Wednesday, July 15, 2009

Anemia Aplastik

PEMBAHASAN


Definisi
Anemia aplastik adalah anemia yang disebabkan oleh berkurangnya sel darah tepi (leukopeni, trombositopeni) sebagai akibat terhentinya pembentukan sel hemopoitik dalam sum-sum tulang.

Dasar Diagnosis
Anamnesis :
• Panas, pucat, lemah, lesu
• Perdarahan (purpura, petekie, epistaksis, perdarahan gusi atau salurancerna, dll)
• Riwayat minum obat-obatan dan radiasi
• Riwayat kehamilan, kongenital.

Pemeriksaan Fisik :
• Pucat, ikterik, sesak
• Tidak ada pembesaran organ
• Bising jantung (+)
• Rumple leed +/-

Laboratorium :
• Gambaran sel darah tepi ditemukan trias : anemi, lekopeni, trombositopeni ; (pansitopeni)
• Waktu pembekuan memanjang; waktu perdarahan normal/memanjang
• Gambaran sumsum tulang :
o Banyak ditemukan jaringan ikat
o Hiposelular/aseluler sumsum tulang
o Aplasia sistem eritropoetik, granulopoitik, trombopoitik.

Pada kasus ini diagnosis anemia aplastik ditegakkan berdasarkan :
• Anamnesis : pucat, lesu, perdarahan gusi
• Px. Fisik : pucat, tidak ada pembesaran organ, rumple leed (+)
• Laboratorium : Pansitopeni, normositik normokrom.

Penatalaksanaan
• Istirahat
• Diet dengan gizi seimbang
• Transfusi (Packed Red Cell) PRC
• Androgen : Dihidrotestosteron 1-2 mg/kgBB/hari atau Metandrostenolon (Dianabol) 0,25-0,5 mg/kgBB. Bila dalam waktu 4 bulan tidak ada respon, pengobatan dihentikan.
• Kortikosteroid : Prednison 2-5 mg/kgBB/hari peroral atau Metilprednisolon 20 mg/kgBB/hari selam seminggu.

Pada kasus ini, penatalaksanaan meliputi :
Non medikamentosa :
Istirahat untuk menghindari trauma dan mencegah perdarahan
Diit lunak 3x1 ; @ (1100 Kkal dan protein 24 gram)
Monitor KU, vital sign dan tanda-tanda perdarahan

Medikamentosa :
Transfusi PRC 2x500 cc, merupakan terapi supportif
Dihidro testosteron 3x12mg , merupakan terapi kausatif yang dapat meningkatkan aktifitas eritropoetik.
Prednison 3x 24 mg, dapat meningkatkan kecepatan pematangan usia tulang yang terangsang oleh androgen, juga meningkatkan resistensi kapiler.

Saturday, July 4, 2009

KANDIDOSIS VULVOVAGINITIS

DEFINITION
Kandidosis vulvovaginitis or also called vulvovaginitis is kandidiasis infection vagina and/or vulva of acute or subakut caused by Candida species,
usually species by Candida albicans (81%) or sometimes T. Glabrata (16%), other species (C.tropicalis, C.stellatoidea, C.pseudotropicalis, C.krusei) are very rare, only around 3%.

Epidemiology
Frequency of women's experience kandidosis vulvovaginitis is 20-50% of all women, another source said kandidosis vulvovaginitis is the frequency of 45% of all cases of vaginitis.
Candida culture found on the woman who asimtomatik as much as 20-50%, and approximately 75% experienced by women in the United States,
there are no racial differences in predileksi kandidosis vulvovaginitis, and generally the age of adolescents and adults.

Etiology
The cause is tersering Candida albicans that can diisolasi from the skin, mouth, vagina and mukosa membrane feses normal people.
Candida microorganisms grow as komensal at 40-80% healthy human form blastospora without capsule oval shape,
and reproduce through the formation of the shoot, hifa a thin, lengthwise, and can not fork tunbuh in culture or in vivo as a sign of the disease is active / budding.
Vertigo

Vertigo comes from the latin language 'vertere' which means around.
Translated in the dictionary with a headache / dizziness.
According to Gowers in 1893 vertigo is a feeling of any movement or
movement of the body or objects in the vicinity of the equilibrium system with aberration (ekuilibrium).
According to another opinion, defined as vertigo disorientation (interference observation) to the room or halusinasi movement,
which can be either rotary or feeling a sense of movement linier.

Based on the anatomy causes vertigo classified up 2 forms, namely:
1. Non-vestibular vertigo, kelainannya can be located at:
• Eyes:
-Paresis eye muscle
-Deviation refraction
-Glaucoma
• Propioseptik:
-Pellagra
-Anemia pernisiosa
-Alcoholism
-Tabes dorsalis
• central nervous system:
-Hipoksia cerebri;
• Chronic Hypertension
• Arteriosclerosis
• Anemia
• Hypertension kardiovaskuler
• Fibrillation
• atrium paroksismal
• Stenosis and insufisiensi aorta
• Hipotensi ortostatik
• heart block
-Infection;
• meningitis
• encephalitis
• Abses
• Lues
-Trauma
-Tumor
-Migraine
-Epilepsy
-Endokrin aberration;
• Hipotiroid
• Hipoglikemia
• Hipoparatiroid
• Tumor medulla adrenal
-Deviation psikoneurosis

2. Vestibular vertigo vertigo that is caused by deviation vestibular system (labyrinth, N. III, nucleus or vestibularis)
• Ear
-The outside
• Serumen
• Foreign Objects
-The middle
• Retraksi menbran tymphani
• Otitis media purulenta akuta
• Otitis media with efusi
• Labirintitis
• Kolesteatoma
• Rudapaksa with bleeding
-In part
• Labirintitis akuta toksik
• Trauma
• The attack vaskuler
• Allergies
• Hidrops labyrinth
• drunk movement
• Vertigo postural
• N. III
-Infection
• acute meningitis
• TB meningitis
• meningitis basilaris luetika
-Trauma
-tumor
• Vestibulum core (brain stem)
-Infection: meningitis, encephalitis and brain abses
-Trauma
-Bleeding
-Trombosis a. Cerebeli postero-inferior
-Tumor
-Multiple schlerosis
Woman Normal Fertile Period

Each woman will have the normal fertile period for the reproduction of a periodic or a cycle.
More fertile period is the period when ovulation where women are at a fertile womb,
where the cells release the egg (Ovulation) is ready to be fertilized. Fertile period this happened one time in one cycle menstruation.
Every couple who wish to have offspring will be required to know fertile period based on the wife because of the above only happens once per cycle,
while the husband does not have cycle or the fertile period every day if he was normal.

How to calculate the fertile period?

1. With the calendar system

The calculation is based on the fertile period or when ovulation to happen on the day 14 of the next menstruation and
reduced 2 days because sperm can live for 48 hours after ejaculation and added 2 days because the eggs can live cells 24 hours after ovulation.

So, for example 28 menstruation day cycle and last period occurred on 1, the date is next month period 28.
Thus, the estimated time ovulation, that is in the middle of the menstrual period 14.
Thus, the fertile period is around 12 to 16 date.

This calendar system is very effective when used on women who have a regular menstruation cycle.
You can try this way to calculate the fertile period or by using an application called JX Ovulation Calendar

2. With a simple examination

• With the rate increase body temperature, body temperature usually rises during and after the ovulation because of the influence of hormones progesterone.

• With fixed rate mucus. Hormone estrogen peak occurs at the time ovulation the mucus and uterus.
Towards the uterus mucus ovulation usually quite thin and so if the two be touched with the fingers form a yarn and colored nodes.

• Hearing Test Ovulation. When this sale is also free diapotik or drug store tools to assess the predictive test that is fertile fertile period or ovulation.
Tool to work with this test measures the level of LH hormone produced during ovulation. This tool is used as a pregnancy test but of course it costs more expensive.

By knowing when your fertile period, which can help you plan and also have children as well as methods of family planning or contraception is still natural to want to delay pregnancy, do not perform sexual fertile at the time.

Tuesday, June 30, 2009

By this blog, I will show you some articles, for helping friends that working in medical field and anyone who need information for health and medication.

Probably its just few from a lot of articles showed yet. It will be updated continously, following the medical science research and development in every month.

Dalam blog ini saya menampilkan beberapa artikel yang dapat membantu teman-teman yang berkecimpung dalam bidang kesehatan dan masyarakat luas yang membutuhkan informasi tentang kesehatan.

Masih banyak artikel yang belum saya tampilkan, artikel-artikel tersebut akan di-update secara bertahap, mengikuti perkembangan ilmu kesehatan.

InsyaAllah...

Semoga bermanfaat bagi Anda semua

Sunday, June 7, 2009

Dalam blog ini saya menampilkan beberapa artikel yang dapat membantu teman-teman yang berkecimpung dalam bidang kesehatan dan masyarakat luas yang membutuhkan informasi tentang kesehatan.

Masih banyak artikel yang belum saya tampilkan, artikel-artikel tersebut akan di-update secara bertahap, mengikuti perkembangan ilmu kesehatan.

InsyaAllah...

Semoga bermanfaat bagi Anda semua