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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. PPPPP Word Count 666

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. PPPPP Word Count 485

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. PPPPP Word Count 670

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. PPPPP Word Count 660

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. PPPPP Word Count 555

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. PPPPP Word Count 657

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. PPPPP Word Count 683

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. PPPPP Word Count 725

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. PPPPP Word Count 726

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. PPPPP Word Count 670

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. PPPPP Word Count 658

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. PPPPP Word Count 576

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. PPPPP Word Count 670

Researching Archery Archery excites those hearts that believe in thrill and excitement. Archery has been there since ages but it has not lost its exuberance. Although advent of firearms made archery obsolete still there are people who love archery. Archery is used for recreational purposes; in sports it has carved a niche for itself. Archery is still in vogue and will remain for years; it is the national sport of Kingdom of Bhutan. If you are fascinated by archery and want to purchase archery equipment then go for archery research. Archery research will probably help you in getting the kind of bows and arrows you have been looking for. You can get the bows and arrows from the numerous archery suppliers who are present all over the world. These suppliers have baskets full of different varieties of bows and arrows. Depending on your preference and your need you can select the best for yourself. Moreover the prices are also affordable. If you are confused and are unable to decide what is best for you then do a proper archery research or you can also go for an expert advice. Bows and arrows, the indispensable parts of archery, are of different variety. Longbow, shortbow, flatbow, recurve bow, crossbow and compound bow are the different kinds of bows which are being used by the archers. Each one has its own individual characteristics. Longbow is very long; the length of the bow is equal to the height of the user and in some cases even exceeds the height of the user. The limb of the Flatbow is wider and the cross-section is rectangular in shape. Shortbow is shorter in length; it is light weight and has a short range. It was basically used for hunting purpose. In crossbow the limbs are mounted in a horizontal manner and not in a vertical manner. The archer finds it very easy to mount the arrow on the compound bow. Shaft, arrowheads, nock and fletching constitute an arrow. Aluminum alloy, carbon fiber, wood and fiberglass are used for the construction of the shaft. Depending on the usage the choice of the arrow will differ from person to person. The arrow should be tight and not flexible. At present arrows made of carbon alloys are popular; these arrows are used even in Olympics. The arrow will be able to hit the target only when it is shot at a proper angle; when the arrow is in the air it should be able to use the air pressure to hit the target. The arrowhead and fletching provides the requisite balance to the arrow. The arrowhead of arrows needs to be made of some hard materials like metals; it is actually the arrowhead which directly strikes the target. Fletching which is at the rear end of the arrow provides balance to the arrow. Bird feathers were used to make fletching but now plastic is also being used. In order to hit the target it is necessary that the arrow is shot at an appropriate angle; this will be possible if the bows and arrows are made of fine material. Archery research will help you make the best use of bows and arrows.

The History of Archery The heroic effort of archers at the battlefield helped several kingdoms win wars. Archery although obsolete today has helped men since ages. Since ages people have used archery to conquer their enemy and to tame wild animals. Studies have shown that archery was widely being used in ancient civilization. Archery history shows that earlier arrows were made of pines which had a long fore shaft that had a flint point. Till date, archaeologists have found the oldest bow in Denmark. Arrow shafts have been found in many places across the globe in Egypt, Sweden, Denmark and India. Bows and arrows are the main constituents of archery. Archery history reveals the fact that the bows were developed in either early Mesolithic age or late Paleolithic age. Pines were used for making arrows. Archery was highly developed in Asia and other Islamic kingdoms. People were specially trained in archery; these archers were used in the battlefields. In fact before the development of firearms archery served as primary weapons. Different types of bows and arrows were manufactured and accordingly they had different range. The archery history is full with saga of great archers. These archers have played a major role in the ancient civilizations of Egypt, India, Greece and Persia. The archery bows which were commonly used were: longbow, shortbow, flatbow, recurve bow, crossbow and compound bow. Longbows were very long bow. The length generally matched the height of the archer and in some cases even exceeded the height of the archer. The limb of the Flatbow is wider and the cross-section is rectangular in shape. Shortbow is shorter in length, is light-weight and have a short range. It was basically used for hunting purpose. In crossbow the limbs are mounted in a horizontal manner and not in a vertical manner. The compound bow is designed in such as manner that the archer is at his ease while mounting the bow. Shaft, arrowheads, nock and fletching constitute an arrow. Aluminum alloy, carbon fiber, wood and fiberglass are used for the construction of the shaft. The shaft should not be too flexible; it should be straight and easy to handle. At present arrows made of carbon alloys are popular and are being widely used by the archers. In fact arrows used in popular sports events like Olympic are made of carbon alloys. Sight shooting and instinctive shooting are the two methods adopted by an archer while shooting an arrow. In instinctive shooting the archer completely concentrates on the target while shooting the arrow. It requires a lot of practice; this method of archery was popular during the early phases. However, later bows with adjustable pins were developed; these pins could be adjusted by the archers to aim a target. This is called as sight shooting and is easy as compared to instinctive shooting. Later when the firearms were developed it replaced archery. Firearms were found to be superior to archery; it was more lethal, it had long range and also using it wasn’t too difficult. In fact hose kingdoms which did not know to use firearms had to suffer heavily on the battlefield. Archery history indicates that men since time-immemorial have been devising ways to lord over others.

Back in the 17th century and in Italy, you’ll find that this is about the time of the baroque architecture. This is a very early style of architecture, but a very beautiful style. Taking the renaissance architecture and modifying it to a new theatrical, sculptural fashion, Baroque architecture became a very fanciful, extravagant style of structural design. When it comes to the renaissance style, it was designed for a more well to do society, and then the baroque architecture became an interest with the Roman Catholic Church. The concerns were for light, shade and color intensity and Baroque found its secular expression in grand palaces first in France, then throughout Europe. Keep in mind that the Chateau de Maisons is still in France and it is known as a huge part of the baroque architecture. One of the most famous though of the Baroque architecture pieces is St. Peter’s Basilica in Rome. When it comes to the Vatican City, you will find that it is one of the most beautiful. Topped with its towering dome, it is a notable feature in the Roman skyline. When it comes to baroque structures you will find that it can be grand in both ornaments and grand. As baroque moved through Europe, it eventually took on the look of European Colonialism. As for England, it is the Greenwich hospital located in London that is one of the most beautiful, English examples of this type of architecture. Founded in 1694 as the Royal Naval Hospital for sailors, the Greenwich hospital is famous for its Baroque Painted Hall, which was painted in honor of King William and Queen Mary. With the chapel, you’ll want to keep in mind that baroque architecture is not only present in the art and décor, but also it is known for the gold painted ceilings.

Art Deco and Architecture When it comes to art deco architecture, it was very popular in the twenties and the thirties. It becomes a movement in interior design and even industrial design. You will find that there are many things like films and pieces of art that also fashion this type of style. The movement was a mixture of many different styles, incorporating cubism, modernism, Bauhaus, Art Nouveau, and Futurism, and its popularity peaked in the roaring twenties. There were many other architectural styles that also had some political roots, and also they had some philosophical influences, but when it comes to art deco it is just for simple decoration. Designed to be beautiful, elegant, functional and modern. One of the best-known pieces of Art Deco architecture in the U.S. is the Chrysler Building in New York. The beautiful Art Deco spire was built between 1928 and 1930. Following close behind the Art Deco period was the Streamline Moderne. The focus was mainly on advancing technologies such as automobiles and aviation. With the art deco architecture it is mainly composed of many man-made pieces. The most popular being glass and stainless steel. Lines were very symmetrical and repetitive throughout structures. It becomes very popular during the depression because it was very simple and very practical. Art Deco still reminded people of the better times and gave them hope of one day reliving them. After the Second World War, it becomes very short live fore the art deco period. You will find that the image of art deco became almost like a false sense of lavishness, but it is still seen in interior design well into the 1960’s. Something that you’ll want to think about it that the beautiful designs of art deco architecture has become very modern and also it still is mixing things up with even today’s styles. Throughout the United States, you will still find that art deco is still alive in some of the bigger cities.

American Architecture When you take a trip across the country and you start to look for beautiful architecture you will find it from coast to coast. You will notice that most of the architecture of America is mostly predominate of the 1780’s. Many wealthy early American settlers like the Anglo-Americans built the structures. Built mostly by wealthy Anglo Americans, the houses afforded several distinct styles depending on local. Also known as Colonial Georgian, these homes were the earliest style to grace the U.S. colonies. A good example of American colonial architecture happens to be the Saltbox. What the Saltbox basically is is a wooden frame house with a high-pitched roof that slopes down to the back. It basically is two stories and the back of the house only has one story. This makes the sides very unequal, but it looks much like a saltbox, which basically was a wooden boxed building where you kept your salt. The saltbox is a simple style of home, but it also has a simple name. Generally, the chimney was centrally located, making the house, from a distance, look like a box with a lid and handle to lift it off. Other defining characteristics of American Colonial architecture are the square, symmetrical shape, the front door placed directly in the middle of the houses front and the even, straight line of windows throughout. Once you are inside there is usually an entryway and then a staircase. You will find that when it comes to rooms, they will branch off from the entryway. When it comes to the homes like saltboxes, they are just timber-framed homes constructed with woodwork joints, because metal nails are too costly. You will find that saltbox homes will also have a wood siding to finish off the home.

Architecture overview When it comes to architecture, you will find that it is a science or even an art. You will want to keep in mind that designing and planning is just half of the wonder when it comes to putting a town together or working on the local surroundings. There are some people who specialize in just architecture and that is known as being an architect. Architecture has played a key part of our entire worlds history. For wherever there have been buildings or structures that were safe for inhabiting, there has been some sort of architecture. When it comes to architecture, you will find that it all begins with imagination and then it is created to be functional, educational, useful, and even fun. From the smallest 1 bedroom home to the grandest palace or biggest cathedral, every structure is based on some form of architecture. Overtime architecture tends to change with time and design. You will find that there are many eras of architectural design as well. Each era has its own style of architecture, from Baroque, Greco-Roman, Art Deco, Victorian to American Colonial, Prairie, and Bauhaus. Lines, materials, structure and symbolism all contribute to the different styles of architecture. Architecture styles can be anywhere from subtle to garish and materials vary from lumber to limestone. When it comes to the earlier designs you will find that they are made from local and natural materials and they are also materials that are bountiful. In Greece, limestone happened to be bountiful and it was the material that most structures were created from. And since marble was not only rare but for a few select islands, but very difficult to transport, it was used sparingly and usually only for ornamentation. When it comes to early America, you will find that the saltbox houses where made from wood, which was readily available and it was easily to build, so it took practically no money at all to build one of these homes. You will find that the joints could have been put together with nails, but they were very expensive, so they were usually put together with wood joints.