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Ascariasis Disease

Ascariasis

Clinical symptoms will be shown on the stadium flyblow and adults.

At the stadium flyblow, Ascaris can cause mild symptoms in the heart and the lungs will cause the Loeffler syndrome. Loeffler syndrome is a collection of signs such as fever, shortness of breath, eosinofilia, and the images seen infiltrat Roentgen thoraks that will be lost for 3 weeks.

In the adult stages, the intestinal worms will cause symptoms typical channels such as indigestion not appetite, vomiting, diarrhea, constipation, and nausea. When the worms go into the channel can cause the gall to eat kolik or ikterus. When the adult worms penetrate peritoneum and then enter the body or the abdomen can cause acute abdomen
Infection

Infections

Infections with these parasites are more common where sanitation is poor and human feces are used as fertilizer.

Prevention of this infection centers around education, not using human feces as fertilizer, and cleanliness, especially among those who handle food.

Infections happen when a human swallows water or food contaminated with unhatched juveniles. The juveniles hatch in the duodenum (1st section of small intestine). They then penetrate the mucosa and submucosa and enter venules or lymphatics. Next they pass through the right heart and into pulmonary circulation. They then break out of the capillaries and enter the air spaces. Acute tissue reaction occurs when several worms get lost during this migration and accumulate in other organs of the body.

The juveniles migrate from the lung up the respiratory tract to the pharynx where they are swallowed. They begin producing eggs within 60–65 days of being swallowed. These are produced within the small intestine where the juveniles mature. It might seem odd that the worms end up in the same place where they began.

One hypothesis to account for this behavior is that the migration mimics and intermediate host, which would be required for juveniles of an ancestral form to develop to the third stage. Another possibility is that tissue migration enables faster growth and larger size, which increases reproductive capacity.

More than 1 billion people are affected by this infection. Infections can be treated with drugs called ascaricides.

How the diagnosis

Ascaris eggs containing embryo

Diagnosis Ascariasis do with the eggs found in the patient's feces or adult worms found in the anus, nose, or mouth.

Treatment

Ascariasis treatment can be used medicines sepreti pirantel pamoat, mebendazol, albendazol, piperasin.

Source : http://iyanarsip.blogspot.com/2009/08/disease-caused-filaria-worms-filariasis.html

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Stroke - Is loss of brain Function

STROKE

A stroke is the rapidly developing loss of brain function(s) due to disturbance in the blood supply to the brain. This can be due to ischemia (lack of blood supply) caused by thrombosis or embolism or due to a hemorrhage. As a result, the affected area of the brain is unable to function, leading to inability to move one or more limbs on one side of the body, inability to understand or formulate speech, or inability to see one side of the visual field. In the past, stroke was referred to as cerebrovascular accident or CVA, but the term "stroke" is now preferred.

A stroke is a medical emergency and can cause permanent neurological damage, complications, and death. It is the leading cause of adult disability in the United States and Europe. In the UK, it is the second most common cause of death, the first being heart attacks and third being cancer. It is the number two cause of death worldwide and may soon become the leading cause of death worldwide.Risk factors for stroke include advanced age, hypertension (high blood pressure), previous stroke or transient ischemic attack (TIA), diabetes, high cholesterol, cigarette smoking and atrial fibrillation. High blood pressure is the most important modifiable risk factor of stroke.

The traditional definition of stroke, devised by the World Health Organization in the 1970s, is a "neurological deficit of cerebrovascular cause that persists beyond 24 hours or is interrupted by death within 24 hours". This definition was supposed to reflect the reversibility of tissue damage and was devised for the purpose, with the time frame of 24 hours being chosen arbitrarily. The 24-hour limit divides stroke from transient ischemic attack, which is a related syndrome of stroke symptoms that resolve completely within 24 hours. With the availability of treatments that, when given early, can reduce stroke severity, many now prefer alternative concepts, such as brain attack and acute ischemic cerebrovascular syndrome (modeled after heart attack and acute coronary syndrome respectively), that reflect the urgency of stroke symptoms and the need to act swiftly.

A stroke is occasionally treated with thrombolysis ("clot buster"), but usually with supportive care (speech and language therapy, physiotherapy and occupational therapy) in a "stroke unit" and secondary prevention with antiplatelet drugs (aspirin and often dipyridamole), blood pressure control, statins, and in selected patients with carotid endarterectomy and anticoagulation.

Treatment

Stroke unit

Ideally, people who have had a stroke are admitted to a "stroke unit", a ward or dedicated area in hospital staffed by nurses and therapists with experience in stroke treatment. It has been shown that people admitted to a stroke unit have a higher chance of surviving than those admitted elsewhere in hospital, even if they are being cared for by doctors with experience in stroke.

When an acute stroke is suspected by history and physical examination, the goal of early assessment is to determine the cause. Treatment varies according to the underlying cause of the stroke, thromboembolic (ischemic) or hemorrhagic. A non-contrast head CT scan can rapidly identify a hemorrhagic stroke by imaging bleeding in or around the brain. If no bleeding is seen, a presumptive diagnosis of ischemic stroke is made.

Treatment of ischemic stroke

Ischemic stroke is caused by a thrombus (blood clot) occluding blood flow to an artery supplying the brain. Definitive therapy is aimed at removing the blockage by breaking the clot, thrombolysis, or by removing it mechanically, thrombectomy. The more rapidly bloodflow is restored to the brain, the fewer brain cells die.

Other medical therapies are aimed at minimizing clot enlargement or preventing new clots from forming. To this end, treatment with medications such as aspirin, clopidogrel and dipyridamole may be given to prevent platelets from aggregating.

In addition to definitive therapies, management of acute stroke includes control of blood sugars, ensuring the patient has adequate oxygenation and adequate intravenous fluids. Patients may be positioned with their heads flat on the stretcher, rather than sitting up, to increase blood flow to the brain. It is common for the blood pressure to be elevated immediately following a stroke. Although high blood pressure may cause some strokes, hypertension during acute stroke is desirable to allow adequate blood flow to the brain.

Thrombolysis

In increasing numbers of primary stroke centers, pharmacologic thrombolysis ("clot busting") with the drug tissue plasminogen activator (tPA), is used to dissolve the clot and unblock the artery. However, the use of tPA in acute stroke is controversial. On one hand, it is endorsed by the American Heart Association and the American Academy of Neurology as the recommended treatment for acute stroke within three hours of onset of symptoms as long as there are not other contraindications (such as abnormal lab values, high blood pressure, or recent surgery).

This position for tPA is based upon the findings of two studies by one group of investigators which showed that tPA improves the chances for a good neurological outcome. When administered within the first three hours, 39% of all patients who were treated with tPA had a good outcome at three months, only 26% of placebo controlled patients had a good functional outcome.

A recent study using alteplase for thrombolysis in ischemic stroke suggests clinical benefit with administration 3 to 4.5 hours after stroke onset. However, in the NINDS trial 6.4% of patients with large strokes developed substantial brain hemorrhage as a complication from being given tPA. tPA is often misconstrued as a "magic bullet" and it is important for patients to be aware that despite the study that supports its use, some of the data were flawed and the safety and efficacy of tPA is controversial. A recent study found the mortality to be higher among patients receiving tPA versus those who did not. Additionally, it is the position of the American Academy of Emergency Medicine that objective evidence regarding the efficacy, safety, and applicability of tPA for acute ischemic stroke is insufficient to warrant its classification as standard of care.

Source: http://iyanarsip.blogspot.com/2009/08/dloriifah-about-stroke.html

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Medical insurance

Medical insurance

Health insurance like other forms of insurance is a form of collectivism by means of which people collectively pool their risk, in this case the risk of incurring medical expenses. The collective is usually publicly owned or else is organized on a non-profit basis for the members of the pool, though in some countries health insurance pools may also be managed by for-profit companies. It is sometimes used more broadly to include insurance covering disability or long-term nursing or custodial care needs. It may be provided through a government-sponsored social insurance program, or from private insurance companies. It may be purchased on a group basis (e.g., by a firm to cover its employees) or purchased by an individual. In each case, the covered groups or individuals pay premiums or taxes to help protect themselves from unexpected healthcare expenses. Similar benefits paying for medical expenses may also be provided through social welfare programs funded by the government.

By estimating the overall risk of healthcare expenses, a routine finance structure (such as a monthly premium or annual tax) can be developed, ensuring that money is available to pay for the healthcare benefits specified in the insurance agreement. The benefit is administered by a central organization such as a government agency, private business, or not-for-profit entity



Find out before you come

The company that you are with, or are going to work for, should provide medical insurance for expatriate staff and their family members, as well as their permanent Indonesian staff. Ask for details from your employer to ensure that your policy will
adequate cover your family members for sickness or accident emergency, whether in Indonesia or when you are returning home on leave or when you are visiting other countries in the course of your work or on vacation.

If you are joining a new company, you must remember that they may never love you more than when you first join. Do not rely on promises that medical insurance coverage will be sorted out when you arrive in Indonesia. It may in fact be taken care of to your satisfaction, but it could be the case that what the company considers ideal coverage may not meet your expectations. Be sure, before you come, that you understand what medical coverage your company will provide for regular medical concerns, and major medical situations such as surgery or deliveries, as well as medical evacuation to another country or from a remote site to a big city in Indonesia.

Medical evacuations are a big factor in medical coverage as the quality of medical service will be quite poor in outlying areas in Indonesia. Emergency medical evacuation (medivac) to a large city or even to a neighboring country is considered essential in most medical emergencies.


Options in Medical insurance coverage

International Medical Insurance plans from the U.K. for instance, include emergency medical evacuation and there is the possibility to add outpatient services to cover everything but minor outpatient items. The reason for excluding minor outpatient claims is to keep the costs down as the paperwork involved in claims could well exceed the claim itself. The outpatient claims therefore have a deductible.

The deductible is related to the illness - not the claim - so the patient may have several doctor and specialist visits plus the prescribed medicine for one particular bout of sickness and there would only be one deductible. A point worth noting is that a person could be undergoing outpatient treatment with a very serious illness, which would not be covered under a local clinic scheme.

There are many foreign joint venture insurance companies with offices in Jakarta selling medical, hospitalization and other general insurance products for group and individual medical insurance policies, so you do have a large choice of companies and products. You could also purchase a medical insurance or travel plan from a company based in your home country which provides some medical cover while you are traveling overseas, however, you must be very sure about the restrictions on such plans as it may not cover you completely while residing overseas.

Finding the best plan for your particular requirements can be very time consuming with the many options. Any local or group venture health insurance company representative will tell you how good the product is from his company. That's what he's paid to do, and it could in fact be the best plan available for you. The representative is not paid to explain that another company does the same thing (or better) at a cheaper cost, and he's not paid to promote his competitors' products.

Consider Costs

Good, comprehensive medical insurance is not cheap, nor is emergency medical evacuation, so most people will take cost into account when making their decision on medical insurance coverage. It is important to find out all your options from an unbiased source, which could be an agency or broker, who can assist you to make the choice based upon your individual or company requirements.

refferences: http://www.expat.or.id/medical/medicalinsurance.html

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