Biosocial and awareness profile of adolescent clients and utilization patterns of the services at an ARSH clinic at Patna, Bihar

Background: Adolescents constitute about 21% of India’s population. Realizing the special needs of adolescents, GOI launched the adolescent reproductive and sexual health (ARSH) program in 2006. ‘Yuva’ clinic was established for the first time in Bihar in 2012 at Patna Medical College for providing services as per ARSH protocols. This study aimed at analyzing the biosocial and awareness profile of the adolescent clients vis a vis ARSH strategy, and the utilization of services at the clinic.Methods: Cross-sectional study using semi-structured questionnaire.Results: Total of 1180 adolescents (950 males, 230 females) was studied. Sixty-six percent males, 74.8% females were urban; about 90% were unmarried. Majority were from upper middle class. No females but 66.6% and 86.7% of males were taking alcohol and tobacco respectively. More than 90% of attendees reported regular physical exercise; 36.8% males and 58% females had abnormal BMIs. Seventy-six percent were nutritionally aware, 24.06% aware about reproductive and sexual health (RSH), and 64.74% about ARSH services. Rural and SES were significantly associated with the adolescents’ awareness of nutrition, RSH, and services available. Females had significantly more knowledge regarding RSH. Sixty-seven percent availed counseling services and 1.35% was referred, 50.6% came for clinical services out of which 69.8% remained unmet.Conclusions: ARSH clinic is a useful initiative. However there are gaps in services vis-a-vis ARSH strategies. If addressed, clinic is likely to attract more adolescents and achieve the objectives of improving their health and capacity to deal with their myriad problems in a better wa

Angelina's choice: private decision, public impact.

The decision of the actress, Angelina Jolie (AJ), to undergo preventive risk-reducing bilateral mastectomy has elicited extreme responses, in support and against. We will discuss whether her decision was justified and if there are other options available to women. AJ, who is 38 years old, inherited the BRCA 1 gene. Because of the lack of randomised trials, there is controversy about the overall benefit that various risk-reduction strategies offer carriers of the BRCA 1, but some of the strategies offer a clear benefit. The decision to opt for mastectomy must be driven by the patient's choice, evidence on the balance of the risks and benefits, the quality of life after surgery and issues relating to body image.