Health & Medicine

Being a good medical student doesn’t mean you’ll be a good doctor, A Doctor's Story

noreply@blogger.com (Naufal Fadhillah Alam) — Sun, 13 Oct 2013 23:47:00 +0000

Doctor

There is a saying that you enter medical school wanting to help people but exit it wanting to help yourself. It may be a cynical view, but a realistic one. The criteria to being a good medical student are far different from being a good doctor. Medical education may be breeding a legion of self-serving, grade-grubbing, SOAP-note spewing machines rather than the empathetic, compassionate and caring physicians of admission essays yore.

I was no different. My first two years of medical school, I was largely a disinterested student. I didn’t care for basic sciences, research or pathology. Like many others, my knowledge waxed and waned with the test schedule, and after Step 1, I entered my clinical years an acceptably successful medical student. Excellent medical student, terrible clinician Third year begins a reign of terror lead by the constant gauntlet of heavily-weighted rotation grades, standardized exams and the looming threat of residency applications and the Match, when, after 20 years of schooling, some pie-in-the-sky computer would tell me if I was good enough or not to be a doctor, and subsequently determine my life for the next three to seven years.

Grades were a priori to make myself the most competitive residency candidate possible. I studied and worked hard. Each patient became an opportunity for me to impress on notes, rapid-fire oral presentations and predict nuanced “pimp’ questions. I learned to charm patients just enough that they’d acknowledge my care to the attending during rounds. I interrogated my patients just enough to write the excellent notes I knew I’d be evaluated on. I learned about my patients by memorizing their daily lab values to proudly recite on rounds. Patients weren’t people with problems but stepping stones to rack up points with the attending.

Once rounds were over, patients became time-sucks from studying time, an exam worth 30% of every rotation grade. Real humans do not follow textbook presentations, but exams do; the warm body in front of me only detracted from my evaluation by cold scantron. By my attendings’ clinical comments, I was an excellent medical student, but I knew I was a terrible clinician, rehearsed only in the games of academia, not medicine. How I learned to stop worrying about the Match and love patient care My shift in paradigm came with a shift in career path. My worst fear as a fledgling surgeon was not matching for a residency spot.

My worst fear as a fledgling emergency physician was killing a patient. Suddenly playing doctor became very real, and in the middle of my OB/GYN rotation, I started to care not about textbook presentations but real-world ones. I didn’t care for OB/GYN and volunteered to cover the peripartum critical care unit, a similar environment to emergency medicine. My first day on the unit, I saw a patient roll in as I was in the middle of practice questions on the computer. I glanced up but returned to my test preparation, justifying my delay in evaluating the patient because the resident was still in surgery. Half an hour later, the resident came to evaluate the patient and I followed — the patient was obtunded, hypotensive and sitting in a growing pool of her own blood. It would not have taken a MD to realize that this patient required immediate medical attention, and I kicked myself for not evaluating her sooner. I may have been a pretend doctor, but it finally struck me that I was a pretend doctor on very real patients.

For the rest of my time in the unit, I made it a point to personally round every hour, on the hour, on every patient. I didn’t always write notes for these hourly rounds — getting credit was no longer important to me — patient care was. While they initially questioned my obsessive rounding, the residents quickly came to trust my dedication and leave me to my own in the unit, knowing I’d alert them if necessary. At my institution, hell hath no fury like an OB/GYN resident unnecessarily interrupted, so I spent my time reading on appropriate treatment courses for the different conditions I saw in the unit.

After I rounded, I’d give the resident a list of orders to put in, and the nurses began to treat me as the main provider in the unit. I got to be the first person to make critical medical decisions, responding to truly acute situations and drastically changing the course of a patient’s treatment. I pulled long hours and hardly studied in the traditional sense with prep books and practice questions, but I was constantly reading on my patients. That shelf exam and clinical evaluations were my best of the year. I had learned to stop worrying about the Match and love patient care. Not “just” a student After that revelation, I fought to earn more responsibility and trust on each rotation; I learned more, gained competence and became more satisfied in my chosen career in medicine.

During emergency medicine , the specialty that started it all for me, I learned more medicine in one month than I did in my entire third year. It was a pass/fail course with no motivation by grading, but I was terrified I would be the first person to evaluate a patient and not recognize a critical condition. That hemorrhaging patient from day one on the peripartum critical care unit still haunted me. People can decompensate quickly and unpredictably — at any moment, you may go from being “just” a student, to being the only medical provider in the room. At the end of that rotation, Step 2 breezed by with none of the misery I experienced with Step 1. Behind each question I’d see faces of patients with that exact presentation; behind each answer choice, I’d see the clinical consequence of making the wrong decision.

Finally, I understood what it mean to be both an excellent medical student, and (at my level of training) an excellent clinician. The academics of medicine often makes us forget the “59 yo AA M, PMH CHF dx 2010 (EF 20% by TTE 8/2013) p/w SOB x 2d” is a real person, with real vulnerabilities and real fears. We are not “just” students, but trainees and members of the medical profession. Grades and exams do not define us, but are simply checks on clinical competence. Trite as it may be, remember what you wrote about in your admissions essay — why you embarked on this journey in the first place. We came to medical school not to become excellent medical students, but to become excellent doctors. Always keep that in mind. Everything else, the grades, the Match, the exams, will fall in place.

source : http://www.kevinmd.com/blog/2013/10/good-medical-student-good-doctor.html

Diabetes Mellitus DIAGNOSIS AND TREATMENT

noreply@blogger.com (Naufal Fadhillah Alam) — Sat, 26 May 2012 11:32:00 +0000

Diabetes is detected by measuring the amount of glucose in the blood after an individual has fasted (abstained from food) for about eight hours. In some cases, physicians diagnose diabetes by administering an oral glucose tolerance test, which measures glucose levels before and after a specific amount of sugar has been ingested.

Once diabetes is diagnosed, treatment consists of controlling the amount of glucose in the blood and preventing complications. Depending on the type of diabetes, this can be accomplished through regular physical exercise, a carefully controlled diet, and medication. Individuals with Type 1 diabetes must receive insulin, often two to four times a day, to provide the body with the hormone it does not produce. Insulin cannot be taken orally, because it is destroyed in the digestive system.

Consequently, insulin-dependent diabetics have historically injected the drug using a hypodermic needle or a beeper-sized pump connected to a needle inserted under the skin. In 2006 the United States Food and Drug Administration approved a form of insulin that can be inhaled and then is absorbed by blood in the lungs. The amount of insulin needed varies from person to person and may be influenced by factors such as a person’s level of physical activity, diet, and the presence of other health disorders.

Typically, individuals with Type 1 diabetes use a meter several times a day to measure the level of glucose in a drop of their blood obtained by pricking a fingertip. They can then adjust the dosage of insulin, physical exercise, or food intake to maintain the blood sugar at a normal level. People with Type 1 diabetes must carefully control their diets by distributing meals and snacks throughout the day so as not to overwhelm the ability of the insulin supply to help cells absorb glucose. They also need to eat foods that contain complex sugars, which break down slowly and cause a slower rise in blood sugar levels. Although most persons with Type 1 diabetes strive to lower the amount of glucose in their blood, levels that are too low can also cause health problems. For example, if a person with Type 1 diabetes takes too much insulin, it can produce low blood sugar levels. This may result in hypoglycemia, a condition characterized by shakiness, confusion, and anxiety.

A person who develops hypoglycemia can combat symptoms by ingesting glucose tablets or by consuming foods with high sugar content, such as fruit juices or hard candy. In order to control insulin levels, people with Type 1 diabetes must monitor their glucose levels several times a day. In 1983 a group of 1,441 Type 1 diabetics aged 13 to 39 began participating in the Diabetes Control and Complications Trial (DCCT), the largest scientific study of diabetes treatment ever undertaken. The DCCT studied the potential for reducing diabetes-related complications, such as nerve or kidney disease or eye disorders, by having patients closely monitor their blood sugar levels four to six times a day, maintaining the levels as close to normal as possible. The results of the study, reported in 1993, showed a 50 to 75 percent reduction of diabetic complications in people who aggressively monitored and controlled their glucose levels. Although the study was performed on people with Type 1 diabetes, researchers believe that close monitoring of blood sugar levels would also benefit people with Type 2 diabetes. For persons with Type 2 diabetes, treatment begins with diet control, exercise, and weight reduction, although over time this treatment may not be adequate.

People with Type 2 diabetes typically work with nutritionists to formulate a diet plan that regulates blood sugar levels so that they do not rise too swiftly after a meal. A recommended meal is usually low in fat (30 percent or less of total calories), provides moderate protein (10 to 20 percent of total calories), and contains a variety of carbohydrates, such as beans, vegetables, and grains. Regular exercise helps body cells absorb glucose—even ten minutes of exercise a day can be effective. Diet control and exercise may also play a role in weight reduction, which appears to partially reverse the body’s inability to use insulin. For some people with Type 2 diabetes, diet, exercise, and weight reduction alone may work initially, but eventually this regimen does not help control high blood sugar levels. In these cases, oral medication may be prescribed.

If oral medications are ineffective, a person with Type 2 diabetes may need insulin doses or a combination of oral medication and insulin. About 50 percent of individuals with Type 2 diabetes require oral medications, 40 percent require insulin or a combination of insulin and oral medications, and 10 percent use diet and exercise alone.

HOW HIV INFECTION SPREADS ?

noreply@blogger.com (Naufal Fadhillah Alam) — Mon, 05 Sep 2011 23:53:00 +0000

Scientists have identified three ways that HIV infections spread: sexual intercourse with an infected person, contact with contaminated blood, and transmission from an infected mother to her child before or during birth or through breast-feeding

A. Sex with an Infected Person
HIV transmission occurs most commonly during intimate sexual contact with an infected person, including genital, anal, and oral sex. The virus is present in the infected person’s semen or vaginal fluids. During sexual intercourse, the virus gains access to the bloodstream of the uninfected person by passing through openings in the mucous membrane—the protective tissue layer that lines the mouth, vagina, and rectum—and through breaks in the skin of the penis. In the United States and Canada, HIV is most commonly transmitted during sex between men, but the incidence of HIV transmission between men and women has rapidly increased. In most other parts of the world, HIV is most commonly transmitted through heterosexual sex.

B. Contact with Infected Blood
Direct contact with HIV-infected blood occurs when people who use heroin or other injected drugs share hypodermic needles or syringes contaminated with infected blood. Sharing of contaminated needles among intravenous drug users has been a primary cause of HIV infection in parts of eastern Europe and central Asia.
Less frequently, HIV infection results when health professionals accidentally stick themselves with needles containing HIV-infected blood or expose an open cut to contaminated blood. Some cases of HIV transmission from transfusions of infected blood, blood components, and organ donations were reported in the 1980s. Since 1985 government regulations in the United States and Canada have required that all donated blood and body tissues be screened for the presence of HIV before being used in medical procedures. As a result of these regulations, HIV transmission caused by contaminated blood transfusion or organ donations is rare in North America. However, the problem continues to concern health officials in sub-Saharan Africa.

C. Mother-to-Child Transmission
HIV can be transmitted from an infected mother to her baby while the baby is still in the woman’s uterus or, more commonly, during childbirth. The virus can also be transmitted through the mother’s breast milk during breast-feeding. Mother-to-child transmission accounts for 90 percent of all cases of AIDS in children. Mother-to-child transmission is particularly prevalent in Africa.

D. Misperceptions About HIV Transmission
The routes of HIV transmission are well documented by scientists, but health officials continually grapple with people’s unfounded fears concerning the potential for HIV transmission by other means. HIV differs from other infectious viruses in that it dies quickly if exposed to the environment. No evidence has linked HIV transmission to casual contact with an infected person, such as a handshake, hugging, or kissing, or even sharing dishes or bathroom facilities. Studies have been unable to identify HIV transmission from modes common to other infectious diseases, such as an insect bite or inhaling virus-infected droplets from an infected person’s sneeze or cough.

50 Branches of Biology

noreply@blogger.com (Naufal Fadhillah Alam) — Wed, 13 Jul 2011 12:52:00 +0000

Biology is the science of very large trees. Because the extent of biological material studies, biology is subdivided into branches of science. Some branches of biology, among others:

1. Zoology, the study of animal
2. Botany, plant science that studies about
3. Physiology, The study of the physiology / function of body work
4. Anatomy or anatomy, the study of body parts
5. Genetics, the study of inheritance
6. Microbiology, the study of the organism
7. Bacteriology, the study of bacteria
8. Mikobiologi, the study of fungi
9. Evolution, the study of living things change over the long term.
10. Molecular Biology, the study of biology at the molecular level
11. Genetic engineering, the study of the nature of genetic manipulation
12. Ecology, the study of reciprocal relationships between living things and their environment
13. Taxonomy, systematic study of living things
14. Ikhtiologi, science that studies on fish
15. Malacology, the study of mollusks
16. Karsinologi, the study of crustacean
17. Ornithology, the study of birds
18. Entomology, the study of insect science
19. Protozoologi, the study of protozoa
20. Algologi, the study of algae
21. Limnology, the study of marsh
22. Embryology, the study of embryonic development
23. Pathology, the study of disease
24. Endocrinology, the study of hormone
25. Cytology, the study of cell
26. Histology, the study of tissue
27. Organological, the study of organ
28. Morphology, the study of form or characteristics outside the organism
29. Enzimologi, the study of enzyme
30. Fikologi Sciences, the study of algae
31. Pteridologi, the study of ferns
32. Bryologi, the study of mosses
33. Dendrology, the study of trees and other woody plants, such as lianas and shrubs
34. Paleobotany, the study of ancient plants
35. Nematologi, the study of nematodes
36. Apiari, the study of livestock including bees bees
37. Mirmekologi, the study of termite
38. Iktiologi, the study of fish
39. Harpetologi, the study of reptiles and ampibia
40. Mamologi, the study of mammalian
41. Primatology, the study of primates
42. Rodentiologi, the study of rodentia
43. Paleozoologi, the study of ancient animals
44. Pulmonology, the study of lung
45. Cardiology, the study of the heart and blood vessels
46. Radiology, science to see inside the human body using radiant or wave radiation, both electromagnetic waves and mechanical waves
47. Neurological Sciences, who deal with deviations in the nervous system
48. Virology, the study of viruses
49. Oncology, the study of cancer and its prevention
50. Enzimologi, the study of enzyme

Perfect Diet and Durable ?

noreply@blogger.com (Naufal Fadhillah Alam) — Fri, 08 Jul 2011 06:10:00 +0000

Diet choises

Pennsylvania, United States, many people lose weight. But weight loss diet results achieved are generally rare painstakingly lasting aka yo-yo dieting because people who succeed diet fail to maintain weight loss diet results.

Though the diet that the body can not consistently give bad effects to the body. This yo-yo dieting can make someone worse shape than before he was on a diet, because it often ignores portion of the exercise or physical activity and poor diet.

A new study conducted by researchers from Penn State College of Medicine, has demonstrated that the technique is to lose weight may not be used or managed in the helps maintain ideal weight.

The study notes there are four strategies that can be done to maintain ideal body weight to keep it but did not make it decreases, as quoted from Healthland.Time, Friday (8/7/2011), namely:

1. Keep eating foods rich in protein but low in fat
2. Keep up a consistent exercise program
3. Appreciate yourself to keep your diet and exercise
4. Considering himself about why he needed to maintain weight

Nutrition and obesity experts said the principles that form the basis of losing weight and keep it the ideal is the same, namely a person should eat a healthy diet and increasing physical activity like sports.

One important thing is to maintain the mindset to start focusing on the long term and not short term, that is, make changes in lifestyle and behavior permanently so that the results obtained can last a long time.

Experts have agreed that the key to success in losing and maintaining weight loss is motivation he had. Due to this motivation will lead a person to change lifestyle and behavior gradually.

source : DETIk

Social effects of Alcoholism

noreply@blogger.com (Naufal Fadhillah Alam) — Thu, 07 Jul 2011 23:55:00 +0000

Throughout most of history, society has viewed people who drink to excess as irresponsible, immoral, and of weak character. Punishment of drunkards was considered necessary to protect the community.

By the early 1900s, experts conceded that alcohol dependence may result from tissue changes caused by the action of alcohol. These changes produce a continued need to drink, such that the individual seeks larger amounts of alcohol at more frequent intervals. However, society still regarded taking or rejecting a drink as a matter of personal decision, thus all excessive drinking was considered a voluntary act. The individual, therefore, was held responsible for his or her behavior.

Although a consensus is growing among health professionals that alcohol dependence is a disease, society’s attitudes toward individuals with drinking problems remain ambivalent and confused. Until the mid-20th century, the typical picture of the alcoholic was of someone without steady employment, unable to sustain family relationships and most likely in desperate financial straits. But this stereotype was largely dispelled when highly respected people publicly admitted their alcohol dependence and shared their successful recovery stories. Particularly critical in changing the way Americans view alcohol-use disorders were New York broker William Griffith Wilson (more familiarly known as Bill W.) and Ohio physician Robert Holbrook Smith (Dr. Bob). In 1935 these two recovered alcoholics developed a program to promote their successful philosophy for recovering from alcohol dependence. The program, which became known as Alcoholics Anonymous, has spread around the world, helping millions of members to avoid alcohol use and rebuild their lives. In the late 1970s Betty Ford, the wife of former U.S. president Gerald Ford, disclosed her struggle to recover from alcohol dependence. She helped raise the public’s understanding about alcohol dependence through her open, honest revelations and her creation of a groundbreaking treatment center for substance abusers in Rancho Mirage, California, now known as the Betty Ford Center.

Intoxication threatens not only the individual who drinks but also the surrounding community. Therefore, societies around the world have attempted to control excessive use of alcohol. Temperance societies in the 19th and 20th centuries pushed for laws ranging from arrest and jail sentences for public drunkenness to prohibition of the manufacture, distribution, and consumption of alcoholic beverages.

Today experts characterize alcohol-use disorders as a form of illness, and one so widespread that it constitutes a major public health problem. According to WHO, alcohol dependence and other alcohol-use disorders undermine global health, accounting for 3.5 percent of the total cases of disease worldwide. This figure equals the hazards posed by unsafe sex and surpasses two other formidable health foes, tobacco and illicit drugs. In the United States alone, the NIAAA estimates that alcoholism causes losses of more than $185 billion a year in lost productivity, illness, and premature death.

Danger behind Isotonic Drinks

noreply@blogger.com (Naufal Fadhillah Alam) — Mon, 04 Jul 2011 23:56:00 +0000

Isotonic drinks more incentive to invade the market. Through advertising, the product is imaged able to replace lost body fluids in a short time. Behind the impression of freshness, isotonic drinks can be dangerous if taken carelessly.

An isotonic beverage ads on television say, ions in the isotonic able to keep the skin moist and your body better than ordinary water. Another ad says, losing two percent of body fluids will decrease your stamina and concentration.
Lecturer at the Department of Food Science and Technology, Bogor Agricultural University, Frances Rungkat Zakaria, said the advertising of products isotonic partly misleading the public. In the ad, as if to drink isotonic anybody and under any conditions.
In fact, Frances warned, could not consume isotonic drinks arbitrary because it contains sodium salt (NaCl).
"Look at the label, there must be its content of Na and Cl," said Frances. He added, isotonic drink is none other than saline solution. By the manufacturer, the solution was then given additional other substances, such as vitamins. Ion which was mentioned very beneficial for the body is actually not only contained in the isotonic.
Each salt is dissolved in water, said Frances, will inevitably turn into ions Na and Cl ions.
"So, the ions contained in the vegetable lodeh with isotonic ion in the same," said Frances. As it contains salt, isotonic should not be taken lightly.
If excessive levels of salt in the body will cause high blood pressure or hypertension. "When you've got hypertension, just waiting for the part of the body is broken first," said Frances.

From food

When our bodies sweat, sodium and chloride contained in body fluids come out through the pores of the skin. If the two substances were not replaced, the cells of our bodies too long will damage and death. The problem, of which sodium and chloride substance is obtained?
Should it be of an isotonic drink? The answer is no.
According to Frances, the food we consume daily is sufficient to replace sodium and chloride out with sweat. "Every time I cook, we always use salt. That's enough to replace the salt out of the body. Even excessive, "said Frances.
He warned, in normal conditions, the adult body requires only 2.3 grams of sodium per day, whereas chloride is only 50-100 mg.
In children, it needs two substances less than adults. When we cook without salt, sodium and chloride also needs can be met from food .. He pointed out, an ounce of red meat contains 70 mg of sodium, while each 10 ounces of rice contains 10 mg of sodium. Other foodstuffs, such as eggs, chicken, beans, fruits, and vegetables, also contain sodium.
"Therefore, under normal conditions, we no longer need to replace body fluids with isotonic," said Frances. Frances reminded, consumed more suitable isotonic athletes who wrestle strenuous exercise.
Strenuous exercise in athletes, the need for sodium is higher than the average person, which is 5-7 grams per day. Even so, should be calculated in advance whether sodium and chloride are required athletes in question had acquired enough of the food consumed. If still less, may be added to the isotonic.
In developed countries, said Frances, there are agencies that examine and calculate the amount of sodium in foods consumed by athletes.
The result, which served meals three times a day it already contains 6 grams of sodium.

Outwit

Although isotonic should not be taken carelessly, some isotonic product advertisements use models instead of ordinary people (not athletes) as
isotonic consumers. Isotonic beverages was also drunk at ordinary conditions, such as stuck in traffic that is not always synonymous with the release of ions to excess body.
Even mentioned, without naming the condition, isotonic better than plain water. According to Frances, such advertising is misleading the public. Manufacturers may only attract a buyer with a creative ad, but the ads have also been included clear information, not misleading information.
Manufacturers should also include beverages that contain salt warning. That consumers can make the best decision, it should be mentioned also how much salt it takes a human per day. "Indeed, manufacturers will be noisy. If the label is applied, their products will not sell.
However, do not because of economic interests, public health is at stake, "said Frances. So, although it seems refreshing, be careful if you want to consume isotonic.

What is the different of Usual DNA Test and Forensic DNA Test ?

noreply@blogger.com (Naufal Fadhillah Alam) — Tue, 21 Jun 2011 01:54:00 +0000

DNA

Jakarta, In some particular cases such as criminal forensic DNA sometimes required examination of the victim. Actually is there a difference between the examination of DNA forensic DNA tests are normal?

"Actually, just the same as regular DNA testing, forensic DNA testing but usually if the case will be brought to court so that the force of law," says Dr. Herath Sudoyo, MD, PhD as senior researcher at the Eijkman Molecular Biological Institute on the sidelines talkshow Loreal Indonesia Fellowship For Women In Science 2011 in the House Higher Education, Jakarta, Monday (06/20/2011).

DNA or Deoxyribo Nucleic Acid is a nucleic acid that stores all information about genetics. DNA is what determines the type of hair, skin color and specific qualities of human beings.

DR Herath said DNA testing could be done for paternity checks, criminal or immigration (eg a country would not accept a person's entry if it was not his family).

"Which is used for DNA testing is part of the body of people who want to be tested and also for comparison," said researcher who received his PhD from the Monas University, Melbourne Australia 1990.

Generally, the body that is easier to do the examination is blood or cheek mucosa graft, whereas if you use the hair but can also have a higher difficulty level.

If using a blood sample is then taken and white blood cells instead of red blood cells. This is because red blood cells have no cell nucleus which is the most accurate test because the cell nucleus can not be changed.

The specimen is then extracted its DNA before it is processed by a variety of molecular techniques to identify the genomic characteristics of the locations have been determined.

The method used in DNA testing is to identify fragments of DNA itself. Or it simply is a method to identify, collect and inventory the files are typical characters of the body.

DR Herath revealed to non-priority cases took over 12 days to get results because it gives time for the laboratory to analyze, while for cases with priority as is the case then the result could bomb out within 1 day.

"Declared fit if the person's DNA with the DNA match 99.99 percent of the comparison, which is seen here is the structure of DNA is its TGCA," says Dr. Herath.

source : DETIK

Physical effects of Alcohol

noreply@blogger.com (Naufal Fadhillah Alam) — Mon, 20 Jun 2011 11:41:00 +0000

Ethyl alcohol, or ethanol, is present in varying amounts in beers and wines, and in distilled liquors such as whiskey, gin, and rum.

When a person consumes alcohol, the stomach and intestines rapidly absorb it. From there alcohol travels in the blood throughout the entire body, affecting nearly every tissue. Moderate and high doses of alcohol depress the functions of the central nervous system, including the brain. The higher the alcohol level is in the blood, the greater the impairment.

As blood passes through the liver, enzymes break down alcohol into harmless byproducts, which are eliminated from the body six to eight hours later. But the rate at which alcohol accumulates in the body may be faster than the rate at which the body eliminates it, resulting in rising alcohol levels in the blood. Consequently, alcohol remains in the body, producing intoxicating effects hours after the last drink was swallowed.

Small amounts of alcohol may relieve tension or fatigue, increase appetite, or produce an anesthetic affect that numbs pain. Larger quantities inhibit or depress higher thought processes, bolstering self-confidence and reducing inhibition, anxiety, and guilt. As a person becomes intoxicated, painful or embarrassing situations appear less threatening and, as drinking progresses, speech may become loud and slurred. Impaired judgment may lead to incautious behavior, and physical reflexes and muscular coordination may become noticeably affected. If drinking continues, complete loss of physical control follows, ending in stupor, and possibly death.

Hazardous Minerals That can Pollute Drinking Water

noreply@blogger.com (Naufal Fadhillah Alam) — Wed, 15 Jun 2011 23:22:00 +0000

Drinking water

The water you drink should be free of compounds or minerals that can be dangerousand even cause death. Actually, what minerals are not allowed in drinking water?

Ben Witham (17 years) a teenager from Mount Buddy, Australia had allegedly died ofarsenic poisoning of the water consumed two months ago. Arsenic is known ashazardous compounds and levels should be kept so as not to exceed the threshold.
Arsenic kill by damaging the digestive system and cause death due to shock. Ifconsumed in a non-lethal doses can eventually cause chronic toxicity andcarcinogenic (cancer causing substances).

In the water it contains natural minerals from the environment that is not harmful to the body such as calcium, sodium, potassium or fluoride. But sometimes also foundminerals that are harmful to the body, as quoted from Lifewater.ca, Wednesday(15/06/2011).

Generally harmful minerals include inorganic mineral species because it can not be absorbed by the body so that the numbers will accumulate over time can damageorgans such as kidney and liver function to remove toxins and even to death if the dose is high.

Some inorganic minerals that should not be contained in drinking water because itcan be harmful to health such as:
1. reciprocal
2. mercury
3. iron
4. arsenic
5. magnesium
6. aluminum
7. manganese

Pollution from inorganic minerals are included in the category of chemical. Althoughthese pollutants are generally not visible, but sometimes the chemical pollutants canbe seen from the murky water color, smell, have a particular taste or yellowish.

The use of water in human life must be free of contaminants and pollutants, especiallyin drinking water. Because if the pollutants in the water enters the body it can damagethe body's system causing disturbances and even death.

Good-quality drinking water should be free from disease-causing organisms, harmful chemicals and radioactive substances as well as having good taste, colorless and odorless.

If you drink water using bleach (such as filters and activated carbon) should be replaced regularly, the cooking water to the boil and perform testing to determinewhether drinking water contains chemicals that can be harmful to the body or not.

source : DETIK

Nutrition Adjustment for Winter

noreply@blogger.com (Naufal Fadhillah Alam) — Thu, 26 May 2011 23:49:00 +0000

by L. Lee Coyne, Ph.D.

The winter season and the typical events that occur throughout the winter (Christmas, New Year's, challenges of snow storms and cold weather, school assignments, exams and the excitement of our winter sports – to name a few) create significant challenges to the immune system.

When the immune system challenges become excessive it manifests in the form of some type of illness. Illnesses ranging from the common cold and flu to more serious conditions leading to cancer and heart disease.

If you develop and maintain a healthy immune system there is no reason for your body to participate in the so-called flu and cold season. In fact it might be more correct to refer to it as the "weakened immune system season". Please appreciate that the "immune system" is not like any other system (cardiovascular, respiratory or digestive systems) in the body. You can’t see it nor localize it. It is really just a term to express all of the mechanisms your body uses to protect and defend itself from the invasions of bacteria, viruses and toxins from the outside world.

Immune system strength is determined by the food you eat and your responses to the "stresses of life" (the neural-humoral connection). The food you eat provides the building blocks for healthy cells that are the most significant part of healthy immunity. During the "busy-season" and the various celebrations we enjoy, often the food choices and other lifestyle habits are not optimal.

To enjoy a healthful, illness-free, high-energy winter, think about forward planning your food choices so they become part of your lifestyle. Don’t let "lifestyle" dictate convenient, less healthful food choices. Appreciate the fact that your current state of health is supported by your lifestyle. To change your health and ill-health risks you must change your lifestyle. "Magic Bullet" products and quick fixes will not endure.

Lifestyle Choice # 1:

Eat enough protein to support optimal health and chosen lifestyle activities. You require approximately 0.75 to 1.25 grams of protein per pound of body weight depending on your physical activity level. (I know that is higher than conventional recommendation, but trust me - it works). As many know I advocate an eating plan of 40% carbohydrate, 30% protein and 30% carefully chosen fat. A caveat is to understand that you only effectively absorb 30 to 35 grams (5 oz steak = 35 gms) of protein per meal or snack so it is necessary to distribute your consumption though-out the day. Eat some protein in every meal and every snack. There is recent evidence that (at least in the Western world it is recent) at least 30 grams of your daily protein should come from soy to provide adequate "isoflavanoids to help build and protect the immune system.

Lifestyle Choice # 2:

Select low" glycemic index" (GI) carbohydrates and avoid those easy to digest high starch and sugar products. GI is a measure of how fast blood sugar rises after eating - sugar = GI of 100 whereas peanuts = GI of 15. That means peanuts raise blood sugar at rate of only 15% of that created by white sugar, lower is better. Fast rising blood sugar means the pancreas produces or over produces insulin. Spikes in insulin production and chronically elevated insulin weakens the immune system and interferes with the production of the "Super hormones" that control many of our other hormones. If you eat low GI carbohydrates, combined with adequate protein and eat some of the protein first, you will control your insulin and be a friend to your immune system.

Lifestyle Choice # 3:

Consume adequate "essential fatty acids" (EFA’s) from nuts, seeds, fish, cold pressed oils and supplements. EFA’s are the building blocks for the "super hormones". Low fat, and high carbohydrates diets put you at risk.

Lifestyle Choice # 4:

Understand that nutritional supplementation is no longer an option if you wish to have optimal health and protect your immune system. On the average we eat less that ½ the Calories that our relatives ate in 1900 (1900 = 3800 Calories, today = 1800 Calories). And much of the food eaten today has a lower nutritional density. Remember that in 1900 "everything" was ORGANIC. In addition, modern life has dramatically increased the risks of Free Radical damage through the chemicals and toxins in our air, water and food supplies.

Numerous reputable research papers and books have demonstrated that the protective levels of the three major anti-oxidant nutrients (beta carotene, vitamin C and vitamin E) are much higher than we can expect to receive from any typical diet. Estimated protective levels of beta-carotene and other carotenoids has been estimated at 50,00O i.u. (30 mg) per day, the equivalent of 6 ½ average carrots or 5 ½ sweet potatoes EVERY DAY. The suggested protective levels for vitamin C are in excess of 1,000 mgs per day, the equivalent of 15 average oranges EVERY DAY, assuming the oranges contained vitamin C – some don’t. The suggested protective level for vitamin E is at least 400 i.u., equivalent to 19 cups of almonds or 2.1 cups of soybean oil. I think these examples demonstrate the difficulty one would have in receiving protective levels of essential anti-oxidants from any average diet. Many other examples of such difficulty are available.

The anti-oxidants mentioned above are merely the most publicized examples available. Other significant anti-oxidants include grape-seed extract, selenium, coenzyme Q10 to mention a few.

Anti-oxidants are known as "Free-Radical" scavengers. They combine with Free Radicals to prevent them from being oxidized. Oxidized Free Radicals are the toxic versions and the ant-oxidants basically neutralize them and allow more available oxygen for energy production. When we exercise we produce more Free Radicals and breath in more oxygen thus increasing the risk of Free-Radical damage. Surveys have shown that up to 40% of Marathon finishers become ill in the week following completion. It therefore behooves all heavy exercisers to protect themselves by increasing their ant-oxidant consumption.

Many people have used or heard of herbal remedies as protectors from flu and colds. The expression is that herbs like Echinacea "stimulate" or "support" the immune system. This has lead to the use of these products upon the appearance of symptoms. However it must be understood that herbs are "herbal remedies" or "herbal medicines" and not food. Echinacea may well stimulate the immune system but if you don’t feed the immune system with protective and constructive nutrients, the effectiveness of herbal remedy will be limited or short lived.

So as the "challenging" season approaches you might consider developing a strategy for a wise and consistent food choices and wise and responsible supplementation along with other smart lifestyle choices like stress reduction, healthy exercise habits and looking after your spirit & soul.

source : www.Centralhome.com

Prevalence of Alcoholism

noreply@blogger.com (Naufal Fadhillah Alam) — Sun, 08 May 2011 00:40:00 +0000

Alcoholism

Alcohol dependence affects a broad cross section of society around the world. Statistics show that alcohol dependence touches successful business executives, skilled mechanics, laborers, homemakers, and church members of all denominations.

Scientists have not identified a typical alcoholic personality, and they cannot predict with absolute certainty which drinkers will progress to alcohol dependence.
Alcohol use varies depending on an individual’s social, cultural, or religious background. Some individuals do not drink at all—about one-third of adults in the United States who are 18 and older, for example, abstain from alcohol. Others drink as part of social custom. Still others drink frequently and in substantial amounts. Those suffering from alcohol dependence drink to appease an uncontrolled craving for alcohol or to avoid experiencing the unpleasant symptoms of withdrawal.

WHO estimates that about 76 million people worldwide suffer from alcohol-related disorders. The prevalence of the illness varies in different countries. In the United States about 15 percent of the population experiences problems related to their use of alcohol. Of these, alcohol dependence affects about 12.5 million men and women, or almost 4 percent of the population. Men are three times more likely than women to become alcoholics, while people aged 65 and older have the lowest rates of alcohol dependence.

In the United States, people who start to drink at an early age are at particular risk for developing alcohol dependence. Estimates indicate that 40 percent of people who begin to drink before age 15 will become alcohol dependent at some point in their lives. These individuals are four times more likely to become alcohol dependent than those who delay drinking until age 21.

In Canada, an estimated 4 percent of the people aged 15 and older are alcohol dependent, and the number of male alcoholics is double that of females. The highest rate of this illness occurs in Canadians between the ages of 20 and 24. In Canadian surveys about one in five current and former drinkers admit that their drinking harmed them at some point in their lives, affecting their jobs or financial position.

Alcohol dependence has reached critical proportions in Russia, where it is estimated that almost a third of all deaths are related, directly or indirectly, to alcohol abuse. Periodic efforts by the government to control drinking by closing distilleries, breweries, and bars have backfired. Instead of solving the problem, such tactics only created a widespread black market for liquor—as well as a country of people who hide their drinking problems.

In Asian nations such as Japan, alcohol abuse has become a social concern. In these countries, drinking almost is required when conducting business. Bars are an extension of offices, places where key decisions are made. A person who declines an invitation to a drink after work risks being passed over for promotion within the company. Alcohol is readily available in Japan—vending machines along the streets of Tokyo dispense cans of beer and sake.

Cause of Aids

noreply@blogger.com (Naufal Fadhillah Alam) — Sun, 01 May 2011 00:44:00 +0000

AIDS is the final stage of a chronic infection with the human immunodeficiency virus. There are two types of this virus: HIV-1, which is the primary cause of AIDS worldwide, and HIV-2, found mostly in West Africa.

Inside the body HIV enters cells of the immune system, especially white blood cells known as T cells. These cells orchestrate a wide variety of disease-fighting mechanisms. Particularly vulnerable to HIV attack are specialized “helper” T cells known as CD4 cells. When HIV infects a CD4 cell, it commandeers the genetic tools within the cell to manufacture new HIV virus. The newly formed HIV virus then leaves the cell, destroying the CD4 cell in the process. No existing medical treatment can completely eradicate HIV from the body once it has infected human cells.

The loss of CD4 cells endangers health because these cells help other types of immune cells respond to invading organisms. The average healthy person has over 1,000 CD4 cells per microliter of blood. In a person infected with HIV, the virus steadily destroys CD4 cells over a period of years, diminishing the cells’ protective ability and weakening the immune system. When the density of CD4 cells drops to 200 cells per microliter of blood, the infected person becomes vulnerable to AIDS-related opportunistic infections and rare cancers, which take advantage of the weakened immune defenses to cause disease.

Regulation of Abortion

noreply@blogger.com (Naufal Fadhillah Alam) — Thu, 21 Apr 2011 12:53:00 +0000

Abortion has been practiced around the world since ancient times as a crude method of birth control. Although many religions forbade or restricted the practice, abortion was not considered illegal in most countries until the 19th century.

There were laws prior to this time, however, that banned abortion after quickening—that is, the time that fetal movement can first be felt. In 1803 England banned all abortions, and this policy soon spread to Asia, Africa, and Latin America. Throughout the middle and late 1800s, many states in the United States enacted similar laws banning abortion. In the 20th century, however, many nations began to relax their laws against abortion. The former Union of Soviet Socialist Republics (USSR) legalized abortion in 1920, followed by Japan in 1948, and several Eastern European countries in the 1950s. In the 1960s and 1970s, much of Europe and Asia, along with the United States, legalized abortion.

An estimated 46 million abortions are performed worldwide each year, of which 20 million are performed in countries where abortion is restricted or prohibited by law. Illegal abortions are more likely to be performed by untrained people, in unsanitary conditions, or with unsafe surgical procedures or drugs. As a result, illegal abortion accounts for an estimated 78,000 deaths worldwide each year, or about one in seven pregnancy-related deaths. In some African countries, illegal abortion may contribute to up to 50 percent of pregnancy-related deaths. In Romania, where abortion was outlawed from 1966 to 1989, an estimated 86 percent of pregnancy-related deaths were caused by illegal abortion. In countries where abortion is legal, less than 1 percent of pregnancy-related deaths are caused by abortion.

A Legalization of Abortion in the United States

In the United States, the legalization of abortion began in 1966 when Mississippi passed a law permitting abortion in cases of rape. In the following four years, other states expanded the use of abortion to include cases in which a pregnancy threatens a woman’s health, the fetus has serious abnormalities, or the pregnancy is the result of incest (sexual intercourse between close relatives). In early 1973 the Supreme Court of the United States decided two cases, Roe v. Wade and Doe v. Bolton, that effectively legalized abortion for any reason before the 24th week of pregnancy, the point when the fetus becomes viable. The ruling allowed individual states to enact laws restricting abortion after viability, except in cases when abortion is necessary to preserve the life or health of the woman.

In 1976 the Supreme Court recognized the right of pregnant girls under the age of 18, known as mature minors, to have abortions. Three years later the Court ruled that states may require the consent of one parent of a minor requesting an abortion. Parental consent is not necessary if a confidential alternative form of review, such as a judicial hearing, is made available for young women who choose not to involve their parents. The Court stated that a judge in a hearing must approve a minor’s abortion, in place of her parents, if the judge finds that the minor is mature enough to make the decision on her own. If the judge finds that the minor is not capable of making this decision on her own, he or she can decide whether the abortion is in the minor’s best interest.

Since these decisions, about 40 states have enacted and enforced parental consent or notification laws, although some laws have been contested in courts for years. In 1990, for example, in Hodgson v. Minnesota, the Supreme Court upheld a law requiring that prior notice be provided to both parents of a minor before an abortion is performed. In a similar case arising in Ohio that same year, the court upheld a requirement for notice or consent of one parent. In 2000, however, the New Jersey Supreme Court struck down a law requiring parental notice for unmarried girls under age 18.

Other state-imposed restrictions regulate who pays for abortions, where abortions are performed, and what information is provided to women seeking abortions. For example, in 1977 the Supreme Court allowed states to limit the use of Medicaid funds (government assistance for health care) for payment of elective abortions—that is, those abortions not medically required. A law upheld by the Supreme Court in 1980 restricted the availability of federal Medicaid funding for abortions deemed medically necessary. After that ruling, abortion payments for poor women in many states were limited to cases in which pregnancy threatened the woman’s life. Also in 1977, the Supreme Court allowed the city of St. Louis, Missouri, to exclude elective abortions from procedures performed in a public hospital.

In 1983 the Court found it unconstitutional to require that a woman considering an abortion be given information developed by the state about risks or consequences and wait 24 hours after receiving information before having the abortion. Similarly, in 1986 the Court struck down a comprehensive Pennsylvania law requiring that state-developed materials about abortion be offered to women undergoing the procedure.

Since the 1989 Supreme Court decision in Webster v. Reproductive Health Services, the Court has permitted several state-imposed restrictions to stand. The Webster case upheld a Missouri law that prohibits the use of public facilities or public employees for abortion and requires a physician to determine the viability of a fetus older than 20 weeks before performing an abortion. In the 1991 case of Rust v. Sullivan, the Court upheld a federal policy that prevented health-care providers who received federal funding from engaging in any activities that encouraged or promoted abortion as a method of family planning. President Bill Clinton later revoked this policy in 1993.

In 1992 the Supreme Court decided Planned Parenthood of Southeastern Pennsylvania v. Casey, a case in which the Court reaffirmed the central ruling of Roe v. Wade—that no undue burden on access to abortion should exist for a woman over 18 years of age prior to fetal viability. But the case also permitted states more freedom in regulating abortion. The Court overturned prior rulings, making it possible for states to again require that a woman be given state-developed information about abortion risks and consequences and wait 24 hours before undergoing the procedure.

In 1996 the Congress of the United States enacted a bill banning the practice of so-called partial birth abortions, also known as the intact dilation and extraction procedure. President Clinton vetoed the law because it failed to permit use of the procedure when a fetus displays severe abnormalities or when carrying a pregnancy to term presents a serious threat to a woman’s health or life. Over 30 states passed laws in the 1990s banning use of the procedure.

In June 2000, in Stenberg v. Carhart, the Supreme Court struck down a Nebraska ban on partial birth abortion. The Court stated that the ban was an unconstitutional violation of both Roe v. Wade and Planned Parenthood of Southeastern Pennsylvania v. Casey. But after Congress passed the Partial Birth Abortion Ban Act of 2003 and President George W. Bush signed it into law, the Court revisited the issue in a 2007 ruling in Gonzales v. Planned Parenthood and Gonzales v. Carhart. This time, with Justice Samuel A. Alito, Jr. replacing the retired Justice Sandra Day O’Connor, the Court upheld the ban on the partial birth abortion procedure in a 5 to 4 decision. Under the law, physicians who perform the banned procedure could face fines and up to two years in prison. The law allows for use of intact dilation and extraction only in cases where the mother’s life is endangered without the procedure.

Since the Supreme Court ruling that legalized abortion in 1973, opponents of abortion have worked continuously to reverse the decision. They have lobbied state and federal officials to place restrictions on women seeking abortions or on individuals providing abortions. They have also held protests directed at clinics that perform abortions, and, in some cases, have accosted and obstructed patients and health-care providers at such clinics. In May 1994 the Freedom of Access to Clinic Entrances Act was enacted, which made it a federal crime to use force, threat of force, or physical obstruction to injure, intimidate, or interfere with reproductive health-care providers and their patients. That same year, in a case known as Madsen v. Women’s Health Center, the Supreme Court upheld the basic right to protest in peaceful, organized demonstrations outside abortion clinics. But the case upheld a Florida law that created a 36 ft (11 m) buffer zone around a clinic to ensure that demonstrations do not prevent access to clinics or disrupt clinic operations. In February 1997 the Court upheld buffer zones around clinics but struck down certain floating, or moveable, buffer zones around individuals approaching clinics.

The Supreme Court’s ruling in 2007 upholding the federal Partial Birth Abortion Ban Act of 2003 was expected to spur further attempts to restrict abortion, if not overturn Roe v. Wade. Supporters of the right to abortion noted that the Court’s majority opinion in the 2007 decision represented the first time since the 1973 Roe ruling that the Court permitted a ban on an abortion procedure, effectively intruding on the privacy of a decision between a woman and her physician. Supporters of the ruling countered that the Court’s decision addressed the moral and ethical concerns put forward by opponents of abortion. They cited Justice Anthony Kennedy’s argument in the majority opinion that “the government has a legitimate and substantial interest in preserving and promoting fetal life.”

The Prevalence of Aids

noreply@blogger.com (Naufal Fadhillah Alam) — Wed, 20 Apr 2011 12:03:00 +0000

AIDS is one of the deadliest epidemics in human history. It was first identified in 1981 among homosexual men and intravenous drug users in New York and California. Shortly after its detection in the United States, evidence of AIDS epidemics grew among heterosexual men, women, and children in sub-Saharan Africa. AIDS quickly developed into a worldwide epidemic, affecting virtually every nation.

The United Nations Program on HIV/AIDS (UNAIDS) estimates that the worldwide number of new cases of HIV infection peaked in the late 1990s with more than 3 million people newly infected each year. However, some regions of the world, especially Vietnam, Indonesia, and other countries in southeast Asia, continued to see an increase in the early 2000s. In addition, the number of people living with HIV or AIDS has continued to rise as the result of new drug treatments that lengthen life.

While cases of AIDS have been reported in every nation of the world, the disease affects some countries more than others. About 90 percent of all HIV-infected people live in the developing world. AIDS has struck sub-Saharan Africa particularly hard. Two-thirds of all people living with HIV infection reside in African countries south of the Sahara, where AIDS is the leading cause of death.

In countries hardest hit, AIDS has sapped the population of young men and women who form the foundation of the labor force. Most die while in the peak of their reproductive years. Moreover, the epidemic has overwhelmed health-care systems, increased the number of orphans, and caused life expectancy rates to plummet. These problems have reached crisis proportions in parts of the world already burdened by war, political upheaval, or unrelenting poverty.

What causes an Anemia ?

noreply@blogger.com (Naufal Fadhillah Alam) — Sun, 17 Apr 2011 13:20:00 +0000

There are three primary causes of anemia: (1) reduced production of red blood cells; (2) excessive destruction of red blood cells; and (3) extensive bleeding.

A Reduced Production of Red Blood Cells

Red blood cell production becomes impaired if the body has inadequate amounts of certain nutrients, including iron, vitamin B12, and folic acid, as well as the hormone erythropoietin, which is produced by the kidneys. Chronic illnesses, such as cancer, kidney disease, diabetes mellitus, and inflammatory bowel disease, may also lead to decreased red blood cell production.

B Destruction of Red Blood Cells

Red blood cells normally live for about 120 days before the immune system removes them from the body. The body compensates by producing new red blood cells. But if the destruction of red blood cells exceeds the body’s ability to produce new red blood cells, anemia results.

Abnormal destruction of red blood cells may be caused by an enlarged spleen, an organ that removes worn red blood cells from the body. The larger the spleen grows, the more red blood cells it traps and destroys. In some cases red blood cells are destroyed by a malfunction of the immune system in which antibodies attach to red blood cells, marking them for destruction. Red blood cells may also be destroyed by some genetic conditions, such as thalassemia, that cause defects in the structure or function of red blood cells.

C Bleeding

Excessive bleeding can cause dangerously low blood pressure as well as insufficient oxygen delivery to body tissues. Large amounts of blood loss may occur suddenly due to injury or surgery. In some cases, excessive bleeding may occur over time, such as from bleeding ulcers or tumors of the intestinal tract.

Abortion methods

noreply@blogger.com (Naufal Fadhillah Alam) — Wed, 06 Apr 2011 14:31:00 +0000

Induced abortions are performed using drugs or surgery. The safest and most appropriate method is determined by the age of the fetus, which is calculated from the beginning of the pregnant woman’s last menstrual period. Most pregnancies last an average of 39 to 40 weeks. This period is divided into three stages known as trimesters.

The first trimester consists of the first 13 weeks, the second trimester spans weeks 14 to 28, and the third trimester lasts from the 29th week to birth. Abortions in the first trimester of pregnancy are easier and safer to perform while abortions in the second and third trimesters require more complicated procedures and pose greater risks to a woman’s health. In the United States, a pregnant woman’s risk of death from a first-term abortion is less than 1 in 100,000. The risk increases by about 30 percent with each week of pregnancy after 12 weeks.

A Drug-Based Abortion Methods

Drug-based abortion, also known as medication abortion, typically requires that a woman take two types of drugs within the first weeks of a confirmed pregnancy. In one method, a pregnant woman first takes the drug mifepristone, also known as RU-486, which blocks progesterone, a hormone needed to maintain the pregnancy. About 48 hours later, she takes another drug called misoprostol. Misoprostol is a prostaglandin (a hormone-like chemical produced by the body) that causes contractions of the uterus, the organ in which the fetus develops. These uterine contractions expel the fetus.

Another type of drug combination that induces abortion is the use of misoprostol with methotrexate, an anticancer drug that interferes with cell division. A physician first injects a pregnant woman with methotrexate. About a week later, the woman takes a pill containing misoprostol to induce uterine contractions and expel the fetus.

These drug-based abortion methods effectively end pregnancy in approximately 96 percent of the women who take them and are most effective when performed very early in a pregnancy. These methods require no anesthesia. However, the use of drugs to induce abortion has not been widely adopted by women in the United States for a number of reasons. These drugs can cause unpleasant side effects—some women experience nausea, cramping, and bleeding. More serious complications, such as arrhythmia, edema, and pneumonia, affect the heart and lungs and may cause death. Perhaps the primary deterrent is that these drug-based abortion methods require at least two visits to a physician over a period of several days, and these methods are no cheaper than a surgical abortion.

B Surgical Abortion Methods

Legal surgical abortion, when done by a trained provider, is essentially 100 percent effective. A number of surgical methods can be used to induce abortions. To end a pregnancy before it reaches eight weeks, a doctor typically performs a preemptive abortion or an early uterine evacuation. In both procedures a narrow tube called a cannula is inserted through the cervix (the opening to the uterus) into the uterus. The cannula is attached to a suction device, such as a syringe, and the contents of the uterus, including the fetus, are extracted. Preemptive abortion uses a smaller cannula and is performed in the first four to six weeks of pregnancy. Early uterine evacuation, which uses a slightly larger cannula, is performed in the first six to eight weeks of pregnancy. Both types of abortions typically require no anesthesia and can be performed in a clinic or physician’s office. The entire procedure lasts for only several minutes. In preemptive abortions the most common complication is infection. Women who undergo early uterine evacuation may experience heavy bleeding for the first few days after the procedure.

Vacuum aspiration is a procedure used for abortions in the 6th to 14th week of pregnancy. It requires that the cervix be dilated, or enlarged, so that a cannula can be inserted into the uterus. Progressively larger, tapered instruments called dilators may be used to dilate the cervix. During the procedure, the cannula is attached to an electrically powered pump that removes the contents of the uterus. In some cases, the lining of the uterus must also be scraped with a spoonlike tool called a curette to loosen and remove tissue. This procedure is referred to as curettage. Vacuum aspiration may require local anesthesia and can be performed in a clinic or physician’s office. Minor bruising or injuries to the cervix may occur when the cannula is inserted.

Dilation and curettage (D&C), performed during the 6th to 16th week of pregnancy, involves dilating the cervix and then scraping the uterine lining with a curette to remove the contents. A D&C often requires general anesthesia and must be performed in a clinic or hospital. Possible complications include a reaction to the anesthesia and cervical injuries. Since the development of vacuum aspiration, the use of D&C has declined.

After the first 16 weeks of pregnancy, abortion becomes more difficult. One method that can be used during this period is dilation and evacuation (D&E), which requires greater dilation of the cervix than other methods. It also requires the use of suction, a large curette, and a grasping tool called a forceps to remove the fetus. D&E is a complicated procedure because of the larger size of the fetus and the thinner walls of the uterus, which stretch to accommodate a growing fetus. Bleeding in the uterus often occurs. D&E is often performed under general anesthesia in a clinic or hospital. It is typically used in the first weeks of the second trimester but can be performed up to the 24th week of pregnancy.

An induction abortion can also be performed in the second trimester, usually between the 16th and 24th week of pregnancy. In this type of abortion a small amount of amniotic fluid, the fluid that surrounds the fetus, is withdrawn and replaced with another fluid. About 24 to 48 hours later, the uterus begins to contract and the fetus is expelled. When this method was first developed, physicians used a strong saline (salt) solution to abort the fetus; today they may also use solutions containing prostaglandins or pitocin, a synthetic form of a chemical produced by the pituitary gland that induces labor. Heavy bleeding, infection, and injuries to the cervix can occur. This procedure is performed in the hospital and requires a stay of one or more days.

Abortions performed at the end of the second trimester and during the third trimester require major surgery. Two such late-term procedures include hysterotomy and intact dilation and extraction. In hysterotomy, the uterus is cut open and the fetus is removed surgically in an operation similar to a cesarean section, but a hysterotomy requires a smaller incision. Hysterotomy is major abdominal surgery performed under general anesthesia.

Intact dilation and extraction, also referred to as a partial birth abortion, consists of partially removing the fetus from the uterus through the vaginal canal, feet first, and using suction to remove the brain and spinal fluid from the skull. The skull is then collapsed to allow complete removal of the fetus from the uterus.

10 most healthy foods for your body !

noreply@blogger.com (Naufal Fadhillah Alam) — Tue, 05 Apr 2011 13:54:00 +0000

Vegetables

Jakarta - A variety of different kinds of food coloring and enliven the world of culinary dishes in different places. But among the many foods available , there are a number of foods there are consired the healthies !

As quoted from Gerome , there are ten that are categorized as the most healthful foods among other , namely :

1. Lemon.
This fruit contains more than 100 percent of vitamin C is needed every day, which works to increase the cholesterol levels of 'good' HDL cholesterol and strengthen bones. Added another, flavonoids contained in the lemon can suppress cancer cell growth and anti-inflammatory role as weapons.

Add the lemon pieces in green tea. A study from Purdue University found that citrus can increase the body's ability untukmenyerap antioxidants in tea by 80 percent.

2. Broccoli.
These vegetables contain more than 100 percent of vitamin K is needed everyday, and nearly 200 percent of the recommended dose of vitamin C for us. Both these nutrients are very important in bone formation and protection from attack cancer.

Use the microwave to retain 90 percent of vitamin C in broccoli. Steaming or boiling technique can only be maintained as much as 66 percent nutrition. Broccoli can be used as a salad ingredient, or any other food preparations.

3. Dark chocolate
By eating 7 grams of dark chocolate every day can lower blood pressure. Cocoa powder is rich in flavonoids, antioxidants that are good in suppressing "bad” cholesterol LDL cholesterol and increase 'good' HDL.

Dark chocolate bars containing 53.5 mg of flavonoids, where as milk chocolate bar has only less than 14 mg of flavonoids. Serve as a mixture of various cakes, cake, drinks, and others, or eaten directly.

4. Potato
Red potato has 66 micrograms of folate-forming cells, the same amount to those found in spinach 30 grams and 91 grams of broccoli. In one sweet potato contains vitamin A eight times more than our daily needs. This vitamin is useful to fight cancer and boost the immune system. The study finds this habit will help you burn more fat 25 percent after eating.

Potatoes can be used as processed food, cakes, and others, or just boiled. Let the potatoes cool before consumption.

5. Salmon Fish
Of marine resources is extremely rich in Omega-3 fatty acids are efficacious to reduce the risk of depression, heart disease, and cancer. Eating 85 grams of salmon is to provide the required 50 percent of niacin per day. Niacin serves to protect us from attack Alzheimer's and dementia.

For maximum results, choose wild salmon than farmed. Sports according to taste, such as roasted, fried, steamed, and other processing with the seasonings to taste.

6. Walnuts
walnuts contain omega-3 fatty acids, cholesterol lowering, at most of the other groups of beans. Plus, Omega-3 also was asked as a mood enhancer and fighting cancer. Antioxidant content of melatonin in walnuts can help adjust the hours of sleep.

usually walnuts for dessert. In addition, it can be processed in a cake mix, cake, and others.

7. Avocado
An avocado has more than 50 percent fiber and 40 percent of folate do we need every day, which will reduce the risk of heart disease.

Adding the avocado in a salad plate will increase the absorption of key nutrients, like beta-carotene, up to 3-5 times compared to the salad without alvocado. This fruit can be eaten without mixed with other ingredients, or may in the juice, and others.

8. Garlic
Garlic is able to suppress the growth of bacteria, including E.coli. The content of allicin in this seasoning works as anti-inflammatory substances and helps lower cholesterol levels and blood pressure.

Use these herbs in treating a variety of cuisine. But do not be too long in hot temperatures or a maximum of 10 minutes, because it will make good nutrition in garlic lost. Can also be used as pickling onions.

9. Spinach
Lutein and zeaxanthin are two antioxidants in spinach-enhancing immune system this very good for eye health. Studies of the Center for Eye Research in Australia found that a diet rich in both nutrients in the upper lower the risk of cataracts.

Mix 30 grams spinach, 110 grams of carrots (grated), 1 banana (cut into small pieces first), 1 cup apple juice and ice cubes in a blender until well blended. Can also be used as soup and other dishes.

10. Legumes (peas)
With Legumes consume four times a week can lower heart disease risk until 22 percent and can reduce the risk of breast cancer. Because the content of antiokasin and in it is quite high.

this peas can be a variety of delicious cuisine prepared with sautéed, fried, and others.

source : Detik

5 advantages of having a pet for health

noreply@blogger.com (Naufal Fadhillah Alam) — Wed, 30 Mar 2011 13:27:00 +0000

Many ways to live healthier. One way is to have pets. By treating an animal, you can better quality of life, not just in terms of physical but also psychological.

If you've never owned a pet, It never hurts to try. As reported by the Woman's Day, there are five benefits you can get.

1. Reduce stress

Research by a team from the State University of New York, found that when someone does a job full of pressure, stress levels reduced when accompanied by pets. This comparison was accompanied with a partner, close friends or other family members.

2. Lowering blood pressure

Having a pet also has the potential to lower blood pressure, especially in patients with hypertension. That's according to the Centers for Disease Control and Prevention (CDC), United States.

"If there are pets around you, can decrease blood pressure," said Marty Becker, author of "Your Dog: The Owner's Manual".

3. Reduce pain

Believe it or not, the animal is the best pain relief medication. Especially for people who experience migraines or chronic pain. "It's like Valium, has a pet can reduce anxiety. Anxiety reduced mean pain diminished, "said Becker.

4. Lowering cholesterol

According to the CDC, have pets, make healthier heart because it can reduce levels of bad cholesterol in the blood. It is known that men who have pets, the level of triglycerides (fats) and lower cholesterol than men who do not have pets.

5. Preventing stroke

"If you have a cat, the risk of heart attack decreases by 30 percent. Then the risk of stroke can be reduced by 40 percent, "said Dr. Becker. Not only that, pet also can help the recovery of patients who had a heart attack.

According to Becker, if someone had experienced a heart attack and having a pet, chances are his life eight times larger

What does Cerebrum do ?

noreply@blogger.com (Naufal Fadhillah Alam) — Sun, 27 Mar 2011 13:24:00 +0000

Cerebrum

Most high level of brain functions take place in the cerebrum. Its two large hemispheres make up approximately 85 percent of the brain's weight. the exterior surface of the cerebrum, the cebral cortex, is a convoluted, or folded, grayish layer of cell bodies kwown as the gray matter.

The gray matter covers an underlying mass of fibers called the white matter. the convolutions are made up of ridgelike bulges, known as gyri, separated by small grooves called sulci and larger grooves called fissures. Approximately two-thirds of the cortical surface is hidden in the folds of the sulci. The extensive convolutions enable a very large surface area of brain cortex-about 1.5m2 (16ft2)in an adult-to fit within the cranium. The pattern of these convolutions is similar, although not identical, in all humans
Head injury can initiate a cascade of damaging events. After a blow to the head, a person may be stunned or may become unconscious for a moment. This injury, called a concussion, usually leaves no permanent damage. If the blow is more severe and hemorrhage (excessive bleeding) and swelling occur, however, severe headache, dizziness, paralysis, a convulsion, or temporary blindness may result, depending on the area of the brain affected. Damage to the cerebrum can also result in profound personality changes.

The cerebrum and cerebellum of higher mammals are highly convoluted in order to fit the most gray matter surface within the confines of the cranium. Such highly convoluted brains are called gyrencephalic. Many lower mammals have a smooth, or lissencephalic (“smooth head”), cortical surface.

WHAT DOES THE CEREBRUM DO?

Your cerebrum makes up most of your brain. Your cerebrum solves problems and makes wishes. All of your thinking goes on in your cerebrum. Speech, language, and emotions come from your cerebrum, especially your cerebral cortex. The cerebral cortex is the outer part of the cerebrum.
Your cerebrum also gets signals from your senses. Nerves carry the signals. Nerves from your eyes and ears go to parts of the cerebrum that let you see and hear. Nerves carry signals to your cerebrum that let you feel, smell, and taste.
Your cerebrum sends messages out along nerves. The messages tell your legs to walk or run. They tell your arm and hand to wave when you see a friend across the street.

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There are so many benefits of reading , one of them is preventing Alzheimer's Disease !

noreply@blogger.com (Naufal Fadhillah Alam) — Thu, 24 Mar 2011 06:31:00 +0000

Do you want to avoid the Alzheimer's disease ? It's easy ! Reading is the answer !

Reading is an activity that brings many benefits because by reading our knowledge will increase. Whether it is knowledge related to science and also just news or information. In addition, experts say that with a lot of reading then we would be separated from the brain disease. A researcher from the Henry Ford Health System, Dr. C. Edward Coffey, proving that just by reading the book one will be spared from the disease "Dementia". Dementia is a devastating disease of the brain tissue. When exposed to dementia, can be sure someone will be difficult to avoid senility. This occurs because the read to create such a buffer layer that protects the brain and replace changes.
Recent brain research has discovered the benefits of reading in growing dendrites, one of the components of the brain nerve cells or neurons. Read new words to stimulate the brain, because the brain likes to challenge and new things. Reading is an activity full of challenges and always bring a person to enter new territory.
Recognized or not, many people are smart and intelligent because of diligent reading. Reading also can make people more mature. Adults here means to have the mindset that no longer childish. By reading, people can look at every problem of life not as a burden, but a challenge that must be resolved. Problems in life is not viewed 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 very unfortunate that the reading interests of Indonesian society is still low. Taufiq Ismail a famous Indonesian writer says that. "We have become a nation paralyzed myopic reading books and writing. " This expression must have a very strong reason. And, true, our problem is the low interest in reading. If offered a book reading, not a few of us who reject the grounds do not have time to read. Our society is more like the medium of television from the book. Though it E. Jordan Ayan is also mentions that the television was still very behind compared toto the book . Television is a "passive media" that does not invite us to participate in learning or creative thinking. But this information does not come down to us because of our lack of reading.
Very different from the culture of reading Japanese society and other developed countries. Everywhere they always carry reading material. 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 people prefer to girl talk and cultured oral. More of his daydream than do reading activities. This we can see from our own behavior as well as the people around us. In fact a lot of free time that we can use to read.
For example, while it is awaiting the departure of the aircraft, at the bus stop, terminal, even for people who have no health problems when reading on the vehicle, can utilize the time to read. Five minutes of reading can add insight to our knowledge. We can build motivation in us by extending the reading includes reading biographies of successful people.

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

1. When busy reading, someone blocked entry into stupidity

2. Reading habits make people too busy to get in touch with the people lazy and not willing to work

3. With frequent reading, one can develop flexibility and fluency in spoken word

4. Reading helps develop thinking and clear thinking

5. Reading enhance one's knowledge and improve memory in understanding

6. With frequent reading someone can benefit from the experience of others, such as wise men follow the example of wisdom and intelligence scholars

7. With frequent reading, one can develop his abilities, both to receive and process science as well as to explore different disciplines and their applications in life

8. Confidence someone will increase when he read books that are useful

9. Reading helps a person to refresh your mind of clutter and save time for not in vain. With frequent reading, one can master a lot of words and study the various models of sentence

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

From 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 my knowledge with them. I therefore invite the reader to turn the culture of reading all this anywhere and anytime there is a time for reading.

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source : DETIK HEALTH

6 Foods that Deplete the Body in seconds and Minutes

noreply@blogger.com (Naufal Fadhillah Alam) — Fri, 18 Mar 2011 10:54:00 +0000

Smoking

it's easy to be healthy ! Various threats to health can be found in everyday foods ranging from sugar, salt to bad fats. Each takes different times to cause damage ranging from a matter of seconds to minutes.

Damage to certain parts in the body can occur in a matter of hours, even minutes. The materials are usually consumed daily through food and drink will lead to damage, of course, if consumed in excess.

How quickly the damage occurs ? the following comparison :

1. Cigarettes : 3 seconds
To reach the lungs, cigarette smoke only takes about 3 seconds and directly stimulate the heart to work harder in pumping blood. Increased pressure due to excessive cardiac work can trigger heart attacks and strokes for those who have a risk.

2. Sugar : 2 minutes
Even before you swallow, the sugar has lead to damage to the tooth enamel due in 2 minutes can trigger the growth of bad bacteria in the oral cavity. Once ingested, 20 teaspoons of sugar can reduce the ability of white blood cells to eradicate the bad bacteria that cause disease only within 2-5 hours afterwards.

3. Alcohol : 6 minutes
Within 6 minutes, 1 liter of beer or 3 glasses of wine alcohol can cause brain damage despite the reversible nature of the alias is not permanent. If you continue to get drunk and done too often, then the damage will be permanent.

4. Salt : 30 minutes
Salty foods can lead to hardening of the arteries, veins alias in just 30 minutes after being swallowed. Another impact of the excess salt is absorbed into the blood vessel so that fluid pressure rises and increases the risk of stroke and heart attack.

5. Caffeine : 30 minutes
Half an hour after drinking coffee, pressure and blood flow to the muscles will increase so that it becomes more stamina because of the release of adrenal hormones. In contrast, blood flow to organs other than muscle would be reduced, thereby reducing its performance.

6. Bad fats : 45 minutes
Saturated fat content in cheese, biscuits and other foods can increase the risk of blood clotting in less than 1 hour. The impact of course is a blockage of blood vessels that can trigger heart attacks. The good news, unsaturated fats and omega-3 fatty acids in nuts and fish oil can neutralize the effects of saturated fat

--THE END--
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source : DETIK HEALTH

10 foods to increase the intelligence of children

noreply@blogger.com (Naufal Fadhillah Alam) — Thu, 17 Mar 2011 12:40:00 +0000

Research shows, a lack of minerals and vitamins that are important to the brain can reduce mental alertness of the brain. A diet rich in fruits and vegetables, whole grains, combined with meat and fish to provide for major minerals and vitamins needed for physical and mental health.

What are some foods that can stimulate the growth of brain cells, improve function, improve memory and concentration and thinking of children? Here are 10 foods recommended by Dr. Saridian Satrix W, SpGK:

Salmon

1. Salmon
Salmon is the best source of omega 3-fatty acids DHA and EPA, which are both essential for growth and development of brain function. The new research also showed that people who earn more fatty acid intake has a sharper mind and recorded satisfactory results in testing capabilities. Omega-3 fatty acid content per 100 grams of fish for salmon is 2.2 grams. Needs of children in omega 3 per day is 1.2 grams.

Eggs

2. Eggs
Eggs are known as an important source of protein which is relatively cheap and the price is quite affordable. Egg yolk was solid part will contain choline, a substance that can help the development of memory or memory. The content of choline in 1 large egg is 126 mg. Compare with 2 tablespoons of peanut butter that contains only 20 mg and 300 grams of beef degan content of 66 mg choline. Needs of children will be 200-375 mg per day of choline

Peanut butter

3. Peanut butter
Groundnut (peanut) that many processed into peanut butter is one source of vitamin E. This vitamin is a source of antioxidants that can protect nerve cell membranes. Together with thiamin, vitamin E helps the brain and nervous system in use glucose for energy needs. Every 2 tablespoons of peanut butter contains 2.9 mg of vitamin E, while the needs of children between 4-10 mg per day.

Mixed nuts

4. Other Nuts
Peanut is a special food because these foods have the energy derived from protein and complex carbohydrates. In addition, nuts are rich in fiber, vitamins, and minerals. Nuts are also good food for the brain because they can maintain the energy and thinking ability of children at its peak in the afternoon if consumed when maakn afternoon. According to the research, red beans and pinto beans contain more omega-3 fatty acids than other nuts, especially ALA, omega-3 type of origin are important for growth and brain function.

Grains

5. Whole grains
The brain requires glucose supply or preparation of the body that are constant. Whole grains have the ability to support those needs. Fiber contained in whole grains may help regulate the release of glucose in the body. Wheat also contains vitamin B which serves to maintain nervous system health. Wheat contains vitamin B, 1.5 mg per 100 grams. While the requirement of vitamin B in children is 1 mg per day.

Oatmeal

6. Oatmeal
Oatmeal is one of the most popular types of cereals among children and rich in essential nutrients for the brain. Oatmeal can provide the energy or fuel for the brain a much needed children's activities started in the morning. Rich in fiber, oatmeal will keep your child's brain needs are met throughout the morning. Oatmeal is also a source of vitamin E, vitamin B, potassium, d of zinc which makes the body and brain to function at full capacity. The content of vitamin E in 250 grams of oatmeal is 0.08 mg. The content of vitamin B 0.26 mg per 250 grams of oatmeal and zinc 6.19 mg per 250 grams of oatmeal.

Berries

7. Berries
Family groups berries (strawberries, cherries, blueberries), the stronger the color the more nutrients they contain. Give contain high levels of antioxidants, especially vitamin C, which is useful to prevent cancer. Some research suggests those who get the extracts of blueberries and strawberries experienced improvements in the functioning of his memory. Seeds from these berries was also rich in omega-3 fatty acids.

Vegetable

8. Colorful vegetables
Tomatoes, red sweet potato, pumpkin, carrots, and spinach are the vegetables that are rich sources of nutrients and antioxidants that will keep brain cells strong and healthy.

Milk

9. Milk and yoghurt
Foods derived from dairy products containing high protein and B vitamins. Two types of nutrients are essential for the growth of brain tissue, neurotransmitters, and enzymes. Milk and yogurt also can make a full stomach because the content of protein and carbohydrate as well as a source of energy for the brain.

Lean beef

10. Lean beef
Iron is an essential mineral that helps the children stay energized and concentrate at school. Lean beef is one source of foods high in iron. The content of iron in 100 grams of beef is 4.05 mg. While the need for iron in children is 30-10 mg per day.

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source : DETIK HEALTH

WHAT CAUSES AN EARTHQUAKE ?

noreply@blogger.com (Naufal Fadhillah Alam) — Sat, 12 Mar 2011 11:23:00 +0000

EARTHQUAKES

Hi friends. I'll to tell you something about earthquake. Firstly, do you know what causes an earthquake ? When Earth’s rocky outer surface shakes, we feel it as an earthquake. Earthquakes occur more than a thousand times a day around the world. Their movements may be so slight that they go unnoticed or so strong that they cause damage to buildings and loss of life. Read the following article to know it ! happy reading :D

Earthquakes are movements in Earth’s crust. The crust is Earth’s rocky outer layer, the solid ground that we live on. Earth’s crust is broken up into many gigantic sections of rigid rock called plates. The plates slide around slowly on a layer of hot, melted rock deep inside Earth. Sometimes the plates crash together. Sometimes the edge of one plate slides under another plate.

Faults are cracks in Earth’s crust between the huge plates. Earthquakes usually happen along faults. The plates on each side of a fault press against each other with tremendous force. An earthquake occurs when the rock along the edge suddenly gives way. Huge chunks of rock underground break and move. They can jolt upward or they can dive down. Sometimes the blocks of rock along a fault grind sideways past each other.

The place where the rock breaks is called the focus of the earthquake. It is usually underground. The breaking and moving makes waves travel through the ground. The waves go through the ground the way waves go through water. The ground ripples and shakes.

The place on the ground directly above the focus is called the epicenter. Earthquakes are strongest near their epicenters. Earthquake waves go out in big circles. Waves made by a powerful earthquake can travel thousands of miles!
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Example of simple , good speech ( The Importance of Protecting the Environment )

noreply@blogger.com (Naufal Fadhillah Alam) — Fri, 11 Mar 2011 06:57:00 +0000

SPEECH

Contoh naskah pidato sederhana berbahasa inggris , dijamin ok dan tidak mengecewakan !!!

Examples of simple English speech, guaranteed ok and did not disappoint !

------>>>>>SIMPLE SPEECH<<<<<<<<-------

Good morning all, Alhamdulillah by the grace of Allah the Almighty God, now I can stand here in front of you all. At this moment we can meet in good condition. Now I will tell you about "The importance of protecting the environment"

Plants, people, animals and the environment are interdependence. Plants need a good environment for growing, animals need plants to eat, and human need everything to survive. Everything went as usual until the human who destroying it. No one of living things on the earth who can destroying it except the human.

Globalization may already be familiar to you . Globalization can accelerate the rate of economy anywhere. Technology developed over the years become a tool that can easily human works. Even to support it many new technologies are born for example a computer. Unfortunately, the speed of current technological improvement not followed by protecting awareness of surrounding environment. Massive oil drilling caused by the human vehicle is increasing along with increasing human populations from year to year. Finally, the waste produced from the vehicles, become one of the main factors polluted air around us. A lot of environmental damage that we often hear, for example, global warming ,acid rain, greenhouse effect, environmental pollution and so on.

The greenhouse effect caused by excessive carbon dioxide gas and causes global warming makes the earth hotter. The next phenomenon is acid rain, although it can prevent global warming but acid rain is more dangerous. humans are the main causes ! Start From now let's keep our environment for our grandchildren one day later. because no matter how small work you do, will be felt by our children and grandchildren one day later.

This is enough from me . sorry if there was a mistake, thank you for your attention.