Author Archives: Paula.KGS

Allergic Rhinitis

What is Allergic Rhinitis?

Allergic rhinitis refers to allergy of the nose. Allergies are basically caused by the interaction between the body’s immune system and irritants or agents referred to as allergens within the external world. Allergic reactions occur when the immune system sees a simple agent as a harmful intruder and reacts with chemical processes that are inappropriate hence they negatively affect the body. Symptoms of allergies are varied and can be mild or severe, some even being fatal.

Allergic rhinitis is among the most prevalent forms of atopic (skin) disorders. It is assumed that its prevalence is due to the nose’s constant exposure to airborne allergens, oftentimes being the initial point of contact between the body and these external stimuli. Airborne allergens are among the most common triggers of allergic reactions. The condition is impartial to gender with both males and females experiencing equal incidence rates.

Symptoms of allergic Rhinitis

Symptoms of this kind of allergy include runny nose and stuffiness, redness of the lower eyelid, sneezing, nasal congestion and other cold-like symptoms, snoring, heavy mouth breathing, the constant clearing of the throat, allergic creases (lines across the nose caused by frequent wiping of the nose in upward swipes made by the index finger often referred to an “allergic salutes”), headaches, nose bleeds or secretions that are tinted with blood, earaches and dark circles under the eyes.

Types of allergic Rhinitis

Allergies of the nose fall under two main categories; these are “perennial’ and “seasonal”. Perennial allergies tend to get worse during the winter months especially for children but are experienced year round. Winter months are associated with increases in allergic reactions in children because they tend to spend more time indoors hence exposures to airborne irritants around the house are more frequent and prolonged.

Seasonal allergic rhinitis results mainly from exposure to plant pollen being circulated by winds. Different irritants exist in different regions since plant life will vary based on natural habitat. The season of attack will differ as well based on the location of those affected. On average, trees produce common allergens during late winter going into early spring months, while grass is a leading cause through-out the rest of spring and the early summer period. Weeds (mainly ragweed) dominate late summer. Mold can trigger allergic rhinitis, so too can perfume and strong fragrances, pollution (unclear air), weather changes, humidity, tobacco smoke, dry air and cosmetics.

Treatment of allergic Rhinitis

Treatments include antihistamines, decongestants (in solid, liquid and nasal sprays), Immunotherapy (also called hyposensitization or more commonly know as allergy shots) and Cromolyn or steroid nasal spray. Strength, type, frequency and duration of treatment will vary based on the condition, allergen and severity of each attack although preventative measures are best. Airborne allergens can be avoided for the most part especially those that are found around the home. For those that cannot be avoided, reducing exposure should be attempted.

Reactions that are persistent or affect natural functions (like breathing or swallowing) should be brought to the attention of a doctor. Mild cases can be treated at home with drugs that can be obtained from local pharmacies without a prescription.

Fresh Flower Arrangement

Materials and equipment

For many arrangements, little is needed beyond a good pair of sharp, strong scissors and some florist’s wire, but elaborate displays on special occasions may need more support.

Canes: thin canes can be used to support hollow and top-heavy stems.

Carpet moss (sheet moss): this moss is useful for covering the surface of arrangements to conceal individual containers, creating the illusion that the flowers are growing in the basket or container.

Cellophane: is used for wrapping bouquets, as a waterproof lining for porous containers and scrunched up as an invisible support for stems in a vase.

Floating candles: a bowl of these surrounded by beautiful fragrant flowers makes a stunning table center piece, especially at night.

Florist’s adhesive tapes: water proof tape is useful for sticking plastic or cellophane to the inside of containers. Strong adhesive double sided tape provides a removable surface on which to stick decorative materials such as moss or vegetation to the sides of vases and containers.

Florist’s foam: as well as the brick shape, spheres and rings are available in various sizes. Rings have a built-in plastic drip tray to make table centre pieces without the worry of flooding.

Florist’s scissors: the most important piece of equipment that no flower arranger can afford to be without is a pair of strong and very sharp scissors. There are numerous designs for both left and right handed flower arrangers.

Florist’s wires: are useful for making false stems to fix cones and nuts to fresh flower designs.

Flower food: the correct amount of flower food should he used in every vase. This harmless preparation of mild disinfectant and sugar inhibits growth of bacteria in the water and encourages buds to mature and open.

Gilt cream paint: gives sheen to nuts, cones and fruits as well as containers. It is available in gold, silver and bronze.

Glass stones: these are widely available from gift shops and garden centers. The transparent ones are most versatile as they resemble precious crystals in the bottom of a glass vase or bowl.

Glue gun and glue sticks: the glue gun is a dream machine for instantly attaching fresh flowers to containers, wreaths and garlands. The liquid glue is extremely hot and potentially dangerous if left unattended and should be kept out of reach of children.

Nuts and cones: walnuts, hazel nuts, acorns and all types of cones can be combined with fresh flowers.

Pebbles and shells: these make decorative mulch and an attractive support for flower stems in glass vases.

Raffia: natural raffia is ideal for tying flowers together as it is strong but does not bite into the stems. Colored raffia is perfect for making lush trailing bows.

Secateurs (pruners): these are more practical than scissors for cutting wires and tough branches.

Containers

The type, size and color of the container you choose should complement the flowers you are arranging. Here are some simple ideas.

Baskets: shallow baskets lined with plastic and filled with florist’s foam concealed with moss provide a support for flowers, and deeper baskets can hide several containers within it filled with fresh blooms.

Glass tanks: are very versatile and are effectively used singly or in a group of varying heights. They can be used to contain a mass of flowers of just a few stems supported with colored glass pebbles or stones.

Glasses and jars: simple, straight sided drinking glasses are cheap and perfect for small posies and table centre pieces.

Terracotta pots: natural colored terracotta pots complement country style arrangements, and with a simple wash of diluted emulsion paint they can be gently colored in minutes to suit any number of styles. Terracotta is porous, so use an inner container or line them with plastic.

Metal containers: some metals react with water and can cause flowers to die prematurely and obviously shouldn’t be used. But galvanized metal is safe and rust proof. A tall metal bucket is ideal for supporting the height of long stems or large branches of foliage. Buckets in bold colors provide instant cheer.

PREPARING FLOWERS

If you are picking your own flowers, gather them in the morning, when the sun has caused the dew to evaporate but before there is a danger of wilting. Ideally, have a container of water with you to hold your harvest. Once back in the house, re-cut the stems, remove all foliage that will he below the water line, then plunge the stems into a bucket of deep water to allow them to have a good, long drink. Stand the bucket in a cool, draught free room, in the dark if you wish to slow the development of the blooms, or in indirect light to accelerate blossoming. During the conditioning time which should be a minimum of six hours, check that the flowers are taking in water. Drooping foliage and limp heads indicate an air lock, roses are particularly susceptible to this problem.

All stems must be cut again before the flowers are placed in the display container. Research has shown that a single, diagonal cut provides the best uptake of water. Fill the hollow stems of flowers such as delphiniums with water and plug the ends with cotton.

Psoriasis

What is Psoriasis?

While still talking about skin inflammations in general, let’s consider that nasty chronic disorder called psoriasis. Fortunately it’s uncommon in children before the age of three years, and is still not common under the age of ten years. It is a disease of the skin, and affects 1-2 per cent of the white population. It is characterised by clearly demarcated areas called papules that coalesce into larger areas called plaques. Generally, these are not itchy but form silvery scales. When these are removed, it leaves minute bleeding points. Once it begins; it often becomes chronic, and persists for many years, probably for the rest of one’s life. It is common, and about 5 per cent of the community suffer from it. Many claim the true figure is much higher.

Although Psoriasis is a chronic skin disorder that occurs infrequently in young children. the name comes from the Greek word psora meaning itch, the lesions are usually not very irritable. Typically it involves the scalp, the ears (externally), the elbows, knees and trunk (about 75 per cent of cases). It varies, and may involve chiefly the scalp, area behind the cars, armpits, and “anogenital region” (i.e. area about the external genitals extending around to the anus). Due to its appearance, and the disfigurement it can produce, it is among the “socially disabling” diseases. If the palms of the hands or soles of the feet are involved, and this is common, deep fissuring can take place. This can be painful and highly irritable, and may interfere with normal working duties.

Sometimes arthritis accompanies it, flaring up if the rash worsens. Most psoriasis patients are reasonably healthy, apart from the joint pains. Sometimes minor illnesses can aggravate the rash. It is often worse during cold weather, and when sunshine is prevented from gaining access to the lesions. In about 30 per cent of cases, there is a family history of psoriasis, and several members of the one family may have the disorder.

Frequently, the nails are affected, and sometimes this is a dominant feature, with characteristic pitting. The cause of psoriasis is unknown, but many doctors now believe that there could be a psychosomatic factor.

Psoriasis Treatment

Innumerable routines have been suggested over the years for this very difficult skin disorder. The fact that there are so many suggests that no single cure is at present available. Many can be tried at home. Some of them offer temporary (and sometimes long-standing) relief. They are worth a trial, for they will do no harm, and could be beneficial. A “spontaneous cure” is unlikely. Cleanse daily, scrubbing the affected areas with soap arid water and a soft brush often helps. It removes surplus scales. “Pinctarsol” may help.

Ointments

Many ointments have been used. Dithranol has been used with reasonable success for many years. It is still widely prescribed in 1-2 per cent creams. Ammoniated mercury ointment 5 per cent applied morning and night, or Anthralin 0.25 per cent may be applied once daily (NB avoid contact with the eyes as it is very irritating). Coal tar ointment 2 per cent smeared on at night and moved next day with liquid paraffin ten assists.

Sebitar is good for the scalp. More acute cases should use applications, such as calamine lotion containing 5 per cent detergent solution coal tar. Lecithin, is claimed by some to give favourable results when taken over a period of time, maybe many months. Ten il7E1MS of the powdered form is sprinkled on the breakfast cereal each morning. This is available from health food shops.

Ascorbic acid

Given in daily doses of 2,000 mg for an extended period of time (months), this may bring relief to some sufferers and is worth a trial. (It is also known as vitamin C.)

Ultra-violet light

Lesions often respond favourably to ultraviolet light. The cheapest and most readily available source is sunshine. Lamps are sometimes ordered and must be used under proper medical supervision.

Other Treatment

See the doctor if the simple remedies do not help. Recent research has made new treatment available that is often curative:

The Psoralens

This family of preparations is available, and is often effective. It is given in the form of trioxsalen or methoxsalen. By concentrating on the five points in life, attention may be diverted from the skin problems to more important facets of life. This is at present debatable. Many different forms of therapy have been tried, and the condition tends to wax and wane, treated or not. Often daily scrubbing with soapy water and a nailbrush will get rid of scales. It helps, so does plenty of sunshine and bathing in the salty water at the beach.

Ointments containing tar are used, salicylic acid, dithralin are popular. Severe cases are treated by the doctor with the corticosteroid family of drugs, but medical supervision is essential. There are some other forms of treatment for severe cases which is the so-called PUVA therapy. A family of drugs called the psoralens (taken by mouth), followed by exposure to the sunlight, or to a special light called ultraviolet (or “black”) light is claimed to effect a cure in certain cases. This again is the field of the skin specialist, for adverse side effects can occur, but many successes have been recorded in the medical journals. Fish oil capsules are also claimed to clear the skin in some people.

Red Splotches

Red Splotches seems to happen in adults as well as with children. This is called a sub-conjunctival haemorrhage. It means that a microscopic blood vessel in the white of the eye has ruptured, and blood oozes out in the space immediately below the surface. It may be quite extensive and can look alarming, especially if large.

In most cases this condition will clear itself up with no therapy. After a few days it will tend to darken into a brown colour. This will fade into a yellow and finally disappear as nature resolves it entirely.

Any recurrence should receive medical attention. In some instances, albeit rarely, important underlying conditions may be the cause. This is usually unlikely – but I don’t believe in taking undue risks, and like to double-check most things, as you know.

How to Build a Rooftop Garden

There are many reasons one can decide on building a rooftop garden, among them; location, ornamental purposes and for the use of social gatherings. For the person in areas that do not allow for gardens around the home because of limited or no space, rooftop gardens provide the perfect solution. They can be traced back to the Hanging Gardens of Babylon and became popular in modern use with the rapid and extensive growth of high-rise buildings.

The best way to determine if your rooftop makes the perfect place for a garden is to study it at intervals throughout the day to ascertain how much sun and shade the area receives at any given time, be sure to document your findings on paper to make sure that you can revisit them when necessary.

Making Preparations for your Garden

When planning your garden, think of a theme that best suits you since you will have to buy the necessary containers to house your plants, clay based ceramic pots are a favorite. Some Terra cotta pots (which are also unglazed), are chosen because they are porous hence assist with proper drainage for plants that require this. Terra cotta pots can also help with achieving a Tuscan look; if unavailable try other containers or pots that are glazed with Mediterranean colors. For those who prefer a more contemporary feel, black and white is a suitable match.

Besides pots, window boxes, 6 to 7 inch masonry beds (built-in), 18-24 inch masonry retaining walls, terrace boxes (mainly made of cedar or redwood) starting at 18 inches deep and 4 to 5 feet wide can be used. Planters or tubs; including barrels, wooden cubes and structures made from concrete and fibre glass (for a more modern look) can also be used.

The next step is to decide on which flowers or plants you will grow. Based on the results of your observation you should have an idea of what you can or cannot grow based on the plants’ need for sunlight or shade, you can also start to plan what goes where. Do research on the flora chosen or get advice from persons at your local garden center. During this stage you can also decide whether to start from planting seeds or skip to bedding plants for a faster result.

Before you start planting, try arranging your containers on the roof to see how well your pattern suits your style or taste. Experiment with them to ensure that your final arrangement adds the level of interest and sophistication you want. The best look comes from placing them at different heights to create somewhat of a layered look. Natural materials like bricks (especially if in a color that compliments your garden) can be used for elevation.

Planting Stage

Once the planning and purchasing of everything needed is over, start planting. Be sure to use the necessary fertilizers and pest control methods, both can be store-bought or homemade, organic or chemical based. Many potting mixes can be used to ensure that soil is rich and balanced for each plant or greenery chosen. Be sure to find out how each operates in the different seasons and water as needed.

Primary Amenorrhoea

Primary Amenotthoea means that menstruation has failed to occur at or after puberty. In some women there is a familial tendency for menstruation to commence late, sometimes delayed up to the age of 16 years or even later. With the social implications of early sexual development in today’s society, it is common for doctors to see girls early who have not started to menstruate. Figures for the Western world show that there is a general trend with modern living for sexual development and menstruation to occur at younger ages. Frequently girls aged 10 or even nine have started. There are many reasons why menstruation does not occur when it should.

Sometimes an imperforate hymen may prevent the escape of blood. This is an obvious and readily curable cause; acute or chronic pelvic disorders may be another. Often psychological reasons may check release of gonadotrophins by the pituitary, so delaying the menses.

It may also be due to a symptom of a general lack of development of the pituitary or the thyroid, or a symptom of juvenile myxoedema. In some, other indications of endocrine deficiencies may be in evidence, such as dwarfism. About 25 per cent of patients with the symptom have a genetic anomaly, having inherited an extra chromosome. This is called Turner’s syndrome. In other cases there is simply no explanation, and the lack of menstruation together with a lack of sexual development simply occurs for reasons unknown.

Primary Amenorrhoea Symptoms

Symptoms are usually obvious. Ovulation does not take place, so normal hormones fail to be produced, and usual menstrual cycle simply does not eventuate. Secondary sexual characteristics do not develop either. Breasts, vulva, vagina and uterus remain rudimentary. Often the mental outlook is immature. The bones may show stunted growth, and dwarfism may occur. If it occurs in conjunction with other hormonal disorders, symptoms due to the primary cause may also be in evidence.

Primary Amenorrhoea Treatment

In most cases there is no correctable underlying cause. Giving sex hormones may at least produce mental and physical development, which many of these girls seek. It can also establish artificial menstruation, which is satisfactory to many. Pregnancy of course will not occur unless ovulation is taking place. The hormones contained in the contraceptive pill, usually a progestogen and an oestrogen, are available. These may be continued long-term.

If the basic cause is a thyroid disorder that may be corrected, then this may respond by allowing ovulation to proceed. The outlook is then good in terms of ovulation and fertility. If merely a late-occurring normal puberty was the reason, the outlook is likewise generally good, and after a few normal cycles, discontinuation of medication may be followed by the regular normal cycles. However, in many, infertility will continue if the cause is a not correctable one, and substitution therapy will be necessary until the change of life and parents.

The average baby will develop normally and naturally, irrespective of what you do to try to hasten this along. After all, baby humans are just another facet of nature. Cows and horses, dogs and cats manage to do quite well and generally develop in a normal healthy way without the need of textbooks and specialists or oral advice. Babies (with two legs) are not much different. Do not expect too much too soon.

There are enormous variables; one child will start to teethe early while another will start months later. The end point is identical. Maybe the late teether will have better teeth in the long run. Trying to force baby along these channels can breed problems, both for you and your child, take it gently. If there are any obvious problems looming, consult your doctor. If there is any major query, seek the expert opinion of a paediatrician.

Epiphyte Facts

Also called air plants, Epiphyte plants are those that do not root in the soil but grow on other plants (mainly trees). Depending on their habitat, they may also grow on buildings and cables or wire. They depend on the things they grow on for support but epiphytes are not parasitic since they do not rely on them for nourishment. Since they do not grow in the soil they rely on the rain and air around them for nutrients, on some occasions they may even extract nutrients from debris that is accumulated around them.

Moisture is taken from the rain, air and sometimes the excess moisture (found mainly in pockets) on the plant they are growing on. However, epiphytes do make their own food in the normal way most plants do; using photosynthesis which is a process in which sunlight is used to make food and produce oxygen.

All major plant groups have epiphyte plants. The Temperate Zone houses many algae, lichens, liverworts and mosses while cacti, orchids, ferns and bromeliads like Spanish moss thrive in the Tropics. There is an estimated 30,000 species of epiphytic plants worldwide and more than half supposedly live in the rainforest. Most grow at very high altitudes however, epiphytic fungi, lichens, ferns, mosses and bacteria are exceptions to the rule. So too are aquatic algae like seaweed since they grow in the water and not in the air.

Epiphytes are highly adaptive, growing parts necessary and situating themselves in environments most susceptible to growth regardless of their habitat. Some will grow roots to help them attach to their hosts as well as structures that specialize in the collection and storage of moisture like scales and cups. And some, for example in Europe along the coastal fringes of the West may grow in the soil suspended in areas on trees. Epiphytic grass, small trees and small bushes are known to do this on rare occasions.

Epiphytes that grow in canopies (clusters of mature tree tops or crowns) benefit greatly from the excess sunlight and gain protection from many herbivores. Those in aquatic habitats form an important part of the ecosystem, serving as homes to anthropods, frogs and microorganisms that also serve as food for larger life forms.

The main problem with epiphytic plants is that they can be thick enough to overcrowd the plants they grow on hence causing damage. They have the ability to evade and take over the spaces of other trees. This is done mainly by large trees that start in canopies then gradually grow roots that travel down the trunks of the hosts until they overpower and replace the host. This process can take decades and once epiphytes become “free standing” trees they are classified as ‘hemiepiphytes’. New Zealand’s Northern rātā and the strangler fig are examples.

They also have the ability to remove the tree bark of the host (which is a protective structure) while growing roots. Since they grow in canopies, they can also lead to starvation of the host by blocking sunlight from its leaves prohibiting or hampering photosynthesis. Epiphytes due to their location can attract insects that can damage the host trees as well as increase the tree’s resistance to wind which can be detrimental in windy areas.

Despite these however, many species have adapted to their environment well enough to live symbiotically with their hosts causing no harm.

Food Safety Guidelines

In addition to improving general safety within the home and making the boundaries more secure, perhaps the main area where you can safe guard your family is by making sure that the food they eat is always safe. How you shop for, store and handle food can have far reaching effects. An understanding of how germs breed and travel underpins the safe kitchen and strict hygiene is essential to safe guard you and your family from the risk of food poisoning.

Shopping for chilled food

The colder you keep chilled and frozen food between buying it and storing it at home, the safer it is. This is because if the food warms up while you are taking it home, bacteria could grow and multiply. To avoid this, keep chilled foods together in the shopping trolley (cart), then pack them together, preferably in a cool bag, making sure that you wrap separately anything that is likely to drip. At home, transfer chilled or frozen food to the refrigerator or freezer immediately. Leaving chilled food in a shopping bag or car for any length of time can raise the temperature sufficiently to allow bacteria to thrive.

CHECKING FOOD LABELS

It is becoming increasingly difficult to guarantee that the food we eat really is what we think it is. With so many additives, genetically-modified and substitute foods, it is now wise to carefully read ingredient labels to check what is in any packaged food. For those wishing to control their intake of certain ingredients such as salt, sugar or far, this is the only way to be sure. It is also essential if anyone in the family suffers from an allergic reaction to any food.

HYGIENE

Keep your hands and all equipment scrupulously clean. Never use a knife with which you have cut raw meat or fish to cut anything else without first washing it thoroughly. Get into the habit of scrubbing chopping boards and worktops (counters) between uses; keep separate boards for chopping raw meat and vegetables or cooked meat. Always store cooked food or any salad items separately from raw food such as meat or fish. Disinfect all work surfaces and the sink regularly, and especially all cloths used for washing up and/or wiping down surfaces, as these can transfer germs readily. Never wipe your hands on towels used for drying utensils.

Refrigerator safety

You need to keep your refrigerator at the right temperature, because if it is not cold enough, harmful bacteria can grow and may cause food poisoning, which can be anything from a stomach upset to serious illness.

Store the most perishable food in the coldest part of the refrigerator; these are pre-cooked chilled foods, soft cheeses, cooked meats, prepared salads (including pre-washed greens as well as potato salads etcetera.), desserts, cream or custard-filled cakes, home-prepared food and leftovers. Foods that are best kept cool to help them stay fresher longer can be stored in the cool cones (which often include special compartments); milk, yogurt, fruit juices, hard cheeses, opened jars and bottles, fats such as butter, margarine, lard and low-fin spreads, and eggs fall into this category. The salad crisper is the warmest part of the refrigerator; it is designed for storing whole vegetables, fruit and fresh salad items such as unwashed whole lettuce, tomatoes, radishes etcetera. Try to keep raw meat and fish on the bottom shelf in case they drip. Prevent them from touching other foods by storing them in containers for added safety.

Do not keep food for too long and always observe use by dates. Once opened, canned food can be kept in the refrigerator for up to 48 hours.

To get the coldest part of the refrigerator to run between 0 5°C/32-41°F, put a thermometer in the coldest part (see the manufacturer’s instructions to locate this) where you can read it as soon as you open the door. Do not use a mercury thermometer as this could break and contaminate food. Close the door and leave for several hours, preferably over night. Open the door and read the thermometer without touching it, if it is not between 0-5°C/32 41°F, adjust the thermostat dial and leave as before. If the temperature is still not right after several hours, try again.

REFRIGERATOR CHECKLIST

  • Keep the coldest part of the refrigerator around 0-5Celcius/32-41Fereheit. Keep a thermometer in the coldest part and check the temperature regularly.
  • Keep the most perishable foods, such as meat, in the coldest part of the refrigerator.
  • Wrap and cover all raw and uncooked foods, to prevent them from touching other foods. Return perishable foods, such as butter, to the refrigerator as soon as possible after use.
  • Don’t overload the refrigerator as this can block the circulation of the cooling air.
  • Don’t put hot Baal into the refrigerator; let it cool first, because hot food could heat up other foods and bacteria breed in warm temperatures.
  • Don’t keep food beyond its ‘use by’ or ‘best before’ date.

Avoiding cross contamination; bacteria will readily cross from one food to another, especially from raw meat to cooked or processed foods. The prevention of cross contamination is paramount for anyone in charge of preparing food for others.

Cooking food

High temperatures kill most bacteria, so always make sure that raw food, especially meat, is cooked right through. The temperature at the centre should reach 7000/158°F or at least two minutes. Large meat joints need care to make sure that the centre is well cooked; a meat thermometer can help. Microwave cookers do not always heat food to the high temperatures that kill food poisoning bacteria, so when using them make sure that the food is piping hot at the centre before serving. If frozen meat, poultry or fish is not completely thawed, the centre may not be properly cooked. The best way to thaw food is either in a microwave or refrigerator.

Raw eggs sometimes contain bacteria which are destroyed by cooking. Current advice is that you should avoid recipes using uncooked eggs.

When reheating food, always heat until it is piping hot all the way through. Never reheat food more than once. When using a microwave for reheating check the instructions regarding standing times to allow the heat to reach all parts of the food.

Insects

Insects, especially flies and cockroaches can transfer germs on to food so it is essential to keep them out of the kitchen. Insect repellents may contain poisons that are also harmful to you, so try to use herbal repellents. Metal gauze screens across open windows will provide a physical barrier, or you may prefer to try a crayon type of repellent that is applied around all openings. Always cover Bread that is left out for any length of time, with a purpose made cover of fabric mesh or a sieve, or use greaseproof (waxed) paper or foil.

HYGIENE AROUND THE KITCHEN

  • Wash your hands in warm water with soap before: touching food, as well as after touching food; after touching pets; dirty washing (laundry); the dustbin (trash can); after going to the lavatory.
  • Cover cuts and grazes.
  • Wipe hands on a separate kitchen towel, not the tea towel (dish towel).
  • Bleach, disinfect or change kitchen cloths or sponges often, especially after raw meat, poultry or fish has been prepared.
  • Wipe the tops of all cans before opening them.
  • Wash dishes, work tops (counters) and cutlery with hot water and detergent. Rinse washing up and let it drip dry if possible.
  • Keep pets away from food, dishes and worktops.
  • Keep food covered. Open packs or spilt food can attract flies, ants and mice, which spread bacteria. Clear up spilt food straight away.
  • Avoid using the same knife or chopping board for raw meat, cooked food and fresh vegetables. If you have to use the same knife or board, always wash it thoroughly between uses.

Free Standing Shelving

Free standing shelf units have several advantages over wall-mounted or built in ones. They can easily be moved if the room layout is changed. They can be moved away from the wall to allow painting or papering. They can even be taken along when moving house. However, they have drawbacks too. Some manufactured shelving and display units are rather flimsy, and may twist out of square or sag if they are heavily loaded. In general, better results are found in building units that use strong materials such as natural wood and plywood. The other problem is getting them to stand upright against the wall; skirting’s (baseboards) prevent standard units from being pushed back flush with the wall surface, and carpet gripper strips make them lean forward slightly. The answer is to design the side supports on the cantilever principle with just one point of contact with the floor, as far as possible from the wall, so that the unit presses more firmly against the wall as the load on the shelves is increased.

Since a shelf unit is basically a box with internal dividers, it can be constructed in several different ways, using simple butt joints or more complicated housings. Perhaps the best compromise is to use gilled butt joints reinforced with hardwood dowels, which give the joints the extra rigidity they need in a unit of this sort.

Start by deciding on the dimensions of the unit, then select materials to suit the likely load the shelves will have to support. Mark up and cut matching groups of components to length in batches to ensure that they are all precisely the same size. Pre-drill all the dowel holes, using a drill stand and depth stop for holes in the board laces and a dowelling jig for those in the board ends. Insert the dowels and make up the joints. A thin plywood or hardboard backing panel can be pinned (racked) on to give the unit extra rigidity.

CONSTRUCTING A FREE-STANDING SHELF

  1. Clamp groups of identical components together. Mark them to length and cut them in one operation to ensure that they are all the same length.
  2. Mark the positions of the shelf dowel holes on the unit sides, ensuring that they match. Drill them all to the required depth, using a drill stand if possible.
  3. Use the dowelling jig to drill the dowel holes in the shelf ends. This ensures that the holes are correctly positioned and centered, and are drilled straight.
  4. Glue the dowels and rap them into the holes in the shell ends. Ensure that they all project by the same amount, and cut down any that are overlong.
  5. Assemble the unit by gluing one end of each of the three shelves and joining them to a side panels. Then glue the other ends and add the second side panel.
  6. Cut a hardboard or plywood backing panel. Check that it is perfectly square, then pin (tack) it to the bark of the unit

Peptic Ulcer

What is Peptic Ulcer?

A Peptic Ulcer means that there is an invasion of the lining of the stomach or duodenum by the powerful hydrochloric acid and pepsin produced by the glands of the stomach wall. It is ironical that the organ producing these juices should in turn be subject to destruction by the product it manufactures.

It is estimated that ten per cent of people have a peptic ulcer during their lifetime. It is most common among young and middle-aged adults, and men are affected four times as often as women. Diagnoses based on endoscopic and X-ray examination indicate that there is a 9:1 preponderance of duodenal over gastric ulcers although other reports claim that at autopsy there is an equal incidence. The exact cause is not known. Why some succumb to the action of the gastric juices while others do not is remarkable. About 15 per cent of patients with gastric ulcers either have, or did have, a duodenal ulcer as well, indicating that there must be some common etiology.

There is increasing evidence of an inherited factor as gastric ulcers occur three times more commonly in relatives of patients who also have a gastric ulcer. Recently it has been shown that a large proportion of ulcer patients belong to blood group 0. The role of stress is still equivocal. A peptic ulcer is anecdotally considered to be the hallmark of success in the striving businessman. However, in many surveys, the results of this are still left in question. Social status has often been claimed to play a part, and certainly in the overall picture, gastric ulcers tend to occur more often in those of poorer social and economic status.

Ulcers appear to be more common in patients who are on certain forms of medication. Patients on regular and high intakes of Salicylates (simple aspirin and compounds) are more likely to develop them. Indeed, this is a common cause of gastric hemorrhaging, and is not without its dangers in children, to whom aspirin compounds should not be given (there are other less dangerous analgesics on the market). The anti-arthritis drugs, called the Nonsteroidal Anti-inflammatory Drugs (NSAI Ds for short) which are widely used by arthritics, are well-known possible causes. Patients taking Corticosteroids are also at high risk. Although the overuse of alcohol, tobacco and condiments has often been cited as a possible cause, this has not been proved to the satisfaction of all researchers.

The sensible approach for the person with an ulcer is attacking all possible causes and rectifying as many as possible, whether they be substantiated or not. While every suggested cause will certainly not apply to everyone, there may be applications in individual cases well worth taking note of and following.

Diagnosis of peptic ulcer is usually made after examination, suggested by the history. Sometimes the first sign of an ulcer is a massive hemorrhage, with blood suddenly pouring from the mouth as well as abdominal discomfort and general weakness and shock. Investigation for an ulcer is primarily dependent on X-ray and endoscopic examination. The barium-meal radiograph will pick up a large number, but a negative result does not mean that an ulcer is not present.

The development and use of the pliable fiber-optic endoscope has revolutionized diagnosis of all conditions of the stomach, duodenum, lower esophagus, and in fact nearly all of the intestinal system. This soft, narrow, extremely maneuverable device can give the operator a direct view into all parts of the stomach and duodenum. No area is invisible, for the leading head can be turned and twisted so as to enable a view of every part.

This makes diagnosis very accurate. It may also rapidly pick up bleeding points, and it can assess progress of treatment when a series of examinations is carried out at later dates. Today, a combination of X-ray and endoscopy form the two chief methods of accurate diagnosis.

Peptic Ulcer Symptoms

Peptic ulcers, whether gastric or duodenal, produce similar symptoms, pain is the chief one. Typically it comes on during the morning and becomes worse toward evening. It is usually localized in the epigastrium, the area just below the far end of the breastbone. The pain may awaken the patient around 2 am and may be eased, or aggravated by food. Alkaline preparations usually bring quick relief in ten to fifteen minutes. Symptoms may disappear only to recur later on, but remissions have been known to last for days, weeks, months and even years. The symptoms run a very fickle course and may occasionally include vomiting. This may be highly acid in nature, and may bring considerable relief. Sometimes water brash occurs; this is an accumulation of saliva at the lower end of the esophagus, which may be regurgitated into the mouth.

The chief complications that may follow on from an ulcer are perforation of the wall of the stomach or duodenum, erosion of a major blood vessel, giving rise to sudden and profuse hemorrhage or, later, scarring near the pylorus (the far end of the stomach), so narrowing the stomach outlet into the duodenum. In some cases, cancer may develop in a chronic gastric ulcer.

Peptic Ulcer produces another type of surgical emergency. This however is more common with duodenal ulcers. A blood vessel in the wall becomes eroded and may bleed violently, producing massive blood loss. This may be vomited up (haematemesis), or passed through the bowel (melaena). When vomited, it may come as bright red blood, or if it has been in the stomach for a period of time, may have the appearance of coffee grounds.

By the time the blood has passed through the bowel it is often altered and may appear black, and be tarry in consistency. Often the blood loss produces severe shock and, especially if this occurs a second time in older patients, it may be fatal.

Peptic Ulcer Treatment

Immediate admission to hospital as a surgical emergency is essential. Here, immediate assessment of the patient and blood transfusion are the most likely factors that will preserve life. After this, an assessment as to the needs for surgical intervention should be made and appropriate action taken.

In recent years there have been many changes in treating peptic ulcers as new information is discovered, new medication developed, and an entirely new system worked out. Long-term “cure” is now believed possible. The present suggested routine, now advised by most doctors, will probably change again as results of current treatment regimens are assessed over the next several years.

Kill the Germ. By serendipity, a Perth doctor discovered an organism in the stomach of patients suffering from peptic ulcers. It was the sheer chance observation of a stomach “culture” having been left in the incubator for longer than usual due to a holiday weekend. By taking a potent brew of the “germ” the doctor developed a severe ulcer himself, which led him to believe it had caused the ulcer, and not necessarily excess acid, which had been the belief until this time.

Although scoffed at by colleagues at the time, he worked on his theory and found a combination of chemicals (including antibiotics) that quickly and permanently destroyed the germ. These are an antibiotic (a synthetic penicillin, often amoxicillin or tetracycline), metronidazole (Flagyl), and a bismuth product called De-Nol. Taken for several days or weeks, the germ was permanently killed.

Today, in many centers (and certainly in America), this is now considered the standard form of treating peptic ulcers. The germ, it seems, in the presence of acid, produces another chemical with the capacity to destroy the cells of the stomach or duodenal wall. It is commonly referred to as “triple therapy,” and may be given in conjunction with the acid-suppressant medication.

Doctors had believed excess acid was the chief cause of ulcers. A large range of powerful acid-suppressant forms of medication have been produced and more are continually being developed, while others are in the developmental pipeline. The two main groups are the “Histamine H2-Receptor Antagonists” and, more recently, the so called Proton-Pump Inhibitors. The first group includes Cimetidine (Tagamet), the first to be developed, Ranitidine (Zantac) and Famotidine (Pepcidine). These medications prevent acid glands in the stomach wall from producing acid. The second group includes Omeprazole (Losec), the first in its class, and Lansoprazole (Zoton).

These are believed to stop acid from being pumped from the glands into the stomach. Undoubtedly, other related medications will appear in time, which may or may not be superior. These medications quickly suppress acid in the stomach. In the past, ulcers tended to heal rapidly. However, it was soon found that although pain relief often occurred within 12 hours or more from commencement of treatment, when stopped, symptoms invariably returned. This simply meant the condition had been relieved, but not cured.

So the method of choice currently seems to be to prescribe the acid-checking medication, as well as to administer triple therapy. Pain vanishes very quickly, especially with the pump inhibitors, often within hours. Acid is kept at a low level, while the triple therapy kills the germ. After a few weeks, all medication can be stopped and, according to latest evidence, with the germ killed, symptoms do not recur, and this may be a lifetime result. Re-infections of course are probable, for the germ is widely dispersed in nature.

With this totally new concept of treatment there is now little need for other forms of medication. Some may find use of the old-time antacids helpful as a temporary measure if there is any residual discomfort. Most of the other medications which claimed to help ulcers heal are now not required. There are no dietetic limitations, except smoking is not recommended, and commonsense should prevail regarding alcoholic intake. Otherwise, the patient may eat whatever foods are desired.

However, although most cases will be cured, some recalcitrant ones may persist. These may be suspect cancers, so other measures may be required. If an ulcer has not healed with intensive medical therapy within four weeks, then surgery may be indicated. This is probably even more important in gastric ulcers, for it is claimed that about ten percent of these prove to be cancerous. Also, there is little hope of a cure if a long-standing peptic ulcer has been present in the duodenum for five years.

Surgical operations that produce satisfactory results are now available. The nature of these has been an unending argument for some years, as each new variation claims to have some value over its predecessor. Surgery is not without its own set of complications in certain patients.

Many patients find the task of ceasing smoking a major one. Efficient methods are now readily available in all capital cities. With development of the stick-on nicotine impregnated skin patch, many patients are able to quickly give up smoking. A commitment is necessary, for success is more likely in highly motivated patients with the desire to “quit.” Medical supervision and support help, and attending an understanding doctor willing to spend time to offer psychological counseling and support is recommended. Most courses last ten to fourteen weeks. Other community and hospital-based services are also available involving other methods.