The HERBAL MEDICINE ELECTRIC BOILER will stop boiling when the water inside goes down to about 200 ml. You start boiling the herbs with about 1,250 ml. of water adding to the herbs. Then it will keep warm until you switch off the electric.
Urticaria is a raised itchy and painful skin rash sometimes called a “nettle rash” or hives. There are two distinct types of urticaria:
Acute urticaria is often caused by an allergy to food or medication and can last between several hours and six weeks.
Chronic urticaria is diagnosed if the rash persists for six weeks or longer, the underlying cause is then usually not due to food allergies.
What are the symptoms of Urticaria?
This blotchy rash consists of a number of pale raised bumps or wheals surrounded by reddened skin.The rash is extremely itchy and debilitating. Lesions tend to move about every 24 hours and “migrate” around on the body.
In chronic cases, the intense itchiness will cause sleepless nights and may lead to a depressive illness (Doxepin is a good treatment for depression and urticaria). Chronic urticaria tends to fluctuate by temporarily settling down and then suddenly relapsing again with co-existent viral illnesses, stress and aspirin containing medication. This chronic pattern may recur for 5 years to 20 years in some cases!
If your urticaria does not disappear after a few weeks, or does not respond to antihistamine medication, and is accompanied by any other health problem, you should go to your doctor. Blood tests may help identify an allergy or underlying immune disorder.
How do we treat urticaria?
Avoid any obvious triggers or exacerbating factors and try these simple measures:
Keep the skin cool, avoid getting hot from exercise and take lukewarm baths. Resist the temptation to rub the itchy skin and apply copious amounts of moisturizing creams to reduce dryness and itch. Avoid alcoholic drinks and foods containing additives (sodium benzoate, colorings and salicylate).
Apply 1% menthol in aqueous cream to soothe the affected skin.
Avoid all aspirin or codeine containing medication (including ibuprofen, diclofenac and mefenamic acid). Only use paracetamol as a painkiller.
Carefully read Side Effects list of any other medication you are currently taking and avoid medicines that are known to trigger urticaria or angioedema.
Pregnancy may specifically aggravate urticaria as Pruritic and Urticarial Papules and Plaques of Pregnancy (PUPPP syndrome).
The mainstay of treatment is high dose ANTIHISTAMINEmedication which may be necessary for prolonged periods (in excess of 6 weeks). Double conventional doses of antihistamines such as Cetirizine, Loratidine and Fexofenadine may be needed for symptom relief. Occasionally we add "stomach-ulcer treatment" medication such as Cimetidine and Ranitidine which are known to also dampen down histamine release. New leukotriene receptor antagonists used for asthma such as Montelukast have produced some symptom relief in chronic urticaria. Oral Doxepin is a good antihistamine but induces drowsiness, while Doxepin cream may soothe the skin. Short courses of oral cortisone or steroids may be necessary to settle more severe symptoms. Cortisone should not be used for prolonged periods of time as this may lead to stunted growth in children and osteoporosis in adults.
Specialist investigations in Chronic Urticaria may be necessary to exclude other underlying illnesses or to confirm the presence of “auto-antibodies” in the blood stream (“Anti IgE Receptor Autoantibodies" and "Basophil Histamine Release” can be measured). The Autologous Serum Skin Test (ASST) raises a weal on re-injection of the patient’s serum and is a good indicator of Auto-antibodies.
Highly specialized treatments may include Immunosuppressive drugs (Cyclosporine, Methotrexate, and Azathioprine), Androgens and Warfarin. Colchicine is useful in treating Urticarial Vasculitis. If available, Immunoglobulin injections, Plasmaphoresis or the use of novel anti-IgE monoclonal antibodies such as Omalizumab (Xolair) may be necessary. The future holds many exciting new therapeutic modalities including DNA Plasmid Vaccines.
THE STAR NEWSPAPER (Malaysia): Hopes pinned on him
People from all over the world queue to see acupuncturist Leong Hong Tole who has made a name for himself in the world of traditional complementary medicine. Click here to read the news at The Star Online Newspaper.
