Appendicitis

                                  
Appendicitis is swelling (inflammation) of the appendix. The appendix is a small pouch attached to the beginning of your large intestine.


Causes, incidence, and risk factors:


Appendicitis is one of the most common causes of emergency abdominal surgery in the United States. It usually occurs when the appendix becomes blocked by feces, a foreign object, or rarely, a tumor.


Symptoms:


The symptoms of appendicitis can vary. It can be hard to diagnose appendicitis in young children, the elderly, and women of childbearing age.

The first symptom is often pain around your belly button. (See: Abdominal pain) The pain may be minor at first, but it becomes more sharp and severe. Your appetite will be reduced, and you may have nausea, vomiting, and a low fever.

As the swelling in the appendix increases, the pain tends to move into your right lower abdomen. It focuses right above the appendix at a place called McBurney's point. This most often occurs 12 to 24 hours after the illness starts.

If your appendix breaks open (ruptures), you may have less pain for a short time and you may feel better. However, once the lining of your abdominal cavity becomes swollen and infected (a condition called peritonitis), the pain gets worse and you become sicker.

Your pain may be worse when you walk or cough. You may prefer to lie still because sudden movement causes pain.

                                                                      

                                                      Later symptoms include

1.Chills

2.Constipation

3.Diarrhea

4.Fever

5.Nausea

6.Shaking

7.Vomiting                    

 Signs and tests:

             If you have appendicitis, your pain will increase when the doctor gently presses on your lower right belly area. If you have peritonitis, touching the belly area may cause a spasm of the muscles.

A rectal exam may find tenderness on the right side of your rectum.

Doctors can usually diagnose appendicitis by:

• Your description of the symptoms
• The physical exam
• Lab tests

In some cases, other tests may be needed, including:

                a. Abdominal CT scan

                 b.Abdominal ultrasound

Treatment:

                      If you do not have complications, a surgeon will usually remove your appendix soon after your doctor thinks you might have the condition. For information on this type of surgery, see: Appendectomy.

Because the tests used to diagnose appendicitis are not perfect, sometimes the operation will show that your appendix is normal. In that case, the surgeon will remove your appendix and explore the rest of your abdomen for other causes of your pain.

If a CT scan shows that you have an abscess from a ruptured appendix, you may be treated for infection. You will have your appendix removed after the infection and swelling have gone away.

Complication:

1. Abnormal connections between abdominal organs or between these organs and    the skin surface (fistula)

2. Abscess

3. Blockage of the intestine

4.Infection inside the abdomen (peritonitis)

5. Infection of the surgical wound

calling your Health care provider :

Call your health care provider if you have abdominal pain in the lower-right portion of your belly, or any other symptoms of appendicitis. Also call your doctor if:

• Your pain is severe, sudden, or sharp
• You have a fever along with your pain
• You are vomiting blood or have bloody diarrhea
• You have a hard abdomen that is tender to touch
• You are unable to pass stool, especially if you are also vomiting
• You have chest, neck, or shoulder pain
• You are dizzy or light-headed
• You have nausea and a lack of appetite with your pain
• You are losing weight that you did not mean to lose
• You have yellowing of your eyes or skin
• You have bloating for more than 2 days
• You have diarrhea for more than 5 days, or your infant or child has had diarrhea for 2 days or vomiting for 12 hours (call right away if a baby younger than 3 months has diarrhea or vomiting)
• You have had abdominal pain for more than 1 week
• You have burning with urination or you are urinating more often than usual
• You have pain and may be pregnant
• Your pain gets worse when you take antacids or eat something

Attention Deficit Disorder (ADD)

Life can be a balancing act for any adult, but if you find yourself constantly late, disorganized, forgetful, and overwhelmed by your responsibilities, you may have ADD/ADHD. Attention deficit disorder affects many adults, and its wide variety of frustrating symptoms can hinder everything from your relationships to your career. But help is available—and learning about ADD/ADHD is the first step. Once you understand the challenges, you can learn to compensate for areas of weakness and start taking advantage of your strengths.


                                        


Understanding ADD In Adults :


                         


                                       Attention deficit disorder is not just a problem in children. If you were diagnosed with childhood ADD/ADHD, chances are, you’ve carried at least some of the symptoms into adulthood. But even if you were never diagnosed with ADD/ADHD as a child, that doesn’t mean you can’t be affected by it as an adult.

              

Attention deficit disorder often goes unrecognized throughout childhood. This was especially common in the past, when very few people were aware of ADD/ADHD. Instead of recognizing your symptoms and identifying the real issue, your family, teachers, or other parents may have labeled you a dreamer, a goof-off, a slacker, a troublemaker, or just a bad student.

Alternately, you may have been able to compensate for the symptoms of ADD/ADHD when you were young, only to run into problems as your responsibilities increase. The more balls you’re trying to keep in the air—pursuing a career, raising a family, running a household—the greater the demand on your abilities to organize, focus, and remain calm. This can be challenging for anyone, but if you have ADD/ADHD, it can feel downright impossible.

The good news is that, no matter how it feels, the challenges of attention deficit disorder are beatable. With education, support, and a little creativity, you can learn to manage the symptoms of adult ADD/ADHD—even turning some of your weaknesses into strengths. It’s never too late to turn the difficulties of adult ADD/ADHD around and start succeeding on your own terms.

                      

                       Signs and Symptoms of ADD 

In adults, attention deficit disorder often looks quite different than it does in children—and its symptoms are unique for each individual. The following categories highlight common symptoms of adult ADD/ADHD. Do your best to identify the areas where you experience difficulty. Once you pinpoint your most problematic symptoms, you can start to work on strategies for dealing with them.

1.Trouble concentrating and staying focused :

                                                          

                 Adults with ADD/ADHD often have difficulty staying focused and attending to daily, mundane tasks. For example, you may be easily distracted by irrelevant sights and sounds, quickly bounce from one activity to another, or become bored quickly. Symptoms in this category are sometimes overlooked because they are less outwardly disruptive than the ADD/ADHD symptoms of hyperactivity and impulsivity—but they can be every bit as troublesome. The symptoms of inattention and concentration difficulties include:

• “zoning out” without realizing it, even in the middle of a conversation.
• extreme distractibility; wandering attention makes it hard to stay on track.
• difficulty paying attention or focusing, such as when reading or listening to others.
• struggling to complete tasks, even ones that seem simple.
• tendency to overlook details, leading to errors or incomplete work.
• poor listening skills; hard time remembering conversations and following directions.

2. Hyperfocus :

                                     

               While you’re probably aware that people with ADD/ADHD have trouble focusing on tasks that aren’t interesting to them, you may not know that there’s another side: a tendency to become absorbed in tasks that are stimulating and rewarding. This paradoxical symptom is called hyperfocus.

Hyperfocus is actually a coping mechanism for distraction—a way of tuning out the chaos. It can be so strong that you become oblivious to everything going on around you. For example, you may be so engrossed in a book, a TV show, or your computer that you completely lose track of time and neglect the things you’re supposed to be doing. Hyperfocus can be an asset when channeled into productive activities, but it can also lead to work and relationship problems if left unchecked.

3.Disorganization and forgetfulness:

                  

                  When you have adult ADD/ADHD, life often seems chaotic and out of control. Staying organized and on top of things can be extremely challenging—as is sorting out what information is relevant for the task at hand, prioritizing the things you need to do, keeping track of tasks and responsibilities, and managing your time. Common symptoms of disorganization and forgetfulness include:

• poor organizational skills (home, office, desk, or car is extremely messy and cluttered)
• tendency to procrastinate
• trouble starting and finishing projects
• chronic lateness
• frequently forgetting appointments, commitments, and deadlines
• constantly losing or misplacing things (keys, wallet, phone, documents, bills)
• underestimating the time it will take you to complete tasks

4. Impulsivity:

                                    

                   If you suffer from symptoms in this category, you may have trouble inhibiting your behaviors, comments, and responses. You might act before thinking, or react without considering consequences. You may find yourself interrupting others, blurting out comments, and rushing through tasks without reading instructions. If you have impulse problems, being patient is extremely difficult. For better or for worse, you may go headlong into situations and find yourself in potentially risky circumstances. You may struggle with controlling impulses if you:

• frequently interrupt others or talk over them
• have poor self-control
• blurt out thoughts that are rude or inappropriate without thinking
• have addictive tendencies
• act recklessly or spontaneously without regard for consequences
• have trouble behaving in socially appropriate ways (such as sitting still during a long meeting)

5.Emotional difficulties:

                                                

              Many adults with ADD/ADHD have a hard time managing their feelings, especially when it comes to emotions like anger or frustration. Common emotional symptoms of adult ADD/ADHD include:

• sense of underachievement
• doesn’t deal well with frustration
• easily flustered and stressed out
• irritability or mood swings
• trouble staying motivated
• hypersensitivity to criticism
• short, often explosive, temper
• low self-esteem and sense of insecurity

6.Hyperactivity:

                                      

• feelings of inner restlessness, agitation
• tendency to take risks
• getting bored easily
• racing thoughts

• trouble sitting still; constant fidgeting
• craving for excitement
• talking excessively
• doing a million things at once