RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES ...

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION MISS. PILLAI REMYA RADHAKRISHNAN. M.Sc. (N) I YEAR CHILD HEALTH NURSING 2010 - 2012.
SRI VENKATESHWARA COLLEGE OF NURSING
NO. 98, MARUTHI INDUSTRIAL ESTATE,
PEENYA 2ND STAGE,
BANGALORE - 560058.
RAJIV GANDHI UNIVRSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
| |NAME OF THE CANDIDATE | |
| |AND ADDRESS |MISS. PILLAI REMYA RADHAKRISHNAN |
|1 | |I YEAR M.Sc. NURSING |
| | |SRI VENKATESHWARA COLLEGE OF NURSING, NO. |
| | |98, MARUTHI INDUSTRIAL ESTATE, PEENYA 2ND |
| | |STAGE, |
| | |BANGALORE - 560058. |
| |NAME OF THEINSTITUTION| |
|2 | |Sri venkateshwara college of nursing |
| | |No. 98, Maruthi industrial estate, |
| | |peenya 2nd stage, Bangalore - 560058. |
|3 |COURSE OF THE STUDY |I year M.Sc. Nursing |
| |AND SUBJECT |Child Health Nursing |
|4 |DATE OF ADMISSION TO |8th June 2010 |
| |THE COURSE | |
|5 |TITLE OF THE STUDY | "A study to assess the effectiveness of |
| | |structured teaching programme on prevention|
| | |of hypothyroidism among adolescent girls |
| | |between the age group of 15-17 years in |
| | |selected pre-university colleges at |
| | |Bangalore." | 6. BRIEF RESUME OF THE INTENTED WORK
6.1 INTRODUCTION Attention women : Sluggish ? Can't shed weight ?
Losing hair ?
"Its not in your head ,
Its in your thyroid!"
Women's
Health Institute, Texas.
Adolescent girls face more problems than boys, largely
due to socio-cultural factors. Adolescent girls are deprived of adequate
health care, good nutrition and opportunity for schooling. Stunted
malnourished girls are usually with inadequate knowledge of personal care,
family planning or child rearing practices and they enter into marriage and
motherhood, thus further increasing the problems of deficiency disorders.
The adolescent period of women offers great opportunities. It provides them
a chance to improve their nutrition and health status, besides preparing
them to become productive and confident.1 Puberty, pregnancy, and menopause place increased demands
upon thyroid hormone functions. A child may seem to be relatively well
until puberty when a number of behavioral problems and physical problems
will suddenly appear. Again, disturbances of growth, problems involving
sexual development, and mental disturbances are paramount features of
hypothyroidism.2 Hypothyroidism is more common in women than in men. In
U.K, the female: male ratio is 6:1. One study on 2779 people in U.K found
that the incidence of clinical hypothyroidism was 40/10,000 women a year
and 6/10,000 men a year. The prevalence was 9.3% in women and 1.3% in men.
The clinical picture in remaining parts of the world is also similar where
there is greater female dominance as compared to males.3 A study was conducted to evaluate the symptoms
and signs of biochemically acquired hypothyroidism in the early stage of
the disease on nineteen children and adolescents. The group consisted of
fourteen girls and five boys ranging from four to fifteen years of age. In
13 of the 19 patients with profound biochemical hypothyroidism, classical
symptoms were often absent and clinical signs were limited. Goiter was the
most consistent finding and was present in all instances of spontaneously
acquired primary hypothyroidism. These observations emphasize the
importance of routine examination of the thyroid gland, particularly in pre
adolescent and adolescent girls. The finding of goiter may be the only
detectable sign of hypothyroidism in early stage of the disease.4 Hypothyroidism and depression are two disorders that are
associated with much common symptomology. Fatigue, mental or physical
slowing, forgetfulness or attention or concentration difficulties and mood
disturbances are characteristics of both the conditions. Women have 10:1
increased incidence of hypothyroidism relative to men. This rate compares
to women's 2:1 increased risk for depression. Interestingly in recent
years, there has been some recognition of the value of T3 in psychiatry, as
several studies on depression have shown that response rates to an
antidepressant medication are improved when T3 is added to the protocol.
And according to a new study treatment with a combination of T3 and T4
showed better results than treatment with either T3 or T4 for depression
clients.5 Based on a research study conducted over the past
few decades, it was found that there are three primary reasons for the
growing number of people with unbalanced thyroid. The three causes are
selenium deficiency, iodine deficiency and estrogen like compound
pollution. The study recommended that increase in uptake of selenium rich
foods (wheat germ, seafood, beef liver), supplementation with iodine, zinc
and multinutrients, avoiding iodine blocking foods like cabbage,
cauliflower and reducing exposure to polluted estrogen compounds organic
pesticides and cleansers etc. can help in keeping the thyroid gland healthy
and prevent thyroid disorders like hypothyroidism.6 Exercises and yoga are two of the best techniques by
which, one can easily keep thyroid gland in its normal state. Light
exercises like brisk walking, treadmill and aerobics are very useful. They
improve the blood circulation in the body and therefore very helpful in
thyroid hormone production. Yoga like Hatha Yoga, Pranayama (the breathing
techniques), Shavasana (the dead posture), simhasana (the lion posture) and
kapalbhanti (another type of breathing technique) help not only keeping
thyroid healthy, but they also boost the persons health keeping him hale
and healthy. Latest researches also support Yoga and breathing techniques
(Pranayama) to be two of the best methods to control and even completely
cure hypothyroidism.7

6.2 NEED FOR THE STUDY
"HYPOTHYROIDISM - The Underdiagnosed Epidemic!"
-Dr. Ward Dean
One of the most underdiagnosed and important condition
in the U.S has been called the unsuspected illness and accounts for a great
number of complaints in children, adolescents and adults. This condition is
an underactive thyroid system in other words hypothyroidism.8 The profile of thyroid disorders encountered in
pediatric and adolescent age groups in India is similar to that seen in
most parts of the world. Clinical presentation is most commonly for
hypothyroidism and goiters and infrequently for hyperthyroidism. Of nearly
800 children referred for thyroid problems, 79% had hypothyroidism
(goiterous and non goiterous), 19% euthyroid goiters and only 2% had
hyperthyroidism. In nearly 200 school children surveyed for hypothyroidism
prevalence, 8% were in high socioeconomic groups and about 21% in low
income groups, had goiters. Female predominance was marked.9

An article about sudden rise in hypothyroidism in
Bangalore in Times of India, Bangalore, Nov. 2010, reveals that sudden rise
in hypothyroidism baffles doctors in Bangalore. According to the general
physician, many gramapanchayats in Karnataka are seeing a fourfold increase
in hypothyroidism for the past 5-7 years. It has increased more among women
in the 20-40 age group. The Director of Karnataka Institute of Diabetology,
also confirmed increase in the number of hypothyroidism. Hypothyroidism is
usually caused due to defect in thyroid gland itself or the pituitary gland
or even the hypothalamus but the causes are largely unknown.10 Iodine deficiency has a great impact on women of all
ages. Primary iodine deficiency can affect a women's reproductive health.
Iodine deficiency occurs more in women in the form of goiter, and first
appear during adolescence. Among women, iodine deficiency is most common
among adolescent girls and pregnant women. Most researchers suggest the
greatest prevalence of iodine deficiency is due to the greater need for
iodine during growth, pregnancy and lactation. Thus examination of
adolescent girls who are often preparing to have children or are already
having c