Chikungunya fever

Definition
Chikungunya fever is an endemic disease (applicable to the sector in the region or population often). Chikungunya virus was first identified in East Africa in 1952. Chikungunya comes from Shawill based on patient symptoms, which means (body position) twisted or curved, referring to the bent posture of the patient due to severe joint pain (arthralgia). The joint pain in the knees and ankle joints of the hands and feet.


Cause
Chikungunya fever is caused by Chikungunya virus (CHIKV). CHIKV belongs to the family Togaviridae, alphavirus genus, and is transmitted by the mosquito Aedes aegypti.


Modes of Transmission
Chikungunya may be said to be 'brothers' with high fever and dengue denggi as transmitted by the same carrier Aedes aegypti and albopictus. The difference, if denggi dengue virus invade the bloodstream, Chikungunya virus attacks the joints and bones. Aedes mosquito bites a person who would normally have been infected by chikungunya virus and move blood to a healthy other prey.


Symptom
Chikungunya symptoms-the clinical symptoms are very similar to denggi fever. Chikungunya typically starts with a sudden high fever that reached 390 ° C other symptoms such as chills, rash on legs, hands and body no appetite headache, red eyes, photophobia (sensitivity to light) and vomiting.

The main symptoms of Chikungunya disease is the body suddenly felt a fever followed by rheumatic pain in joints. In fact, because one typical symptom is the emergence of a sense of fatigue, pain, pain may also arise in the bones, there are named as bone fever or flu-bone. In some cases also found that infected patients without causing any symptoms at all or silent chikungunya virus.

This disease does not cause death. Pain in the joints will not cause paralysis. After over five days, the fever gradually subsided, feeling pain or pain in the joints and muscles is reduced, and the sufferer will recover to normal. Patients in some time and then can move her body as usual. Although in some cases the pain is still lagging sometimes for days to months. Usually this condition occurs in patients who previously had a history of frequent bone pain and muscle.


Diagnosis
To obtain an accurate diagnosis needs some serologic tests such as obstacle agglutination test (HI), serum neutralization, and IgM capture ELISA. But this is only bermanfaant serology is used for epidemiological and research interests, not useful for practical purposes everyday clinical.


Treatment
Chikungunya fever include? Self Limiting Disease? or illness that resolves on its own. There is no vaccine or specific drug for this disease. Treatment given only symptomatic therapy or eliminate the symptoms of the disease, such as pain relievers or fever as class paracetamol . Should avoid the use of similar drugs aspirin. Antibiotics are not needed in this case. Use of antibiotics to prevent secondary infection is not considered useful. To improve the general condition of the patient is recommended to eat nutritious foods, especially carbohydrates and sufficient protein and drink as much as possible. Expand consume fresh fruit or fresh fruit juice.

Granting immunity-enhancing vitamins may be beneficial for the treatment of disease. In addition to vitamins, foods that contain enough protein and carbohydrates also increase endurance. Endurance is good and adequate rest can accelerate the healing of disease. Also advised to drink lots of fluids to address the need to increase the time of fever.

Prevention
The only way to avoid this disease is to eradicate mosquitoes carrying the virus. This mosquito, happy to live and breed in stagnant water such as a bathtub, flower vases, and also cans or bottles that hold water.

Black and white patterned mosquito is also happy to live in objects such as clothes hanging on the back door. In addition, this mosquito also enjoys place dark and stuffy.

Given the spreading of this disease is the mosquito Aedes aegypti then the best way to break the chain of transmission is to combat the mosquito, as is often suggested in the fight against dengue fever.

Insecticide used to kill mosquitoes is from malathion group, whereas themopos larvae-larvae to turn off.

Malathion is used by way of fumigation, not by spraying into the wall. This is because the Aedes aegypti do not like to rest on the walls, but the hanging objects. However, prevention is cheap and effective way to combat mosquitoes is to drain the clean water reservoirs, bath, flower vases and so on, at least once a week, since mosquitoes are breeding from the egg to mature within a period of 7-10 days .

Yard or gardens around the house must be clean of objects that allow rainwater clean, especially during the rainy season like now. Doors and windows should be open every day, from morning till evening, so that fresh air and sunlight to enter, resulting in the exchange of air and healthy lighting. Thus, creating an ideal environment for the mosquitoes. How to prevent an outbreak of chikungunya is to reduce outbreaks of mosquito ketahap maximum. This includes breeding larvae destroy the nest to stop the life cycle and transmission. There are various ways to protect yourself from mosquito bites, among others:

Individual prevention can be done in a special way as the use of skin ointment (insect repellent) containing the active ingredient DEET or other EPA. The use of long sleeves and long pants are also recommended for certain areas in the state is an increase in cases, bed use mosquito nets and mosquito ambush on casement pairs.

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Drug Interactions

Preliminary
Drug interaction is a change in the effect of a drug due to the use of other drugs (drug-drug interactions) or by food, traditional medicine and other chemical compounds. Significant drug interactions may occur if two or more drugs are used together.
Drug interactions and adverse drug reactions need attention. An American study showed that each year nearly 100,000 people had to be hospitalized or have to stay in hospital for longer than it should, even in cases of death due to interactions and / or side effects of drugs. Patients who were admitted to hospital often receive therapy with polypharmacy (6-10 kinds of drugs) as the subject for more than one doctor, so it is very possible drug interactions mainly affected the severity of illness or age.
Clinically important drug interactions result in increased toxicity when and / or a reduction in drug effectiveness. So keep in mind, especially when it comes to drugs with narrow safety margin (therapeutic index is low), such as cardiac glycosides, anticoagulants and cytostatic drugs. It is also worth noting the drugs commonly used together.
Incidence of hard drug interactions in clinical estimate because:
a. documentation is lacking
b. often escaped notice, due to lack of knowledge of the mechanisms and the possibility of drug interactions. This resulted in drug interactions include increased toxicity seen as idiosyncratic reaction to one drug, while the form of interaction penurunakn effectiveness ascribed the increased severity of illness of patients
c. the incidence or severity of drug interactions are influenced by individual variations, in which certain populations more susceptible such as geriatric patients or severely diseased, and could also be due to differences in metabolic capacity between individuals. In addition, factors specific diseases, especially renal failure or severe liver disease and other factors (large doses, the drug ingested together, chronic administration).

Mechanism Drug Interactions
Interactions are classified by involvement in a process of pharmacokinetics and pharmacodynamics. Pharmacokinetic interaction is characterized by changes in drug plasma levels, area under the curve (AUC), onset of action, half time, etc.. Pharmacokinetic interactions caused by changes in the rate or extent of absorption, distribution, metabolism and excretion. Pharmacodynamic interactions are usually associated with the ability of a drug to alter the effects of other drugs without altering the properties of farmakokinetiknya. Pharmacodynamic interactions include additive (A drug effect = 1, B = 1 effects of drugs, the effects of a combination of both = 2), potentiation (effect A = 0, B = 1 effect, the effect of the combination of A + B = 2), synergism (effect A = 1, the effect of B = 1, the effect of the combination of A + B = 3) and antagonism (effect A = 1, B = 1 effect, the effect of the combination of A + B = 0). Mechanisms involved in the interactions are pharmacodynamic effects of changes in tissues or receptors.

Pharmacokinetic interactions
1. Absorption
The drugs are taken orally bisaanya absorbed from the gastrointestinal tract into the circulatory system. There are many possibilities for drug interactions occur through the gastrointestinal tract. Drug absorption can occur through passive and active transport, where most of the drug is absorbed passively. This process involves the diffusion of the drug from an area with a high concentration to areas with lower levels of medication. On the displacement of the drug active transport against a concentration gradient (ie ion-ion and water-soluble molecules) and this process requires energy. Absorption of active drug transport is faster than in the passive tansport. Drugs in the form of non-terion fat soluble and easily diffuses across the cell membrane, whereas the drug in the form of fat and insoluble terion can not diffuse. Under normal physiological conditions, but the level of absorption is slightly delayed absorption is usually perfect.
When the absorption rate changes, significant drug interactions will occur more easily, especially drugs with short half-life time or when needed peak plasma levels were quick to get the effect. Interaction mechanism due to impaired absorption, among others:
a. Direct interaction
Interaction physically / chemically between drugs within the lumen of the gastrointestinal tract before absorption can interfere with the absorption process. This interaction can be avoided or greatly dikuangi when interacting drugs are given within a period of at least 2 hours.
b. pH changes in gastrointestinal tract
Gastrointestinal fluid alkalis, for example due to antacids, will increase the solubility of drugs that are poorly soluble acid in the gastrointestinal tract, such as aspirin. Thus aspirin accelerated by alkaline dissolution will accelerate absorption. However, the atmosphere alkalis in the gastrointestinal tract reduces the solubility of a drug that is alkaline (eg, tetracycline) in the gastrointestinal fluids, thereby reducing absorption. Decreased gastric acidity by antacids will reduce the destruction of drugs that are not acid resistant thus increasing bioavailabilitasnya.
Ketoconazole is taken by mouth requires a medium acid to dissolve the required amount so as not allows supplied with antacids, anticholinergic drugs, inhibition of H 2, or proton pump inhibitors (eg, omeprazole). If necessary, the drug should be abat-given at least 2 hours after administration of ketoconazole.
c. formation of insoluble complexes or chelate, and adsorsi
The interaction between the antibiotic group fluorokinolon (ciprofloxacin, enoksasin, levofloxacin, lomefloksasin, norfloxacin, ofloxacin and sparfloksasin) and divalent ions and trivalent (eg Ca 2 + ions, Mg 2 + and Al 3 + from antacids and other drugs) can cause a decrease in significant gastrointestinal absorption, bioavailability and therapeutic effect, because formation of complex compounds. This interaction also decreases the activity of fluoroquinolone antibiotics. This interaction effect can be significantly reduced by providing an antacid a few hours before or after administration of fluoroquinolones. If antacids are really needed, adjustment of therapy, such as drug-pbat replacement with H 2 receptor antagonists or proton pump inhibitors do.
Several antidiarrheal medication (containing attapulgite) adsorb other drugs, resulting in lower absorption. Although there is no scientific research, use of these drugs should interval with other drugs as long as possible.
d. drug being bound to the bile acid sequestrant (BAS: bile acid sequestrant)
Cholestyramine and kolestipol can bind to bile acids and prevents reabsorpsinya, consequently bonding can occur with other drugs, especially acidic (eg warfarin). We recommend the use of interval kolestipol with cholestyramine or other drugs as long as possible (minimum 4 hours).
e. changes in gastrointestinal function (acceleration or slow emptying of the stomach, changes vaksularitas or gastroduodenal mucosal permeability, or damage to the intestinal wall mucosa).
Examples of drug interactions on the absorption process can be seen in the following table:

Obat yang dipengaruhi Drugs affected	Obat yang mempengaruhi Drugs that affect	Efek interaksi Interaction effects
Digoksin Digoxin	Metoklopramida Metoclopramide Propantelin Propantelin	Absorpsi digoksin dikurangi Reduced digoxin absorption Absorpsi digoksin ditingkatkan (karena perubahan motilitas usus) Digoxin absorption increased (due to changes in intestinal motility)
Digoksin Digoxin Tiroksin Thyroxine Warfarin Warfarin	Kolestiramin Cholestyramine	Absorpsi dikurangi karena ikatan dengan kolestiramin Reduced absorption due to bonding with cholestyramine
Ketokonazol Ketoconazole	Antasida Antacids Penghambat H 2 Inhibitor of H 2	Absorpsi ketokonazol dikurangi karena disolusi yang berkurang Ketoconazole absorption is reduced due to the reduced dissolution
Penisilamin Penicillamine	Antasida yang mengandung Al 3+ , Mg 2+ , preparat besi, makanan Antacids containing Al 3 +, Mg 2 +, iron preparations, food	Pembentukan khelat penisilamin yang kurang larut menyebabkan berkurangnya absorpsi penislinamin Penicillamine chelate formation which leads to reduced absorption of poorly soluble penislinamin
Penisilin Penicillin	Neomisin Neomycin	Kondisi malabsorpsi yang diinduksi neomisin Neomycin induced malabsorption conditions
Antibiotik kuinolon Quinolone antibiotics	Antasida yg mengandung Al 3+ ,Mg 2+ , Fe 2+ , Zn, susu Antacids that contain Al 3 +, Mg 2 +, Fe 2 +, Zn, milk	Terbentuknya kompleks yang sukar terabsorpsi Complex formation is difficult adsorbed
Tetrasiklin Tetracycline	Antasida yang mengandung Al 3+ , Mg 2+ , Fe 2+ , Zn, susu Antacids containing Al 3 +, Mg 2 +, Fe 2 +, Zn, milk	Terbentuknya kompleks yang sukar terabsorpsi Complex formation is difficult adsorbed

Among the above mechanisms, the most significant is the formation of insoluble complexes, chelate formation or if the drug is bound resin that binds bile acids. There are also some drugs that alter the pH of the gastrointestinal tract (eg, antacids) which resulted in significant changes in drug bioavailability.

.1. Distribution

Once the drug is absorbed into the circulatory system, drugs brought into the workplace where the drug will react with a variety of body tissues and or receptors. During their stay in the bloodstream, the drug can be attached to various blood components, especially protein albumin. Fat-soluble drugs have a high affinity to adipose tissue, so drugs can be stored in the adipose tissue. The low blood flow to the tissue resulting in fatty tissue into depot for fat-soluble drugs. This prolongs the effects of the drug. The drugs are highly lipid soluble groups such as phenothiazines, benzodiazepines and barbiturates.

Number of acidic drugs have an affinity for blood proteins, especially albumin. The drugs have an alkaline affinity binding to α-acid-glycoprotein. Plasma protein binding (PPB: plasma protein binding) expressed as a percent indicating percent bound drug. Albumin-bound drug is pharmacologically inactive, whereas drugs that are not tied, commonly called fractions free, pharmacologically active. When two or more drugs are highly bound to protein is shared sasam, competition binding occurs at the same place, which resulted in a shift in one of the drug binding to the protein, and it finally happened peninggatan free drug levels in the blood. When the drug displaced of proteins by binding with other drugs, there will be increased levels of free drug is distributed through various networks. Albumin levels in patients with drug-free or active form will be higher.

Valproic acid was reported to shift phenytoin of bonds with proteins and also inhibits the metabolism of phenytoin. If patients take both drugs, unbound phenytoin levels will increase significantly, causing more side effects large. Conversely, phenytoin may decrease plasma levels of valproic acid. The second combination drug therapy should be monitored with tight and dosage adjustments made.

Medications that tend to interact on the distribution of the drugs are:

percent protein bound high (over 90%)

bound on the network

has a small volume of distribution

have a low hepatic excretion ratio

have a narrow therapeutic range

has a rapid onset of action

used intravenously.

Drugs that have a high ability to shift to other drugs from protein binding is salicylic acid, phenylbutazone, sulfonamides and nonsteroidal anti-inflammatory.

.2. Metabolism

To produce a systemic effect in the body, the drug must reach the receptor, means the drug must be able to pass through the plasma membrane. For the drug must dissolve fat. Metabolism can change the fat-soluble active compounds into water-soluble compounds that are not active, which will be excreted primarily through the kidneys. Drug metabolism can pass through two phases, namely phase I and II metabolism. In the phase I metabolism, oxidation, demethylation, hydrolysis, etc.. by liver microsomal enzymes that are in the endothelium, produce more drug metabolites water-soluble. In the phase II metabolism, drug reacts with the water-soluble molecules (eg glucuronic acid, sulfate, etc.) into metabolites that are not or less active, which is soluble in water. A compound can pass one or both of the above fasemetabolisme until a water-soluble form. Most of the drug interaction clinically significant result from the phase I metabolism of the phase II.

a. Increased metabolism

Some medications can increase the activity of hepatic enzymes involved in the metabolism of other drugs. For example, phenobarbital increase the metabolism of warfarin thus lowering antikoagulannya activity. In this case the dose of warfarin should be increased, but after discontinued use of phenobarbital dose of warfarin should be reduced to avoid potential toxicity. Can be used as an alternative sedative than barbiturates, benzodiazepines such groups. Phenobarbital also increases the metabolism of other medications such as steroid hormones.

Other barbiturates and drugs such as carbamazepine, phenytoin, and rifampin also cause enzyme induction.

Pyridoxine accelerate decarboxylation of levodopa into its active metabolite, dopamine, in the peripheral tissues. Unlike levodopa, dopamine can not cross the barrier blood brain to provide antiparkinsonian effects. Giving karbidopa (an inhibitor of decarboxylation) together with levodopa, levodopa activity can prevent interference by pyridoxine,

b. Inhibition of metabolism

A drug may also inhibit the metabolism of other drugs, with impacts extend or increase the action of drugs that are affected. For example, allopurinol reduces the production of uric acid by inhibiting the enzyme ksantin oxidase, which metabolizes some potentially toxic drugs such as merkaptopurin and azathioprine. Ksantin oxidase inhibition can significantly enhance the effects of these medications. So if used with allopurinol, merkaptopurin or azathioprine dose should be reduced to 1/3 or ¼ dose usually.

Cimetidine inhibits oxidative metabolic pathways and may increase the action of drugs that are metabolized by this pathway (eg, carbamazepine, phenytoin, theophylline, warfarin and mostly benzodiazepines). Cimetidine did not affect benzodiazein action lorazepam, oksazepam and temazepam, which undergoes glucuronide conjugation. Ranitidine has an effect on oxidative enzymes lower than cimetidine, famotidine and nizatidin while not affect the oxidative metabolic pathway.

Erythromycin reportedly inhibits hepatic metabolism of some drugs such as carbamazepine and theophylline thereby increasing their effect. Fluoroquinolones such as ciprofloxacin drug class also increases the activity of theophylline, presumably through the same mechanism.

3. Excretion

Unless an inhalation anesthetic drugs, most drugs are excreted via bile or urine. Blood enters the kidney along the renal artery, first delivered to the glomeruli tubules, where small molecules that fit through the glomerular membrane (water, salt and some specific drugs) filtered into the tubules. Large molecules such as plasma proteins and blood cells were detained. Blood flow then passes through another part of the renal tubule where active transport to move the drug and its metabolites from blood to tubular filtrate. Tubular cells then perform active and passive transport (by diffusion) for reabsorbing the drug. The interaction can take place due to changes in renal tubules active excretion, changes in pH and changes in renal blood flow.

a. Changes in renal tubules active excretion

b. changes in urine pH

c. Changes in renal blood flow

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Oxidative Phosphorylation

Oxidative phosphorylation is a metabolic pathway that uses energy released by the oxidation of nutrients to produce adenosine triphosphate (ATP). Although many forms of life on earth using various types of nutrients, almost all carry out oxidative phosphorylation to produce ATP. This track is very commonly used because it is a very efficient way to release some energy, as compared to other alternatives such as fermentation anaerobic glycolysis.

Electron transport chain in mitochondria is the site of oxidative phosphorylation in eukaryotes. NADH and succinate generated in the citric acid cycle is oxidized, releasing energy for use by the ATP synthase.
During oxidative phosphorylation, electrons are transferred from the electron donor to the electron acceptor through redox reactions. The redox reactions that release energy used to make ATP. In eukaryotes, these redox reactions carried out by a complex series of proteins in the mitochondria, when in prokaryotes, these proteins are in the cell membrane. The enzymes that are interconnected is referred to as the electron transport chain. In eukaryotes, five main protein complexes involved in this process, when in prokaryotes, there are many different enzymes that are involved.
The energy released by the movement of electrons through the electron transport chain is used to transport protons across the membrane of mitochondria. This process is called chemiosmosis. The transport of potential energy in the form of a pH gradient and an electrical potential along the membrane. The energy stored in the form utilized by allowing protons to flow back across the membrane through an enzyme called ATP synthase. This enzyme uses this energy to generate ATP from adenosine diphosphate (ADP) through the phosphorylation reaction. This reaction is driven by the flow of protons, which encourages rotation of one part of the enzyme.
Although oxidative phosphorylation is a vital part of metabolism, it produces reactive oxygen species such as superoxide and hydrogen peroxide. This can lead to the formation of free radicals, damage cells, and may also cause aging. The enzymes involved in these metabolic pathways are also a target of many drugs and toxins that can inhibit enzyme activity.

  Overview of Energy Transfer Through chemiosmosis

Oxidative phosphorylation works by using chemical reactions that produce energy to drive reactions that require energy. Both sets of reactions are said to join. This means that one can not walk without a reaction other reactions. The flow of electrons through the electron transport chain is exergonic process, releasing the energy, when the synthesis of ATP is an endergonic process, which requires energy. Good electron transport chain and ATP synthase present in the membrane, and the energy transferred from the electron transport chain to ATP synthase proton movement across the membrane through this. This process is called chemiosmosis. [1] In practice, this is similar to an electrical circuit, driven by proton flow from the negative side to the positive side of the membrane by a proton-pumping enzymes that of the electron transport chain. This enzyme such as batteries. The movement of protons creates an electrochemical gradient along the membrane, which is often called the force proton (proton-motive force). This gradient has two components: the difference in proton concentration (pH gradient) and the difference in electrical potential. Stored energy in the form of electrical potential differences in the mitochondria, as well as a pH gradient in chloroplasts. [2]
ATP synthase releases this stored energy to complete the circuit and allow protons to flow back to the negative side of the membrane. [3] This enzyme such as electric motors, which use proton motive power to drive the rotation of the structure and use this movement to synthesize ATP.
The energy released by oxidative phosphorylation is quite high compared to the energy released by anaerobic fermentation. Glycolysis produces only 2 ATP molecules, whereas the oxidative phosphorylation 10 with 2 molecules of NADH molecules formed succinate conversion of one molecule of glucose into carbon dioxide and water, produced 30 to 36 molecules of ATP. [4] The yield of ATP is actually a maximum theoretical value : in practice, the resulting ATP is lower than that value. [5]

 Molecular electron and proton transfer

Electron transport chain carries both protons and electrons, proton transport from donor to acceptor, and run through the membrane proton transport. This process uses a soluble molecule and molecule bound to the transfer. In the mitochondria, electrons are transferred in the intermembrane space using electron transfer protein cytochrome c is soluble in water. [6] He was just transporting electrons, and these electrons are transferred using the reduction and oxidation of iron atoms bound to the protein in the heme group structure. Cytochrome c is also found in some bacteria, where it is located in the periplasmic space. [7]
In the inner membrane of mitochondria, coenzyme Q10 carrier lipid-soluble electron carries both electrons and protons using a redox cycle. [8] benzokuinon small molecule is very hydrophobic, so it will diffuse freely into the membrane. When Q receives two electrons and two protons, he became ubikuinol reduced form (QH2); when the QH2 releases two electrons and two protons, it is oxidized back into shape ubikuinon (Q). Consequently, if the two enzymes are prepared so universally Q is reduced on one side of the membrane and QH2 oxidized on the other hand, ubikuinon will confront these reactions and shuttle protons across the membrane repeat. [9] Some of the bacterial electron transport chain use different quinones, such menakuinon, besides ubikuinon . [10]
In proteins, electron transfer between the flavin cofactor, [11] [3] iron-sulfur clusters, and cytochromes. There are several types of iron-sulfur clusters. The simplest types are found in the electron transfer chain consists of two iron atoms are linked by two sulfur atoms; This is referred to as the cluster [2Fe-2S]. The second type, called a [4Fe-4S], sebua cube containing four iron atoms and four sulfur atoms. Each atom in the cluster is coordinated by amino acids, usually coordination between the sulfur atoms with Cysteine. Metal ion cofactors undergo redox reactions without binding or releasing protons, so that the electron transport chain it only serves as an electron carrier. Electrons move far enough through these proteins by jumping around the cofactor chain. [12] This occurs through quantum tunneling, which occurs rapidly at distances smaller than 1.4 × 10-9 m. [13]

 Electron transport chain of eukaryotic

Many catabolic biochemical processes, such as glycolysis, the citric acid cycle and beta oxidation, resulting in the reduced coenzyme NADH. Coenzyme contains electrons that have a high transfer potential. In other words, he would release enormous energy during oxidation. However, the cell will not release all this energy at the same time because it will be uncontrolled reaction. Instead, electrons are removed from NADH and transferred to oxygen through a series of enzyme that will release a small amount of energy in each of these enzymes. Which consists of a series of enzyme complexes I through IV complex is referred to as the electron transport chain and is found in the inner mitochondrial membrane.
1. Complex I (NADH dehydrogenase)
2. Complex II: succinate-Q oxidoreductase.
3. Complex 3 (Q-cytochrome c oxidoreductase)
4. Complex IV: Cytochrome C oxidase.
5. Complex V (ATP synthase)

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Cara Ampuh Menurunkan Berat Badan

Apabila saat ini Anda dalam posisi yang gagal menurunkan berat badan serta sudah mulai desperate mencoba cara lain, coba saja satu hal yang ampuh berikut ini. Hal ini telah terbukti membantu sekian banyak orang menurunkan berat badannya, dengan cara sederhana yang justru malah disepelekan.

Sebelum lebih lanjut membahas satu jurus jitu, perlu Anda ketahui bahwa hal yang membuat Anda gemuk dan berat badan tak kunjung turun adalah masuknya asupan yang tidak terkontrol. Saat ada makanan yang mengandung kalori maupun karbohidrat, tentunya berat badan akan bertambah. Apabila tidak terjadi pembakaran, maka kalori tersebut tidak akan keluar dan muncullah timbunan-timbunan lemak di dalam tubuh.

Lemak-lemak tersebut tak hanya tertimbun di satu bagian tubuh saja, tetapi akan berkembang ke bagian tubuh lainnya juga.

Stop makan di malam hari

Adalah sebuah cara jitu untuk membuat berat badan Anda turun dengan bersikap tegas dan disiplin, tidak mengonsumsi makanan dengan kandungan karbohidrat atau kalori tinggi di malam hari. Makanan-makanan seperti nasi, daging, makanan ringan dari yang manis hingga asin harus dihentikan.

Apabila memang Anda lapar, Anda boleh mengonsumsi sayuran atau buah-buahan. Pun demikian, disarankan makan dua jam sebelum Anda akan tidur.

Pernyataan tersebut, seperti dikutip dari health.com didukung oleh dua studi yang melibatkan para partisipan sukarelawan. Dilakukan observasi terhadap para sukarelawan tersebut, antara mereka yang masih makan di malam hari, dan yang tidak.

Dalam jangka beberapa waktu, berat badan dan lingkar pinggang diukur kembali. Hasilnya, mereka yang menghentikan kebiasaan makan di malam hari, mengalami penurunan berat badan.

Apakah dengan cara ini saja tubuh bisa langsing?

Jawabannya tentu tidak. Satu langkah ampuh ini harus didukung dengan cara-cara lainnya, seperti:

• Diet makan-makanan yang bernutrisi dan sehat
• Hindari mengonsumsi junk food
• Olahraga rutin dan lakukan cardio setidaknya 20-30 menit setiap harinya
• Tidur cukup dan tidak begadang
• Mengurangi asupan makanan yang manis dan asin
• Hindari makan di atas jam 6 sore, dan apabila memang Anda merasa lapar, setidaknya batasi jam makan di bawah jam 8 malam.

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Ciri Ciri Gejala Penyakit Kanker Mulut

Kanker mulut bisa terjadi disemua bagian mulut. Dan siapapun bisa terkena kanker mulut, tetapi risikonya lebih tinggi untuk para pria yang berusia lebih dari 40 tahun, merokok, dan minum alkohol. Di Singapura, sekitar 150 sampai 200 pasien terdiagnosis kanker mulut setiap tahun. Sekitar 75-90% dari kasus tersebut berkaitan dengan merokok dan alkohol.

Gejala kanker mulut:

Bercak putih atau merah dalam mulut;
Luka mulut yang tidak kunjung sembuh;
Pendarahan dalam mulut;
Masalah atau sakit saat menelan;
Benjolan di leher;
Ulkus atau bengkak di bibir.


Ketidaknormalan lainnya termasuk benjolan atau bengkak, atau sulkus yang tidak sembuh dalam dua minggu sampai sepuluh hari. Ulkus yang bersifat kanker cenderung menjadi keras dan tidak selalu sakit. Jika kanker menyebar ke lidah, maka pasien mungkin tidak berbicara dengan baik atau sulit makan.

Selama beberapa tahun terakhir, ditemukan pasien yang lebih muda terkena kanker mulut. Sejumlah pasien tersebut mengidap infeksi virus HPV yang merupakan penyebab kanker serviks. Meski lapisan mukosa saluran genital serupa dengan mulut, bukan berarti kanker diinduksi oleh HPV. Hingga kini, kebanyakan bentuk kanker tersebut adalah tipe orofaringeal di belakang mulut, dan prognosis kanker ini lebih baik. Kanker juga berkaitan dengan banyaknya pasangan seks oral dan vaksinasi melawan HPV bagi perempuan muda yang belum aktif secara seksual mendorong beberapa kalangan merekomendasikan hal yang sama untuk laki-laki.

Kanker bibir biasanya berkaitan dengan kerusakan akibat sinar matahari khususnya di kulit ras Kaukasia dan ditunjukkan sebagai ulkus yang tidak sembuh dan berdarah. Kanker lidah juga dapat ditunjukkan sebagai ulkus yang tidak sembuh yang tidak menyakitkan. Ulkus apapun yang tidak sembuh lebih dari 10 hari atau 2 minggu harus segera diselidiki untuk meniadakan kanker. Kanker rahang biasanya ditunjukkan sebagai benjolan.

Sayangnya, banyak pasien kanker mulut yang tidak mengalami gejala apapun sampai terlambat. Pasien yang seperti ini biasanya terdiagnosis saat kanker sudah parah dan harus menjalani operasi dengan peluang lebih besar untuk kambuh dan meninggal.

Terkadang jika kanker telah menyebar luas. Pada kasus yang parah, kanker sering kambuh kurang dari enam bulan. Sembilan dari 10 pasien bertahan selama lima tahun ketika kanker terdeteksi lebih awal. Tapi, ketika mencapai stadium lanjut, gambaran ini menurun.

Deteksi awal kanker mulut juga berarti menghindari kemoterapi atau radioterapi – tidak seperti pasien yang terdiagnosis pada stadium lanjut. Pengobatan hanya dengan pemeriksaan rutin untuk memastikan kanker tidak kembali. Deteksi awal bisa berarti 80 sampai 90% peluang kesembuhan, tetapi jika kanker terdeteksi terlambat, maka peluangnya jatuh sampai 20%.

Bentuk utama perawatan adalah operasi, jika memungkinkan, dibedah keseluruhan dari mulut pasien. Operasi rekonstruktif mikrovaskuler dapat membantu untuk mengganti struktur yang dihilangkan – seperti bagian lidah, mulut atau bahkan bagian rahang dan membantu pasien mendapatkan kembali fungsi normal mulut seperti makan dan menelan. Hal ini memberi pasien peluang kesembuhan dan jika kanker berstadium lanjut, radioterapi tambahan dapat membantu “membersihkan” daerah untuk mengurangi peluang kambuh. Terkadang dalam beberapa kasus lanjut, kemoterapi diperlukan untuk membunuh sel kanker yang telah menyebar ke daerah tersembunyi seperti paru, hati dan otak.

Pengobatan “terbaik” masih berupa pendeteksian awal dan para pasien disarankan untuk melakukan pemeriksaan mulut sendiri (lihat www.orofacialsurgery.com.sg) dan berkonsultasi dengan dokter jika ditemukan daerah yang mencurigakan. Dokter pesialis mulut dan maksilofasial dengan minat dalam kanker rongga mulut akan melakukan biopsi dan membantu membuat diagnosis awal. Kebanyakan pembedahan mulut dilakukan dokter gigi yang tidak berurusan dengan perawatan primer kanker
mulut. Tetapi, dokter spesialis mulut dan maksilofasial biasanya dokter berkualifikasi ganda dalam bidang kedokteran dan kedokteran gigi (dokter gigi dan dokter) yang memungkinkan mereka memiliki pengetahuan khusus tentang mulut dan gigi serta pengalaman bedah umum untuk menangani operasi onkologi dan konstruktif.

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Manfaat dan Penggunaan Simplisia Jahe

Jahe sudah di kenal oleh banyak orang. Mulai dari anak kecil hingga orang dewasa, hampir semuanya tahu seperti apa jahe itu. Tanpa kita sadari jahe juga memiliki banyak khasiat dalam dunia pengobatan. Oleh karena itu, kami akan membuat sedikit catatan tentang manfaat dan penggunaan jahe.

Berikut beberapa informasi umum tentang Jahe :

Nama Simplisia : Zingiberis Rhizoma
Nama Lain : Jahe
Nama Tanaman Asal : Zingiber officinale
Zat Berkhasiat : Resin, Zingeron, Zingerol, Zingiberen
Pemerian : Bau aromatik, Rasa pedas
Bagian Yang di gunakan : Akar tinggal yang sebagian kulitnya dikupas








Kegunaan atau Manfaat Jahe :

• Karminativa (Obat Kembung)
• Stimulansia (Penambah Tenaga)
• Diaforetika (Memperbanyak Pengeluaran Keringat)
• Ekspektoransia (Obat Batuk Berdahak)
• Amara (Penambah Nafsu Makan)

Waktu Panen (Jika berminat membudidayakan):

 Panen dapat dilakukan pada umur 9-12 bulan setelah tanam. Panenan pada umur 6 bulan dapat dilakukan untuk mendapatkan rimpang muda, kurang berserat, yang umumnya dipakai membuat manisan dan keperluan bumbu dapur. Panen pada umur 9-12 bulan dilakukan bila tanaman sudah mulai mengering seluruhnya sampai rebah rumpun-rumpunnya. Lalu simpan di dalam wadah tertutup baik.

Macam-macam Jahe :

Berdasarkan bentuk

• Jahe putih besar, rimpangnya lebih besar dan ruas rimpangnya lebih mengembung.

• Jahe putih kecil, Ruasnya kecil agak rata sampai sedikit mengembung.

• Jahe Merah, Rimpangnya berwarna merah dan lebih kecil dari jahe putih kecil.

Berdasarkan Pengolahan

• Black Ginger/Jahe Hitam : Jahe segar yang direndam dalam air mendidih kemudian di keringkan cepat-cepat.
• White Ginger/Jahe Putih : Jahe segar yang dicuci secara hati-hati dikupas lapisan gabus dan dicuci berulang-ulang dan dikelantang. Jika dimaserasi dengan air kapur akan nampak putih karena lapisan kapurnya.
• Green Ginger/Jahe Hijau : Jahe segar atau yang dikeringkan tanpa pengolahan khusus dan dipakai untuk bumbu masak.

Macam sediaan dari Jahe :

• Laserin Syrup®
• Avogin Tablet®

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Cara Mengatasi Telapak Tangan Yang Berkeringat

Sering mengalami keringat berlebih pada telapak tangan? Jika ya, tentu Anda sering merasa tidak percaya diri. Apalagi, jika harus berjabat tangan dengan rekan bisnis atau tamu. Telapak tangan yang berkeringat cenderung terjadi ketika seseorang mengalami tingkat stres yang sangat tinggi.

Meskipun ini merupakan fenomena alami, bisa jadi Anda mengalami kondisi yang disebut hiperhidrosis. Telapak tangan berkeringat biasanya disertai dengan keringat berlebih di telapak kaki dan di area lain pada tubuh.

Jika Anda merasa keringat sangat berlebihan, segera periksakan diri ke dokter. Masalah keringat tersebut sebenarnya juga bisa disiasati dengan trik khusus. Lakukan saja lima langkah berikut.

1. Baking soda
Baking soda dapat Anda gunakan sebagai obat penyembuh telapak tangan yang berkeringat. Campurkan satu sendok baking soda ke dalam air hangat dan rendam tangan selama beberapa menit. Alkalin alami yang terkandung di dalam baking soda dapat membuat telapak tangan Anda berhenti berkeringat selama beberapa jam.

2. Talc powder
Jika Anda sering mengalami keringat berlebih di telapak tangan, namun masih dalam level sedang, aplikasikan talc powder atau bedak bayi untuk membuatnya berhenti berkeringat. Anda dapat membawa bedak ke mana pun untuk mengontrol produksi keringat.

3. Kantung teh
Rendam sekitar empat hingga lima kantung teh di dalam air hangat, kemudian rendam tangan Anda selama beberapa menit. Teh berfungsi sebagai antiperspirant alami yang sangat bermanfaat dalam mengatur keringat.

4. Alkohol
Celupkan bola kapas ke dalam alkohol dan gosokkan pada seluruh permukaan telapak tangan Anda secara merata. Menggosokkan alkohol dapat mengeringkan keringat berlebihan selama beberapa jam. Pastikan Anda tidak menggosokkan alkohol terlalu banyak, karena dapat menyebabkan kulit mengalami kekeringan.

5. Meditasi
Meditasi, seperti dilansir dari Bold Sky, dapat jadi solusi untuk masalah emosi dan fisik, termasuk keringat berlebih. Keringat berlebihan umumnya disebabkan rasa lelah dan stres. Dan, meditasi dapat membantu pikiran Anda tetap tenang dan mengatur tingkat stres.

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Pertolongan Pertama Pada Kecelakaan

 Pertolongan pertama adalah pertolongan sementara yang di berikan kepada seseorang yang sakit mendadak atau yang mendapat kecelakaan sebelum mendapat pertolongan dari seorang ahli (Dokter).

 Dalam memberikan pertolongan pertama maka hal-hal yang di dahulukan adalah penderita yang memerlukan tindakan segera yang menyangkut nyawa seseorang ,yaitu :

• Pendarahan Hebat
• Pernafasan Berhenti
• Keracunan
• Gangguan keaddaan umum seperti pingsan, shock ,mati suri

Tindakan yang harus dilakukan :
Setiap ada keccelakaan maka tindakan-tindakan yang harus dilakukan adalah :

1. Memanggil dokter sesegera mungkin atau membawa penderita ke rumah sakit.
2. Menghentikan pendarahan.
3. Mencegah dan mengatasi shock atau gangguan keadaan umum lainnya.
4. Mencegah terjadinya infeksi.

Gangguan Umum 
Gangguan keadaan umum  adalah gangguan yang mengenai alat vital untuk hidup ,yaitu :

• Susunan Pernafasan yaitu gangguan yang ditandai dengan tpernafasan yang tidak teratur sampai tidak bernafas sama sekali.
• Susunan Saraf Pusat yaitu gangguan yang ditandai dengan menurunnya kesadaran.
• Sistem Peredaran Darah yaitu gangguan yang ditandai dengan denyut nadi/jantung yang tidak teratur sampai berhenti atau tidak berdenyut sama sekali.

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Cara Paling Mudah Mengatasi Rambut Rontok

Kali ini kami akan membahas mengenai Cara Paling Mudah Mengatasi Rambut Kita Yang Rontok, tapi sebelumnya kami akan menjelaskan mengenai Pengertian dan Jenis-Jenis Rambut.

Rambut adalah sesuatu yang keluar dari kulit dan kulit kepala, rambut tidak mempunyai syaraf perasa, sehingga rambut tidak terasa sakit jika dipangkas. Rambut sering kali disebut sebagai Mahkota yang berfungsi sebagai pelindung kepala dari panas terik matahari maupun pada saat cuaca dingin. Rambut membutuhkan penataan dan perawatan secara teratur supaya rambut tetap sehat, indah, dan berkilau.

Jenis Rambut dapat dibedakan menjadi 4 bagian yaitu:

Rambut Normal
Rambut normal yaitu rambut yang terlihat sehat, kokoh, lembut, dan mudah dirapikan, baik diwaktu basah maupun kering. Kalau sedang bersih akan terlihat mengkilat tetapi tidak berminyak. Cirinya kelihatan segar, tidak lengket dan tidak kusam sehingga mudah diatur.

Rambut kering
Rambut kering adalah rambut yang kelihatan suram dan mudah rusak, hal ini disebabkan oleh akibat kekurangan sekresi kelenjar sebasea. Rambut yang cenderung mudah kusut, disisir akan merusak batang rambut dan ujung rambut yang pecah, kutikel rambut menjadi terangkat dan lepas. Penyebab rambut kering ini terjadi pada rambut yang sering kena trauma baik mekanik maupun kimiawi, terlalu kencang diikat, terlalu kuat dipucatkan, terlalu sering shampoo , diblow dan sebagainya.

Ciri – cirinya: Bila dipegang tangan kaku, gersang, bersuara dan pudar, warna rambut pirang/merah tidak bercahaya, tumbuhnya sering tipis & sisik-sisiknya lebih merenggang jadi lebih mudah menerima zat cair

Rambut Porous ( termasuk jenis rambut kering
Rambut porous adalah rambut yang menyerap zat cair, kering, bercabang, dengan pertumbuhan rambut yang sedikit serta kadang berwarna kemerahan yang diakibatkan oleh banyaknya penyasakan, dan bahan kimia kosmetik rambut.

Rambut Berminyak
Rambut berminyak adalah rambut yang terlihat basah dan lengket, mudah kotor karena debu, mudah lengket dan kadang membentuk rumpun rambut (gimbal).

Setelah mengetahui jenis rambut anda, berikut beberapa cara alami yang anda dapat lakukan untuk mengatasi Rambut Rontok.

Teh
Teh hijau dengan kandungan antioksidan yang tinggi dapat anda manfaatkan untuk melindungi serta merawat rambut dari paparan polusi terlebih dari serangan UV yang dapat merusak rambut bahkan menyebabkan kerontokan.

Berikut beberapa macam teh dan fungsinya:

• Teh melati memiliki manfaat untuk menjaga bahkan membuat rambut anda semakin berkilau. 
• Teh daun mint, berfungsi sebagai penyejuk bagi kulit kepala anda bahkan mampu mengangkat minyak berlebih serta kotoran penyebab ketombe dikulit kepala serta mengurangi rasa gatal. 

Mencuci rambut dengan teh dapat anda lakukan dengan mengendapkan air rebusan daun teh semalaman kemudian anda gunakan untuk mencuci rambut anda. Air teh yang sudah anda endapkan tersebut, dapat juga anda gosokkan pada kulit kepala. Lakukan cara mengatasi rambut rontok dengan menggunakan teh ini pada saat sebelum keramas.

Alpukat
Cara mengatasi rambut rontok yang disebabkan oleh rambut kering, dapat anda gunakan perawatan dengan memanfaatkan alpukat. Kandungan alami alpukat yang tinggi asam lemak serta nutrisi yang baik bagi rambut tentunya dapat menjaga kesehatan rambut anda serta mencegah rambut anda rontok. Gunakan alpukat ini sebagai masker untuk menutrisi rambut rontok pada perawatan harian rambut anda.

Lumatkan alpukat yang sudah matang benar, hancurkan hingga benar-benar lembut atau hingga menjadi pasta. Usapkan secara merata dan menyeluruh pada rambut anda mulai dari akar hingga ujung rambut. Diamkan kurang lebih setengah jam lalu bilas rambut anda dengan menggunakan air bersih.

Kemiri
Cara mengatasi rambut rontok bisa juga anda manfaatkan kemiri, minyak kemiri dapat memperbaiki serta mampu menguatkan akar rambut hingga tidak mudah rontok. Kandungan minyak yang terdapat pada kemiri sangat bagus sekali bagi akar rambut anda. Selain anda dapat membeli minyak kemiri anda juga dapat membuat minyak kemiri sendrii dirumah. Cara membuat minyak kemiri, ambil secukupnya kemiri lalu tumbuk kasar kemiri tersebut setelah itu kemiri kasar tadi sangrai menggunakan api yang sedang. Setelah disangrai, tumbuk kembali kemiri hingga halus benar hingga mengeluarkan minyak alami. Anda dapat menggunakan minyak kemiri ini pada saat creambath sebelum keramas.

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Waktu Menelan Obat

 Bagi kebanyakan obat waktu di telannya tidak begitu penting, yaitu sebelum atau sesudah makan. Tetatpi ada pula obat dengan sifat atau maksud pengobatan khusus guna menghasilkan efek maksimal atau menghindarkan efek samping tertentu.

 Sebenarnya penyerapan obat dari lambung yang kosong berlangsung paling cepat karena tidak dihalangi oleh isi usus, contoh :

• Obat-obat yang diharapkan memberikan efek yang cepat sebaiknya ditelan sebelum makan, misalnya analgetika (kecuali asetosal).
• Obat yang sebaiknya diberikan pada lambung kosong yakni 1 jam sebelum atau 2 jam setelah makan adalah Penisilin, Sefalosporin, Eritromysin, Rovamysin, Linkomisin, dsb.
• Obat lain yang bersifat merangsang mukosa lambung harus digunakan pada waktu setelah makan, meskipun absorpsinya menjadi terhambat misalnya obat-obat kortikosteroid dan rematik, antidiabetika oral, garam-garam besi, obat cacing, dsb.

sumber : Buku Farmakologi Kelas X | Pilar Media

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