent teens to attend school when they have asthma but it is not difficult also at the same time if proper coordination is made among the teenager, doctor, family and school employees. It is a good idea to consult teachers, nurses and other pertaining employees of the school and let them know that the teenager has asthma and may have special requirements. Also, let the school management know on medications the teenager regularly takes and how to help the teenager when an attack occurs. The school staff should be asked to treat the teen normally once the attack subsides. The physical education coach should also be informed about the condition so that he/she can let the kid stretch the muscles before any exercises or to deal with asthma attack induced due to exercises. Also, before admitting the teenager to a new school care must be taken to check the quality of air, irritants and allergens if any present in the school. The school staff should take considerations to avoid symptoms which could hamper the energy level kids. Also asthmatic teens should be assured from time to time that they are no different from others and asthma in any way does not slow them down, They need this emotional confidence otherwise they may have personality problems.

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