The appendix is a small, finger-shaped pouch attached to the large intestine in the right belly area. It is a vestigial organ as it has no specific role to play in humans, but the organ is still seen, though in a very small size compared to the earlier living beings in the evolutionary chain. Acutely inflamed appendix is the most common cause leading to it removal, often seen in the ages of 10 to 19.

Causes: the appendix gets infected by two main reasons - general infection in the abdomen that reaches the appendix or blockage of the appendix leading to inflammation and swelling within it. The appendix is a blind pouch, and there is a good chance for its blockage from food particles, lymphatic tissue, or even sometimes feces. Some of the potential risk factors for appendicitis include a diet low in fiber, high in sugar, gut flora, and family history.

Symptoms/diagnosis: in adults, the appendicitis has very characteristic symptoms including acute pain in the right upper part of the belly associated with fever and vomiting. However, in children, the pain may not be as tell-tale a sign but is still quite diagnostic of appendicitis. However, presence of the following symptoms together is surely indicative of appendicitis.
1. Right abdominal pain, especially rebound tenderness, where pressure placed in the right upper part of the belly and released leads to excruciating pain.
2. Fever, nausea, and vomiting
3. Abdominal fullness or bloating
4. Elevated white blood count (as with most infections)
Additionally, the younger the child, the symptoms are not very clear, but ultrasound will confirm the diagnosis. The inflamed, enlarged appendix will be visible on the images and could be surrounded by free fluid. Ct scan also can be considered if required to confirm the diagnosis.

Treatment: as noted above, children present with symptoms that do not pinpoint to appendicitis. Treatment usually takes two routes:

If diagnosed as appendicitis before rupture, then surgical removal is the best method to contain its symptoms. Other symptoms like fever and nausea and vomiting usually subside a couple of days after the surgery.
If the appendicitis goes unnoticed and ruptures, then the intestinal cavity can get infected, which is called peritonitis. Earlier, the preferred approach was to control the infection and then go for removal. However, lately, removing the appendix followed by antibiotics to control the infection is the preferred approach.
The prognosis and recovery from appendicitis is very good. Deaths have occurred only in very small infants, where they are not able to pinpoint the area and therefore it can go undiagnosed, leading to rupture and subsequent death.

Early identification is the key to proper identification, immediate treatment, and complete recovery from appendicitis.

Appendicitis in Children

There is always a sense of anxiety, whenever we tend to start off with something new, as people are resistant to change. It is more so in the case of young children. School refusal refers to the refusal of children to attend school as a result of emotional distress. This school refusal can wreak a kind of havoc on families.

Elaborate on symptoms a little more and causes

Symptoms

There are certain symptoms related to the refusal of children to attend schools. They include:

Often it comes in the form of tantrums
Frequent complaints of stomachaches, vomiting, nausea, exhaustion, headaches or diarrhea
There could be loud meltdowns in an overwhelming manner, which include their refusal to leave the house, running down the street to avoid getting inside the car or on the school bus
Children might even become aggressive and lash out at their parents with physical blows
Child feeling fearful of being alone in a room or dark


Causes

Some of the primary causes include:

It arises out of students having a feeling of separation from their parents and homely atmosphere, hence, leading to anxiety
It comes out of an emotional attachment which children tend to have with their parents, especially mothers
Children tend to feel scared with the thought of getting into an unknown atmosphere all of a sudden.
Consistent fear of criticism, ridiculing, confrontation or punishment by the teacher or any other person in the school
Having learning difficulties
Being afraid of qualifying the tests
Not feeling comfortable with school activities like singing, playing or attending school assembly
Fear of being ridiculed due to appearance, clothes, weight, etc.
Fear of being bullied by a class or schoolmate
How Can Children be Helped to Get Rid of this Problem?

The ideal treatment to help all those children struggling with school refusal includes a team approach. It will be beneficial to have a strong team which includes the class teacher, family and if possible, a mental health professionals. The steps include:

1. Assess: The very first step is to complete medical and psychological examination. Given the fact that school refusal is usually linked to an underlying anxiety or depressive disorder, it is necessary to get to the root of the problem and begin there. This would include both family and teacher questionnaires for interviews.

2. Cognitive Behavioral Therapy: This is a very structured form of therapy, which helps children to identify their maladaptive patterns of thought and also learn replacement behaviours. It would help children to confront and work through their anxiety.

3. Desensitization in a Systematic Manner: Those children who struggle with school refusal, need a graded approach to return to school. They can return for a some increased amount of time and then gradually build upon it.

4. Training for Relaxation: This is extremely essential for all those children who struggle with anxiety. Some of the relaxation strategies include deep breathing, guided imagery and mindfulness, which kids practice at home and also utilize in school.

5. Plan for Re-entry: The treatment team even creates a plan to help children re-enter the classroom. The plan includes contingencies to help the student during anxious moments throughout the day.

6. Routine and Structure: Children who are anxious can even benefit from routines at home that are predictable. Establishing healthy sleeping habits and a regular sleep cycle during holidays and on weekends can yield positive results.

School Refusal - Symptoms, Causes & Treatments Of It!

Abdomen pain or abdominal pain is usually experienced in the area between the chest and the stomach. This kind of pain usually comes as a dull cramp that also produces shooting stabs of pains intermittently, or it may be a localised pain in one side of the stomach. This may also be accompanied by inflammation and other diseases related to organs like intestines, kidneys, pancreas, liver, spleen and stomach. So what are the causes of stomach or abdomen pain? Read on to find out:

Food Poisoning: Food poisoning can be caused due to dirty water or contaminated food. This can give rise to various infections as well as conditions like traveler's diarrhea or loose motions.

Gastro-Intestinal Conditions: GERD or gastroesophageal reflux disease and gastroenteritis, among various others, can also lead to abdomen pain as a symptom along with severe acidity and nausea. Irritable bowel syndrome is another major ailment which can leave you with persistent abdominal pain. 

Generalized Pain: This kind of pain occurs in the overall area all around the stomach and may point at the presence of conditions like Crohn's Disease, a traumatic injury, appendicitis, flu, or even a urinary tract infection. Further, when the gas settles and tightens the stomach due to the inability to pass a motion on a normal, regular basis, this may be termed as constipation. This also leads to abdomen pain. 

Localised Lower Abdomen Pain: Pain that is found specifically in the lower area of the abdomen can be caused due to appendicitis, obstruction or blockage in the intestine or colon, and other ailments. This pain can also be accompanied by nausea and vomiting. 

Localised Upper Abdomen Pain: This kind of pain may emanate due to the presence of gallstones, liver inflammation or hepatitis, pneumonia, or even in the middle of a heart attack.

Localised Centre Abdomen Pain: Pain in the centre part of the stomach or abdomen may be caused due to gastroenteritis, an injury or even the accumulation of waste products in the body, otherwise known as uremia.

Abdomen Pain and Women: For women, such localised pain may be caused due to pelvic inflammatory disease, urinary tract infection, endometriosis, ectopic pregnancy, menstrual cramps which are also called dysmenorrhoea, and fibroids. Miscarriages can also cause pain in this part of the abdomen, for women.

Renal Stones: Renal stones or stone in kidney is one of the most common causes of abdomen pain. The pain caused by kidney stone is such that it can make a patient roll in bed and this pain may radiate to toward the groin as well. Persistent pain and nausea that come with vomiting and finally give rise to blood in the vomit or stool should be checked by the doctor immediately, so as to rule out any serious ailment. Imaging tests, ultrasound and an X-Ray can help in diagnosis.

Abdomen Pain - Knowing The Common Causes Of It!

If you are experiencing a whizzing sound while you breathe or having difficulty in breathing, you are suffering from asthma. It is a medical condition characterized by paroxysmal wheezing respiration dyspnoea. There is no definite way to prevent asthma, but by following a step-by-step daily plan, you can prevent asthma attacks or keep them in check. Here are some important measures to follow to prevent asthma:

You need to strictly follow your asthma action plan. The plan should be laid down after a detailed discussion with your doctor or healthcare team. All the medicines you require to prevent the asthma attacks will be written down for you.
You should get vaccinated for pneumonia and influenza. This will prevent these conditions from triggering asthma attacks or flare-ups.
You need to identify the asthma triggers and stay away from them. Several outdoors irritants and allergens from pollen to cold air can trigger asthma attacks.
You have to monitor your breathing. By recognising the warning signs of an attack like wheezing, slight coughing or shortness of breath, you can prevent an asthma attack. You need to measure and record your peak airflow regularly using a home peak flow meter.
By acting quickly, you can identify a fatal attack and prevent it from occurring. When the peak flow measurement decreases, you need to take your medicines immediately and abstain from any activity which may have triggered the attack.
You need to keep taking your prescribed medicines, even if your asthma symptoms have improved. You should not change your medication schedule without consulting a doctor. It is recommended that you to bring along the medicines you take at your doctor s appointment as he will be able to tell whether you are taking them right.
If you use your quick relief inhaler a lot, the asthma is not under control. You need to visit your doctor as soon as possible and he/she will make some modifications to your treatment.
For prevention of asthma, you should use allergy proof pillow covers and mattresses. You must wash your bedding every week in hot water to eliminate dust mites. You may use a dehumidifier for reducing excess moisture to prevent mold.
Do not allow your pets in the bedroom and on the furniture. Pet dander is a common trigger of asthma and it cannot be avoided by people who own pets.
You can also fit an air filtration system in your home. It will help in the elimination of asthma triggers such as pollen, dust mites and other allergens.
Many doctors suggest immunotherapy for asthma prevention in the form of allergy shots. Immunotherapy aims at altering a person s immune response by making it less sensitive to asthma triggers.

Asthma - 10 Ways to Keep it Under Control

Tonsillitis is an affliction that plagues a fair share of people. Located at the back of your throat, tonsils are essentially two small glands, which contain white blood cells to defend your body against infection. However, on account of germ attacks, sometimes the tonsils get infected and this results in the swelling of the tonsil glands, which in turn causes sore throat and aligned maladies. 

Tonsillitis may be cured through surgical procedures. However, an isolated case of the inflammation of the tonsils need not warrant a surgery. Tonsillectomy or the surgical method of curing tonsillitis is only recommended for extreme cases of tonsillitis. Only the frequent sufferers of tonsillitis take recourse to tonsillectomy for a durable and effective solution. Surgeries are only done on those who have had at least seven bouts of strep throats within a span of a year. 

Tonsillectomies essentially involve surgical removal of the tonsils either using a scalpel or burning the tissues in the tonsils with the use of ultrasound vibrations. Usually performed under anesthesia, it is a fairly painless and a non-hazardous procedure. Tonsillectomies generally last for about an hour. However, the recovery period sometimes entail a few physical discomforts. Sore throat, difficulty in swallowing, pain in the jaws and ears are common symptoms of post tonsillectomy conditions. While there are palliative medicines available in the markets, adequate rest and proper diet speeds up the recovery. 

Tonsillectomy generally leaves no side effects and the success rate of this surgery is quite heartening. Tonsillectomy has also known to cure several other associated health problems in the likes of breathing troubles, sleep apnea, bleeding of the tonsil glands or cancerous developments in the tonsil glands. That aside, tonsillectomy is only performed on acute cases of tonsillitis and often regarded as the lender of last resort when medicines stop according any relief to the patient.

When to go for a Tonsil Surgery?

Pulmonary Function Tests or PFTs are a set of tests that are used to determine, measure or observe the functioning of the lungs. The most common pulmonary function tests used are spirometry, gas diffusion, and lung plethysmography. 

Highlights of pulmonary function tests

A spirometry test is used to measure the amount of air inhaled and exhaled. It also measures the amount of time taken to complete a respiration cycle.
A lung plethysmography measures the amount of air in the lungs after the patient has taken a deep breath. It also measures the amount of air that remains in the lungs after the patient has exhaled as much air as possible.
What does a Pulmonary Function Test measure?
Pulmonary function tests would not only check how well the person is breathing but also how effectively the lungs are able to conduct oxygen to the rest of the body. In addition to air flow, these tests would measure the size and volume of the lung and lung diffusion.

These tests can also be used to measure

Total Lung Capacity   the amount of air present in the lungs after breathing in deeply
Forced Vital Capacity   the amount of air that can be exhaled after breathing in deeply
Minute Volume   the amount of air exhaled per minute
Vital Capacity   the total volume of air that can be breathed out after inhaling as much as possible
Tidal Volume   the amount of air inhaled or exhaled when breathing normally
Maximum voluntary ventilation   the amount of air that can be inhaled and exhaled in one minute
Functional Residual Capacity   the amount of air that remains in the lungs when breathing normally
Forced Expiratory Flow   the flow or volume of air during an exhalation
Peak Expiratory Flow Rate   the rate at which a person can exhale
When are Pulmonary Function Tests recommended?
A physician might recommend a patient undergo a PFT as part of a routine physical check-up. This test would be advised if the patient is experiencing any symptoms associated with lung problems or disorders such as asthma, respiratory infections, chronic obstructive pulmonary disease, COPD. A doctor would also use these tests to monitor and check whether a certain treatment prescribed for a lung disease or condition is working effectively.

Pulmonary function tests are safe as they are non-invasive but it is important to follow the instructions of the doctor or technician before, after and during the test. It is important to make your doctor aware of any surgeries, respiratory infections, chest pains or heart attacks that you might have experienced before the test. If you are taking any medications you might need to follow the advice of the doctor as to whether you can take them before the test.

Your doctor would also advice you on how to prepare for the test such as not eating a large meal, avoiding caffeine and wearing loose-fitting clothes. If you have any doubts, concerns or queries discuss them with your doctor.

Pulmonary Function Tests - Why Is It Required?

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