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No Cancer Link With Cell Phone Towers

2010-06-25T16:29:00.001+07:00

June 24, 2010 (London, United Kingdom) — There is no association between a pregnant mother's proximity to a cell phone tower and early childhood cancers, according to results of the largest study of its kind to date.

Paul Elliott, MD, PhD, professor of epidemiology and public health medicine from Imperial College, London, United Kingdom, led the research. The paper was published online June 22 in BMJ.

"We found no pattern to suggest that the children of mums living near a [cell phone tower] during pregnancy had a greater risk of developing cancer than those who lived elsewhere," Dr. Elliot told Medscape Oncology.

He added that unlike previous studies of associations between cancer and cell phone towers, this study used larger numbers of cases so was not subject to the selection and reporting biases seen with smaller sample sizes.

Case–Control Study

In this British study, data on nearly 1400 children younger than 4 years were drawn from the national cancer registry. All case subjects had leukemia or tumors of the central nervous system or brain from 1999 and 2001. Each child with cancer was matched with 3 control subjects for sex and date of birth from the national birth register.

The distance between registered address at time of birth and the nearest of 81,781 cell towers was assessed for each case. Likewise, total power output across all towers within 700 meters (765 yards) of the cell tower was recorded. The researchers then computed modeled power density at each birth address for towers within 1400 meters (1531 yards). Exposure beyond 1400 meters was considered to be at background levels.

This information was correlated with the incidence of cancers of the brain and central nervous system, leukemia, and non-Hodgkin's lymphomas, and all cancers combined.

In their paper, the authors acknowledge that despite low levels of exposure from cell phone towers, there are theoretical concerns about the effects on children because of the relatively greater dose (per kg body mass), the potentially greater susceptibility of children than of adults, and the potential effects of lifelong cumulative exposure to radiofrequency electromagnetic fields.

Only cancers with a short latency period, typically within the first 4 years of life, were investigated. In addition, the study was restricted to exposure of children in utero, although the authors state that postnatal exposure might be relevant to the incidence of early childhood cancers.

"We only looked at estimated exposures during the fetal period and were unable to look at exposure patterns for the children after birth. This is clearly a limitation and it would have been good to look at data after birth, if they had been available. However, our findings do not suggest any link between early childhood cancers and [cell phone tower] exposure," added Dr. Elliott.

Encourage Patients Not to Worry

In an accompanying editorial, John Bithell, MA, DPhil, honorary research fellow at the Childhood Cancer Research Group, University of Oxford, United Kingdom, points out that of the 3 surrogates of exposure considered in the study, the most convincing is the modeled power density at varying distances from the nearest tower. "This is probably the best measure used in an epidemiological study to date."

However, he adds that individual exposure could still vary substantially according to building design, lifestyle, and migration, so the prospects for good estimates of individual exposure are poor.

Based on these results, he concludes that the medical profession should encourage their patients not to worry about harm caused by proximity to cell phone towers. "The epidemiological evidence is also supported by experimental evidence, which has so far failed to show any biological effects — in vivo or in vitro — that might lead us to worry about the impact on health," concluded Dr. Bithell.

However, Sam Milham, Jr. MD, MPH, former chronic disease epidemiologist at the Washington State Department of Health and clinical associate professor at the University of Washington, School of Public Health, Seattle, believes the study used the wrong metric.

"All cell towers operate on direct current, which is changed from the grid alternating current (AC) by switching power supplies. These interrupt the AC current and create high-voltage transients, which get back into the grid. The transients are a potent carcinogen," he explained.

Dr. Milham, who was approached by Medscape Oncology for comment, is currently investigating a cluster of cancers in school teachers in Palm Springs, California. He explained the relation between distance from tower, transient levels, and cancer cases.

"It has a cell tower 20 feet from a classroom wing. The transient levels in the classrooms are inversely related to distance from the tower base, and the cancer cases are found to be overrepresented in the rooms near the tower. This is a close-in phenomenon. I also find very high transient levels in firehouses and businesses near cell towers."

"The BMJ study's high-dose group, by distance, was under 612 meters [669 yards]. If they can show me that the case–control risks were similar for residences less than 100 and 200 meters [109 and 218 yards, respectively] from the tower, I'll accept their findings," Dr. Milham said.

The study was funded through the UK Mobile Telecommunications Health Research (MTHR) Programme, an independent body set up to provide funding for research into the possible health effects of mobile telecommunications. The MTHR is jointly funded by the UK Department of Health and the mobile telecommunications industry. Dr. Elliott and Dr. Milham have disclosed no relevant financial relationships. Dr. Bithell reports a beneficial interest in shares in Vodafone Group not exceeding £3000 in value.

How Does the San Francisco Syncope Rule Perform in Canada?

2010-06-25T08:00:00.000+07:00

How Does the San Francisco Syncope Rule Perform in Canada?
The rule had a sensitivity of 90% for predicting serious outcomes at 30 days

Patients with syncope often are admitted to the hospital despite negative
emergency department (ED) evaluations. The San Francisco Syncope Rule was
developed to identify syncope patients who are at sufficiently low risk for
serious outcomes to be safely discharged home after ED evaluation. The rule
classifies patients as high risk if they have histories of congestive heart
failure, hematocrit <30%,>
or triage systolic blood pressure <90>
to have 96% and 98% sensitivity for predicting serious outcomes at 7 days
and 30 days, respectively, but has not performed as well in subsequent
validation studies in the U.S. and Australia, where sensitivities ranged
from 74% to 90% (JW Emerg Med Sep 19 2008 and JW Emerg Med Jun 8 2007).

To evaluate performance of the rule in Canada, researchers retrospectively
applied the rule to 505 patients who presented to a single tertiary care
hospital with syncope during an 18-month period. Serious outcomes were
defined as death, myocardial infarction, arrhythmia, pulmonary embolism,
stroke, subarachnoid hemorrhage, significant bleeding, any procedural
intervention to treat a related cause of syncope, any condition causing or
likely to cause a return emergency visit, and hospitalization for a related
event. Overall, 9.7% of patients had serious outcomes within 30 days. The
rule had a sensitivity of 90% for predicting these outcomes.

Comment: The results of this study are consistent with those from other
validation studies. The San Francisco Syncope Rule will likely need to be
improved and then validated before it is adopted in practice. Until then,
clinical judgment should continue to guide treatment and disposition.

— Richard D. Zane, MD, FAAEM
Published in Journal Watch Emergency Medicine

SOUTH AFRICAN DOCTOR INVENTS FEMALE CONDOMS WITH "TEETH" TO FIGHT RAPE

2010-06-24T21:02:00.000+07:00

South African doctor invents female condoms with 'teeth' to fight rape

Dr. Sonnet Ehlers was on call one night four decades ago when a devastated rape victim walked in. Her eyes were lifeless; she was like a breathing corpse. "She looked at me and said, 'If only I had teeth down there,'" recalled Ehlers, who was a 20-year-old medical researcher at the time. "I promised her I'd do something to help people like her one day." Forty years later, Rape-aXe was born. Ehlers is distributing the female condoms in the various South African cities where the World Cup soccer games are taking place. The woman inserts the latex condom like a tampon. Jagged rows of teeth-like hooks line its inside and attach on a man's penis during penetration, Ehlers said.

Once it lodges, only a doctor can remove it -- a procedure Ehlers hopes will be done with authorities on standby to make an arrest. "It hurts, he cannot pee and walk when it's on," she said. "If he tries to remove it, it will clasp even tighter... however, it doesn't break the skin, and there's no danger of fluid exposure." Ehlers said she sold her house and car to launch the project, and she planned to distribute 30,000 free devices under supervision during the World Cup period. "I consulted engineers, gynecologists and psychologists to help in the design and make sure it was safe," she said.

After the trial period, they'll be available for about $2 a piece. She hopes the women will report back to her. "The ideal situation would be for a woman to wear this when she's going out on some kind of blind date ... or to an area she's not comfortable with," she said. The mother of two daughters said she visited prisons and talked to convicted rapists to find out whether such a device would have made them rethink their actions. Some said it would have, Ehlers said.

Critics say the female condom is not a long-term solution and makes women vulnerable to more violence from men trapped by the device. It's also a form of "enslavement," said Victoria Kajja, a fellow for the Centers for Disease Control and Prevention in the east African country of Uganda. "The fears surrounding the victim, the act of wearing the condom in anticipation of being assaulted all represent enslavement that no woman should be subjected to." Kajja said the device constantly reminds women of their vulnerability. "It not only presents the victim with a false sense of security, but psychological trauma," she added. "It also does not help with the psychological problems that manifest after assaults."

However, its one advantage is it allows justice to be served, she said. Various rights organizations that work in South Africa declined to comment, including Human Rights Watch and Care International. South Africa has one of the highest rape rates in the world, Human Rights Watch says on its website. A 2009 report by the nation's Medical Research Council found that 28 percent of men surveyed had raped a woman or girl, with one in 20 saying they had raped in the past year, according to Human Rights Watch.

In most African countries, rape convictions are not common. Affected women don't get immediate access to medical care, and DNA tests to provide evidence are unaffordable. "Women and girls who experience these violations are denied justice, factors that contribute to the normalization of rape and violence in South African society," Human Rights Watch says.

Women take drastic measures to prevent rape in South Africa, Ehlers said, with some wearing extra tight biker shorts and others inserting razor blades wrapped in sponges in their private parts. Critics have accused her of developing a medieval device to fight rape. "Yes, my device may be a medieval, but it's for a medieval deed that has been around for decades," she said. "I believe something's got to be done ... and this will make some men rethink before they assault a woman."

Jadilah Pasien Pintar! (In Bahasa Indonesia)

2010-06-16T16:03:00.000+07:00

Jadilah Pasien Pintar!

Salah satu sebab mengapa orang enggan pergi ke dokter atau rumah sakit, bisa jadi karena persoalan komunikasi. Hal ini diungkapkan guru besar Fakultas Kedokteran Universitas Indonesia, Prof. Daldiyono Hardjodisastro, dalam bukunya yang berjudul Pasien Pintar dan Dokter Bijak.

Dalam buku tersebut diungkapkan, untuk mendapat hasil maksimal dari pertemuan dengan dokter, pasien harus mempersiapkan diri, di antaranya:

* Mengenakan pakaian yang memudahkan dokter melakukan pemeriksaan.

* Mencatat keluhan yang hendak disampaikan ke dokter secara lengkap, kapan dirasakan, dan upaya yang sudah dilakukan untuk mengurangi rasa sakit. Beritahukan pula penyakit yang pernah atau sedang diderita, obat yang sedang diminum, serta jika ada alergi.

* Dari tanya jawab soal keluhan dan pemeriksaan fisik pasien, dokter akan menegakkan diagnosis kemudian memberikan terapi, termasuk resep obat. Pasien berhak mendapat informasi yang jelas mengenai hasil pemeriksaan, menanyakan bila ada yang belum jelas, juga mengambil keputusan untuk menerima atau menolak saran dokter tentang terapi yang akan diberikan. Jika pasien tidak menerima keputusan dokter, ia berhak mencari pendapat kedua (second opinion) dari dokter lain.

* Pasien yang pintar perlu bertanya dan mengetahui obat apa yang diresepkan dokter serta manfaatnya.

* Jika kondisi keuangan tidak memungkinkan, pasien perlu meminta obat generik. Hilangkan persepsi bahwa penyakit harus cepat sembuh. Ingat, pengobatan memerlukan waktu, kesabaran, dan ketekunan. Tak jarang, ada dokter terbawa kemauan pasien yang ingin cepat sembuh, sehingga melakukan berbagai jenis pemeriksaan yang belum tentu diperlukan atau memberi obat berlebihan.

* Sebaliknya, dokter yang bijak adalah yang mampu berkomunikasi secara efektif dengan pasien. Dokter mau mendengarkan keluhan pasien, menjawab pertanyaan dan menjelaskan situasi pasien, memberi nasihat cukup, serta tidak sekadar memberi resep, sehingga pasien merasa puas.

* Kemampuan berkomunikasi merupakan inti dari pekerjaan dokter. Kepandaian sebenarnya hanya nomor dua. Pasalnya, 60 persen pasien sebenarnya tidak sakit, tetapi mengalami kelainan fungsional. Hanya 40 persen yang benar-benar sakit, itu pun 20 persennya akan sembuh sendiri.

Lalu, bagaimana menghadapi dokter yang tidak komunikatif? Konsultan gastroenterologi-hepatolog

i ini menyarankan untuk meninggalkan ruangan dan segera pindah dokter jika memungkinkan.

Jika Merasa Tak Puas

Pernah dikecewakan oleh pelayanan di rumah sakit? Agar keluhan Anda tersampaikan dengan baik, berikut beberapa caranya:

* Jika mempunyai keluhan, catat dengan jelas tanggal, hari, dan jam kejadian, kalau perlu nama petugas yang memberikan pelayanan. Kemudian Anda dapat menghubungi bagian humas maupun customer service rumah sakit tersebut.

* Ada rumah sakit yang kepala perawatannya bertugas mengurus masalah atau keluhan, sehingga pasien disarankan menghubungi Kepala (Bidang) Perawatan bila merasa tidak puas. Bila masalah belum terpecahkan, tidak tertutup kemungkinan langsung maju ke direktur atau pimpinan rumah sakit.

* Anda dapat menghubungi perwakilan Persatuan Rumah Sakit Seluruh Indonesia setempat. Persi mempunyai kepengurusan di semua wilayah di seluruh provinsi di Indonesia.

* Manfaatkan kotak saran yang ada di setiap rumah sakit untuk mengomunikasikan hal-hal yang dianggap pasien (konsumen) tidak patut dilakukan oleh petugas rumah sakit. Hal ini merupakan masukan positif agar pihak rumah sakit memperbaiki diri. Tanpa masukan dari konsumen, pengelola rumah sakit akan selalu merasa bahwa pelayanan yang diberikan sudah cukup baik. Jadi, masukan atau kritik harusnya diterima sebagai satu mekanisme kontrol dari pengguna jasa rumah sakit.

* Jika merasa tidak puas dengan layanan dokter, konsumen dapat langsung mengklarifikasi dengan dokter yang merawat terlebih dahulu. Termasuk adanya dugaan kesalahan prosedur layanan (obat, dosis, maupun tindakan).

* Sangat tidak dibenarkan bila sewaktu pasien melakukan klarifikasi, dokter tidak melayani dengan baik, misalnya menghindar atau mengaku tidak punya waktu. Seorang dokter yang memberikan layanan kepada pasien sudah terikat satu kontrak, yang dikenal dengan kontrak terapeutik (Prof. Dr. Leenen), sehingga dokter bersangkutan harus memberikan penjelasan atas setiap pertanyaan pasien. Sikap profesional harus dijaga oleh para dokter.

* Pahami hak pasien, salah satunya mendapatkan informasi yang jelas dan benar. Pergunakan hak itu dengan baik, beritahu dokter bahwa Anda berhak mendapatkan informasi yang Anda inginkan. Bila ada yang kurang jelas, misalnya soal pilihan jenis obat (generik atau paten), dosis, tindakan medis, pasien juga memiliki hak bertanya atas kuitansi tagihan rumah sakit bagi penderita rawat inap untuk diklarifikasi hingga jelas benar, juga mengenai penggunaan obat dan peralatan yang harus bayar.

* Mencermati dan meneliti tindakan medis apa saja yang sudah lakukan, apakah sesuai dengan yang seharusnya dibayarkan. Adalah hak pasien untuk mengetahui setiap rupiah yang dikeluarkan untuk membayar biaya rumah sakit.

Red : Kes. Kompas

When Fights Over Money Ruin Marriages

2010-06-16T14:53:00.005+07:00

Much has been written about how tough economic times have forced couples to postpone divorces. They just can't afford it. Legal costs and accountant fees grow as a union dissolves and a two-income household lives cheaper than a two-household pair of singles. As the economy improves, we will probably see divorce rates creep up. But even if money woes are keeping couples together, financial disputes remain the root cause of irreconcilable differences

Here are seven common financial issues that can lead to divorce:

Paycheck Envy
More women are entering marriage with assets of their own and many are earning more than their spouses. According to the Bureau of Labor Statistics, one in three married women out-earns her husband. That amount expands to more than half if they earn $55,000 or more. Men can feel threatened by not having their traditional bragging rights as breadwinners. For women, it means they have their own money to protect from the irresponsible actions of a mate. With more at-stake, women can't afford to be deferential to their mate the way past generations were.

Debt
Utah State University professor Jeffrey Dew authored a widely cited study that concluded that couples who argue about finances at least once a week are 30% more likely to divorce than those who only vent occasionally about money issues. Couples with no assets were 70% more likely to divorce compared to couples with assets of $10,000. Cutting into the ability to build assets is America's longstanding addiction to credit cards, but there may be cause for optimism. Having amassed a record-setting $988 billion in revolving debt in 2008, Americans chipped away at nearly $90 billion of it last year, according to the Federal Reserve. Fewer credit cards and less debt should mean increased savings, more assets and potentially happier couples.

Bills
As part of a survey last year, Fidelity Investments found that less than half of couples make day-to-day financial decisions together on issues such as budgeting and paying bills (45%). In many couples, one person always pays monthly bills early while the other might procrastinate until the due date and beyond. Cutting checks can be even more stressful when an unnecessary shopping spree blows the monthly budget or a mate doesn't take kindly to the premium cable channels or costly text messages their better half piles into the mix.

Saving
While one half of a relationship may be thrifty, dedicated to building savings and committed to a retirement plan, the other may be more carefree, with a "live for today, you can't take it with you" outlook.

Investing
One can assume that investment decisions are increasingly dividing couples if both partners are financially savvy. Risk tolerance may be incompatible, with goals out-of-synch.

Dump
Apple or go long may be as divisive a debate as how often a mother-in-law should visit. Looking over an investment portfolio or 401(k) plan, one spouse may want to explore emerging market funds, while the other dismisses anything but safe domestic large caps and bonds. Can a quant guy find true happiness with a fundamental-analysis kind of gal?

Differing Expectations
There's no shortage of men and women who value money more than love and companionship. You may be quite content to "live on love" and weather financial situations "for better or worse." But she may feel entitled to a McMansion in a tony suburb and a Mercedes in which to drive your kids to private school. Trouble will be brewing along with her high-priced lattes.

Secret Stash
Financial infidelity is a newly coined term that describes situations in which a spouse hides cash or credit from his mate. It may seem a good idea to have a secret credit card or bank account that you can dip into, but your partner will probably take great offense at the covert action. Beyond the financial dishonesty on display, such hidden reserves may be a warning sign of even bigger transgressions -- keeping a slush fund to pay for strip club tabs or supporting a mistress on the sly.

The Link Between Endometriosis and Cancer

2010-06-11T02:53:00.005+07:00

Endometriosis and Cancer Risk

Women with endometriosis appear to be more likely to develop certain types of cancer. What scientists know about the link -- and why it might occur -- were the focus of a session at the inaugural symposium of the Endometriosis Foundation of America.

"We've got pretty good evidence that there's some increase in the risk for ovarian cancer" with endometriosis, said Louise Brinton, PhD, Chief of the Hormonal and Reproductive Epidemiology branch at the National Cancer Institute, in an interview with Medscape following the session. "But there are still other cancers that need further study."

Dr. Brinton's interest in the long-term effects of endometriosis led her to Sweden about 20 years ago. Using the country's national inpatient register, she identified more than 20,000 women who had been hospitalized for endometriosis. After an average follow-up of more than 11 years, the risk for cancer among these women was elevated by 90% for ovarian cancer, 40% for hematopoietic cancer (primarily non-Hodgkin's lymphoma), and 30% for breast cancer. Having a longer history of endometriosis and being diagnosed at a young age were both associated with increased ovarian cancer risk.

"We found an increased risk for tumors with increasing years of follow-up," said Dr. Brinton, "making it unlikely that the ovarian cancer diagnoses were related to increased surveillance during endometriosis treatment." Also of special interest was the finding that "women whose site of origin of endometriosis was the ovary ... had a particularly high risk for ovarian cancer."

Dr. Brinton and colleagues published their research in 1997. A larger, more recent examination of the Swedish register, published in 2006 by Anna-Sofia Melin and colleagues, produced similar results.

"The 2 studies indicate a high risk related to follow-up time and site of origin of endometriosis, which suggests a biologic effect between the 2 diseases," said Dr. Brinton. On the other hand, confounding factors could be at work. For example, women being treated for endometriosis are more likely to be experiencing infertility, which affects risk because childbearing offers some protection against ovarian cancer.

A 2002 pooled case-control study by Roberta B. Ness and colleagues found that the odds of developing ovarian cancer were 50% higher among women diagnosed with endometriosis, even after adjusting for factors such as duration of oral contraception use and number of births. The risk was even higher -- a 3.5-fold increase -- for women with endometrioid or clear cell tumors, 2 subtypes of ovarian cancer. A 2005 case-control study by Brinton and colleagues also found a 2.5- to 3.5-fold increase in endometrioid and clear cell tumors among women with endometriosis.

The overall lifetime risk for ovarian cancer is 1.4%, according to the American Cancer Society. Endometriosis affects as many as 7% to 15% of women of reproductive age.

Farr Nezhat, MD, Chief of Gynecologic Minimally Invasive Surgery and Robotics at St. Luke's and Roosevelt Hospitals in New York City and Professor of Obstetrics and Gynecology at Columbia University, spoke on the pathogenesis of endometriosis and ovarian cancer. Dr. Nezhat also cited research on the link between epithelial ovarian cancer and endometriosis. According to a 2000 study of women with ovarian cancer by Hiroyuki Yoshikawa and colleagues, endometriosis was present in 39% of the women with clear cell tumors and 21% of those with endometrioid tumors, vs just 3% of those with serous or mucinous tumors.

Dr. Nezhat's own research with Liane DeLigdisch and colleagues also identified a link between endometriosis and ovarian cancer. A pathology review of samples from 76 patients with stage 1 ovarian cancer revealed that most were associated with endometriosis or endometrioma. Most patients presented with pelvic pain or adnexal mass, supporting the idea that healthcare providers should be alert to the possibility of ovarian cancer in women with a history of endometriosis.

Studies have been inconsistent on whether endometriosis is linked to breast cancer or non-Hodgkin's lymphoma. Anecdotal evidence has linked endometriosis to melanoma, brain and endocrine cancers, and thyroid cancer. Large epidemiologic studies are required to examine these associations.

The Pathogenesis of Endometriosis and Cancer
What do endometriosis and ovarian cancer have in common? A lot, it turns out.

"Both of these diseases are progressive and depend on estrogen for their growth," said Dr. Nezhat. Studies have shown that endometrial tissue shows elevated activity of aromatase, an enzyme used for a key step in the biosynthesis of estrogens.

Another factor that appears to play a role in both diseases is inflammation. "We know that inflammation can cause cancer, as in hepatitis of the liver and asbestosis of the lung," said Dr. Nezhat. Endometriosis is characterized by a chronic inflammatory state, which leads to the release of cytokine. These cytokines may promote the growth of tumors by causing unregulated mitotic division, growth, and differentiation.

"If you combine inflammation with estrogen, it's going to be a vicious circle," said Dr. Nezhat.

The 2 diseases share numerous other characteristics. For example, both are related to early menarche and late menopause, infertility, and nulliparity. Factors that relieve or offer protection against both conditions include tubal ligation, oral contraceptives, hysterectomy, and progesterone exposure.

Mutations in genes that are known to suppress tumors, such as PTEN, p53, and bcl, have been found in both ovarian tumors and adjacent endometriotic lesions.

Of course, links between the 2 diseases don't prove that one causes the other. But Dr. Nezhat said there's reason to believe that endometriosis contributes to ovarian cancer, as evidenced by Dr. Brinton's finding that cancer risk increases with duration of endometriosis.

If endometriosis does increase the risk for ovarian cancer, then treating it might reduce the risk. "Endometrial implants produce estrogen and inflammation," he said. "So if you remove the endometriosis, you should theoretically reduce the risk for cancer."

Advice to Surgeons and Patients
Dr. Nezhat said that surgeons who operate on women with endometriosis, which includes fertility specialists performing in vitro fertilization (IVF), need to be alert to the possibility of ovarian cancer. "Do an ultrasound during the preoperative evaluation and during the follow-up," he told Medscape. He also cautioned surgeons to biopsy any ovarian cysts instead of draining them. "Every adnexal mass has to be thoroughly evaluated," he said.

Although the elevated risk for ovarian cancer appears to be real, Dr. Brinton emphasized that women with endometriosis should not become anxious about it. "Even though we see a 2- to 3-fold increase in the risk for ovarian cancer, it's still a very rare condition," she said. "The absolute risk is low."

The New FIGO Staging for Carcinoma of the Vulva, Cervix, Endometrium, and Sarcomas

2010-06-11T02:29:00.011+07:00

The International Federation of Gynecology and Obstetrics (FIGO) staging systems for vulva, cervix, endometrium, and sarcomas have been revised for the first time in over a decade. The purpose of the staging system is to provide uniform terminology for better communication among health professionals and to provide appropriate prognosis to the patients which results in treatment improvement. This is a constantly evolving process as new therapeutic modalities are developed, new imaging and surgical approaches are applied, and more prognostic information becomes available. The previous system did not reflect the prognosis in some patient subsets where medical research and practice have shown explosive growth of new knowledge in recent years. The 41st Annual Meeting of the Society of Gynecologic Oncologists was held in March 2010. Several abstracts reported retrospective studies that evaluated the prognostic significance of new 2009 FIGO staging guidelines compared to the old 1988 FIGO system. In endometrial cancer, the reduction in the substages within stage I, and the separation of pelvic and para-aortic nodal involvement further clarified important prognostic factors that yielded clear delineation of survival. The new 2009 FIGO vulvar cancer staging system was validated by clearly demonstrating distinct groups with differing survivals. The following revisions on carcinoma of vulva, cervix, and endometrium staging will replace prior tables 41-6, 41-8, and 41-9, respectively.

Carcinoma of the Vulva

IA Tumor confined to the vulva or perineum, = 2cm in size with stromal invasion = 1mm, negative nodes

IB Tumor confined to the vulva or perineum, > 2cm in size or with stromal invasion > 1mm, negative nodes

II Tumor of any size with adjacent spread (1/3 lower urethra, 1/3 lower vagina, anus), negative nodes

IIIA Tumor of any size with positive inguino-femoral lymph nodes
(i) 1 lymph node metastasis greater than or equal to 5 mm
(ii) 1-2 lymph node metastasis(es) of less than 5 mm
IIIB
(i) 2 or more lymph nodes metastases greater than or equal to 5 mm
(ii) 3 or more lymph nodes metastases less than 5 mm

IIIC Positive node(s) with extracapsular spread

IVA
(i) Tumor invades other regional structures (2/3 upper urethra, 2/3 upper vagina), bladder mucosa, rectal mucosa, or fixed to pelvic bone
(ii) Fixed or ulcerated inguino-femoral lymph nodes IVB Any distant metastasis including pelvic lymph nodes

Carcinoma of the Cervix

IA1 Confined to the cervix, diagnosed only by microscopy with invasion of <>
IA2 Confined to the cervix, diagnosed with microscopy with invasion of > 3 mm and <>
IB1 Clinically visible lesion or greater than A2, <>
IB2 Clinically visible lesion, > 4 cm in greatest dimension
IIA1 Involvement of the upper two-thirds of the vagina, without parametrial invasion, <>
IIA2 > 4 cm in greatest dimension
IIB With parametrial involvement
IIIA/B Unchanged
IVA/B Unchanged

Carcinoma of the Endometrium

IA Tumor confined to the uterus, no or < ½ myometrial invasion
IB Tumor confined to the uterus, > ½ myometrial invasion
II Cervical stromal invasion, but not beyond uterus
IIIA Tumor invades serosa or adnexa
IIIB Vaginal and/or parametrial involvement
IIIC1 Pelvic node involvement
IIIC2 Para-aortic involvement
IVA Tumor invasion bladder and/or bowel mucosa
IVB Distant metastases including abdominal metastases and/or inguinal lymph nodes

Uterine sarcomas were staged previously as endometrial cancers, which did not reflect clinical behavior. Therefore, a new corpus sarcoma staging system was developed based on the criteria used in other soft tissue sarcomas. This is described as a best guess staging system, so data will need to be collected and evaluated for further revision.

Uterine Sarcomas (Leiomyosarcoma, Endometrial Stromal Sarcoma, and Adenosarcoma)

IA Tumor limited to uterus <>
IB Tumor limited to uterus > 5 cm
IIA Tumor extends to the pelvis, adnexal involvement
IIB Tumor extends to extra-uterine pelvic tissue
IIIA Tumor invades abdominal tissues, one site
IIIB More than one site
IIIC Metastasis to pelvic and/or para-aortic lymph nodes
IVA Tumor invades bladder and/or rectum
IVB Distant metastasis

Adenosarcoma Stage I Differs from Other Uterine Sarcomas
IA Tumor limited to endometrium/endocervix
IB Invasion to < ½ myometrium IB Invasion to > ½ myometrium

MANAGEMENT OF SEVERE COPD REVIEWED

2010-04-18T16:23:00.000+07:00

Various strategies and recommendations to treat patients with severe chronic obstructive pulmonary disease (COPD) are provided in a clinical review published in the April 15 issue of the New England Journal of Medicine.

"The sentinel clinical feature of severe ...COPD is dyspnea on exertion," writes Dennis E. Niewoehner, MD, from the Pulmonary Section, Veterans Affairs Medical Center in Minneapolis, Minnesota. "Its onset is usually insidious, and it may progress to severe disability over a period of years or decades. Other common symptoms include cough, sputum production, wheezing, and chest congestion."

The typical clinical manifestations of advanced COPD result from severe airflow obstruction, which can be confirmed by spirometry. Although physical findings may include a barrel-shaped chest, inspiratory retraction of the lower ribs (Hoover's sign), a prolonged expiratory phase, and use of the accessory muscles of respiration, these findings are sometimes absent even in patients with severe COPD.

Failure to confirm COPD with spirometry often leads to misdiagnosis. However, spirometry is a poor guide for decision making regarding treatment continuation or modification in an individual patient. Spirometric evidence of airflow obstruction is defined as a ratio of the postbronchodilator forced expiratory volume in 1 second (FEV₁) to a forced vital capacity of less than 0.70. Overall severity of COPD can be classified based on FEV₁ percentage of the predicted normal value, as well as on clinical criteria, such as the degree of breathlessness caused by specific tasks and the frequency of exacerbations.

Exacerbations often require medical visits and hospitalizations, causing a dramatic increase in healthcare costs. The relative risk for treatment failure (defined as no resolution or clinical deterioration) is lowered by approximately 50% when antibiotics are used for COPD exacerbations. Antibiotics are most effective in patients who have cough productive of purulent sputum.

Complications of severe COPD include pulmonary hypertension and cor pulmonale resulting from chronic hypoxemia and hypercapnia. Severe COPD is also associated with an elevated risk for cardiovascular disease, osteoporosis, lung cancer, depression, and other systemic diseases.

Management Strategies

Management should include patient education during the initial visit, which should focus on the signs and symptoms of a severe exacerbation and the need for prompt recognition and treatment. The most important aspect of management is smoking cessation, which should be addressed at every visit, as long as the patient continues smoking.

Pharmacotherapy may include an inhaled long-acting β2-agonist, an inhaled long-acting anticholinergic agent, and/or an inhaled corticosteroid. The long-acting β2-agonists salmeterol and formoterol offer at least 12 hours of sustained bronchodilation, whereas the inhaled long-acting anticholinergic agent tiotropium is effective for at least 24 hours.

Drugs from 2 of these 3 classes should be combined for patients with severe, exacerbation-prone COPD. Because they lower the relative risk for a severe exacerbation by 15% to 20%, these medications should be continued even if they do not provide symptomatic relief. Adverse events of long-acting bronchodilators are typically mild.

For rescue use, a short-acting bronchodilator should be given. Albuterol or other short-acting β2-adrenergic agonist and ipratropium bromide, a short-acting anticholinergic agent, may be used alone or combined. Patients should be instructed regarding proper inhaler technique. The faster onset of action of albuterol vs ipratropium bromide may give patients more rapid relief.

Long-term oxygen therapy should be prescribed and used for 18 hours or more each day if arterial oxygen saturation is 88% or lower at rest in a stable clinical state.

Patients with COPD should be vaccinated against influenza every autumn, and they should also receive pneumococcal vaccination, with revaccination as needed, unless there is a contraindication.

Patients with access to pulmonary rehabilitation should be offered this therapy, provided there are no medical contraindications.

The recommendations in this review are generally consistent with guidelines on the management of COPD published by the Global Initiative for Chronic Obstructive Lung Disease, the American Thoracic Society-European Respiratory Society, and the American College of Physicians.

Conclusion: Uncertainty Remains

"The role of disease-management programs for patients with COPD remains uncertain," Dr. Niewoehner concludes. "Randomized, controlled trials of case management for COPD have shown promise in reducing hospitalization rates, but the evidence is insufficient to make specific recommendations. Pulmonary rehabilitation improves health status and exercise capability for selected patients, but national surveys indicate that few patients complete such programs, and it is unclear how best to maintain the benefits achieved."

Dr. Niewoehner has received consulting fees from Boehringer Ingelheim, Adams Respiratory Therapeutics, GlaxoSmithKline, AstraZeneca, Nycomed, and Forest Research Institute and speaking fees from Boehringer Ingelheim, Pfizer, Sepracor, and Nycomed.

N Engl J Med. 2010;362:1407-1416.

WHAT IS "COPD" ???

2010-04-18T16:05:00.004+07:00

What Is COPD?

COPD, or chronic obstructive pulmonary (PULL-mun-ary) disease, is a progressive disease that makes it hard to breathe. "Progressive" means the disease gets worse over time.

COPD can cause coughing that produces large amounts of mucus (a slimy substance), wheezing, shortness of breath, chest tightness, and other symptoms.

Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. Long-term exposure to other lung irritants, such as air pollution, chemical fumes, or dust, also may contribute to COPD.

Overview

To understand COPD, it helps to understand how the lungs work. The air that you breathe goes down your windpipe into tubes in your lungs called bronchial tubes, or airways.

The airways are shaped like an upside-down tree with many branc

hes. At the end of the branches are tiny air sacs called alveoli (al-VEE-uhl-eye).

The airways and air sacs are elastic. When you breathe in, each air sac fills u

p with air like a small balloon. When you breathe out, the air sac deflates and the air goes out.

In COPD, less air flows in and out of the airways because of one or more of the following:

The airways and air sacs lose their elastic quality.
The walls between many of the air sacs are destroyed.
The walls of the airways become thick and inflamed (swollen).
The airways make more mucus than usual, which tends to clog the airways.

In the United States, the term "COPD" includes two main conditions—emphysema (em-fi-SE-ma) and chronic obstructive bronchitis (bron-KI-tis).

In emphysema, the walls between many of the air sacs are damaged, causing them to lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones.

In chronic obstructive bronchitis, the lining of the airways is constantly irritated and inflamed. This causes the lining to thicken. Lots of thick mucus forms in the airways, making it hard to breathe.

Most people who have COPD have both emphysema and chronic obstructive bronchitis. Thus, the general term "COPD" is more accurate.

Outlook

COPD is a major cause of disability, and it's the fourth leading cause of death in the United States. More than 12 million people are currently diagnosed with COPD. An additional 12 million likely have the disease and don't even know it.

COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself.

Most of the time, COPD is diagnosed in middle-aged or older people. The disease isn't passed from person to person—you can't catch it from someone else.

COPD has no cure yet, and doctors don't know how to reverse the damage to the airways and lungs. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease.

Other Names for COPD

Chronic obstructive airway disease
Chronic obstructive bronchitis
Chronic obstructive lung disease
Emphysema

What Causes COPD?

Most cases of COPD develop after long-term exposure to lung irritants that damage the lungs and the airways.

In the United States, the most common irritant that causes COPD is cigarette smoke. Pipe, cigar, and other types of tobacco smoke also can cause COPD, especially if the smoke is inhaled. Secondhand smoke—that is, smoke in the air from other people smoking—also can irritate the lungs and contribute to COPD.

Breathing in air pollution and chemical fumes or dust from the environment or workplace also can contribute to COPD.

In rare cases, a genetic condition called alpha-1 antitrypsin deficiency may play a role in causing COPD. People who have this condition have low levels of alpha-1 antitrypsin (AAT)—a protein made in the liver.

Having a low level of the AAT protein can lead to lung damage and COPD if you're exposed to smoke or other lung irritants. If you have this condition and smoke, COPD can worsen very quickly.

Who Is At Risk for COPD?

The main risk factor for COPD is smoking. Most people who have COPD smoke or used to smoke. People who have a family history of COPD are more likely to get the disease if they smoke.

Long-term exposure to other lung irritants also is a risk factor for COPD. Examples of other lung irritants include air pollution and chemical fumes and dust from the environment or workplace.

Most people who have COPD are at least 40 years old when symptoms begin. Although it isn't common, people younger than 40 can have COPD. For example, this may happen if a person has alpha-1 antitrypsin deficiency, a genetic condition.

What Are the Signs and Symptoms of COPD?

The signs and symptoms of COPD include:

An ongoing cough or a cough that produces large amounts of mucus (often called "smoker's cough")
Shortness of breath, especially with physical activity
Wheezing (a whistling or squeaky sound when you breathe)
Chest tightness

These symptoms often occur years before the flow of air into and out of the lungs declines. However, not everyone who has these symptoms has COPD. Likewise, not everyone who has COPD has these symptoms.

Some of the symptoms of COPD are similar to the symptoms of other diseases and conditions. Your doctor can determine if you have COPD.

If you have COPD, you may have frequent colds or flu. If your COPD is severe, you may have swelling in your ankles, feet, or legs; a bluish color on your lips due to low levels of oxygen in your blood; and shortness of breath.

COPD symptoms usually slowly worsen over time. At first, if symptoms are mild, you may not notice them, or you may adjust your lifestyle to make breathing easier. For example, you may take the elevator instead of the stairs.

Over time, symptoms may become bad enough to see a doctor. For example, you may get short of breath during physical exertion.

How severe your symptoms are depends on how much lung damage you have. If you keep smoking, the damage will occur faster than if you stop smoking. In severe COPD, you may have other symptoms, such as weight loss and lower muscle endurance.

Some severe symptoms may require treatment in a hospital. You—with the help of family members or friends, if you're unable—should seek emergency care if:

You're having a hard time catching your breath or talking.
Your lips or fingernails turn blue or gray. (This is a sign of a low oxygen level in your blood.)
You're not mentally alert.
Your heartbeat is very fast.
The recommended treatment for symptoms that are getting worse isn't working.

How Is COPD Diagnosed?

Your doctor will diagnose COPD based on your signs and symptoms, your medical and family histories, and test results.

He or she may ask whether you smoke or have had contact with lung irritants, such as air pollution, chemical fumes, or dust. If you have an ongoing cough, your doctor may ask how long you've had it, how much you cough, and how much mucus comes up when you cough. He or she also may ask whether you have a family history of COPD.

Your doctor will examine you and use a stethoscope to listen for wheezing or other abnormal chest sounds.

You also may need one or more tests to diagnose COPD.

Lung Function Tests

Lung function tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs can deliver oxygen to your blood.

The main test for COPD is spirometry (spi-ROM-eh-tre). Other lung function tests, such as a lung diffusing capacity test, also may be used. (For more information, see "Types of Lung Function Tests.")

Spirometry

During this painless test, a technician will ask you to take a deep breath in and then blow as hard as you can into a tube connected to a small machine. The machine is called a spirometer.

The machine measures how much air you breathe out. It also measures how fast you can blow air out.

Your doctor may have you inhale medicine that helps open your airways and then blow into the tube again. He or she can then compare your test results before and after taking the medicine.

Spirometry can detect COPD long before its symptoms appear. Doctors also may use the results from this test to find out how severe your COPD is and to help set your treatment goals.

The test results also may help find out whether another condition, such as asthma or heart failure, is causing your symptoms.

Other Tests

Your doctor may recommend other tests. These tests include:

A chest x ray or chest computed tomography (CT) scan. These tests create pictures of the structures inside your chest, such as your heart and lungs. The pictures can show signs of COPD. They also may show whether another condition, such as heart failure, is causing your symptoms.
An arterial blood gas test. This blood test measures the oxygen level in your blood using a sample of blood taken from an artery. The test can help find out how severe your COPD is and whether you may need supplemental oxygen therapy.

How Is COPD Treated?

COPD has no cure yet. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease.

Quitting smoking is the most important step you can take to treat COPD. Talk to your doctor about programs and products that can help you quit. Many hospitals have programs that help people quit smoking, or hospital staff can refer you to a program. Ask your family members and friends to support you in your efforts to quit. Also, try to avoid secondhand smoke.

The National Heart, Lung, and Blood Institute's "Your Guide to a Healthy Heart" booklet has more information about how to quit smoking.

Other treatments for COPD may include medicines, vaccines, pulmonary rehabilitation (rehab), oxygen therapy, surgery, and managing complications.

The goals of COPD treatment are to:

Relieve your symptoms
Slow the progress of the disease
Improve your exercise tolerance (your ability to stay active)
Prevent and treat complications
Improve your overall health

Specialists Involved

To assist with your treatment, your family doctor may advise you to see a pulmonologist. This is a doctor who specializes in treating people who have lung problems.

Medicines

Bronchodilators

Bronchodilators relax the muscles around your airways. This helps open your airways and makes breathing easier.

Depending on how severe your disease is, your doctor may prescribe short-acting or long-acting bronchodilators. Short-acting bronchodilators last about 4 to 6 hours and should be used only when needed. Long-acting bronchodilators last about 12 hours or more and are used every day.

Most bronchodilators are taken using a device called an inhaler. This device allows the medicine to go right to your lungs. Not all inhalers are used the same way. Ask your health care team to show you the right way to use your inhaler.

If your COPD is mild, your doctor may only prescribe a short-acting inhaled bronchodilator. In this case, you may only use the medicine when symptoms occur.

If your COPD is moderate or severe, your doctor may prescribe regular treatment with short- and long-acting bronchodilators.

Inhaled Glucocorticosteroids (Steroids)

Inhaled steroids are used for some people who have moderate or severe COPD. These medicines may reduce airway inflammation (swelling).

Your doctor may ask you to try inhaled steroids for a trial period of 6 weeks to 3 months to see whether the medicine is helping with your breathing problems.

Vaccines

Flu Shots

The flu (influenza) can cause serious problems for people who have COPD. Flu shots can reduce your risk for the flu. Talk with your doctor about getting a yearly flu shot.

Pneumococcal Vaccine

This vaccine lowers your risk for pneumococcal pneumonia (nu-MO-ne-ah) and its complications. People who have COPD are at higher risk for pneumonia than people who don't have COPD. Talk with your doctor about whether you should get this vaccine.

Pulmonary Rehabilitation

Pulmonary rehab is a medically supervised program that helps improve the health and well-being of people who have lung problems. Rehab may include an exercise program, disease management training, and nutritional and psychological counseling. The program aims to help you stay more active and carry out your day-to-day activities.

Your rehab team may include doctors, nurses, physical therapists, respiratory therapists, exercise specialists, and dietitians. These health professionals work together and with you to create a program that meets your needs.

Oxygen Therapy

If you have severe COPD and low levels of oxygen in your blood, oxygen therapy can help you breathe better. For this treatment, you're given oxygen through nasal prongs or a mask.

You may need extra oxygen all the time or just sometimes. For some people who have severe COPD, using extra oxygen for most of the day can help them:

Do tasks or activities, while having fewer symptoms
Protect their hearts and other organs from damage
Sleep more during the night and improve alertness during the day
Live longer

Surgery

In rare cases, surgery may benefit some people who have COPD. Surgery usually is a last resort for people who have severe symptoms that have not improved from taking medicines.

Surgeries for people who have COPD that's mainly related to emphysema include bullectomy (bul-EK-to-me) and lung volume reduction surgery (LVRS). A lung transplant may be done for people who have very severe COPD.

Bullectomy

When the walls of the air sacs are destroyed, larger air spaces called bullae form. These air spaces can become so large that they interfere with breathing. In a bullectomy, doctors remove one or more very large bullae from the lungs.

Lung Volume Reduction Surgery

In LVRS, surgeons remove damaged tissues from the lungs. This helps the lungs work better. In carefully selected patients, LVRS can improve breathing and quality of life.

Lung Transplant

A lung transplant may benefit some people who have very severe COPD. During a lung transplant, your damaged lung is removed and replaced with a healthy lung from a deceased donor.

A lung transplant can improve your lung function and quality of life. However, lung transplants have a high risk of complications. These include infections and death due to the body rejecting the transplanted lung.

If you have very severe COPD, talk to your doctor about whether a lung transplant is an option. Discuss with your doctor the benefits and risks of this type of surgery.

Managing Complications

COPD symptoms usually slowly worsen over time. However, they can become more severe suddenly. For instance, a cold, the flu, or a lung infection may cause your symptoms to quickly worsen. You may have a much harder time catching your breath. You also may have chest tightness, more coughing, changes in the color or amount of your sputum (spit), and a fever.

Call your doctor right away if this happens. He or she may prescribe antibiotics to treat the infection and other medicines, such as bronchodilators and glucocorticosteroids, to help with your breathing.

Some severe symptoms may require treatment in a hospital.

How Can COPD Be Prevented?

You can take steps to prevent COPD before it starts. If you already have COPD, you can take steps to prevent complications and slow the progress of the disease.

Prevent COPD Before It Starts

The best way to prevent COPD is to not start smoking or to quit smoking before you develop the disease. Smoking is the leading cause of COPD.

If you smoke, talk to your doctor about programs and products that can help you quit. Many hospitals have programs that help people quit smoking, or hospital staff can refer you to a program. The National Heart, Lung, and Blood Institute's "Your Guide to a Healthy Heart" booklet has more information about how to quit smoking.

Also, try to avoid secondhand smoke and other lung irritants that can contribute to COPD, such as air pollution, chemical fumes, and dust.

Prevent Complications and Slow the Progress of COPD

If you have COPD, the most important step you can take is to quit smoking. This can help prevent complications and slow the progress of the disease. You also should avoid exposure to the lung irritants mentioned above.

Follow your treatments for COPD exactly as your doctor prescribes. They can help you breathe easier, stay more active, and avoid or manage severe symptoms.

Talk with your doctor about whether and when you should get flu and pneumonia vaccines. These vaccines can lower your chances of getting these illnesses, which are major health risks for people who have COPD.

Living With COPD

COPD has no cure yet. However, you can take steps to manage your symptoms and slow the progress of the disease. You can:

Avoid lung irritants
Get ongoing care
Manage the disease and its symptoms
Prepare for emergencies

Avoid Lung Irritants

If you smoke, quit. Smoking is the leading cause of COPD. Talk to your doctor about programs and products that can help you quit. Many hospitals have programs that help people quit smoking, or hospital staff can refer you to a program. The National Heart, Lung, and Blood Institute's "Your Guide to a Healthy Heart" booklet has more information about how to quit smoking.

Try to avoid secondhand smoke and other lung irritants that can contribute to COPD, such as air pollution, chemical fumes, and dust. Keep these irritants out of your home. If your home is painted or sprayed for insects, have it done when you can stay away for awhile.

Keep your windows closed and stay at home (if possible) when there's a lot of air pollution or dust outside.

Get Ongoing Care

If you have COPD, it's important to get ongoing medical care. Take all of your medicines as your doctor prescribes. Make sure to refill your prescriptions before they run out. Bring all of the medicines you're taking when you have medical checkups.

Talk with your doctor about whether and when you should get flu and pneumonia vaccines. Also, ask him or her about other diseases for which COPD may increase your risk, such as heart disease, lung cancer, and pneumonia.

Manage COPD and Its Symptoms

You can do things to help manage your disease and its symptoms. Depending on how severe your disease is, you may ask your family and friends for help with daily tasks. Do activities slowly. Put items that you need often in one place that's easy to reach.

Find very simple ways to cook, clean, and do other chores. Some people find it helpful to use a small table or cart with wheels to move things around and a pole or tongs with long handles to reach things. Ask for help moving things around in your house so that you will not need to climb stairs as often.

Keep your clothes loose, and wear clothes and shoes that are easy to put on and take off.

Prepare for Emergencies

If you have COPD, knowing when and where to seek help for your symptoms is important. You should seek emergency care if you have severe symptoms, such as trouble catching your breath or talking. (For more information on severe symptoms, see "What Are the Signs and Symptoms of COPD?")

Call your doctor if you notice that your symptoms are worsening or if you have signs of an infection, such as a fever. Your doctor may change or adjust your treatments to relieve and treat symptoms.

Keep phone numbers handy for your doctor, hospital, and someone who can take you for medical care. You also should have on hand directions to the doctor's office and hospital and a list of all the medicines you're taking.

Key Points

COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe. "Progressive" means the disease gets worse over time.
COPD can cause coughing that produces large amounts of mucus (a slimy substance), wheezing, shortness of breath, chest tightness, and other symptoms.
Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. Long-term exposure to other lung irritants, such as air pollution, chemical fumes, or dust, also may contribute to COPD.
In the United States, the term "COPD" includes two main conditions—emphysema and chronic obstructive bronchitis. Most people who have COPD have both conditions. Thus, the general term "COPD " is more accurate.
COPD is a major cause of disability, and it's the fourth leading cause of death in the United States.
COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself.
Your doctor will diagnose COPD based on your signs and symptoms, your medical and family histories, and test results.
COPD has no cure yet. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease.
Quitting smoking is the most important step you can take to treat COPD. Other treatments include medicines, vaccines, pulmonary rehabilitation, oxygen therapy, surgery, and managing complications.
You can take steps to prevent COPD before it starts. The best way to prevent COPD is to not start smoking or to quit smoking before you develop the disease. Also, try to avoid other lung irritants that can contribute to COPD.
If you have COPD, you can take steps to manage your symptoms and slow the progress of the disease. Quit smoking and try to avoid other lung irritants. Also, get ongoing care, manage the disease and its symptoms, and prepare for emergencies.

HEALTH TIPS FOR MUSICIAN

2010-04-17T16:57:00.002+07:00

HEALTH TIPS FOR THE MUSICIAN

Being healthy means you don't miss gigs, and don't have to spend money you would rather spend on studio time or instruments on a doctor's visit. Here are a few ways you can keep a little more of that money in your pockets, and where it can do more for your career.

WATER IS YOUR FRIEND

Sometimes the simplest things are the hardest to do. There is a lot to be said for drinking more water and less other things. Water has no calories, costs very little to nothing, and is great for keeping vital things like vocal cords and skin healthy. There are few things more irritating than a scratchy throat or split fingers if you are trying to play your instrument, and drinking plenty of water can help prevent both of these. This can also help you keep your skin less wrinkled and your weight down, allowing you to need less money in the long run trying to fix appearance problems as you age, and, in this sadly Hollywood-image field we are in, can probably up your chances of getting contracts simply because you are more youthful and healthy looking than your competition. If you happen to play in a very air-conditioned or heated area, keeping the place humidified can also keep your instruments in better shape and prevent a lot of cracking problems in things like wooden parts and skins, saving you money in repairs and replacement costs. To help keep humidity in the place if you can't afford a humidifier, try keeping a few potted plants around-keeping them moist enough to be healthy seems to keep the air around them the right moisture level as well. Keeping some lotion around that you find works helps a lot, too-seal in all that good moisture to your hands and face.

LEARN TO RELAX

This is another simple thing that is really hard to do. Many musicians have a really hard time "coming down" from a stage show, big meeting with industry bigwigs, or a really good writing session. Many methods exist to allow one to sit still and force oneself to unwind without the need for chemicals so you can get a decent night's sleep. Consider taking a class in Yoga or meditation; find something that really helps you wind down like a warm bubble bath, reading or some other pursuit. Things that work for me, strangely enough, are working on my taxes (so boring it numbs my brain out), curling up in front of the television watching cartoons, a long, slow workout followed by a hot shower or reading a book-especially if the book has a lot of imagery or highly technical data to absorb. I've also found that doing the meditation trick of thinking about sitting and relaxing doing something that soothes you is very helpful-many classes do the scene about sitting on a beach and thinking about being there, while I find thinking about doing yard work or building very relaxing. The important thing is to bore yourself with something that is fun for you, or lets you feel you are accomplishing something beneficial to you. Avoiding chemicals also prevents you from becoming habituated to them-something that can hurt you in the long run. Longer and longer runs or reading can only do you good, while costly chemical solutions often end careers in one way or another. Try to find fun, healthy, low-cost rituals instead.

CREATIVE FIDGETING

You can never really get enough practice, so try to find ways to practice even if you don't have your instrument around. Flexing your fingers backwards like your hands are eagle claws about to strike is great for many instrumentalists, as is doing this then drawing your fingers towards your palms after doing the claw stretch, as if you were about to make a fist, but then allowing the finger to come back to the initial position. I find this is a great way to work kinks out if I have been doing too much work with a pencil, too, at times when I have been frantically writing lyric ideas down. Pretending you are doing scales with both fingers or trying to make your fingers hold a certain chord position helps, too. Drawing your knees up as high as you can one at a time while sitting watching television or doing desk duty at work can help keep your legs and waistline in shape, too, and this can not only help your appearance but help things like your singing or ability to stand holding your instrument for longer periods of time, too. Try surfing the web for other fun exercises you can do while seated-there are lots of fun ones, and any exercise helps keep your weight down and helps you avoid all the health problems associated with that.

So try these simple suggestions and see how it helps your writing. It is amazing how much more endurance you may find you'll have just by drinking more water, learning to relax, and getting a little more exercise.

WHAT MAKES MUSICIANS PRONE TO REPETITIVE STRAIN INJURIES (RSI) ?

2010-04-14T13:07:00.001+07:00

What makes musicians prone to Repetitive Strain Injuries (RSI)?

Many musicians have heard horror-stories about comrades who were excellent performing artists until they developed a repetitive strain injury to the arm or hand. Then their career either temporarily stopped or was finished due to this debilitating injury. Why are musicians prone to these injuries? What can be done about them? In this article you will learn why your hands and arms are at risk for injury, and what you can do to help prevent problems from developing in the first place.

In my experience working with hundreds of people who have suffered RSIs, there's a common trait among them. It is the "I thought the pain would go away" concept. Many musicians are out their (maybe yourself) who are currently attempting to play their instrument, even though their arms, elbows, shoulders, or neck are killing them. You have to realize that pain is your body's warning signal. It is like the oil light in your car. If the oil light goes on, do you simply say "let's see if that will turn off by itself. It can't be that important." That would be ludicrous, wouldn't it? Eventually, the engine would dry out, heat up, and for all intensive purposes seize up and be destroyed.

Are you letting this happen to your body? Are you letting the signs and symptoms of a major malfunction in your body, escalate to the point of total
destruction? I'm sorry to say, but I usually see musicians who've reached this point. They come in my office in desperation, stating they can't play anymore because of the pain, and their career is ruined. Don't let this happen to you!

Let's first begin to understand why the body malfunctions. There's some basic information you need to know about the body. I'll keep it simple and
as short as possible.

Your nervous system (the brain, spinal cord, and all the nerves that branch off the spinal cord) controls EVERYTHING in your body. This includes muscles, organs, glands, tissues, cells, immunity, hormones, etc. Let's put it another way - there's nothing that occurs in your body without the brain
controlling it.
The nerve system is the "life force" of the body. It literally supplies life to the muscles, tissues, glands, and organs. Without this life-supplying nerve input, your tissues disease and eventually die. Ever see what a spinal cord injury does to a person? That's a pure example of a deadened nerve system.
Insults to your body, in the form of physical stresses, chemical stresses, or emotional stresses can "blow fuses" and irritate the nervous system. This causes abnormal signals to reach the tissues, organs, and glands. Let's break down these types of stresses and how they relate to musicians:
- Physical stresses: (things that physically stress your body) Bad posture while playing your instrument, prolonged playing times without breaks,
  playing in one position (sitting for example) for a long time, previous car or motorcycle accidents, birth injuries (as a baby), quickly ramping up practicing times due to an upcoming gig or recital, being out of shape & overweight, sitting at computers for a long time, playing computer games hour after hour.
- Chemical Stressors: (things to knowingly, or unknowlingly put into your body), drugs and alcohol, prescription drugs, fast food, vaccines, toxic
  chemicals in your environment (like chemicals you're exposed to by work or at home), a bad water supply.
- Emotional stressors: (stuff you're thinking about) getting that recording contract, composing and finishing songs by a deadline, record company execs being a pain is the most, family stresses, relationship stressors, job stresses other than your music career, death of loved ones, relocating, being on tour without family or loved ones nearby, and finally your negative thinking AKA "stinkin' thinkin'" I bet you never thought that all these things mentioned have a direct impact on your body!
Continued physical, chemical, and emotional stressors will short-circuit your nervous system and lead to things called "spinal subluxations". "A spinal what?" you ask? A subluxation is a misalignment of a spinal bone(s) that exerts stress on your nerve system. This leads to malfunction of the
tissues that affected nerves supply, in some cases muscles, in some cases organs, and in some cases, both!
These continued stressors will eventually lead to symptoms due to repeated stress on the nerve system. Prolonged, uncared for stresses will lead to disease, disability, and eventually a shortened life-span.

So let's summarize in a real, practical situation that every musician can understand. You feel that you're in pretty good health, except for the fast food (chemical stress) that seems to be part of your lifestyle lately. You know that you're not eating right, but hey, there's this recording deal that you have to provide music for. You're spending 8 to 10 hours a day composing music, (physical stress) sitting at your guitar and piano. That certainly doesn't give you time to fix good meals. What's worse is that your girlfriend (or boyfriend) is hounding you because you don't spend enough time with them. (Emotional stress) Your dad recently had a heart attack, and your torn because you can't spend enough time with him right now. (emotional stress) You're finding that one or two beers isn't sufficing anymore. Drinking a six-pack is becoming part of your practice sessions. (chemical stress) To top things off, your back is beginning to hurt after playing guitar for more than a few hours, so you begin taking some ibuprofen every day to make it through the sessions. (chemical stress)

Now do you see what I'm getting at? Your health is a conglomerate of YOU. What you're eating, taking, saying, doing, and hearing. YOU ONLY DEVELOP AN INJURY WHEN THESE CONTINUED STRESS FACTORS BEGIN TO BREAK DOWN YOUR NERVOUS SYSTEM AND CAUSE YOUR MUSCLES, ORGANS, AND GLANDS TO DISEASE.

So, let's consider your injury, if you have one, at this point in time. Look back at this list of stressors and see which ones you've experienced lately.
And it doesn't have to be within the past month or two. This list can go back to birth! Complicated you say? You're right. When a person walks in my office with an RSI, we have to investigate that entire person's life to find out what stressors led him/her to this current symptom. In many cases, even though the pain is in the arm, the actual nerve stress that is leading to the symptom can stem from the brain stem, neck, upper back, and lower
back. You have to investigate the whole body.

So what can you do now that you understand this better? First, work at relieving stressors in your life. (That's not easy) Second, if you think your life stressors have taken their toll on your body, then visit a chiropractor to determine if your nervous system is shutting down, or is working at half-mast. Third, if you are having active RSI-type symptoms, don't wait - run, to a chiropractic office for a complete eval and treatment. And the last, feel free to asking me some advice if you meet some problems likes above...

LONG LASTING VALUES

2010-04-08T23:06:00.003+07:00

I'm a medical doctor,
I'm a hardcore kids and musician as well,
well in the mean time,
one of my biggest endeavour is to make how my music (HxC / Hard Core) become
more healthy, more safe, avoid whole injuries in gigs, and more productive...
I brought whole knowledge that I had,
and contribute for ourselves with my own capabilities
in the scene itself,
I hope you all guys in the same line with me...

(Iman Firmansyah, B.Sc., M.D.)

CARCINOGENS FROM PARENT'S " TOBACCO SMOKE FOUND IN THEIR BABIES"

2010-04-07T17:38:00.005+07:00

Carcinogens From Parents 'Tobacco Smoke Found In Their Babies'

PHILADELPHIA - When mom or dad puffs on a cigarette, their infants may inhale the resulting second-hand smoke. Now, scientists have detected cancer-causing chemicals associated with tobacco smoke in the urine of nearly half the babies of smoking parents.

"The take home message is, 'Don't smoke around your kids,'" said Stephen S. Hecht, Ph.D., professor and Wallin Chair of Cancer Prevention at The Cancer Center at the University of Minnesota.

According to a study of 144 infants, published in the May issue of Cancer Epidemiology, Biomarkers & Prevention, Hecht and his colleagues found detectable levels of NNAL* in urine from 47 percent of babies exposed to environmental tobacco carcinogens from cigarette smoking family members.

NNAL is a cancer-causing chemical produced in the human body as it processes NNK**, a carcinogenic chemical specific to tobacco. "The level of NNAL detected in the urine of these infants was higher than in most other field studies of environmental tobacco smoke in children and adults," Hecht said. "NNAL is an accepted biomarker for uptake of the tobacco-specific carcinogen NNK. You don't find NNAL in urine except in people who are exposed to tobacco smoke, whether they are adults, children, or infants."

A previous study by Hecht and his colleagues indicated that the first urine from newborns whose mothers smoked during pregnancy contained as much as one-third more NNAL compared to the babies in the current study. The newborn infants, however, took in the carcinogen directly from their mothers through their placentas rather than by breathing second-hand smoke in the air in their family homes and cars. In the current study, when babies had detectable levels of NNAL, Hecht said that family members smoked an average of 76 cigarettes per week, in their home or car while the babies were present. In children of smokers whose babies had undetectable levels of NNAL in their urine, the average number of cigarettes smoked by family members was reported at 27 per week. "With more sensitive analytical equipment, the NNAL from urine of babies in lower frequency cigarette smoking households would most likely be detectable " Hecht said.

While studies have not determined how the long term risk of exposure to cancer-causing tobacco smoke affects the genetics of babies during their early years when they are growing rapidly, Hecht said that this study demonstrated substantial uptake of NNK and its metabolite NNAL in infants exposed to environmental tobacco smoke. "These findings support the concept that persistent exposure to environmental tobacco smoke in childhood could be related to cancer later in life," he said. Hecht conducted his study in collaboration with Steven G. Carmella, Ky-Ahn Le, Sharon E. Murphy, Angela J. Boettcher, Chap Le, Joseph Koopmeiners, Larry An, and Deborah J. Hennrikus from the Transdisciplinary Tobacco Use Research Center and The Cancer Center, University of Minnesota.

* 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol
** 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone

SINUSITIS, BAGAIMANA MENGHADAPINYA ?

2010-04-05T21:59:00.005+07:00

Sinusitis, bagaimana menghadapinya?

(Bahasa Indonesia Version)

Selesma yang umumnya dianggap penyakit rutin setiap pergantian musim, tetapi bagi penderita sinusitis lebih dari derita yang tiada berakhir, kepala terasa nyeri untuk nenunduk, hidung tersumbat, ingus kuning kehijauan tak henti mengalir, hidung berbau tak sedap. Apa yang harus dilakukan untuk meredakan infeksi dan radang sinus itu ? Pada tahap pertama, sinusitis dapat diobati dengan obat-obatan tradisional dan antibiotik yang membunuh bakteri penyebab infeksi. Andai kata Anda penderita sinusitis kronis atau musiman, jangan sepelekan penyakit itu, sebab, salah diagnosa dan terapi, penyakit pun akan tetap saja membandel. Rongga hidung terdiri dari empat set rongga cekung, lapisan dengan selaput tipis terletak di atas, belakang dan samping hidung. Fungsi utamanya menghasilkan lendir, normalnya sampai dua liter perhari untuk membersihkan bakteri, debu, dan polutan lain yang ikut terhirup waktu bernafas. Lapisan cilia ( bulu getar ) yang mirip dengan rambut di rongga hidung berguna untuk menyapu lendir sampai ke hidung, kemudian ke bagian belakang kerongkongan yang ditelan dan dilarutkan oleh asam pencernaan. Lapisan cilia tidak akan berfungsi sebagaimana mestinya bila rongga hidung meradang. Akibatnya, lendir terjebak di dalam rongga dan menjadi tempat pembiakan bakteri.

Sebenarnya ada dua macam sinusitis yang masing-masing membutuhkan terapi tersendiri. Sinusitis akut lebih umum terjadi dan di sertai selesma, penderitaan ini biasanya dapat disembuhkan dalam waktu kurang dari tiga minggu, bila dideteksi lebih dini biasanya memberi hasil yang cepat dan optimal, cukup dengan meminum obat-obatan di rumah. Beberapa langkah terapi berikut :

Manfaatkan dengan air panas. Saat mandi, gunakan shower air hangat, usap dahi, hidung dan dagu dengan waslap yang dibasahi air panas, agar lubang hidung terbuka lebar. Rongga hidung yang kering lebih mudah terinfeksi daripada yang basah.

Gunakan obat semprot bergaram. Caranya sangat mudah, hanya di semprot atau di teteskan kedalam hidung, selaput akan lembab, bakteri dan debu pun terbuang, cuma jangan di gunakan lebih dari 4-6 hari, efeknya akan memburuk dan justru bisa menyebabkan peradangan. Akibatnya hidung menjadi tambah tersumbat dan Anda pun membutuhkan dosis obat ini yang lebih banyak lagi, ketahuilah, semakin sering obat semprot digunakan, kian buruk kondisi hidung. Perbanyak memakan makanan yang pedas, umumnya makanan berbumbu pedas dapat memperlebar lubang hidung.

Usahakan hidung selalu dalam kondisi lembab, terutama tatkala cuaca di luar panas terik.

Perbaiki daya tahan tubuh. Caranya, istirahat yang cukup dan makan panganan yang penuh gizi. kurangi merokok atau kalau bisa berhenti merokok.

Sinusitis yang kronis, dengan infeksi terus-menerus, kebanyakan yang terjadi akibat infeksi berulang-ulang atau sebelumnya tidak tuntas di tangani. Gejalanya berupa batuk, hidung tersumbat, berbau tidak sedap, pilek, rongga hidung memerah, kemampuan mencium berkurang dan lendir dari hidung berwarna kuning kehijauan, keluhan ini mungkin bisa hilang dalam waktu lebih dari enam minggu. Akibatnya akan terluka oleh infeksi sebelumnya, rongga hidung menyempit atau tertutup dan tidak dapat mengeluarkan ingus. Sinusitis yang kronis sulit diobati, kondisinya akan makin parah jika tidak cepat-cepat diobati ketika kambuh. Bisa-bisa terbangun pada pagi hari, kelopak mata menonjol, rasa sakit menusuk dari dahi sampai ke bagian atas gigi dan demam, tidak hanya itu, daya menciumnya juga hilang, seperti kebal. Salah satu jalan yang terbaik bagi penderita sinusitis yang kronis adalah operasi, operasi sinus adalah alternatif pengobatan yang terakhir. Itu juga merupakan indikasi sinusitis yang berat dan gagal diterapi.

Operasi dengan endoskopik secara dramatis dapat mengurangi derita pasien, dan pada umumnya lebih cepat memulihkan fungsi drainase. Ada prosedur pengobatan baru dengan memakai teknologi tinggi, suatu tabung semacam pipa kecil, yang dilengkapi kamera fiberopik dan instrumen lainnya dimasukkan melalui hidung. Kemudian diberi antibiotika selama sepuluh hari dan nasal steroid untuk mengurangi peradangan yang lebih jauh dan wajib istirahat antara tiga hingga lima hari. Kasus sinusitis terburuk terjadi empat tahun terakhir, mengapa ? Karena dunia telah banyak terkontaminasi. polusi di mana-mana, Akibatnya banyak organisme yang lebih kebal di lingkungan sekitar kita saat ini. Harapan satu-satunya adalah agar segera di kembangkan antibiotika baru. Kalau tidak, sinusitis tetap mewabah, tetapi sejauh ini, sinusitis masih dapat dikontrol, asal gejalanya dapat di ketahui dan ditangani secara dini.

Trichomoniasis: Sexually Transmitted Disease Without Symptoms

2010-04-05T19:08:00.004+07:00

Trichomoniasis: Penyakit Menular Seksual Tanpa Gejala (Bahasa Indonesia Vesion)

Sebagai pria yang menyenangi kesehatan, tentunya Anda perlu mengetahui berbagai penyakit yang berada di sekitar kita. Apalagi jika berkaitan dengan penyakit yang bersamaan dengan seks. Mengerikan sekali jika kita tidak mengetahuinya sejak awal. salah satunya adalah Trichomoniasis.

Trichomoniasis alias "trich", merupakan infeksi parasit yang bisa terjadi pada laki-laki dan perempuan. Pada laki-laki, tanda-tandanya muncul pada uretra (saluran yang mengalirkan urin ke luar tubuh). Pada perempuan, yang terkena adalah vagina dan serviks (leher rahim).

Pada laki-laki yang terinfeksi parasit ini tidak merasakan gejala apapun namun dapat menularkan ke pasangannya. Demikian juga sebaliknya, saat perempuan terinfeksi parasit ini, dia bisa juga tidak merasakan gejalanya. Trichomoniasis kerap terjadi bersama dengan penyakit menular seksual lainnya, seperti gonorrhea dan nongonococcal urethritis (chlamydia), khususnya pada perempuan.

Trichomoniasis di negara AS lebih tinggi terjadi pada perempuan dibanding laki-laki. Diperkirakan 5 juta kasus baru terjadi setiap tahunnya dan infeksi ini terjadi pada 10% perempuan yang datang untuk mengobati penyakit menular seksual yang dideritanya. Pada 2000, the Centers for Disease Control and Prevention (CDC) melaporkan bahwa trichomoniasis biasanya dapat diobati pada perempuan muda dengan kehidupan seksual aktif.

Untuk lebih mengetahui penyebabnya, Anda perlu tahu adalah Trichomoniasis disebabkan oleh parasit yang disebut Trichomonas vaginalis, yang ditularkan khususnya melalui kontak seksual secara langsung. Penyakit ini juga dapat ditularkan melalui mutual masturbation dan berbagai sex toys (alat bantuk seks)

Gejala umumnya muncul dalam 4-20 hari setelah infeksi. Perempuan yang terinfeksi parasit Trichomonas akan mengeluarkan cairan dari vagina berwarna kuning kehijauan atau abu-abu serta berbusa dalam jumlah banyak, kadangkala disertai pendarahan dan bau tidak sedap, gatal pada vulva sehingga menimbulkan rasa tidak nyaman.

Sering buang air kecil dan terasa sakit, pembengkakan vulva, rasa tidak nyaman selama berhubungan seksual dan sakit di wilayah perut. pendarahan di serviks mungkin terjadi, namun ini bukan gejala umum.

Sementara gejala pada laki-laki jarang terjadi. Namun jika pasangan mengeluhkan keluarnya cairan dari fanis berwarna putih pucat dan merasa sakit atau sulit saat buang air kecil, besar kemungkinan dia terkena trichomoniasis. Namun sekali lagi hal ini harus dipastikan dengan pemeriksaan klinis.

Trichomoniasis yang tidak ditangani tuntas dihubungkan dengan meningkatnya risiko terinfeksi HIV (virus yang menyerang sistem kekebalan tubuh yang akan berkembang menjadi AIDS). Perempuan hamil yang terinfeksi Trichomonas berisiko melahirkan bayi prematur, berat badan lahir rendah dan infeksi hingga pelepasan plasenta. Sedangkan peradangan pada prostat (prostatitis) dan saluran kencing (cystitis) kerap dikaitkan dengan trichomoniasis pada laki-laki.

Diagnosis

Membiakkan sampel cairan vagina/penis merupakan metode yang dapat diandalkan untuk menegakkan diagnosis trichomoniasis. Diperkirakan butuh waktu 10 hari untuk mendapat hasilnya. Pada perempuan untuk menegakkan diagnosis juga perlu dilakukan pemeriksaan mikroskopis cairan vagina, pap smear dan urinalysis. Leher rahim juga diperiksa jika terjadi pendarahan. Karena trichomoniasis sering terjadi bersama penyakit menular seksual lainnya, pasien perlu diperiksa untuk menentukan jenis infeksinya, apakah chlamydia, gonorrhea, syphilis, atau HIV.

Pengobatan

Sejauh ini metronidazole dikenal sebagai obat yang dapat mengobati trichomoniasis, yang diminum dalam dosis tunggal. Orang yang mengonsumsi metronidazole harus menghindari alkohol selama pengobatan, sebab reaksi kimia yang ditimbulkan dapat menyebabkan mual dan muntah. Efek samping yang timbul antara lain mual, sakit kepala dan kram bagian perut. Perempuan hamil yang hendak mengonsumsi obat ini harus konsultasi dulu ke dokter.

Meski gejala trichomoniasis pada laki-laki dapat sembuh dengan sendirinya dalam beberapa minggu, namun karena laki-laki yang terinfeksi parasit Trichomonas bisa saja tak menunjukkan gejala sehingga dia dapat menularkannya ke orang lain, untuk itu sebaiknya rajin memeriksakan diri ke dokter dan meminum obatnya secara teratur untuk mematikan parasit ini.

Trichomoniasis: Sexually Transmitted Disease Without the Symptoms (English Version)

As a man who enjoys the health, of course you need to know the various diseases that are all around us. Especially when it comes to the same disease with sex. How awful if we did not know it from the beginning. one of them is Trichomoniasis.

Trichomoniasis or "trich", is a parasitic infection that can occur in men and women. In men, the signs appear in the urethra (the channel that drains urine out of the body). In women, the affected are vagina and cervix (neck of the uterus).

In men infected with this parasite does not feel any symptoms but can pass on to their partner. And vice versa, while women are infected with this parasite, she may not feel the symptoms. Trichomoniasis often occurs along with other sexually transmitted diseases, such as gonorrhea and nongonococcal urethritis (chlamydia), especially in women.

Trichomoniasis in the U.S. state higher occur in women than men. An estimated 5 million new cases occur each year and this infection occurs in 10% of women who came to treat sexually transmitted diseases suffered. In 2000, the Centers for Disease Control and Prevention (CDC) reported that Trichomoniasis can usually be treated at a young woman with an active sexual life.

To know better about the cause, you need to know is Trichomoniasis is caused by a parasite called Trichomonas vaginalis, which is transmitted mainly through sexual contact directly. This disease can also be transmitted through mutual masturbation and other sex toys (sex bantuk tool)

Symptoms generally appear within 4-20 days after infection. Women who are infected with the parasite Trichomonas will remove fluid from the vagina yellow-green or gray and foaming in large quantities, sometimes accompanied by bleeding and odor, itching at the vulva, leading to discomfort.

Frequent urination and pain, swelling of the vulva, discomfort during intercourse and pain in the stomach area. bleeding in the cervix may occur, but this is not a general phenomenon.

While the symptoms in men are rare. But if the couple complained fanis discharge from pale white and feel sick or difficult urination, chances are he hit Trichomoniasis. But again this must be confirmed by clinical examination.

Trichomoniasis is not handled thoroughly associated with an increased risk of HIV infection (the virus that attacks the immune system will develop into AIDS). Pregnant women infected with Trichomonas risk of premature babies, low birth weight and placental infection until the release. While inflammation of the prostate (prostatitis) and urinary tract (cystitis) often associated with Trichomoniasis in men.

Diagnosis

Vaginal fluid samples breed / penis is a reliable method for diagnosis Trichomoniasis. Estimated to take 10 days to get results. In the women to make the diagnosis also needs to be done vaginal fluid microscopic examination, pap smear and Urinalysis. The cervix is also checked if there is bleeding. Because Trichomoniasis often occurs with other sexually transmitted diseases, patients need to be examined to determine the type of infection, whether chlamydia, gonorrhea, syphilis, or HIV.

Theraphy

So far, metronidazole is known as a drug that can treat Trichomoniasis, which is taken in a single dose. People who take metronidazole must avoid alcohol during treatment, because the resulting chemical reaction may cause nausea and vomiting. Side effects that arise include nausea, headache and abdominal cramps. Pregnant women who want to take this medication should consult a doctor first.

Although symptoms of Trichomoniasis in men can be healed by itself within a few weeks, but because men are infected with the parasite Trichomonas may not show symptoms so he can spread it to someone else, for that should be diligently went to the doctor and take his medicine regularly to kill these parasites.

PO CHAI PILLS WILL CAUSE A CANCER (in Bahasa Indonesia)

2010-04-05T16:09:00.005+07:00

Obat Sakit Perut Po Chai yang Sebabkan Kanker

Departemen Kesehatan Hong Kong melarang dan menarik kembali peredaran dua jenis obat sakit perut tradisional China Po Chai. Akankah obat yang telah dikonsumsi anak-anak hingga manula sejak berusia ratusan tahun itu berakhir?

Pil Po Chai telah menjadi akrab di kalangan masyarakat Asia termasuk di Indonesia. Jika anak-anak sakit perut, ibu-ibu zaman dulu hingga saat ini masih menggunakan Po Chai untuk penyembuhannya.

Pil Po Chai digunakan untuk meredakan gangguan pencernaan, mulas, muntah, diare dan kembung. Obat ini juga digunakan untuk mencegah mabuk.

Seperti dilansir dari data perusahaan pochaipills.com, pil Po Chai pertama kali dibuat oleh Li Shiu Kei di Foshan, Guangdong pada tahun 1896. Li kemudian mengembangkan usahanya ke Hong Kong setelah perang saudara di China yang berakhir pada 1936.
Di Hong Kong, Li kemudian mengibarkan bendera Li Chung Shing Tong (Holdings) Limited yang menjual pil Po Chai ke seluruh dunia. Sedangkan perusahaan di Guangzhou, China di bawah bendera Wanglaoji Guangzhou Pharmaceutical Company Limited hanya menjual obat untuk
daratan China saja.

Po Chai adalah ramuan herbal yang mengandung Halloysitum, akar Rhizoma, Oryzae Satiae, daun Herba Menthae, Selerotrum Porifungal, Radix Puepariae, daun Herba Agastaches, Excarpium Citri, Cortex magnoliae dan daun Masse Fermentata Neaven. Namun kini Po Chai bakal susah dicari.

Departemen Kesehatan Hong Kong melarang dan menarik obat-obat Po Chai dari pasaran sejak 24 Maret 2010.

Selain Hong Kong, Singapura sudah terlebih dahulu melarang penjualan obat ini sejak 8 Maret 2010.

Dalam keterangannya seperti dilansir dari news.gov.hk, Selasa (30/3/2010), Departemen Kesehatan Hong Kong memerintahkan semua pil Po Chai baik dalam bentuk kapsul maupun botol ditarik dari gerai ritel lokal.

Penarikan tersebut dilakukan setelah mempelajari hasil temuan otoritas Singapura yang melarang obat yang mengandung phenolphthalein dan sibutramine karena menyebabkan kanker dan obesitas. Po Chai ternyata mengandung dua bahan tersebut.
Hasil temuan Departemen Kesehatan Hong Kong, obat yang tercemar ini adalah bahan bubuk dalam kapsul. Dua kapsul yang dicurigai berbahaya yang telah diekspor ke Singapura itu adalah kapsul nomor 21217 dan 21133.

Dan juga berdasarkan pengalaman saya dalam praktek sehari-hari, dalam 3 tahun belakangan ini, saya menemukan reaksi alergi (Drug Eruption) pada pasien saya yang mengkonsumsi pochai pills ini. Semoga bermanfaat.

OBAMA ; HEALTH & EDUCATION POLICY GRANTED

2010-03-31T16:30:00.004+07:00

OBAMA ; HEALTH & EDUCATION POLICY GRANTED

President Obama signed into law Tuesday a package of revisions to his
new health-care overhaul that includes a measure aimed at making higher
education more affordable.

The provision ends what Obama called a long-standing "sweetheart deal"
for banks in federally guaranteed student loans.

In a speech and signing ceremony at the Alexandria campus of Northern
Virginia Community College, Obama said the health-care reform
legislation and the revisions represent "two major victories ... that
will improve the lives of our people for generations to come."

He said the Health Care and Education Reconciliation Act of 2010 would
save taxpayers $68 billion in the coming years by cutting out the role
of banks and lending institutions as middlemen in federally guaranteed
student loans. The money is to be channeled into the Pell Grant
program, invested in community colleges and historically black colleges
and used to make student loans more affordable by capping repayments at
10 percent of discretionary income starting in 2014.

Republicans in Congress were unified in their opposition to the health-
care overhaul, and a spokesman for Senate Minority Leader Mitch
McConnell (R-Ky.) criticized the student-loan legislation Tuesday,
saying it would have "devastating consequences" for employees of
lending institutions. He pointed to estimates that 30,000 jobs could be
lost nationwide. The largest student lending firm, SLM Corp., known as
Sallie Mae, has said it could be forced to lay off nearly 30 percent of
its 8,600 U.S. employees.

Obama said billions of dollars that could have been spent helping more
students to attend college or easing tuition burdens went instead to
"padding student lenders' profits." He told the audience that major
banks "hired an army of lobbyists" to defeat the legislation and that
Sallie Mae "spent more than $3 million on lobbying last year alone."

Before signing the bill, Obama paid tribute to lawmakers who had "the
courage to do what's right" by supporting the health-care and student
loan legislation in the face of attacks he described as "fierce and
unrelenting -- and inaccurate."

Obama said the education measures would help meet his national goal of
having the highest proportion of college graduates in the world by
2020.

Because of the reforms, he told a cheering crowd at the community
college, "the foundation on which America's future will be built is
stronger than it was one year ago."

"Today we mark an important milestone on the road to health-insurance
reform and higher-education reform," Obama said. "But more broadly,
this day affirms our ability to overcome the challenges of our politics
and meet the challenges of our time."

Obama was introduced by Jill Biden, the wife of Vice President Biden.
An English teacher at the Alexandria school, she was asked by Obama to
host a summit on community colleges at the White House this fall.

"I am pleased to say that the reforms in this bill will make a huge
difference to those Americans who need it most," Biden said.

FAT-LIPID PREJUDICE

2010-03-31T16:09:00.004+07:00

ANOTHER WRONG MYTHS ABOUT FAT-LIPID
(well i'll try to put it on a better prospective)

Lemak sering kali dituding sebagai "biang keladi" obesitas serta berbagai jenis penyakit berbahaya lainnya. Akibatnya, kian hari kian banyak saja perempuan yang menyingkirkan lemak dari menu sehari-hari.
Padahal, beberapa di antara pernyataan buruk tentang lemak itu hanyalah mitos yang menyesatkan.

Mitos 1: Jangan Minum Susu kalau Mau Kurus, Tubuh kita membutuhkan protein, vitamin (A dan D), mineral, dan suplai energi yang terkandung di dalam susu. Susu juga amat baik karena kandungan kalsium yang tinggi (116-290 mg kalsium per 100 gram susu). Kekurangan kalsium akan membuat Anda rentan terserang osteoporosis dan kekurangan produksi hormon yang bisa membantu mengurai lemak di dalam tubuh.

Tip: Minumlah susu 1-2 kali sehari. Perempuan berusia di bawah 30 tahun masih boleh mengonsumsi susu full cream. Susu low fat ataupun nonfat adalah pilihan terbaik bagi yang usianya di atas 30 tahun.

Mitos 2: Avokad adalah Jenis "Buah Terlarang" Lemak di dalam avokad adalah asam lemak omega-9, jenis lemak baik yang justru mampu menekan kadar kolesterol jahal (LDL). Avokad juga kaya serat sehingga bisa menyerap kelebihan LDL dan membuangnya bersama sisa-sisa pembakaran. Avokad pun kaya kalium yang berkhasiat menstabilkan debar jantung dan tekanan darah serta memelihara kesehatan sistem saraf. Juga kaya vitamin E dan B yang penting untuk menjaga kesehatan kulit, mencegah penuaan dini, dan memperkuat imunitas tubuh.

Tip: Santap avokad tanpa tambahan dressing, seperti susu, cokelat, ataupun gula. Avokad juga lezat dinikmati sebagai pengganti mentega atau butter untuk melapisi roti.

Mitos 3: Mentega Lebih Baik daripada Minyak Goreng Mentega terbuat dari krim susu sehingga kandungan kolesterol di dalamnya justru lebih tinggi dibandingkan minyak goreng. Terlebih, minyak goreng yang terbuat dari bahan nabati, seperti minyak zaitun, minyak kanola, atau minyak wijen. Meski minyak goreng nabati mengandung lebih banyak lemak dibandingkan mentega, sebagian besar kandungan lemak yang terdapat di dalamnya tergolong lemak "baik" yang mudah diuraikan tubuh.

Tip: Hindari memproses makanan dengan cara digoreng dan pilihlah makanan yang direbus, dikukus, atau ditumis. Jika terpaksa mesti menggoreng, pilihlah jenis minyak nabati.

Mitos 4: Banyak-banyak Makan Telur Itu Aman Memang banyak olahragawan yang makan telur banyak-banyak demi mendapatkan tubuh berotot. Tapi, mereka punya panduan diet yang membatasi jumlah konsumsi telur dan mengimbanginya dengan asupan nutrisi lain. Telur memang mengandung banyak zat gizi, seperti vitamin B-kompleks, asam amino esensial, seperti mineral (besi, fosfor, dan kalsium). Namun, selain kaya gizi, kandungan kolesterol di dalam kuning telur amat tinggi sehingga konsumsinya harus dibatasi.

Tip: Batasi makan telur menjadi 2 butir per minggu. Bersama telur, konsumsilah sayur-sayuran yang kaya vitamin A, D, E, dan K, seperti wortel dan tauge, untuk membantu melarutkan lemak.

Mitos 5: Pantang Makan Daging Bikin Tubuh Langsing Daging adalah bahan pangan yang kaya protein serta asam amino esensial yang penting bagi tubuh. Di dalam daging ikan terkandung asam lemak omega-3 yang berguna mencegah penyakit jantung serta omega-6 yang mampu meningkatkan pembakaran energi dalam tubuh, mengatasi retensi (penarikan air dalam tubuh) dan penyakit jantung koroner.

Tip: Perbanyak konsumsi ikan dibandingkan daging sapi dan ayam. Buang kulit dan bagian yang berlemak. Jika ingin menyantap steak, hindari steak prime rib atau T-bone yang banyak lemak.

Mitos 6: Doyan Es Krim Bikin Badan Melar Es krim yang berbahan dasar susu memang mengandung lemak dan kolesterol dalam jumlah bervariasi. Tetapi, jangan lupa, di dalam setiap jenis makanan terdapat zat gizi yang baik dan buruk bagi tubuh. Selain lemak dan kolesterol, es krim juga mengandung banyak sekali mineral (kalsium, magnesium, natrium, kalium, besi, seng, dan iodium), protein, serta vitamin A, B, D, dan E. Kalsium malah mampu meningkatkan produksi hormon yang bertugas menguraikan lemak dalam tubuh.

Tip: Pilih es krim rendah lemak, sorbet, ataupun gelato. Lebih baik lagi, nikmatilah es krim dengan dicampur beraneka macam potongan buah.

Mitos 7: Kacang-kacangan adalah Camilan yang Menggemukkan Penelitian di Purdue University menyatakan, menyantap kacang-kacangan bisa mendatangkan rasa kenyang lebih lama dibandingkan camilan diet, seperti biskuit beras dalam jumlah sama. Lemak dalam kacang adalah omega-9, lemak "baik" yang mampu menurunkan level LDL. Kacang almon, hazelnut, dan walnut mengandung asam amino arginine yang mampu memperlebar pembuluh darah arteri dan menurunkan tekanan darah.

Tip: Menurut penelitian, mengemil kacang 5 kali seminggu masing-masing 1 bungkus kecil dapat menurunkan risiko serangan jantung sebesar 25-39 persen. Tapi, konsumsi kacang yang dipanggang, jangan yang digoreng.

DO YOU WANT TO SPARED FROM DEMENTIA ?

2010-03-24T02:23:00.015+07:00

DO YOU WANT TO SPARED FROM DEMENTIA ?
READING IS ONE THE BEST SOLUTION
APAKAH ANDA INGIN TERHINDAR DARI PENYAKIT PIKUN ?
MEMBACA ADALAH SALAH SATU SOLUSI TERBAIK

[ENGLISH]
Reading is an activity that brings many benefits for the reading of our knowledge will increase. Whether it is knowledge related to science or just a news or information. In addition, experts say that with a lot of reading, we are released from the brain disease. A researcher from the Henry Ford Health System, Dr.. C. Edward Coffey, proving that just by reading a book one will be spared from the disease "Dementia". Dementia is a disease that damages the brain. When exposed to dementia, can be sure someone will be difficult to avoid dementia. This happens because the reading can create a kind of buffer layer that protects the brain changes and change.

Brain research has discovered the benefits of the latest reading in growing dendrites, one component of the brain's nerve cells or neurons. Read new words can stimulate the brain, because the brain likes to challenge and new things. Reading is a challenging activity and always bring someone to enter new territory.

Recognized or not, a lot of smart and intelligent people because of diligent reading. Reading also can make people more mature. Adults here means having a mindset that no longer childish. By reading, one can look at every problem of life not as a burden, but the challenges that must be resolved. Problems in life are seen not only from one side, but from different sides. People who look at problems from different sides of life is usually more prudent and wise in life.

However, it is unfortunate that the public interest in reading from Indonesia is still low. Taufiq Ismail, a famous Indonesian writer says that. "We have become a near-sighted people to read books and write lame". This phrase must have had a very strong reason. And, true, our problem is the low interest in reading. If offered a reading book, not a few of us who reject the grounds do not have time to read. Our society prefers the medium of television from the book. Epilepsy is also mentioned that the television was still very behind compared to the book. Television is a "passive media" that does not invite us to participate in learning or creative thinking. But this information is not up to us because of our lack of reading.

Very different from reading culture of Japanese society and other developed nations. Everywhere they always bring a book reading. If there is spare time they are filled with reading. So it is not surprising that their science is more advanced than we are. Indonesian society is more like girl talk and oral culture. More of his daydream rather than reading activity. This we can see from our own behavior as well as the people around us. And lots of free time we can use to read. For example when you're waiting for the plane departure, at the bus stop, terminal, even for people who do not have health problems if you read the above vehicles, can use the time to read. Five minutes of reading can broaden our knowledge. We can build our inner motivation to expand reading, including reading biographies of successful people.

One doctor from Saudi Arabia named Dr. Al Qarni Aidh in his book "Laa Tahzan" (Do not be sad) wrote 10 reading benefits:

1. When someone is busy reading, someone blocked entry into stupidity

2. The habit of reading to people too busy to connect with the people lazy and do not want to work

3. With a lot of reading, one can develop flexibility and fluency in spoken

4. Reading helps develop thinking and clear thinking

5. Reading increases a person's knowledge and understanding of memory in mengingkatkan

6. By reading a person can often benefit from the experience of others, such as copying the wisdom of the wise and the intelligence of the scholars

7. With a lot of reading, one can develop his abilities, both to receive and process knowledge as well as to study the various disciplines and their applications in life

8. Will increase one's beliefs when he read the books useful

9. Reading helps a person to refresh his mind from the clutter and save time so as not in vain,. With a lot of reading, one can master a lot of words and sentences to learn the various models

10. Furthermore, it can increase its ability to absorb concepts and to understand what is written on the line by line (to understand what is implied).

Of several explanations above, we can draw the conclusion that the habit of always reading will bring huge benefits. Not only for ourselves, but also for other people if we want to share knowledge with them. Therefore I invite the reader to turn all of this reading culture anywhere and at any time to read.

[BAHASA INDONESIA]

Membaca adalah kegiatan yang mendatangkan banyak manfaat karena dengan membaca pengetahuan kita akan bertambah. Baik itu pengetahuan yang berhubungan dengan keilmuan maupun hanya sekedar berita atau informasi. Di samping itu menurut para ahli bahwa dengan banyak membaca maka kita akan terlepas dari penyakit otak. Seorang peneliti dari Henry Ford Health System, Dr. C. Edward Coffey, membuktikan bahwa hanya dengan membaca buku seseorang akan terhindar dari penyakit “Demensia”. Demensia adalah penyakit yang merusak jaringan otak. Apabila terkena demensia, bisa dipastikan seseorang akan sulit terhindar dari kepikunan. Hal ini terjadi karena membaca dapat menciptakan semacam lapisan penyangga yang melindungi dan mengganti perubahan otak.

Riset-riset otak mutakhir telah menemukan manfaat membaca dalam menumbuhkan dendrit, salah satu komponen sel saraf otak atau neuron. Membaca kata-kata baru dapat merangsang otak, karena otak suka akan tantangan dan hal-hal baru. Kegiatan membaca adalah kegiatan yang penuh tantangan dan senantiasa membawa seseorang untuk memasuki wilayah baru.

Diakui atau tidak, banyak orang pintar dan cerdas disebabkan dari rajin membaca. Membaca juga bisa membuat orang lebih dewasa. Dewasa di sini artinya memiliki pola pikir yang tidak lagi kekanak-kanakan. Dengan membaca, orang bisa memandang setiap permasalahan hidup bukan sebagai beban, namun tantangan yang harus diselesaikan. Permasalahan dalam kehidupan tidak dipandang hanya dari satu sisi, tetapi dari berbagai sisi. Orang yang memandang permasalahan hidup dari berbagai sisi biasanya lebih bijaksana dan arif dalam menjalani kehidupan.

Akan tetapi sungguh sangat disayangkan bahwa minat membaca dari masyarakat Indonesia masih rendah. Taufiq Ismail seorang sastrawan Indonesia yang terkenal mengatakan bahwa. “Kita telah menjadi bangsa yang rabun membaca buku dan lumpuh menulis”. Ungkapan ini tentunya punya alasan yang sangat kuat. Dan, benar adanya, persoalan kita adalah minat baca yang rendah. Jika ditawari buku bacaan, tidak sedikit dari kita yang menolak dengan alasan tidak punya waktu untuk membaca. Masyarakat kita lebih menyukai media televisi dari pada buku. Ayan juga menyebutkan bahwa televisi masih amat ketinggalan dibandingkan dengan buku. Televisi merupakan “media pasif” yang tidak mengajak kita berpartisipasi dalam belajar atau berpikir kreatif. Namun hal informasi ini tidak sampai kepada kita karena kita kurang membaca.

Sangat berbeda dengan budaya membaca masyarakat Jepang dan negara-negara maju lainnya. Ke mana-mana mereka selalu membawa buku bacaan. Jika ada waktu luang mereka mengisinya dengan membaca. Sehingga tidak mengherankan jika ilmu pengetahuan mereka lebih maju daripada kita. Masyarakat Indonesia lebih senang ngerumpi dan berbudaya lisan. Lebih banyak ngelamun-nya ketimbang melakukan aktivitas membaca. Hal tersebut bisa kita saksikan dari perilaku kita sendiri maupun orang-orang di sekeliling kita. Padahal banyak waktu luang yang bisa kita manfaatkan untuk membaca. Misalnya ketika sedang menunggu keberangkatan pesawat, di halte, terminal, bahkan bagi orang yang tidak memiliki gangguan kesehatan jika membaca di atas kendaraan, bisa memanfaatkan waktunya untuk membaca. Lima menit membaca sudah bisa menambah wawasan pengetahuan kita. Kita bisa membangun motivasi dalam diri kita dengan memperbanyak membaca termasuk membaca biografi orang-orang sukses.

Salah seorang Doktor dari Arab Saudi yang bernama Dr. Aidh Al Qarni dalam bukunya ”Laa Tahzan” (Jangan bersedih) menulis 10 manfaat membaca :

1. Ketika sibuk membaca, seseorang terhalang masuk ke dalam kebodohan

2. Kebiasaan membaca membuat orang terlalu sibuk untuk bisa berhubungan dengan orang-orang malas dan tidak mau bekerja

3. Dengan sering membaca, seseorang bisa mengembangkan keluwesan dan kefasihan dalam bertutur kata

4. Membaca membantu mengembangkan pemikiran dan menjernihkan cara berpikir

5. Membaca meningkatkan pengetahuan seseorang dan mengingkatkan memori dalam pemahaman

6. Dengan sering membaca seseorang dapat mengambil manfaat dari pengalaman orang lain, seperti mencontoh kearifan orang bijaksana dan kecerdasan para sarjana

7. Dengan sering membaca, seseorang dapat mengembangkan kemampuannya, baik untuk mendapat dan memproses ilmu pengetahuan maupun untuk mempelajari berbagai disiplin ilmu dan aplikasinya di dalam hidup

8. Keyakinan seseorang akan bertambah ketika dia membaca buku-buku yang bermanfaat

9. Membaca membantu seseorang untuk menyegarkan pikirannya dari keruwetan dan menyelamatkan waktunya agar tidak sia-sia,. Dengan sering membaca, seseorang bisa menguasai banyak kata dan mempelajari berbagai model kalimat

10. Lebih lanjut lagi, ia bisa meningkatkan kemampuannya untuk menyerap konsep dan untuk memahami apa yang tertulis di antara baris demi baris (memahami apa yang tersirat).

Dari beberapa penjelasan di atas, kita bisa menarik kesimpulan bahwa membiasakan diri untuk selalu membaca akan mendatangkan manfaat yang sangat besar. Bukan hanya untuk diri kita, tetapi juga untuk orang lain asal kita mau berbagi ilmu dengan mereka. Karena itu saya mengajak kepada pembaca sekalian untuk menghidupkan budaya membaca ini di mana saja dan kapan saja ada waktu untuk membaca.

10 The Wrong Presumption About Eye Diseases

2010-03-23T23:29:00.005+07:00

10 Anggapan Salah Tentang Penyakit Mata

Banyak mitos menyesatkan tentang penyakit mata yang tak jarang menjerumuskan pasien. Mengobati sendiri penyakit mata tak selalu aman dan perlu diwaspadai, karena tidak semua kelainan dan penyakit mata sama obatnya.

1. Penyakit mata merah disebabkan oleh debu

Tidak selalu benar. Lebih sering mata merah disebabkan oleh bibit penyakit. Kita mencurigai mata merah sebagai infeksi jika terjadi dalam musim-musim tertentu dimana banyak orang yang terkena mata merah. Bisa jadi sudah terjadi wabah mata merah di suatu kota atau wilayah.

Namun, bisa juga mata merah disebabkan oleh debu. Debu, pasir, kotoran, sabun mandi, dapat menimbulkan mata merah. Namun perlu dibedakan dengan mata merah sebab infeksi.

Pada mata merah infeksi, selain gatal, rasa tidak enak mengganjal seperti ada pasir, banyak mengeluarkan airmata, dan merahnya mata semakin hari semakin bertambah. Mungkin disertai pembengkakan kelopak mata, dan waktu bangun tidur mata rapat, banyak kotoran mata (belekan).

Mata merah sebab debu biasanya tidak belekan, jarang membengkak, dan merahnya semakin hari cenderung semakin pudar dan bisa mereda sendiri. Mata merah infeksi sukar menyembuh sendiri tanpa obat. Penyakit infeksi mata bisa saja tidak harus menimbulkan mata merah. Orang-orang menyebutnya penyakit infeksi mata putih. Yang merah bagian dalam kelopak matanya (conjunctiva palpebra), bukan putih matanya. Penyebabnya juga infeksi bibit pernyakit, mulai dari virus, kuman, sampai jamur.

2. Bintitan sebab sering mengintip

Tidak benar. Bukan sebab sering mengintip orang jadi bintitan. Ini juga tergolong infeksi mata. Bedanya dengan penyakit mata merah, bibit penyakitnya bersarang bukan di bola mata atau selaput lendir kelopak mata, melainkan di kelenjar-kelenjar yang ada di kelopak mata. Kita tahu di kelopak mata terdapat beberapa kelenjar, seperti kelenjar airmata, kelenjar minyak pembasah bulu mata. Jika kelenjar ini dimasuki bibit penyakit, maka akan terbentuk bisul. Bisul kelenjar ini yang menimbulkan penyakit bintit (hordeolum).

Bintit tidak boleh dibiarkan berlama-lama tanpa pengobatan. Kenapa? Oleh karena jika bisulnya sudah telanjur membatu, sukar mengempis kembali kendati diobati. Terlambat mengobati bintit, memerlukan tindakan operasi untuk membuang batu bisulnya.

3. Penyakit rabun jauh dapat diobati dengan banyak makan wortel

Salah. Kita tahu, penyakit rabun jauh disebabkan oleh tidak tepatnya bayangan jatuh pada retina (layar bola mata). Pada kelainan mata myopia begini, bayangan yang kita lihat jatuhnya di depan retina. Keadaan ini dapat disebabkan oleh kelainan kornea (hitam mata), gangguan lensa, atau sumbu bola mata.

Bola mata yang kelewat besar (seperti anak-anak sekarang), menjadikan sumbu bola mata lebih panjang dari normal. Itu yang membuat bayangan yang kita lihat selalu jatuh di depan retina, sehingga bayangan tidak tampak jelas, melainkan samar-samar ketika sedang melihat jauh. Tidak soal ketika melihat dekat.

Wortel dan sumber vitamin A lainnya bermanfaat untuk sel-sel di layar retina (bagian belakang bola mata), tempat bayangan yang kita lihat ditangkap lalu dikirimkan ke otak untuk ditafsirkan.

Sel-sel retina, selain untuk menangkap penglihatan terang-gelap, juga untuk warna. Jika penyebab kelainan mata adalah gangguan sel-sel saraf retina, masuk akal wortel bisa membantu. Namun, rabun jauh lebih sering disebabkan oleh berubahnya sumbu bola mata. Sebagian sebab keturunan.

Kelainan sumbu bola mata hanya mungkin dinormalkan dengan mengoreksi sumbu bola mata yang kelewat panjang, agar bayangan tepat jatuh di retina.

Caranya dengan memberi lensa pembantu (lensa minus) sebesar yang memberikan hasil bayangan yang kita lihat menjadi tepat jatuh di retina. Semakin terlalu panjang sumbu bola mata, sehingga semakin jauh bayangan jatuhnya di depan retina, semakin besar minus lensa bantuan yang perlu diberikan.

4. Tidak semua orang dalam hidupnya perlu berkacamata

Juga tidak benar. Orang yang matanya sehat dan normal pun setelah berumur lewat 40 tahun, akan memerlukan kacamata baca untuk rabun dekat (presbyopia). Rabun dekat bukan penyakit, melainkan bagian dari proses menua. Suka tidak suka, setiap orang akan mengalami rabun dekat. Untuk itu perlu dibantu dengan kacamata baca (lensa positif). Semakin bertambah tua, semakin besar kacamata baca yang diperlukan, agar pada jarak baca sehat (33 cm) orang bisa jelas membaca.

Pada orang dengan mata sakit, mungkin sudah sejak kecil memerlukan kacamata. Mata minus keturunan umumnya sudah dialami sejak masih sekolah dasar. Kasus ini tidak bisa diobati tanpa kacamata. Jika myopia dibiarkan, minusnya akan cepat bertambah. Penyakit mata rabun jauh myopia tidak bisa berkurang, apalagi kembali seperti mata normal lagi, kendati sudah memakai kacamata.

5. Rabun senja dapat dikoreksi dengan memakai kacamata

Keliru. Penyakit rabun senja, yaitu mereka yang terganggu melihat gelap (setelah matahari terbenam), tidak bisa dikoreksi dengan kacamata. Penyakit rabun senja terjadi jika sel-sel saraf pembeda terang-gelap di retina terganggu. Ini umumnya terjadi sebab kekurangan vitamin A untuk waktu lama. Anak kurang gizi, yang umumnya kurang makan sumber vitamin A yang yang banyak dalam ikan, susu, sayur-mayur, dan buah, banyak mengidap rabun senja. Maka, cara koreksinya bukan dengan kacamata, melainkan dengan memberi ekstra vitamin A dosis tinggi.

6. Mata buta sebab dibawa sejak lahir

Tidak selalu. Hanya sedikit kelainan mata yang berakibat kebutaan yang dibawa sejak lahir. Penyakit yang diidap ibu selama hamil ada beberapa yang bisa mengganggu mata, seperti toxoplasma. Namun, kebutaan lebih banyak disebabkan oleh kekurangan vitamin A, glaucoma, dan katarak.

Di Indonesia, angka kebutaan sebab kekurangan vitamin A masih banyak. Jika rabun senja sebagai gejala awal kekurangan vitamin A dibiarkan tanpa koreksi dengan memberi vitamin A dosis tinggi, kerusakan mata akan berlanjut. Tampak bercak putih pualam pada putih mata (bitot spot), yang jika masih tidak dikoreksi juga, akan merusak bola mata, menjadi bisul di putih mata, dan akhirnya bola mata akan mengempis, lalu menciut. Pada stadium lanjut ini, mata sudah tak mungkin diselamatkan lagi, dan akhirnya buta sama sekali.

7. Obat tetes mata bisa untuk mengobati semua mata merah

Tidak benar. Ada banyak jenis obat tetes mata. Kita mengenal obat tetes mata merah yang disebabkan oleh infeksi. Jenis ini bukan yang dijual di warung-warung. Mata merah sebab infeksi tidak bisa disembuhkan dengan obat tetes warung. Bahkan, memakai obat tetes warung malah bisa membuat penyakit mata merah bertambah parah, alih-alih menyembuh.

Obat tetes mata untuk infeksi mata juga dibedakan pula, ada yang untuk kuman, ada pula untuk virus, jamur, dan jenis infeksi mata yang tanpa luka (tukak) mata. Pada kasus infeksi mata tanpa luka, boleh diberikan tetes mata yang ditambahkan obat corticostreroid sebagai antiradangnya, namun tidak untuk kasus yang ada luka atau tukaknya.

Sudah disebut di atas, mata merah sendiri bukan melulu disebabkan oleh infeksi. Bisa juga sebab debu atau alergi, dan sebab penyakit mata glaucoma. Pada penyakit ini, tekanan bola mata meninggi, dengan salah satu gejalanya mata merah.

Sudah barang tentu, mata merah sebab glaucoma tidak mempan diobati dengan tetes mata infeksi atau tetes mata yang dibeli di warung, melainkan harus dengan obat khusus penurun tekanan bola mata. Membiarkan glaucoma berkepanjangan bisa berakhir dengan kebutaan.

Mata merah sebab virus herpes tak mempan diobati dengan tetes mata biasa, melainkan dengan tetes mata antivirus. Demikian pula jika mata merah sebab alergi, yang hanya mereda jika diobati dengan tetes mata yang mengandung obat antialergi.

Apa makna semua itu? Tidak semua mata merah boleh sembarang diberi tetes mata. Selain tidak selalu berhasil menyembuhkan, ada bahaya terselubung jika memakai sendiri obat tetes mata secara serampangan. Melihat mata merah tetangga, lalu berniat baik langsung memberikan obat tetes mata bekas ketika pernah sakit mata merah. Ini tidak arif. Niat baik bisa berujung petaka kalau berakibat buruk. Dan ingat, obat tetes mata yang masih tersisa untuk infeksi sebaiknya tidak dipakai lagi. Selain mungkin sudah tidak ampuh, berubah kepekatannya, obat mungkin sudah tercemar bibit penyakit dari mata saat memakainya.

8. Penyakit mata glaucoma disebabkan oleh tekanan darah tinggi

Salah. Penyakit glaucoma disebabkan oleh meningkatnya tekanan di dalam bola mata. Penyebabnya banyak. Ada yang turunan, sehingga sistem saluran cairan mata di dalam bola mata tersumbat, atau menyempit.

Yang bukan turunan bisa disebabkan oleh gangguan lensa, katarak yang sudah matang atau pecah, pasca-bedah mata, penyakit pada bagian dalam bola mata (iris mata), yang berakibat terganggunya sistem aliran cairan mata, dan berakhir dengan meningginya tekanan bola mata.

Meningginya tekanan bola mata tidak ada hubungannya dengan tekanan darah tinggi. Orang yang darah tinggi tidak harus tekanan bola matanya juga tinggi. Sebaliknya, orang yang darah rendah belum tentu tidak glaucoma.

9. Katarak hanya pada orang berusia lanjut

Tidak selalu benar. Memang lebih banyak katarak terjadi pada usia lanjut, sebagai bagian dari proses menua. Namun, usia bayi pun bisa katarak juga. Katarak sejak lahir dibawa bayi sejak dalam kandungan mula. Jenis katarak bayi berbeda dengan katarak dewasa dan usia lanjut.

Katarak sebagai komplikasi penyakit lain bisa diderita sebelum usia lanjut, termasuk komplikasi kencing manis, akibat radiasi, cahaya matahari, atau kerusakan lensa mata oleh radikal bebas, yang akan terjadi jauh hari sebelum usia lanjut.

10. Mata bayi baru lahir tak mungkin tertular penyakit kelamin ibunya

Salah. Justru perlu diwaspadai jika ibu melahirkan bayi sebelum keputihannya disembuhkan. Sebab, bisa jadi keputihannya disebabkan oleh penyakit kelamin kencing nanah (gonorrhoea). Mata bayi bisa tertular kencing nanah pada saat persalinan berlangsung. Seminggu setelah lahir, mata bayi membengkak, lengket penuh nanah, dan meradang, tanda tertular kencing nanah dari kemaluan ibunya.

Selain kencing nanah, ibu juga bisa keputihan oleh bibit penyakit lain. Itu sebab setiap bayi baru lahir secara rutin diberi tetes mata antibiotika, untuk jaga-jaga kalau-kalau matanya tercemar bibit penyakit dari jalan lahir ibu.

SHISHA...WOULD IT BE WORST THAN CIGARS ???

2010-03-22T21:22:00.006+07:00

DO YOU KNOW ABOUT SHISHA ???
WOULD IT BE WORST THAN CIGARS ???

Selama ini shisha dikenal sebagai bentuk relaksasi dari Timur Tengah yang dianggap aman dan tidak menimbulkan efek yang membahayakan.. ternyata persepsi tersebut SALAH!!!!!

WHY????!!!

Check This Out.....

ROKOK ARAB BERIBU RASA
Shisha kerap disebut rokok arab, karena diusung pertama kali oleh negara-negara Timur-Tengah. Meski tak seperti rokok pada umumnya, pada prinsipnya shisha sama dengan rokok yaitu dinikmati dengan cara menghisap dan mendapatkan ketenangan dari bahan dasar tembakau. Bedanya, untuk menghisap shisha digunakan alat khusus bernama Bong.

Perbedaan berikutnya, penikmat shisha bisa mendapatkan sensasi berbeda karena tersedia dalam beragam aroma, dari buah-buahan hingga aneka bunga.

Lantas Kenapa berbahaya?????!!!!

Menurut Agen Anti Tembakau Prancis (L'Office Francais de prevention du Tabagisme OFT) menyatakan :

Satu hisap shisha setara dengan 70 hisapan rokok biasa.
Kandungan tar dari asap 1 shisha sama dengan 27-102 batang rokok.
Menghisap 1 shisha sama aja dengan menghirup karbon monoksida setara 15-52 batang rokok biasa.

Nahh.. Bahaya-bahaya dari racun utama shisha seperti CO, Tar dan Nikotin adalah sebagai berikut:

1. Karbon Monoksida Karbon monoksida (CO) apabila terhirup ke dalam paru-pari akan ikut peredaran darah dan akan menghalangi masuknya oksigen yang dibutuhkan oleh tubuh. Hal ini dapat terjadi karena gas CO bersifat racun, ikut bereaksi secara metabolis dengan darah (hemoglobin)

Ikatan karbon monoksida dengan darah (karboksihemoglobin) lebih stabil daripada ikatan oksigen dengan darah (oksihemoglobin). Keadaan ini menyebabkan darah menjadi lebih mudah menangkap gas CO dan menyebabkan fungsi vital darah sebagai pengangkut oksigen terganggu.
Keracunan gas karbon monoksida dapat ditandai dari keadaan ringan, berupa pusing, rasa tidak enak pada mata, sakit kepala, dan mual. Keadaan yang lebih berat dapat berupa detak jantung meningkat, rasa tertekan di dada, kesukaran bernafas, kelemahan otot-otot, gangguan pada sisten kardiovaskuler, serangan jantung sampai pada kematian.

2. Tar

Tar adalah substansi hidrokarbon yang bersifat lengket dan menempel pada paru-paru. Tar bukanlah zat tunggal, terdiri atas ratusan bahan kimia gelap dan tergolong sebagai racun pembuat kanker

3. Nikotin

Nikotin sangat mempengaruhi dan dapat mengubah fungsi otak dan tubuh kita. Nikotin membuat si perokok merasa relaks dan kemuadian merasa lebih energik dan bersemangat, atau sebaliknya. Efek ini umum dikenal sebagai biphase effect. Sialnya, semakin sering seseorang merokok, akan semakin merasa ketagihan dan bertambah pula dosis yang akan kita gunakan.

Saat seseorang menghisap sebatang rokok, nikotin akan diserap dalam tubuh (darah), diringi dengan pelepasan Adrenalin dan pemblokade-an hormone insulin. Adrenalin lebih dikenal sebagai hormon “Fight or Flight”.
Jika anda mencintai film horror, atau sangat suka dengan roller-coaster, pasti sangat familiar sekali dengan efek Adrenalin ini, yang juga akan anda alami saat merokok:

* Detak jantung yang sangat cepat
* Meningkatnya tekanan darah
* Tarikan nafas yang berat dan cepat

Saat Adrenalin dilepas tubuh kita pun akan melepaskan cadangan glukosa ke dalam darah. Kemudian, insulin akan memerintahkan sel tubuh untuk menyerap kelebihan glukosa dalam darah. Efek ini sering disebut sebagai hyperglycaemic, yaitu tingginya kadar gula dalam darah. Inilah alasan kenapa saat merokok, seseorang tidak merasa lapar dan akan tahan untuk tidak makan selama berjam-jam. Lebih banyak dijumpai perokok yang berbadan kurus dibandingkan perokok yang kelebihan berat badan.

Dalam jangka panjang, Nikotin dapat meningkatkan kadar kolesterol dalam darah, mengakibatkan si perokok, walaupun sudah lama berhenti merokok, sangat rentan terhadap serangan jantung dan stroke. Ini sebagai akibat dari rusaknya pembuluh arteri dalam darah, yang salah satu fungsinya, mengedarkan oksigen ke seluruh tubuh.

Di dalam otak, sebagai respon terhadap Nikotin, otak akan memerintahkan tubuh untuk membuat zat endorphin lebih banyak lagi. Endorphin adalah senyawa protein yang lebih tepat disebut sebagai body’s natural pain killer. Struktur kimia Endorphin tidaklah jauh berbeda dengan painkiller kelas atas seperti morphine. Endorhpin dapat membuat seseorang merasa relaks dan euphoria. Terkadang, merokok (endorphin) dapat menstimulus sex anda.

Water Birth, Melahirkan di Air Tanpa Rasa Sakit

2010-03-21T15:01:00.011+07:00

(BAHASA INDONESIA)

Anda ingin melahirkan normal tanpa rasa sakit berlebihan? Anda bisa mencoba metode water birth, melahirkan di dalam air. Metode ini diyakini sebagai cara melahirkan yang lebih rileks dengan tingkat kesakitan yang jauh berkurang.

0ppie Andaresta memilih melahirkan normal di dalam air awal Juli lalu. Pilihan tersebut didasari oleh keinginannya melahirkan serba alamiah don jauh dari stres. Penyanyi balada ini melahirkan di Klinik Bumi Sehat di Mas Ubud, Nyuh Kuning, Ubud, Bali. Sebelum persalinan, hari-harinya diisi dengan yoga, meditasi, latihan napas, dan berjalan-jalan di pantai Kuta.Saat memasuki bukaan keenam, Oppie dimasukkan ke dalam kolam persalinan. Dan ketika memasuki bukaan kesepuluh, kata Oppie, bidan memberi aba-aba: "Oke, satu kali lagi push, baby akan keluar." Saat itu, ia merasakan buah hatinya "lolos" begitu saja tanpa sakit. Selanjutnya, bayi ditempelkan ke dadanya dan langsung diberi ASI.

Sama seperti Oppie, pesinetron Natalie Margaretha mengaku proses persalinan awal November lalu sangatlah berbeda dibandingkan ketika dia melahirkan anaknya terdahulu, dengan operasi Caesar.Meski tak bisa membandingkan rasa sakitnya, Natalie mengaku merasa lebih rileks dan tak merasakan sakit usai persalinan. Hari-hari sebelum persalinan, Natalie mengisinya dengan latihan terapi hipnobirthing yang diajarkan oleh Lanny Kuswandi.

Cara Kuno Orang Tanimbar

Secara umum ada dua pilihan melahirkan, yakni normal (pervaginam) dan Caesar (perabdominam).

Water birth adalah pilihan lain melahirkan secara normal. Di Eropa Timur, Amerika, Australia, dan beberapa negara Asia, cara ini telah banyak menjadi pilihan.

Bagaimana di Indonesia?

Water birth tergolong metode yang dikira baru. Di Jakarta, baru beberapa rumah sakit yang menyediakannya.

Namun, sesungguhnya metode ini sama sekali tidak baru. Ir. Surato, seorang anggota perguruan silat Merpati Putih, menceritakan bahwa melahirkan di dalam air sudah ia kenal sejak tahun 1960 di Kepulauan Tanimbar, Indonesia Timur.

"Waktu itu sempat didokumentasikan ilmuwan asal Uni Sovyet," kata Surato.Menurut Dr. Ivan R. Sini, Sp.OG, FRANZCOG, GDRM, Vice President Director Bundamedik, water birth bukanlah metode baru di dunia kebidanan dan kandungan.

Metode ini muncul di Rusia tahun 1960-an, diperkenalkan oleh Igor Tjarkovsky. Selanjutnya berkembang di Perancis di akhir tahun 60-an, dan Amerika tahun 1961.

Suami Memijat PunggungMelahirkan di air tidak berbeda dengan melahirkan di tempat tidur. Hanya saja, proses kelahiran dibuat sefisiologis mungkin. Dalam hal ini si ibu biasanya tidak begitu merasakan sakit seperti ketika persalinan di atas tempat tidur.

Proses dan prosedur persalinan dalam air sama seperti proses normal lainnya, kecuali tempatnya yang berbeda, yakni di dalam kolam yang berisi air. Pada pembukaan enam, pasien dimasukkan ke dalam kolam air hangat. Air hangat ini membuat kulit vagina menjadi elastis, sehingga proses kelahiran lebih mudah dan cepat.

Kolam berisi air hangat itu, menurut Nanny Kuswandi, memberikan rasa nyaman, tenang, dan rileks sehingga membuat proses mengejan tidak terlalu berat. "Air hangat juga mampu menghambat impuls-impuls saraf yang mengantarkan rasa sakit," ujar praktisi rileksasi yang kerap mendampingi ibu-ibu melahirkan di dalam air ini."Selain itu," tambah mantan bidan di RS Carolus, Jakarta ini,"vagina akan lebih elastis dan lunak, sehingga proses mengejan tidak perlu terlalu keras. Cukup pelan-pelan, bahkan bila lancar vagina tidak perlu dijahit."Dr. Ivan menambahkan, saat proses persalinan, suami juga bisa membantu memberikan pijatan-pijatan di punggung istri. Tujuannya agar istri merasa lebih rileks dan nyaman. Biasanya proses persalinan memakan waktu sekitar 1-2 jam.

Selanjutnya, setelah bayi lahir, dokter atau bidan akan mengangkat bayi ke permukaan dan langsung memberikannya kepada sang ibu untuk diberikan ASI pertama.Bayi yang dilahirkan melalui persalinan water birth dipastikan tak akan mengisap air yang membuatnya sulit bernapas. "Ketika bayi akan lahir, ia masih bernapas dengan ari-ari atau tali pusar yang masih tersambung ke perut ibu. Jadi, tak ada masalah saat bayi dilahirkan dalam air," ungkap Dr. Ivan.

Syarat Water Birth

Tidak semua rumah sakit melengkapi fasilitas persalinannya dengan metode water birth. Selain dibutuhkan tenaga medis yang terlatih, rumah sakit juga harus memilliki kolam bersalin berdesain khusus (birth pool).Kolam bersalin khusus ini biasanya berukuran 1,6 x 1,2 atau 2 meter. Volume air di dalam kolam berada di bawah pusar ibu, baik ketika proses melahirkan dengan duduk, berdiri, atau sambil tiduran.Airnya juga harus steril. Menurut Dr. Ivan, kolam yang sudah disterilisasi diisi air yang suhunya disesuaikan dengan suhu tubuh, yaitu sekitar 37 derajat Celsius. Suhu itu memiliki kesamaan dengan air ketuban, dengan maksud agar bayi tidak merasakan perbedaan suhu yang ekstrem antara di dalam perut dan di luar. Selain itu bayi tidak mengalami hipotermia (suhu tubuh terlalu rendah) atau hipertermia (suhu tubuh terlalu tinggi).

Fasilitas pendukung lainnya adalah pompa pengatur, agar air tetap bersirkulasi. Di RS Bunda, Jakarta, tempat ia berpraktik, digunakan air suling, sehingga pasien tidak perlu takut jika terminum. Bebauan dari terapi aroma serta musik rileksasi menjadi perlengkapannya.Ada beberapa syarat untuk melakukan proses melahirkan melalui media air ini. Pertama, proses kelahiran dikehendaki melalui jalan lahir normal. Kedua, tidak ada infeksi. Ketiga, posisi bayi dalam rahim pada kondisi normal, tidak terbalik (sungsang). Keempat, ibu tidak memiliki penyakit menular, dan kelima, ketuban belum pecah sebelum masuk ke kolam air.

Tawaran Melahirkan Normal

Kekhawatiran tentang lamanya proses persalinan dan membayangkan rasa sakit, seringkali menghantui pikiran ibu yang akan melahirkan. Jalan pintas seringkali ditempuh, semisal memilih persalinan dengan operasi caesar.Tingginya angka proses caesar membuat Dr. Ivan R. Sini prihatin. Setelah hampir lima tahun berpraktik di Australia dan menjumpai ibu-ibu di Australia banyak yang memilih proses persalinan di dalam air, ia mencoba menawarkan metode ini kepada pasien-pasiennya."Metode ini adalah salah satu pilihan buat pasien dengan syarat persalinan normal pada umumnya. Cara ini paling tidak mampu memberikan kemudahan dan mengurangi rasa sakit saat proses melahirkan," tutur dokter lulusan spesialis kebidanan dan kandungan di Universitas Royal, Australia ini.

Sejak dibuka layanan water birth Januari lalu, rumah sakit tempatnya berpraktik sudah menangani 20-an pasien menggunakan metode ini. IQ Bayi Lebih TinggiAda beberapa manfaat melahirkan di dalam air. Kata Dr. Ivan R. Sini, suhu air yang hangar membuat sirkulasi pembuluh darah lebih baik, sehingga kontraksi lebih mudah. Mulut rahim menjadi lembek dan mudah dibuka. Dalam beberapa kasus, mulut rahim bahkan tak perlu dijahit lagi karena tidak robek.Berbagai kepercayaan lain menyebutkan water birth bisa meningkatkan kecerdasan anak. Hal itu, kata Lanny Kuswandi, dimungkinkan karena prosesnya yang alamiah tanpa adanya pemaksaan atau tarikan pada kepala bayi, sehingga bayi tidak mengalami trauma kepala seperti yang mungkin terjadi pada persalinan normal ataupun Caesar.

Beberapa manfaat water birth yang perlu disimak adalah:

Bagi Ibu:

• Ibu akan merasa lebih rileks karena semua otot yang berkaitan dengan proses persalinan menjadi elastis.

• Metode ini mempermudah proses mengejan, sehingga rasa nyeri selama persalinan tidak terlalu dirasakan.

• Di dalam air proses pembukaan jalan lahir relatif lebih cepat.

Bagi Bayi:

• Menurunkan risiko cedera kepala bayi.

• Meskipun belum dilakukan penelitian mendalam, pakar kesehatan meyakini bahwa lahir dengan metode ini memungkinkan IQ bayi menjadi lebih tinggi dibandingkan dengan bayi yang lahir dengan metode lain.

• Peredaran darah bayi lebih baik, sehingga tubuh bayi akan cepat memerah setelah dilahirkan.

ENGLISH VERSION will available ASAP, due my current programs, works and tons of job demand, it will commenced immediately as soon I got a lot of time to write down in further time, Well apparently in the weekend...xixixi cheers guys

CIRCUMSITION, SUNAT MENCEGAH RESIKO TERTULAR HIV/AIDS

2010-03-21T04:08:00.002+07:00

New York - Bukti baru menyebutkan sunat dapat mencegah tertular HIV (virus yang melemahkan kekebalan tubuh), juga penyakit lain yang mematikan jutaan orang. Kini beberapa dokter mempertimbangkan kembali pandangan mereka tentang prosedur ini.Sunat adalah prosedur operasi yang sudah umum. Tetapi juga menjadi hal yang sensitif jika terkait budaya dan agama. Bahkan di komunitas medis sendiri, masih ada perdebatan dan pro-kontra mengenai alasan dilakukannya sunat pada anak lelaki.

Selama beberapa dekade, sadar akan kepekaan ini, kalangan medis diam tentang sunat.Sekarang bukti-bukti memperlihatkan bahwa prosedur memotong kulup pada penis dapat mencegah sejumlah penyakit menular seksual.

Penelitian yang dilakukan oleh Pusat Pengendalian dan Pencegahan Penyakit (CDC), Amerika Serikat, di Afrika Selatan, Kenya, dan Uganda antara 2005 dan 2007 menunjukkan bahwa sunat pada laki-laki dewasa mengurangi risiko tertular HIV hingga 50 - 60 persen. Hal ini telah mengarah ke pengembangan program yang menawarkan sunat di sejumlah negara Afrika, yang didukung oleh Organisasi Kesehatan Dunia, dengan prediksi bahwa dalam jangka panjang sunat dapat menyelamatkan jutaan nyawa.

Sunat sempat memicu kontroversi di Amerika. "Sunat merupakan prosedur medis yang tidak etis," kata Georganne Chapin, direktur eksekutif Intact America, yang bersikap kontra terhadap sunat. "Kami tidak akan membiarkan mereka melakukan tindakan ini pada anak cowok mereka.

"Dengan mencermati bukti-bukti manfaat sunat, seperti yang diperoleh peneliti dari CDC di tiga negara Afrika tersebut, Ronald H. Gray, profesor pada Universitas Johns Hopkins, mengatakan, "Bukti-bukti yang diperoleh makin kuat dengan adanya hasil uji coba tentang potensi manfaat sunat.""Sunat secara substansial tentu akan mencegah sejumlah infeksi," kata Gray.

"Risikonya jauh lebih kecil dibanding manfaatnya."Selain mengurangi risiko HIV, riset menunjukkan sunat memotong risiko terkena HPV (virus penyebab kanker leher rahim) dan herpes, menurut ulasan Gray yang diterbitkan Januari 2010 di Archives of Pediatric & Adolescent Medicine. Menurut Gray, perempuan yang berhubungan seks dengan pria yang bersunat sedikit kemungkinan terkena HPV dan infeksi bakteri.

Wanna be a Doctor ??? (State of Mind)

2010-03-19T20:47:00.002+07:00

Saya Ingin Jadi Dokter, Om!!!

Setiap orang pastinya memiliki cita-cita ataupun harapan akan menjadi apa dan bagaimana dia kelak di masa yang akan datang. Cita2 juga dapat menjadi impian sekaligus pelecut semangat seseorang untuk dapat terus berusaha dan berkarya dalam mencapai apa yang dicita-citakan tersebut. Cita-cita dapat mucul seiring dengan berjalannya waktu berdasarkan hobi, kemampuan, ketrampilan, maupun pengalaman hidup seseorang. DIharapkan setiap orang bisa memiliki cita-cita dan memilikinya sejak usia sedini mungkin. Sedini mungkin??
Ketika iseng-iseng menanyai beberapa anak-anak usia sekitar di bawah 5 tahun, termasuk juga melihat kolom `Sahabatku` di salah satu koran lokal edisi hari Minggu, ternyata rata-rata anak-anak yang masih ingusan ini sudah punya cita-cita. Dan hebatnya lagi sebagian besar dari mereka dengan `mudah`nya menyebutkan : “Saya ingin jadi dokter, Om!!”. Saya cukup terhenyak, mengingat keputusan saya untuk bercita-cita menjadi seorang dokter baru muncul pada saat saya duduk di kelas III SMU. Apakah benar anak-anak ini sudah mengetahui `konsekuensi` yang harus ditempuh ketika bercita-cita menjadi seorang dokter? Bahwa betapa besar pengorbanan tenaga, waktu, biaya untuk mewujudkan cita2 mereka. Atau jangan-jangan anak-anak yang masih ingusan ini bahkan belum tahu apakah arti cita-cita itu sebenarnya. Dan kemungkinan apa yang mereka lontarkan secara spontan, yang dikatakan sebagai cita-cita itu sebenarnya merupakan harapan atau keinginan dari orang tua mereka
yang sedari kecil sudah berusaha ditanamkan dalam otak mereka. Ah, ataukah saya lah yang terlalu `negative thinking` terhadap mereka? Namun ada satu hal yang pasti di sini, hingga sekarang profesi dokter masih menjadi salah satu profesi yang paling diinginkan oleh banyak orang.
Setiap tahun saat persiapan tes penerimaan mahasiswa baru, maka salah satu jurusan yang paling padat peminat adalah jurusan Fakultas Kedokteran. Hampir semua keluarga ingin anaknya ada yang menjadi dokter. Dokter dipandang memiliki derajat status yang lebih tinggi, memiliki uang banyak, hidupnya pasti makmur dan sejahtera. Tidak heran setiap tahun betapa banyak orang tua yang bersusah payah dan berjerih lelah untuk memasukkan anak mereka ke fakultas kedokteran, syukur-syukur bila diterima di universitas favorit. Bahkan tidak sedikit yang rela mengeluarkan uang hingga ratusan juta rupiah sekedar untuk memuluskan `impian`nya itu.
Memang benar bahwa ketika anda menjadi seorang dokter, maka dapat dikatakan kehidupan anda minimal akan tercukupkan. Hal ini didasarkan pada kenyataan bahwa ke mana pun anda pergi, kebutuhan akan seorang dokter selalu akan ada. Malahan banyak pula dokter yang karena profesinya itu dapat hidup berkelimpahan. Memang benar pula ketika dokter masih dianggap strata yang cukup tinggi di mata masyarakat. Saya teringat seorang teman, yang notabene bukan seorang dokter, diminta oleh keluarganya untuk mencari kerja saja di fakultas kedokteran sebagai pegawai, dengan harapan kalau-kalau saja dapat memperoleh jodoh seorang dokter di sana!!!
Namun, apakah benar menjadi dokter itu sangat menyenangkan??? Pengalaman saya, menjadi dokter itu perlu perjuangan yang sangat berat. Semasa menuntut ilmu di bangku kuliah pun, seorang mahasiswa kedokteran diharapkan memiliki waktu belajar yang `lebih` dibandingkan teman-teman lainnya. Menjadi dokter pun memerlukan waktu yang lebih panjang, sekitar 4 tahun kuliah ditambah 2 tahun praktek di RS sebagai co-asisten. Belum lagi ketika selesai mereka akan melakukan proses `pengabdian` di daerah-daerah selama beberapa tahun. Belum lagi bila mereka ingin melanjutkan ke pendidikan spesialistik yang akan memakan waktu 4-5 tahun.
Dokter pun dihadapkan dengan tanggung jawab yang lebih besar dimana yang dilayani secara langsung adalah manusia sebagai obyek. Terasa perbedaan dalam hal besarnya tanggung jawab ketika, misalnya seorang montir yang sedang `membedah` sebuah mobil dibandingkan dengan seorang dokter yang tengah `membedah` seorang pasien di meja operasi. Seorang dokter pun sering kali harus menempatkan tugas dan tanggung jawab mereka sebagai dokter sebagai prioritas utama dalam hidup. Betapa banyak dokter yang harus menghabiskan waktu kerja maupun jaga malam di rumah sakit ataupun pusat pelayanan kesehatan lainnya setiap hari, sehingga keluarga seolah-olah menjadi prioritas nomor dua. Belum lagi saat ini profesi dokter saat ini sering `diganggu` oleh segelintir oknum-oknum yang mencari-cari kesalahan dengan memanfaatkan istilah `malpraktek`.
Saya teringat cerita teman saya. Dikatakan jadi dokter sekarang sudah berbeda dengan menjadi dokter pada 30 atau 40 tahun lalu. Pada jaman lampau, kebutuhan banyak namun tenaga dokter masih kurang. makanya tiap lulusan akan langsung terangkat menjadi PNS atau pun terserap di lapangan kerja yang lain. Namun sekarang situasi sudah beda. Setiap penerimaan PNS, terutama di kota besar, formasi dokter yang tersedia paling cuma 2-3 orang saja, sementara peminatnya bisa berjumlah ratusan. Makin banyaknya universitas dengan fakultas kedokteran, juga membuat persaingan antar dokter menjadi lebih berat, utamanya di kota besar, dimana sebagian besar dokter memilih berkarya di kota besar. Sungguh miris melihat dokter praktek swasta yang memasang tarif sekali periksa pasien yang hanya `sebanding` dengan seporsi nasi campur, mengingat betapa besarnya tanggung jawab yang dipikul oleh dokter tersebut dalam menangani pasiennya.
Namun terlepas dari itu semua, saya tidak menyesal menjadi seorang dokter. Dokter tetaplah adalah suatu profesi yang mulia. Adalah suatu kebahagiaan yang tak terkira, ketika seorang pasien datang ke pada dokter berterima kasih karena ternyata setelah berobat, penyakit yang dideritanya itu akhirnya sembuh. Mungkin hal itulah yang selalu menjadi kekuatan dan kebahagiaan terbesar menjadi seorang dokter.
Saya senang menjadi seorang dokter. Saya senang mendengar anak-anak itu memiliki cita-cita mulia ini sedari kecil. Saya senang mendengar mereka berkata : “Mama, saya ingin menjadi seorang dokter!!”