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Adolescent/Teen Health

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Acne in Adolescents

Acne is one of the most common problems in adolescent teens affecting 
nearly seventeen million people in the United States. Acne is nothing 
but a disorder involving sebaceous glands and hair follicles. Acne 
results from the clogging of sebaceous glands leading to the formation 
of pimples and cysts. The condition usually begins with the onset of 
puberty. Going by the facts, as teens attain puberty the androgens also 
called male sex hormones are produced in high number leading to 
sebaceous glands becoming over active which results in sebum being 
produced in high proportions. 

Sebum, which is nothing but oil is produced by sebaceous glands which 
travel to the skin surface through hair follicles. But, skin cells block 
the follicles which results in oil also being blocked. When these hair 
follicles are blocked it results in the development of skin bacteria 
known as Propionibacterium Acnes within the follicles which in turn 
results in swelling of the skin called Acne. If the hair follicles are 
partially blocked it results in blackheads. If the follicles are 
completely blocked they result in whiteheads. But if these plugged 
follicles are not treated they ultimately burst causing the oil, 
bacteria and skin cells to spill all over the skin resulting in 
irritation and formation of pimples. Acne can be shallow as well as deep 
in various individuals depending on the nature of skin and amount of oil 
produced. 

There can be various causes why Acne forms. Apart from rising hormone 
levels due to puberty it can also be attributed to certain other factors 
like intake of drugs which contain lithium, barbiturates and 
corticosteroids. Acne can also be caused due to excess grease and oil in 
the scalp, due to cooking oil and use of some cosmetics can actually 
alleviate the acne problem. Acne problem many times is inherited also. 
Acne problem is worsened if the pimples are squeezed or scrubbed too 
hard. 

Acne can form at any place of the body but they most commonly form in 
the areas where there sebaceous glands are present in high proportions 
like face, chest, shoulders, neck and upper back. The symptoms may 
differ from person to person but commonly seen symptoms are: formation 
of blackheads, whiteheads, lesions filled with pus and which are very 
painful and lastly nodules. One may get confused sometimes as symptoms 
of acne may be like some other skin condition and it is always advised 
to consult a doctor in this scenario. 

There are lots of treatments available today to treat acne. The primary 
goal of the treatment is to reduce scars and better appearance. There 
are various treatments and the doctor decides which specific treatment 
you need based on: the extent of acne problem, age, medical history, 
overall health, tolerance to specific medications and procedures, 
expectations and last but not the least what patients prefer. 

Treatment of acne is classified into topical and systemic drug 
therapies which are given based on extent of severity. In some instances 
the combination of both the methods might be the way to go for acne 
treatment. Topical medication is nothing but creams, gels, lotions, 
solutions etc. prescribed to patients for acne treatment. Some of the 
examples of topical medication are: Benzoyl Peroxide which kills the 
Propionibacterium Acnes bacteria, antibiotics helps in stopping or 
slowing down the growth of the bacteria and also reduces inflammation, 
Tretinoin helps in stopping the formation of new acne lesions and 
Adapalene reduces formation of comedo. 

Systemic drug therapies involve prescription of systemic antibiotics 
primarily for the treatment of acne problem which is moderate to severe 
in nature. The examples of antibiotics prescribed are Doxycycline, 
erythromycin and tetracycline. In some cases an oral drug called 
Isotretinoin is prescribed for teenagers with severe acne problem which 
shrinks down the sebaceous glands that produce oil. The results are 
pretty good and almost ninety percent of the adolescents have success 
with this oral drug. But the drug has some serious side-affects and thus 
it is very important that one consults a doctor before use. 

Asthma in Adolescents

Most of the teenagers who have asthma are also allergic to many things. 
The asthma can get severe even if the people with asthma are exposed to 
allergens of low grade. Allergies play an important role in asthma cased 
which are undiagnosed. Other factors that also trigger childhood asthma 
include upper respiratory infections like colds, second hand smoke, and 
certain climate conditions like cold air and due to emotional physical 
expressions like laughing, crying or yelling. However, it is not the end 
of the road for asthmatics as they can live active and healthy if they 
manage asthma properly by avoiding asthma triggers, regular intake of 
prescribed medications, being alert of the warnings and be aware of the 
ways to deal with an asthma attack.

There is a great consensus among the parents whether their children 
would outgrow asthma as they grow up. But the truth is it depends from 
child to child. While some children experience improvement in their 
teens others see asthma becoming even more severe. But almost half of 
the children who have asthma outgrow asthma as they grow although some 
symptoms may come back later.

Many parents have questions like whether their children can take part 
in sport activities. The answer is both yes and no. Some kids may get an 
asthma attack when they participate in exercises like running. But with 
proper management a teenager suffering from asthma can actively 
participate in sports. Special aerobic exercises can improve airway 
function. This strengthens the breathing muscles. Some of the ways that 
one can participate in sports is to follow the regimen of stretching the 
muscles prior to and after exercising, nose-breathe instead of breathing 
through the mouth and make sure that humidified air passes through the 
airways. Also parents should make sure that the adolescent has taken all 
prescribed medication supposed to be taken before they begin exercising. 
Carrying a reliever is a must for asthmatic teens which would come handy 
if asthma attack occurs. Asthmatic teenagers should make sure that they 
wear something over their mouth and nose to stop cold air from entering.

It is not easy for adolescent teens to attend school when they have 
asthma but it is not difficult also at the same time if proper 
coordination is made among the teenager, doctor, family and school 
employees. It is a good idea to consult teachers, nurses and other 
pertaining employees of the school and let them know that the teenager 
has asthma and may have special requirements. Also, let the school 
management know on medications the teenager regularly takes and how to 
help the teenager when an attack occurs. The school staff should be 
asked to treat the teen normally once the attack subsides. The physical 
education coach should also be informed about the condition so that 
he/she can let the kid stretch the muscles before any exercises or to 
deal with asthma attack induced due to exercises. Also, before admitting 
the teenager to a new school care must be taken to check the quality of 
air, irritants and allergens if any present in the school. The school 
staff should take considerations to avoid symptoms which could hamper 
the energy level kids. Also asthmatic teens should be assured from time 
to time that they are no different from others and asthma in any way 
does not slow them down, They need this emotional confidence otherwise 
they may have personality problems. 

Anemia in Adolescents

To understand what is anemia one should begin with breathing. The 
oxygen that is inhaled simply doesn't stop in lungs. It circulates 
though out the body and fuels the brains also. Oxygen travels to all 
parts of the body though bloodstream and to be precise in the RBCs I.e. 
red blood cells. Now, these RBCs are produced in the bone marrow of the 
body and they serve as boats carrying oxygen in the bloodstream. RBCs 
have something called hemoglobin, a protein which holds oxygen. To make 
adequate hemoglobin body requires iron in plenty. The iron is supplied 
by the foods that we take along with other nutrients. When these RBCs 
are fewer in number than what is needed anemia occurs in the body. There 
can be 3 primary reasons: RBCs are lost due to some reason, the 
production of RBCs is slower than what is needed and lastly the body is 
destroying the RBCs. Different types of anemia are linked to at least 
one of these causes. 

The bone marrow replaces small amounts of blood is lost due to some 
reason without making a person anemic. But in cases where considerable 
amount of blood flows in small amount of time as a result of an injury 
due to a serious example for instance, it may not be possible for bone 
marrow to replace RBCs so quickly resulting in anemia. Also, losing 
small amounts of blood over long periods of time may also lead to 
anemia. Example of this situation can be seen in girls who get heavy 
periods attributed mainly to deficiency of iron in the diet. 

Anemia due to iron deficiency is the most common kind of anemia in the 
United States. It occurs mainly due to lack of iron in a person's diet. 
A teen with iron deficiency would have lower hemoglobin production and 
consequently lower RBCs. When the production of RBCs is low the person 
is regarded as anemic. The signs of anemia are paleness and tiredness. 
There can be other reasons as to why enough RBCs are not produced in the 
body. Folic acid and Vitamin B-12 are also essential to produce RBCs. 
Getting these in adequate quantities is this important too. There can be 
a problem with bone marrow's working too resulting in anemia. 

Hemolytic anemia occurs when a person has RBCs whose lifespan is 
shorter. The bone marrow may not be able to produce new blood cells if 
the blood cells die too early. This can result due to many reasons 
including person having disorders like sphenocytosis or sickle cell 
anemia. In some cases the immune system of the body may itself destroy 
the RBCs. In some cases certain antibodies can form in the blood as a 
result of reaction to certain drugs or infections and may attack the 
RBCs. 

Teens get anemia as they grow rapidly the amount of iron intake may not 
be enough to keep up with the pace of the growth as it needs more 
nutrients in this process. In the case of girls they need more iron 
after puberty and are at risk due to heavy blood loss during menstrual 
periods. In some cases pregnancies also leads to anemia. Also, teens who 
diet excessively to lose weight may also be at risk of having iron 
deficiency. Meat eaters especially red meat eaters are at less risk 
compared to vegetarians as meat has rich iron in it. 

Allergies in Adolescents

Allergies are reactions by immune system that are abnormal in nature to 
stuff that are usually harmless to majority of the people. When somebody 
is allergic to something the immune system of that person gets confused 
and thinks that the substance is detrimental to the body. The substances 
causing allergic reactions are known as allergens. The examples of 
allergens are dust, food, plant pollen, medicine etc. The body produces 
antibodies to protect itself from these allergens. The antibodies make 
certain cells present in the system to let chemicals to mix with the 
bloodstream and one of them is histamine. This chemical then acts on 
nose, eyes, skin, lungs, gastrointestinal tract and results in allergic 
reaction symptoms. Exposure to the same chemicals in future triggers 
same response to the antibodies again meaning every time one comes in 
contact with the same allergen, allergic reaction is produced in the 
body.

Allergic reactions can range from mild symptoms like runny nose to more 
severe ones such as difficulty in breathing. Teenagers suffering from 
asthma often have allergic reaction to cold and get asthma attack is 
another example of allergies. Some kinds of allergies trigger multiple 
symptoms. Allergic reactions in very rare cases also produce severe 
reaction known as "anaphylaxis" for which the signs are difficulty in 
breathing, difficulty in swallowing, swelling in tongue, lips and throat 
and dizziness. This allergic reaction occurs as soon as the system is 
exposed to substances that trigger allergic reactions like peanut 
although some reactions are delayed by as much as four hours. 

The reasons why people get allergies can be various and one of the 
reasons could be hereditary but that that does not necessarily mean that 
children are bound to get allergies from their parents.  Some of the 
common allergens include food, airborne particles, insect bite and 
sting, medicines, chemicals etc. Food allergies typically occur in 
infants and usually vanish as the child grows. The list of food 
allergens includes milk & dairy products, wheat, soy, eggs, peanuts, and 
seafood. Some people are allergic to stings and bites of certain 
insects. The venom in the bite is the one which actually causes reaction 
and can be as serious as anaphylactic in some teens. Some teens are also 
allergic to airborne particles which are also known as environmental 
allergens. They are also the commonest of all the allergens. Examples of 
these allergens include dust mites, animal dander, mold spores, grass 
pollens, trees and ragweed. Some adolescents are also allergic to 
certain antibiotic medicines. Another common allergen is chemical, 
certain chemicals present in laundry detergents or cosmetics can cause 
rashes that are itchy in nature. 

Allergists usually treat allergic problems. They may ask questions like 
symptoms of the allergy and whether it is hereditary. They may also 
prescribe certain diagnostic tests like blood or skin test depending on 
the type of allergy. The best way to treat allergies is to completely 
avoid the substances that cause allergies. However there are certain 
medications and injections are also available to treat allergies. 

One can follow certain things to avoid allergies like people who have 
food allergies that contain should peanuts and any food containing 
smallest amount of peanuts. Also avoid using cosmetic that contain 
chemicals allergic to the skin. One can also avoid airborne allergies by 
keeping pets in restricted areas and away from bedroom. Replace carpets 
and rugs from time to time. Avoid keeping things that accumulate dust. 
And also clean the room and house frequently. 

Adolescent Pregnancy

Adolescent pregnancy in ninety nine percent of the cases is unwanted 
and is the major consequence of adolescent sexual activity, other than 
STDs. This issue has affected youth, families, educators, health care 
professionals, and government official. A study on the high school 
adolescents has concluded that forty eight percent of the males and 
forty five percent of the females are sexually active. One fourth of the 
high school students had sexual contact by fifteen years of age. The 
average age of boys is sixteen and a girl is seventeen, who have had 
intercourse. Ninety percent of adolescents, in the age range of fifteen 
to nineteen, say their pregnancy is unintended. 

Seventy four percent of females above fourteen years and sixty percent 
of females below fifteen years have reported to have involuntary sex. 
Fifty percent of the adolescent pregnancies are within the time period 
of six months after the initial sexual intercourse. More than nine 
hundred thousand teenagers are reported to have become pregnant every 
year in the United States. Fifty one percent of the adolescent 
pregnancies result in live birth, thirty five percent result in induced 
abortion and fourteen percent result in stillbirths or miscarriages. 
Four out of ten adolescent females get pregnant, before they turn 
twenty, at least once.  Twenty five percent of adolescent deliveries 
aren't the mother's first child. When a teenager gives birth to her 
first child, she increases the risk of begetting another child. One 
third of the adolescent parents are themselves result of adolescent 
pregnancies.  

There are many reasons why adolescents choose to become sexually active 
at an early stage in life. The reasons can be early pubertal 
development, poverty, sexual abuse in childhood, lack of parent's 
attention, lack of career goals, family and cultural patterns of early 
sex, substance abuse, dropping out from school and poor school 
performance. Factors which discourage an adolescent to become sexually 
active are stable family environment, parental supervision, good family 
income, regular prayers, connectedness with parents and living with 
complete family and both the parents. The factors which are responsible 
for the consistent use of contraceptive among adolescents are academic 
success, anticipation for successful future, and involvement in a stable 
relationship. 

There are many medical risks associated with adolescent pregnancies. 
Adolescents who are less than seventeen years are at a greater risk of 
developing medical complications, when compared to adult females. The 
risk is even more in teenagers below seventeen. The weight of the child, 
given birth by an adolescent, is very low in these pregnancies. It is 
usually below 2.5 kilogram. The rate of neonatal birth is also three 
times greater in adolescents, when compared to adults. Other problems 
caused by adolescent pregnancies are prematurity of the child, birth of 
underweight child, poor maternal weight gain, poor nutritional status, 
anemia, STDs and hypertension induced due to pregnancy.     

Although there is an increase in the use of contraceptive methods by 
adolescents during their first sexual contact, only sixty three percent 
of the high school students have said to use condom while having sex 
previously. Adolescents, who use prescription contraceptives, delay 
their doctor's visit until the time they become sexually active for over 
a year. 

According to a research, youngsters who have participated in sex 
education programs which gave them knowledge about contraception 
methods, abstinence, sexually transmitted diseases and youngsters who 
involved in discussions in order to get a clear picture, used 
contraceptives and condoms effectively without any increase in sexual 
activity. The Center for Disease Control & Prevention has said that the 
solution for unwanted adolescent pregnancies and STDs are barrier 
contraceptive use and abstinence. 

Diabetes in adolescents

Diabetes is a rapidly growing, serious health problem among youngster 
today. Above thirteen thousand adolescents are diagnosed for type 1 
diabetes, every year in America. There has also been an increase in the 
number of teenagers with type 2 diabetes, which was more common among 
adults above forty and who were overweight. Clinics are reporting that 
nearly half of the new childhood diabetes cases are of type 2. 
Adolescents, who are obese and had type 2 diabetes in the family 
history, are at a greater risk of developing diabetes. 

Diabetes is a disease where the human body is incapable of producing or 
utilizing insulin. Insulin is a hormone produced by the body in order to 
get energy by converting starches, sugar and other items. Since the 
insulin isn't used properly in diabetic people, the blood sugar level 
increases. This glucose buildup is found in blood and is then passed 
onto the urine and comes out of the body and the major source of body 
energy is lost. 

Diabetes is a serious chronic disease and should be handled at proper 
time; otherwise it can create serious problems. It can pose a risk and 
can damage parts of the human body such as eyes, teeth, gums, blood 
vessels, nerves, and kidneys. This is the reason why diabetes is 
responsible in most of the cases of adult blindness, kidney failure and 
lower limb amputations. And if left untreated, it can cause stroke, 
heart disease and eventually, death.  These problems are not only faced 
by adults, but also adolescents who get diabetes in their childhood. The 
important factor in treatment of diabetes is to keep the blood sugar 
level normal at all times. 

There are basically two types of diabetes that will affect an 
adolescent. It is type 1 diabetes and type 2 diabetes. Type 1 diabetes 
affects the immune system's function as the systems attacks the 
pancreas' insulin producing cells, also known as the beta cells. Because 
of this, the pancreas loses the ability to manufacture insulin. This is 
the reason why people with type 1 diabetes take insulin everyday. The 
symptoms are weight loss, increase in urination & thirst, blurred 
vision, tiredness and constant hunger. And if the adolescent isn't 
treated at the right time, he/she can slip in to diabetic coma which can 
endanger his/her life. In type2 diabetes, the body is incapable of 
properly using the insulin produced by the body and requires insulin 
from an external source, too. The symptoms of type 2 diabetes are 
similar to type 1 diabetes. The teenager feels sick, tired, nauseated, 
and thirsty. The wounds will recover very slowly; he/she will get 
infections frequently, will develop blurred vision and will experience 
weight loss. 

Parents play a vital role in determining the problem. They should 
constantly observe their child for eating disorders or signs of 
depression. Although cigarette, drugs and alcohol should be avoided by 
all adolescents and children, it is even more important that youngster 
with diabetes should stay away from these things as they can worsen the 
situation. A person with diabetes, who switches to smoking, is at risk 
of developing cardiovascular diseases and circulatory problems. 
Consumption of alcohol can cause hypoglycemia or low blood sugar. It is 
the duty of the parents to make their child aware of the possible risk 
they would face if they start to smoke, drink alcohol or take drugs.  

Children and adolescents, who have diabetes, face many challenges while 
trying to lead a normal life. They have to think twice before doing 
simple things as going to a party, playing sports and even when staying 
over with friends. This is because they require to intake oral 
medication or insulin. Their blood sugar level must be checked many 
times through out the day. Also, at gatherings, they have to avoid many 
food items. Because of this they will feel different from the crowd and 
can feel left out. Not only does diabetes pose behavioral challenges, 
but also emotional challenges. 

Along with doctor consultation, a psychologist must also be consulted 
who can deal with the emotional challenges of the adolescent. The family 
should also play an active role in making the youngster feel better. The 
family should work in collaboration with physician, dietitian and 
diabetes educators. Teachers, counselors, school nurses, day care 
providers, and other community members can provide extended support and 
guidance. They can provide help with transportation, mental health 
counseling, health education, social services and financial services. 

Depression in Adolescents

Depression in adolescents is a disorder which occurs due to persistent 
sadness, loss of interest, loss of self worth and discouragement. 
Depression is normally a temporary reaction towards situations of 
stress. Depression is a normal part of the maturation process of 
adolescents. It is even induced due to production of sex hormones. 
Adolescent females are depressed twice more than adolescent boys 
according to a study.

Adolescent behavior is normally marked with good and bad moods. The 
transition from a good mood to bad mood and vice-versa, can take 
minutes, hours and even days. That is the reason why true depression is 
very difficult to find out. Depression in adolescents can be caused due 
to bad school performance, break up with boyfriend or girlfriend, and 
failing relations with friends and family. These causes can lead to 
persistent depression. Other serious causes are chronic illness, 
obesity, child abuse, stressful lifestyle, poor social skills, unstable 
care giving and depression in family history. 

Symptoms of depression in adolescents are eating disorders, weight 
change, irritable mood, excessive sleeping in daytime, excessive temper, 
criminal behavior, memory loss, fatigue, self preoccupation, sadness, 
difficulty in concentrating, worthlessness feelings, loss of interest, 
self hatred, obsession with death and thought & attempts of suicides. 
When these symptoms are being noticed for more than two weeks, it is 
important to get treatment for the adolescent.  Depression not only 
affects interpersonal relationships, but school performance as well. 
Depressed adolescents are more prone to take onto drugs and alcohol as 
an attempt to overcome their depression. Such problems require intensive 
treatment. 

The doctor will take blood test and perform physical examination to 
determine the cause of depression. The adolescent can also be tested for 
substance abuse such as smoking, heavy alcohol consumption, marijuana 
smoking, and usage of other drugs. After the physical examination, 
psychiatric evaluation is also done to understand the cause of sadness, 
loss of interest and irritability. Depression can also lead to the 
development of other psychiatric disorders such as schizophrenia, mania 
and anxiety. It is also important to determine whether the adolescent 
poses a risk for himself/herself and others. Family and school personnel 
can provide valuable information about the adolescent to the doctor. 

Treatment for depression for adolescent is similar to the treatment of 
depression for adults. Along with the treatment, the adolescent are 
given antidepressant medication and psychotherapy. Antidepressant 
medications include tricyclics, Prozac, selective serotonin reuptake 
inhibitors or SSRI. Some of the medicines increase the risk, so it is a 
good idea that parents discuss the possible risks with the doctor. Only 
some of the antidepressant medications are meant for children and 
adolescents. Adolescents with severe depression need to be hospitalized 
as they are more prone to kill themselves.     

Family and school support is necessary to tackle the depression of the 
adolescent. Parents can get their children admitted in emotional growth 
schools, boot camps or wilderness programs, to solve the behavioral 
problems. These programs consist of non medical staff and 
confrontational therapies. But care must be taken as some of the 
programs can in turn harm children who are depressed and sensitive. 
Adolescents, who get caught due to criminal offense, should be taken 
special care of by their parents. It is best that the child face the 
consequences and learn a lesson from it. Depressed adolescents respond 
well to treatment if they are treated comprehensively and early. More 
than half of the adults are known to have depression when they were in 
their teens.  

Eye problems and injuries in Adolescents

Every year more than one million people get eye injuries, out of which 
ninety percent are preventable if safety eyewear is used. One hundred 
and twenty five thousand eye injury cases are caused by household 
products. 

It is a good habit to wash hands regularly, especially after handling 
household chemicals. When using detergents and hazardous solvents, the 
handler must wear chemical safety goggles. Also, no children must be 
around while handling chemicals. While spraying, the nozzle must be 
turned away from the face. Fertilizers, pesticides and paints must be 
stored away from reach. While doing household activities proper 
protective gears such as goggles, gloves, boots and helmet should be 
worn, if required. The house must be illuminated adequately to avoid 
accidents in the dark. Stairs should also be illuminated and the rails 
must also be installed. The instructions for opening the tops of bottles 
must be read carefully to avoid them from popping and injuring other 
people. Children and adolescents should read instructions before 
handling operating equipment before playing games. All power equipment 
must be installed with guards. While playing outside, the eyes must be 
protected by UV protective goggles and it is a bad idea to look at the 
sun directly. 

Precautions should not only be taken indoors, but outdoors too. This is 
because; more than forty thousand people get eye injuries outdoors. 
Ninety nine percent of the injuries are caused while playing sports. So 
it is necessary for the youngsters to wear protective eyewear while 
playing sports or when involved in outdoor recreational activities. A 
special helmet is designed with wire shield or polycarbonate face mask 
which is not only safe, but comfortable, too. Protective eyewear should 
also be worn while performing experiments in science lab. Fireworks must 
only be handled by adults. 

Because of increasing use of computers, more and more youngsters are 
getting eye strains. The symptoms of eye strain caused by computer are 
red & watery eyes, focusing problems, aching & tired eyelids, eye muscle 
spasm, backache and headache. In such an environment, eye exercise must 
be done regularly. The eyes must be made to focus on distant objects and 
should be rotated from side to side. It is extremely important to give 
ample rest to the eyes. Glasses with UV shield must be worn when looking 
at the computer screen. Eye strain can be avoided by increasing the 
distance from the monitor.   

Eye hazards are also caused when cosmetics are used improperly by 
contact lens wearers. Some of the adverse reactions are injury, eye 
irritation, allergy, dryness, infection, and lens deposition. That is 
the reason why adolescents must be made aware of the risk they will face 
when opting for contact lens. Girls should understand that they should 
buy hypoallergenic cosmetics and especially the non-scented variety, 
manufactured by big brand names. Cosmetics should not be shared with 
anything else. The applicator brushes must be washed regularly and old 
mascara must be disposed and not refilled. Eye shadows which are 
glittery, pearlized, frosted or iridescent contain ground tinsel or 
oyster shell, which should be always avoided. Eyeliner should not be 
applied in the inner lid edge. Loose powder should be avoided. Cream 
should not be applied near the eyes. The wearer should wash hands while 
handling contact lens. No crying, washing of face or bathing should be 
done with the contact lens on. 

Eating Disorders in Adolescents

Since the adolescence is the age where bones are sprout and grow 
rapidly, well nourished food must be given to the adolescent to 
facilitate normal growth & development. The nutritional intake must be 
monitored regularly and modified depending upon the growing needs. 
Teenagers tend to develop eating disorders which affect their 
nutritional health. The eating behavior must be corrected as early as 
possible as it can lead to the development of complex illnesses. Eating 
disorder is the third common chronic illness, especially in adolescent 
females and the number has been increasing rapidly from the past thirty 
years. 

There are two subcategories of eating disorders, anorexia nervosa and 
bulimia nervosa. Anorexia nervosa is the restrictive form, where the 
intake of food is limited severely. In bulimia nervosa is the eating 
disorder where the adolescent binges on food and then tries to minimize 
the effects by forcibly vomiting, fasting, and catharsis or over 
exercising. When handling adolescence eating disorders, they must be 
handled differently from adult eating disorders. Adolescents face 
problems such as growth retardation, suppressed height, abnormal weight, 
pubertal delay, menstrual periods absence, and menses unpredictability. 
When the adolescent is growing there will be critical tissue components 
loss like loss of body fat, muscle mass and bone mineral.  

Nutritional imbalance is also caused which reflect abnormalities in the 
levels of vitamins, mineral and other trace elements. The problem is 
that these abnormalities cannot be recognized clinically. But since 
protein and calories are essential to the growth of the adolescent, it 
is important to trace their abnormalities. Because of the problems, 
healthy adulthood is not a possible thing. Because of all these reasons, 
it is important to diagnose adolescence eating disorders as early as 
possible. Eating disorders give rise to peak bone mass impaired 
acquisition in case of adolescents. When they turn into adults, this 
problem aggravates to osteoporosis. Even internal organs get affected 
due to eating disorders.  All this can be prevented by early 
intervention so as to limit, prevent and ameliorate medical 
complications, which can turn become life threatening.

Adolescents who practice unhealthy weight control practices and are 
obsessive about figure, weight, food or exercise should be treated 
clinically. Not only should the symptoms be checked, but their duration, 
intensity and frequency should also be checked. Although most of the 
physical complications caused due to eating disorders get solved with 
the help of nutritional rehabilitation some of the conditions become 
irreversible and the long term consequences of this are very dangerous.  
It is best if the eating disorders are recognized in the early stages as 
it won't result in irreparable damage. The medical monitoring should be 
pursued till the adolescent returns back to appropriate psychological 
and medical health.  

Eating disorders not only result in physical abnormalities, but also 
psychological abnormalities. Adolescents with eating disorders take onto 
social isolation, low self esteem, affective disorders, low self 
concept, substance abuse, anxiety, and depression. Usually adolescents 
switch to unhealthy eating habits because of depression and lack of 
knowledge about affective techniques to lose weight. So the patients who 
are being treated for eating disorders must also be treated for 
psychiatric illness, if they have any. Even if the habits doesn't fit 
the strict criteria, adolescents who limit food intake, binge, vomit or 
purge accompanied with or without harsh weight loss, should be monitored 
because of the involvement of risk of even death. Early treatment will 
have an improved outcome. But the level of intervention in adolescents 
should be less when compared to adults.   

Common Oral Health Problems in Adolescents

Adolescents face many oral health problems which may require them to 
visit a dentist or any other healthcare professional. Irregular teeth 
growth is a common problem and adolescents with braces are a common 
sight. Another problem is wisdom teeth extraction or the removal of the 
third molar. Dental cavities are yet another common problem in 
adolescents. 

Orthodontics is a specialty in dentistry which deals with correction, 
development and prevention of irregular teeth, jaw and bite. 
Orthodontics also helps to correct jaw disorders and facial 
abnormalities. If a general dentist feels abnormalities in the 
adolescent, he/she will refer the patient to an orthodontist. The 
American Dental Association suggests that every adolescent above the age 
of seven should get an orthodontic evaluation done. Problems which 
require orthodontic treatment are crowded or crooked teeth, extra teeth, 
missing teeth, under-bite, overbite, jaw joint disorder, and incorrect 
or misaligned jaw position. 

To get braces or any other orthodontic treatments, the appropriate age 
is ten to fourteen years. But regardless of the age, the same physical 
and biological process is used in correcting and moving the teeth 
alignments. Braces are also known as fixed orthodontic appliances. There 
are three types of braces used to move and reposition the teeth. The 
first consists of brackets which are made out of plastic or metal. They 
are either of tooth color or clear and are bonded onto the teeth. The 
second type is the lingual type of brackets which are attached to the 
back teeth and cannot be seen while talking. The third type is a band. 
It is a metal band which covers the teeth and wraps around the last 
ones.  

When adolescents wear braces they have to take certain precautions in 
order to avoid any more oral health complications. The most important 
precautionary measure is to brush the teeth regularly after every meal. 
Since the food can be easily lodged in braces, it is a good idea to 
brush carefully with soft bristles toothbrush and fluoride toothpaste. 
In the morning, the adolescent must floss between the braces and teeth. 
Food stuffs which are sticky or hard must be avoided as they are very 
difficult to remove. Foods like caramel, chew candy, popcorn, and nuts 
must be avoided. Cleaning must be done by the orthodontist or general 
dentist, every five to six months. 

The wisdom teeth or third molars can grow in people of the age fifteen 
to twenty five. These teeth cause problem, because most of the mouths 
are too small to adjust new teeth and hence they need to be removed. If 
the wisdom tooth has place to grow, without affecting other teeth, they 
can be left to themselves. But if the adolescent experiences pain, 
facial swelling, mouth infection and gum-line swelling, then they should 
be extracted immediately. They can also destroy the second molars and 
impact other tooth. Various gum and jaw diseases can be caused. There 
can be a tumor development; cysts development and plaque build up. 
Hence, a surgery is performed to remove the tooth or teeth. The gum 
tissue covering the wisdom tooth is removed and the connective tissue 
connecting the tooth to the bone is detached. The tooth is then removed 
and the opening is sutured. A general dentist can perform wisdom tooth 
surgery in the local office using anesthesia. 

Five times common than asthma is tooth cavities. The tooth above the 
gum line is made up of enamel, the hardest tissue within the human body. 
The tooth below the gum-line comprise of nerves, roots and dentin. 
Dentin is another type of tissue and isn't as hard as the enamel. The 
acid which leads to tooth decay is produced by bacteria. These acids, 
along with dietary sugar, attach the enamel and eat away the minerals 
within the enamel, until a cavity is formed. This is known as tooth 
cavity. The biggest prevention against dental cavities is brushing teeth 
twice a day and even better, after every meal with fluoride toothpaste 
and soft bristle toothbrush. Carbonated drinks must be avoided strictly 
and must be replaced with fruit juices and sugary food must be avoided. 
Intake of fluoridated water also helps a lot or fluoride supplements can 
be used as replacement.  

Cholesterol in Adolescents

Parts of adolescent's body are filled with a waxy stuff identified as 
cholesterol. It helps to produce vitamin D, cell membranes and certain 
hormones. Blood cholesterol comes from two different sources, liver 
within the body and food. The adolescent's liver produces enough 
cholesterol to carry out proper functioning. 

The blood acts as the carrier of cholesterol and transports it to 
different parts of the body. They are transported in round particle form 
known as lipoproteins. There are two types of lipoproteins called the 
low density lipoproteins or LDL and high density lipoproteins or HDL. 
Low density lipoprotein or LDL cholesterol is commonly known as bad 
cholesterol. It helps in the building up of plaque in arteries and this 
condition is known as atherosclerosis. The LDL level must be low in the 
blood and if it is high it must be decreased. Healthy weight must be 
maintained and exercise should be done regularly. Food items which have 
high contents of calories, dietary cholesterol and saturated fat must be 
avoided.   

High density lipoprotein or HDL cholesterol is the good cholesterol. It 
is actually a kind of fat in blood which helps to remove bad cholesterol 
from the body and stops the build up of plaque in the arteries. The more 
the HDL cholesterol in the blood the better it is. The HDL can be raised 
by at least twenty minutes of exercising daily, decreasing body mass and 
keeping away from food with saturated fat. Some adolescents need to take 
medications in order to increase HDL. In such cases, increasing HDL can 
be a complicated procedure and the physician can make a therapeutic plan 
to increase HDL in the blood stream. 

Cholesterol screening helps to determine the cholesterol and fat levels 
in the blood. Children and adolescents with normal cholesterol level is 
a thing of the past. Because of the changing lifestyle and junk food 
trend, even they have a high risk to develop high levels of cholesterol 
which also increases the risk of developing heart diseases which can 
affect the blood vessels and the coronary arteries. The main cause of 
this change is obesity, junk food high in fat, fast food diets, 
sedentary lifestyle and high cholesterol level in family history. 
Keeping the blood cholesterol levels at normal is a good way of avoiding 
high blood pressure and coronary artery diseases.

The blood cholesterol level can vary from individual to individual. 
Healthy levels of LDL is less than one hundred and thirty milligrams, 
HDL is greater than thirty five milligrams. If the HDL is less than 
thirty five milligrams then the adolescent is at a higher risk of 
developing heart diseases. And LDL more than one hundred and thirty 
milligrams is dangerous. But a high level of LDL cholesterol is a 
problem in many citizens of America. And there is an expected increase 
in number, the figure is unknown, of adolescents who have a family 
history of high cholesterol levels. 

An adolescent or a child who has a parent having high levels of blood 
cholesterol and family history of heart diseases at an early age, should 
take cholesterol test from the age of two. Adolescents who are obese 
also should have lipid test along with cholesterol test. The lipid test 
shows levels of kinds of fats in blood such as triglycerides, LDL and 
HDL. 

Tests and Examinations for Adolescent Girls

Adolescence is the time when girls face many changes as they not only 
become physically mature, but sexually, too. In order to maintain good 
health, they need to consult gynecologist, adolescent medicine physician 
and obstetrician. Adolescents who are sexually active need to get some 
test done like pelvic examination, Pap test and test for checking 
sexually transmitted diseases. This helps the early determination of 
conditions that can affect reproductive, gynecological and sexual 
health.   

Schiller test is conducted where the iodine solution is used to cover 
the cervix. In colposcopy, colposcope is used to check the cervix and 
the vagina. Cancer is checked by biopsy. In this a small quantity of 
cervical tissue is removed and a pathologist checks the tissue for 
abnormal cells.    

The most important test is the Pap test or a pap smear. The cells from 
the mouth of the womb or the cervix are collected to check for cancer, 
abnormal cells, infection or inflammation. The detection of 
abnormalities shows signs of cancer. Therefore it is recommended that 
every female must take Pap test regularly to check out for invasive 
cancers in the early stages itself. And if invasive cancer is detected, 
it can be successfully treated in the early stages. Apart from detecting 
invasive cancer, other changes, such as cancer cells or dysplasia and 
inflammation, of the vagina and cervix can also be determined. 
Inflammation can be caused by pregnancy, abortion, miscarriage, 
hormones, trichomoniasis infections, viruses, bacteria, yeast 
infections, and other medication. 

The repetition Pap test will be suggested by the gynecologist. When a 
girl becomes sexually active, she will have to test for cervical cancer 
after three years of becoming active because it usually takes many years 
for the significant development of cancer or abnormality. Usually there 
are some cervical cell changes and transient human papilloma virus 
infections or HPV infections which are very common. Therefore, a Pap 
test for cervical cancer is recommended every three years. But women who 
are under thirty years are at a higher risk of getting HPV infections of 
higher risk. It would be more feasible if every individual takes advice 
from her doctor about when she can begin screening, the frequency of the 
test to be taken, and when she can discontinue the tests. 

In a Pap test, if abnormal cells are determined, usually more tests are 
recommended to detect abnormalities which will require treatment. 
Abnormal Pap test will be handled differently for adolescents when 
compared to adults. Usually the low grade cervical lesions will not 
require any treatment and will go away on their own. That is the reason 
why the Pap test is repeated after a gap of six to twelve months, after 
the original Pap test which identifies abnormalities. But this 
repetition will vary from individual to individual depending on her 
health status and kind of abnormalities found. 

A replacement of the Pap test is thinprep test. It involves new 
technique for testing cells from the cervix for abnormalities. But the 
cost of getting a thinprep test done is double the cost of getting Pap 
test done. The advantage of getting a thinprep test is that it requires 
to be re-done less number of times and detects lesions in initial stages 
itself. The cervical cells, instead of getting smeared on a slide, are 
introduced into a liquid vial. After the filtration of the liquid, the 
cells from the cervix are examined by being placed on the slide. 	

Heat-Related Illnesses in Teens

Heat related illnesses are caused due to prolonged exposure to heat and 
also humidity without any reprieve and due to inadequate intake of 
fluids. Kids and teens adjust to the variations in heat compared to 
adults who adapt more quickly. However the heat production is high in 
them when compared to adults but sweat relatively less. Sweating is the 
natural action of the body and cooling mechanism to counter heat. Kids 
and teens often ignore these facts and do not hydrate themselves enough 
while playing, participating in sports and exercises.

Kids and teens with health problems that are chronic or those who are 
on certain prescription could be more susceptible to heat related 
problems. Overweight adolescents or those who wear heavy clothing in 
times of exertion also suffer heat related illnesses. Heat related 
illnesses are basically classified into three types. They are: Heat 
cramps, heat stroke and heat exhaustion. 

Heat cramps are the mildest of all heat related injuries and constitute 
aching muscle cramps and also spasms that occur during intense 
exercising and also after intense exercising and also sweating in high 
heat.  The symptoms of heat cramps include cramps that are painful in 
the legs. Flushed and moist skin is also symptoms of heat cramps. The 
symptoms could also include mild fever generally below 102 degree 
Fahrenheit. Teens suffering from heat cramps should move to a cool place 
and take adequate rest. Remove any excessive clothing and wear or put 
cool clothing on skin or cool skin using air conditioner or fan. Sports 
drinks which are cool and which contains sugars and salts can also be 
taken. Stretching out cramped muscles slowly and steadily also helps 
reduce heat cramps. 

On the other hand hear exhaustion is more serious and severe compared 
to heat cramps and occur due to heavy loss of salt and water from the 
body. Extreme heat conditions, inadequate fluid intake and excessive 
sweating results in this conditions. Also, heat exhaustion occurs as a 
result of inability of the body to maintain the body temperature below 
the normal which can deteriorate further and also result in a heat 
stroke which is even worse. The symptoms of heat exhaustion are: muscle 
cramps, moist skin, pale skin, nausea, fever above 102 degree 
Fahrenheit, diarrhea, vomiting, fatigue, headache, weakness, anxiety and 
faint feeling. Teens suffering from heat exhaustion should stay in cool 
surrounding and take enough rest. Removing excessive clothing, putting 
on cool clothes and sitting in fan or air conditioning also helps the 
situation. Intake of cold sports drinks which contains salts and sugars 
are also advisable. If a teen doesn't show any signs of improvement even 
after taking all these measures a physician should be consulted 
immediately. 

Heat stroke is the severest condition of all heat related illnesses. In 
this condition the body gets overwhelmed with excessive heat and the 
efficiency of the system that regulates body heat goes down considerably 
which can result in a serious emergency requiring immediate medical 
care. The symptoms of heat stroke include dry and warm skin, very high 
fever generally above 104 degree Fahrenheit, increased heart rate, 
appetite loss, nausea, headache, vomiting, fatigue, agitation, 
confusion, stupor, seizures, coma and possible death. A teenager 
experiencing symptoms of heat stroke should stay in a cool place and 
have adequate rest. Heat stroke is a serious condition and emergency 
attention should be sought by calling 911. In the meanwhile the affected 
teenager should be made free of excessive clothing and should be worn 
with cool clothes and also put cool water on the skin to lower the 
temperature. Placing ice bags in armpits also helps. Make the teenager 
drink cool drinks if the teenager is alert. 

Heat strokes are very much preventable if certain precautions are taken 
like drinking adequate water during hot days, avoiding alcoholic and 
caffeine drinks, wearing light clothes, exercising in cooler time of the 
day, wearing sunglasses and hat, using umbrella on a hot day, applying 
sun cream with a spf of at least 15 etc. 




Tennis Elbow in Adolescents

Tennis elbow is a condition in which tendon fibers that attach on 
epicondyle on the elbow's exterior degenerates. The tendons talked about 
here anchor the muscles that help wrist and hand to lift. Although 
tennis elbow occurs mostly in patients of thirty to fifty years of age 
but it can happen to people of any age. Also tennis elbow affects almost 
fifty percent of teenagers who are in racquet sports thus the name 
"tennis elbow". But still most of the patients who suffer with tennis 
elbow are people who don't play racquet sports. Majority if the times 
there isn't any specific injury before the symptoms start showing up. 
Tennis elbow can also happen to people who use their forearm muscles 
frequently and vigorously for day to day work and recreational 
activities. Ironically some patients develop the condition without any 
of the activity related reasons that leads to the symptoms. 

The symptoms of tennis elbow include severe burning pain on the elbow's 
exterior region. In majority of the cases this starts as a slow and mild 
pain gradually worsening with the passage of few weeks or sometimes 
months. The pain worsens when one tries to lift objects. In some cases 
it may pain even while lifting light objects like a book or full coffee 
cup. In the severest cases it can pain even at the movement of the 
elbow. 

The diagnosis of the tennis elbow involves physician enquiring about 
the medical history of the teenager and a physical examination of the 
elbow by pressing directly on the part where bone is prominent on the 
elbow's exterior to check if it causes any pain. The physician may also 
ask the teenager to lift the fingers or wrist and apply pressure to 
check if it causes any pain again. X-rays are never opted for diagnosis. 
However a MRI scan may be done to see changes in tendons at the 
attachment to the bone. 

There are many treatment options available and in majority of the cases 
non-surgical treatment is given a try. The ultimate goal of the 1st 
phase of the treatment is pain relief. Be ready to hear from the 
physician to stop any activity leading to the symptoms. The doctor may 
also tell the teenager to apply ice to elbow's exterior and he/she may 
also tell the teenager to take anti-inflammatory medicines for relief 
from pain. 

The symptoms also diminished with the help of orthotics. The physician 
may also want to go for counterforce braces and also wrist splints which 
can greatly cut down symptoms by providing rest to tendons and muscles. 
The symptoms should show signs of recovery within 4 to 6 weeks otherwise 
next option would be to go for a injection called corticosteroid in the 
vicinity of the elbow. This greatly reduces pain and is also very safe 
to use. There are many side affects involved if it is overused. 
Once there is a relief from pain the treatment's next phase starts 
which involve modification of activities in order to prevent the 
symptoms from returning. The doctor may also prescribe the teenager to 
go for physical therapy which may include stretching exercises to 
gradually increase the strength of the affected tendons and muscles. 
Physical therapies have high success rates and return your elbow back to 
normal working again. Again non-surgical procedures are highly 
successful in eighty five to ninety percent patients. 

Surgical procedure is considered only when patients undergo relentless 
pain that doesn't improve even after 6 months of non-surgical treatment. 
The procedure involves removal of affected tendon tissue and attaching 
it back to bone. The surgery is done on outpatient basis and does not 
need stay at the hospital. The surgery is done by making a small 
incision on elbow's exterior's bony prominence. In recent years a 
surgery known as arthroscopic surgery has also been developed but no 
major benefits have been seen using it over the traditional method of 
open incision. 

Sprains and Strains in Adolescents

Sprains and strains are among the majority of the injuries caused while 
playing sports. Sports injuries can be caused by small trauma which 
involves ligaments, muscles and tendons including bruises, sprains and 
strains. The body part which is most commonly involved in spraining or 
straining is the ankle. The 3 ligaments that are involved during ankle 
sprain or strain include anterior talofubular ligament, posterior 
talofibular ligament and calcaneofibular ligament. 

An injury caused to the soft tissue as a result of a direct force like 
fall, kick and blow is called a contusion or a bruise. A sprain is 
nothing but a ligament injury which is wrenched or twisted. Sprains 
usually affect knees, wrists and ankles. On the other hand a strain is 
an injury caused to a tendon or muscle which usually results from force, 
stretching and overuse. 

Sprains/Strains are usually diagnosed by a physician after a physical 
examination. The physician asks for thorough medical history of the 
adolescent and asks various questions that lead to the cause of the 
injury. Various diagnostic procedures are also available which also 
helps in evaluating the problem. X-ray is one of the oldest and common 
diagnostic tests done to know the extent and exact location of the 
injury. An x-ray uses electromagnetic waves to get photos of internal 
tissues, organs and bones onto a film. MRI scan is one of the recently 
evolved diagnostic procedures which also help in evaluating a physical 
injury. This procedure actually called Magnetic Resonance Imaging makes 
use of bug magnets, computer and radio frequencies to get detailed 
pictures of structures and organs inside the body. Another diagnostic 
procedure called Computed Tomography Scan or CT scan is also used to 
evaluate the extent and location of injury. This procedure uses a blend 
of computers and x-rays to get cross sectional pictures in horizontal 
and vertical alignment. It shows thorough pictures of any part of the 
body like muscles, bones, fat and organs. They provide more information 
than conventional x-rays. 

There are various symptoms of strain and sprain depending on each 
teen's physical condition and they may vary accordingly. One of the 
symptoms includes pain in and around the area injury. There could also 
be a swelling around the injured area. Some teens also experience 
difficulty when they use or move the area of the body that is injured. 
Some teenagers also undergo bruises or redness in the area that is 
injured. Many times the symptoms of sprains and strains may look similar 
to other medical conditions and a doctor's advice is the best option in 
this scenario. 

Depending on various factors the treatment of sprains and strains will 
be prescribed by the teenager's physician that include teenager's age, 
overall health of the teenager, and medical history of the adolescent. 
To what extent the teen is injured is also a factor in determining the 
nature of treatment. A teenager's level of tolerance to certain 
medications, therapies and procedures is also taken into consideration 
before opting for a particular method of treatment. The treatment also 
depends of what expectations one has and also preference and opinion. 

Various options available for treatment include things like restriction 
of the activity after the injury, application of cast/splint on the 
injured spot, crutches or wheelchair, physical therapy which involves 
stretching exercises to give strength to the muscles, tendons and 
ligaments that are injured and last but not the least is the surgery 
which is opted for in worst case scenario. 

In the long-term scenario bruises, sprains and strains heal pretty 
quickly in kids and teenagers but it is important that the adolescent 
sticks to the restrictions imposed during the treatment and healing 
process like restriction of activity and regularly attending physical 
therapy sessions if any. It is noted that majority of the sports related 
injuries results either due to traumatic injury or excessive use of 
muscles and joints. But, they can be avoided and prevented with right 
training, by wearing right protective gears and by using right equipment 
for training. 

Smoking Related Health Problems in Adolescents

Smoking is the cause of many diseases and kills about four hundred and 
forty two thousand people every year in the United States. In spite of 
anti smoking campaigns and billboard warnings, more and more people are 
joining the bandwagon of smokers every year. Out of the total number of 
new smokers, ninety percent are children and adolescents, replacing 
smokers who have quit or died early due to a disease caused by smoking. 
Smoking is the top cause of preventable and premature deaths, followed 
by obesity.  

Smoking not only increases the risk of lung disease, but also increases 
the risk of contracting lung cancer, oral cancer, emphysema, stroke and 
heart disease.  Certain statistics by the American Lung Associations 
show alarming results. Over five thousand adolescents smoke their very 
first cigarette every day, out of which over two thousand turn into 
regular smokers. Presently there are nearly five million adolescents 
smokers. Twenty percent of the twelfth graders smoke cigarettes 
regularly. 

Smoking has many harmful affects on the health of a human being. It 
damages the cardiovascular system, causes high blood pressure, increases 
heart rate, increases the risk of ischemic stroke, increases the risk of 
formation of blood clot formation, and decreases the oxygen amount which 
reaches the tissues in the body, reduces coronary blood flow & cardiac 
output, and damages the blood vessels. Smoking not only affects physical 
health, but mental health too. It causes psychological distress and 
depression. 

Smoking not only affects the person who smokes but also other people 
who surround him/her. According to the American Heart Association, 
nearly thirty five thousand passive smokers die of smoke inhaled from a 
lit pipe, cigar or cigarette. People who do not smoke directly and 
inhale smoke from a cigarette smoke by his/her neighbor is known as 
passive smoker, secondary smoker or indirect smoker. Among the passive 
smokers, women, children and infants are at a higher risk. Infants and 
children who are exposed to smoke develop asthma, frequent ear 
infections and may even experience infant death syndrome. The symptoms 
experienced by secondary smokers are coughing, excess mucus formation in 
the airways, chest discomfort, chest pain, and lung irritation. They 
even feel irritation of throat, nose and eyes. If the passive smokers 
experiences chest pain, it can be an indication of a heart disease. 
Sometimes the symptoms of secondary smoking can coincide with the 
symptoms of other medical conditions. Hence, it is recommended to 
contact the doctor immediately after the surfacing of the symptoms. 

In active smokers, smoking, apart from building up high cholesterol in 
blood, increases the risk of cardiovascular disease, obesity, high blood 
pressure, physical inactivity and diabetes. So smoking cessation will 
not only reduce the risk of coronary heart disease, which is top of the 
list, but also decreases the risk by fifty percent of heart attacks and 
deaths caused by it. But quitting smoking undertakes lots of physical 
and mental efforts. The person should be made mentally relaxed and 
stress free. In case of adolescents, they can be asked to exercise 
regularly and sleep adequately. The American Lung Association and The 
American Academy of Otolaryngology have developed certain tips which can 
be of great help to the smokers who are thinking of quitting. The 
smokers must first be made to understand the reason for quitting. Stress 
only makes even more difficult to quit smoking, so a stress free period 
should be chosen to quit. Family and friends' encouragement and support 
are extremely necessary to persuade the smoker to quit. If the support 
isn't sufficient, smokers can join a smoking cessation program or a 
support group to attain their goals. A balanced diet is a must, along 
with lots of rest.

Sometimes taking nicotine replacement products, such as nicotine 
chewing gum, nicotine inhalers, and nicotine patch, are a great help to 
smokers who want to quit. By using these products the smokers can 
satisfy their nicotine craving. The good thing is that these nicotine 
replacement products can deduct the poisonous gases and tars emitted by 
the cigarettes. But nursing and pregnant women should consult a doctor 
before trying nicotine replacement products. For such people non-
nicotine alternative is available in the market.   

Sexually Transmitted Diseases in Adolescents

Sexually transmitted diseases are transmitted through unprotected 
sexual intercourse and are highly infectious diseases. Unprotected 
sexual contact risks the lives of the young by afflicting with sexually 
transmitted diseases such as HIV infection and even unwanted pregnancy. 
Every year, nearly nineteen million cases of sexually transmitted 
diseases are reported in the United States alone and out of these, half 
of the cases involve people from the age group of fifteen years to 
twenty four years. 

The best way to make sure the adolescent doesn't contract sexually 
transmitted diseases is to abstain from all types of sexual activities. 
In spite of this, if the adolescent becomes sexually active, he/she must 
be advised by the parents to take precautionary measures to reduce the 
risk of getting a sexually transmitted disease. The best precautionary 
measure is to use a condom every time the adolescent has sexual 
intercourse. Only when other sexually transmitted diseases are prevented 
and controlled, HIV infections can be prevented. 

It is best when the adolescent delays and abstains from sexual 
relationships, because the younger the person, the more susceptible 
he/she is to get a sexually transmitted disease. Having sexual contact 
during menstruation is also risky. It is good to avoid anal intercourse 
and if it is performed condom is a must, even when having oral sex. 
Every person should get STD checkups as frequently as possible, 
irrespective of being sexually active or not, after they turn into 
adolescents. Precaution must also be taken when getting injected by an 
intravenous drug, that the needle used to inject must be sterile. The 
adolescent must be educated about the symptoms and risks of sexually 
transmitted diseases. 

Adolescents must be thoroughly informed even if they say they know it 
all. They must be asked to indulge in only safe sex, if doing so. 
Parents should talk honestly and calmly about safe sex and must answer 
all their child's queries. Topics such as STDs, birth control methods, 
having sex because of peer pressure, and date rape must be discussed in 
detail. Most people think that kissing is safe, but it can spread the 
sexually transmitted disease, herpes and many other diseases. Condoms do 
not provide hundred percent protections for genital warts, AIDs and 
genital warts. Females shouldn't douche as it can make the infection go 
deeper into the reproductive tract and can also wash off spermicidal 
protection. At a time, sexual intercourse must be provided with only one 
partner, who isn't involved with any other sexual partner. 

The sexually transmitted diseases are Acquired Immune Deficiency 
Syndrome or AIDS, Human Papillomaviruses or HPVs, chlamydial infections, 
pelvic inflammatory disease or PID, Gonorrhea, Genital Herpes, syphilis, 
and genital warts. The symptoms of sexually transmitted diseases take 
time to surface. Some of them are also symptom less and even these 
diseases can be contagious. Especially in the case of female, the 
symptoms of sexually transmitted diseases can be confused with the 
symptoms of other diseases. But females get severe symptoms and get it 
more frequently. Sexually transmitted diseases can harm the fallopian 
tubes and uterus. It can even lead to inflammatory disease, which in 
turn can cause ectopic pregnancy or infertility.  Cervical cancer, in 
females, can be associated to sexually transmitted diseases. If a female 
gets a sexually transmitted disease during her pregnancy, the disease 
can pass onto her child. Sometimes the newborn's infections can be 
treated successfully, but at other times, the child can be disabled for 
life or die.  

If an adolescent is diagnosed with sexually transmitted diseases, his 
or her treatment must start immediately. The early the sexually 
transmitted diseases are diagnosed, the easier it is to treat them 
successfully. The other sexual partner must be informed so that they can 
get themselves diagnosed and can undergo treatment. The adolescent must 
be instructed to stay away from sexual activity while the treatment is 
going on. The checkup must be followed after the treatment. Tests such 
as pelvic examination, Pap test, and test for STDs should be taken 
periodically. 

Sexually transmitted diseases can affect people of all economic levels 
and backgrounds. Half of the cases of sexually transmitted diseases 
involve young people below the age of twenty five. The more sexually 
active the person is the more risk he/she is. And multiple sex partners 
at a given time are very dangerous too and must be strictly abstained 
from. 

Scoliosis in Adolescents

Normally, a spine when viewed from rear should appear straight but if 
the spine is lateral or curved or sideways or rotated then it is 
affected by scoliosis. It gives an appearance as if the person has 
leaned to a side. According to Scoliosis Research Society the definition 
of scoliosis is the curving of the spine at an angle greater than 10 
degrees on an x-ray. Scoliosis is a kind of spinal deformity and 
shouldn't be confused to poor posture. Usually there are 4 common kinds 
of patterns of curves experienced in Scoliosis which are: Thoracic 
wherein the right side has ninety percent curves, lumbar wherein left 
side has seventy percent curves, thoracolumbar wherein right side has 
eighty percent curves and double major where both right and left sides 
have curves.

In majority of the cases, as high as eight to eighty five percent, the 
cause of the deformity is unknown, this is also known as idiopathic 
scoliosis. It is observed that females have scoliosis more commonly than 
males. According to some established facts 3 to 5 children per 1000 has 
chances of developing spinal curves which is a number big enough 
requiring medical treatment. There are three types of scoliosis that can 
develop in children namely congenital, neuromuscular and idiopathic. 
Congenital scoliosis is seen in 1 out every 1,000 births which is caused 
due to vertebrae's failure in normal formation, vertebrae is absent, 
vertebrae is formed partially and vertebrae is not separated. 
Neuromuscular scoliosis is linked with various neurological conditions 
and particularly in children who don't walk like cerebral palsy, 
muscular dystrophy, spina bifida, tumors in spinal cord, paralytic 
conditions and neurofibromatosis. The cause of third type of scoliosis 
called Idiopathic scoliosis is still unknown. It is further divided into 
infantile, juvenile and adolescent scoliosis. Infantile scoliosis occurs 
up to the age of 3 years from birth wherein the vertebrae curve is 
towards left and is more frequently observed in boys. The curve takes 
normal shape with the growth of child. Juvenile scoliosis is common in 
children of age three to nine. Adolescent scoliosis is common in kids of 
age ten to eighteen and this is also the most common form of scoliosis 
occurring more in girls than boys.

The other possible causes of the deformity include hereditary reasons, 
different lengths of legs, injuries, infections and tumors. There are 
numerous symptoms attributed to scoliosis which can vary from individual 
to individual. The symptoms are: Difference in heights of the shoulders, 
off-centered head, difference in the height or position of the hip, 
difference in the position or height of shoulder blade, different arm 
lengths in straight standing position and lastly different height back 
sides when the body is bent forward. Other symptoms include leg pain, 
back pain and change in bladder and bowel habits do not belong to the 
symptoms of idiopathic scoliosis and require medical checkup by a 
doctor. The symptoms may be similar to other problems related to spinal 
cord or other deformities or could result from an infection or injury 
and consulting a doctor is the best bet in this situation who may 
conduct diagnosis to know what exactly it is.

The diagnosis of scoliosis requires thorough medical history of the 
teenager, diagnostic tests and also physical examination. The doctor 
asks for entire prenatal history, birth history and also would want to 
know if anyone in the family has scoliosis. The doctor may also ask for 
the milestones related with the development of the teenager since some 
kinds of scoliosis are known to be related to neuromuscular disorders. 
The delay in development may need additional medical evaluation. Doctor 
may also prescribe x-ray, CT scan and MRI scan of the back to measure 
the degree of curvature in the spinal. There are various treatments 
available for scoliosis which is decided by the physician depending on 
teenager's age, medical history and health in general. The method of 
treatment also depends on the extent to which disease has reached. The 
tolerance of the teenager to certain medicines, therapies and procedures 
are also taken into consideration. Expectations and opinion of the 
parents or teenager is also the criteria in deciding the type of 
treatment. The main aim of the treatment is stop the curve from 
progressing and avert deformity. The treatments include observation and 
repetitive examinations, bracing and surgery to correct the defect. 

Periodontal Disease in Adolescents

The meaning of the word "periodontal" is around the tooth. Also known 
as gum diseases periodontal diseases are nothing but serious infections 
caused by bacteria that harm the gums and tissues in the vicinity of the 
mouth. While dental cavities or caries only affects the tooth 
Periodontal disease is devastating affecting the bones that surround the 
tooth, gums, coverings of teeth root and tooth membrane. A physician 
specializing in the treatment of periodontal disease is known as 
Periodontist. 

The disease should not be taken lightly and if it's left untreated it 
can spread and affect the bones under the teeth which would eventually 
dissolve and would not longer support the teeth in its place. The 
chronic form of the disease is responsible for tooth loss in seventy 
percent of the cases affecting seventy five percent of the people at 
some time in their lives. 

The causes of periodontal disease are similar to any other oral disease 
wherein plaque buildup and bacteria are responsible for the condition. 
According to statistics plaque buildup is the main cause of gum related 
diseases. Apart from the causes listed, the other possible causes of 
periodontal disease include: Genetics, unkempt oral hygiene, food 
getting stuck to frequently in the gums, mouth breathing, low nutrient 
diet or vitamin c deficient diet, smoking, diabetes, autoimmune/systemic 
disease, changes in hormone levels, certain medications and constantly 
teeth grinding. 

According to statistics nearly sixty six percent young adult population 
suffers from periodontal disease and nearly fifty percent of teenagers 
suffer from periodontal disease. Also, it is the most widespread tooth 
loss cause in adults. But, what are the symptoms of periodontal disease? 
There are various symptoms and it could differ from one adolescent to 
the other which may include swollen, tender, and red gums; if one gets 
bleeding during brushing or flossing the teeth it is also one of the 
symptoms of periodontal disease; receding gums; constant odorous breath; 
loose teeth; dentures not fitting any longer; change in alignment of jaw 
and bite. The symptoms of the disease may be similar to other medical 
conditions and doctor's consultation is the best in this regard. 

Periodontal disease can be diagnosed by a dentist or a periodontist 
after reviewing the complete medical history and also physical 
examination of the teenager's mouth. Usually x-ray of the teeth is taken 
to evaluate the disease. Periodontal disease is classified into 
different types based on what stage the disease is in. The mildest form 
of gum disease is known as "gingivitis" in which gums become swollen, 
red and tender resulting in bleeding while daily brushing and flossing. 
Gingivitis is again divided into 4 groups primarily acute, sub-acute, 
recurrent and chronic. Acute gingivitis is nothing but sudden appearance 
which lasts for shorter duration and could be painful. Sub-acute 
gingivitis is less severe type of gingivitis. Recurrent gingivitis is 
the one that comes back after treatment. Chronic gingivitis is the one 
that onsets slowly, lasts longer and is generally painless. A dentist's 
treatment and proper and continuous care can easily solve the problem of 
gingivitis but if left untreated could result in periodontitis. 

Periodontitis is further classified into mild and moderate to advance. 
Periodontitis results from untreated gingivitis. In this stage the 
deterioration of the bone in the vicinity of the tooth becomes evident. 
The common symptoms include red gums that bleed; mouth tastes bad; loose 
teeth; tooth loss. Proper treatment is a must to control the disease and 
prevent further deterioration. Periondontitis which is in moderate to 
advanced stage shows signs of major loss of tissue and bone loss near 
the teeth. 

There are various treatments available for periodontal disease which is 
decided by the dentist depending on teenager's age, medical history and 
health in general. The method of treatment also depends on the extent to 
which disease has reached. The tolerance of the teenager to certain 
medicines, therapies and procedures are also taken into consideration. 
Expectations and opinion of the parents or teenager is also the criteria 
in deciding the type of treatment. The treatment usually involves plaque 
removal, medication and in worse cases a surgery. 

Orthopedic Problems in Adolescents

Physical health problems encountered during adolescence can affect the 
development of the body, if not treated. There are few anatomic regions, 
such as spine, knee and ankle, in adolescents which can get orthopedic 
problems such as Osgood-Schlatter disease, and Slipped Capital Femoral 
Epiphysis. 

Osgood-Schlatter disease is caused due to injury or overuse of the knee 
which causes swelling and pain in the area below the knee, above the 
shin bone. The patellar tendon and the soft tissues surrounding it gets 
inflamed, because of the constant pulling of the area where the tendon 
joins the below knee. Usually, adolescents who participate in sports 
actively and are athletic, such as football, basketball, soccer, ballet 
and gymnastics, tend to get the Osgood-Schlatter disease. Boys of age 
eleven to fifteen and girls of age eight to thirteen are at greater 
risk. The reason why adolescents get this problem is that their bones 
grow faster when compared to the tendons and muscles in this age and 
because of this the muscles and tendons stretch and become tight.    

The symptoms of Osgood-Schlatter disease are swelling of knee, 
tenderness below knee area and limping. The doctor will check the 
medical history of the patient and will conduct physical examination and 
diagnostic procedures such as taking an X-ray. The physician will decide 
on the treatment to be done by studying the overall health, age, medical 
history, tolerance for certain medications and extent of the disease. 
Treatment will include medications, rest, compression, elevation, 
neoprene knee sleeve and physical therapy. The main aim will be to 
control and limit the knee pain by cutting down on the adolescent's 
physical activities. Usually the Osgood-Schlatter disease gets healed 
over a period of time and in very rare cases is a surgery required. 

Slipped capital femoral epiphysis is a problem which affects the hip 
joint. The ball or head of the thigh bone, also known as femoral head 
slips from the thigh bone's neck. Because of this the hip joint becomes 
stiff and painful. Slipped capital femoral epiphysis is the most common 
disorder of the hip which can happen in both the hips or one and it is 
more common in boys when compared to girls. Basically, adolescents of 
the age ten to eighteen years and who are overweight can be affected by 
this condition. The condition can arise over a time interval of few 
weeks or years. The condition, if resulted because of trauma and is also 
called acute slip and if results after a period of time is called 
chronic slip. Slipped capital femoral epiphysis is caused because of 
medications, radiation treatment, thyroid problems, and chemotherapy.

There are three degrees of intensity of slipped capital femoral 
epiphysis, mild, moderate and severe. In mild slipped capital femoral 
epiphysis, only one third of femoral head slips from the thigh bone. In 
moderate, one third to half slips and in severe, more than half of the 
femoral head slips. The symptoms of this condition are pain in hip which 
increases upon movement, pain in thigh, knee & groin and limpness in the 
leg. When an adolescent walks there will be a clicking sound in the hip 
and his/her legs will be turned outwards. 

Apart from studying the medical history of the patient, the doctor will 
recommend diagnostic procedures such as bone scans, X-ray, magnetic 
resonance imaging and blood test. The bone scans will determine the 
arthritic changes and degenerative changes in the joints, which helps to 
detect tumors & bone diseases and the cause of pain and inflammation. 
The X-ray will give the inside picture of the bones, tissues and organs. 
The magnetic resonance imaging provide detailed image of the structures 
within the body with the help of large magnets. It is best if slipped 
capital femoral epiphysis is determined in the early stages, so that the 
femur bone's head doesn't slip off any further. The adolescent may need 
to undergo a surgery along with physical therapy.          

Obsessive Compulsive Disorder in Adolescents

Obsessive compulsive disorder or OCD starts from adolescence onwards. 
OCD is feeling of strong obsessions and compulsions which result in 
intense discomfort and affects daily functioning. Obsessions are 
thoughts which are persistent and recurrent. They even include unwanted 
images and impulses which lead to distress and anxiety. These feelings 
and thoughts are usually irrational or unrealistic. Compulsions are 
repetitive rituals or behavior such as checking something again & again, 
or mental acts such as counting. These obsessions & compulsions cause 
intense distress and anxiety and can interfere with the daily 
activities, relationships, social activities and academic functioning. 
The person with OCD thinks that he has no control over his actions. OCDs 
are relapsing and chronic illness.  

The thoughts change as the adolescent grows. Younger children suffering 
from OCD often have thoughts of harm befalling on them and their family 
such as thief getting into the house through an unlocked door.  This 
will make the children to recheck the door and windows again and again 
fearing that they might have left the door unlocked accidentally. 
Teenagers suffering from OCD fear that they might get fall sick due to 
germs, contaminated food and AIDS. The adolescent develops certain 
rituals, such as washing hands innumerable times, in order to get over 
the fear. These rituals help them to think that they have overcome the 
problem for the time being and give them temporary relief. If they do 
not perform these rituals, they become more and more anxious.  

OCD is a sign of brain circuitry's unusual functioning and it involves 
the striatum part of the brain. The brain activity patterns of such 
people differ from normal people and people with other mental disorders. 
Researchers have concluded that OCD is usually a family problem and is a 
disorder of the brain. Streptococcal bacterial infection can create or 
worsen the condition of OCD. Adolescents with no family history of OCD 
can also develop it. Most of the adolescents feel embarrassed to talk 
about their OCDs. They think that people will label them as crazy and 
this will make them feel ashamed. This will make it difficult for the 
parents to talk to their children about their OCD, in order to solve 
them. Parents need to develop good communication skills for this 
purpose. Parent's support is also very important to the adolescent. 
Cooperation is extremely important along with treatment, because if the 
problem is not treated the adolescent will grow into a disturbed adult.      

Most of the adolescents with OCD can receive effective treatment. The 
treatment can include psychotherapy and intake of medications such as 
fluoxetine, clomipramine, fluvoxamine, paroxetine, sertraline and other 
serotonin reuptake inhibitors. When OCD is caused due to streptococcal 
infection, the adolescent can be administered with antibiotics to kill 
the bacterium which is causing it. Exposure and response prevention 
behavioral therapy is very useful in solving OCD. In this therapy, the 
adolescent is wontedly exposed to his/her fears which give him/her 
obsessive thought. After that he/she is trained to avoid these thoughts 
and the rituals which he/she carries out to tackle the anxiety. 

An adolescent having OCD can also have depression, substance abuse, 
attention deficit hyperactivity disorder, eating disorders, and other 
types of anxiety disorders. When a person with OCD and other mental 
illness, is treated, OCD becomes more difficult to treat and even 
diagnose.      

Infectious Mononucleosis

Also known as mononucleosis or mono Pfeiffer's disease or glandular 
fever, infectious mononucleosis can be identified by inflamed lymph 
glands and constant fatigue. The disease is named so as the amount of 
mononuclear leukocytes which belong to white cells increase in number. 
The cause of the disease is EBV (Epstein -- Barr virus) or in some cases 
cytomegalovirus. Both these viruses belong to the family of herpes 
simplex. According to statistic majority of the adults in the United 
States are exposed to the virus Epstein  Barr, a very widespread virus. 
Although the virus does not show any visible affects in children but it 
does in adolescents which can lead to infectious mononucleosis in nearly 
fifty percent of cases of exposure to the virus.

The other virus called cytomegalovirus which also belongs to the family 
of herpes simplex causes the cells to become enlarged. According to 
statistics, about eighty percent of adolescents infected with this virus 
generally don't see any further symptoms. Although EBV has potential to 
develop infectious mononucleosis in adolescents the virus could make 
throat and blood cells its home for the lifetime. The virus has the 
capability to bounce back and reactive from time to time but the 
consolation is that it would reactivate without symptoms. 

The condition usually lasts for 1-2 months. The symptoms may vary from 
one adolescent to other but may include inflamed lymph glands in areas 
such as groin, neck and armpits, fever, continuous fatigue, enlarged 
spleen, sore throat as a result of tonsillitis that can make things 
difficult to swallow and last but not the least minor liver damage that 
can lead to short-term jaundice. Some adolescents may also experience 
symptoms such as abdominal pain, petechial hemorrhage, muscle ache, 
headache, depression, loss of appetite, skin rash, weakness, dizziness, 
enlarged prostrate, dry cough, swelled genitals and puffy and swollen 
eyes. Some parents are puzzled by the symptoms of mononucleosis as it 
may be similar to other medical conditions. It is safe to consult a 
doctor in such cases. 

The viruses are usually transmitted to other people through saliva (the 
reason why it is also called kissing disease), blood, sharing drinks and 
sharing utensils. The symptoms usually lasts for 4-6 weeks and do not 
cross 4 months. The disease is diagnosable but requires a though medical 
history of the adolescent. The diagnosis also involves physical 
examination of the adolescent and is based on symptoms reported to the 
physician. The diagnosis is further supported by laboratory test like 
blood test, antibody test and test to count white blood cells. 

A rest of about a month is generally advised and normal activities can 
be resumed after acute symptoms disappear. Also care should be taken to 
avoid physical activities which are heavy in nature and also activities 
or sports involving physical contacts should also be avoided. Care must 
also be taken to avoid eating sweet things in excess for few months. 

High Blood Pressure in Adolescents

High blood pressure is a condition where the blood pressure is more 
than normal. It is also known as hypertension. Heart pumps out blood, so 
that oxygen can reach to different parts of the body via blood. The 
pressure with which heart pumps blood is known as blood pressure. The 
blood pressure comprises of two measures, the systolic pressure and 
diastolic pressure. Systolic pressure is the larger figure and 
represents the pressure within the artery of the heart, when 
contractions take place which pump blood to different parts of the body. 
Diastolic pressure is the pressure within the artery of the heart, when 
the blood is filling in the heart and it is at rest. Both the pressures 
are measured in millimeters of mercury or mmHg. High blood pressure is 
abnormal increase in systolic pressure or diastole pressure. 

Blood pressure is measured by putting a blood pressure cuff on the arm 
and placing a stethoscope on the chest. There can be very little 
variation in blood pressure depending upon the time, emotional moods, 
age, gender, weight, height, physical activity, stress and other illness 
such as heart disease and kidney disease.  Children and adolescents 
become anxious when they visit the doctor. This is also an important 
factor which affects the blood pressure and the readings taken get 
tampered because of it. That is the reason why many blood pressure 
readings are taken in order to determine whether the adolescent has high 
blood pressure or not. The nurse may even ask the adolescent to calm 
down while taken the readings. Time gap is given between each reading, 
so as to give time to the adolescent to calm down. Emotions can also 
affect the blood pressure reading. 

An infant will have a normal blood pressure reading of 80/45, where as 
an adolescent will have a normal blood pressure reading of 110/70. 
Therefore, age, gender, and height are important factor when determining 
the normal blood pressure level. Adults will have a higher blood 
pressure than the infants and teenagers. Also, boys have a higher blood 
pressure when compared to girls and tall people have a higher blood 
pressure than short people. An adolescent is said to have high blood 
pressure when the blood pressure is more than the blood pressure of 
ninety percent people of his/her age, gender and height.      

There are many risks associated with hypertension or high blood 
pressure. The risk of developing coronary heart disease increases 
proportionally. The arteries will develop greater resistance towards the 
blood flow, because of which the heart will pump blood harder. Stroke is 
also another risk. Adolescents who have had high blood pressure as a 
child, develop harmful effects on the blood vessels and heart till the 
time they turn twenty. 

The causes of high blood pressure can be classified as primary and 
secondary. If the causes are definite, they are primary and if the cause 
is linked to some illness, it is secondary. Primary causes are high 
blood cholesterol levels, smoking, stagnant lifestyle and overweight. 
Secondary causes are obesity, immobility due to chronic illness, 
prescription drugs, intense pain due to burns or cancer and illegal 
drugs. High blood pressure can develop due to hereditary reasons. 

Hypertension is diagnosed by blood test and urinalysis. The kidney 
function will also be checked, along with blood cholesterol levels. 
Family history check is another important factor. Adolescents' eating 
habits, exercise levels, activities in school and home will also be 
studied thoroughly. High blood pressure is dealt with by weight 
reduction, healthy diet, and increase in physical activity. If 
hypertension is due to illness, the illness is treated first. These 
treatment measures will decrease the systolic blood pressure and 
diastolic blood pressure. It will also strengthen the heart and decrease 
the level of cholesterol in blood. This also helps to keep heart 
diseases at bay.  The good thing is that only one percent of the 
adolescents, who have high blood pressure, need medication to bring back 
the blood pressure to normal.    

Obesity in Adolescents

Obesity and overweight are the second most major reasons of preventable 
deaths in America. Stagnant lifestyle and junk food is to be blamed for 
more than three hundred thousand deaths per annum. The sad thing is that 
this problem is on the rise. Obesity is a chronic disease which poses 
serious health risk to the health of an individual. Also, obesity is the 
easiest recognizable medical problem, but is very difficult to deal 
with. 

People usually confuse obesity with overweight. Overweight is gaining 
of a few extra pounds. A person is considered obese when the total body 
weight is minimum ten percent more than the recommended weight for 
his/her body structure and height. According to an estimate every year 
hundred billion dollars are spent on the obesity problem. It is very 
important to treat the problem as early as possible. Obese children 
between the age of ten and thirteen have eighty percent chances of 
growing into obese adults, unless they change their ways and adopt a 
healthier lifestyle. The obesity problem starts from the age of five and 
continue till adolescence. 

Obesity can be caused due to complex reasons including biological, 
genetic, cultural and behavioral factors. Usually a person gets obese 
when he/she consumes more calories than the body burns. Also there are 
fifty percent chances of becoming obese when both one of the parent is 
obese and when obesity has affected both the parents, the chances 
increases to eighty percent. One percent of obese people can have that 
fat because of health reasons, as obesity can be caused due to few 
medical disorders. The causes of obesity in adolescence are overeating, 
family history, bad eating habits, little or no exercise, medical 
illness, low self esteem, medications, depression, emotional problems, 
stressful life, and family problem.   

Obesity can cause many major problems. Some of them are diabetes, 
sleeping disorders, high blood pressure, breathing problems, emotional 
problems and increase in heart disease risk.  Teenagers are more prone 
to get emotional problems. Because of the weight, they develop low self 
esteem. They get into depression, obsessive compulsion disorder and 
anxiety. 

Adolescents who want to tackle the obesity problem should approach a 
pediatrician who will thoroughly evaluate the cause. If no physical 
disorder is to be blamed, the weight is reduced by limiting the calorie 
intake and increasing physical activity. The doctor can advice a weight 
management program and change the eating habits of the teenager, slowly. 
The patient must avoid oily, fatty, fast and junk food. The potions must 
be reduced in order to decrease the calorie intake. If the adolescent 
has developed emotional problems because of obesity, an adolescent 
psychiatrist can collaborate with the pediatrician in order to make a 
comprehensive plan for treatment. The plan includes reasonable goals, 
behavior modification, family participation, and management of physical 
activity. 

Self motivation is extremely necessary in loosing weight. Because 
obesity is more a family problem and not an individual problem, the 
whole family can switch to eating healthy food and exercising regularly. 
This can make the weight control program a success. Parents can play a 
major role by boosting the self esteem of their children by 
concentrating on their strengths and encouraging them, instead of 
targeting the weight problem. The whole family should eat meals 
together, instead of eating individually while watching a movie. This 
helps all the members to focus on the food and the quantity being eaten. 
If the teenager isn't getting support from his family members, he/she 
can join support groups which can help towards the goals. 

After the adolescent has lost weight, it is very important that he/she 
maintains it. In majority of the cases, people shift back to their old 
eating habits after loosing weight. That is the reason why obesity is 
more of a lifetime issue. So the main aim of any weight loss program 
must be make the adolescent like healthy food. He/she must also be made 
to exercise regularly, irrespective of the weight. 

Menstrual Disorders in Adolescent Girls

Adolescence is the time when there is sudden transformation in the body 
and many questions arises in the minds of the adolescents. Firstly they 
are not able to cope with the changes and secondly the changes bring 
along problems with them. The most challenging problems are related to 
menses, in girls. Menstrual conditions are many that may require 
physician's attention or any other healthcare professional's attention. 
The most common of the menstrual disorders are premenstrual syndrome, 
dysmenorrheal and amenorrhea. 

Before the onset of the menses, females face many uncomfortable 
symptoms which last for a short period, stretching from few hours to few 
days. But some of them can be very intense and can disturb the normal 
functioning of the person. These symptoms are grouped as premenstrual 
syndrome. In usual cases, the symptoms come to a halt when the menses 
begin, but for some they may last even after the menstrual periods are 
over. Eighty five percent of the females experience some of the symptoms 
of premenstrual syndrome at one time or the other. Nearly forty percent 
experience the symptoms so intensely that their daily chores are 
affected by it and ten percent are disabled by it. 

There are many premenstrual syndrome symptoms which can be broadly 
classified as neurologic & vascular symptoms, psychological symptoms, 
gastrointestinal symptoms, fluid retention, eye problems and respiratory 
problems. The cause of premenstrual syndrome are fluctuations in the 
levels of progesterone & estrogen, hypoglycemia, hyperprolactinemia, 
psychogenic factors, changes in carbohydrate metabolism, excessive 
aldosterone, progesterone allergy and water retention by kidneys. The 
good thing is that premenstrual syndrome can be prevented by exercising 
regularly, eating balanced diet and sleeping adequately. 

Dysmenorrhea is feeling intense menstrual pain and cramps. Depending on 
the severity, dysmenorrhea is stated as primary dysmenorrhea or 
secondary dysmenorrhea. Primary dysmenorrhea symptoms are felt from the 
onset of the menstrual periods and are felt life-long. Because of 
abnormal uterine contractions due to chemical imbalance, severe 
menstrual cramping is experienced. Secondary dysmenorrhea starts in the 
later stages. The causes are different for primary and secondary 
dysmenorrhea. Secondary dysmenorrhea can be blamed on medical conditions 
such as endometriosis, uterine fibroids, pelvic inflammatory disease, 
tumors, infections, and abnormal pregnancy.         

Dysmenorrhea symptoms are lower abdomen cramping & pain, lower back 
pain, nausea, diarrhea, vomiting, fatigue, fainting, weakness and 
headaches. Females who are overweight, smoke, and have started to 
menstruate before turning eleven are at a higher risk of developing 
dysmenorrheal. Females who drink alcohol during menstrual period 
experience prolonged pain. After studying the health conditions, age, 
cause of dysmenorrhea, and extent of condition of the individual, 
corresponding treatment will be recommended. Regular exercise, abdominal 
massage, hot bath, vitamin supplements, and dietary modifications can 
help overcome dysmenorrhea. 

Amenorrhea is the condition in which the female skips her menses for 
more than three consecutive menstrual cycles. Amenorrhea is also 
classified as primary amenorrhea and secondary amenorrhea. Primary 
amenorrhea develops from the onset of menstrual periods. In this 
condition, the adolescent might not get periods when she enters puberty. 
Secondary amenorrhea is a condition where periods become irregular after 
a period of time and not from the start. 

There are many causes of amenorrhea such as ovulation abnormality, 
eating disorders, birth defects, anatomical abnormalities, 
malnourishment, anorexia, bulimia, pregnancy, over exercising, thyroid 
disorder, obesity and other medical conditions. Out of these ovulation 
abnormalities are a common cause for absent or irregular periods. It is 
a must that an adolescent start getting menses at least by the age of 
sixteen. If not, anatomical abnormality, birth defect and other medical 
conditions are the cause. Adolescents who participate in sports actively 
and are athletic have a lower body fat content because of which they 
have absent menses. Even because of malnourishment, the body is 
incapable of sustaining pregnancy. So in turn the body itself shuts down 
the reproductive system and menses. Extra fat cells in the body 
interfere with ovulation and that is the reason why obese female have 
irregular menses. Amenorrhea is treated by dietary modifications, 
ovulation inhibitors and hormone treatment.





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