SKIN CARE: NAPKIN RASH

When dealing with a baby’s skin problems, certain facts must be born in mind. These are that the skin of a baby is thinner, softer, and has fewer hairs and sweat glands than an adults.

There is no single cause of rash on the skin in the area broadly covered by the baby’s napkin. Obviously, almost any skin disorder can manifest itself in this area. Furthermore, any of these disorders may be further aggravated by a physical environment of warmth, moisture, humidity and exposure to various infective organisms present in this area.

Contact dermatitis is one of the commonest causes of a rash in this area. This may be due to a chemical present in either the urine or faeces. Previously it was thought that ammonia formed from the breakdown of urea by various bacteria was the main cause. This, however, is probably only one of many possible chemicals involved. Occasionally detergents used in the laundering of the napkins are implicated. Even creams innocently applied by mothers either to prevent or treat a napkin rash, may be involved.

The eruption usually has the appearance of a burn. Initially it may simply be red, but then blisters and ulceration can occur. The classical distribution is on the convex surfaces in closest contact with the napkin, the creases being spared.

Seborrhoeic dermatitis is probably the second commonest cause of a rash in this area. It is an ill-understood, self-limiting condition which may also affect adults. There is usually no family history of the condition, and no nutritional or infective factor evident. Frequently there is associated ‘cradle cap’. This is a mixture of grease and scale that piles up on the crown of an infant’s head to form a coating resembling a cap. The exact cause is unknown, but may result from over-cautious bathing or fear of injuring the ‘soft spot’. Initially this condition consists of retained vernix, the greasy film which assists the passage of the babe through the birth canal. When this vernix persists as a dry crust on the scalp, it is termed cradle cap.

Seborrhoeic dermatitis usually commences in the napkin area between the ages of three months and one year. The symptoms are usually fedness with scaling. The creases and folds are involved, unlike with contact dermatitis. Frequently other creases, such as the armpits and under the chin subsequently become involved. In severe cases other areas of the trunk can also be affected. The baby is usually quite well, and does not scratch the rash. ”

Infantile eczema usually occurs in infants of parents with the atopic tendency to either eczema, hay fever, hives or asthma. The rash usually appears between the ages of two to three months. It is often first manifest on the cheeks and forehead, but not necessarily. The rash is invariably red, lumpy and involves the creases. It is always itchy, unlike the other rashes.

Psoriasis may occur solely in the napkin area of infants. The features are similar to psoriasis in other areas. It is thought to be induced by external factors such as monilia, in a genetically predisposed infant. It develops very rapidly, and rarely confines itself solely to the napkin area. Usually it clears quickly with appropriate treatment. Relapses are exceptional, and the long-term prognosis is fair. It is estimated that only between 10-20 per cent of these infants will develop psoriasis in later life.

Thrush, sometimes known as monilia, is a frequent cause of and contributing factor to napkin rash. This is a yeast infection caused by the fungus Candida albicans. It can occur at any age. The appearances of a bright red rash, not necessarily symmetrical, with small pustules is very suggestive of thrush. Frequently the area about the tip of the penis is very red, and small, bright red satellite spots appear elsewhere. The area may weep, particularly in the creases. The source of infection may be bowel, particularly after a course of antibiotics. Alternatively, the infection may originate from mothers with vaginal thrush.

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FATS, HEALTH AND FAT LOSS

It should be obvious from the discussion above that fats in food are not necessarily bad. In fact, a severe restriction of polyunsaturated fats may compromise the intake of essential fatty acids and vitamin E. As the human body requires a minimum daily fat intake, it is neither wise nor practical to advocate a ‘no-fat’ diet.

The health implications of particular fats and oils are influenced by the proportion of different fats they contain. For example, olive oil is described as a monounsaturated fat but olive oil also contains polyunsaturated and some saturated fatty acids. Its predominant fatty acid is the monounsaturated oleic acid, so it is called monounsaturated. Margarines are often thought to be made up of polyunsaturated fats—in fact, about 20 per cent of the fat in these products is saturated fat. They also have some monounsaturated fatty acids and up to 15 per cent of the undesirable trans fatty acids. Their total polyunsaturated fat content makes up about half the fat they contain.

The percentage of different fatty acids is really only important if the total amount of fat in the food is significant. The fat content of both margarine and butter for example is about 80 per cent. This means that for every 100g they have 80g of total fat. One teaspoon—about the equivalent of a thin spread on a slice of bread—would contain about 4g of fat. About 30-40 per cent of the margarine will be cholesterol-raising fats (saturated plus trans) or about 1.5g per teaspoon. Butter, on the other hand, rates a high 60 per cent saturated and 5 per cent trans fatty acids in every 100g, or about 2.5g per teaspoon. The total fat content and the total energy in both products however are equal. By contrast, a food such as an egg has about 6g of fat, of which 2g is saturated (all of this in the yolk—egg white has no fat) which is midway between a thin spread of margarine and a thin spread of butter. The occasional consumption of small quantities of any of these foods (a teaspoon of spread or a whole egg) is likely to have little effect on the intake of both saturated and total fat. This fact contrasts with common consumer beliefs regarding the perceived fat contents of margarine, butter and eggs.

One other postulated health implication is the susceptibility of fats to ‘oxidise’ (a chemical alteration to the fat molecule caused by reactions with oxygen ‘free radicals’). Polyunsaturated fatty acids (PUFAs) are the most susceptible to oxidation, especially the long chain highly unsaturated Omega-3 fish oils (which is why fish ‘goes off faster than meat which contains mainly saturated fat). Balanced against this is the intake of antioxidants, especially vitamins C, E and beta carotene. Oxidised fats and other compounds in the body have been linked to many detrimental processes, including atherosclerosis, cancer formation, cataracts and ageing. Research is still intense in this area and many answers about oxidation and health effects are not yet available.

Monounsaturated fats (i.e. olive oil, canola oil, avocados) are generally seen as the best type of fat for health purposes. They tend to reduce blood cholesterol at least as well as the polyunsaturated, but don’t oxidise as readily and have no known links with other health problems. In the case of olive oil, a major source of monounsaturated fat, we also have a long history of people safely consuming substantial amounts of it without apparent detrimental effects. Its major virtue may be not only that it contains a good mix of fatty acids, but that it also contains a wide variety of antioxidants. However, olive oil still contains the same energy, gram for gram, as other types of fats. And while there is some recent research now querying the fat storing potential of all fats, the prudent advice for those interested in lowering or maintaining body fat is still to decrease all fats in the diet.

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COPING WITH ENDOMETRIOSIS: VITAMIN AND MINERAL THERAPY

Many women with endometriosis have heard of the benefits of treating the disease with vitamins and minerals and certainly members of the Endometriosis Association (Victoria) have talked about success with vitamin B6 and evening primrose oil in eliminating pain and treating lethargy and depression.

Most vitamins and minerals discussed in this section below can be bought off the shelf at your local health food shop.

Vitamin B

Vitamins can help in alleviating pain; in particular, vitamin B6 has been reported as being beneficial in the treatment of premenstrual syndrome and associated problems.

Although it is not certain why vitamin B6 helps, many PMS sufferers vow it has been instrumental in alleviating their symptoms of depression, lethargy, mood swings, irritability and pain.

Vitamin C

The merits of vitamin C have long been acknowledged. Alternative therapists say it helps not only with heavy bleeding (because it strengthens the blood vessel walls and helps the body to absorb iron) but also helps promote healing.

Vitamin E

Another healing vitamin, it is often recommended for the prevention of thick scar tissue and to promote healthy skin; this would explain why it helps alleviate pain as it acts on adhesions and scar tissue left by endometriosis implants.

Zinc

Many practitioners believe zinc helps with PMS symptoms and also improves fertility.

Evening primrose oil

Many PMS sufferers cannot do without their evening primrose oil (EPO) as they say it helps alleviate symptoms and keeps the condition under control.

Endometriosis sufferers on hormonal drug therapy also report that it has helped them cope with the side effects often associated with these drug treatments.

Evening primrose oil is expensive (currently about $20 for a month’s supply) so you have to weigh up the benefits with the cost. EPO is a good source of gammalinolenic acid (GLA) — one of the essential fatty acids which produce prostaglandin.

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IS ENDOMETRIOSIS BECOMING MORE COMMON

There is much debate as to whether or not endometriosis is becoming more common.

Some gynaecologists believe that there has been an increase in the actual number of women who have endometriosis. These gynaecologists believe that the condition has become more common because women are having fewer children and having them later in life — two factors which they believe predispose women to developing endometriosis.

Other gynaecologists believe that there has only been an increase in the number of women being diagnosed. The rate at which endometriosis has been diagnosed has certainly increased over the last 30 years, particularly since the introduction of laparoscopy in the early 1970s. This does not mean that the condition is more common than it was 30 or 40 years ago. It is more likely to mean that the condition is being diagnosed more frequently because the introduction of laparoscopy has made it much easier to diagnose and because there is a greater awareness and recognition of the condition by the medical profession.

The increased rate of diagnosis could also be a reflection of the fact that nowadays women are less likely to accept that some of the symptoms of endometriosis such as period pain and heavy bleeding are a normal part of a woman’s life. Consequently they are more persistent in seeking a diagnosis — and treatment — for their symptoms.

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VIRUSES

Not really a complete cell but simple nucleic acid (DNA or RNA) encased in protein, a virus must make use of other cells to function and reproduce as a lifeform. Thus it invades cell tissue and interferes with its normal function and genetic behaviour.

Often viruses will kill the host cell and move quickly to invade others. Sometimes they do not kill the cell but live on within it, manipulating its genetic codes in order to reproduce. Such viruses are known as retroviruses and include HIV, which causes AIDS.

Other illnesses and ailments arising from viral infection include the commom cold, chicken pox, measles, warts, influenza, cold sores and genital herpes. The body reacts to their presence by producing special kinds of blood proteins called antibodies. These antibodies remain in the blood after the virus has been beaten and reinfection by the same virus is not possible. Unfortunately, many viruses quickly mutate, rendering the antibodies useless. An example of a rapidly mutating virus is influenza which a person could catch every year. Non-mutating viruses such as mumps are rarely caught twice in a lifetime.

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SUGGESTIONS FOR THOSE SUFFERING FROM CLINICAL DEPRESSION, ALSO KNOWN AS MAJOR DEPRESSIVE DISORDER OR DYSTHYMIA

Major depressive disorder and dysthymia are officially recognized conditions. By definition major depressive disorder disrupts one’s capacity to function and enjoy one’s life. It is reasonably severe and lasts for at least two weeks. Dysthymia is less severe in terms of the number of symptoms required for its diagnosis, but is by definition rather chronic and, as such, also exacts a toll of one’s life.

The directions for getting started on St John’s Wort are the same as those described above. If you experience no response within five weeks, however, and are experiencing no unacceptable side-effects, you may consider pushing up the dosage to eight, 11 or even 13 135-mg tablets per day. Maintain the three times a day dosing schedule, remembering to take St John’s Wort with food, and wait at least three or four days between dosage increments. There is a range of effective dosages for all other antidepressants and there is no reason to believe that such a range would not apply for St John’s Wort as well. Sometimes a full clinical response to an anti-depressant will not be observed until the dosage is pushed into the higher levels of the accepted therapeutic range. So far there has been only one published clinical trial in which 1,800 mg (about 13 Kira™ tablets) of St John’s Wort were given per day. According to the researcher in charge of the study, levels of side-effects were not noticeably higher for the 1,800-mg per day dosage than he has generally observed when treating people with the more conventional 900-mg per day dosage.

Unless the depression is really severe, it is quite reasonable to use St John’s Wort as a first-line treatment, in combination with other methods of promoting an anti-depressant lifestyle. Monitor your symptoms as described above. Since it is a daily log, as opposed to the weekly log provided above, it enables you to get a more fine-tuned sense of your mood control and helps you to recognize influences that may have an adverse or beneficial effect on your mood. Subtle mood cycles can also become apparent, and their pattern may suggest certain specific types of treatment.

Once again, allow five to six weeks for the treatment to work. If it doesn’t work by that time, consult your doctor about either adding an anti-depressant or switching to a more conventional anti-depressant. On the other hand, if you have detected a partial response and your symptoms are not too severe, you may want to wait a further few weeks before deciding on making any other medical changes.

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THE ECOLOGY UNIT IN THE DIAGNOSIS AND TREATMENT OF ALLERGIES: COMPLICATIONS OF TREATMENT

The complications of this hospital regimen are strikingly few. Occasionally, a patient may decide voluntarily to leave the hospital during the fasting period. This may be the result of an inordinate fear of fasting, the iron grip of some addiction, or an inability to cope with the withdrawal symptoms. There have been a few such instances in which patients left in the midst of acute reactions, following the feeding of a suspected food.

Pregnancy is no problem, however, and pregnant women have been successfully fasted for a few days. Diabetics can also be handled, although in advanced cases the fasts cannot be complete.

In all, patients ranging from young children to elderly people have fasted in our program. Although reactions to foods can be troublesome, it is important to note that no deaths or irreversible complications have ever resulted from this program. Contrast this record to that of conventional medicine, with its emphasis on surgery, radiation, electroshock, and drug therapy. The clinical-ecology approach to chronic illness is logical, effective in many cases, and, above all, safe.

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CALCIUM AND OSTEOPOROSIS

Nowadays, with so much emphasis being put on the need to reduce the fat in our food and to increase our dietary intake of fiber and bulk-producing vegetables, care must be taken to avoid a deficiency of calcium.

Fat-containing dairy products, especially milk and ice cream, used to provide us with most of our calcium, whereas the vegetables and cereals, which we are now taking in their place, bind with calcium in the intestines and thus interfere with its absorption, Medical World News (25#12:41) reports. The net result, if we are not careful, is a calcium deficiency that leaves our bones weaker and more brittle than usual and unusually prone to be fractured, even in response to minor trauma.

While no one denies that low fat and high fiber diets benefit us by greatly reducing our liability to heart disease and stroke, we must take care to compensate for the decreased availability of calcium they bring about. We can help ourselves by taking, in addition to our one vitamin-mineral pill a day, half a gram (500 mg) tablet of calcium carbonate three times daily (or four times if one is big) as well.

It is important to note that it matters when we take these tablets. Since the calcium in pills can only be absorbed if there is a normal amount of acid in the stomach, the Journal of the American Medical Association (257:541) reports that older people, whose stomachs no longer produce much acid, cannot benefit from taking calcium between meals. Taken with food, however, calcium is absorbed, regardless of the lack of gastric acid.

Another article in the Journal of the American Medical Association (247:1106) emphasizes that taking calcium alone is not enough and, even in optimal amounts, can do nothing to prevent the bones from becoming osteoporotic in people who are inactive. Both exercise and calcium are needed to restore osteoporotic bones. Because exercise (e.g., walking two miles every day) can be difficult or impossible for those who have already become disabled by osteoporosis, prevention is truly better than cure.

Also, according to the Mayo Clinic Proceedings (61:116), it has been discovered that the density and amount of calcium in an older woman’s spinal bones correlates very closely with the strength of her back muscles. Thus, it is believed, older women may be able to protect themselves against collapse of the spinal bones by regularly performing exercises that increase the tone of the back muscles. Although it will take many years to obtain final proof that this works, it is reasonable for women to perform daily back exercises (sit-ups or with a rowing machine), so long as they do not overexert or hurt themselves.

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HEADACHES IN CHILDREN

Symptoms: Pain, ache, or throbbing in any area of the head.

Home care:

Give aspirin or paracetamol to relieve pain.

Apply cold compresses to the forehead.

Have the child lie down in a dark room.

If the headache is accompanied by nasal congestion, antihistamines or nose drops may ease both conditions. Warm compresses may also help.

Try to identify any source of stress that may be causing headaches. Comfort and cuddle the child whose headache may be due to emotional factors.

See the doctor if the headaches persist.

Precautions

-    Get medical help immediately if the child has a sudden, severe headache, especially if it is accompanied by any of the following: fever, extreme weakness or collapse, severe vomiting, stiff neck, or confusion.

-    If the child has recurring headaches that become more frequent or severe, consult the doctor.

-    Your information about the child’s headaches will be important to the doctor. Note where the pain is located, when it occurs, what circumstances seem to provoke it, how long it lasts, if there are also other symptoms, and whether or not the headache responds to pain-relieving medication.

Headaches are probably as common in children as in adults and have as many or more causes. Fever and strong emotions (anxiety, fear, excitement, sadness, and worry) account for about 95 percent of all headaches in children. Less common causes of childhood headaches are high blood pressure, head injuries and concussions, tumours and inflammation of the brain (such as meningitis, encephalitis), bleeding inside the skull, sinusitis, eye strain, and psychiatric problems.

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REDUCING RISKS OF ACCIDENTS: FOLLOWING SAFETY ADVICES

Drive yourself sober

If you’re thinking of driving after drinking, think first of this sobering fact: More than 40 percent of fatal crashes involve a driver or pedestrian who had been drinking. “It doesn’t make any sense to gamble and hope that you’re not the one affected. Don’t be so cocky to ignore the risks,” says Kennedy. You’re also forcing everyone who crosses your path to take the same risk. Nearly half of the people killed in crashes are innocent victims killed by drivers who had a few – or less than a few.

So try heeding the following advice from safety experts to help reduce your risk of being involved in an alcohol-related accident.

Use common sense. Some people stick to the guideline of having one drink an hour, followed by a nonalcoholic drink in the second hour, to monitor their blood alcohol level, says James Fell, chief of research and evaluation at the National Highway Traffic Safety Administration in Washington, D.C. “But we really can’t say what a safe ÂÀÑ is because everyone is affected differently, considering their age, weight, fat, food intake, and experience. The motto, plain and simple,” Fell adds, “is that if you have to drive, don’t drink. If you have to drink, don’t drive.”

Act like it’s New Year’s Eve. People have a heightened awareness of how dangerous the roads and highways are when everyone’s out ringing in the New Year, says Kennedy. “Well, any time you’re on the road late at night, especially on the weekends, you are driving among a lot of people who have been drinking,” he says.

Be aware of your surroundings. Keep yourself safe by leaving plenty of room between you and the cars around you. And by all means, don’t challenge anyone’s reaction time by making a quick turn in front of another car or cutting into traffic, Kennedy says. “Just being mindfully aware of the potential danger can keep you safer,” he advises.

A Need to Heed Speed

When engineers make roads, they take a lot of factors into consideration before telling you how fast you can go, Kennedy says. “Those numbers you see indicating the speed limit aren’t arbitrary. Road engineers consider the population of the neighborhood, the angle of the curves, the volume of traffic, and numerous other factors to figure the maximum speed you can safely travel,” he says.

The problem is that lots of folks choose to ignore the limits. Going faster than the posted speed limit contributes to more than 68 percent of fatal car crashes, according to the National Safety Council.

You don’t have to have your foot through the floorboards to get killed in a speed-related crash either. Only about 13 percent of speeding-related deaths occur on high-speed interstate highways. The rest happen as folks are flying around their familiar stomping grounds, generally after they’ve been drinking.

The take-home message here is to slow the heck down. You risk killing not just yourself but also some innocent mom, dad, or child who crosses your path, says Kennedy.

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