An All-Natural Deadly Insecticide But Non-Toxic (& Drinkable) to Humans

It's about TIME!!! I read this fascinating story on NPR here.

An all-natural insect repellant called nootkatone found in Alaska yellow cedar trees and citrus fruits (like grapefruit) is being developed by the CDC. It is so safe for humans, it is even an FDA-approved food additive.

Nootkatone is not only safe for humans and the environment, it is a highly effective insect repellant. In fact, it is not only a bug repellant, but an insecticide causing death to biting insects like mosquitoes within 15 seconds.

Application of 2% nootkatone will also control ticks for up to 42 days at greater than 97 percent efficacy.

It is non-greasy, dries very quickly, and it has a very pleasant, citrus-y grapefruit odor to it.

Sounds too good to be true... But it is true! The only downside right now is that it is not available in the market, mainly because it is expensive — $4,000 per kilogram for highly purified food-grade material, which is used in parts-per-million amounts as a flavoring agent.

However, there are two companies that are currently working to make it available as insect control, hopefully in the near future!

Read more about this here.

References:
Susceptibility of four tick species, Amblyomma americanum, Dermacentor variabilis, Ixodes scapularis, and Rhipicephalus sanguineus (Acari: Ixodidae), to nootkatone from essential oil of grapefruit. J Med Entomol. 2011 Mar;48(2):322-6.

Mode of action for natural products isolated from essential oils of two trees is different from available mosquito adulticides. J Med Entomol. 2010 Nov;47(6):1123-6.

Ability of two natural products, nootkatone and carvacrol, to suppress Ixodes scapularis and Amblyomma americanum (Acari: Ixodidae) in a Lyme disease endemic area of New Jersey. J Econ Entomol. 2009 Dec;102(6):2316-24.

Use of novel compounds for pest control: insecticidal and acaricidal activity of essential oil components from heartwood of Alaska yellow cedar. J Med Entomol. 2005 May;42(3):352-8.

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Fauquier Hearing Aid and Hearing Testing Services Offered at Fauquier ENT

Even though our office has been offering hearing tests and hearing aid services in Fauquier County for over a decade, many people are still surprised when they learn they can get hearing tests, hearing aids, ear plugs, and other ear & hearing services in our office. The additional benefit is having a ENT specialist also present in the same office.

Furthermore, we offer a comprehensive suite of other related services including non-sedated ABR (auditory brainstem response) hearing testing to specialized custom ear plugs for hunters and musicians.

We evaluate all different ages from 1 day old infants to the 99 year old hearing impaired patient.

The full list of Fauquier Hearing services we provide include:

Comprehensive Hearing & Audiometric Evaluations

• Hearing Testing from Birth to Adult
• Newborn Hearing Screening and Follow-up
• Otoacoustic Emmission Testing (OAE)
• Auditory Brainstem Response Testing (ABR)
• Tone Burst Auditory Brainstem Response (TB-ABR)
• Bone Conduction ABR Auditory Brainstem Response (BC-ABR)
• Auditory Steady State Response (ASSR)
• Electrocochleography (ECoG)
• Central Auditory Processing Evaluations (CAPD)

Hearing Aid Services

• Hearing Aid Evaluations and Consultation
• Hearing Aid Dispensing
• Advanced Digital and Wireless Hearing Aid Technology
• Aural Rehabilitation Counseling
• Hearing Aid Service and Repair
• Hearing Aid Accessories and Batteries
• Resources for Parents of Deaf and Hard of Hearing Children

Balance Evaluations

• Electronystagmography (ENG)
• Vestibular Evoked Myogenic Potentials (VEMP) for Meniere's Disease
• Vestibular Rehabilitation Counseling
• Canalith Repositioning 

Hearing Conservation

• Custom Swim Plugs
• Custom Hearing Protection
• Musicians Filtered Earplugs
• Earplugs for Hunters
• Custom Earmolds for iPods, Cell phones, Headsets
• Assistive Listening Devices and Technology 

For more information, please go to our webpage here.

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Non-Sedated ABR & OAE Now Offered at Fauquier ENT

What is ABR/OAE? ABR (Auditory Brainstem Response) as well as OAE (Oto-Acoustic Emission) are specialized hearing tests that can evaluate whether a child/infant/newborn can hear without requiring them to respond.

These tests are completely non-invasive. Just like an EKG measures a heart's electrical activity using little stickers, ABR/OAE testing checks out the electrical activity from the ear to the brain. Special stickers on the head enable us to "see" whether the brain "hears" any sounds introduced into the ear.

If the ABR/OAE testing comes back normal, rest assured your child's hearing in both ears is normal.

Specifically, OAE is performed by placing an earpiece and playing clicks into the ear. The machine than listens for an echo which indicates that the ear "heard" the clicks.

ABR is performed just like an OAE, but special leads are placed behind the ear and forehead which measures brainwaves (just like an EEG or an EKG) to see if the brain "hear" the clicks produced by the testing machine. There are several different types of ABR (regular, tone burst, bone conduction, ASSR) depending on the age of testing and reason for the testing.

Traditionally, ABR/OAE testing required sedation in order to obtain accurate and reliable results as any muscle activity can lead to false reports. Furthermore, there are a lot of wires going from the patient to the equipment and as such required the patient to stay still. In the case of infants/children, this mandated general anesthesia in a hospital operating room.

Fortunately, new technology that our office possesses eliminates the need for such sedation and still obtain accurate ABR/OAE test results. Our office uses Vivosonic Integrity which incorporates wireless technology and the use of an in-situ bio-amplifier which amplifies biologic electrical activity at the ear source thereby reducing interference from environmental electric, magnetic, and RF field-induced noises. This also dramatically reduces artifacts which result from other muscular and ocular electrical activity.

What does this all mean for a patient?

It means that an ABR/OAE can be obtained in our office on a child/infant who is actively moving and playing around, eating food, chewing gum... all without being attached to wires. No sedation. No medications. No needles. No pain.

Click here for more info.

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A Crime For Doctors to Ask About Guns?

When I saw this report on ABC about a Florida politician wanting to make it a crime if a physician asks about guns in the home or else face 5 years in jail and up to $5 million fine, I could not believe it.

Who cares that more children die of accidents than of diseases.

It is standard practice for pediatricians to provide guidance on a variety of unintentional injury-prevention counseling for infants, preschool-aged children, school-aged children, and adolescents as well as their parents. These include:

• Traffic safety
• Burn prevention
• Fall prevention
• Choking prevention
• Drowning prevention/water safety
• Safe sleep environment
• Cardiopulmonary resuscitation
• Poison prevention
• Firearm safety
• Sports safety

According to the American Academy of Pediatrics, gunshot wounds account for one in 25 admissions to pediatric trauma centers in the United States. Furthermore, a gun in the home is 43 times more likely to be used to kill a friend or family member than a burglar or other criminal.

As the trite but true saying goes, an ounce of prevention is worth a pound of cure.

And in this day where healthcare costs are spiraling, how precious and common-sense it is to ask and provide guidance on firearm safety and security at a cost of one physician visit rather than a child accidentally getting shot and using up hundreds of thousands of dollars worth of surgeries, hospitalizations, studies, physician visits, etc.

Read the ABC report here.

Why as an ENT am I even bothered about this? It's because I often have to ask similar but what some people may consider very private questions akin to asking about guns (ie, oral sex).

Reference:
Office-based counseling for unintentional injury prevention. Pediatrics 2007 Jan;119(1):202-6.

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Kids Who Eat Fish and/or Live On a Farm At Less Risk of Allergies Later in Life!

Researchers in Germany who have followed thousands of families with children have discovered that children who eat fish before the age of 9 months had less allergies 4.5 years later than children who did not eat fish at the same age.

Furthermore, they found that school-age kids living on/near a farm were two-thirds less likely to suffer from hay fever or asthma than children with no exposure to a farm.

These studies will be published soon. Read the media report here.

Our office provides allergy testing and allergy shots / allergy drops.

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Home Remedies Preferred Over Drugs for Kids' Coughs and Colds

In the May 2010 volume of Otolaryngology-Head & Neck Surgery, researchers at Johns Hopkins published an article entitled "Over-the-counter cough and cold medications in children: Are they helpful?"

The blunt answer is that they do not!

At least before the age of 2 years, one should stick to "home remedies" to address a young child's cough and cold. Such home remedies include humidity, saline spray, and bulb suctioning of the nose. When they are a bit older and coordinated, saline gargles can be added to the regimen.

Read the abstract here.

Read a LA Times article on this here.

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