Tekanan Darah Tinggi

Tekanan darah tinggi adalah tanda adanya kelainan pada daya kerja jantung dan kelainan kondisi pembuluh darah. Pada seseorang dengan kelemahan otot jantung, organ jantung perlu bekerja keras untuk mempompa cukup darah ke seluruh tubuh. Hal demikian juga bisa terjadi bilamana ada penyempitan di pembuluh darah. Dalam hal ini, organ jantung juga harus bekerja lebih keras untuk dapat mempompa cukup darah melalui pembuluh – pembuluh darah yang menyempit tersebut. Hal-hal ini adalah beberapa kondisi yang menyebabkan tekan darah tinggi. Hal-hal tersebut biasanya berhubungan dengan penyakit/kondisi yang lain, seperti:
· Kegemukan, dimana kelebihan lemak dalam tubuh mengendap di pembuluh darah dan menyebabkan penyempitan pembuluh darah
· Penyakit kencing manis, dimana kelebihan gula di dalam tubuh menyebabkan kerusakan pada pembuluh-pembuluh darah kecil di organ tubuh, termasuk di jantung. Akibatnya, sebagian otot jantung mati atau tidak berfungsi baik.
Tekanan darah tinggi perlu benar-benar dirawat, dengan:
* Gaya hidup yang lebih sehat, seperti olah raga rutin yang teratur, tidak makan berlebihan, mengurangi konsumsi makan berlemak dan mengurangi konsumsi garam, dan lain-lain.
* Obat pengontrol tekanan darah dan kondisi-kondisi yang berhubungan dengan tekanan darah tinggi (bila perlu dan sesuai dengan anjuran dokter)

Chronic Lymphocitic Leukemia

Chronic Lymphocitic Leukemia is a type of cancer that starts from a group of white blood cells in bone marrow named Lymphocytes which function to protect human body from infections. Eventually the cancerous cells spread into human’s blood circulation. This type of cancer is called chronic because the cancer progresses more slowly than other types of Leukemia. In 25% of this type of cancer cases, when the cancer was first diagnosed, it has already in end stage of cancer development (i.e. stage IV). Peak incidence of this cancer is higher from 55 years old population. The cancer is usually treated with chemotherapy regimen, which would destroy not only the cancer cells but also all other normal cells. So, in many cases, after completing chemotherapy sessions, bone marrow transplantation might be done to inject healthy bone marrow producing normal blood cells.

Penangan Penyakit Asma

Asma adalah penyakit peradangan menahun dari saluran pernafasan.Dalam proses peradangan yang menahun tersebut, tubuh penderirta asma bereaksi dengan menghasilkan cairan kental di saluran pernafasannya, yang selanjutnya membuat saluran nafas menyempit atau tersumbat. Akibatnya, penderita asma mengalami sesak nafas, dikurangi batuk-batuk, dan gejala-gejala asma yang lain.
Perawatan pasien asma yang efektif harus memfokuskan pada peengendalian penyakit asma tersebut. Pasien asma umumnya harus diobati dengan obat untuk mencegah munculnya gejala asma, mencegah serangan asma mendadak, dan meningkatkan funsi paru-paru. Jika asma-nya masih tidak terkontrol, pengobatan asma-nya harus ditingkatkan, dengan tambahan obat-obatan dan/atau tambahan dosis obat yang dipakai.
Bilamana gejala asma-nya sudah terkendali, pengobatannya bisa dikurangi secara bertahap sampai mencapai dosis yang paling rendah tapi efektif.
Cara penanganan asma ini dinamakan “a step approach” oleh Global Initiative for Asthma (GINA). Penanganan semacam ini perlu diterapkan secara berkelanjut untuk pengendalian penyakit asma secara efektif.

Statistics of Mental Illnesses/Statistik berkenaan dengan Penyakit Kejiwaan

Various researches on mental illnesses conclude the following few points:
* 25% of population may have mental illnesses, and most of them are not diagnosed
* Mental illnesses affect and are affected by other chronic illnesses, such as hypertension and coronary heart disease.
* Mentally ill group of people have higher morbidity and mortality rates than non mentally ill group of people
* The higher the severity of a depressive condition, the higher morbidity and mortality rates of the depressed patients
* Among depressed elderly, men tend to have higher mortality rates than women
* However, studies show that mild depression does not affect or does not significantly affect morbidity and/or mortality rates

Dysmenorrhoea (or "Nyeri pada masa haid" in Indonesian languange)

Dysmenorrhoea is cyclical lower abdominal or pelvic pain, which may also radiate to the back and thighs, occurring prior to or during menstruation, or both. In general, we can classify dysmenorrhoea into two types:
* Primary dysmenorrhoea occurs in the absence of any obvious underlying disease. Cause is unknown.
* Secondary dysmenorrhoea is due to an underlying disease, most commonly endometriosis. Other possible causes are fibroid, adenomyosis, pelvic inflammatory disease, intrauterine device, and cervical stenosis. Secondary dysmenorrhoea usually are often present with other gynaecological symptoms, such as intermenstrual bleeding, painful sexual intercourse, and post-coital bleeding.
Dysmenorrhoea’s management itself is meant to relieve/reduce the pain using the following treatments:
* Drug treatment including Non Steroid Anti Inflamatory Drugs (pain killers), combined oral contraceptive pills (for patient who also requires contraception), and menstrual cycle suppressant (e.g. danazol)
* Non drug and surgical treatment including neurectomy, uterine nerve ablation, and transcutaneus electrical nerve stimulation.

Marfan Syndrome Patients

Marfan syndrome is a condition in which your body's connective tissue is abnormal due to a genetic disorder. Connective tissue helps support all parts of our body and helps control how our body grows and develops. Marfan syndrome predominantly affects connective tissue supporting heart and blood vessels, eyes, and bones. Most people with Marfan syndrome have heart and blood vessel problems, such as a weakness in the aorta or heart valves that leak. They are often very tall, thin and loose jointed. They may also have problems with their eyes, skin, nervous system and lungs.
Marfan syndrome patients had average lifespan of 40 to 50 years, height of 186 ± 12 cm, and 10-year survival of 82%. For those undiagnosed and untreated, the average age of death is 32.

Wolff-Parkinson-White Pathways

Patients with Wolff-Parkinson-White (WPW) pathways have extra electrical pathways between heart chambers (i.e. between the atria and the ventricles), known as accessory pathways (short cut) that look like normal heart muscle, but they may conduct impulses faster than normal and/or conduct impulses in both directions instead of normal one direction from the atria to the ventricles. These symptoms occur in about 50 percent of people with WPW; some may have atrial fibrillation, a common irregular heart rhythm distinguished by disorganized, rapid, and irregular heart rhythm. The greatest concern for people with WPW is the possibility of having atrial fibrillation with a fast ventricular response that worsens to a life-threatening arrhythmia. Most people experience symptoms between the ages of 11 and 50 years old. The highest incidence occurs between the ages of 30 and 40 years old. In the general population, men have a higher incidence of WPW than women do, and there is a higher incidence of multiple accessory pathways in men.
Patients who have such symptoms because of this abnormality are said to have the WPW syndrome. During tachycardia (when heart pulses are faster than normal), patients may experience sudden heart pounding, fluttering, racing feeling in the chest, shortness of breath, dizziness, lightheadedness, anxiety, fainting, or rarely sudden death.
Some patients have the WPW pathway, but no experience in heart beats that are faster than normal. They do not have WPW syndrome, but may develop it at some point. These patients are said to have a WPW pattern, which can be detected on a routine electrocardiogram (ECG). They do not need treatment.
However, patients with WPW syndrome require treatment when or if they have an episode of tachycardia due to the serious potential risks. Treatment focuses on stopping the tachycardia and preventing its from recurring. The most common treatment options for Wolff-Parkinson-White syndrome are medications and catheter radiofrequency ablation, a minimally-invasive procedure to remove the abnormal, extra electrical heart pathway. Rarely, open-heart surgery may be performed if patients have other heart conditions in addition to WPW syndrome.

Pembawa Virus Hepatitis B

Sebagian pasien yang terinfeksi virus Hepatitis B sembuh tapi tidak benar-benar bebas dari virus Hepatitis B. Lima sampai 10 persen pasien Hepatitis B usia dewasa, dan sekitar 90% pasien Hepatitis B usia bayi membawa virus tersebut seumur hidupnya. Pasien semacam ini dinamakan pembawa virus Hepatitis B atau “Hepatitis B Carriers”. Mereka biasanya tidak tampak sakit, atau tidak merasa sakit, dan tidak mengalami kerusakan organ hati. Akan tetapi, tes darah mereka menunjukan bahwa mereka masih membawa virus Hepatitis B di dalam darah tubuh mereka, dan mereka masih tidak mempunyai daya tahan tubuh terhadap virus Hepatitis B. Pasien semacam ini masih dapat menyebarkan infeksi kepada orang lain, ataupun virus Hepatitis B yang mereka bawa dapat berlipat ganda dan berkembang menyebabkan Infeksi organ hati kronik. Diperkirakan sekitar 25% dari pasien pembawa virus Hepatitis B menderita Infeksi organ hati kronik, dan beresiko untuk mempunyai penyakit organ hati yang lebih serius seperti pengerasan organ hati and kanker hati. Kendati jarang, Hepatitis B juga dapat menyebabkan komplikasi di luar organ hati, seperti kerusakan organ ginjal dan kelainan kulit. Dalam hal yang semacam ini, tes fungsi organ hati mungkin tidak nampak ada kelainan, tetapi tanda-tanda medis yang lain mungkin menunjukan bahwa kondisi di luar organ hati tersebut disebabkan oleh virus Hepatitis B.

Hepatitis B Carriers

Some patients who were infected by Hepatitis B virus do not recover completely. Five to 10% of adults and about 90% of babies who get hepatitis B will go on to "carry" or keep the virus for the rest of their lives. These people are called "hepatitis B carriers." Hepatitis B virus carriers feel healthy, do not feel sick or look sick, have no ongoing hepatitis or liver damage. However, their blood tests show they still have the virus and have not developed Hepatitis B antibodies. Therefore, they can pass on the virus to other people or replication of the Hepatitis virus in their blood can active again and cause their own liver damages. About a quarter of the carriers would develop chronic hepatitis, and at increased risk of having serious liver disease including cirrhosis and liver cancer.
Although rare, Hepatitis B can also cause complications outside the liver (non liver condition), such as kidney damages, and skin lesions. It may or may not involve liver. If no liver involvement, the client's liver function may appear relatively normal, but medical evidence may show that Hepatitis B virus was the main cause of the condition.

Bird Flu and Swine Flu Infections

There are 3 types of influenza viruses - A, B and C. Only types A and B cause significant human disease. Influenza A is further sub-typed into 15 different H types (H1, H2, H3, etc) and 9 different N types (N1, N2, N3, etc). The past outbreak of Bird Flu in poultry which affected humans is caused by H5N1 subtype of Influenza A virus or we named it as A/H5N1 virus. Bird Flu spreads to humans mainly through contact with infected birds, which shed the virus in their saliva, nasal secretions and faeces. Very rarely, inefficient and limited human-to-human transmission “may” occur. Unlike Bird Flu, the current Swine Flu pandemic is caused by novel H1N1 subtype of Influenza A virus. It is contagious and spreading from human to human through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something – such as a surface or object – with flu viruses on it and then touching their mouth or nose.
There is currently no vaccination to prevent against both Bird Flu and Swine Flu in humans. The available vaccination is for protection against human strains of the influenza virus. Two drugs, oseltamivir (commercially known as Tamiflu) and zanamivir (commercially known as Relenza) can reduce the severity and duration of illness caused by seasonal influenza. The efficacy of the two drugs depend on their administration within 48 hours after symptom onset. For cases of human infection with H5N1/H1N1, the drugs may improve prospects of survival, if administered early, but clinical data are limited. If there are no complications, most of the symptoms of influenza usually disappear after 6-7 days, although a cough may persist for over 2 weeks.

Piles

Haemorrhoids (often known as Piles) are enlarged and engorged blood vessels in or around the back passage (anus). You may notice a pain, itch, or ache around the anus and lower bowel (rectum), which can be really quite severe. There may be bleeding from the back passage. This will be bright red blood, not usually mixed in with the motion, but often seen on the toilet paper. There is often a feeling of something coming down, or a bulge or lump at the anus. If a haemorrhoid at the outside of the anus gets a blood clot in it (thrombosed external pile) it leads to a particularly tender, hardish lump.
Haemorrhoids are very common, especially in countries where the diet has traditionally been more processed and low in fibre. The main contributory causes are those things that cause us to raise the pressure in the abdomen, such as those chronically straining with constipation, overweight people, and people with heavy lifting jobs. This causes the blood vessels to swell and become engorged.

As implied above, useful aspects of prevention are:
* Avoid becoming overweight, and lose weight if you are.
* Eat a high fibre diet
* Exercise regularly

It is usually best, with haemorrhoids, to get by with the least treatment possible, as even after the most extensive treatments they may still return. Many times they will settle down over a matter of days without any treatment. But the majority of patients with mild haemorrhoidal symptoms would be more appropriately treated by fibre supplements, life-style changes and possibly apply cream or suppositories, bullet-shaped tablets to be inserted into the anus, may be bought over the counter. These soothe itching and pain, and cause swelling and bleeding to diminish. Cold compresses, even ice can be helpful. If you do not get better with these approaches, then you should see your doctor.

PET/CT Scan

PET Scan stands for Positron emission tomography, also called PET imaging is a type of nuclear medicine imaging that uses small amounts of radioactive material to measure important body functions, such as blood flow, oxygen use, and sugar (glucose) metabolism, to help doctors evaluate how well organs and tissues are functioning or to detect certain abnormalities within the body, including many types of cancers, and heart disease.
Whereas CT scan — also called computerized tomography is an X-ray technique that produces images of the body that can provide excellent information about internal organ structure.
Nowadays, most PET scans are performed on instruments that are combined PET and CT scanners. The combined PET/CT scans produce special pictures offering details on both the structure and function of organs and tissues. They are more accurate to detect presence and severity of cancers, neurological/brain conditions, and cardiovascular disease, and recurrence of cancer than the two scans performed separately.Total scanning time is approximately 30 minutes.
In USA, PET scan charges range from USD1200-USD3500, depending on the type of scan. In Taiwan, a hospital based nuclear medicine facility offers PET/CT Scan examination package for about USD1700. In Singapore, PET/CT Scan procedure costs about USD1500.

Gallbladder Sludge

Gallbladder sludge is a mixture of particulate matter and bile that occurs when solutes in bile precipitate. The formation of gallbladder sludge is due to an imbalance between bile salts and cholesterol, then the bile fluid turns to sludge. This thickened fluid consists of a mucus gel containing cholesterol and calcium bilirubinate. If the imbalance worsens, cholesterol crystals can eventually form gallstones.
It is generally a slow process, and usually causes no pain or other symptoms. The clinical course of biliary sludge varies. It can develop complications like abdominal pain, inflammation of biliary tract (i.e. cholecystitis), and formation of gallstone. However, in about 50% of cases, gallbladder sludge spontaneously disappears and in 20% of cases persists but no symptom over a 3-year period.