IN September, the Department of Community Medicine and School of Public Health, PGI, Chandigarh, will launch a unique project that will use E-counselling and a mobile application to reach out to girls of Chandigarh in the age group of 12 to 19 to address signs, symptoms of Polycystic Ovary Syndrome (PCOS) and related issues.
Titled, ‘Development, validation and evaluation of the impact of implementation of E-counselling based macro-micronutrient and lifestyle intervention programme on PCOS related signs/symptoms in adolescent girls of Chandigarh’, the principal investigator of the project is Dr Amarjeet Singh, Professor and Head, with Dr Kathirvel S, Associate Professor the co-principal investigator, Dr Ishwarpreet Kaur, the Research Associate and Natasha Bharwaj, Lab Technician. Also involved in the project are the Departments of Obstetrics and Gyanecology, Endocrinology, Biochemistry, with the research funding by ICMR, New Delhi.
The prevalence of PCOS, explains Dr Ishwarpreet, is rising steeply among adolescents due to unhealthy lifestyles, nutritional deficiencies, and lack of awareness regarding the condition. Adolescent girls, she said, represent one of the most vulnerable sections of society and their needs pertaining to routine health problems remain unaddressed.
The primary clinical features of PCOS among adolescents include menstrual irregularity, hirsutism, acne, insulin resistance, obesity, etc. If not managed properly, PCOS can increase the risk of long-term morbidities like metabolic and cardiovascular disorders, reproductive complications and psychological ailments. Menstrual irregularity and many cosmetic issues faced by PCOS patients may cause frustration, embarrassment and increased stress.
Pharmaceutical treatment includes oral contraceptive pills, insulin sensitising drugs and anti-androgens. “Unfortunately, these are not fully able to deal with all the clinical parameters and are not a preferred choice of treatment for adolescent girls. Adolescents are generally recommended to manage the condition with lifestyle modification. This treatment is ‘no cost’ and ‘safe’ and the probability of emergence of these problems can be minimised by adopting a health promoting and multi-disciplinary approach,” she said.
The present project, is planned to evolve effective strategies to resolve PCOS-related health problems in a comprehensive way.
Following the assessment of lifestyle (macro-micronutrient intake, exercise, etc) and gut microbiota among adolescent girls with PCOS and health controls, the project will develop technology-based educational intervention for treatment and follow-up for better compliance to dietary and lifestyle recommendations and thereby better outcomes. “Young girls are hesitant to talk about these issues, and therefore, do not seek help and delay in treatment can cause many health-related issues later in life. And this is an issue that is not restricted to young girls from rural areas, but also from educated, urban families. This is a project that is being launched for the first time, and is one of its kind in India,” adds Dr Ishwarpreet.
A two-group intervention will be provided to 110 patients. The cases will be recruited from the gynaecology department OPD of PGI, after initial check-up by the gynaecologist.
The study will not interfere with the existing medical/medicinal regimes prescribed by the doctors. The subjects of Group 1 will receive E-counselling-based lifestyle intervention and Group 2 will receive face-to-face lifestyle intervention. The E-Counselling group will get follow-up counselling session on phone along with free access to the app, being developed for the project.
The project, says the doctor, is pertinent to Chandigarh as the problem of PCOS is rising in the city among adolescent girls and the city will become a role model through implementation of such technology-based intervention among adolescent girls with PCOS. After demonstration of its success up-scaling of this system may be tried for the entire nation as it is a simple investigation and is easily replicable.
“For the first six months, we will focus on lifestyle changes to bring about change in the condition, like a healthy diet, portion control, exercise, opting for unprocessed, seasonal, and locally produced food The condition is very manageable by following these simple, lifestyle changes, which will be provided under one roof,” said Dr Ishwarpreet.
Citing evidence of success from a previous study, among 52 patients who received lifestyle counselling in the past reported an average weight reduction from 66 kg to 63 kg. At least 13 per cent obese girls regained normal weight and there was 50 per cent improvement in the hormone levels, while 60 per cent girls reported improvement in their menstrual regularity.