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How to know if your child has allergies, and manage it

How to know if your child has allergies, and manage it

When the immune system of a child is unable to insulate itself from allergens in certain foods, dust or pollens, the result is an allergic reaction and the child is said to have allergies.

Allergies can impair a child’s ability to sleep, play and function in school.

Children with eczema – a skin condition that is usually the earliest manifestation of allergies – have a predisposition to develop other allergies.

Eczema, also called atopic dermatitis, is more likely to occur in young children. These children may later develop allergies of the nose or the lungs.

This process of evolution of one form of allergy to another is known as the Atopic March. The term “atopic” signifies that a child is allergic to various foods and environmental triggers.

Allergies seem to be more prevalent among children whose family members have a history of allergies.

As it is not feasible for parents to control the external environment and their child’s eating habits completely, their attention should be focused on observing the symptoms.

The early detection of allergies enables parents and doctors to formulate strategies to control the symptoms and enable the child to lead a normal life.

In the United States, up to 50 million people, including many children, suffer from some form of allergy.

Symptoms and causes

Common symptoms of allergies in children are:

• Skin rashes

• Wheezing

• Trouble breathing

• Stomachache, vomiting and/or diarrhoea

• Itchy and watery eyes

• Cold, cough and/or sneezing

Common allergens include:

• External environmental triggers like plant pollen and insect bites

• Indoor allergy triggers like pet or animal fur, dust mites and cockroaches

• Food allergens like cow’s milk, eggs, fish, peanuts and wheat

Many children outgrow allergies to cow’s milk and eggs as they get older. However, fish and peanut allergies generally persist.

Meanwhile, wheat can cause a severe life-threatening allergic reaction.

• Medicine allergies like allergies to penicillin or sulpha drugsAllergies, eczema, atopic dermatitis, hay fever, allergic rhinitis, asthma, allergens, food allergy, food intolerance, medicine allergy, Star2.com

Diagnosis and treatment

Some allergies can be fairly easily identified, while others can have obscure symptoms that are difficult to pinpoint to an allergy.

Eczema manifests itself through skin rashes, accompanied by severe itching.

Allergic rhinitis, also called hay fever, is a nasal allergy that is common among children suffering from eczema.

Most children do not start suffering from hay fever until they reach school age. Allergy triggers in the environment like pets, pollen and dust, can cause hay fever.

If cold symptoms persist for a week or two in a child, or symptoms always occur at a certain time of the year, hay fever should be suspected.

Asthma, a form of lung allergy, manifests itself as cough, wheezing and difficulty in breathing. Such children generally show a good response to medicine given in inhaled form.

Symptoms of food allergies observed in young children include vomiting, diarrhoea, runny nose and sneezing.

In rare cases, children may suffer a severe reaction called anaphylaxis, which can be fatal.

It is important to identify whether the reaction observed in young children is due to food allergies or food intolerance.

The signs and symptoms of food intolerance and food allergy can be similar, but are generally milder in the former.

A classic example of food intolerance is lactose intolerance, where the enzyme needed to digest lactose in milk is deficient.

A person with lactose intolerance can drink lactose-free milk without any problems.

Medicine allergies generally manifest as skin rashes, and in rare cases, may cause life-threatening anaphylaxis.

Diagnostic tests to identify the allergens triggering the allergic reaction include both skin and blood tests.

Test findings are usually correlated with the observed symptoms before making a final diagnosis.

In severe cases, the child may need consultation with an allergist, who is a medical doctor who specialises in allergies.

While allergies cannot be eliminated totally, their impact and symptoms can be managed through appropriate treatment strategies.

To protect children from airborne allergies, the following measures may be helpful:

• Keeping pets out of the house

• Keeping stuffed toys out of the child’s bedroom

• Removing any carpets or rugs in the house

• Keeping windows closed to mitigate pollen-related allergies

• Using encased mattresses and pillows to minimise dust mite allergies

Children and their caregivers must be educated to avoid exposure to identified allergens.

However, if avoiding allergens is not feasible or not effective, doctors might prescribe anti-allergic medications such as antihistamines, inhalers, eye drops and nasal sprays.

In severe cases, the child may need allergy shots, which will help desensitise the child to the allergens.

Assoc Prof Dr Razia Latif is the Paediatric programme clerkship director at Perdana University Graduate School of Medicine. This article is courtesy of Perdana University. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
The importance of continuing rehabilitation at home

The importance of continuing rehabilitation at home

Many conditions like stroke and arthritis affect a person’s ability to move and participate in daily living activities.

Such a person requires help from rehabilitation professionals, including physiotherapists and occupational therapists, to undergo a rehabilitation programme.

Rehabilitation is a process by which abilities such as range of motion, strength and endurance, are restored or maintained through therapy programmes.

For example, a stroke patient with limb weakness has to follow specific exercise routines in order to regain functions of the affected upper and lower extremities.

Doing it at home

Most patients attending therapy in rehabilitation settings like the hospital or rehabilitation centres, receive around one hour of therapy for at least once or twice a week.

This is often not enough for a therapy to be effective for certain conditions, therefore, the therapists will usually advise patients on further activities or exercises to be conducted by themselves at home.

This is known as the home programme, which ensures the continuity of the therapy and its effectiveness.

Complying with your rehabilitation programme at home is similar to adhering to your medication routine.

Just like taking pills twice a day, for example, the time spent on a home programme and the number of repetitive exercises has to be strictly followed as a part of your journey to recovery.

However, due to the lack of supervision and support, many patients struggle to continue therapy at home.

According to a study, patients’ non-compliance to their rehabilitation programme can be as high as 70%, which greatly impacts the outcome of therapy and has many negative consequences.

Common issues influencing a person’s motivation to continue with therapy are as follows:

● Self-efficacy

This belief in our own abilities especially affects those with chronic conditions where little or no progress can be seen.

● Mental health problems

Depression and anxiety are common among patients with physical injuries or conditions, which leave them feeling sad, hopeless, worried or afraid all the time.

● Helplessness and poor social support

Helplessness refers to those who believe that there is no escape from their current condition.

Without proper support and the determination to proceed with therapy, patients are likely to become increasingly frustrated, leading to low adherence to the therapy programme.

● Overprotective significant others

Patients with families that discourage any activity that may cause discomfort are more likely to be less active and less adherent to a home programme.

● Pain during exercise

Some movements may cause pain, which often occurs during or immediately after exercise.

● Other barriers

This includes problems with transportation, life roles, schedules and memory function, as well as time or financial constraints.

Ignoring therapy

So, what happens when you do not stick with your rehabilitation programme?

● Lack of progress

When a patient does not continue with the prescribed exercise routines at home, they will take longer to get better.

● Increased treatment costs

Frequent visits to the rehabilitation centre means more money spent on therapy and other related costs, such as transportation and unpaid leave.

● Medical complications

This may happen when the condition gets worse due to lack of preventive exercises.

For example, muscle-shortening due to lack of movement can lead to muscle contracture.

When muscle contracture occurs, rehabilitation may no longer be effective and surgery might be required.

Increasing compliance

Here are some strategies to motivate you to stick to your rehabilitation programme:

● Know your conditions and set realistic goals

Some conditions are progressive in nature, so acknowledging the nature of your condition may help you to anticipate your progress.

Discuss with your therapist how to set realistic goals in order to reduce your disappointment.

● Keep a diary

Having an exercise logbook may help in tracking all the effort and time you have put in to achieving your rehabilitation goals. You’ll be amazed at how far you have come.

It can also be a reference for your therapists to modify or intensify your home programme activities.

● Set reminders or an alarm

A daily reminder will ensure you remember when it is time to do your therapy activities.

Phone or alarm clocks are examples of devices that can help you to adhere to your therapy schedule.

● Getting involved in group activities or a support group

Social media groups or association groups are some of the various platforms that can be used to discuss your problems and keep yourself (and other members) motivated to continue therapy.

● Incorporate therapy into daily living activities

Occupational therapists are the key people to suggest individualised occupation-based activities to be conducted at home.

Activities can include daily routines such as doing laundry, gardening and cooking, according to your preference.

● Reward yourself

Treat yourself to something you really like when you accomplish certain goals, e.g. buy yourself a new shirt or go to a movie.

In summary, the home programme is a crucial part of rehabilitation and recovery is dependent on the patient’s perseverance and motivation to continue with therapy.

Aifah Jamaludin is a lecturer in the Perdana University School of Occupational Therapy. This article is courtesy of Perdana University. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Smokers, vaping is not necessarily safer than cigarettes

Smokers, vaping is not necessarily safer than cigarettes

Vaping is the act of inhaling and exhaling an aerosol produced by a vaping device, such as an electronic cigarette (e-cigarette).

Pocket vapes, pen vaporisers and box mod vaporisers are other vaping devices available on the market. Vaping doesn’t require burning like cigarette smoking.

The device, usually battery-operated, heats a liquid into a vapour, which then turns into aerosol and is breathed in by the individual through a mouthpiece.

This vapour contains about a dozen ingredients and flavouring agents, including nicotine.

How it began

A vaping device was first patented by Herbert A. Gilbert in 1963.

His model of replacing paper and burning smoke with heated moist and flavourful vapour was rejected by cigarette companies then as the smoking community was not aware of the health risks of cigarettes as they are now.

E-cigarettes hit the shelves successfully only in 2003 in Beijing, China.

Pharmacist and researcher Hon Lik, also a hopeless smoker, created the first commercial e-cigarette after his father died of lung cancer.

He later revealed in an interview that he had dreamt of drowning in a sea. Suddenly, the water vaporised and he was able to breathe easily.

This dream sparked an idea that laid the foundation to the making of e-cigarettes.

He introduced e-cigarettes in the United States and Europe in 2006. Since then, e-cigarettes have journeyed into many countries under various regulations.

In 2008, the World Health Organization (WHO) stated that it does not consider e-cigarettes safe and demanded that marketers immediately remove any such suggestions from their product.

In 2009, then-US President Barack Obama gave the US Food and Drug Administration (FDA) the power to regulate the manufacturing, marketing and sale of tobacco.

In 2011, the agency announced that it will regulate e-cigarettes just like traditional cigarettes and other tobacco products.

Its regulations on e-cigarettes was released officially in 2016, and included age and marketing limitations for the product.

Last year, the US FDA called the increasing trend of e-cigarette usage among teenagers an epidemic and introduced a youth tobacco prevention plan to stop it.

Aside from restricting availability and raising awareness, the agency is also evaluating a policy to restrict flavoured vaping liquids, which are the main attraction of e-cigarettes for young people.

The effects of vaping

• Lung

The American Lung Association (ALA) says that e-cigarettes contain many toxic substances such as aldehydes, acrolein (a herbicide) and benzene (found in car exhaust), which can cause irreversible lung damage and result in many lung diseases, including asthma and lung cancer.

Some of the flavouring agents used in vaping liquids are also known to cause serious lung disease.

Heart

Vaping liquids contain many heart-toxic substances. They not only result in heart disease, but also accelerate disease progression in those who already have heart disease.

Evidence suggests that e-cigarettes have a substantial negative effect on blood vessels, hence increasing the risk of a heart attack.

Researchers from the University of Kansas in the US say that: “When you smoke e-cigarettes, you are much more likely to have an MI (myocardial infarction or heart attack), coronary artery disease or stroke, and are more prone to suffer from depression.”

Vaping also reduces the release of nitric oxide by blood vessels, which may result in heart disease.

Brain

Nicotine has been shown to be toxic to the developing brain of young people.

Scientists have found that many vaping devices produce vapour that contains lead concentrations above the safety limits established by the US government, which can cause nerve and brain damage.

Lead is a known neurotoxicant, which means that it has direct toxic effects on the brain and nervous system.

With their brains still developing, teenagers and young adults are highly susceptible to these negative effects.

Researchers have found that about 40% of vaping liquids contain manganese above the recommended safe levels.

People who work with manganese are likely to develop manganism, which is a Parkinson’s-like disease that deteriorates the brain.

Pregnancy

Nicotine has been shown to have negative effects on reproductive health.

It can harm the developing foetus when their mother is exposed to it, and lead to babies born with low birth weight.

Children

Those who experience secondhand vaping are also likely to be inhaling these toxic metals and putting their health at risk.

Other than damage to their developing brain, children who have been exposed to nicotine also have more respiratory problems.

Cancer

In addition to high levels of nicotine, e-cigarette liquids also contain propylene glycol and glycerine, which can irritate the eyes and airways.

When heated and vaporised, these ingredients degrade into formaldehyde and acetaldehyde, which are carcinogenic.

Many vaping devices produce vapour containing chromium, a cancer-causing agent, at concentrations above limits established by the US government.

Gateway to cigarettes

E-cigarettes produce vapour rather than tobacco smoke, which means that they deliver less nicotine than traditional cigarettes. However, that doesn’t mean that they’re safer.

The most intimidating thing that has been discovered about e-cigarettes is that they keep people addicted to nicotine.

Research shows that around 70% to 90% of e-cigarette users are still smoking traditional cigarettes.

E-cigarettes may prove less harmful than traditional cigarettes, but are still not completely safe.

Because of the misconception that vaping is harmless, young adults who would never have been introduced to nicotine in their lifetime, are now getting addicted to it.

Dr Barani Karikalan is a senior lecturer in pathology at the Perdana University Graduate School of Medicine. This article is courtesy of Perdana University. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
The many ways of killing bacteria

The many ways of killing bacteria

Before we learn how to kill bacteria, we should know what bacteria are and why we need to kill them.

Bacteria are single-celled prokaryotic microorganisms found mostly under the Eubacteria kingdom in the Linnaeus classification.

A prokaryotic organism does not have a nucleus or membrane-bound organelles in its cells.

In contrast, humans, animals and plants are all eukaryotic organisms that have nuclei and membrane-bound organelles in their cells.

Bacteria are not visible to the naked eye – we must use a light microscope in order to see them.

They are present everywhere. Many of them are harmless, while some are beneficial for the human body.

But there are also many pathogenic, or harmful, bacteria that cause disease in humans.

We need to learn how to kill bacteria in order to prevent ourselves from getting harmful infections, to prevent spoilage of food, and to prevent contamination of materials used in pure culture work in laboratories.

Sterilisation and disinfection

The process of killing bacteria and other microorganisms either in a vegetative or a spore state, is known as sterilisation.

In other words, sterilisation refers to any process that eliminates, removes, kills or deactivates all forms of biological agents like fungi, bacteria, viruses, spore forms, prions and unicellular eukaryotic organisms like Plasmodium parasites.

These can be present in a specified region like a surface, a volume of fluid, medication, or in a compound like a biological culture media.

Meanwhile, disinfection is defined as the destruction of all pathogenic organisms or organisms capable of giving rise to infection.

It is less effective than sterilisation as not all disinfectants can destroy spores.

Sterilisation involves many physical and chemical changes in a cell, which finally leads to the removal or destruction of that cell.

These changes include the destruction of the structure of the cell’s proteins (denaturation) at a high temperature, the alteration or disruption of a cell’s metabolic processes through chemicals, and damage of the cell’s nucleus through radiation.

Sterilisation can be brought about by many methods, including physical methods, irradiation, and chemical agents or disinfectants.

Killing agents

Killing bacteria, sterilisation, disinfection, autoclave, Star2.com

Autoclave machines can also be found in a tattoo parlour, where they are used to sterilise needles used for tattooing.

Red heat: This has its main application in the sterilisation of laboratory equipment such as wires, forceps and spatulas.

These are held in the flame of a Bunsen burner until they are red hot.

This method can be used in laboratories, hospitals and homes, but only for materials made of iron.

Flaming: Scalpels, needles, culture tube mouths, glass slides, cover slips and others can be sterilised by passing them a few times through a Bunsen flame without allowing them to become red hot.

This way the bacteria gets burnt by the direct flame.

This method is applied to items that cannot be held in the flame for a longer time without melting.

Hot air steriliser (oven): This resembles the electric oven we use at home.

It is used to sterilise glassware, forceps, scissors, scalpels, all glass syringes, swabs, some pharmaceutical products such as liquid paraffin, sulphonamides, dusting powder, fat, grease and others.

Commonly, sterilisation in the oven uses a temperature of 1,600°C for one to two hours, 1,700°C for one hour or 1,800°C for 30 minutes.

We can sterilise glasses, plates and kitchen utensils in this way.

The items need to be wrapped in aluminium foil before using the oven.

Infra-red radiation: The infra-red rays are directed from an electrically-heated element onto the objects to be sterilised.

Heating at or above 2,000°C by infra-red in a vacuum is employed as a means of sterilising surgical instruments and glass syringes.

Using water and rays

Moist heat is used for the sterilisation of culture media and other liquids that need to retain their water content.

This method is utilised by the autoclave, which is the most reliable method of killing bacteria and other microorganisms.

Autoclaving provides moist heat at a temperature higher than 1,000°C through steam that is under increased pressure. This machine is often used in laboratories and hospitals.

Another popular method of killing bacteria using moist heat is boiling. Many of us boil water for 15-20 minutes before drinking.

However, we must remember that boiling can kill bacteria, but not all bacterial spores.

Meanwhile, radiation kills bacteria by causing damage to the cell itself, particularly its DNA.

There are two types of radiation: ionising (e.g. gamma rays, x-rays) and non-ionising (e.g. ultraviolet).

Germicidal lamps that emit ultraviolet radiation are widely used in hospital operating rooms, aseptic filling rooms, the pharmaceutical industry, and the food or dairy industries for treatment of contaminated surfaces.

Chemical agents

The exposure of bacteria to chemical disinfectants produces a variety of effects, such as the disruption of cell processes, the separation of cell proteins from the cell, inactivation of enzymes in the cell and the leakage of amino acids from the cell.

A few common chemical disinfectants are:

 Phenol and phenolic compounds

A 5% aqueous solution of phenol rapidly kills bacteria. It is widely used for decontamination of infective discharges (like pus), bathrooms, bedpans and hospital floors.

• Alcohol

A 70% ethyl alcohol solution is among the most effective and frequently used agents for disinfection.

It is widely used in reducing the microbial flora of skin to help prevent infection, e.g. before you receive an injection.

• Iodine

Killing bacteria, sterilisation, disinfection, boiling water, drinking water, kettle, Star2.com

A commonplace, everyday act of killing bacteria using moist heat is boiling our drinking water.

Iodine is one of the most effective germicidal agents. It is effective against all kinds of bacteria, as well as spores, fungi and viruses.

It is used as a rapid skin disinfectant and is valuable for the preparation of the skin for surgery.

It can also be used at home to disinfect a wound before bandaging it.

Iodine is also used for the disinfection of water and air, and sanitisation of food utensils.

 Chlorine and chlorine compounds

These are used in water treatment, the food industry and medicine, as well as for sanitising dairy equipment and eating utensils, disinfecting open wounds, and treating athlete’s foot, among others.

• Copper

Copper sulphate is much more effective against algae and moulds than bacteria. It is used in swimming pools and open water reservoirs to prevent algal growth.

• Detergents

Soaps reduce surface tension, thereby increasing the wetting power of water.

Soapy water has the ability to emulsify and disperse oils and dirt. Bacteria will become enmeshed in the soap lather and removed by the rinse water.

Several detergents are bactericidal and available commercially.

• Formaldehyde

Formaldehyde in gas form is used for disinfection of enclosed areas, rooms, furniture etc. It can kill spores almost as readily as the vegetative forms of bacteria.

• Glutaraldehyde

Glutaraldehyde kills bacteria and spores, and is effective against viruses.

It is used in the medical field for sterilising urological instruments, lensed instruments, respiratory therapy equipment, cytoscopes, anaesthetic equipment etc.

• Ethylene oxide

Ethylene oxide kills bacteria (and their endospores), mould and fungi.

It is widely used to sterilise the majority of medical supplies such as bandages, sutures, endoscopes, stethoscope and surgical implements.

There are many factors that can influence the killing of bacteria.

The time of exposure, temperature, concentration and pH of the disinfectants, as well as the number of bacteria present, need to be considered before we choose the method of killing bacteria.

Dr Mohammad Nazmul Hasan Maziz is a medical microbiologist and research fellow at the Perdana University Graduate School of Medicine. This article is courtesy of Perdana University. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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