What is allergy? – Part 1

repared by Dr. M. Yadav, Consultant Allergist of a private hospital in Kuala Lumpur. Dr. Yadav can be contacted at telephone number – 03-22828795

(Dr. M. Yadav was former Professor in Immunology in the Department of Genetics and Cellular Biology, Universiti Malaya. He has published over 200 research papers on various aspects of allergy and immunology in international journals. He has worked in many parts of the world and received several awards. He currently manages an allergy testing and diagnostic service at Pantai Medical Centre. His book entitled ‘Causal Triggers of Allergy and Asthma’ is expected to be released in 2004.
Here he explains the nature of allergy, what tests need to be performed to diagnose the trigger factors and how to manage the problem over long terms)

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What is allergy?
An allergy is an abnormal exaggerated physical reaction (with development of any of the following symptoms: diarrhea, vomiting, skin rashes, hives, sneezing, runny nose, asthma, chronic cough, joint pains, puffiness of the eye orbit or face, ear infection, anaphylaxis) to one or more substances called allergens that are harmless to most people. Skin, oral and nose allergy symptoms are associated with intense itch. Sources of common allergens that trigger the allergy symptoms include house dust mites, plant pollens (called hay-fever in temperate regions during spring/summer) mould spores, pet dander (skin scales from pets), foods (for example eggs, peanuts, cows milk, shrimps and many others), drugs (for example penicillin, sulphonamides), venom of stinging insects (for example mosquito bites, wasp sting, ant sting) perfumes (both naturally derived from flowers and artificially synthesized), and many others. Frequent exposure to the provoking allergen will trigger the development of allergy symptoms. Individuals with allergy often have a genetic predisposition with a strong family history of the disease.

Developmental milestones

This below information is provided by Dr Cheang Hon Kit, Consultant Paediatrician/Neonatalogist of a private hospital in Penang.

DEVELOPMENTAL MILESTONES

(Reference note: The actions mentioned in the bullet form are some of the things that a baby/child is able to do at the different ages. Those marked in bold are warning signs that you may wish to refer to your respective paediatrician if you observe them.)

6 weeks old

* Smiles
* Stares at faces
* Startles to sudden noise

3 months old

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Holds rattle placed in hand
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Eyes follow moving person/object
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Vocalises & laughs

6 months old

* Sits with support
* Rolls prone to supine
* Reaches out to grasp
* Turns to voice

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Warning : Hand preference

Persistence of fisting

12 months old

* Walks holding furniture
* Bangs 2 objects held in hands
* Waves bye-bye
* Papa/mama specific

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Warning : Unable to sit or bear weight

Absence of babbling

18 months old

* Walks unsupported
* Scribbles
* Feeds self with spoon
* 3 words other than papa/mama

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Warning : Inability to stand without support

Inability to understand simple commands

2 years old

* Kicks ball
* Imitates vertical line
* Combines 2 different words

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Warning : Unable to speak in short sentences

3 years old

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Pedals tricycle
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Copies circle
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Dresses with help
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Names 4 pictures

4 years old

* Hops
* Copies cross and square
* Brushes teeth without help
* Recognise 4 colours

5 years old

* Walks down stairs one foot per step
* Draws man with 6 parts
* Dramatic group play
* Define 6 words

The MMR doubts expressed by mothers – Pt 3

According to my child’s schedule, the MMR is a one time jab which consist of Mumps, Measles and Rubella (German Measles). Usually this vaccine comes in a glass nebsules and only one injection.

For MMR, the recommended age to jab is between 12 – 15 mths. Most hospitals recommend 15 months.

At 5 yrs old, a child has to be jabbed again a booster dose. After that, no more jabs. So, MMR is a one dose jab.

But a majority of children weren’t given the MMR when they were small and there is a risk of an outbreak. Thus, the Government is paying millions of ringgit to get every child jab.

Right now, my two older children, age 14 yrs and 12 yrs are going to get another jab because I cannot prove to the Government Healthcare that I had given them the jab when they were 5 yrs old. My paed told me that at their age, they can take another booster dose.

From the pattern found in the UK (paed said) bigger children contract measles. Not because the jab earlier was ineffective but probably, the virus has gotten smarter.

As for taking separate jabs of MMR, I cannot fathom the wisdom behind it. Firstly, the vaccine producer made them in one shot. It saves our babies the pain of 3 jabs. Secondly, MMR has been MMR and not M, M and R. All 3 of these infections have their own danger. Measles if not treated early can lead to death. Mumps sometime affects the testicles of male children. Rubella – it is deadly to fetus.

Previously, the risk of MMR was because they used mercury/thimoresal as the preservative in the vaccine. But now, it has been phased out. It is wise to ask your doctor about this and also find out the name of company manufacturing the vaccine. As I know, there are good and expensive drugs and there are cheaper alternatives. So, also good to find out whether one is getting the latest and best one available.

I heard that MMR is available free in district clinic too.

My paediatrician has provided a link for further readings on the MMR issue.