In a broad sense, all forms of resuscitation is the medical business, which is committed against those who are in serious or critical condition, to prevent death. Death in the clinic is defined as loss of consciousness and all the reflexes, accompanied by cessation of breathing and blood circulation irreversible. Therefore, all resuscitation efforts is the Restore function to the respiratory system, circulatory and nervous, which interrupted or disturbed in such a way so that its functions can be stopped at any time, in order to return to normal as semula.1
Success or failure of the heart lung resuscitation depends on fast and precise technique of Action implementation. Some of the circumstances, resuscitation measures are not recommended (not effective), among others if the cardiac arrest (the arrest) has berlangung more than 5 minutes since it is usually permanent brain damage has occurred, the stadium KEGANASAN advanced, refractory heart failure, refractory pulmonary edema, which precedes renjatan "arrest", severe neurologic disorders, kidney disease, liver and lung lanjut.2
Resuscitation performed on:
 cardiac infarction "small" resulting in "electric death"
death of heart muscle disease due to blocked coronary blood vessels that supply blood to the heart muscle. In laymen, marked by a heart attack which destroyed large heart muscle known as heart failure, and the result can cause fatal kematian.3
 attack Adams-Stokes
Not aware of a sudden heart rhythm disturbance due to a slowdown or even cause fainting removal heartbeat with or without seizures, kejang.4
 Trauma
 Inhalation of smoke (toxic)
Acute Hypoxia 
Hypoxia is a revenue decrease of oxygen to the tissue below physiological levels of tissue perfusion despite adequate blood. 5.6
 poisoning and overdosing on drugs
 shock
 vagal reflex
 Drowning and other accidents that still gives the opportunity to live.
2. Resuscitation was not done at:
 death of normal, as is common in acute illness or severe Chronicle.
Estadio terminal illness  An incurable again.
 When almost certainly cerebral function that will not heal, that is, after ½ - 1 hour proven there is no pulse on normotermia without RJP.7
Resuscitation efforts performed on the state of clinical death is when a large pulse (circulation) and breathing stopped, but it is doubtful whether the two functions Spontaneous breathing and heart had stopped for sure or irreversible.8
When do we Begin CPR
Doing CPR decision to be taken after we got the results of primary examination, namely: no conscious, no breath, no heartbeat. The incident that led to doing CPR:
1. Ensure Victim Response
We must conduct monitoring of patient response to the shaking shoulders and Ask a situation, for example, "Are you all right?"
2. Repositioning Victim
Victim repositioning if needed, for example you find the victim in the tummy.
3. Make sure breath Open Road
Perform maneuvers head-tilt, chin lift or modified jaw down, as needed.
4. Check Breathing
See, Hear and Feel the breath. Ensure the presence or absence of breath within 3-5 seconds. At the victim is not breathing do not directly do CPR, but you must conduct ....
5. 2 ratings resuscitate
Perform rescue breathing techniques. If you notice any airway obstruction, Do techniques to clear the airway. If the victim's airway clear and he was still in a state of continuous breath after you give 2 breaths made it ...
6. Check Absent carotid
Maintain head tilt with one hand on the victim's forehead and use other hand to feel the carotid pulse. If no palpable pulse when you check in 5-10 seconds, this means that the victim in a state of cardiac arrest and you have to. ...
7. Begin CPR
With cardiac arrest victims to lie down on a hard surface, such as the floor, ground or spinal board. Injuries that occur on the victim is not a reason to delay CPR. CPR should be done as soon as possible.
In CPR procedures always include the principles of ABC. A CPR would not be effective if the airway is not open. CPR is also ineffective if circulation stops. Circulating blood will not be effective, unless the blood is oxygenated. Always remember If bleeding can interfere with circulation. Therefore, if a victim loses too much blood does the CPR ineffective. When the bleeding is happening so great, as in the case of severe bleeding from large arteries (eg: A. femoralis) so that we do CPR may actually accelerate the bleeding, and Causing death Biologik. Although such cases are rare, but we have to Conduct Action to Reduce the amount of blood lost prior to CPR. In CPR, we aim to force the blood of victims who had stopped the circulation to re-circulate with the conduct of external chest compression, which is known as circulation buatan.9
When are resuscitation is terminated?
 Have resurgent Spontaneous circulation and ventilation are effective.
 resuscitation efforts have been taken over by the PARTIES that more competent and responsible to continue resuscitation (if there is no doctor).
 A doctor bull charge.
 Helper too tired so can not continue resuscitation.
 Patients declared dead.
 Given then that after resuscitation, the stadium was in a terminal patient that the disease can not be healed again, or almost certainly will not come back Obtaining Patient serebralnya function, that is, after 0,5-1 hours, proved there was no pulse in the resuscitation without normotermia paru.10 heart

1. Safar P. Heart Lung Brain resuscitation. Jakarta: Ministry of Health of the Republic of Indonesia. pp: 4, 1984.
2. Alkatri J, et al. Heart lung resuscitation, the book Medicine Ajar, Editor Soeparman, part I, ed. Ke-2, Hall Publisher FKUI, Jakarta, pp: 281, 1987.
3. Stem cell therapy Treat Heart Infarction. http://www.kompas.com/read/xml / 2008/04/06/1654448/terapi.sel.induk.obati.infark.jantung. (1 December 2009)
4. Adam Stokes Attacks definition. http://www.medterms.com/script/main/art.asp? articlekey = 19,423. (December 1, 2009)
5. Rima et al., 1996, "Hypoxia", Dorlan Medical Dictionary, pp: 898, cet.II, EGC, Jakarta.
6. Sylvia AP, Lorraine MW, 1995, Signs and Symptoms of Respiratory Disease, "Hiperkapnea and Hipokapnea", pp: 685, Physiological Disease Processes, ed. 4, Book II, EGC, Jakarta
7. DR Sunatrio, Heart Lung Resuscitate, Editor Muchtaruddin Mansyur, IDI, Jakarta, pp: 193.
8. Sunatrio, S. Determination of Death, Termination of Emergency and Long-Term Resuscitate. http://repository.ui.ac.id/contents/koleksi/11/be94c925ae70fb1c58a298c2586d8ca7249e5541.pdf. (1 December 2009)
9. Technique: Heart Lung Resuscitate. ge/216 http://groups.yahoo.com/group/jejakpetualang/messa. (December 1, 2009)
10. Sunatrio, S. Determination of Death, Termination of Emergency and Long-Term Resuscitate. http://repository.ui.ac.id/contents/koleksi/11/be94c925ae70fb1c58a298c2586d8ca7249e5541.pdf. (1 December 2009

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Shock and the handling

Shock is a state of metabolic and hemodynamic disturbances are very heavy yan marked by the failure of the circulatory system to maintain adequate organ perfusion. This condition can be caused by a blood volume inadequate (hypovolaemic shock), inadequate cardiac function (cardiogenic shock) or inadequate vasomotor tone (neurogenic shock and septic).
Causes of shock include:
• The inability of the heart to pump enough blood to the organs.
• lost a lot of blood: So the amount of blood flow is not sufficient.
• dilatation (development) excessive blood vessels.
In a state of shock organs will be starved of oxygen. Organ oxygen deficiency will not give symptoms and signs as follows:
• Thirst
• Weak
• Dizziness spin
• Nervous, scared
• Pernapafasan rapid and shallow (the lungs)
• Rapid and weak Nadi (heart)
• Skin is pale, cold and damp (skin)
• Front looked pale and bluish on the lips, tongue and ear as well (skin).
• Pupil dilation / widening (eye).
• Nausea vomiting.
Based etiloginya the shock of some kind are classified as follows: Hypovolaemic Shock, Cardiogenic Shock, and Shock Distributive
Hypovolaemic shock
Hypovolaemic shock is the type most common shock characterized by decrease in intravascular volume. Body fluids contained in the intracellular and extracellular compartments. Intracellular fluid occupies nearly 2 / 3 of total body water and the extracellular body fluids found in one intavaskular and interstitial compartment. Interstitial fluid volume is approximately 3-4x of intravascular fluid. Hypovolaemic shock occurs when decline in volume intavaskuler 15% to 25%. This will describe the loss of 750 ml to 1300 ml in men with body weight 70 kg.
The conditions that put patients at risk of hypovolaemic shock are (1) loss of external fluids such as: trauma, surgery, vomiting, diarrhea, diuresis, (2) displacement of internal fluids such as: internal and hemoragi burns
The main goal in dealing with hypovolaemic shock is (1) restore intravascular volume to reverse the order of events that do not lead to tissue perfusion is not adequate. (2) redistribute the volume of liquid, and (3) fix the underlying causes of fluid loss as soon as possible.
ü Treatment of underlying causes.
If the patient is experiencing hemoragi, attempts were made to stop the bleeding. Includes installation of pressure on the bleeding or may need surgery to stop internal bleeding.
ü Replacement Fluids and Blood
Installation of two intra-venous lines with large kjarum installed to make access to intra-venous fluids. Meaning allow for simultaneous fluid therapy and blood components if necessary.
For example: Ringer's lactate and 0.9% Sodium clorida, Colloid (albumin and dextran 6%).
ü redistribution of fluid
Giving the modified trendelenberg position by elevating the legs of patients, about 20 degrees, knees aligned, trunchus horizontal and head slightly raised. The goal, to increase the flow through the veins that are influenced by gayagravitasi.
ü medication therapy
Medication will be prescribed to overcome dehidarasi if the underlying cause is dehydration. For example, insulin will be given to patients with dehydration secondary to hyperglycemia, desmopresin (DDVP) for diabetes insipidus, anti-diarrhea preparations for diarrhea and anti-emetic to vomit.
ü Military syoc anti trousersn (MAST)
Pkain go round that is designed to correct internal bleeding and hypovolaemia by providing back pressure around the legs and abdomen. This tool creates artificial peripheral resistance and helps keep perfusion Coroner.
SYOK cardiogenic
Cardiogenic shock caused by the failure of heart pump function leading to cardiac output is reduced or stopped altogether.
Causes of cardiogenic shock has the aetiology of coronary and non coronary. Coronary, myocardium caused by infarction, while non-coronary cardiomyopathy caused by, valve damage, cardiac tamponade, and dysrhythmias.
Destination management of patients with cardiogenic shock are:
1. Limiting further damage miocardium
2. Miocardium recuperate
3. Improving the ability of the heart to pump effectively.
The main management of cardiogenic shock include:
a. Additional supply of oxygen
In the early stages of shock, supplemental oxygen is given through a nasal cannula 3 to 5 Liter / min.
b. Controlling heartburn
If the patient menglami chest pain, morphine sulfate given intravenously to relieve the pain. Providing semi-Fowler position, can help to provide a comfortable position and improve lung expansion.
c. Provision of drugs vasoaktif
Vasoaktif drug therapy consisting of multiple pharmacological strategies to restore and maintain adequate cardiac output. In cardiogenic shock, coronary, diujukan drug therapy to improve cardiac contractility, reduced preload and afterload, or stabilize the heart frequency. For example, Dopamine and nitroglycerin.
d. Support a particular liquid
Giving fluids should be carefully monitored by nurses to detect signs of fluid excess. Bolus intravenous fluid that continues to be given diingkatkan with great care starts with the number of 50 ml to determine the optimal filling pressure to improve cardiac output.
SYOK distributive
Distributive shock or vasogenik occurs when abnormal blood volume in the move vaskulatur as blood in the peripheral blood vessels.
Distributive shock can be caused either by loss of sympathetic tone or by the release of chemical mediators into the cells. Kondosi-conditions that put patients at risk of distributive shock (1) neurogenic shock, such as spinal cord injury, spinal anesthesia, (2) shock sensitivity anafilaktik such as penicillin, transfusion reactions, bee sting allergy (3) septic shock such as immunosuppressive, age extremes of> 1 yr and> 65 years, malnutrition
Various mechanisms that lead to the beginning of shock vasodiltasi further distributive shock classification divides this into 3 types:
1. Shock Neorugenik
In neurogenic shock, vasodilatation occurs as a result of loss of sympathetic tone. This condition can be caused by spinal cord injury, spinal anesthesia, and damage to the nervous system. This shock can also occur as a result of work depressant drugs or the lack of glucose (eg, insulin reaction or shock). Spinal neurogenic shock is marked by dry skin, warm and not cold, damp as happened in hypovolaemic shock. Another sign is bradikardi.
- Neurogenic shock Specific treatment depends on the cause. If the cause Hypoglycemia (insulin shock) is giving quickly glucose.
- Neurogenic shock can be prevented in patients who mendapakan spinal or epidural anesthesia by elevating the head of the bed 15 to 20 degrees to prevent the spread of anastetik to the spinal cord.
- On Suspicion spinal cord, neurogenic shock can be prevented by immobilization of the patient carefully to prevent damage to the spinal cord further.
- Elastic stockings and elevate the foot of the bed can minimize the collection of blood in the legs. The collection of blood in lower limb placing patients at increased risk of thrombus formation.
- Provision of heparin, compression stockings and pneumatic compression of the legs can prevent the formation of thrombus.
2. Shock Anafilaktik
Anafilaktik shock caused by an allergic reaction when a patient who previously had formed an anti body against foreign substances (anti-gene) experienced a reaction of anti-gene antibody systemic.
- Provision of drugs that will restore vascular tone, and support emergency basic life functions. Example: epinephrine, aminophylline. Epinephrine given intravenously to vasokonstriktifnya effects menaptkan. Difenhidramin given intavena to fight the effects of histamine thus reducing the effects of capillary permeability. Aminophylline given intravenously to counteract histamine bronkospasme result.
- If there is a threat or has cardiac arrest and stopped breathing, is cardiac pulmonary resuscitation (CPR)
3. Septic shock
Septic shock is the most common form of shock caused by distributuf and widespread infection. Septic shock incidence can be reduced with infection control practice, doing a careful aseptic technique, perform debriden wound to remove necrotic tissue, maintenance and cleaning equipment properly and wash hands thoroughly
Microorganisms causing septic shock is gram-negative bacteria. When microorganisms attack the body's tissues, the patient will show an immune response. Generate an immune response is the activation of chemical mediators that have various effects that lead to shock. Increased capillary permeability, which engarah the permeation liquid from the capillary and vasodilatation are two such effects.
- The collection of specimens of urine, blood, sputum and wound drainage performed with aseptic technique.
- Giving high nutritional supplementation aggressively proteins made during the 4 days of awitan shock.
- Providing intravenous fluids and medications are prescribed, including antibiotics and drugs to restore vasoaktif vascular volume
First aid on the patient in shock

- Enable SPGDT (called an ambulance).
- Check the ABC, and if necessary to do artificial breathing and CPR
- Wlaupun person is able to breathe alone, keep check breathing every 5 minutes until help arrived
- If the person is conscious and has no injuries to the head, legs, neck or spine, place in a shock position of the person put in place a flat and moved out about 12 inches. Do not lift his head. And if her feet would cause membahyakan something, then let the person is lying on his back.
- Give appropriate first aid for the closure of the wound or injury.
- Keep warm and comfortable and loosen tight clothing.

The most important
- Do not give anything into the mouth of the victim, including eating and drinking
- Do not move the affected victims of spinal sedera
- Do not let the mild symptoms became worse until help has arrived.

by Mochamad Faisal Adam




http://www.healthscout.com/ency/1/000039trt.html # cont

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rheumatic genetic

Genetic rheumatic symptoms occur, especially starting at the age of 20's, even some who under the age of 20 years. Gradually, this disease will develop, usually until the peak occurs at age 40-45 years.

The main symptoms, lower back pain. "We also have to expect a person suffering from the U.S. if he's the man, because this disease attacks men more than women," said Harry. Comparison of male and female patients of about 8:1.

"Patients with this disease are young men around 20 years old who suffered from constant back pain for more than three months," said Harry. The pain is not like the pain from an accident or other factors, such as by lifting weights too heavy. Symptoms also can occur before the age of 16 years, the so-called juvenile ankylosing Spondylitis. This was also experienced by men vie.

The initial symptoms of pain will usually worsen when patients wake up in the morning. Only after a lot of exercise, the pain lessened. "These movements make the stiffness and pain in the waist down. Because, with the move, waist or other parts of the sick was bent." What often happens, pain in the waist is considered as a regular back pain due to accidents, lifting heavy loads, or pinched nerve. In fact, "There have been people who perform the operation because he thought the pain was due to pinched nerve."

Pain in the hip caused by a condition called entesopathy, which is inflammation of the ligaments attach to the spine. Ligaments function to connect the two vertebrae. When inflammation occurs long enough, there will be new bone formation, and two vertebrae may be joined. This unification process is slow, and each year will be repeating the merging of two vertebrae.

"This process occurs from the waist to neck. Starting at the age of 20, and gradually, as the patient's age was 40 years old, a segment will be merged. Penyatuannya process like bamboo tree, "said Harry.

Vertebrae together will result in the patient is difficult to move the body. As a result, it became difficult to bend. And if it is bent, difficult to enforce return. Or if the neck is attacked, turned into a job that was almost impossible.

"To see the entire body must come to move," said Harry. In fact, the weight level, the patient's body will be bent like a comma punctuation mark. People could not sleep on her back because her "curved," and forced to sleep on his side.

In addition to the waist pain, arthritis can also attacked the genetic peripheral joints, the central joints in the spinal cord of man. This peripheral joints are the knees, fingers, toes, elbows, too. This condition is attacked 20 percent of the total number of patients.

"The most frequently attacked are ankles, knees, hips, and shoulders. Usually the patient complains of pain is also part of that, "said Harry. There is a possibility, pain in the waist and peripheral joints was also accompanied by another disease that attacks the eyes, skin, gastrointestinal tract, and other variants. (Nova / Bestantia)

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squat toilet is healthier than seat toilet ?


Bladder dysfunction may actually be reduced in various ways. One of them by reducing the consumption of beverages containing caffeine, alcohol, and drugs.

"Caffeine is a substance that can boost heart rate and increased urine production," said Mulyadi Tedjapranata, Medizone Clinic physicians in Apartment Taman Kemayoran, Central Jakarta.

According to Mulyadi, urinary disorders prevention efforts could be true as early as possible. Some ways you can do is get used to not resist the urge to urinate. For the kids, doing exercises urinating or even toileting assistance was to be done since the children aged below five years old or a toddler.

Another effective way is to avoid the use of the toilet seat. The use of the toilet seat in the long run will increase the risk of urinary tract infection that can lead to urinary problems. Because the surface of the toilet is generally to mediate the spread of germs. The use of squat toilets are even more better.

The reason is, this will make users not in direct contact with the surface so that more hygienic toilets. "Moreover, if you frequently use public toilet facilities, better squat toilets," he said.

Not only that, the use of the toilet seat also makes muscles of the urinary tract to work harder when twitched or remove the urine. In the mild stage, urinary tract infections are usually marked with Anyang-anyangan or discharge of urine which was completely, lower abdominal pain, and pain at the end of urination.

This condition would interfere with our activities. In fact, if allowed to go on, it can cause urinary tract infections, psychosocial disorders such as depression and sleep disorders. (KONTAN / Herlina Kartika Dewi)

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the most expensive disease

Medical expenses each year almost all diseases are increasing. But among all types of diseases that cost was very expensive. 10 Avoid this sickness if you do not want to fall in poverty.

As quoted in Forbes, Wednesday (16/12/2009), there are 10 diseases with the highest costs in the United States.

1. Mental illness
Increased costs per year 6 per cent. The total cost of handling this disease in the United States has reached U.S. $ 142.2 billion.

Including mental illness is Alzheimer's, Parkinson's, Schizoprenia, depression and others. Recent drug development and the long healing process makes this disease a disease with the highest medical costs among all the existing diseases.

2. Heart disease
Increased cost-per-year 5 per cent. The total cost of handling this disease in the United States has reached U.S. $ 123.1 billion.

Heart disease remains the number 1 killer disease in the world. This is because more and more people who smoke and increasing unhealthy lifestyle such as high cholesterol foods and lack of exercise.

3. Trauma
Increased costs per year 6 per cent. The total cost of handling this disease in the United States has reached U.S. $ 100.2 billion.

Medical expenses of people affected by the trauma continues to increase because each case different ways of treatment. Also tools to diagnose this disease such as Computed tomography scans are expensive enough.

4. Cancer
Increased cost-per-year 7 per cent. The total cost of handling this disease in the United States has reached U.S. $ 99.4 billion.

Cancer treatment costs are most expensive colon cancer, breast cancer, lung cancer and prostate cancer. A key part of avoiding this disease is by avoiding smoking and maintaining a healthy food intake.

5. Phthisis
Increased costs per year 6 per cent. The total cost of handling this disease in the United States has reached U.S. $ 64.6 billion.
Which include lung diseases including asthma, emphysema (swelling or inflammation of the lungs) and Chronic diseases obstructive pulmonary disease (COPD) others.

6. Hypertension (high blood pressure)
Increased cost of 9 percent per year. The total cost of handling this disease in the United States has reached U.S. $ 50.2 billion.

This disease requires significant costs because many doctors who prescribe the amount of unsparing in his patients. Drug quality also determines the price. If hypertension is made generic drugs may cost this disease can be suppressed.

7. Osteoarthritis (arthritis / rheumatism)
Increased cost-per-year 8 per cent. The total cost of handling this disease in the United States has reached U.S. $ 48 billion.

Obesity and an enlarged waist size is a factor that increases the risk of this disease. Expensive drugs such as Vioxx and Celebrex that emerged in early 2000 to add expensive arthritis cure this. In 2004, Vioxx, withdrawn from the market because the risk of triggering a heart attack.

8. Back pain
Increased cost of 9 percent per year. The total cost of handling this disease in the United States has reached U.S. $ 40.1 billion.

Expenditures for these diseases was spent for operations. There are also drugs that are expensive narcotic (drug) to overcome this disease. But a study published in the Journal of the American Medical Association, said that all the expensive treatments that did not make a person better.

9. Kidney disease
Increased cost-per-year 13 per cent. The total cost of handling this disease in the United States has reached U.S. $ 35.9 billion.

The discovery of dialysis techniques for patients with kidney disease makes it an expensive disease management. Dialysis technique is the first technology that is very expensive to handle kidney disease.

10. Diabetes
Increased cost-per-year 8 per cent. The total cost of handling this disease in the United States has reached U.S. $ 35.8 trillion.

Nearly 24 million Americans affected by diabetes and obesity triggers are highest. Diabetes could trigger other diseases such as heart disease and cancer. However, because the diseases were different back treatments, the diabetes itself does not take a higher cost of heart disease or cancer.

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brain is able to feel the others person's pain

Have you ever felt as if the pain is being felt someone else? Your feelings may be right. A study using brain imaging to show, some people have the ability to feel the pain suffered by others.

By using brain imaging techniques MRI (magnetic resonance imaging), researchers from the UK found evidence that people who say they experience pain as other people in fact do so.

MRI examination of the unknown, the brain activity that serves the pain increases when people are watching other people in pain or injured. The ability to feel pain is referred to as functional illness.

"People who have functional pain experience pain even though he was not physically injured or illness," said Dr Stuart Derbyshire of the University of Birmingham, one of the researchers in this study.

Derbyshire henceforth study to determine whether people who are able to feel pain also have a functional response as if he saw pictures of people injured.

In his research he asked 108 volunteers to watch some of photographs of people in pain situations, such as athletes who suffered injuries during the game or the person being injected. Nearly a third of participants admitted they were not only experiencing emotional reactions but also feel the pain as seen in the picture.

Based on the MRI finding out whether the changes in blood circulation in the brain and the brain areas that respond to pain are also more active when respondents looking at photos of people in pain situation. Also note also that the functional brain activity in terms of emotion seemed more active.

"We feel the results of the study was a proof enough that some people do feel a physical reaction when watching someone else get hurt or in pain," said Derbyshire.

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The Case against Prita, a bad communication doctor and patient

The case against Prita Mulyasari could have been prevented if there is good communication between patients and physicians. As stated by the Honorary Chairperson of the Medical Ethics (MKEK) Indonesian Doctors Association (IDI) West Jakarta Branch Prof. Dr. Budi Sampurna, SH, SpF, DFM.
Budi suggested, a bridge between patients and doctors should be strengthened. This also was trying to remember people's awareness of the needs of medical information continues to increase. Awareness of physicians, that societies need to find peace with his illness, even increasing.

Budi deliver it in layman seminar titled How Berobat In Smart held in order to commemorate the 90th anniversary Cipto Mangunkusumo Hospital (RSCM) last week. In this seminar, given knowledge about the diagnosis and treatment approach of a physician as well as suggestions and ways of avoiding malpractice.

Budi suggested that the patient did not hesitate to ask the doctor about the disease so avoid the miscommunication that led to the dispute. In addition, doctors should be more communicative to the patient about the patient's illness experience.

In a separate occasion, Chairman of the Medical Council of Indonesia (KKI) Prof. dr Menaldi Rasmin, Sp P (K) FCCP, giving a response to malpractice cases in general. He personally said, no doctor who deliberately intend to make mistakes in practice because it involves the credibility and his career.

"If you deliberately do so, gradually everyone will know and a long career to a halt. Please note that the doctor is also a human being," he said.

According Menaldi, all doctors will try to work as well as he did. However, an accident and one other thing could have happened outside the predicted action. "All the medical action is certainly risky. All possible risks have been tried to be prevented, so be prepared if the worst does happen something unexpected, then the patient's family could not accept. But this is the name dispute is not medical malpractice and therefore the most important thing is communication between doctors and patients, "he said.

Furthermore, Menaldi explained that a doctor working only for the interests of patients. If the patient does not want to do something, then it is up to the patient. Duty doctor just explained. However, the choice of patients. "If patients want to take action, then the patient should be informed and agree. The patient also must sign a consent procedure.

What matters, he said, doctors should be concerned with the patient and not himself. Do not forget to communicate the bad and the good things that might happen to the patient between patients and physicians, thereby reducing the risk of medical disputes.

"You'd better give me all the medical information into the right patient, but need to be reminded also that doctors are not gods and can happen things that are beyond our reckoning," said Menaldi.

dr.Intan Airlina Febiliawanti

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Asthma...Doing the treatment at home

Asthma caused by chronic airway inflammation that causes breathing conduit sensitive, easy to tighten if it exposed to something, such as house dust.

Asthma treatment consists of drugs that dilate the airway tube (bronchodilators) and drug-reducing inflammatory processes. Usually bronchodilators drugs can be stopped if the patient is not crowded anymore (airway tube was widened again).

However, anti-inflammatory drugs should be used consistently in persistent asthma. Anti-inflammatory drugs reduce the inflammatory process beneficial and will reduce the sensitivity of the airway tube. Expected long-term airway tube which will be hyper-reactive airways resemble those pipes are not asthma. These drugs are generally groups of steroids. The most widely used is in the form of inhaled drugs.

Steroid drugs useful, but the use of systemic (either tablets or injections) will lead to long-term risk of side effects, such as cataracts, hypertension, or diabetes mellitus.

Inhaled steroid drugs can also cause side effects, but including light and not difficult to overcome, a fungus on the throat and vocal cords. For that, after inhaling this medicine, it is recommended gargling with warm water.


Patients with chronic diseases, including asthma, should be familiar with the disease and treatment properly. Patients need to recognize the early symptoms of an attack can be coughing or shortness. Usually, before a trigger, such as fatigue, allergies (such as house dust and animal hair), and respiratory infections, particularly viral infections.

Afflicted with asthma may experience an attack of influenza. Therefore, trigger asthma attacks should be avoided. To avoid influenza, can by avoiding people who are influenza, wash your hands regularly, and influenza vaccination.

One of asthma therapy is to progress the achievement of a good quality of life. Formerly with asthma are limited activities for fear of attacks occur. With the new therapy and if it can be controlled completely, patients can berkegiatan like other people, including quite heavy exercise.

To be able to control the total, required a good cooperation between doctors and patients. Progressive asthma medication is given to achieve the best lung function.

Asthma medication side effect was not breathing heavier than taking drugs, even lighter. Therefore, current treatment of chronic asthma asthma drug sniff priority, both for bronchodilators and anti-inflammatory.

Recognize drug

Patients or families should recognize that drugs should be used. With asthma should not run out of medicine because of the late administration of drugs can make asthma attacks more severe. Asthma medications work more quickly sniff so it can quickly relieve the attack.

Patient or family must be good at monitoring the results of therapy. If no improvement occurs, must be treated at the nearest hospital emergency room. Do not wait until morning or depend on a particular doctor.

The element of time in therapy of acute asthma attacks is essential. The sooner treated, it usually also quicker recovery. Patients who had not had an attack can be a sudden onset of severe acute attacks. In this situation, patients should be treated in hospital.

Mild asthma and are easier to treat than severe asthma. In severe asthma drug combination is needed. In addition to inhaled drugs, are sometimes necessary medicine to drink and injections. Chronic asthma can be controlled by avoiding triggers and using anti-inflammatory drugs and bronchodilators added if necessary.

Treatment of chronic asthma can not be done with a single injection or take medicine only a few days. Anti-inflammatory drugs should be used in a long time and if symptoms of asthma need plus bronchodilators.

For the beginning of treatment, inhaled asthma medication is more expensive. However, for the long term can actually save the drugs should be used if there is an acute attack or prevent the hospital. (Dr. Samsuridjal Djauzi)

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A New Record!! an old woman gave birth!!

Haryana, India - An Indian named Rajo Devi became the oldest woman in the world that can still give birth. She gave birth to her daughter on November 28, then when she was 70 years suda reach.

Obstetricians in Hospital Hisar Haryana state of India, Anurag Bishnoi said, Devi pregnant with his child through IVF process. Embryo transfer process made on 19 April. "Mother and baby are in excellent health," said Bishnoi

Previous record held by a Spanish woman named Maria Del who in 2006 gave birth to twins. She gave birth at the age of 67 years.

Devi's husband, Bala Ram, now 72 years old, had also married the sister Devi. This is because Devi could not give her children during the first 10 years of age marriage.

Ram claims to have made every effort to produce offspring. "I'm afraid that no one can continue our generation," said Ram. Adopting a child, according to Ram, no problem. Haryana in the mountains, living with other families is common. Only, it does not come from his own flesh and blood

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Advantages of onion

Europeans have used since the Bronze Age onions, but onions may come from West Asia or Central Asia. Pentateuch, the oldest part of the Bible, and even has a record of the onion and garlic. The name "onion" which means garlic comes from the era of the late Latin "cepa," or derivatives, "cepolla."

Onions can serve double, either as vegetables or herbs. Most food in the world add onions in many dishes. The Austrians, for instance, consumes an average of 6 pounds of onions per person each year.

Onion varieties very much in shape, color and taste. Mild onion taste of Spain ideally suited for grilled meats, as a spice (in a mixture with other vegetables, to add flavor). Onion even lighter, and is used mainly in salads. Onions with a strong garlic taste and unique aroma that is very desirable to provide aroma in food. And, do not forget the green onion, leek and garlic types other.

Sharpness characteristics derived from the content of onion belerangnya containing oil. Vegetables that contain high sugar levels (up to 8%) proved to provide a sweet taste and delicious for serving food. Garlic is presented as a vegetable dish is almost free of fat, and also contain minerals and vitamins with a high percentage. Also can increase your metabolism.

Onions can be regarded as a plant antibiotic, because of its ability to kill bacteria and prevent inflammation of the mouth and digestive system. Some sources even consider garlic has the ability to heal, in this case as a mild heart disease, blood clotting and prevention of cancer. In general, garlic can help increase blood sugar, lower cholesterol and work has antioxidant properties.

Beneficial for the whole onion digestive system. Vegetables (from green onion) stimulate the appetite and help the development of the production of stomach, internal organs and bile. Onions can be launched urination, and can improve bladder function. Garlic has an interesting appeal to the (cell) skin, and can help heal wounds, including a mild infection in general, insect bites, minor burns, cuts, ulcers and boil lightly for a moment. When symptoms of cold, flu or runny nose, onions can be used as a deterrent, and can relieve cough and mild sore throat.

Garlic is a healthy vegetable that can be also served or eaten as a tonic juice, for a healing effect.

Onion juice can be made as follows: take one small onion seeds, peeled and chopped, mixed with two tablespoons of honey and ½ cup water. Heat slowly to boiling for five minutes.

After the mixture boils, stir, remove from heat, let stand for five hours, until completely cold.

Strain the pulp. Drink one tablespoon of water, three times a day, as flu prevention, or for health benefits in general.

In this way the presentation, can be presented mentahan onions, fried or pan-fried with a little oil. (aneh22.blogspot.com)

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horrible allergies because the hair coloring

Be careful if you love hair coloring. A girl in England had experienced a very severe allergies after dyed her hair because her hair paints trigger eczema reaction. Experienced the suffering, the court sentenced salon owner to pay compensation of 20 thousand pounds to the girl.
The case experienced Gilchrist Charlotte in 2004 when he was 16 years old. At that time he experienced an allergic reaction so severe after the hair coloring in a salo. As a result of this allergy Charlotte schools had not a few days and require hospitalization.

Charlotte went to the salon to change her hair color because it will attend the event at her school dance. But after doing the coloring, not only changed her hair but her face became swollen and he could not see for 5 days.

Shortly after her hair colored, Charlotte began to feel the itch on his head and then followed by the burning. The pain is unbearable obliged to leave school the next day and returned to the salon. However, he only got treatment called cooling but did not give any effect.

"I was very afraid, when he woke up the next morning the right side of my face was swollen, there is a clear liquid that comes out of my head and makes me can not see. Can you imagine it all happened just because the paint hair dye? "Said Charlotte, as quoted from Dailymail, Wednesday (2/12/2009).

When he returned to the salon, the officer simply said that this is a result of the use of shampoo, and shampoo has been used for years and never a problem.

Charlotte decided to go to the hospital and the doctor gave him an antihistamine to reduce swelling. But it takes up to five days to reduce inflammation and restore vision.

"Five days without being able to see anything, it is very worrying, and when awake at night my head became very itchy and painful," he said.

Charlotte finally taking legal action and sue the salon owner. The court on December 1, 2009 and eventually won his case require salon owners to provide compensation of 20,000 pounds.

What happened to Charlotte is the reaction of the skin disease eczema or very serious, Charlotte is now strictly forbidden to dye her hair. And a recent study in Wales showed about 84 percent of workers painting the hair salon without seeing his client's instructions first.

"You should do the skin test in advance if you want to dye your hair, because it can happen to anyone and sometimes some people do not realize that he has very sensitive skin. So that the skin test must be done first, "said Charlotte, who is now 21 years old.

Although until now the cause of eczema reaction is unknown, but usually is often caused by a combination of dry skin, irritated skin and poorly functioning immune system.

Complications can be caused due to an allergic reaction to this person may have a case of neurodermatitis in a long time can change the color of skin, skin infections and complications in the eye if not treated quickly can result in permanent eye damage.

Because it should not be arbitrary if you want to dye your hair, choose a place that was already received training and make sure you do not have any allergic reactions and do not have sensitive skin. (Detik.com)

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