Allergic plants in metros

The above is a plant growing in a divider in Mumbai city. It is a weed. Along with the ornamental plants due to lack of proper care this plant has grown unhindered. It is called Amaranthus spinosus or Chawli bhaji. It is a strong aeroallergen.

Other plants spotted in Mumbai are

  • castor oil or ricinus communis growing at the sides of the Nullahs or aqueducts,
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  • carica papaya or papaya tree. however, papaya trees have been stripped bare of their leaves due to the belief that they are helpful in the treatment of dengue;
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  • congress grass or parthenium.
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  • agreratum or neelam
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  • Durva grass or cynodon dacytlon, known as bermuda grass, Commonly used in Ganesha pooja
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  • raintree or Samania Saman
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  • coconut tree or cocos nucifera
  • In the warm and humid climate of Mumbai, these allergens are present throughout the year.
  • They are commonly seen in roadside areas, at the side of the railway tracks, gardens of educational campuses, offices and institutions, public gardens, lawns, plantations, etc
  • other irritatants like petrol and diesel fumes, pollutants, dust add to the effect of these pollutants

TIPS TO PREVENT POLLEN ALLERGIES:

  • Keep doors and windows closed early morning and late evening
  • Don’t go for a walk at these times as pollen exposure will be more
  • wear a mask while outside walking, and a full sleeve dress
  • Immediately take a shower and put your clothes for washing on returning home, especially from a long day outside, to remove pollen stuck to your clothes and body
  • wash hair regularly

Firecrackers in Diwali: Is restricting them a good thing ?

I remember Diwali when we were kids, sprucing the house, endless preparation of traditional sweets, lighting of Diyas and lanterns, Preparing of Rangolis, etc

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Bursting of firecrackers too!

Nowadays Diwali celebrations have changed with the times. Rangoli designs have progressed,  people dress up in westerns, too and chocolates, dry fruits and different sweets have replaced traditional sweets.

The issue nowadays is about firecrackers. Kids used to burst them, be daredevils in spite of the risks involved.

People argue that firecrackers are part of tradition. Kids enjoy bursting firecrackers. Diwali is incomplete without them.

There are two schools of thought for firecrackers.Arguments have been put forward that pollution is increasing anyway, other reasons are responsible for it. I feel that it is a good thing that use of firecrackers is restricted. Wherever possible we should try to do our bit in reducing environmental pollution.

It’s a good thing that lots of people are becoming more aware of the hazards of firecrackers.

Wishing you all a Happy and Safe Diwali!

Care of Common ENT problems in Young children.

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Everyone hates it when their small child falls ill. Small children cannot tell what’s troubling them, they cry a lot, stop eating, and in coughs and colds they vomit while coughing. As shown above, the ear, nose and throat are connected so ENT problems are interrelated.

Coughs, colds are at a peak when children interact with other children in the play group. As they grow older, their immunity builds up and they fall less sick. The following are common problems in small children:

Respiratory Viral infections

Common cold viruses, flu viruses, measles, chicken pox, mumps, etc. These make the child sick and prone to allergies.

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Allergies

Allergies to dust, pollen, fungi and various foods are present

Food allergies are more common in children such as peanut, egg, wheat, milk, tree nuts, soya and seafood. These have to be identified as soon as possible and avoidance measure should be followed

The Child should have Epi-pen ready for prompt use in case of food allergy for an anaphylactic attack

( Please refer to the previous blogs on allergies)

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Adenoids and Tonsils

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Infections of the tonsils and adenoids are very common in small children. The tonsils and adenoids are protective mechanisms of the body and help prevent spread of infection to the rest of the body. After the age of 5-7 years, the frequency of infections will go down and the tonsils and adenoids should become small in size

However, tonsils and adenoids become cause of concern if,

  • The child has repeated severe infections at least once a month.
  • The tonsils and adenoids are so huge that the child finds it difficult to breath especially during sleep.(childhood sleep apnea)
  • Tonsillar infection and blocked nose persist after 7 years of age.
  • Enlarged adenoids lead to chronic mouth breathing if untreated at the proper time. This affects the development of the face leading to typical ‘adenoid face’ , mouth open, the cheek bones don’t grow as they should leading to flattening of the face, high arched roof of the mouth and dental problems

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The misconception is that children will ‘outgrow’ these infections, and so sometimes surgery is delayed. If the child is very sick it is advisable to go for adenotonsillectomy due to the following reasons:

  • Infected tonsils and adenoids carry a lot of bacteria. They no longer can ‘protect’ the body.  In fact they become more dangerous as infection from them can spread to the body and can lead to complications like rheumatic heart disease
  • The cosmetic appearance of the face is changed
  • The child has to suffer unnecessarily

Tonsils and adenoids can be removed by Coblator Assisted Surgery.  It is a plasma wand, and at near normal temperature tissue is ablated with minimal bleeding.

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Adenoids are no longer scraped out like as was done earlier. This was a blind procedure and remnants used to cause adenoids to regrow. The surgery is done by visualizing the adenoids with an angled endoscope which is either inserted through the nose or through the mouth after pulling the palate back. They are removed under vision, leading to a complete removal and no recurrence.

Otitis Media

Frequent colds lead to fluid build up in the middle ear.

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Acute Otitis media is frequent in small children as the tube connecting the ear and the throat is more horizontal and wider and opens up easily leading to more fluid collection

Smaller children cannot tell what is wrong.

  • They keep on crying and may or may not clutch their ear. The pain is relieved with proper antibiotics and decongestant medications.
  • In extreme cases the fluid , sometimes bloody, comes out through  a small pinpoint hole in the ear drum and the pain is relieved.
  • This is a relief since the pus can even reach the brain and other structures, if this does not happen

Chronic otitis media or otitis media with effusion.

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  • In some cases, especially small children with chronic allergies, there is a collection of clear fluid behind the ear drum, leading to difficulty in hearing. This fluid should subside with treatment for 2 or more months.
  • In extreme cases a grommet or a ventilation tube is placed for the fluid to drain off. This grommet extrudes itself within a year or can be removed easily by the ENT doctor.

Discharging Ear

Sometimes pus coming from the ear does not dry completely. With frequent colds and infections a hole in the ear drum forms. This is common with flu, chicken pox, and measles or similar viral infections.

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  • In chronic cases a pus culture/ sensitivity is done to determine the organism and to start the proper antibiotic. In case of hole in the ear drum Tympanoplasty surgery is advisable.
  • Surgery in young adults and at an earlier age is more successful because as time goes by, the bones of hearing become stiff, scar tissue forms and healing is affected.

Cholesteatoma

If coughs and colds persist for a long time, part of the ear drum gets pulled inside due to vacuum. This skin of the ear drum forms a pouch which starts expanding and growing inside the bone of the middle ear known as the mastoid cavity. This is called a cholesteatoma.

Choleasteatomas can also be at birth. these are formed by small ‘pearls’ or sacs of skin embedded in the mastoid bone. As the child grows, these pearls grow too and expand and cause infection in the middle ear.

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Cholesteatomas don’t get better with medicine alone. If untreated they can reach the brain, the organs of balance and the facial nerve, the nerve which deals with movement of the face. In extreme cases the hearing of the ear is already damaged.

The child has to be operated. The disease is completely removed from the middle ear and the bone, with care taken to preserve important structures.

The above article is for information only. Please contact your doctor for expert advice and managment

Winter is coming: basic skin care tips

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So we’re done with monsoon, and the Indian summer and October heat has finally set in. Navratri is on and everyone is in the mood to dance.

All the humidity is out of the air, and within a few weeks the weather should turn for the cold.  So after the summer heat and muggy monsoon, everyone is looking forward to enjoy the winter weather

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With the dry weather 2 problems have come up

1: Dry skin

2: Allergies

1: Dry Skin

Dryness of skin leads to

  • Thick dark patches of dry skin. This is common in areas like the elbow and knee, and especially in the folds around the neck, behind the ear.
  • Irritation and itching
  • Rashes and hives
  • Allergic problems and skin infections

Prevention is better than cure. Skin types are of two types, dry and oily. People with oily skin require a different set of care, such as washing frequently with mild soaps, using mild skin care solutions.

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  • For people with dry skin, proper moisturizing should start early. Use a gentle non-perfumed moisturizer. You can use coconut, olive oil or sesame seed oil too. Any time you have contact with water, your skin loses moisture. Long periods of skin contact makes your skin wrinkly. Especially if your hands have been in water for too long. you should moisturize
  • After a bath
  • If you have been working in water for too long
  • After swimming or water sports
  • Don’t use heavy makeup or harsh cosmetics, chemicals will worsen contact irritation
  • Astringents and alcohol based solutions with dry and harden your skin if used in excess

Get your thyroid levels checked

Hypothyroidism leads to dry skin. Thyroid supplements will help you and even in losing weight.

Avoid synthetic fabrics:

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Synthetic polymer fabrics have a lot of static electricity in dry weather. That worsens your dry skin and leads to rashes.

Allergies:

Though some people find winter months pleasant, others will have their allergies worsened.

Dry dust gets airborne and causes sneezing, itching, watering of eyes.

Some grasses and plants have their flower and pollen season in winter.

With proper care, you should not be stopped from enjoying the pleasant winter season.