Desirable body size associated factors in Trinidadian adolescents

OBJECTIVES: To determine body size considered desirable by adolescents in Trinidad and to identify factors associated with it. DESIGN AND METHODS: A random sample of 1,139 adolescents, aged 14-17 years and attending secondary schools in Trinidad were selected for the study. Silhouettes of different body sizes were used to determine what was considered desirable body size. Weights and heights were measured to determine actual body size. RESULTS: 1,090 (96 percent) students participated, 512 males and 578 females. The calculated BMI indicated that 15 percent were underweight, 73 percent were normal and 13 percent were overweight. There was a significant gender difference in desirable body size (p<0.001). The majority of females (83 percent) wanted to be normal while 13 percent wanted to be underweight. In contrast, 66 percent of males wanted to be normal and 31 percent overweight. In males, sports personalities (55 percent) and movie stars (31 percent) were most important in influencing desirable body size while movie stars (44 percent) and fashion models (43 percent) were most important for females. There was no association between actual and desirable body size in females but the association was significant in males (p=0.004). More overweight males chose the overweight figure (45 percent) compared with normal (31 percent) or underweight (23 percent) males. Although 41 percent of adolescents said that they would like to remain the same size, more females (37 percent) than males (20 percent) said that they wanted to lose weight while more males (38 percent) than females (3 percent) wanted to gain weight (p<0.001). CONCLUSION: It is important that appropriate intervention be implemented to address this desire by adolescent males to be overweight.(Au)

Cold-knife cervical conization

Forty-six cervical conizations were performed over a ten-year period for diagnostic or therapeutic purposes. Twenty-nine women were under 45 years of age. The most common reason for conization was an abnormal Papanicolaou smear. The overall incidence of neoplasia was 80.4 per cent. The high complication rate of 28.4 per cent emphasizes the need for a less traumatic technique of excisional biopsy (AU)

Risk factors and treatment of endometrial carcinoma

A twelve-year retrospective study of 54 consecutive cases of endometial carcinoma revealed that post-menopausal bleeding was the commonest symptom, and the major associated risk factors were obesity and hypertension. Panhysterectomy was the corner-stone of treatment while adjunctive therapy was based on certain prognostic factors and the operator's preference (AU)

Factors affecting the onset of the menopause in Trinidadian women - abstract

There are many factors that may affect the onset of the menopause, particularly cigarette smoking. The purpose of this study was to determine which factors may influence the onset of the menopause in Trinidadian women. A consecutive sample of 384 post-menopausal women attending Chronic Disease Clinics in 12 randomly selected Health Centres in North Trinidad comprised the study population. A pretested interview-type questionnaire was the instrument used to collect the data. Our findings from 379 (98.7 per cent) respondents aged 45 - 81 (mean = 61.5) years showed a mean age at menopause of 49.3 years. There were more women of African (56.3 per cent) than East Indian (28.3 per cent) origin; 84.9 per cent of women were non-smokers, 40 (10.6 per cent) and 17 (4.5 per cent) were smokers and ex-smokers, respectively. The mean age of menopause in Trinidadian women who smoke was reduced by as much as 5 years (49.7 vs 44.6 years), while women who were ex-smokers showed a reduction in the age of onset of the menopause by 3 years (49.7 vs 46.5 years). Chi-squared test showed these differences to be significant (p = 0.00312). However, there were no relationships with nutritional status, parity, chronic disease status or the use of hormonal contraception. It was interesting to note that all the hypertensive women in this sample acquired the disease post-menopause and 95 per cent acquired diabetes mellitus similarly (AU)

Is adolescent pregnancy hazardous?

A study of the pregnancy outcome in 3320 teenagers revealed a low incidence of pre-eclampsia and anaemia and high rates of eclampsia, prematurity and low birthweight. The perinatal loss was 2.2 per cent and there was one maternal death. A comprehensive programme designed to improve antenatal surveillance is recommended for adolescents. (AU)

Shoulder dystocia: an obstetrical nightmare

A nine-year review of 103 cases of shoulder dystocia identified obesity, diabetes mellitus and postdatism as important predisposing risk factors. There was a positive correlation with birthweight. Abnormal labour patterns were invariably absent and perinatal outcome was disastrous. The best strategy is to anticipate and avoid this obstetrical emergency (AU)

Therapeutic alternatives for the hirsute woman

A retrospective analysis of 21 hirsute women seen at a gynecological endocrine clinic revealed a high incidence of infertility, menstrual irregulaties and abnormal androgen profile. Polycystic ovarian syndrome (PCOS) was the underlying abnormality in the majority of cases. Cyproterone acetate (CPA) with ethinyl oestradiol in a reverse sequential regime was more effective and better tolerated but much more expensive than the combination of spironolactone and the oral contraceptive pill (OCP). (AU)

Chlamydia trachomatis in antenatal women at Mount Hope Women's Hospital in Trinidad and Tobago: prevalence and perinatal transmission

Chlamydia trachomatis infection is being increasingly recognized as an important public health problem worldwide. The prevalence and rate of perinatal transmission of chlamydia was examined in 200 women attending antenatal clinic at the Mt. Hope Women's Hospital using tissue culture (TC), ELISA and fluorescent antibody (FA) methods. 27 (13.6 percent) women were found to be chlamydia positive by TC. 13 of the babies born to these mothers were also found to be positive, giving a vertical transmission rate of 48 percent. Compared to TC, the ELISA test was 96 percent sensitive and 100 percent specific while FA was 67 percent sensitive and 99 percent specific. Chlamydial infection was significantly associated (p<0.001) with being of Afro-Trinidadian descent, age <25 years, being unmarried and having two or more sexual partners in the past five years. The association with ethnicity could be explained on the basis of numbers of sexual partners and marital status. Chlamydia is often asymptomatic and no association was found with a history of previous STD, vaginitis or lower abdominal pain. It is recommended that women attending antenatal, family planning and STD clinics be screened for chlamydia infection and treated, together with their sexual partners, as an effective way of prevention. Enhanced chlamydia surveillance and strengthened laboratory capabilities are also recommended. (AU)