THE macOS is now much better with the release of the macOS Mojave, with several new features and new apps as well as a redesigned Mac App Store.

Among the fresh features are Dark Mode and Dynamic Desktop, which can make your Macbook and Mac desktop computer look much better.

I tested the Mojave on a MacBook Pro and loved Dark Mode, which transforms the desktop with its dark colour scheme that highlights content and makes it easier on the eyes in low light.

Dark Mode is beautifully integrated across built-in Mac apps including Mail, Messages, Maps, Calendar and Photos. Users can enable Dark Mode in System Preferences and third-party app developers can also integrate Dark Mode in their own apps.

The Mojave is the first macOS with Dynamic Desktop. The desktop background features a series of images that shift to match the time of day wherever you are in the world.

The desktop, featuring the rolling sand dunes of the Mojave Desert, transitions with different lighting variations based on the time of day, from dawn to midday, dusk and evening, to give the user an all-new experience.

If you store files on the desktop until it becomes cluttered, you will love Stacks, which can quickly clear up the mess. Stacks automatically organises files into neat groups based on file types, similar images, presentations, PDFs and text documents.

You can also customise Stacks to sort based on other file attributes, including dates and tags. Stacked files are easily accessed by clicking to expand them.

Screenshots on the Mojave is much easier to use and very useful indeed. It now comes with on-screen controls for quick access to new video capabilities. The controls include options for setting a timer and even choosing where to save the screenshots.

The Finder in the new macOS now features an all-new Gallery View that lets users skim through files visually, while a Preview Pane shows all of a file’s meta-data, making it easier to manage media assets.

Quick Actions now appear in the Preview Pane within Finder and allow you to do things like create and password-protect PDFs. Quick Look now lets you rotate and crop images, mark up PDFs and trim video and audio clips. Quick Look can be accessed by selecting a file and pressing the space bar. I found it very convenient.

A new feature of the new macOS is called Continuity Camera. You can shoot or scan a nearby object or document using your iPhone and have it appear on your Mac. You simply need to use the function “Import From” in Pages, Keynote, Numbers, Notes, Mail and other supported apps to scan or shoot.

Other useful iOS apps, including News, Stocks, Voice Memos and Home, come with the new macOS.

Use News to get information from trusted sources as selected by the editors and personalised for you. Use Stocks to track the market and read the news alongside your personalised watch-list with quotes and interactive charts.

The Home app allows you to control HomeKit-enabled accessories, from turning on lights to adjusting a thermostat or checking a baby monitor. And Voice Memos makes it easy to record personal notes, lectures, meetings, interviews or song ideas with the Mac’s built-in microphone and then later access them through iCloud from iPhone, iPad or Mac.

The Mojave has the Mac App Store completely redesigned. It now features rich editorial content that makes it easier to find apps and a Discover tab that highlights the hottest new apps, plus Create, Work, Play and Develop tabs to find apps for a specific project or purpose.

The Safari web browser of the new macOS comes with enhanced Intelligent Tracking Prevention that helps prevent social media “Like” or “Share” buttons and comment widgets from tracking users without permission.

Safari also presents simplified system information when you browse the Web to prevent data companies from creating a unique “fingerprint” that can be used for tracking.

Safari helps you better manage passwords by automatically creating, auto-filling and storing strong passwords when you create new online accounts.

Safari now supports website icons in the browser tabs so you can easily identify their open tabs at a glance. This can be enabled in Preferences.

Another improved function is Siri on Mac that lets you control HomeKit-enable devices. It has improved knowledge of food, celebrities and motor sports.

Mail comes with a new feature with an emoji menu within the composition window. This makes it quick and easy for you to add emojis to your email.

And the FaceTime video call of macOS Mojave now lets you add up to 32 people to your group video call. And the same call can include both audio and video callers.

The macOS Mojave is available today as a free software update for Macs introduced mid-2012 or later, plus 2010 and 2012 Mac Pro models with recommended Metal-capable graphics cards.

COMPATIBLE WITH:

MacBook early 2015 or later

MacBook Air mid-2012 or later

MacBook Pro mid-2012 or later

Mac mini late 2012 or later

iMac late 2012 or later

iMac Pro all models

Mac Pro late 2013, plus mid-2010 or mid-2012 models with recommended Metal-capable graphics card

HARD DISK SPACE:

2GB memory, 12.5GB of available storage space, or up to 18.5GB of storage space when upgrading from OS X Yosemite or earlier

JIM THOMPSON brings elegance to the home this winter with a new furniture collection that revives the iconic designs of leading American architect Ed Tuttle.

Committed to creating contemporary designs that represent local culture, Tuttle was behind the striking makeover of the Park Hyatt Paris-Vendome, the Park Hyatt Milan and Aman Resorts in Indonesia. More recently he has undertaken renovation projects for the five-star Sukhothai Hotel in Bangkok and Chiva-som International Health Resort in Hua Hin.

Famous for his minimal but luxury style, Tuttle plays with geometric forms to create abstract sofas, semi-precious stone hand-inlaid tables, comfortable lounge chairs and hand-crafted lamps. This is a made-to-order service, allowing customers can choose their own favourite wood, upholstery fabric and colours from a catalogue. The work takes between 45 to 90 days to complete depending on the designs.

“The partnership between Jim Thompson and Tuttle began 15 years ago when Tuttle expanded his reach to include interior design. He invited us to hold an exclusive production license of Ed Tuttle Furniture by Jim Thompson to supply furniture and home furnishings for his design projects,” says Sasaya Buranastidporn, director of Home Furnishing Asia Pacific & International Operations.

“Our furniture was made in Austria and France but all textiles were produced at the Jim Thompson Factory in Pak Thongchai district of Nakhon Ratchasima. Today, all the production is based in Thailand because Tuttle is working on more projects in Asia.”

To help customers visualise how the pieces can be used in an interior, Tuttle has designed and styled four different vignettes at Jim Thompson Home Furnishings Showroom on Surawong Road. The room showcases his special furniture in juxtaposition with fabric walling and textile panels as well as contemporary Southeast Asian art he personally picked.

Focusing on simplicity and classic designs for urban living, the remarkable Patsri large lounge chair and low dining armchair are made of solid teak and finished with detachable chenille canvas cushions, making them a perfect fit for both indoor and outdoor spaces.

Using special techniques to form their dedicated structure, these low-seat chairs showcase the very finest of Thai craftsmanship. They take an inspiration from the chairs Tuttle designed for his friend Patsri Bunnag to use on their shared yacht the “Mahabhetra”.

The Maia dining chair and armchair have a chic, sleek feminine character that is influenced by his celebrity friend Mai Vejjajiva. Their frames are made of ash and finished with a zebrano and ebony veneer for a classy look.

The Lite sofas and daybeds come in the shapes of C and L. Their structures are a mixture of ash wood and metal, complete with refined upholstery that easily matches other furnishings. Following its name –sky in French – the Ciel series gives a feeling of floating on air when sitting on its Meridien sofa, two-seater sofa and armchair thanks to the super soft seat stuffed with duck feathers.

Tuttle has added some new tables and lamps to his home furnishing collection. One of the highlights is the Square Gem side table, adapted from the full dining table at Park Hyatt Milan, for which hand-inlaid techniques are used to create a beautiful top made with such gemstones as malachite, agate and onyx.

The black Micro Mosaic table and console are complemented with agate and amethyst stones, while the Organic Pair table has smoked brass legs and free-form African granite finishing and the Gueridon features a gunmetal-shaded stainless steel frame, mahogany legs and African granite top.

Perfectly paired with Patsri chairs, the Drilled Glass low dining table comes with teak legs wrapped with ropes. The X stainless steel tables are scratch-resistant and come in three colours of gunmetal, rose-gold and gold. There’s also the Wood Column mahogany table lamp with a silk shade, the inside of which is adorned with woven gold ropes.

Tuttle also presents a new design of hand-woven, silk-rayon fabric called Rice that is available in 22 colours to complete his furniture. The look is minimal yet sophisticated, with the natural yarns in the warp and weft making it the perfect accompaniment for the complex silhouettes.

Find out more about the furnishings by calling (02) 632 8110 or emailing showroom@jimthompson.com.

The Hong Kong Cyclothon – the biggest cycling event in Hong Kong featuring four races and five cycling activities – has become a must attend event among cyclists from around the globe. The fourth edition, held last weekend, saw an increase in the number of amateur and professional cyclists of more than 5,000 over last year.

“This cyclothon has gone from strength to strength in just four short years and continues to draw more top-notch cyclists,” says Anthony Lau, executive director of the Hong Kong Tourism Board.

“The high level of competition means that we have been able to upgrade the UCI Asia Tour Class 1.1 road race into a world-class spectacle, which is in line with our continued efforts to enhance every element of our diverse range of mega events and underline Hong Kong’s status as the events capital of Asia.”

Adrian Ferguson, a civil engineer from Fermanagh in Ireland, who has lived in Hong Kong for six years but only signed up for the cycling event this year, was delighted with the race.

“It’s brilliant. The route is very flat, and yes it is very good,” said Ferguson, an experienced cyclist who brought along his wife and two children.

This year too saw celebrities and cyclists fly in from Thailand to take part, among them model Surampha “Golf” Yokchotisakul and Channel 8’s actress Rattanaporn “Mint” Klinkularbhirun, who took part in the 50-kilometre ride. Also along for the ride was Pawin “Pong” Suwannacheep, the drummer of modern rock band ModernDog who signed up for the Elite Partners Men’s Open Race over three laps.

“It was really exciting cycling over the bridges, which usually are used for vehicles, and crossing the Hong Kong islands. The wind was very strong,” said Golf.

“Before coming here, I saw some pictures of last year’s cycling event and was astonished at the suspension bridges and the tunnels, which are closed to traffic for this event. The hardest aspect was the 10 cutoff times throughout the 50-kilometre distance. We were really wondering how we would manage our time,” added Mint.

The 10 cutoff times of the 50km ride were at junction of Jordan Road and Lin Cheung Road at 3.6km, Nam Cheong (the junction between Tsing Sha Highway and West Kowloon Highway) at 6.5km, Tsing Long Highway (near the slip road to Tsing Yi Road West) at 14.3km, Nam Wan Tunnel (near Sai Tso Wan Entry) at 15.2km, Nga Cheung Road Flyover (ICC) at 25.9km, Nam Wan Tunnel (near the Sai Tso Wan Entry) at 28.2km, Tsing sha Highway (near Lai Po Road) at 34.3km, Eagle Nest Tunnel (Shatin Toll Plaza) at 38.5km, Eagle Nest Tunnel (Kowloon Side Entry) at 40.7km, and Nga Cheung Road Flyover (ICC) at 47.5km.

Golf and Mint, key opinion leaders and in Hong Kong at the invitation of the Hong Kong Tourism Board, agreed that the most exhausting part of the route was the climb over the long bridge. The admitted they found it hard, even though they had experience of cycling up hills during the International Angel Challenge in Ratchaburi.

“Cycling on the long bridge was tiring and we had to struggle against the wind. We tried to control our bikes while also watching out for other cyclists riding into us,” said Golf.

“We saw one cyclist who had come off his bike and had blood pouring from a head injury.”

I also took part in the 50km ride and was shocked to see the number of injuries. I passed one cyclist who had been left unconscious by his fall and others with obvious though not life-threatening injuries.

“I think that the road was too narrow for the large number of cyclists,” said Golf, who won plenty of admiring looks from hot-blooded Hong Kong males. “I was nearly hit by another cyclist though all the local bikers were friendly and generous.”

“For me, it was thrilling to cycle through the tunnels though I found it more difficult to breathe. We don’t have many tunnels in Thailand,” she said.

“The views were stunning though,” added Mint. “And I was really impressed at how smooth the expansion joints on the bridge were.”

Drummer Pong was excited about taking part in the Men’s Open Race but discovered the age categories defined in the registration meant little in actual race terms.

“I ended up cycling behind some 70 stronger cyclists. But I did my best to follow the group and am pleased to say I didn’t finish last.

“You really need a proper warm up to take part in this kind of race. Usually, I spend longer warming up on my indoor bike but here I had to share with other cyclists so only got 10 minutes. The route took us over bridges and through tunnels and there were a lot of sharp curves. It was fun though I tried to remain aware of safety throughout.”

The climax of this fourth edition Hong Kong Cyclothon was the finale of the Hammer Series 2018 – the first Hammer Series race to be held in the SAR. Some of world’s top professional cycling teams were taking part, among them BMC Racing Team and Trek-Segafredo from the USA, Bora-Hansgrohe and Team Sunweb from Germany, Quick-Step and Lotto Soudal from Belgium, Mitchelton-Scott from Australia, and Team Sky from Great Britain.

The Mitchelton-Scott claimed victory though they admitted the going was tough.

“It was really hard,” said Matteo Trentin, after the finish. “Especially because the time trial followed immediately after the 40km point race. There wasn’t any time to recover but I liked it.”

“It’s a really good way to round out the season,” added Cameron Meyer. “It’s an important event to us – it’s new in the world of cycling and for us to win the series in a city like Hong Kong is really great.”

Wat Krachee is a temple with a stake through its heart. Dating back to the middle Ayutthaya period, approximately 1550 AD, or 2093 BE by the Buddhist calendar, the temple’s chedi has two intertwined trees growing from its main section, pushing the spire precariously off kilter. With the mortar binding the bricks together almost entirely eroded, the structure has shifted and settled to the degree that the original shape of the base is not even sure.

By any measure, the rescue and conservation of Wat Krachee seems an ambitious undertaking, navigating not only considerable structural complexities but also the social considerations of a project carried out in a community’s backyard. And yet it is also a test case. Having chosen Wat Krachee as a pilot project –admittedly a difficult one – Unesco Bangkok, the Thai Ministry of Culture’s Department of Fine Arts and other partners have brought together a multidisciplinary group of archaeologists, engineers, materials scientists, architects, craftspeople and artisans to develop a plan for Wat Krachee chedi that can address every possible dimension of value-based conservation issues.

This collaborative approach marks a fundamental shift in Thailand’s strategy to protect its cultural heritage. Jumphot Trassiri, a former FAD civil engineer, has watched that process evolve over the course of his career.

“There’s been an enormous change in the working method. When I first joined the Fine Arts Department in 1978, it was a small group of people who went to a site and all the decisions were taken by just that little group,” Jumphot recalls. “We began to move towards doing more studies and finding evidence before coming up with a conservation plan. Now we’re getting to the point with this project where we have all of these different disciplines involved, which allows us to have a more comprehensive approach to the restoration work and, in my opinion, moves towards more international standards.”

Specialists from different fields also bring multiple perspectives to the philosophy of conservation for each project. Even within Ayutthaya National Park, there is no single standard that is applied to the conservation of sites, although the first considerations are the imminent danger to the structure as well its significance. The latter term, however, can be defined in many different ways, particularly with the participation of so many specialists, and evolving conservation philosophies have expanded beyond the traditional importance assigned to historical, architectural and archaeological definitions.

Particularly at sites such as Wat Krachee, which is embedded in the Ayutthaya community, conservation is also invested with considerable cultural and religious significance.

“You have to consider the difficulty of doing conservation work on a site in the public,” says Chatchai Raksa, a sculpture and mural conservator with the FAD.

“People who are visitors have the right to have their own interpretations of the aesthetic, historical value or archaeological meaning.”

In practice, that means taking the local community into account regarding conservation goals. “You need to consider the balance of both sides of the archaeological and historical accuracy and how this can convey the same meaning to the people who come and see it,” Chatchai adds. “As a professional doing conservation work, the goal is to make it look as it was originally, and to stabilise it. My seniors always taught me, the more you change, the less value you maintain; the less you change, the more value.”

That light-handed ethic has not always been the case, as testified by other, more intrusive restorations that covered over original designs and features with new, anachronistic structures. But in Wat Krachee’s case, however, the conservationists’ concern for minimal alterations has to be reconciled with an urgent priority – preventing the chedi from collapse.

The two trees that sprout from the chedi’s side, just above the long-ago pillaged reliquary, are the most apparent structural threat. For Manop Kuanpoj, a veteran brick mason at the park, however, the trees are not a problem unique to Wat Krachee. One of the most iconic images symbolising Thailand, after all, is that of a Buddha head enveloped in the roots of a Bodhi tree, which comes from Wat Mahathat, another temple situated in Ayutthaya Historic Park.

Caretakers and conservators have had plenty of experience dealing with unruly nature, which has led to differing opinions whether the trees should be removed from the chedi entirely. “To keep them together, you need to really cut back the tree to maintain a bonsai growth,” Manop says. “But the easier way would be to gradually cut it away and replace it with bricks.”

Even the decision whether to leave the trees raises questions about what conservation approach to choose. The original Ayutthaya period builders clearly did not envisage invasive flora as a feature of the structure and yet, just as at Wat Mahathat, nature has become an integral part of the temple and its historicity. Newer approaches to conservation seek to stabilise a structure, but also document changes over time, including previous deterioration and restoration efforts that sometimes did more harm than good.

Setting aside those considerations, Manop judges that the basic stabilisation project would be more difficult if the trees were allowed to remain, but there are other major structural issues to contend with in any event. “Right now there is no such thing as an assumption design to work on. The difference between other main sites and here is that it is difficult to find the evidence,” he explains. “For example, the trails of the masonry are all collapsed, but at other bigger sites the structure is such that, if I have to fix the bricks, I know where the next brick goes to follow the line. It’s not only about the loss of material, but the loss of the form as well.” In addition to the erosion of mortar, the amorphous structure is also partly attributable to the size of the original bricks, which are thinner than the four- or five-centimetre-thick bricks used in other monuments.

Even as the original form is still being assessed, the emergency repairs require immediate new applications of mortar to strengthen the chedi under the threat of the rains. At some monuments, restoration efforts have in the long-term done more harm than good, using new building materials such as cement that are stronger or have less porosity than the original, which actually accelerates its erosion. Even at Wat Krachee, there is evidence of previous restorations that have not been documented, requiring conservators to distinguish between the newer material and old.

The multi-disciplinary approach is being brought to bear on the problem. Among the experts working at the site is Dr Nuanlak Wadsantachat, a conservation specialist from Silapakorn University’s Faculty of Architecture, whose recent work on the catalysation of mortar involved taking samples from 12 monuments constructed during three different periods of Ayutthaya architecture.

“I tried to find if the materials were different during each period, but what I found was that it was different even for each period and even within the same monument,” Dr Nuanlak says.

“That’s why I came to the conclusion that we have to test, categorise and study the materials and construction techniques in every monument on a case-by-case basis.”

Different materials might have been available over the course of construction, which could have taken more than a year depending on the size and importance of the monument. Dr Nuanlak also speculates that aesthetics played a role: if a structural feature is clearly visible, that area was made with quality material, while the hidden bits got the leavings.

As the team of several dozen experts and artisans work on the chedi – mapping and researching, cleaning and reinforcing, formulating the eventual plan – all such considerations have to be taken into account and reconciled. In the Wat Krachee project, there is no single authoritative boss on site, requiring discussion and consensus on each aspect. Engineer Jumphot, reflecting on the project from his vantage point of 40 years of experience, sees only strengths from this approach.

“It will definitely be slower, but that is not a negative thing as such. Not taking a multidisciplinary approach on the other hand, because of constraints like trying to quickly use up a budget, that’s how you end up with mistakes,” he muses.

“A lot of times conservation only treats the symptoms, but not the disease, so it’s going to come back.’

And so the work goes on. Having helped to facilitate the coordination of the project and bring the disciplines together, Unesco Bangkok is handing its role over to the Fine Arts Department, in a conservation effort that should become a national model. The consultations will continue to determine the fate of the chedi, not to mention the two trees, while work continues on the foundations and more mysteries wait to be uncovered.

• Jeremy Walden-Schertz is the Media Officer at UNESCO Bangkok

The tattooing technique involves utilising a blade or needle to draw or make fine incisions in the top layer of the skin. The ink is applied and left to be absorbed by the skin. Accomplishing this look is easier than ever but what do you do when you want fuller brows and end up with bad brows – ones that are disproportionate, an unnatural shape, discoloured or over bold?

Fortunately these nightmare brow tattoos can be removed. The ink used in tattooing the brows can be lightened or removed just like any other tattoo with laser treatment.

The latest generation of laser, known as the “Nu Pico Laser”, holds more promise in effectively removing tattoos, with fewer sessions and less unwanted side effects.

The “Nu Pico Laser” uses a sophisticated, cutting-edge technology called “picosecond”. Picosecond technology works at a trillionth of a second – 1,000 times faster than a traditional laser that uses nano technology.

The picosecond technology delivers laser energy into the skin in a much shorter time, producing a photoacoustic effect that’s non–thermal, which can shatter tattoo ink into miniscule particles.

The tiny broken ink particles can be then easily removed from the body by the lymphatic system. To remove the brow tattoo, you will need approximately three to five sessions, half the number of treatments you would require with a nanosecond laser. The clinical efficacy of picosecond laser in removing tattoos was first reported in the late 1990s and today it’s more effective and faster than ever before.

As it uses a shorter pulse duration, this novel laser has lower a risk of thermal damage, causes less pain and reduces post-treatment side effects such as burns or hypopigmentation. It is effective for any skin type, including Asian skin.

The Nu Pico Laser uses three distinct wavelengths of energy, which give a dermatologist the versatility to treat the multi colours of tattoo ink. Before the tri–wavelength Nu Pico Laser, blue and green inks were two of the most difficult colours to remove. Thanks to newer technology, laser tattoo removal has become more effective and easier. Patients can return to normal activity immediately following treatment as there is no downtime or special wound care requirement.

THANISORN THAMLIKITKUL MD is a member of the American Society of Cosmetic Dermatology and Aesthetic Surgery and certified in dermatological laser surgery. Send your questions for her to info@romrawin.com.

Two years ago, a primary school girl in Surin was catapulted into the headlines after being forced to prostrate herself at her teacher’s feet in front of hundreds of her fellow students. Her crime? Refusing to eat the egg tofu soup served as part of the school lunch having been told by her doctor that it could potentially cause an allergic reaction. Her teacher refused to believe her and ordered her to prove it by eating the egg tofu. And while this time the child was lucky and didn’t develop an allergic reaction, the results could have been very different.

The video clip of the incident went viral and the teacher was condemned for her misguided handling of the situation. But she is far from alone. Many Thais consider a food allergy a minor problem and deal with symptoms based on what their family and friends say rather than medical advice. Some even swallow an antihistamine before eating what they are allergic to. And several believe the old wives’ tale that an allergy can be cured by eating a little of the food culprit everyday until the body is able to resist.

Such behaviour is not only stupid – it could potentially kill you.

Prof Emeritus Pakit Vichyanond, director of the Samitivej Allergy Institute (SAI) at Samitivej Thonburi Hospital, is emphatic about the dangers.

Even though Thailand isn’t facing the same level of severe allergies like in the US, Europe or Australia where people die from food allergies – the well-reported case of a British teenager collapsing and dying after ingesting the tiniest trace of sesame in a sandwich – the prevalence of food allergies globally has increased by between 300 per cent and 400 per cent over the last 15 years. Here in Thailand, allergies among young children have risen from 0.5 per cent to 4 per cent.

Dr Pakit, who worked at Siriraj Hospital before his retirement, says he used to see perhaps one or two food allergy cases a year. Today, he is seeing two cases a week.

“Many people do not understand or are not aware of the danger of food allergies. Most of them think that the symptoms are not severe, just skin rashes or other conditions that are inconvenient rather than fatal. In fact, if the allergy affects more than two body systems or leads to anaphylaxis, death might very well occur. Patients with severe symptoms of a food allergy should seek emergency treatment and be properly diagnosed by a medical specialist,” he says.

Prof Emeritus Pakit Vichyanond

The symptoms of a food allergy are one of the most common health conditions in Thailand and can be found in all age groups from infants to the elderly. More than 1,660 foods can cause allergic reactions, but eight foods account for 90 per cent of allergic reactions: tree nuts (cashews, macadamia), peanuts, eggs, milk, fish, soy, shellfish (shrimp, crab) and wheat. In Thailand, seafood is considered a major allergen in adults but wheat flour can cause severe allergies in children.

Food allergies produce symptoms that can affect five systems: the skin (hives, rashes), respiratory system (stuffy or runny nose, sneezing, asthma), gastrointestinal tract (vomiting or diarrhoea) and the neurological and cardiovascular systems (headaches, impaired breathing, shock, a drop in blood pressure). If reactions occur in two or more systems, this is anaphylaxis – the life-threatening allergic reaction that needs to be treated right away with an epinephrine (adrenaline) shot and the victim taken to hospital as soon as possible. Antihistamines have no effect on anaphylaxis.

“In the last three years, our institution is seeing more and more patients allergic to wheat flour. It can be life-threatening if a certain amount of food containing wheat flour is consumed,” says Dr Pakit.

Open since 2015, the Samitivej Allergy Institute regularly invites leading global allergy organisations and well-known allergists to analyse and share perspectives of allergy symptoms with the aim of developing an efficient treatment in Thailand.

Last week, the honoured guests were Dr Hugh A Sampson, chairman of the Icahn Medical School at Mount Sinai Hospital in the United States and a well-known allergist-immunologist and Dr Gary Wong, the president of Asia Pacific Association of Paediatric Allergy, Respirology and Immunology who participated in the first International Samitivej Allergy Institute Symposium dubbed “Food Allergy: The State of the Art”.

The event was organised to provide in-depth information about critical trends in food allergies that can cause life-threatening reactions and how best to clear up the public misunderstandings of the symptoms. The symposium allowed for an exchange of ideas between the global allergist and allergists from the Samitivej Allergy Institute and specialists from all Samitivej Group affiliates.

“In the United States, we have a much larger problem with food allergies than what you see in Thailand. One of the things that’s become very clear over the last 10 years is that food allergy is really a global problem and we’re seeing an increase all over the world. While the rate in Thailand is probably at this point still under two per cent, I can assure you as time goes on you’re will see it rise just as it has in other countries,” Dr Sampson says.

Drs Hugh A Sampson and Gary Wong

“Asia is a very special area: there are countries in which the incidence of food allergy is very high such as Japan and Singapore and countries where it is very low like Vietnam or Indonesia. Thailand is somewhere in between – not the lowest but not the highest. We are seeing a rapid change in the lifestyles of people in the Asia Pacific region including in Thailand. This happens when countries go from a rural farming type of environment to predominantly urban setting. Here, the conditions are more sterile and people eat a lot of processed food thus reducing their immunity and leading to a rise in food allergies. I hope all the lessons we have learned from North America, Europe and Australia will mean we won’t make the same mistakes that result in a very high level of allergies,” Dr Wong adds.

Wong believes that the environment is much more important than genetics in the prevalence of food allergies. “Genetics may contribute to the development of allergies but if you look at people with food allergies, for example, many of them, particularly in Asia, have no family history of food allergies or asthma. Yet migrant studies show that the children born in Asia to Asian parents who settled in Australia do not have a lot of allergies but the children born in Australia have more and worse allergies than Caucasian Australians. That is evidence that we Asians are not protected from the development of allergies and that given the right environment and exposure we will develop them,” he says.

Prof Pakit says the best way to ensure proper treatment for food allergies is to undergo diagnostic tests to find out which particular food or foods are causing an allergic reaction. When the causes of food allergies are identified, the doctor can recommend treatments to reduce symptoms and prevent allergy attacks.

One of these treatments is the Oral immunotherapy treatment (OIT) that involves administering gradually increasing amounts of the food allergen under medical supervision. “And you increase it slowly over time with the idea that you desensitise the patient. This has been done with drug allergies and through shots that introduce pollens and environmental allergens,” Sampson says. “But this treatment must be conducted under the strictest medical supervision.”

The OIT is available at the Samitivej Allergy Institution also and treatment can take several months if not years.

“With oral immunotherapy, we can generally desensitise about 75 to 80 per cent of patients. The one downside to oral immunotherapy is there are lots of adverse reactions. Basically all the children we treat are going to experience some symptoms such as itching, itchy mouth or throat or stomach aches. About five per cent get more severe allergic-reactions,” Sampson says.

He adds that another treatment is epicutaneous immunotherapy, which uses a patch is containing the allergen. More often than not, this contains peanut and is placed on the child’s back. The patch is replaced every day and the rate of major adverse reactions is much lower. “Though they do get itchiness and redness around the patch but not the other symptoms we see with oral immunotherapy.

“But what I need to stress is that neither of those treatments cure the food allergy. What they will do is protect patients from what we call the contamination levels. In the US where we eat peanut butter sandwiches all the time, this is not to make all these peanut butter allergic patients be able to eat large quantities of peanuts. There are many other forms of therapy that are currently in phase one trials. Some involve DNA vaccines, nanoparticle vaccines and common combinations with cytokines. These are all probably five to 10 years off but we are looking at many new ways to try and treat food allergies,” says Dr Sampson.