GCS (Glasgow Coma Scale) is a scale used to assess the patient's level of consciousness, (whether the patient in a coma or not) by assessing the patient's response to the stimulus provided.
Response of patients who need to be considered include the 3 things that is eye-opening reaction, speech and motor skills. Examination results are expressed in degrees (score) with a range of numbers 1-6 depending on the response.
Eye (eye-opening response):
(4): spontaneous
(3): with sound stimuli (tell the patient opened his eyes.)
(2): with pain stimuli (give pain stimuli, such as pressing the finger nails)
(1): no response
Verbal (verbal responses):
(5): good orientation
(4): confused, talk mess (frequently asked repeatedly) disorientation of place and time.
(3): words only (not speak clearly, but words are still clear, but not in one sentence. For example "... oh, father ...")
(2): sound without meaning (groan)
(1): no response
Motor (motor response):
(6): following orders
(5): localized pain (reach out & keep the stimulus when given painful stimuli)
(4): withdraws (dodge / pull extremitas or body away from the stimulus when given painful stimuli)
(3): flexi abnormal (one or both arms rigid position on the chest and leg extensions when given painful stimuli).
(2): abnormal extension (one or both extension arms at your sides, with clenched finger and foot extension when given painful stimuli).
(1): no response
The assessment level of awareness based on GCS expressed in symbols E ... V ... M ...
Furthermore, the values added together. GCS is the highest value is 15 which is E4V5M6 and the lowest is 3, ie E1V1M1.
If associated with head injury cases, the obtained results:
GCS: 14 - 15 = CKR (mild head injury)
GCS: 9 - 13 = CKS (currently head injury)
GCS: 3-8 = CKB (severe head injury)
Rabu, 30 Maret 2011
Selasa, 22 Maret 2011
Cardiac Catheterization
Definition
Cardiac catheterization is a minimally invasive action by inserting a catheter (tube / plastic tube) through a vein into the heart and coronary blood vessels that make the heart bleed.
Cardiac catheterization is a general term used for a series of imaging procedure to insert a catheter into the heart chambers or blood vessels. When the catheter was in a position that has been determined, the tool can be used to implement a number of further examination procedures and treatments such as coronary angiography (coronary angiography), angioplasty (angioplasty) and the installation of an artificial valve (balloon valvuloplasty).
Cardiac catheterization performed through the catheter trajectory (a thin flexible tube) into the right and left heart. The catheter can be inserted through an artery or vein in the arm or upper thigh), which then slowly directed to the heart with the help of a special x-ray machine. Once the catheter was in a position that has been determined, then the contrast fluid (contrast dye) is injected through the catheter so that x-ray images of heart valves, coronary arteries and heart chambers can be recorded by the x-ray machine to produce the right image.
Goal
Through cardiac catheterization, we can measure blood pressure, both in the veins, arteries, foyer (atrium), both right and left ventricle (LV), right or left, as well as large blood vessels such as aorta and pulmonary artery. In addition, we also can obtain hemodynamic data and radiological data (angiography) for diagnostic purposes. For example, in patients with coronary heart disease who have coronary artery narrowing, we can ensure the location of the narrowing, the number of refinements, and the level of severity of narrowing it.
Indication
New cardiac catheterization can we do for the following indications.
- A history of coronary heart disease (narrowing of the coronary arteries) that require bypass surgery or interventions
- Abnormalities of the heart valves: to determine the severity of heart valve abnormalities before surgery, so it can be determined whether the patient required valve replacement or valve repair alone.
- Impaired left ventricular function
- Congenital heart disease requiring surgery: to determine the anatomical changes that occur in heart.
Contraindications and Risks
Cardiac catheterization performed mainly in patients with heart diseases, life-threatening. Therefore, kontraindikasinya is relative. Catheterization determined based on consideration of severity of heart disease / health condition of the patient and the greater the risk of catheterization.
Relative contraindications, including: uncontrolled blood pressure with medication, acute interruption of blood flow the brain (acute stroke), severe anemia, acute gastrointestinal bleeding, allergies to dye, acute renal failure, heart failure in which the patient may not sleep on their backs , and disorders of blood clotting process heavy. However, most of these conditions can be addressed before catheterization performed.
As with any surgery, the risk of catheterization include: bleeding, infection, heart failure, rhythm disturbances, and the frequency of heart beat (arrythmia), kidney failure, and blockage of blood vessels of the brain (stroke). Increasingly risk in those aged sixty and over, people with kidney failure, heart failure, stroke or diabetes. But the statistics showed: severe complications is less than one percent and deaths from catheterization only about 0:08 per cent.
In the future Electro Beam Computed Tomography (EBCT) is expected to shift the cardiac catheterization. Unlike the Computed Tomography (CT) in which the electron transmitting tube rotated around the patient, then on EBCT electron electronically rotated in the tungsten anode tube. The movement of electrons is much faster to produce X-ray image more and is ideal for photographing moving organs like the heart is always with blood vessels.
Cardiac catheterization is a minimally invasive action by inserting a catheter (tube / plastic tube) through a vein into the heart and coronary blood vessels that make the heart bleed.
Cardiac catheterization is a general term used for a series of imaging procedure to insert a catheter into the heart chambers or blood vessels. When the catheter was in a position that has been determined, the tool can be used to implement a number of further examination procedures and treatments such as coronary angiography (coronary angiography), angioplasty (angioplasty) and the installation of an artificial valve (balloon valvuloplasty).
Cardiac catheterization performed through the catheter trajectory (a thin flexible tube) into the right and left heart. The catheter can be inserted through an artery or vein in the arm or upper thigh), which then slowly directed to the heart with the help of a special x-ray machine. Once the catheter was in a position that has been determined, then the contrast fluid (contrast dye) is injected through the catheter so that x-ray images of heart valves, coronary arteries and heart chambers can be recorded by the x-ray machine to produce the right image.
Goal
Through cardiac catheterization, we can measure blood pressure, both in the veins, arteries, foyer (atrium), both right and left ventricle (LV), right or left, as well as large blood vessels such as aorta and pulmonary artery. In addition, we also can obtain hemodynamic data and radiological data (angiography) for diagnostic purposes. For example, in patients with coronary heart disease who have coronary artery narrowing, we can ensure the location of the narrowing, the number of refinements, and the level of severity of narrowing it.
Indication
New cardiac catheterization can we do for the following indications.
- A history of coronary heart disease (narrowing of the coronary arteries) that require bypass surgery or interventions
- Abnormalities of the heart valves: to determine the severity of heart valve abnormalities before surgery, so it can be determined whether the patient required valve replacement or valve repair alone.
- Impaired left ventricular function
- Congenital heart disease requiring surgery: to determine the anatomical changes that occur in heart.
Contraindications and Risks
Cardiac catheterization performed mainly in patients with heart diseases, life-threatening. Therefore, kontraindikasinya is relative. Catheterization determined based on consideration of severity of heart disease / health condition of the patient and the greater the risk of catheterization.
Relative contraindications, including: uncontrolled blood pressure with medication, acute interruption of blood flow the brain (acute stroke), severe anemia, acute gastrointestinal bleeding, allergies to dye, acute renal failure, heart failure in which the patient may not sleep on their backs , and disorders of blood clotting process heavy. However, most of these conditions can be addressed before catheterization performed.
As with any surgery, the risk of catheterization include: bleeding, infection, heart failure, rhythm disturbances, and the frequency of heart beat (arrythmia), kidney failure, and blockage of blood vessels of the brain (stroke). Increasingly risk in those aged sixty and over, people with kidney failure, heart failure, stroke or diabetes. But the statistics showed: severe complications is less than one percent and deaths from catheterization only about 0:08 per cent.
In the future Electro Beam Computed Tomography (EBCT) is expected to shift the cardiac catheterization. Unlike the Computed Tomography (CT) in which the electron transmitting tube rotated around the patient, then on EBCT electron electronically rotated in the tungsten anode tube. The movement of electrons is much faster to produce X-ray image more and is ideal for photographing moving organs like the heart is always with blood vessels.
Jumat, 07 Januari 2011
Preeklamsi - Eklamsi
Preeclampsia is a collection of symptoms that occur in pregnant women, maternity and childbirth consisting of hypertension, edema and protein menjukkan Uriah but no signs of vascular abnormalities or previous hypertension, whereas symptoms usually appear after age 28 weeks gestation or more (Rustam Muctar, 1998 .)
Eclampsia is an acute case in patients with preeclampsia, which is accompanied by comprehensive seizures and coma. (Sarwono prawirohardjo, 2009)
Preeclampsia and eclampsia is a collection of symptoms that occur in pregnant women, maternity and childbirth during which consists of triad: hypertension, proteinuri, and edema, which is sometimes accompanied konvuisi to coma. (Synopsis of obstetrics vol 1, 1998)
Causes of pre-eclampsia and eclampsia as yet known. But there is a theory that can explain the causes of pre-eclampsia and eclampsia are:
For increasing frequency in primigraviditas, multiple pregnancy, hidramnion, and hydatidiform mole.
For a further increase in the frequency of parents pregnancy
For repairs to the state of patients with fetal death in uterus
Because eclampsia rarely occurs in pregnancy - the next pregnancy
Because the occurrence of hypertension, edema, proteinuria, seizures and coma
Preeclampsia develops in about 7% of pregnancies. The incidence was significantly higher in low socioeconomic groups. About 5% of women with preeclampsia develop eclampsia, these, about 15% die from PIH itself or its complications. high fetal death due to an increased incidence of premature delivery and uteroplacental insufficiency.
Eclampsia is an acute case in patients with preeclampsia, which is accompanied by comprehensive seizures and coma. (Sarwono prawirohardjo, 2009)
Preeclampsia and eclampsia is a collection of symptoms that occur in pregnant women, maternity and childbirth during which consists of triad: hypertension, proteinuri, and edema, which is sometimes accompanied konvuisi to coma. (Synopsis of obstetrics vol 1, 1998)
Causes of pre-eclampsia and eclampsia as yet known. But there is a theory that can explain the causes of pre-eclampsia and eclampsia are:
For increasing frequency in primigraviditas, multiple pregnancy, hidramnion, and hydatidiform mole.
For a further increase in the frequency of parents pregnancy
For repairs to the state of patients with fetal death in uterus
Because eclampsia rarely occurs in pregnancy - the next pregnancy
Because the occurrence of hypertension, edema, proteinuria, seizures and coma
Preeclampsia develops in about 7% of pregnancies. The incidence was significantly higher in low socioeconomic groups. About 5% of women with preeclampsia develop eclampsia, these, about 15% die from PIH itself or its complications. high fetal death due to an increased incidence of premature delivery and uteroplacental insufficiency.
Sabtu, 01 Januari 2011
Osteoporosis
Osteoporosis is a very common bone disease that causes bone to become weak.
Bone weakness can lead to fracture of the spine, hip, and wrist from simple falls or even a snezze or cough
About 10 million americans have osteoporosis,80 % of them are women
Bone is a living tissue. It mostly made of collagen,a protein that provides a soft framework and calcium phospate, a mineral that haredes the framework.
What reason that osteoporosis may occur ?
If the person does not have enough strong bone mass by age 30 before bone loss begin
If the loss after age 30 happens too fast
Symptoms
People may not know they have a osteoporosis until their bone become so weak that a sudden strain,bump, or fall causes a hip fracture or acollapse vertebra.
Collapsed vertebra may causes a savere back pain, spinal deformities or saverily stoped posture.
Causes
What is the causes of osteoporosis??????
doesn’t get enough calcium
doesn’t get enough vitamin D
Risk factor
Main risk factor:
Age
Body size
Other risk factor that you can’t control are :
Race
Family
Risk factor that you can control :
Calcium and vitamin D intake
Smoking
Excess alcohol
Inactivity
Medicine
Treatment
A healthy diet including calcium,vit D, and calcium suplement. Such as milk,cheese,and oranges,because suplement may cause constipation,so you must drinking more waters,and eat food rich in fiber
Medication.
For slow bone loss :alndronate,risendronate
Esterogen for bone metabolism : raloxifene
Injectable hormon for helps build more bones :
Terparatide
Always ask your doctor for best medication !!!
Prevention
A healthy,balanced diet rich in calcium and vitamin D
Staying active
Not smoking
Not drinking excessively
Summary
Osteoporosis is a very common condition that be prevented by good nutrition, and a healthy lifestyle. Many medication are now available to help prevent or threat osteoporosis after a woman reaches monopouse. Calcium and vitamin supplements are also available and inexpensive. For people with osteoporosis fracturing bone is a main concern. Avoiding falls,triping,and bumping into a object can prevent fracture and allow people with osteoporosis to live very healthy and productive lives !
Hordeolum
Almost everyone knows timbilen or timbil which in medical language is called Hordeolum. This disease can affect anyone, from children to parents. Mentioned that the incidence in adulthood more than children. There was no difference in the incidence (incidence rate) among women with men. Sometimes a person really easy experience timbilen (recurring). Proverbial, recovering one, and then reappear somewhere else timbil.
Hordeolum (the style) is an infection or inflammation of the gland at the edge of the upper eyelid and the bottom is caused by bacteria, usually by the Staphylococcal bacteria (Staphylococcus aureus). Hordeolum can occur in 1 or more eyelid gland. Eyelid gland include Meibom gland, gland Zeis and Moll.
Based on the place, hordeolum divided into 2 types:
1. Hordeolum internal, occurs in Meibom gland. In this internal hordeolum bump leads to the conjunctiva (the lining of the inner eyelid).
2. Hordeolum externa, occurs in the lymph gland Zeis and Moll. The lump appeared from the outside on the outside of the eyelid skin (palpebra).
SYMPTOMS
Hordeolum signs are very easily identifiable, ie visible lump on the upper eyelids or below, reddish. Occasionally visible whitish or yellowish spots accompanied by swelling of the eyelids.
In internal hordeolum, bumps will appear more clearly with open eyelid.
Complaints are often felt by people with such a sense hordeolum prop the eyelids, pain and more pain say when bent. Sometimes eyes watery and sensitive to light.
Hordeolum can form an abscess in the eyelid and rupture with release of pus.
TREATMENT
In general hordeolum can heal themselves (self-limited) in 1-2 weeks. But often require special treatment, topical medications (antibiotic ointment or eye drops) or in combination with oral antibiotics (taken).
Hordeolum treatment sequence is as follows:
Warm compresses for about 10-15 minutes, 4 times daily.
Topical antibiotics (ointments, eye drops), for example: Gentamycin, Neomycin, Polimyxin B, Chloramphenicol, Dibekacin, Fucidic acid, and others. Topical medications used for 7-10 days, as recommended by your doctor, especially in the phase of inflammation.
Oral antibiotics (taken), for example: Ampicillin, Amoxicillin, Erythromycin, Doxycyclin. Oral antibiotics are used if hordeolum showed no improvement with topical antibiotics. The drug is administered for 7-10 days. The use and choice of oral antibiotics only upon the recommendation of a doctor according to the examination.
The antibiotic dose in children based on body weight according to each type of antibiotic and the severity of hordeolum.
Symptomatic medications (to reduce complaints) can be given to relieve pain, such as acetaminophen, mefenamic acid, ibuprofen, and the like.
Recommendation FOR PATIENTS
Avoid rubbed or pressed-ucek hordeolum.
Do not squeeze hordeolum. Let hordeolum broke by itself, then clean with sterile gauze when out pus or fluid from hordeolum.
Close your eyes when cleaning hordeolum.
To temporarily stop the use of make-up of the eye.
Remove contact lenses (contact lenses) during the treatment period.
When was performed incision?
It is recommended that the incision (cutting) and drainage on hordeolum, if:
Hordeolum showed no improvement with topical antibiotic medications and oral antibiotics within 2-4 weeks.
Hordeolum who have already shown great or abscess phase.
After the incision is recommended controls in a week or more to the incision wound healing in order to really complete recovery.
PREVENTION
Keep your facial hygiene and hand washing before touching the face for hordeolum not easily repeated.
Wipe the eyelids gently with warm washlap to clean the gland excretion of fat.
Maintain cleanliness of equipment for eye makeup are not contaminated by germs.
Use goggles if traveling in dusty areas.
Hordeolum (the style) is an infection or inflammation of the gland at the edge of the upper eyelid and the bottom is caused by bacteria, usually by the Staphylococcal bacteria (Staphylococcus aureus). Hordeolum can occur in 1 or more eyelid gland. Eyelid gland include Meibom gland, gland Zeis and Moll.
Based on the place, hordeolum divided into 2 types:
1. Hordeolum internal, occurs in Meibom gland. In this internal hordeolum bump leads to the conjunctiva (the lining of the inner eyelid).
2. Hordeolum externa, occurs in the lymph gland Zeis and Moll. The lump appeared from the outside on the outside of the eyelid skin (palpebra).
Hordeolum signs are very easily identifiable, ie visible lump on the upper eyelids or below, reddish. Occasionally visible whitish or yellowish spots accompanied by swelling of the eyelids.
In internal hordeolum, bumps will appear more clearly with open eyelid.
Complaints are often felt by people with such a sense hordeolum prop the eyelids, pain and more pain say when bent. Sometimes eyes watery and sensitive to light.
Hordeolum can form an abscess in the eyelid and rupture with release of pus.
TREATMENT
In general hordeolum can heal themselves (self-limited) in 1-2 weeks. But often require special treatment, topical medications (antibiotic ointment or eye drops) or in combination with oral antibiotics (taken).
Hordeolum treatment sequence is as follows:
Warm compresses for about 10-15 minutes, 4 times daily.
Topical antibiotics (ointments, eye drops), for example: Gentamycin, Neomycin, Polimyxin B, Chloramphenicol, Dibekacin, Fucidic acid, and others. Topical medications used for 7-10 days, as recommended by your doctor, especially in the phase of inflammation.
Oral antibiotics (taken), for example: Ampicillin, Amoxicillin, Erythromycin, Doxycyclin. Oral antibiotics are used if hordeolum showed no improvement with topical antibiotics. The drug is administered for 7-10 days. The use and choice of oral antibiotics only upon the recommendation of a doctor according to the examination.
The antibiotic dose in children based on body weight according to each type of antibiotic and the severity of hordeolum.
Symptomatic medications (to reduce complaints) can be given to relieve pain, such as acetaminophen, mefenamic acid, ibuprofen, and the like.
Recommendation FOR PATIENTS
Avoid rubbed or pressed-ucek hordeolum.
Do not squeeze hordeolum. Let hordeolum broke by itself, then clean with sterile gauze when out pus or fluid from hordeolum.
Close your eyes when cleaning hordeolum.
To temporarily stop the use of make-up of the eye.
Remove contact lenses (contact lenses) during the treatment period.
When was performed incision?
It is recommended that the incision (cutting) and drainage on hordeolum, if:
Hordeolum showed no improvement with topical antibiotic medications and oral antibiotics within 2-4 weeks.
Hordeolum who have already shown great or abscess phase.
After the incision is recommended controls in a week or more to the incision wound healing in order to really complete recovery.
PREVENTION
Keep your facial hygiene and hand washing before touching the face for hordeolum not easily repeated.
Wipe the eyelids gently with warm washlap to clean the gland excretion of fat.
Maintain cleanliness of equipment for eye makeup are not contaminated by germs.
Use goggles if traveling in dusty areas.
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