Laboratory MedNews

Signs to help you draw the line between having a child that is naturally active and having a child who has ADHD. ADHD, also known as attention – deficit hyperactivity disorder, is a disorder that is common in school-aged children, and characterized by the triad of inattention, hyperactivity or impulsivity. A child who has ADHD need not manifest all three symptoms. In fact, ADHD is divided into three subtypes depending on which of the triad predominantly manifests in the child.

The subtypes of ADHD are the following:

1. ADHD Predominantly Inattentive
2. ADHD Predominantly Hyperactive Impulsive
3. ADHD Predominantly Combined

One thing that may be of great concern to a parent is that manifestations of ADHD can affect a child’s social functioning and academic performance. Often, it is the school teacher who first suspects that a child has ADHD.

The school teacher will most likely inform the parent with regards to the observed signs of ADHD. However, a lot of children who has ADHD are within a regular classroom setting, and most teachers in the regular classroom setting do not have special training with regards to detecting signs of children with special needs, in particular, children with ADHD. Thus, it will also be helpful to a parent to know such signs and symptoms to be able to have an idea if the child has ADHD.

Based on the DSM-IV Diagnostic Criteria for ADHD established by psychiatry experts, the following are “red flags” that can make a parent suspect that his or her child has ADHD:

• For the predominantly inattentive type:

1.      Child has poor attention span

(a child with less than 10 minutes focus to a particular task is said to have poor attention span)

2.      Child is very forgetful with details

3.      Child often complains of losing his things (like school supplies, toys, etc.)

4.      Child has problems with following instructions, as observed when answering exams or when child is instructed a particular chore (take note that inability to follow instructions is not because of inability to understand the instructions)

5.      Child often commits mistakes on school exams because of carelessness

6.      Child has difficulty in organizing things

7.      Child is unwilling to participate on tasks that require prolonged mental effort

• For the predominantly hyperactive – impulsive type:

1.      Child is excessively talkative

2.      Child seems never to run out of energy

3.      Child seems to always move about

4.      Child has difficulty to comply when asked to behave

5.      Child has cannot remain on his seat for long periods of time

6.      Child loves to butt into other people’s conversations

7.      Child butts into someone who is talking (answers questions before someone has finished asking)

8.      Child has trouble with taking turns

• A combination of the above signs and symptoms characterizes that a child who has ADHD is categorized in the predominantly combined subtype.

Parents, in collaboration with school teachers, must be watchful of these enumerated “red flags” in identifying if a child has ADHD. Although issues have been raised with regards to the effect of labeling a child with “having ADHD”, special educational needs might be met if we can identify that a child has ADHD. If a parent or concerned school teacher has suspicions that a child has ADHD, the professional that can best help with making a specific diagnosis is a developmental pediatrician.

(For more detailed readings on the DSM-IV criteria for ADHD, the complete criteria may be read on any psychology or psychiatry book)

This video was uploaded by Johnson and Johnson, which is about child ADHD.

• The four levels of stress differentiate the extent at which stressors cause an impact to an individual’s daily life. These levels present the extremes of a spectrum wherein stress is healthy to an individual at one end, and very harmful to an individual on the other end.

These are the four levels of stress:

Level 1 :

The first level is characterized by mild anxiety. Among the four levels of stress, it is the first level that is considered as “healthy stress”. On this level, a person is highly motivated and his energy

levels are sufficient to cope up with the stressor. It is also in this level that a person feels very productive. Examples of situations of the first level are times when manageable life changing events occur, like a job promotion or getting married.

Level 2 :

The second  level of stress is experienced by an individual when a stressor continues to make a considerable effect on an individual’s daily life. At this stage, the individual may already have some complaints of overloading and a feeling of overwhelm and distress.

Level 3 :

The third level is already characterized as chronic stress. If the stressor is still not addressed

during this level of stress, there would already be explicit negative manifestations of stress such

as feelings of irritability and even somatic manifestations such as tension-related headaches.

Level 4 :

At this stage, the individual chronically feels exhausted, both physically & emotionally. The individual may even feel a reduced sense of self-fulfillment. Some serious somatic manifestations without supporting medical diagnosis may also be experienced. This final level among the four levels of stress requires consideration of anti-stress remediations.

• There are factors that can determine which among the four levels of stress a person might go through.

• First, the characteristics of the stressor may contribute to the level of stress an individual might be experiencing. Some stressors are acute stressors which can place an individual on the lower levels. Examples of acute stressors are daily life hassles like traffic jam, arguing with an officemate or preparing for an important exam. However, some stressors are chronic, and can bring the individual on the higher levels of the four levels of stress. Among the major chronic stressors are: unsatisfactory marriage, very demanding job or financial difficulties.

• The controllability of an event also influences our levels of stress. A stressor that is more controllable like dealing with a stubborn colleague brings a person to lower levels of stress. However, major uncontrollable events like having cancer or death of a loved one can really cause the individual to experience the higher levels of stress.

• These four levels of stress are identified to help one determine if stress has already reached a level dangerous to one’s physical and mental health. It is advised that a person should watch out for signs that one is already on the higher levels of stress. It may be a loved one or it may be you. Once determined, one must seek help regarding coping mechanisms to avoid self-injurious behavior like suicide or major psychosomatic illnesses.

Urinalysis is one of the most common diagnostic procedures or tests requested by doctors. This is probably because of the easy availability of specimen, ease of collection and relatively inexpensive cost of the test. However, the simplicity of the procedure should not be a reason for either the patient or medical technologist to be too lax about urinalysis. Although the test seems easy to do, it is one of the most useful diagnostic tools used by doctors to screen diseases. Here are some of the important things you must know about the test.

Illnesses Detected

Urinalysis detects various medical conditions. Since urine is an ultra filtrate of blood, it contains information about your body’s most important processes. The few amount of urine can help you diagnose possible kidney related problems such as urinary tract infection, renal stones and glomerulonephritis. It can also detect chronic conditions like diabetes mellitus. Usually, doctors request for urinalysis when you show symptoms like low back pain, painful urination, abdominal pain and blood in the urine. The diagnostic procedure is very useful in diagnosing urinary tract infections, UTI.

Patient Preparation

The patient preparation depends on the kind of urine specimen requested from you. However, the most common specimen required is the random and first morning specimen. Since random specimen may be taken anytime of the day, there are no special preparations needed. For the first morning specimen, you have to collect the urine upon waking up in the morning. This is more preferred as the various urinary constituents have been pooled overnight which represent a better view of the body’s metabolism. For both types, you need to do a “clean-catch mid-stream”. For ladies, wash the vaginal area prior to collection. Allow the few drops of urine to come out before collecting the middle part. Avoid contaminating the specimen with tissue paper or water.

Test

The actual urinalysis test will only take 10-15 minutes. During this time, the medical technologist will do a visual, chemical and microscopic examination. After the test, your doctor will then interpret the results with consideration of your medical history, signs and symptoms and results from other diagnostic procedures.

Low Back Pain
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Home remedies for low back pain are effective if you know how to use them properly. Low back problems are one of the most common complaints experienced during adult life. The term “low back pain” is a very general term that represents a wide range of disease categories that may all manifest as pain on the lumbar area. Among the various conditions related to low back pain are the following: mechanical strains to the low back, herniated disks, fractures, arthritis, kidney infections, or even pregnancy.

The frequency of low back pain among adults brings a great deal of attention to this condition, especially in the field of rehabilitation medicine. Aside from its frequency, its impact on an individual’s functional activity poses a great deal of concern. It is said to be the most common cause why workers lose productive time at work.

Furthermore, studies have shown that the costs of treatment for low back pain may reach up to billions of dollars each year. Owing to these high costs of treatment, and also because this condition warrants immediate relief from pain and discomfort, knowledge regarding home remedies for low back pain may be very useful.

Among the home remedies for low back pain are the following:

* Application of superficial heat over the lumbar area

* Massage and therapeutic exercises that are focused on strengthening & stretching of key muscles that contribute to stability of the spine, especially on the lumbar area.The therapeutic benefits of these back pain remedies will be discussed further.

* Application of superficial heat is a very convenient home remedy for back pain. It can be done by using hot packs or hot water bottles applied over the painful area for 20 minutes. This can relieve the patient because of the thermal effects of heat causing analgesia, general relaxation and decreased muscle spasms.

* Another notable thermal effect of heat application over a localized area is vasodilation of blood vessels, which causes an increased blood flow to that particular area. Where blood flow increases, there would be more oxygen & nutrient supply to the area.

* Massage may be the most popular among the suggested home remedies for low back pain. It is the manual manipulation of superficial & deep muscles, done in a variety of strokes & techniques. During a session of massage, palpation of muscles spasms may be done to detect particular trigger points in the low back area. Just like heat, massage also causes, increased blood flow to the area, decreased muscle spasms & analgesia.

* Of all the given home remedies for low back pain, the therapeutic exercises are the interventions that provide long term effects. When muscles of the lumbar area are tight, they are in a state of increased tension, resulting to low back pain.

* stretching exercises of these muscles are advised to decrease their state of tightness. Strengthening exercises of the abdominal muscles are also advised because the abdominal muscles act as a corset that provides stability to the low back.

Among the popular strengthening exercises for the abdominals are curl ups, sit-ups or straight leg raising. It is important to note that of all home remedies for low back pain, the therapeutic exercises require active participation of the individual. Thus, compliance of the individual to do the exercises regularly is important to have its long-term benefits.

All of the home remedies for low back pain suggested above can provide both short term & long term relief for back pain. These techniques have the advantage of convenience and accessibility because they do not require purchase of expensive equipments and modalities. However, if in any case that these home remedies for low back pain are tried but offers no pain relief, it is suggested that the individual seeks further evaluation procedures to detect if there is other pathology that causes low back pain.

There are several alternate sites for capillary puncture. These alternate sites are also good alternatives when the designated puncture area is injured.

Capillary puncture is the collection of blood through the capillaries; hence, through the capillaries of the skin. The most common sites are the pads of the fingers.

Alternate sites include:

Ear lobes

Big toes

Heel of infants

These are alternate sites of puncture that you can take advantage of. Remember to wipe the first drop of blood before collection as this is contaminated with tissue juices. Knowing the correct procedure in collecting from these alternate sites will ensure the reliability of your laboratory results.

The world you live in has continuous demands that have to be met. Whether you are working or you are still in school, oftentimes people have the same common sources of stress. The stressors come in different ways. Although stress may be good, too much of it can also be a bad sign, because you might not be able to manage all of them. Thus, it is recommended that you learn to cope with most of them. The best way to reduce the stress in your life is to be aware of their common sources.

Interpersonal Relationships

Maintaining a good interpersonal relationship with the significant people around you entails effort and time. The key in keeping the harmony with your family and friends is an open line of communication. Generally, simple misunderstandings can lead to big arguments if you do not communicate well. Misunderstandings are common sources of stress.

Life Adjustment

If your body is accustomed to your daily routine, changing your regular schedule can cause significant stress in your life. If you have been used in working, enjoying financial abundance, and physical wellness, a sudden change in these situations can put pressure to you. Loss of employment, economic crisis and illness require life adjustment. If you are not ready for these sources of stress and you lose support from your family, you might end up feeling depressed.

Because changes are constant in life, you need to be ready for these common sources of stress. The best way to prepare for these adverse situations is by keeping an intact interpersonal relationship with others and knowing when to say no.

The human brain is so complicated that even the best scientist cannot fully understand all the details about it. For a patient with bipolar disorder, the function is more complex. It is characterized by two opposing faces, mania and depression. To understand more about it, here are the faces of bipolar patients.

Mania

Bipolar disorder is a mood problem where a patient experiences extreme episodes of high levels of energy. Sometimes, the elevated mood can lead to some forms of euphoria. The patient fails to relax and go on several days without sleep. Health professionals describe the stage as thoughts rushing in the mind which is exhibited by pressured speech. The behavior is aggressive, unstoppable and very irritable.

Depression

After the manic episode, the patient enters the depressive mood. There is extreme sadness, fear and guilt about everything. Isolation is a common manifestation of the stage where the individual refuses to interact with others and loses interest to do daily activities. During this stage, suicidal tendencies are very high. The episode can last for two weeks and may even persist if treatment is not started.

Because bipolar disorder is very difficult to diagnose, you need to bring your loved one to a psychiatrist when you see any unusual withdrawal from the environment followed by extreme energy.

Vaccination
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Vaccination is one of the greatest achievements of public health. Within the last decades, many infectious diseases have been controlled because of immunization of the general population especially of children. However, some parents are still not aware of the benefits of the vaccination and are even worried about the health risks. If you are one of them, this article will clear some of your apprehensions about it.

Benefits

Vaccination does not only protect the individual but the people around him. When one gets vaccinated, he reduces the risk of exposing other people from infectious diseases. With only an average cost of $20, a child can be fully immunized from many diseases. If you will compare the amount to the potential cost of hospitalization and medication and even the life of the child, the amount is too small.

Risks

The possible risks of vaccination are very rare and mostly insignificant if you compare the advantages. Common side-effects include abscess from the injection site and slight fever. Although there are some claims relating autism with immunization, there are still no direct studies to prove such claims.

Since prevention is still better than cure, vaccination remains to be the crowning glory of public health works. As a parent, you can weigh the advantages and disadvantages of immunization if you are unsure of what to do.

Oftentimes, babies make night their day. During the day, they sleep all day long, and when night comes, the baby cries all night, leaving you and your partner awake for 24 hours. To avoid this situation, there are some helpful tips to keep your little angel asleep the whole night.

Provide a Comfortable Atmosphere

Before you bring your child to sleep, prepare the beddings well. Give your baby a short bath and gently massage the body. Turn off the light and reduce the noise in the room. You can play a soothing music until he falls asleep. Avoid distractions once your baby has fallen to sleep.

Encourage Activity during the Day

Researches show that daytime activities stimulate better sleep at night. During the day, surround your baby with toys. Keep him busy by playing with him and providing him with educational activities while he is active.

Set Consistent Nap Routines

Set a regular day time nap if you want to avoid disruptions at night. Schedule sleep rituals and stick to it. For example, lie down with your baby every 11 am and 3 pm to stimulate sleepiness. Babies who have consistent nap times sleep better at night.

Check for any unseen injuries

You may have accidentally folded a skin or cause inadvertent injuries like tight clothing, bugs in the diaper, wrinkled skin, and the like. Check his clothing inside and out to make sure he is not injured. Helping your baby sleep through the night is something a parent can do something about with a little common sense.

Capillary Puncture
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There are different ways to draw blood from a patient and capillary puncture is one of them.  If you compare it with venipuncture and arterial puncture, it is the easiest way to obtain a blood specimen. Usually doctors request the procedure when there is minimal volume of blood needed. If you have a blood request stating capillary puncture in the laboratory request form, here are some basic information about the procedure.

Capillaries

Also known as the “finger stick”, the capillary puncture involves the smallest blood vessels in the body. Since the capillaries are found all throughout the body and in a more superficial location, it only involves poking the skin with a sharp object called a lancet.  The most common sites for specimen collection are the palmar surfaces of the fingers, ear lobe and big toe or heel for the infants. Once the blood starts to ooze from the punctured site, the medical worker will collect the specimen in a capillary tube or in an appropriate specimen container.

Preparation

There are no special patient preparations indicated for capillary puncture. In fact, it only requires minimal training to correctly perform the blood collection. Even non- health workers can obtain the blood provided that they have the necessary equipment and basic knowledge on the proper collection technique. Oftentimes, diabetic patients are the most common lay persons who perform the capillary puncture at home for their daily blood sugar monitoring.

Procedure

The principle in obtaining blood through capillary puncture is the same with venipuncture and arterial puncture. Of course, the health worker needs to correctly identify the patient and choose the most appropriate site. Highly calloused fingers or those with skin injuries like hematoma and bruises and edematous areas are not recommended. Once the health provider has settled with the site, he/she has to clean the site of puncture with a cotton and alcohol starting from the center moving outwards. Using a swift and deliberate motion, he/she will then puncture the skin with a lancet, wipe the first drop of blood and collect the blood using a capillary tube.

Precautions

During the collection, squeezing of the punctured must be avoided. It leads to dilution of blood with tissue juices, thereby leading to erroneous results. Since young children are the common patients indicated for capillary puncture, assistance from adults and use of restraining devices may be necessary. If your kids are the patients, you must help the health worker explain the procedure to your child. Be truthful about what to expect. Tell them about the minimal but tolerable pain that they will feel. Do not tell them it does not hurt, because it does. Reassure them though that the pain is tolerable.

Aftercare

Since capillary puncture involves a minor puncture, there are no known health risks for it, if performed by knowledgeable personnel. However, you must apply pressure to the site for 3 to 5 minutes to stop the bleeding. The whole procedure only takes up to 5 minutes to complete. After the capillary puncture, you can always go back to your regular activities.