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| Sunday, 7 August 2005 |
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Features |  |
| News Business Features Editorial
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No more snoring by Dr. W. Ratnayake, Consultant ENT Surgeon
The condition of snoring is often identified with adults, but a considerable number of children do snore. The reasons for a child snoring is different to that of adults and most of the time they need some form of treatment, unlike in the case of adults where snoring is often accepted, tolerated and untreated. Snoring is due to an obstruction in the upper part of the airway through which we breathe ie. the nose and the throat. Commonly, the structures that cause this block are large tonsils and adenoids. There are 'lymph glands' that normally form in the throat area. Lymph glands or lymph nodes are found all over the body in large numbers and have a protective function especially against infections. They capture the harmful organisms like bacteria and viruses that invade the body, imprison them inside the node and eventually destroy them. However this action is not always successful and the invaders escape into other areas of the body, causing the person more ill with fever etc. In children, the tonsils and adenoids are large, which is often normal. As they grow up, these structures get smaller and by the age of about 10 years, tonsils are very small, and often the adenoid completely disappears. Therefore, a large tonsil seen in a child is often not a disease. Sometimes parents panic when they see large tonsils, a reaction fuelled by a misbelief in some circles that large tonsils might join together one day, causing obstruction and death. However, extremely large tonsils and adenoid can cause problems. Large Adenoids block the airway of the nose and the child has to keep the mouth open to breathe. This eventually becomes a habit and the child becomes a chronic mouth-breather. Although the child manages to breathe this way during daytime, the situation worsens when he falls asleep, because then the mouth closes and the tongue falls back into the throat narrowing the passage. The obstruction therefore now causes a noise ie. snoring. Sometimes, this snoring may be mild and therefore may not disturb the child's sleep, although it would be a nuisance to others at home. When the airway obstruction is worse, sleep gets disturbed. The air intake during inspiration gets inadequate. The child has to make an extra effort to breathe in causing indrawing of chest wall with each inspiration. The oxygen level in the blood falls which will affect the normal functions of the body during sleep. It has been noted that occasionally some children stop breathing for about a minute during sleep, and the snoring is not heard. These are called apnoeic attacks. If this happens frequently, it is considered a dangerous sign. This reduces the oxygen in blood, raises carbon dioxide levels and if the situation continues, the child's heart can get affected. It should be stressed that this is a very rare situation and should not cause undue anxiety to parents of snoring kids. What more commonly happens is a child who has not had a sound sleep, who is irritable, lethargic, falling asleep during day time and sometimes a poor performer at school. If the child has only mild snoring without disturbance to sleep, it could be left alone, with the hope that the adenoid will shrink as the child grows. However, the situation might worsen a bit when the child has a cold, but the obstruction caused could be relieved to a great extent by nose drops and drugs including antibiotics in deserving cases. Getting a child to turn to a side and sleep also helps to some extent. If the adenoid causes frequent sleep disturbances, laboured breathing and worse still breath-holding spells, it is advisable to remove the adenoid by an operation. This is a relatively safe procedure and brings immediate relief to the suffering child. Large tonsils are a less common cause of snoring than adenoids. When tonsils are very large, in addition to the breathing problems, the child also will have problems with swallowing of solid food. Due to the narrowing of the throat, the child eats slowly and does so in small amounts, thus he will be considered a poor eater. Large tonsils causing obstruction often need removal. However, it should again be stressed that tonsils which just look large without any obstruction or causing recurrent sorethroats do not need any treatment. Removal of tonsils and adenoids is very frequently done in the west, and such necessity may be due to environmental factors causing problems with these structures. Although they do have a function, research has not shown any long term ill-effects, probably because there are a large number of lymph glands elsewhere in the body, as well as in the throat. Catarrh or allergic rhinitis is a common illness in the older child and the adult. This causes nose blocking especially in the night and causes a noisy breathing less loud than typical snoring. In catarrh, the lining of the nose swells up blocking the nose intermittently when exposed to various allergies in the environment and in the food, and also to climatic changes. This condition can often be controlled with drugs and changes in the patient's life style. Catarrh can sometimes lead to formation of polyps, which are grape-like lumps that form inside the nose, causing permanent blocking until properly treated. However, this is rare in children. ########## Things to know about eggs Eggs and egg dishes are nutritious foods. But-if improperly handled-they will cause food-borne diseases. Consumers, including travellers, should avoid eating raw eggs or uncooked food made with raw eggs. Food made with unpasteurised eggs like ice creams, deserts are dangerous. Elders, Infants and young children, pregnant women, and persons with suppressed immune systems are more susceptible to infections, like Salmonellosis, a major microbiological problem in eggs and egg products. Here, are some hints to prevent food-borne diseases related to eggs. Use pasteurised eggs(if available) Eggs that have not been pasteurised should be cooked until all parts reach a minimum temperature of 70 Degree C. Both the yolk and the white should be firm. Scrambled and fried eggs should be cooked in small batches until they are firm (not runny) throughout. Boil eggs for 7-9 minutes to ensure that the yolk becomes firm. Dishes made with raw eggs should also be well cooked. Leftovers and foods prepared in advance should be kept at refrigeration temperature or kept hot at minimum of 60 Degree C. Stored food containing eggs should be thoroughly reheated to a minimum temperature of 70 Degree C. Avoid cross-contamination between raw eggs and other food. Wash the utensils used to prepare thoroughly. Hands need frequent and careful washing; before preparation of foods, after handling shell eggs and other foods that may be contaminated, and after every interruption in food preparation, particularly after having used the toilet. Shell eggs should not be washed. If they are soiled with faecal matter or blood the eggs should be washed soon. Cracked eggs are more likely to be contaminated and pose a higher health risk. They should be used immediately after the crack occurs and if the time of crack is not known, the eggs should be destroyed. Source: Food Safety News Ministry of Health ############# Holistic healing Digestion - cornerstone of good health by Dr. Danister L. Perera Agni in Sanskrit means fire. In Ayurveda, Agni is the digestive and metabolic "fire" produced by the doshas that grabs the essence of nourishment from food, feelings, and thoughts and transforms it into a form your body can use. Agni helps various tissues of the body produce secretions, metabolic reactions, and other processes needed to create energy and maintain and repair the body. Agni is also part of the immune system since its heat destroys harmful organisms and toxins. The activity of agni varies throughout the day and maintaining the strength and natural ebb and flow of your digestive fires is needed for good digestion, good immune function, and resistance to disease. Agni is needed to form ojas. According to Ayurveda, digestion is the cornerstone of good health. Good digestion nourishes the body. Eating the proper foods will make a big difference in your well-being. There are two aspects to the food and nutrition in Ayurveda. One is the physical food you eat, digest, and assimilate. In this process, the organs of your digestive system has a big role. The second aspect of it is what you consume through your mind-body. What you see, hear, taste, smell, feel, and think are all important for your well-being and impact your health considerably. For example, stress plays a key role in the health. Ayurveda had recognised the importance of the environment in the total health. Remember, everything in your environment is composed of doshas that interact with your own doshas. You are affected by everything else which goes on in this universe as you are part and parcel of this cosmos. Thus we have the "big picture" or "holistic outlook" in Ayurveda tongue or feeling tired all the time are signs of ama. Agni is the fire constantly burning with our minds and bodies that kindles all the biological processes of life; it is the fire which powers the transformation of one substance into another. The most obvious function of agni is to promote digestion. But for living beings, everything depends on it-our appearance, body temperature, auto-immunity, awareness, understanding, intelligence; our health, our energy, our lives. Many diseases are connected directly or indirectly to an abnormality of agni. Not only is agni responsible for the breakdown of food substances, but also for neutralising toxins, bacteria, and viruses which can disrupt our immune system. When agni is healthy there is excellent digestion, normal elimination, proper tissue formation, good circulation, high energy, strong immunity, good complexion, pleasant body odor and breath, intelligence, enthusiasm, and perception. When agni is unhealthy however, digestion is inefficient and incomplete and all the functions mentioned above are disturbed. Most importantly, when agni is disturbed, incompletely digested food form an internal toxin known as ama. This substance can further putrefy and ferment within the intestinal tract and can spread throughout the body to cause disease. Thus, without exaggeration, the care of agni is central to maintaining health and treating diseases. There are thirteen forms of agni, the most important of which is jatharagni, which regulates and contributes a part of itself to the other agnis. Sometimes jatharagni is referred to as kosthagni (Kosthadigestive tract) or pachakagni (Pachana=cooking). A principal function of jatharagni is to cook the ingested food and separate the sara (nutrients) from the kitta (waste). The sara is also known as ahara rasa which is the substrate for the first bodily tissue, rasadhatu. The other twelve agnis are the dhatagnis (7) and the bhutagnis (5), which are related to the tissues and the five subtle elements, respectively. The dhatagnis regulates the physiological processes in each of the seven tissues, while the bhutagnis regulates the further digestion and assimilation of the pancha mahabhuta contained in the ingested foods. These people have a tendency toward inflammations and acidity. Usually seen in pitta constitutions. Mandagni (mild) usually manifests as slower digestion, low appetite, cravings for heavy or sweet foods, and a tendency to carry excess body weight. Samagni (regular, balanced) occurs in individuals who are well-balanced, eating proper amounts and kinds of foods, exercising, and resting appropriately. One sees normal appetite, satisfaction surrounding meals, normal bowel movements, endurance, (mental) clarity, and (emotional) stability. |
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