The Star Online: Lifestyle: Health
The Star Online: Lifestyle: Health |
| Posted: 28 Nov 2012 03:25 AM PST Adenoids, similar to the tonsils in function, can be problematic when swollen. MY five-year-old son has difficulty breathing. At first, I thought it was asthma. I took him to the paediatrician, and was told that he has enlarged adenoids. I have never heard about adenoids. What are they? Adenoids are a single clump of tissue at the back of your nose, which is also called the nasopharynx. To find them, a paediatrician or ear, nose and throat surgeon can look up the back wall of your throat. Adenoids are located about 2.5cm above your uvula (which is the little pendant-shaped tissue that hangs down from your soft palate). In children, adenoids usually shrink after age five and disappear when they turn into teenagers. Are they the same as tonsils? No. Your tonsils are two pieces of tissue which are located on either side of your throat – in the left and right grooves of your palate. They abut against either side of your tongue and are located far at the back of your throat. What are adenoids useful for? Why do they exist? Adenoids serve the same purpose as your tonsils – they consist of lymphoid tissue which contains lymphocytes. These are extremely important in producing antibodies to fight off infections. Your adenoids and tonsils are not the only places where lymphoid tissue exists, of course. It also exists in your gut. Adenoid tissue can temporarily swell during an infection because the lymphocytes proliferate (become more numerous) as your body tries to fight off the bacteria or virus. How would I know if I have enlarged adenoids? Enlarged adenoids are mostly a childhood disease. They can cause: ·Difficulty in breathing through your child's nose, and reduction of his sense of smell ·Noisy breathing ·Mouth breathing ·Your child may talk as if his nostrils have been pinched ·Snoring ·Sleep apnoea (this is what happens when your child sleeps, and stops breathing for a few seconds, only to start breathing again) ·Frequent "sinus" infections ·Frequent middle ear infections The paediatrician suggested that I should have my son's adenoids removed. I am hesitant. Won't they shrink on their own when he gets older? Surgery is only necessary if these enlarged adenoids are really bothersome to your child, and especially if medications like antibiotics cannot control them. Surgical removal of your child's adenoids is called adenoidectomy. This is usually recommended when: ·Your child has difficulty breathing. It's very distressing to your child to keep experiencing this. Your child's sleep, eating and schoolwork may be affected. ·Your child has sleep apnoea. This disrupts his sleep and can make him tired, sleepy during the day and irritable. He can also fail to concentrate and lose focus. When sleep apnoea continues for a long time, your child's growth and development may be affected – including physical development (e.g. face and teeth structures). ·Your child has recurrent infections, especially that of the middle ear, and sinus. If his adenoids are perpetually swollen, they can block the Eustachian tube – the tube that connects the middle ear to the throat. Bad middle ear infections can lead to hearing loss. Yes, your child's adenoids will regress one day. But if you have to wait years and years for this to happen on its own, it might not be worth the price your child has to pay. The paediatrician also suggested that I should have my son's tonsils removed together with his adenoids. Is this common? Yes, it's quite a common thing for tonsillectomy to be done with adenoidectomy, but only if your child's tonsils are enlarged or giving trouble too. Very often, when doctors leave the tonsils in during an adenoidectomy, the tonsils themselves become enlarged and give rise to obstruction. Is this adenoidectomy procedure very difficult? Must it be done under general anaesthesia? I'm afraid about my son going under GA at so young an age. General anaesthesia is nowadays very safe, so don't worry. The actual procedure itself is quite simple and takes only five to 15 minutes. But your son has to be put under GA because it is quite distressing for a child to have to go under the surgical knife while awake for so long, especially since it involves his mouth and throat. Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health advice, computers and entertainment. For further information, e-mail starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. |
| Posted: 28 Nov 2012 03:25 AM PST Food safety is a vital 'ingredient' for a healthy diet. A BALANCED, healthy diet is an important part of achieving a healthy lifestyle. And the first step to a healthy diet starts with practising proper food storage and preparation. According to the Department of Statistics, Malaysia, food poisoning incidences certainly are not rare in the country, especially in Kelantan, Terengganu and Kuala Lumpur, with the incidence rate of 85.1, 83.4 and 75.1 per 100,000 of the populations, respectively. Recently, Prof Silvia Bonardi was in Malaysia to speak on the topic, "Rapid molecular detection of food borne pathogens to minimise contamination risk". The event was organised by 3M Malaysia Food Safety Division, and the professor shared her experiences about food safety and some common practices to prevent food contamination. Know your enemy Foods that are commonly contaminated include poultry, eggs, milk, seafood and dairy products. The testing of food contaminants can be done from "farm to folk", for example, before the food is processed, at the semi-processed stage, after chilling, before packing, and even before the food is released to the market. Some of the common food contaminatants are Salmonella, Campylobacter, E. coli, Listeria monocytogenes, Staphylococcus aureus and Bacillus cereus. Bacterial toxins can also contaminate food. These include Staphylococcal aureus enterotoxins, Bacillus cereus toxin or C. botulinum toxins. Contamination by viruses can also occur. Examples include noroviruses and the hepatitis A and E viruses. Some parasites, such as toxoplasma, trichinella, anisakis and giardia, may be present in different types of food (especially meat and fish products). Food contamination Contamination may occur at various levels. Primary contamination can occur during the production of raw materials (at slaughter, fishing or during milking). Secondary contamination occurs during the processing of raw materials, such as during cutting and grinding of meat, the addition of ingredients and packaging of products, or during the production and ripening of cheeses, or during evisceration, cutting, salting and packaging of fishery products. Contamination can also occur during transport and marketing of food. This is called tertiary contamination. Quaternary contamination refers to contamination during the preparation of food, such as in kitchens and canteens. In kitchens, so-called cross-contamination occurs frequently, i.e. the transfer of bacteria or viruses from a contaminated product to a healthy one due to the use of contaminated instruments (cutting boards, knives, pans, dirty hands, dirty gloves, etc). It is very difficult to distinguish contaminated food from healthy food, unless you run laboratory tests. Food that is contaminated with pathogenic bacteria does not exhibit any particular appearance that indicates it is contaminated. What you can do is pay attention and prevent opening cans that appear swollen, which could be due to gas production by spore-forming bacteria that have survived heat treatments, such as Clostridium botulinum. Its toxins are very dangerous to humans, causing botulism (a serious disease characterised by progressive paralysis and even death). When a certain food has altered its organoleptic characteristics (bad smell, abnormal colour, softening), it is usually contaminated with non-pathogenic spoilage bacteria, such as fresh meat altered by psychotropic Pseudomonas and other bacteria that are able to grow at refrigeration temperatures. Top 10 tips for food safety 1. Storing raw food Separate raw foods from cooked foods and store them at refrigeration temperature. You should also separate raw meat, fish and eggs in shell and vegetables. Refrigerate foods quickly because cold temperatures keep most harmful bacteria from multiplying. If you accidentally break an egg, don't keep it in the fridge to be used later. 2. Storing cooked food Cooked food should be protected from external contamination by wrapping or covering it. Plastic or metal containers, or bowls with lids, are fine. Cooked foods should not be stored at high temperatures (e.g. room temperature) unless they are consumed very quickly (maximum within half an hour). They should be stored at low temperature and then eventually re-heated before consumption. Alternatively, cooked products to be consumed warm can be stored at more than 60°C. It is very dangerous to store cooked food at 40°C, as many caterers do, because this temperature allows bacteria to grow very quickly. 3. Defrosting Defrost frozen foods at refrigeration temperatures and not at room temperature as some pathogenic bacteria in food can double their number, even at low temperatures. The more bacteria there is, the greater the chances of one becoming sick from eating the food. 4. Wash your hands and utensils Wash your hands before preparing food and always use clean utensils such as cutting boards, plates, knives, kitchen scissors, forks, spoons and containers. 5. Do not cross-contaminate Do not use tools or utensils used to prepare raw foods such as meat, fish, and vegetables to prepare cooked food. This increases the risk of cross-contamination of a cooked product, which favours bacterial growth as it is without its own competitive flora. When handling raw meat, poultry, seafood and eggs, keep these foods and their juices away from ready-to-eat foods. 6. Shelf life Eat food during its shelf-life – before the "use by" date or the "best before" date. Never buy too much food with a long shelf-life and never buy food too close to its "use by" date. 7. Raw food Cook raw meat and raw fish at proper temperatures (minimum 70°C for meat). Boil raw milk (and that includes goat or cow's milk that is delivered to your home). 8. Wash your food Wash fruits and vegetables before eating; if you cannot peel them, disinfect with chlorinated products. 9. Dispose properly Waste disposal of meat, vegetables, and raw fish must be carried out immediately in the appropriate containers, both in the kitchens of restaurants and in domestic kitchens. Even leftover cooked products that are no longer used must be disposed of quickly to prevent bacteria growing. 10. Clean – Separate – Cook – Chill These are the four key words for food safety. Prof Silvia Bonardi is an associate professor at the Department of Animal Health (Food Inspection Section), Faculty of Veterinary Medicine, University of Parma, Italy. She is author and co-author of more than 120 articles concerning food hygiene, food microbiology and molecular characterisation of food borne pathogens. 3M Malaysia recently launched the 3M Molecular Detection System, a faster and easier method for pathogen detection. The system combines Isothermal DNA amplification and bioluminescence detection technology. |
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