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Up to a fifth of the UAE population suffers from allergies.

Summary: In conversation: Dr Ahmed El-Rafel, Medical Director, Novomed Allergy and Asthma Clinic

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When was Novomed founded, what are the services offered?

Novomed was founded in Beverly Hills in the US in 2014. The brand was introduced to the UAE in 2017. Novomed Allergy & Asthma clinic opened the same year.

The services offered at Novomed Allergy & Asthma include the FeNO test, or exhaled nitric oxide test (a gas produced by cells involved in inflammation, and associated with allergic asthma), to determine how much lung inflammation is present and how well inhaled steroids are working to suppress it; Spirometry (measuring of breath), a common lung/pulmonary function test that measures lung function, specifically the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled (this can assess the degree of asthma and help its management accordingly); and the Allergy skin test and patch test.

How prevalent are allergies in the UAE and is enough being done to alleviate discomfort among patients?

Over 14 per cent of UAE residents suffer from asthma. Up to one fifth of the UAE's population may suffer from a form of allergy.

The first step in treating allergies is to know where your allergies are coming from. With skin testing, we can identify the culprit allergen. Once the cause is identified, we can treat your allergy with immunotherapy or allergy vaccines, also known as allergy shots. - Dr Ahmed El-Rafel, Allergist and Medical Director, Novomed Allergy and Asthma clinic

Asthma is treated with inhalers that can alleviate symptoms and prevent symptoms or attacks. A nasal allergy is treated with anti-allergic/antihistamine pills and steroid nasal sprays. A skin allergy can be treated in various ways based on the allergy type. All treatment options are available in the UAE.

What's trending in allergy treatment and immunotherapy, how accessible are they in the UAE?

The first step in treating allergies is to know where your allergies are coming from. With skin testing, we can identify the culprit allergen. Once the cause is identified, we can treat your allergy with immunotherapy or allergy vaccines, also known as allergy shots.

Allergy shots, in use since 1911, stimulate your immune system to fight allergies effectively and, most importantly, naturally. Most children and adults, including pregnant women, are suitable candidates for allergy shots.

Treatment involves injections of a small amount of allergy extract into the skin using a tiny needle, which means very little pain perception, especially among children. The extracts are made from the substances causing your reactions, such as pollen, mold, cat or dog dander or dust mites.

What causes allergies in children?

Dr Carlos Baptista, Paediatric Allergist at Novomed, gives the lowdown on why allergies are more prevalent in children and how the centre manages cases

Why are allergies more prevalent among children than adults?

The immune system starts to work pretty early in life. The way it interacts with the environment is what seems to give rise to allergic diseases. The pattern and distribution changes with age, the so-called allergic march. While infants are more likely to suffer from food allergies or atopic eczema, older children typically present with allergies like asthma or allergic rhinitis. The numbers worldwide are staggering: One in eight children have asthma, one in 13 suffer from eczema, one in eight have allergic rhinitis and around one in 20 have a food allergy. Some countries report higher numbers.

Some research indicates that excessive use of certain medications, like antibiotics, runs parallel to a rise in allergies. It is suggested that early antibiotic use changes the bacterial flora, and thereby the healthy gut environment, impacting the development of allergic diseases such as asthma and food allergies.

Have a written plan that includes details of what to do when you're fasting, when and how much asthma medicine to take, how to know when your asthma is getting worse and what to do if it does and finally, what to do if you have an asthma attack. If you notice that your child's asthma symptoms are getting worse, contact your doctor. If you're not using your child's asthma medicines or you have adjusted your medicines during the fast, you could be at risk from an asthma attack. - Dr Carlos Baptista, Paediatric Allergist at Novomed

Lifestyle plays a role with diet changes, leading to rising rates of chronic conditions.

What tips do you have for asthma patients planning to fast this Ramadan?

Have a written plan that includes details of what to do when you're fasting, when and how much asthma medicine to take, how to know when your asthma is getting worse and what to do if it does and finally, what to do if you have an asthma attack. If you notice that your child's asthma symptoms are getting worse, contact your doctor. If you're not using your child's asthma medicines or you have adjusted your medicines during the fast, you could be at risk from an asthma attack. If you would rather not use your preventer inhalers in daylight hours, speak to your doctor about using your preventer inhaler before sunrise and after sunset.

Carry your reliever inhaler (usually blue) at all times. Even if you have agreed with your doctor not to use your child's preventer inhalers during the fasting period, your reliever inhaler could save your life if you have an asthma attack. Again, most religious leaders agree that using an inhaler does not break your fast.

Don't skip your annual asthma review while fasting, book one before you fast (or if this isn't possible, soon after you stop fasting) so that your doctor can see how you're doing.

What are the common food allergies among children diagnosed at Novomed, how are they managed?

Most food allergies are related to a small number of foods: cow's milk, egg, soy, wheat, peanut, tree nuts, shellfish and fish. At the Novomed Allergy and Asthma Centre, allergies to cow's milk, egg, peanut and tree nuts are frequently diagnosed. Any child suspected of having a food allergy should seek the help of an allergy expert. The primary way to manage a food allergy is avoidance of the culprit food, but avoiding an allergen is easier said than done, which is where a dietitian helps. Once identified, Novomed's dietitians offer tips on avoiding foods that trigger your allergies, ensuring that even if certain foods are excluded from the diet, the important nutrients are being provided for.

Since fatal and near-fatal food allergy reactions can occur at school, it's important that parents make sure their child's school has a written emergency action plan, providing instructions on preventing, recognising and managing food allergies.

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Publication:Gulf News (United Arab Emirates)
Geographic Code:7UNIT
Date:Apr 25, 2019
Words:1124
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