Wednesday 29 February 2012

MENGATASI MASALAH ALAHAN (RESDUNG)

Masalah resdung seringkali berkaitan dengan gatal hidung, bersin, hingus cair dan hidung sumbat. Dalam bahasa perubatan ia lebih sesuai dipanggil sebagai ‘Allergic Rhinitis’ atau alahan hidung. Pesakit juga boleh mengalami simptom gatal pada bahagian mata dan kulit muka. Gejala ini berlaku kerana pesakit alah kepada pelbagai bahan terutamanya hama, makanan laut, belacan dan sebagainya.

Perkara utama dalam menangani masalah alahan hidung adalah untuk mengelak dari bahan yang menyebabkan alahan atau ‘alergen’. Salah satu cara untuk mengenalpasti alergen adalah dengan mencatatkan dalam diari makanan yang diambil setiap hari dan juga keadaan persekitaran. Seringkali apabila diimbas kembali pesakit mungkin dapat meneka alahan mereka dengan tepat.

Selain daripada usaha pencegahan, para doktor mungkin mengesyorkan pengambilan ubat anti-alahan hidung samada dalam bentuk pil antihistamin atau pam/spray hidung. Ubat ini dapat membantu mengawal simptom alahan hidung dengan lebih berkesan, terutamanya bagi pesakit yang mengalami alahan yang teruk atau yang terpaksa terdedah kepada alergen seperti mereka yang bekerja di gudang yang berhabuk.

Langkah- langkah mengatasi alahan

Elak dari terdedah kepada alergen
Pengambilan ubat yang disyorkan doktor apabila mengalami kes alahan teruk



Mengatasi masalah alergen utama iaitu HAMA
Ramai pesakit alahan hidung mempunyai alahan terhadap hama. Hama adalah binatang yang hanya dapat dilihat melalui kanta mikroskop. Sebenarnya alahan itu adalah terhadap najis hama tersebut. Hama hidup dengan memakan sel kulit mati yang terdapat pada katil dan perabot di dalam rumah kita. Ia suka kepada keadaan yang panas dan lembab.



Selain dari alahan hidung, alahan kepada hama juga boleh menyebabkan sakit asma (lelah) atau gatal kulit (eczema). Ciri utama dalam mengatasi alahan hama adalah pencegahan dan kebersihan.

Cara mengatasi hama
  1. Elak penggunaan permaidani di dalam rumah terutamanya di bilik tidur
  2. Elak mengunakan terlalu banyak kusyen atau perhiasan rumah yang dapat mengumpul habuk
  3. Alat mainan seperti patung beruang seharusnya jenis yang boleh dibasuh dengan senang dan kerap
  4. Basuh cadar dan selimut sekurang-kurangnya dua kali seminggu
  5. Elok basuh cadar dan selimut dengan menggunakan air panas 600C
  6. Menggunakan hampagas untuk mengurangkan habuk. Penggunaan hampagas yang mempunyai filter yang bagus (high efficiency filter, HEPA) dapat mengurangkan habuk dan hama dengan berkesan
  7. Mengelap perabot dengan kain lembap lebih berkesan dari menggunakan bulu ayam/plastik
  8. Memakai 'face mask' terutamanya semasa mengemas rumah ataupun di tempat kerja yang berhabuk
  9. Mengelakkan haiwan peliharaan seperti kucing atau anjing dari kawasan bilik tidur
  10. Penggunaan lapik katil dan bantal yang anti-hama (anti-dust mite covers) juga dapat membantu

Apa yang boleh berlaku sekiranya masalah alahan hidung (resdung) tidak dikawal?
  • Boleh menyebabkan masalah infeksi atau jangkitan kuman pada rongga hidung dan sinus (sinusitis)
  • Boleh menyebabkan masalah polip hidung
  • Gejala hidung yang sentiasa sumbat boleh mengurangkan daya konsentrasi dan menyebabkan pesakit merasa lesu
  • Hidung tersumbat boleh mengganggu tidur yang berkualiti
  • Alahan hidung juga berkait rapat dengan penyakit asma/lelah yang sukar dikawal
  • Alahan hidung juga boleh menyebabkan pesakit mengalami masalah jangkitan telinga ‘otitis media’ terutamanya pada kanak-kanak

Thursday 23 February 2012

TMJ DISORDERS- PAIN IN THE EAR?

TMJ stands for temporomandibular joint. It’s the joint that allows our jaws to open and close. By anatomical position, it is situated in front of the ear canal. And like any joints it can give rise to pain when inflammed. However symptoms of TMJ disorder are unlike other usual joints. Most patients will present with ear pain, headache or ear pain on chewing.

Symptoms of TMJ disorder
Ear pain
Headache
Pain on chewing
Jaw pain
Facial pain
Uncomfortable bite
Locking of jaw
Clicking sound during mouth opening


Why does it happen?
Most of the time, it is difficult to determine the actual cause or trauma that relates to TMJ disorder. There are certain risk factors associated such as it occurs more commonly in women between 30 to 50 years of age and those with jaw deformity. It can also be related to rheumatoid arthritis, teeth grinding during sleep or fibromyalgia.

During the doctor’s consultation
A thorough history is taken to assess the condition. Examination of the ear, nose, throat and face area is done to ascertain other causes for the symptoms. The TMJ on both sides is assessed and often is tender on palpation. Clicking or grating sounds can also be heard during mouth opening. Further imaging studies may be required to assess the joints.

Treatment
Treatment often consists of painkillers and medication to help ease the pain and relax the jaw muscles. Certain jaw exercises can also help, which will be taught by the doctor. These exercises will help to stretch the jaw muscles and reduce the pain.
If there is a very abnormal bite or teeth grinding then the patient is advised to seek corrective dental treatment and use bite guards.  Surgery is reserved for very advanced joint disease.

TAKE AWAY ADVICE
Avoid chewing gum or other chewing habits
Eat soft food in small sizes
Avoid eating nuts
Ice packs applied over joint area
Relaxation to reduce stress and jaw clenching

Tuesday 14 February 2012

MIDDLE EAR EFFUSION


Middle ear effusion (MEE) is a condition caused by fluid in the middle ear. The fluid can be thin and serous like, or thick and glue like. Therefore middle ear effusion is also synonymous with others names such as glue ear, otitis media with effusion, secretory otitis media etc.

How does it occur?
The middle ear is normally an air-filled space deep to the ear drum. The pressure in the middle ear is equalized to the atmospheric pressure through the Eustachian tube. The Eustachian tube would open and close when we swallow or yawn. When there is poor function of the Eustachian tube, negative pressure will develop in the middle ear which leads to fluid accumulation.


Risk factors for MEE
Exposure to secondary smoking
Frequent upper respiratory tract infections
Frequent ear infections
Attending daycare centres
Allergic rhinitis


MEE is usually common in children especially those with frequent upper respiratory tract infections and allergies.  It can also occur within weeks after an acute middle ear infection, which doctors call acute otitis media.  It is less common in adults and if unilateral, it can be associated with nasopharyngeal carcinoma.

Symptoms of MEE

Ear block
Tinnitus
Reduced hearing- children may become inattentive in classroom or not respond to soft sounds
Ear pain, fever and irritability- if infected

How is MEE diagnosed?

An otoscopic examination by the doctor may show fluid or bubbles behind the ear drum. The ear drum may also take a yellowish hue.
The diagnosis can also be confirmed by performing a tympanometry which shows impaired mobility of the ear drum. A hearing test would also show a conductive type of hearing loss.

Treatment of MEE

Most cases of middle ear effusion will resolve within weeks. However doctors would prescribe medication to treat the underlying conditions. Antibiotics are indicated when there is infection and antihistamines are considered in patients with allergies. Nasal decongestants are sometimes prescribed to treat the nasal congestion.

Unfortunately in some cases the MEE persists despite medical treatment. In these cases a simple procedure such as myringotomy and grommet insertion is performed to remove the fluid and restore ventilation to the middle ear. This surgery is indicated in chronic MEE especially with significant hearing loss.

The hearing loss in MEE can be significant enough to affect the speech development in infants and the learning process of a school going child.