Evaluation of Gynaecological Problems among Adolescent Girls attending Gynaecology out Patient Department at Tertiary Care Hospital in Western Rajasthan

Background To evaluated various gynaecological problems among adolescent girls attending gynaecology out patient department at tertiary care hospital in Western Rajasthan Methods Hospital Based cross sectional study conducted on 138 adolescent girls. Study population will consist of all unmarried Adolescent girl’s age 10-19 yrs. attending outpatient department of obstetrics and Gynaecology Sardar Patel medical college Bikaner. Inclusion criteria All the unmarried adolescent female with age 10-19 yrs. Who come to Gynae OPD with any gynaecological complaint and willing to participants? Exclusion criteria Those not willing to participate and not given consent.


Introduction
Gynaecological problem of adolescent are unique, special and specific for the age group (between 10 to 19 yrs).Adolescent girls are highly susceptible to the exogenous and endogenous influences at this crucial period [1]   .21.4% population of India or One Fifth World's population are adolescent there are about 1.2 billion and number is increasing [2] .
Various gynaecological problems are menstrual disorder like abnormal uterine bleeding, primary amenorrhea, PCOD, puberty menorrhagia leading to severe anaemia, sexual abuse, pregnancy related problem, adenexal mass, endocrinopathies.
Obstructive genital anomalies like imperforate hymen to transverse vaginal septa agenesis present with primary amenorrhea and pelvis mass.Dysmenorrhea is very common problem among adolescent girl, study from India reported the prevalence range between 50 to 87.8%.Adolescent sexual and reproductive health forms a major component of global burden of sexual ill health but has been historically overlooked in terms of sexual and reproductive health intervention. [3]e International federation of gynaecology and obstetrics (FIGO) emphasize that Adolescent sexual and reproductive health (ASRH) is an important area of concern for women especially in developing countries like India.Policies and programs for promoting adolescent health in India demand more research on adolescent girls problem so that effective measure can be taken to improve the adolescent health [4] .
Our study aims to evaluate the different gynaecology problem of adolescent girls attending gynaecology outpatient department at tertiary care hospital in western Rajasthan.Data will collected with the help of pre designed pre tested questionnaire after taking proper informed written consent from the patient or parent as age appropriate.Specific mentioned proforma will fill using a checklist for each of study participant which included their personal demogragphic details, complaints for which they visit our health facility.Menstrual history, past as well as family history, personal history, medical history and examination finding including height, weight, secondary sexual characteristic, per abdomen or per rectal examination wherever its needed.Appropriate blood tests and investigations are done according to their problems.

Data analysis
Collected data will be entered into Microsoft Excel spreadsheet and will be presented in the form of tables, figures, graphs, diagrams.Appropriate statistical tests wherever necessary will be applied using suitable statistical software and test of significance considering level of significance as p<0.05.

Discussion
The present study "Evaluation of gynaecological problem among adolescent girls was conducted on outpatient department of obstetrics and gynaecology at S.P. Medical College and PBM hospital, Bikaner" during July 2021 to June 2022.
The objective of the study was to evaluate the different gynaecological problems in adolescent girls attending the OPD at tertiary care hospital in western Rajasthan and to evaluate the prevalence of severe anaemia requiring indoor admission in adolescent girls with puberty menorrhagia and also to assess the causative factors, investigation required and treatment modalities.
138 were unmarried adolescent female in age group 10-19 yrs, who had visited the Gynae OPD with a gynaecological complaint and were willing to participate.
In our study, the treatment modalities of participants girls in which maximum number of cases i.e. 68 were on hormonal treatment.Amongst which 25 cases, 38 cases, 5 cases were treated by norethisterone, OCP, thyroxine respectively followed by 28 cases were treated by oral antibiotics, 20 cases were treated by hematinics and hemostatics, 7 cases were treated by NSAIDs and 6 cases were treated by reassurance and surgery respectively and 3 cases were treated by only hematinics.

Conclusion
Teenage problems need to be dealt with utmost sensitivity.Counseling of teenage girls as well as parents is an integral part of the treatment strategies.Awareness regarding health, nutrition and hygiene should be included in the counselling in order to curtail problems like anaemia, leucorrhoea.
Adapting healthy life style, regular yoga, avoidance of junk food etc. must be encouraged in adolescence girls.It must be a part of school health program.
Prevention is always better so there is urgent need of awareness programs about gynaecological disorders at school and college levels so that these young girls can be made aware and seeks medical advice timely, thus preventing long term complications of gynaecological disorders.

Sample size: 138 adolescent girls Sampling methods: -random sampling. Inclusion criteria 1. All the unmarried adolescent female with age 10-19 yrs. Who come to Gynae OPD with
Study place: This study will be conducted in the department of obstetrics and Gynaecology, Sardar Patel Medical College and associated group of hospital Bikaner, Rajasthan.