Concentration problems and trouble in focusing on one task at a time can be termed as Attention Deficit Hyperactivity Disorder or ADHD, in rare and severe cases. While most of the cases are identified in one's childhood, it has been seen that many cases persist into adulthood while still others go completely undiagnosed. This mental health disorder comes with a number of symptoms and management methods. Read on to know more.

Symptoms: While many patients suffering from this disorder may not display any obvious symptoms at a young age as children are supposed to be brimming with energy, the symptoms for adult ADHD, start to show up in a more obvious fashion. Wavering concentration and low levels of focus along with disorganised living with impulsiveness are the first signs of adult ADHD. Such adults also have trouble when it comes to finishing one task at a time, or even focusing on a task for a prolonged period of time. Bouts of impatience and excessive activity can also show up as symptoms, while restlessness is a quality that most of these patients seem to possess.

Diagnosis: The diagnosis of this condition is slightly difficult because most adults may complain of some or the other symptoms related to this condition at some point in their lives. Anxiety and mood swing related symptoms can help in diagnosing the condition in a better manner. If the condition ends up disrupting your normal life, work, socialising and behaviour in general, then you may want to see a doctor regarding the same, so that proper diagnosis may take place.

Causes: While genetic predisposition is said to be the foremost cause of this condition, especially when it continues well into adulthood, there are various environmental factors that may also have a significant bearing on the onset of the condition. Exposure as a child increases the risk of falling prey to this condition. Also, when there are problems with the central nervous system during the developing years, the patient may start to develop symptoms connected with this disorder later on.

Treatment: Stimulants and other medication like anti-depressants, nonstimulant amphetamine are also used for treating this condition along with therapy and psychological counselling for better organisation in life.

ADHD in Adults

Which baby doesn't spit up their food! This is usually not a reason to worry, but if this spitting up is chronic and is accompanied by other symptoms it is known as Gastroesophageal reflux disease or GERD. Severe GERD can cause weight loss and breathing problems and thus, should not be ignored.

Reflux occurs when food is pushed out of the stomach and back up the esophagus. This is usually because the digestive system in babies is not yet fully developed. Vomiting often during the day is one of the most common symptoms of GERD. Other symptoms include:
- A persistent cough
- Choking or gagging while eating
- Refusing to eat
- Crying while feeding
- Heartburn
- Pain in the stomach

Most cases of GERD can be diagnosed by its symptoms and a look at the baby's medical history. In some cases, additional tests may be required, such as:

Barium swallow
The child is given a chalky substance to drink. This highlights the esophagus, stomach and upper part of the small intestines in a special X-ray. It is used to check if there are any blockages in the digestive system.
pH probe

A long, thin tube with a probe at one end is put down the child's throat. This is kept in the esophagus for 24 hours. The probe measures the levels of acidity in the stomach. This test is usually done when the child complains of breathing problems along with reflux.

Upper GI endoscopy
Here the doctor puts a thin, flexible tube down the child's throat. At one end of the tube is a camera that allows the doctor to look into the esophagus, stomach and small intestine.

Gastric emptying study
One of the causes of reflux is the slow emptying of the stomach. To check this, the doctor will mix a radioactive chemical with the baby's milk that allows a special camera to follow its path down the digestive system.

In most cases, GERD can be treated by making a few lifestyle changes. Some of these are:
- Raise the head of the baby's crib
- After feeding the baby, do not let him lie down, but hold him upright for half an hour or so.
- Change his feeding schedule
- Ask your doctor if you can try giving him solid food. Else, check if you can thicken his feed with cereal.
- Make the baby burp after feeding

Most infants outgrow this condition within a year, so do not stress yourself and enjoy life with your baby.

Gastro-Oesophageal Reflux In Babies

Coughing is a common problem of the respiratory tract and often indicates a deeper problem. It can be very irritating and can affect eating habits and socialization. A cough which persists for more than 4 weeks is believed to be chronic in nature. Tuberculosis (TB) is the most common cause of chronic cough in India. TB is an airborne bacterial infection caused by the organism - 'Mycobacterium tuberculosis', that primarily affects the lungs, although other organs and tissues may be involved. Cardinal features are: 

Chronic cough with or without sputum.
Fever more in the night time. 
Poor appetite. 
Unintentional weight loss. 
Read on to know about other common causes of chronic cough and how to manage them.

Allergies: People with allergies usually have a chronic cough, which gets aggravated when exposed to the allergens such as pollen or environmental dust. Staying away from allergen provides relief. Antihistamines are also useful, which most people detected with allergies keep in handy. Inhalers might be required, if there is associated congestion or shortness of breath.
Asthma: This is a very common chronic condition, caused by inflammation and swelling of the lungs, in addition to wheezing and shortness of breath. Asthma patients often suffer from a chronic cough. An asthma attack usually happens during the night or early morning, and is triggered by colds, cigarette smoke, air pollutants or allergens, which can even include certain foods. Most asthmatics usually carry their steroids, inhalers, and bronchodilators, as the onset of attack can be unpredictable.
Bronchitis: This condition of inflammation of the bronchial region is very common among smokers and among the elderly. There is excessive mucus accumulation, which the body tries to clear via coughing. The lungs are weakened and therefore, the coughing is painful.
Gastroesophageal reflux disease (GERD): This is a problem of the digestive system, but regurgitation of food into the airway induces cough. GERD is a chronic issue and so most people also end up with a chronic cough. It is worse with sitting up than with sitting down. Treatment includes H2 blockers to suppress acid production and dietary changes including small, frequent meals and avoiding spicy food items.
Upper airway cough syndrome: There could be multiple problems in the upper airway, which leads to a constant postnasal drip. Here, there is constant dripping of the sputum into the air passage, which can lead to a chronic cough whenever there is impaired air flow. This can be caused by various forms of chronic sinusitis and rhinitis. People diagnosed with this condition usually resort to antihistamines and decongestants for relief.
Other causes: There are a number of other causes as noted below. Smoking, tuberculosis, congestive heart failure, pertussis or whooping cough, foreign body in the airway, cancer in the airway passage, chronic aspiration of foods, etc. can all lead to chronic cough.
The key is to identify the reason that is causing the chronic cough. Most people who are diagnosed are educated to handle it and carry the required medications including steroids, bronchodilators, and inhalers.

Suffering from Chronic Cough - How to Manage it?

The word epilepsy brings to mind visions of people frothing at the mouth and rolling on the ground. However, epilepsy affects each patient in a different way. This can make it hard to recognize at times. In the more serious cases of epilepsy, an epileptic attack can make a patient injure himself or develop other life threatening conditions. In rare cases, epilepsy can even cause death. Thus it becomes imperative to understand how to deal with epilepsy.

Treatment options for epilepsy can be categorized as medication, surgical procedures and dietary changes.

Medication
Medication for epilepsy is prescribed on the basis of the symptoms presented and the type of epilepsy the patient is suffering from. In most cases, seizures can be controlled with a single type of medication, but in others, the doctor may need to prescribe a combination of medicines to control epilepsy. These forms of medication do have side effects and hence any reactions to the medication must be immediately brought to the doctor's notice. The dosage for epilepsy medication may need to be varied with time. An epileptic patient should never discontinue medication on their own.

Surgery
Depending on the type of seizures and the area of the brain affected, a doctor may advise surgery in cases of severe epilepsy. Surgery can help reduce the number of seizures experienced or completely stop them. Surgery to treat epilepsy is of many types. Some of the common procedures are:

1. Surgery to remove tumor of any such conditions that may be triggering the epileptic attacks
2. Surgery to remove a small section of the brain from where a seizure originates. This may also be referred to as a lobectomy.
3. Multiple subpial transaction or a surgery that involves making a series of cuts in the brain to prevent the seizures from spreading to other parts of the brain.
4. Surgery to sever the neural connections between the right and left hemispheres of the brain.
5. Surgery to remove half the brain's cortex or outer layer

Dietary changes
A diet rich in fats and low in carbohydrates can help reduce seizures. This is known as a ketogenic diet and aims at making the body break down fats instead of carbohydrates. It can cause a buildup of uric acid in the body and thus should be practiced only under the guidance of a dietician. In cases where epileptic attacks are triggered by malnutrition and birth defects, taking vitamin supplements can help lower the frequency of seizures.

How to Deal with Severe Epilepsy

Women tend to develop high levels of blood sugar during their pregnancy (especially within the 24th and 28th weeks), irrespective of whether they already had suffered from diabetes prior to their pregnancy. However, gestational diabetes, if not taken proper care of, might escalate the risks of developing diabetes in the near future for both the mother and the child, accompanied by complications in pregnancy or labor. Gestational diabetes is usually characterized by mild symptoms such as excessive urge to urinate, excessive thirst, blurred vision and fatigue.

Causes:
Insulin, a hormone produced by the pancreas, allows for the utilization of the glucose for energy. The food consumed is broken down by the digestive tract of the body, converting carbohydrates into glucose before releasing it into the bloodstream. The glucose is then absorbed by the cells to be used as an energy source. Now, at the time of pregnancy, the placenta (organ nourishing the fetus) connecting the baby to the blood supply also produces various other hormones in high levels, for instance, estrogen and human placental lactogen. Most of these hinder the normal functioning of insulin in the cells, hence raising the blood sugar count. With subsequent growth of the baby, the placenta keeps on producing more amounts of such insulin resistant hormones to an extent that they are capable of meddling with the development of the baby.

Treatment:
1. Monitoring the blood sugar count at least four to five times a day and keeping it under control might help to ease the complication.
2. A healthy diet consisting of whole grains, vegetables and fruits in the right proportion and limiting sugar or other highly refined carbs meets the nutrition and fiber requirement of the body. Guard against additional weight gain during pregnancy as that hampers the entire process.
3. Exercise or regular physical activities help to normalize blood sugar level by boosting glucose absorption in the cells. Furthermore, exercises also enhance the sensitivity of the cells towards insulin. This means that only a little amount of insulin production by your body would be enough for the transportation of sugar.
4. Medication, If exercise and diet fall inadequate, insulin injections are often administered to control blood sugar count.
5. Keeping the baby under close observation with the help of repeated ultrasound and other tests to record its growth and development is an essential part of the treatment plan.

Gestational Diabetes - How It Can Be Treated?

Child sexual abuse is a pressing issue in society today. Statistically, there has been a considerable increase in the number of cases related to juvenile sex abuse over the past decade. Most of the cases report the abuser to be a close family member or a family friend rather than a complete stranger.
Future Consequences-
A sexually abused child may develop severe mental health conditions and have major difficulties coping with as an adult. One of the most common disorders affecting survivors of child sexual abuse is Post-Traumatic Stress Disorder (PTSD). This involves the individual reliving the trauma all his/her life, thus leading to panic, stress and difficulties in living a healthy life in the longer run.
The individuals who were abused as a child normally suffer from a very low self -esteem. They continue to blame themselves for the events that occurred and hence have a rather demeaning view of themselves, leading to adjustment issues in the future.
They may also be diagnosed with clinical depression owing to the previous trauma. This hampers the everyday functioning of the individual. The individual may continue to relive the past traumatic events in the mind that further fuels their depression and contribute to the vicious cycle, eventually.
Most often, survivors of child sexual abuse have a rather impulsive nature owing to the hampered functioning of impulse-control. They have lesser control over their emotions, especially anger and are rather quick to act on it.
Because of all the complications, they might be less socially competent and thus fail to build firm peer relationships. They grow up to be adults with severe trust issues; they are hence, often side-lined because of their cynicism which leads to further depressive symptoms.
Genophobia or the fear of sex is another complication that they may experience as adults. They may avoid sex altogether or engage in sexual activities that are rather violent in nature. Some survivors may develop certain sexual fetishes that can be rather dangerous; the most common being  paedophilia  or the sexual arousal involving prepubescent children.
Conclusion-
The seriousness of the condition is often undermined. In treatment, various therapeutic techniques are used according to the need and age of the patient. Therapists work to promote positive thinking among the sufferers so that it becomes easy for them to accept their past and move on in life with a better outlook. With proper guidance and help, the individuals are able to overcome their mental health issues and live a wholesome life.


Sexual Abuse -  Mental and Psychological Effects on Children

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