ADHD in Adults

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ADHD Symptom Snapshot

There are 3 core symptoms of ADHD: inattention, impulsivity, and hyperactivity. The following are examples of how ADHD symptoms may appear in adults.

Only a doctor or other health care professional can diagnose ADHD.

ONLY A DOCTOR OR OTHER HEALTH CARE PROFESSIONAL CAN DIAGNOSE ADHD

Symptoms of Inattention

  • Often makes careless mistakes and lacks attention to details
    (Examples: overlooking or missing details or handing in work that is inaccurate)
  • Often has difficulty paying attention to tasks
    (Example: difficulty remaining focused during lectures, conversations, or lengthy readings)
  • Often seems to not listen when spoken to directly
    (Example: mind seems elsewhere, even in the absence of obvious distraction)
  • Often fails to follow through on instructions, chores, or duties in the workplace
    (Example: starts tasks but quickly loses focus and is easily sidetracked)
  • Often has difficulty organizing tasks and activities
    (Examples: messy, disorganized work; poor time management; fails to meet deadlines)
  • Often avoids, dislikes, or is reluctant to participate in tasks requiring sustained mental effort, like preparing reports, completing forms, or reviewing lengthy papers 
  • Often loses things like tools, wallets, keys, paperwork, eyeglasses, and mobile phones
  • Often easily distracted by other things, including unrelated thoughts
  • Often forgetful in daily activities, such as running errands, returning calls, paying bills, and keeping appointments

Symptoms of Hyperactivity and Impulsivity

  • Often fidgets with or taps hands and feet or squirms in seat
  • Often leaves seat when remaining seated is expected
    (Example: leaves their place in the office or other workplace setting or in other situations that require remaining seated)
  • Often runs or climbs where it is inappropriate or feels restless (in adults, may be limited to feeling restless)
  • Often unable to participate in leisure activities quietly
  • Often acts as if “on the go” or “driven by a motor”
    (Example: is unable to be or uncomfortable being still for an extended time, as in meetings or restaurants)
  • Often talks excessively
  • Often blurts out an answer before a question has been fully asked
    (Examples: completes people’s sentences; cannot wait for next turn in conversation)
  • Often has difficulty waiting his or her turn, for example, while waiting in line
  • Often interrupts or intrudes on others
    (Examples: butts into conversations, games, or activities; may start using other people’s things without asking or receiving permission; may intrude into or take over what others are doing)

Europe’s most dangerous pathogens: Climate change increasing risks

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Europe’s most dangerous pathogens: Climate change increasing risks

Date:
August 2, 2017
Source:
University of Liverpool
Summary:
The impact of climate change on the emergence and spread of infectious diseases could be greater than previously thought, according to new research.

The impact of climate change on the emergence and spread of infectious diseases could be greater than previously thought, according to new research by the University of Liverpool.

The study, published in Scientific Reports, is the first large-scale assessment of how climate affects bacterium, viruses or other microorganisms and parasites (pathogens) that can cause disease in humans or animals in Europe.

The results will help policy makers prioritise the surveillance for pathogens that may respond to climate change and, in turn, contribute to strengthening climate change resilience for infectious diseases.

Epidemics

There is growing evidence that climate change is altering the distribution of some diseases, in some cases causing epidemics or making diseases spread within their natural range, for example, Zika virus in South America, or bluetongue and Schmallenberg disease in livestock in Europe.

Dr Marie McIntyre, who led the project at the University’s Institute of Infection and Global Health, explained: “Although there is a well-established link between climate change and infectious disease, we did not previously understand how big the effects will be and which diseases will be most affected.

“Climate sensitivity of pathogens is a key indicator that diseases might respond to climate change, so assessing which pathogens are most climate-sensitive, and their characteristics, is vital information if we are to prepare for the future.”

Largest effects

The researchers carried out a systematic review of published literature on one hundred human and one hundred domestic animal pathogens present in Europe that have the largest impact on health.

Nearly two-thirds of the pathogens examined were found to be sensitive to climate; and two-thirds of these have more than one climate driver, meaning that the impact of climate change upon them will likely be multifaceted and complex.

Diseases spread by insects and ticks (vector-borne diseases) were found to be the most climate sensitive, followed by those transmitted in soil, water and food. The diseases with the largest number of different climate drivers were Vibrio cholerae (cause of cholera), Fasciola hepatica (cause of liver fluke), Bacillus anthracis (cause of anthrax) and Borrelia burgdorferi (cause of tickborne Lyme disease).

Future effects

Dr Marie McIntyre, commented: “Currently, most models examining climate effects only consider a single or at most two climate drivers, so our results suggest that this should change if we really want to understand future impacts of climate change on health.”

Zoonotic pathogens — those that spread from animals to humans — were also found to be more climate sensitive than those that affect only humans or only animals. As 75% of emerging diseases are zoonotic, emerging diseases may be particularly likely to be impacted by climate change.

However, the researchers stress that their response to climate change will also be dependent on the impacts of other drivers, such as changes to travel and trade, land-use, deforestation, new control measures and the development of antimicrobial resistance.

Big Data

The top 100 human and animals list was compiled using the Enhanced Infectious Disease Database (EID2), — a comprehensive and open-access ‘Big Data’ record of over 60 million scientific papers, electronic sources and textbooks associated with infectious diseases that was developed in Liverpool.


Story Source:

Materials provided by University of LiverpoolNote: Content may be edited for style and length.

Typhoid fever

Typhoid fever is caused by Salmonella typhi bacteria. Typhoid fever is rare in industrialized countries. However, it remains a serious health threat in the developing world, especially for children.

Typhoid fever spreads through contaminated food and water or through close contact with someone who’s infected. Signs and symptoms usually include high fever, headache, abdominal pain, and either constipation or diarrhea.

Most people with typhoid fever feel better within a few days of starting antibiotic treatment, although a small number of them may die of complications. Vaccines against typhoid fever are available, but they’re only partially effective. Vaccines usually are reserved for those who may be exposed to the disease or are traveling to areas where typhoid fever is common.

Symptoms

Signs and symptoms are likely to develop gradually — often appearing one to three weeks after exposure to the disease.

Early illness

Once signs and symptoms do appear, you’re likely to experience:

  • Fever that starts low and increases daily, possibly reaching as high as 104.9 F (40.5 C)
  • Headache
  • Weakness and fatigue
  • Muscle aches
  • Sweating
  • Dry cough
  • Loss of appetite and weight loss
  • Abdominal pain
  • Diarrhea or constipation
  • Rash
  • Extremely swollen abdomen

Later illness

If you don’t receive treatment, you may:

  • Become delirious
  • Lie motionless and exhausted with your eyes half-closed in what’s known as the typhoid state

In addition, life-threatening complications often develop at this time.

In some people, signs and symptoms may return up to two weeks after the fever has subsided.

When to see a doctor

See a doctor immediately if you suspect you have typhoid fever. If you become ill while traveling in a foreign country, call the U.S. Consulate for a list of doctors. Better yet, find out in advance about medical care in the areas you’ll visit, and carry a list of the names, addresses and phone numbers of recommended doctors.

If you develop signs and symptoms after you return home, consider consulting a doctor who focuses on international travel medicine or infectious diseases. A specialist may be able to recognize and treat your illness more quickly than can a doctor who isn’t familiar with these areas.

Causes

Typhoid fever is caused by virulent bacteria called Salmonella typhi (S. typhi). Although they’re related, S. typhi and the bacteria responsible for salmonellosis, another serious intestinal infection, aren’t the same.

Fecal-oral transmission route

The bacteria that cause typhoid fever spread through contaminated food or water and occasionally through direct contact with someone who is infected. In developing nations, where typhoid fever is endemic, most cases result from contaminated drinking water and poor sanitation. The majority of people in industrialized countries pick up typhoid bacteria while traveling and spread it to others through the fecal-oral route.

This means that S. typhi is passed in the feces and sometimes in the urine of infected people. You can contract the infection if you eat food handled by someone with typhoid fever who hasn’t washed carefully after using the toilet. You can also become infected by drinking water contaminated with the bacteria.

Typhoid carriers

Even after treatment with antibiotics, a small number of people who recover from typhoid fever continue to harbor the bacteria in their intestinal tracts or gallbladders, often for years. These people, called chronic carriers, shed the bacteria in their feces and are capable of infecting others, although they no longer have signs or symptoms of the disease themselves.

Risk factors

Typhoid fever remains a serious worldwide threat — especially in the developing world — affecting an estimated 26 million or more people each year. The disease is endemic in India, Southeast Asia, Africa, South America and many other areas.

Worldwide, children are at greatest risk of getting the disease, although they generally have milder symptoms than adults do.

If you live in a country where typhoid fever is rare, you’re at increased risk if you:

  • Work in or travel to areas where typhoid fever is endemic
  • Work as a clinical microbiologist handling Salmonella typhi bacteria
  • Have close contact with someone who is infected or has recently been infected with typhoid fever
  • Drink water contaminated by sewage that contains S.
  • Complications

    Intestinal bleeding or holes

    The most serious complications of typhoid fever — intestinal bleeding or holes (perforations) in the intestine — may develop in the third week of illness. A perforated intestine occurs when your small intestine or large bowel develops a hole, causing intestinal contents to leak into your abdominal cavity and triggering signs and symptoms, such as severe abdominal pain, nausea, vomiting and bloodstream infection (sepsis). This life-threatening complication requires immediate medical care.

    Other, less common complications

    Other possible complications include:

    • Inflammation of the heart muscle (myocarditis)
    • Inflammation of the lining of the heart and valves (endocarditis)
    • Pneumonia
    • Inflammation of the pancreas (pancreatitis)
    • Kidney or bladder infections
    • Infection and inflammation of the membranes and fluid surrounding your brain and spinal cord (meningitis)
    • Psychiatric problems, such as delirium, hallucinations and paranoid psychosis

    With prompt treatment, nearly all people in industrialized nations recover from typhoid fever. Without treatment, some people may not survive complications of the disease.

  • Preparing for your appointment

    Call your doctor if you’ve recently returned from travel abroad and develop mild symptoms similar to those that occur with typhoid fever. If your symptoms are severe, go to an emergency room or call 911 or your local emergency number.

    Here’s some information to help you get ready and know what to expect from your doctor.

    Information to gather in advance

    • Pre-appointment restrictions. At the time you make your appointment, ask if there are restrictions you need to follow in the time leading up to your visit. Your doctor will not be able to confirm typhoid fever without a blood test, and may recommend taking steps to reduce the risk of passing a possible contagious illness to others.
    • Symptom history. Write down any symptoms you’re experiencing and for how long.
    • Recent exposure to possible sources of infection. Be prepared to describe international trips in detail, including the countries you visited and the dates you traveled.
    • Medical history. Make a list of your key medical information, including other conditions for which you’re being treated and any medications, vitamins or supplements you’re taking. Your doctor will also need to know your vaccination history.
    • Questions to ask your doctor. Write down your questions in advance so that you can make the most of your time with your doctor.

    For typhoid fever, possible questions to ask your doctor include:

    • What are the possible causes for my symptoms?
    • What kinds of tests do I need?
    • Are treatments available to help me recover?
    • I have other health problems. How can I best manage these conditions together?
    • How long do you expect a full recovery will take?
    • When can I return to work or school?
    • Am I at risk of any long-term complications from typhoid fever?

    Don’t hesitate to ask any other related questions you have.

    What to expect from your doctor

    Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:

    • What are your symptoms and when did they begin?
    • Have your symptoms gotten better or worse?
    • Did your symptoms briefly get better and then come back?
    • Have you recently traveled abroad? Where?
    • Did you update your vaccinations before traveling?
    • Are you being treated for any other medical conditions?
    • Are you currently taking any medications?
    • Tests and diagnosis

      Medical and travel history

      Your doctor is likely to suspect typhoid fever based on your symptoms and your medical and travel history. But the diagnosis is usually confirmed by identifying S. typhi in a culture of your blood or other body fluid or tissue.

      Body fluid or tissue culture

      For the culture, a small sample of your blood, stool, urine or bone marrow is placed on a special medium that encourages the growth of bacteria. The culture is checked under a microscope for the presence of typhoid bacteria. A bone marrow culture often is the most sensitive test for S. typhi.

      Although performing a culture test is the mainstay for diagnosis, in some instances other testing may be used to confirm a suspected typhoid fever infection, such as a test to detect antibodies to typhoid bacteria in your blood or a test that checks for typhoid DNA in your blood.

    • Treatments and drugs

      Antibiotic therapy is the only effective treatment for typhoid fever.

      Commonly prescribed antibiotics

      • Ciprofloxacin (Cipro). In the United States, doctors often prescribe this for nonpregnant adults.
      • Ceftriaxone (Rocephin). This injectable antibiotic is an alternative for people who may not be candidates for ciprofloxacin, such as children.

      These drugs can cause side effects, and long-term use can lead to the development of antibiotic-resistant strains of bacteria.

      Problems with antibiotic resistance

      In the past, the drug of choice was chloramphenicol. Doctors no longer commonly use it, however, because of side effects, a high rate of health deterioration after a period of improvement (relapse) and widespread bacterial resistance.

      In fact, the existence of antibiotic-resistant bacteria is a growing problem in the treatment of typhoid fever, especially in the developing world. In recent years, S. typhi also has proved resistant to trimethoprim-sulfamethoxazole and ampicillin.

      Other treatments

      Other treatments include:

      • Drinking fluids. This helps prevent the dehydration that results from a prolonged fever and diarrhea. If you’re severely dehydrated, you may need to receive fluids through a vein (intravenously).
      • Surgery. If your intestines become perforated, you’ll need surgery to repair the hole.
      • Prevention

        In many developing nations, the public health goals that can help prevent and control typhoid fever — safe drinking water, improved sanitation and adequate medical care — may be difficult to achieve. For that reason, some experts believe that vaccinating high-risk populations is the best way to control typhoid fever.

        A vaccine is recommended if you’re traveling to areas where the risk of getting typhoid fever is high.

        Vaccines

        Two vaccines are available.

        • One is injected in a single dose at least one week before travel.
        • One is given orally in four capsules, with one capsule to be taken every other day.

        Neither vaccine is 100 percent effective, and both require repeat immunizations, as vaccine effectiveness diminishes over time.

        Because the vaccine won’t provide complete protection, follow these guidelines when traveling to high-risk areas:

        • Wash your hands. Frequent hand-washing in hot, soapy water is the best way to control infection. Wash before eating or preparing food and after using the toilet. Carry an alcohol-based hand sanitizer for times when water isn’t available.
        • Avoid drinking untreated water. Contaminated drinking water is a particular problem in areas where typhoid fever is endemic. For that reason, drink only bottled water or canned or bottled carbonated beverages, wine and beer. Carbonated bottled water is safer than uncarbonated bottled water is.

          Ask for drinks without ice. Use bottled water to brush your teeth, and try not to swallow water in the shower.

        • Avoid raw fruits and vegetables. Because raw produce may have been washed in unsafe water, avoid fruits and vegetables that you can’t peel, especially lettuce. To be absolutely safe, you may want to avoid raw foods entirely.
        • Choose hot foods. Avoid food that’s stored or served at room temperature. Steaming hot foods are best. And although there’s no guarantee that meals served at the finest restaurants are safe, it’s best to avoid food from street vendors — it’s more likely to be contaminated.

        Prevent infecting others

        If you’re recovering from typhoid fever, these measures can help keep others safe:

        • Take your antibiotics. Follow your doctor’s instructions for taking your antibiotics, and be sure to finish the entire prescription.
        • Wash your hands often. This is the single most important thing you can do to keep from spreading the infection to others. Use hot, soapy water and scrub thoroughly for at least 30 seconds, especially before eating and after using the toilet.
        • Avoid handling food. Avoid preparing food for others until your doctor says you’re no longer contagious. If you work in the food service industry or a health care facility, you won’t be allowed to return to work until tests show that you’re no longer shedding typhoid bacteria.

What are kidney stones?

kidney stones on x-ray

The cause of most stones is unknown, but they can be associated with a high concentration of calcium in the urine or occasionally in the blood.

They can also be caused by Dehydration, infection, obstruction of urine and various kidney disorders.

Crystals of salts found normally in the urine aggregate together and gradually enlarge in size to form stones, which may vary greatly in size. Some are as small as a grain of sand whereas others are so big they fill the entire renal pelvis.

Kidney stones typically occur in healthy men aged between 30 and 50. The male to female ratio for kidney stone disease is 4:1.

Patients who have had stones before are more at risk of further stones and sometimes the problem runs in families.

What are the symptoms of kidney stones?

  • Kidney stones may cause sudden, intense pain. If the stone travels down the ureter (the tube leading from the kidney to the bladder) it may get stuck at one of several points. The pain that this causes is usually concentrated on one side of the back but may also move into the stomach or down to the groin where it can result in colicky pains. The same type of pain may also be caused by bleeding or infection in the urinary system.
  • Kidney stone attacks can be so painful they cause great distress to the sufferer. The pain is often accompanied by nausea and vomiting.
  • They may cause scratches in the lining (mucosa) of the renal pelvis or the ureter. This leads to blood in the urine. There is not always enough to be seen with the naked eye but a diagnostic test can detect it.
  • Frequent infections in the urinary system may be a sign of kidney stones.

What should you do if you have an attack?

If you have a kidney stone attack, you may need medical help to ease the pain if simple painkillers (for example ibuprofen) are not helpful.

If you have never had a stone before, investigations will be necessary to make a diagnosis because other serious abdominal problems may cause similar pain.

Stones less than 5mm are very likely to pass out of the ureter spontaneously.

Once the stone reaches the bladder, it normally passes out of the body in the urine without further problems and often without you even being aware of it.

Larger stones may not pass on their own and may need an operation to remove them.

The doctor may want to see the stones. They are obviously difficult to catch but one solution is to try urinating through a sieve or through a coffee filter paper.

Will you need to go to hospital?

If the kidney stone is so big that it cannot come out by itself or the pain continues, it will be necessary to go to hospital.

In the past X-ray or ultrasound were used but it is becoming more common to use a CT scan to diagnose the problem.

CT is very good at showing the size of the stone and where it is situated. This is important because it helps doctors decide how, and when, the stone should be removed. If the stone is small and lying close to the bladder, it may be left to pass on its own.

There are many modern methods of removing stones that involve passing a small telescope via the bladder through which a variety of stone disintegrators can be used. Most commonly lasers are now used to fragment the stone.

Occasionally, a small opening is made directly into the kidney for large stones. It is very rare nowadays for patients to need open surgery.

What is lithotripsy?

Lithotripsy uses shockwave therapy to break up kidney stones. The treatment is performed in hospital using special equipment and is becoming more and more common.

The stone is fragmented into pieces by the treatment and these smaller pieces can then pass out of the body unaided in the urine.

If the stone is larger than 1 cm, then more than one treatment session may be required.

7 Natural Remedies For Joint Pain

Natural Remedies For Joint Pain

When joint pain flares up, you want relief—fast. But you might not want to pop a pain reliever, especially if you’re concerned about side effects or interactions with other drugs. Or maybe meds alone aren’t doing enough, so you’re looking to add a drug-free remedy to your arsenal. Ice and heat are great, but they’re not your only options. Here are 7 more natural ways to fight inflammation and ease your ache. (The Power Nutrient Solution is the first-ever plan that tackles the root cause of virtually every major ailment and health condition today; get your copy now!)

Stick a pin in it

The scientific proof that acupuncture improves osteoarthritis pain is a little iffy. (Studies have been mixed, and it’s hard to rule out the placebo effect.) But a 2013 research review did conclude that there’s some evidence that this alternative treatment improves pain and stiffness in people with fibromyalgia(an arthritis-like condition characterized by widespread musculoskeletal pain). So if you’re not averse to needles, book a few sessions. Just remember that frequent visits may be needed before you see results, and most insurance plans won’t cover it, says Sheryl Mascarenhas, MD, an assistant professor of rheumatology at The Ohio State University. (See what else acupuncture can treat.)

MORE: 11 Effective Solutions For Sciatic Nerve Pain

Take to the water.
Take to the water

Swimming, water aerobics, and other aquatic activities “promote flexibility and strength without high impact,” says Mark Karadsheh, MD, an orthopedic surgeon at the William Beaumont Hospital in Royal Oak, MI. A 2014 review in the journal Physical Therapy found that exercising in water reduces pain and improves physical functioning in people with osteoarthritis of the lower limbs. Meanwhile, a 2015 study from The Netherlands found that a 45-minute aquatic circuit training session helped relieve the pain of knee osteoarthritis.

Spice things up.
Spice things up

Capsaicin, a substance responsible for the heat in hot peppers, is also used in topical pain-relieving creams and ointments. “It temporarily uses up substance P [a brain chemical that stimulates pain receptors], which redirects nerves so you don’t feel pain in the joint,” explains Mascarenhas, who notes that it can provide significant relief. In fact, a study from Case Western Reserve University found that 80% of people with osteo or rheumatoid arthritis had less pain after applying capsaicin cream four times a day for 2 weeks.

Consider supplements.
Consider supplements
Consider supplements.

Glucosamine and chondroitin sulfate (both found in human cartilage) are popular for treating the pain and swelling associated with osteoarthritis. Studies on their effectiveness have been mixed, but a 2015 research review determined that this combo significantly reduces pain and improves functioning in people with osteoarthritis of the knee. “There’s no risk associated with taking them so they’re worth a shot,” says Karadsheh.

Go fish.
Go fish

It’s no secret that omega-3 fatty acids, including fish oil supplements, have anti-inflammatory properties. It turns out these supplements also could help aching joints feel better. A 2015 study from Thailand found that when people with osteoarthritis of the knee took 1,000 mg of fish oil supplements (a combination of EPA, or eicosapentaenoic acid, and DHA, or docosahexaenoic acid) once a day for 8 weeks, their pain decreased and their functioning improved significantly. Other research has found that getting more omega-3s enabled people with rheumatoid arthritis to reduce their reliance on NSAIDs.

Embrace an ancient martial art.
Embrace an ancient martial art

Practicing tai chi is a low-impact way to strengthen the muscles around your joints and increase your range of motion, says Karadsheh. A 2013 review of seven randomized controlled trials found that a 12-week tai chi program improves symptoms of pain, stiffness, and physical function in peopl

Lower abdominal pain in women

All women will experience pain in the lower abdomen from time to time. Most commonly this can occur due to their periods or menstruation.

In many cases it is difficult to diagnose the exact cause of the pain, but noting certain features will help your doctor come to a diagnosis.

The most common causes are a urinary disorder, such as bladder or kidneyproblems, a bowel problem or a problem with the reproductive system – the uterus, Fallopian tubes and ovaries.

Abdominal pain arising from the urinary system

Urine infections are common and present symptoms, such as burning when you pass urine and going to the toilet more often.

Infection can spread to the kidneys (pyelonephritis) and can make you feel unwell with a high temperature and back pain.

If you have pain that spreads from your back down to your groin and is severe – your doctor may be more concerned that you have kidney stones. The doctor will test your urine if you have any of the above symptoms.

If you have any blood in your urine, it’s important to tell the doctor because this always needs investigation.

Tumours of the urinary system are not common, and the doctor will certainly take into account the duration of your symptoms first.

Abdominal pain arising from the digestive system

Pain arising from the large intestine is a particularly common cause of lower abdominal pain in both men and women. Features suggesting your pain may be to do with the bowel are:

  • Pain associated with pooing
  • A change in bowel habit
  • Loss of blood when you poo
  • Bloating with wind

Both constipation and diarrhoea can give you pain.

The pain they are often associated with is described as crampy or ‘colicky.’ This means that it comes and goes in waves. Large bowel pain is characteristically relieved on opening the bowels. Potential causes of pain arising from the bowel include irritable bowel syndrome (IBS), which can give you alternating diarrhoea, constipation and bloating. Other conditions include diverticular disease and it’s complications which are more frequent in older patients. Inflammatory bowel disease (ulcerative colitis or Crohn’s). A rare but important diagnosis is colorectal cancer.

Bloating and swelling is also a common symptom that people report and can be due to a problem affecting the bowels.

If you have any fresh bleeding from your back passage or you notice that your poo is black in colour then your should alert your doctor. These symptoms require investigation.Woman having her stomach examined by doctor

Abdominal pain arising from the reproductive organs

Pain can originate from your uterus (womb), Fallopian tubes or ovaries. It’s usually felt in the middle of the lower abdomen.

Pain that is felt more to the side can be more typical of a pain coming from the ovary.

Pain coming from the uterus is often worse during your period and is called dysmenorrhoea.

Some conditions affecting the reproductive system can also cause pain during intercourse. This is called dyspareunia and it is important to let your doctor know if you are troubled by it.

Examples of conditions of the reproductive organs include endometriosis, fibroids, pelvic inflammatory disease, ovarian cysts and problems related to the early stage of pregnancy such as a miscarriage or ectopic pregnancy.

What will the doctor do?

The doctor will ask lots of questions regarding your periods, passing of urine and bowel movements. They may also ask about general symptoms such as fever, nausea and vomiting.

If appropriate, they may ask questions about a person’s emotional life-family, home, work and sex life.

Next the doctor will examine you. They will examine your abdomen and may examine you internally also (vaginal, rectal or sometimes both) may be necessary.

Often the doctor will ask for you to give a urine sample, which can be tested for infection.

If you have symptoms of vaginal discharge or other related symptoms the doctor may take some vaginal swabs.

Depending on your symptoms and their duration the doctor may decide to arrange for further investigations.

These may include:

  • Gynaecological causes may require vaginal swabs, cervical smears or pelvic ultrasound examination. Ultrasound may also be performed from within the vagina. Specialised blood test for ovarian cancer, CA-125, are usually performed. More invasive tests will depend upon the doctor’s suspicion of the cause of the pain.
  • Urinary causes can be investigated by urine culture, ultrasound or CT scan.
  • Colonic causes may require internal endoscopic examination of the bowel by Flexible Sigmoidoscopy or Colonoscopy.
  • A CT (Computerised Tomography Scan) may be appropriate for all three major sites of pain.

To determine how far to investigate lower abdominal pain takes skill and judgement. Pain can even arise outside the abdomen, for example from the back. Depending on the exact symptoms and duration, possible referral to the appropriate specialist is often required.

Other people also read:

Irritable bowel syndrome (IBS): what are the symptoms of IBS?

Lumbago (lower back pain): what are the danger signs?

Vaginal discharge: what can the doctor do?

Based on a text by Dr Erik Fangel Poulsen, specialist

Vaccines for adults: Which do you need?

Vaccines offer protection from infectious diseases. Find out how to stay on top of the vaccines recommended for adults.

You’re not a kid anymore, so you don’t have to worry about shots, right? Wrong. Find out how to stay on top of your vaccines.

What vaccines do adults need?

Vaccines for adults are recommended based on your age, prior vaccinations, health, lifestyle, occupation and travel destinations.

The schedule is updated every year, and changes range from the addition of a new vaccine to tweaks of current recommendations. To determine exactly which vaccines you need now and which vaccines are coming up, check the Centers for Disease Control and Prevention’s website.

What factors might affect my vaccine recommendations?

Several factors can affect whether you need certain vaccines. Be sure to tell your doctor if you:

  • Are planning to travel abroad
  • Have had your spleen removed
  • Work in certain occupations where exposures could occur
  • Are or might be pregnant
  • Are breast-feeding
  • Are moderately or severely ill or have a chronic illness
  • Have any severe allergies, including a serious allergic reaction to a previous dose of a vaccine
  • Have had a disorder in which your body’s immune system attacks your nerves, such as Guillain-Barre syndrome
  • Have a weakened immune system or are being treated with an immunosuppressant
  • Have recently had another vaccine
  • Have recently had a transfusion or received other blood products
  • Have a personal or family history of seizures

Your doctor might also recommend certain vaccines based on your sexual activity. Vaccinations can protect you from hepatitis A and hepatitis B, serious liver infections that can spread through sexual contact. The HPV vaccine is recommended for men up to age 21 and women up to age 26.

Why are some vaccines particularly important for adults?

Adults of any age can benefit from vaccines. However, certain diseases, such as the flu, can be particularly serious for older adults or those living with certain chronic illnesses.

How can I keep track of my vaccines?

To gather information about your vaccination status, talk to your parents or other caregivers. Check with your doctor’s office, as well as any previous doctors’ offices, schools and employers. Some states also have registries that include adult immunizations. To check, contact your state health department.

If you can’t find your records, talk to your doctor. He or she might be able to do blood tests to see if you are immune to certain diseases that can be prevented by vaccines. You might need to get some vaccines again.

To stay on top of your vaccines, ask your doctor for an immunization record form. Bring the form with you to all of your doctor visits and ask your provider to sign and date the form for each vaccine you receive.

Symptoms Fatigue

Causes

Most of the time fatigue can be traced to one or more of your habits or routines, particularly lack of exercise. It’s also commonly related to depression. On occasion, fatigue is a symptom of other underlying conditions that require medical treatment.

Lifestyle factors

Taking an honest inventory of things that might be responsible for your fatigue is often the first step toward relief. Fatigue may be related to:

  1. Use of alcohol or drugs
  2. Excess physical activity
  3. Jet lag
  4. Lack of physical activity
  5. Lack of sleep
  6. Medications, such as antihistamines, cough medicines
  7. Unhealthy eating habits

Conditions

Unrelenting exhaustion may be a sign of a condition or an effect of the drugs or therapies used to treat it, such as:

  1. Acute liver failure
  2. Anemia
  3. Anxiety
  4. Cancer
  5. Chronic fatigue syndrome
  6. Chronic infection or inflammation
  7. Chronic kidney disease
  8. Acute liver failure
  9. COPD
  10. Depression (major depressive disorder)
  11. Diabetes
  12. Emphysema
  13. Meralgia paresthetica
  14. Grief
  15. Heart disease
  16. Hyperthyroidism (overactive thyroid)
  17. Hypothyroidism (underactive thyroid)
  18. Inflammatory bowel disease (IBD)
  19. Medications and treatments, such as chemotherapy, radiation therapy, pain drugs, heart drugs and antidepressants
  20. Multiple sclerosis
  21. Obesity
  22. Pain that’s persistent
  23. Sleep apnea
  24. Stress
  25. Toxin ingestion

When to see a doctor

 Call 911 or your local emergency number

Get emergency help if your fatigue is related to a mental health problem and your symptoms also include:

  • Thoughts of harming yourself or of suicide
  • Concern that you may harm someone else

Also get emergency care if your fatigue is accompanied by any of the following:

  • Chest pain
  • Shortness of breath
  • Irregular or fast heartbeat
  • Feeling that you might pass out
  • Severe abdominal, pelvic or back pain

Seek immediate medical attention

Get someone to take you to an emergency room or urgent care if fatigue is accompanied by:

  • Abnormal bleeding, including bleeding from your rectum or vomiting blood
  • Severe headache

Schedule a doctor’s visit

Call for an appointment with your doctor if your fatigue has persisted for two or more weeks despite making an effort to rest, reduce stress, choose a healthy diet and drink plenty of fluids.