Health news blog

The history of cosmetics dates back to antiquity. Creams for soothing the skin, removing superfluous hair, banishing wrinkles, preventing baldness and more, are described in Egyptian parchments written more than 3000 years ago. The word ‘cosmetic’ is itself derived from the Greek kosmetikos, to adorn.

The use of cosmetics is universal and prodigious, and the number used increases every year. Increasingly men too are being attracted by subtle advertisements suggesting means of improving their appearance—lured perhaps by the implied promises of sexual and material rewards.

People have been looking for the fountain of youth since time immemorial, and the emphasis on youth has never been greater than in today’s leisure and youth oriented society. Because ageing causes such visible changes in the skin, many men and women would like to delay or reverse these changes. Although many products on the market claim to do just this, unfortunately none has ever lived up to its claims. Some of these so-called rejuvenating creams contain Allantoin, Plankton and embryo or placental extracts. The particles of these extracts are too large to penetrate the skin, and so can have no effect on the skin. Others contain unibiogen’ from the butterfly cocoon. This is advertised as a ’skin food or fertilizer which jolts tired cells back into their plump youthful state’. Aloe Vera, the juice of the aloe plant leaf which contains 99-5 per cent water and 0,5 per cent of various amino acids and carbohydrate, is also touted as a rejuvenating cream. As already mentioned, none of these appear to have the kind of effect that would iend any support to their therapeutic claims. Mink and turtle oil, marketed as superior to other oils in cosmetic preparations, owe their dubious reputations respectively to the expense and beauty of mink pelts and the longevity of the turtle.

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The G.I. factor is important in heart disease too. It has a role in the diets of people who already have heart disease, but perhaps of greater significance in the long term, it has a practical role in the prevention of heart disease.

Why do people get heart disease? Atherosclerotic heart disease develops early in life when the many factors that cause it have a strong influence. Over many decades doctors and scientists have identified the processes in fine detail and now most of the factors which cause heart disease are well known. Theoretically this type of heart disease might be largely prevented if everyone’s risks were assessed in youth and if all the right things were done throughout the rest of their lives. In practice there has been only a limited development of the ways to screen people for risk early in life, and the resources needed to achieve prevention are just not available. However a great deal is already being done to identify risk factors in healthy people and those with established heart disease. Those who take the necessary action reduce their risk.

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Fat distribution is now regarded as of equal or greater importance to total fat as a health risk and new techniques of measuring fat distribution have recently been developed. Abdominal fat has been regarded as one of the key indicators and measures of this include waist-to-hip ratio (WHR) and the Gonidty or C-Index. Visceral fat, which in the future is likely to prove to be the most powerful predictor of disease, can only be measured in vivo, or in live organisms, through the imaging machines discussed below. How-ever, estimates can be made from techniques that measure abdominal fat including WHR, and the C-index, and more recently using techniques to measure sagittal diameter (SAD), or a measure of abdominal thickness known as the abdominal diameter index (ADI).

Skinfold measures. Skinfold calipers, discussed above, can be used as a measure of fat distribution as well as a total fat measure with specific body sites (such as subscapular) being used for relative measures of fat loss.

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Older children sometimes suffer from a disorder that affects their joints. But this is simply the tip of the ice-berg, for the condition usually subsides leaving little joint discomfort or pain. The long-term result can be a serious disorder of the heart. As one famous paediatrician says: ‘rheumatic fever licks the joints but bites the heart’.

It is much less common than in times past and is more likely where housing difficulties occur; poverty, overcrowding and domestic difficulties seem to predispose to it.

It seems to attack children in the 5-15 year age group. It is rare before this and rare afterwards.

In acute cases, the child runs a fever and feels ill. Pain starts commonly in a large joint, such as the knee, ankle, elbow or wrist. It may become hot and swollen. After a few days the pain and swelling may leave that joint and spread to another one. Sometimes there is a rash. Occasionally, small swollen lumps appear over the elbows or wrists or at the base of the skull.

The heart is frequently involved. As the fever continues, the heart starts beating at a much faster rate than normally. Prompt medical attention is essential.

Some children, especially girls, may develop odd, irregular, muscular movements along with the joint pains. This is called chorea, or St Vitus’s dance. Often the child becomes emotionally upset and unstable, fidgets and is clumsy in movements. Strange movements of the limbs and weird facial twitchings and face pulling occur. These are entirely out of the child’s control. In mild cases, they may seem to be a bit like habit spasms, but in severe forms they can be marked and widespread.

Most cases of acute rheumatic fever are preceded by a simple throat infection by the germ called the beta-haemolytic streptococcus, and the strange joint symptoms may commence from one to three weeks later. The odd movements of chorea may start at any time from three to 15 weeks after the initial infection.

Sometimes acute attacks of rheumatic fever will continue in a silent manner, leading on to a condition called chronic rheumatic fever. This means the heart is definitely involved, and scarring of the heart muscle or the valves has taken place. The doctor usually finds special tell-tale signs that indicate this has occurred.

Treatment

Many doctors believe that prevention is better than cure, for many infected throats can herald this disorder. Prompt medical treatment by the doctor for sore throats in children may prevent onset of the disease, and parents should always be alert to complaints from their children. They should also make certain that medication prescribed is taken for the full course, and not merely for a few days until the throat seems a bit better.

Common sense in making certain the child has a good nutritious diet is essential. Making every effort to keep a reasonable standard of living will at least reduce the chances of contracting infections in the first place.

The doctor will work out a programme of treatment and it is essential it be followed. For acute cases, bed-rest, the salicylates, antibiotics and sometimes the steroid drugs are prescribed. A good diet is essential, and emotional back-up for the child always useful.

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Measles is a highly infectious disease of childhood. Its technical name is rubeola, and it is most common in the 2-14 year age group. By the time a child who has not been vaccinated has reached the age of ten, it is highly probable he or she has contracted the disorder.

It is totally different from German measles (rubella). Even though the names are similar, they are caused by entirely different viruses and the implications are also very different.

The incubation period is between 8 and 14 days; this is the time that elapses between the moment of infection and the onset of symptoms. There is a prodromal period of 3-4 days; this is the period between the onset of symptoms and the appearance of the typical rash.

This is characterized by a fever which persists for several days, and symptoms much like an ordinary cold. There is often a sore throat, nasal discharge, and a dry barking cough. Towards the end of the prodrome, the eyes frequently become sore and inflamed and there may be a discharge. Light often causes uncomfortable irritation, a condition called photophobia. Lymph glands in the neck swell and become uncomfortable.

White spots, called Koplik’s spots, may appear on the pink mucous membrane which lines the oral cavity. They start at the back near the molar teeth, and gradually spread until they may cover a large area of tissue. They invariably vanish just before the appearance of the typical skin rash. These spots are of diagnostic significance only—if they are there, then there is no doubt about the diagnosis. However, by the time the doctor arrives, they have usually vanished.

On about the fifth day of the disease, the rash appears. This starts out as a pink, blotchy, irregular reddening of the skin, and it gradually becomes redder and more fiery as the days pass. It starts on the face and behind the ears. From here it spreads to the chest and abdomen, and finally to the limbs.

The rash lasts from four to seven days and it may be itchy. Finally, it tends to fade. Often there is a fine shedding of tissue (a bit like bran); this may last two to three days. After this a light brown pigmentation may be left, and this finally vanishes also. The majority of cases settle down, and the person returns to normal.

However, there are several complications, and a patient can develop one or more of them. The most serious is called encephalitis. Fortunately it occurs in only about one case per 3000. It means the measles virus penetrates the brain barrier and sets up an infection in the brain substance. It may be lethal and is the main reason why vaccination is offered to children as a preventive measure.

There may be a further increase in fever, lethargy, headaches (which may be severe) and convulsions. Infections of the ear are common, and may produce an acute otitis media, in which the temperature remains elevated and there is considerable pain in the ear on one or both sides. Other unrelated germs often complicate the picture, and respiratory ones are notorious and probably affect most cases. Infections of the pharynx, larynx, throat, bronchi and lungs are all well known. These may lead to sore throats, a cough, a husky voice, and severe chest pain.

Treatment

It is customary to isolate the child for about a week from the onset of the rash. The patient is very infectious, and secretions from the nose, eyes and throat particularly so, and can readily spread to others. Isolation need not be an unhappy period—for the first few days the child will be happy to stay in bed and let the world (and school) pass quietly by. Elevated temperature usually makes a person feel lethargic and disinterested in surroundings. The body will usually overcome the infection by its own inbuilt immune system, so all that is necessary is to help nature do its job uninhibited.

Plenty of fluids are a good idea. These assist by helping to swish dead germs and metabolic debris from the system. Water-based fruit juices, water and lemonade are all satisfactory. Sucking flavoured ice-blocks is usually attractive. Add some glucose D and flavouring to make them taste nicer.

There are no food restrictions, but often the child will be off tucker for a few days. Small, high-protein, high-vitamin, attractively served meals are the best when the young patient does feel like eating.

Paracetamol elixir for children under the age of 6 will decrease body temperatures and make them feel brighter and less achey (see the dosage on label). Paracetamol or aspirin tablets for older children are suitable (one tablet four-hourly, or after meals, while the fever persists).

Gargling the throat with hot, salty water often brings relief if it is sore. Nasal drops or steam inhalations will often make the nasal passageways feel clearer and cleaner. Pre-cleanse with paper tissues and burn these after use, for they are very infectious. The same applies to secretions collected from the eyes.

Bathing the eyes with weak saline is advisable two to four times a day. If the eyes are affected, protection from direct bright light is wise, but do not enshroud the room in total darkness, as I have seen frequently done. Tilt Venetian blinds so that bright sunlight is kept out. Watching television or doing a lot of reading is inadvisable whilst the eyes are affected.

If there is a cough, any simple cough mixture is suitable. Lemon and honey is good; or use a pholcodeine cough elixir, available from the pharmacist.

If complications occur, call the doctor. Most cases of measles are self-limiting and simple measures are usually adequate.

However, the final suggestion is to have children vaccinated at the age of 12 months. One single injection is given by the doctor. It is now considered to be quite safe and very effective. Parents should consider this as part of the infant’s normal immunization routine. Doctors familiar with the serious complications of measles are very keen on vaccination.

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