Tonsillitis

Sore throat

The tonsils are lymph nodes at the back of the throat that serve as the first line of defense against germs entering the body through the nose and mouth. Tonsillitis occurs when the tonsils themselves get infected by the micro-organisms they filter. The disorder is common in childhood but rare in adults, who usually experience sore throats or pharyngitis instead. Some children get recurring attacks.

Symptoms

• Swollen tonsils on either side, which sometimes have white spots on them.
• Flu-like symptoms, fever, headache : Tiredness, weakness, loss of appetite.
• Pain when swallowing.
• Earache.
• Foul-smelling breath.

In children (in come cases):

• Abdominal pain.
• Cough.
• Vomiting.
• Swellings on either side of the neck due to enlarged lymph nodes (other then the tonsils).

Complications

• Quinsy (an abscess on the tonsil).
• Rheumatic heart disease, due to an untreated bacterial infection.
• Kidney damage due to an untreated bacterial infection.

Cause

Viral (more common) or bacterial infection on the tonsils.

What you can do

• Nothing. The disorder goes away on its own in a few days.
• Stop smoking.
• Drink plenty of fluids.
• Gargle with mouthwashes or warm salt water.
• Suck antiseptic lozenges or cough drops.
• Take simple painkillers or antifever medicine. However, give a child paracetamol, not aspirin. Aspirin puts him at a risk of contracting Reye's syndrome, a rare life-threatening disease which affects the brain and liver.
• Consult a doctor if symptoms persist for more than 2 days, you run a high fever, or pus can be seen on the tonsils.

What your doctor can do

• Determine the cause of the infection.
• Prescribe antibiotics for bacterial infection.
• Treat the complications.
• Perform tonsillectomy (surgical removal of the tonsils), in rare cases.

Prevention tips

At the first sign of a sore throat, suck antiseptic lozenges.

For products see Sore throat page 511, Oral hygiene page 435

This article is reffered to Malaysia Healthcare Guide - The family health guide, MIMS, 2nd edition, 1997, page 530.

Constipation

The frequency of moving stool varies from individual to individual, ranging from three times a day to twice a week. Constipation happens when this function is unduly delayed from the normal pattern. Occasional constipation is not serious but a long-standing disruption of this pattern, and changes in the appearance and consistency of the stool may be signs of a more serious disorder (eg intestinal cancer, hypothyroidism).

Symptoms

• Delay or difficulty in bowel movement.
• Pellet-like stool (small, dry, and hard).
• Pain, which may come and go in waves.
• Flatulence (excessive gas in the bowels) and frequent passing of air.
• Abdominal distension and discomfort.

Common causes

• Change of diet.
• Insufficient fluid and fibre in the diet.
• Too little exercise, causing the colon contractions that push the stool down to weaken.
• Ignoring the urge to pass stool when busy.
• Haemorrhoids (piles) or anal tissues (tears in the skin arround the anus), which cause pain when passing stool. (See PILES page 452).
• Certain drugs and minerals (eg painkillers, iron tablets) and cough mixture with codeine.
• Pregnancy, in which the fetus pushes down on the bowel.
• Illness which causes loss of fluids, alters the diet, or hinders a person's mobility (eg paralysis).
• In bottle-fed infants, feeding formulas that are too strong.
• Aging process. The abdominal muscles gradually weaken with age.

What you can do

• Eat plenty of fibre daily (eg four servings of cereals, fruits, and vegetables).
• Drink 6-8 glasses of fluids a day.
• Eat at regular hours.
• Exercise everyday. Walk briskly for at least half an hour.
• Consult a doctor if the measures listed above fail.

What your doctor can do for you

• Rule out haemorrhoids, anal tissues, and the more serious causes of constipation (eg colon or rectal cancer).
• Emphasize exercise and dietary strategy.
• Prescribe a laxative.
• Prescribe suppositories or an enema (passing fluid into the rectum through a tube inserted into the anus to induce bowel movement).
• Treat the complications.

Prevention tips

• Take plenty of fluids and fresh fruits and vegetables daily.
• Exercise regularly.
• Keep regular hours for your meals.
• Follow a regular pattern for bowel movement. Do not ignore the urge to pass stool.

This article is reffered to Malaysia Healthcare Guide - The family health guide, MIMS, 2nd edition, 1997, page 280-281.

Asthma

Also see Allergy page 197

During an asthma attack, the muscles in the walls of the small airways contract (bronchopasm), the linings of the small airways become inflammed, and excessive mucus is produced in the small airways. All three reactions combine to narrow the airways, thus limiting the passage of air, especially during breathing out. The disorder usually begins in childhood, with about half the children outgrowing it.

Symptoms

• Chest tightness.
• Breathing difficulty; laboured breathing in episodes. (Symptoms are worse at night.)
• Wheezing (a whistling sound while breathing).
• Coughing, with or without thick sputum.
• During severe attacks, cyanosis (bluish discoloration) around the lips, sweating, and a fast pulse rate.
• In infants, fast breathing, with the lower ribs being drawn in.

Complications

• Pneumothorax (collapsed lung due to an air leak).
• Acute respiratory failure.
• Death.

Common causes
Asthma is the result of a hypersensitivity reaction to stimuli, inflammation and constriction of the air passages. It is a condition due to both hereditary and environmental factors. An asthma attack may be provoked by:

• Allergens (eg. animal dander, dust, certain food and medicines, mites, mold spores, pollen, etc).
• Viral or bacteria infections (eg. bronchitis, common cold, coughs, sinusitis).
• Environmental irritations (eg. exhaust gases, hair spray, perfumes tobacco smoke).
• Emotional stress (eg. excitement, upheaval).
• Strenuous exercise.

What you can do

• Consult a doctor the first time you start wheezing, or if the condition does not respond to the prescribed treatment.
• Take the medication prescribed by the doctor (eg bronchodilator). Inhaled bronchodilators are usually recommended. Wait 15-20 minutes after an inhaled dose. Rrepeat if necessary.
• Take your peak expiration flow rate.

Call your doctor or go to the hospital if:
. you or your child is not getting better after following the doctor's instructions.
. you or your child is unable to talk because of breathing difficulty.
. you or your child requires inhaled bronchodilator very often (eg more than 3-4 hourly).
. your child looks exhausted.

• Try to be calm and call for help if you cannot cope. See HELPLINES.
• Rush the nearest hospital's emergency room if you have an accute attack.

The bystander:

• Sit the person upright and make him lean forward, with both arms resting on the table.
• Rush the person to the nearest hospital's emergency room if an acute attack does not respond to the prescribed medication.

What your doctor can do for you

• Administer oxygen.
• Administer a bronchodilator via nebulisation.
• Administer oral or intravenous steroids.
• Treat an accompanying chest infection with antibiotics.
• Prescribe long-term anti-inflammatory treatment.
• Teach you how to manage acute attacks, and how to use certain devices (eg inhaler, turbuhaler, rotahaler, diskhaler) to ensure optimum benefit from them.
• Teach you how to use a peak flow meter to monitor your asthma.

Prevention tips

• Know what triggers the asthma attack. If possible, avoid the factors that trigger the disease. (Keep your home free of dust, animal hair, mites, etc.; and stay away from irritations such as cigarette smoke, exhaust fumes, etc).
• Stop smoking.
• Take the medications prescribed by the doctor to reduce the frequency and severity of subsequent attacks.
• Exercise regularly to improve lung and heart function.

Helplines
Persatuan Asma Malaysia 03-757 6641

This article is reffered to Malaysia Healthcare Guide - The family health guide, MIMS, 2nd edition, 1997, page 223-224

Eczema

Skin rash

Also see Allergy page 197

Eczema is a skin rash or inflammation characterised by blistering, cracking, itching, oozing, redness, or scaling. The skin often becomes thick and discolored due to constant scratching. Eczema is common, recurrent, and sometimes persistent, but it is not contagious. Most affected children outgrow the condition by puberty.

Symptoms

• Swelling and redness.
• Itchy rash, which is sometimes intense.
• Blisters (small bumps filled with fluid) that may ooze due to scratching.
• Crusty, dry and cracked, leathery, scaly, thickened, or weeping areas of skin.
• Pain, soreness, discomfort.

Complications

• Secondary bacterial infection.

Cause
There are many types of eczema. They are due to combination of endogenous (internal) and external factors.

• Allergy - allergic contact eczema.
• Skin irritation - irritant contact eczema.
• Photosensitive eczema - sunlight-induced.

What you can do

• Seek treatment early.
• Avoid scratching as much as possible, as it can lead to bacterial infection.
• Apply cream, lotion, or moisturizer to prevent dryness.
• Apply soothing ointment on the affected area to ease irritation and cover with dressing to prevent scratching.
• Wear cotton clothes. Do not use wool and synthetic fabrics as this tend to irritate the skin.
• Take antihistamine (anti-allergy medicine). Take sedative antihistamines at night and non-sedative in the day or at work.
• Consult a doctor if the condition shows signs of spreading or is distressful, or if there is an infection.

What your doctor can do for you

• Conduct skin allergy tests.
• Prescribe hydrocortisone (anti inflammatory cream) or other creams.
• Prescribe antibiotics for bacterial infection.
• Diagnose the type of eczema, help to identify the cause.
• Prescribe oral histamines.

Prevention tips

• Try to determine the substances that cause allergic reactions or skin irritation in you and avoid them as best as you can.

For products see Skin antiseptics & disinfectants page 498, Skin anti-itch agents & antihistamines page 491

This article is reffered to Malaysia Healthcare Guide - The family health guide, MIMS, 2nd edition, 1997, page 342-343

That You Will Love

Psoriasis

Psoriasis is a skin disorder characterised by thick, red patches of skin that are covered by white or silvery scales. It usually appears between the ages of 20 and 30, and it tends to run in families. It is not infectious although the patient can go into remission by treatment on spontaneously. Psoriasis, even in mild causes severe embarassment, shame and social isolation. Psoriasis, cannot kill easily but ruins people's lives.

Symptoms

• Raised red patches of skin, covered with dry white or silvery scales. The patches usually appear on the elbows, knees, nails (fingers and toes) scalp, and trunk.
• Itch, in some cases.
• Pitted, cracked, or deformed nails; loose nails.
• Profuse shedding of dead skin (looks like dandruff when on the scalp), in severe cases.
• Cracked painful skin, blisters on the palms and soles.

Complications

• Arthritis (inflammation of the joints), in severe cases.
• Impaired use of hands or feet.
• Depression due to social isolation and anxiety.

Cause
Not yet fully known, but is associated with:

• The overproduction of new skin cells (10 times as fast as normal), leading to the buildup of live cells (the cause of thickened patches) and profuse shedding of the outer skin layer.
• A combination of factors have been implicated including hereditary factors, stress, after physical illness or infection.
• Immunologic.

What you can do

• Sunbathe for 15-30 minutes daily, but not to the point of being sunburnt. A sun (ultraviolet) lamp is an alternative.
• Apply petroleum jelly to the affected areas.
• Avoid ingestion of alcohol.
• Avoid or learn to manage stress.
• Proper stress management and follow a healthy lifestyle. Keep a healthy body weight.
• Consult a doctor if you suspect psoriasis. He will help you control the disorder.

What your doctor can do for you

• Explain the condition; counsel.
• Recommend cream, ointment, or other treatment to clear the psorisis (eg coal targel).
• Prescribe anti-inflammatory medicine for arthritis.
• Recommend ultraviolet treatment.

Helplines
Psoriasis Association of Malaysia 03-254 6160

For other products see Skin medicated soaps/cleansing agents/gloves page 501

PRODUCT GUIDE
BE-PROSALIC K H Hoe
Ointment 15 g, 450 g (871164A)
Contains Betamethasone dipropionate 0.064%, salicylic acid 3%.
Uses Relief of skin inflammations, eg psoriasis, dermatitis & seborrheic dermatitis.
How to use Wash & dry the affected area. Apply the ointment sparingly to the affected areas & rub-in twice daily, or as prescribed by the doctor.
Precaution For external use only. If symptoms persist, consult your doctor. This medicament is to be used only for your present condition. Do not allow use by other person & discard unused ointment after healing is complete. Caution in use if to be applied to large areas, particularly in children. Avoid prolonged use & contact with eyes. Burning sensation, irritation, skin eruptions, dryness & changes in skin color may occur.

BEPROGEL K H Hoe
Topical solution 0.5 mg x 30 ml [913399A]
Contains Betamethasone dipropionate 0.064%
Uses Treatment of skin inflamation, eg eczema, dermatitis, seborrheic dermatitis & psoriasis.
How to use Wash & dry the affected area. Apply the topical solution sparingly to the affected areas & rub-in once or twice daily, or as prescribed by your doctor.
Precaution For external use only. If symptoms persist, consult your doctor. This medicament is to be used only for your present condition. Do not allow use by other person & discard unused solution after healing is complete. Caution in use if to be applied to large areas, particularly in children & in occlusive dressing. Avoid prolonged use.

BEPROGENT K H Hoe
Cream 1.5 g, 450 g (871377A)
Ointment 450 g (871378A)
Contains Per g Betamethasone dipropionate 0.64 mg, gentamicin sulphate 1.7 mg
Uses Treatment of eczema, dermatitis, seborrheic dermatitis & psoriasis aggravated by secondary bacterial infection.
How to use Apply the cream or ointment to the affected area twice daily.
Precaution For external use only. If symptoms persist, consult your doctor. This medicament is to be used only for your present condition. Do not allow use by other person & discard unused cream/ointment after healing is complete. Caution in use if to be applied to large areas, particularly in children & in occlusive dressing. Avoid prolonged use & contact with eyes. Deafness, burning sensation, irritation, skin eruptions, dryness & change in skin color may occur.

BEPROSOL K H Hoe
Ointment 15 g (940218A)
Contains Betamethasone dipropionate 0.064%
Uses Treatment of skin inflammation, eg eczema, dermatitis, seborheic dermatitis & psoriasis.
How to use Wash & dry affected area. Apply the ointment sparingly to the affected area once or twice daily, or as prescribed by your doctor.
Precaution For external use only. If symptoms persist, consult your doctor. This medicament is to be used only for your present condition. Do not allow use by other person & discard unused ointment after healing is complete. Caution in use if to be applied to large areas. Avoid prolonged use.
Warning Do not use in chicken pox, acne, viral, bacteria or fungal skin infections, on the eye or occlusive dressing.

BEPROSONE K H Hoe
Cream 15 g, 450 g (870597A)
Ointment 450 g (870596A)
Contains Betamethasone dipropionate 0.064%
Uses Treatment of skin inflammation, eg eczema, dermatitis & psoriasis.
How to use Apply the cream/ointment to the affected area as prescribed by your doctor.
Precaution Caution in use in applying to large skin areas, particularly in children & in occlusive dressing. Burning sensation, skin irritation, dryness, changing in skin color & skin eruptions may occur.

BETNOVATE
Glaxo Wellcome
Cream 5 g x 12's, 15 g x 12's, 100 g [860146A]
Ointment 5 g x 12's, 15 g x 12's, 100 g [870601A]
Contains Betamethasone valerate 0.1%
Uses Treatment of eczema, psoriasis, seborrheic dermatitis & other skin inflammations not due to virus, bacteria or fungi.
How to use Apply a small amount of cream or ointment to the affected area 2 or 3 times daily until there is an improvement.
Special Instruction occlusion may be applied, using a plastic film in severe cases.
Precaution Avoid prolonged use, especially in infants & children. Thinning of the skin may occur.
Warning Do not use in acne, chickenpox & mouth ulcers, viral, fungal or bacterial skin infections.

Keep all medicines safely out of reach of children.

BETNOVATE SCALP APPLICATION
Glaxo Wellcome
Scalp application 30 mL [870598A]
Contains Betamethasone valerate 0.1%
Uses Treatment of hair scalp infections eg psoriasis & severe dandruff.
How to use Apply a small amount to the scalp night & morning until there is an improvement.
Precaution Avoid contact with the eyes or use near an open flame. Avoid prolonged use.
Warning Do not use if there is scalp infection.

BETNOVATE-N
Glaxo Wellcome
Cream 5 g x 12's, 15 g x 12's, 100 g [871159A]
Ointment 5 g x 12's, 15 g x 12's, 100 g [871152A]
Contains Betamethasone 0.1%, neomycin sulphate 0.5%
Uses Treatment of eczema, psoriasis. Also helps relief insect bites, sunburn, prickly heat, itching arround the skin of the anus & external ear infections.
How to use Apply a small amount of cream or ointment to the affected area 2 or 3 times a day until there is an improvement.
Special Instruction Occlusive may be applied , using a plastic film in severe cases.
Precaution Avoid prolonged use, especially in infants & children. Thinning of the skin may occur.
Warning Do not use in acne, chickenpox & mouth ulcers, bacterial, viral or fungal skin infections. Do not use if you have a perforated or injured ear drum.

CELESTODERM-V
Schering Plough
Cream 15 g, 450 g [870619A]
Contains Betamethasone valerate 0.1%
Uses Relief of skin inflammations, eg eczema, dermatitis, seborrheic dermatitis & psoriasis.
How to use Apply a thin film of cream to the affected area 1-3 times a day.
Precaution For external use only. Avoid contact with eyes or mucous membranes, prolonged use or occlusive dressing, particularly in infants & children. Disconue use if irritation or rash occurs & consult your doctor.
Warning Do not use for bacterial, viral or fungal skin infections.

CELESTODERM-V WITH GARAMYCIN
Schering Plough
Cream 15 g, 450 g [871375A]
Contains Per g Betamethasone valerate 1 mg, gentamycin sulphate 1 mg
Uses Treatment of skin inflammations or allergy, eg eczema, pruritus (severe itch), dermatitis, seborrheic dermatitis & psoriasis.
How to use Apply a small amount of cream to the affected area twice daily, or as prescribed by the doctor.
Precaution For external use only. Avoid contact with eyes or mucous membranes. Caution in use when applying to large surface areas or under occlusive dressing.
Warning Do not use in bacterial, viral or fungal skin infections.

CELESTODERM-V WITH NEOMYCIN
Schering Plough
Cream 15 g [871173A]
Contains Per g Betamethasone valerate 1 mg, neomycin sulphate 5 mg
Uses Relief of skin inflammations eg psoriasis, eczema, dermatitis & seborrheic dermatitis.
How to use Apply a thin film of cream to the affected area 2 or 3 times a day.
Precaution For external us only. Avoid contact with eyes or mucous membranes, open wounds or damaged skin, prolonged use or occlusive dressing, particularly in infants & children. Irritation, burning sensation, dryness or deafness may occur.
Warning Do not use for bacterial, fungal or viral skin infections.

CLODERM SCALP APPLICATION
K H Hoe
Scalp application 30 mL [930240A]
Contains Clobetasol propionate 0.05%
Uses Treatment of hair scalp inflammation, eg psoriasis & eczema.
How to use Wash & dry the affected area. Apply the scalp application sparingly to the affected area & rub-in twice daily, or as prescribed by your doctor.
Precaution If symptoms persist, consult your doctor. This medicament is to be used for your present condition only. Do not allow use by other person & discard unused scalp application after healing is complete. Caution in use in children, large surface areas & long-term treatment. Avoid contact with eyes. Burning sensation, irritation, dryness, skin eruptions & changes in skin color may occur.
Warning Do not use in children below 1 yr, infection of scalp & dermatitis.

DAIVONEX Leo
Ointment 50 ug/g x 30 g [921382A]
Contains Calcipotriol
Uses Treatment of psoriasis vulgaris.
How to use Apply the ointment to the affected area twice daily, up to a maximum of 100 g weekly.
Precaution Avoid contact with the face since it may cause facial irritation. Wash hands carefully after application.

DERMOVATE
Glaxo Wellcome
Cream 5 g x 12's, 15 g x 12's, 100 g [870583A]
Ointment 5 g x 12's, 15 g x 12's, 100 g [870584A]
Contains Clobetasol propionate 0.05%
Uses Treatment of psoriasis, eczemas & other conditions which do not respond to less active steroids.
How to use Apply the cream or ointment sparingly to the affected area once or twice daily until there is an improvement.
Special Instruction Occlusion may be applied, using a plastic film in severe cases.
Precaution Avoid prolonged use, especially in infants & children. Thinning of the skin may occur.
Warning Do not use in acne & mouth ulcers, in children under 1 yr & in nappy rash, chickenpox & fungal, viral or bacterial skin infections.

DIPROCEL, DIPROGENTA, DIPROSALIC, DIPROSONE
All by Schering Plough, see page 466

EGOPSORYL TA Ego
Cream 30 g, 500 g [913162X]
Contains Sulphur 0.5%, coal tar 1%, phenol 0.5%
Uses Control of general psoriasis & psoriasis of the scalp. Chronic dermatitis.
How to use Apply 2-4 times daily. As the condition improves, reduce the number of times of application gradually.
Special Instruction Do not stop application suddenly. For enhanced effect, apply petroleum jelly over Egopsoryl TA.
Precaution For external use only. Irritation, acne-like eruptions on the skin & sensitivity to light may occur. Discontinue use if irritation occurs.
Warning Do not use on acutely inflammed or weeping skin. Do not use for a long time without consulting a doctor. If you are using another medication inform your doctor.

ESPERSON Hoechst
Ointment 0.25% x 30 g [870492]
Contains Desoximetasone
Uses Treatment of eczema, psoriasis, severe skin infections, burns, sunburn, insect bites & stings.
How to use Apply the ointment to the affected skin areas & if possible, rubbed in slightly 2 0r 3 times a day at the beginning of treatment. If there is improvement, the frequency of applications may be reduced. To prevent the disease to recur, treatment should be continued for some time even after the complete disappearance of symptoms.
Precaution Caution in use for infants & small children; long-term treatment & application to large area or near eyes.
Acne, changes in skin pigmentation may occur.

FLUCIDERM K H Hoe
Cream 15 g [913400A]
Contains Fluocinolone acetonide 0.025%
Uses Treatment of skin inflammation, eg eczema, dermatitis, seborrheic dermatitis & psoriasis.
How to use Wash & dry the affected area. Apply the cream sparingly to the affected areas & rub-in once or twice daily, or as prescribed by your doctor.
Precaution For external use only. Avoid contact with eyes. Caution in use in large areas or occlusive dressing. If symptoms persist consult your doctor. This medicament is to be used only for your present condition. Do not allow use by other person & discard unsed cream after healing is complete. Caution in use in children & in large areas of the skin. Burning sensation, dryness of skin, changes in skin color & skin eruptions may occur.
Warning Do not use in acne, chickenpox, viral, bacterial or fungal skin infections.

H-S-C K H Hoe
Ointment 450 g [871319A]
Contains Per g Hydrocortisone 10 mg, salicylic acid 20 mg, strong coal tar solution 30 mg
Uses Treatment of psoriasis.
How to use Apply the ointment thinly to the affected area once or twice daily depending on the seriousness of the condition. When use in scalp disorders, a small amount of ointment should be rubbed gently into the roots of the hair.
Precaution Avoid prolonged use or occlusive dressing, or when using on large areas especially in children. Caution in use when exposed to sunlight. For external use only. Not for use on the eyes. Burning sensation, dryness, change in skin color & skin eruptions may occur.
Warning If you are sensitive to sunlight, consult your doctor first before using this medicament.

K H HOE HYDROCORTISONE
K H Hoe
Cream 450 g [870471A]
Ointment 450 g [870472A]
Contains Hydrocortisone 1 %
Uses Treatment of skin inflammations, eg eczema, dermatitis & psoriasis.
How to use Apply thinly the cream or ointment to the affected area 1-4 times a day, depending on the seriousness of the condition. Occlusive dressing may be used when treating psoriasis.
Precaution For external use only. Avoid prolonged use or contact with eyes. Caution in use when applying an occlusive dressing, in children. Burning sensation, dryness of skin, changes in skin color & skin eruprions may occur.

NERISONE Schering AG
Cream 10 g, 50 x 10 g [900556A]
Fatty ointment 10 g, 50 x 10 g [900558A]
Ointment 10 g, 50 x 10 g [900557A]
Contains Diflucortolone valerate 0.1%
Uses Skin infections, eg in dermatitis, eczema, psoriasis, burns, sunburns & insect bites.
How to use Apply the cream or ointment thinly to the affected area 2-3 times daily.
Special Instruction Use the cream for weeping skin conditions; ointment for skin that is neither weeping nor very dry; fatty ointment for very dry conditions.
Precaution Avoid application to large areas of the skin or for prolonged periods. Avoid contact with the eyes.
Warning Do not use if you have viral diseases, eg chickenpox, shingles.

NEUTROGENA T/GEL SHAMPOO
Neutrogena
Shampoo 4.4 fl oz, 8.5 fl oz [911817X]
Contains Solubilized coal tar extract 2%
Uses Helps control psoriasis, seborrheic dermatitis & dandruff.
How to use Wet hair thoroughly. Massage liberal amount into the scalp. Leave lather on scalp for several minutes. Rinse well & repeat.
Precaution For external use only. Do not apply to inflammed or broken skin. If irritation develops, discontinue use & consult your doctor. Discoloration of gray, blonde, bleached or tinted hair may occur.

PINETARSOL BATH OIL
Ego
Bath oil 200 ml [912398X]
Contains Pine tar 2.3%
Uses Dry, itchy, inflammed, or flaky skin conditions. Supplementary relief of the symptoms of dry skin, eczema & psoriasis.
How to use Adults Bath Add 10-15 mL to a lukewarm water & bathe for 5-10 minutes daily, more often in severe cases. Shower Wet skin, then smooth a small amount onto the skin. Leave on for 2-3 minutes, then rinse off. Pat skin dry. Patients in bed, elderly patients Add 3 ml to a basin of water & wash skin gently. Pat skin dry. Infants Add 3 ml to a baby's bath. Pat skin gently dry. Do not rub.
Precaution For external use only. Avoid contact with eyes. Skin irritation may occur.

PINETARSOL/PINETARSOL GEL
Ego
Gel 100 g [912381X]
Solution 200 mL, 5 L [912380X]
Contains Gel Pine tar 1.6%, glycerin 5% Solution Pine tar 2.3%, triethanolamine lauryl sulphate 6%
Uses Relief of itch & inflammation associated with dermatitis, psoriasis & eczema, chicken pox, heat rash & eruptions in the napkin area of various origins.
How to use Gel : Use as an alternative for shower use & patients in bed. Apply to wet skin & gently smooth over affected area. Leave on for 2-3 minutes & rinse. Pat skin dry.
Solution : Bath Add 15-30 ml to a lukewarm bath (3 ml to a baby's bath) & bathe for 5-10 minutes daily, more often in severe cases. Pat skin dry. Shower Wet skin & spray on a small amount. Leave for a few minutes, then rinse. Pat skin dry. Patients in bed Add 15 ml to 3 L of water & sponge freely. Pat skin dry.
Avoid using with Soap on inflammed areas skin. Precaution For external use only. Avoid contact with the eyes & nostrils. Skin irritation & acne-like eruptions may occur.

PSORIGEL Galderma
Gel 4 oz [920445X]
Contains Coal tar solution 8.8% (equivalent to 1.75% coal tar)
Uses Controls skin itching, flaking & scaling associated with psoriasis.
How to use Apply to the affected areas 1-4 times daily or as directed by a doctor. Rub in well, let dry & remove any excess by patting with tissue paper.
Avoid using with Utltraviolet radiation treatment, other medicines for treating psoriasis. Precaution For external use only. Avoid contact with eyes. Upon contact, flush eyes with water. Do not use this medicament in or arround the rectum, the genital area or groin except on medical advise. Do not use on highly inflammed or broken skin. Avoid exposure to direct sunlight after applying this medicament. If undue irritation develops, discontinue use & consult your doctor/pharmacist.

SEBITAR Ego
Liquid 250 mL [912421X]
Contains Pine tar 1%, coal tar 0.2%, salicylic acid 2%, undecylenamide 1%
Uses Relief of itch, inflammation & flaking skin conditions associated with dandruff, seborrhea, eczema & psoriasis of the scalp.
How to use Wet hair, apply to the affected area & massage well. Apply to the remainder of the scalp & hair & work into a lather. Leave for 5 minutes, rinse thoroughly.
Precaution For external use only. Avoid contact with eyes, nostrils & broken skin. Skin irritation & acne-like eruptions may occur.

TRAMSONE K H Hoe
Cream 15 g [913401A]
Contains Triamcinolone acetonide 0.1%
Uses Treatment of skin inflammations, eg eczema, dermatitis, seborrheic dermatitis & psoriasis.
How to use Wash & dry affected area. Apply the cream sparingly to the affected area & rub-in once or twice daily as prescribed by your doctor.
Precaution If symptoms persist, consult your doctor. This medicine is to be used for your present conditon only. Do not allow use by other person & discard unused cream after healing is complete. Avoid contact with eyes. Caution in use in children & if to be applied to large areas or when under occlusive dressing. Burning sensation, dryness & skin eruptions may occur.
Warning Do not use in skin viral infection, eg chickenpox, acne & skin tuberculosis.

Are you in the habit of eating fast? If you are, you may tend to overeat! This is because your body takes 20 minutes to tell your mind that it's satisfied. Try to chew your food well, eat slowly and enjoy every bite. This way, your body will have time to tell your brain that you've had enough!

This article is reffered to Malaysia Healthcare Guide - The family health guide MIMS 2nd edition 1997 page 464-468