Prevention of Cervical Cancer

Cervical cancer is cancer that occurs in the cervical region is the entrance to the uterus, located between the womb (uterus) with a hole intercourse (vaginal).

Almost all cervical cancers (99.7%) are directly related to previous infection by one or more types of HPV (Human Papilloma Virus) that are oncogenic (Judson 1992; Walboomers et al, 1999). Infection occurs after active female sexual activity, usually begins after the age of adolescents (between the ages of 20-30 years) and progression to cervical cancer usually occurs after 10-20 years later, although in rare cases, some types of early lesions can be cancer in a short time within 1-2 years.

It is estimated about 10% of women infected with HPV will have pre-cancerous changes in cervical connective tissue (dysplasia) and 8% of women who undergo pre-cancerous changes will be early cancer confined to the outer layer cells of the cervix (CIS / Carcinoma In Situ), and about 20% of women who experienced CIS will develop into malignant cancer (invasive cancer) when pre-cancerous lesions or CIS are not detected and treated.

Which is a risk factor for cervical Cancer include:

1. Sexual activity (age<20 years)
2. Multiple sexual partners
3. Exposure to IMS
4. Mother or sister suffering from cervical cancer
5. An abnormal PAP test earlier
6. Decreased immunity, which caused suffering from HIV / AIDS or chronic use of corticosteroids (asthma and lupus).

Clinical Symptoms of Cervical Cancer at an early stage is much less pronounced, but the following signs can rely on in determining suspicion of cervical cancer:

1. Pain during intercourse,
2. Removing a little blood after intercourse,
3. Excessive bleeding during menstruation (hypermenorrhea),
4. Bleeding outside the menstrual cycle (Polymenorrhea),
5. Abnormal vaginal discharge (color is not clear, odor or itching),
6. At an advanced stage: no appetite, nausea, back pain, pain and swelling in the thigh, drastic weight loss, constipation, spontaneous bleeding after menopause, brittle bones easily and pelvic pain.

Prevention of cervical cancer can be divided into, as follows:

1. Primary prevention, carried out by administering a vaccine is the most effective way to prevent cervical cancer and other genital cancers. Each person needs to be immunized at an early age before they are sexually active. Control Risks is very important (especially the modifiable risk factor) in preventing the chances of developing cervical cancer (cervical cancer).
2. Secondary prevention, carried out by early detection of cervical precancerous lesions (as early as possible). Tests of cancer or pre-cancer is recommended for all women aged 30 to 50 years old through IVA test (Visual Inspection Acetic Acid). IVA test can be done at any time in the menstrual cycle, including during menstruation, during pregnancy and post-partum or post-abortion care. IVA test is very important for women who have a risk factor, especially in women suspected of exposure to STIs or HIV / AIDS.

IVA test can be performed in clinics that have the following facilities:

1. Desk Check
2. Sources of light / lamp
3. Bivalved speculum (Cusco or Graves)
4. Rack or container equipment.

The light must be strong enough so that the officer can see the end of the vagina where the cervix is. Examination can not be done if there is enough light to see the entire cervix. It is important also kept the light source are not too hot.

The materials required to perform the test IVA must be available on site, including:

1. Cotton swab sticks for
2. Check out new gloves or surgical gloves that have been in DTT
3. Spatula of wood and or condoms
4. The liquid solution of 3-5% Acetic Acid (white vinegar can be used)
5. 0.5% chlorine solution for decontamination of equipment and gloves
6. Notes form to record findings.

Acetic acid is the main ingredient of vinegar. It is recommended to use Acetic Acid with a concentration of 3-5%. Countries are caused no vinegar. Often sold in the market is a substitute for the real vinegar is acetic acid. If vinegar or acetic acid are not available pharmacist or local chemical supplier can dilute acetic acid solution using the formula:

Total Section (TB) Water = (% concentrate : % solution) - 1

Treatment and Follow-up, In most countries with limited resources, Cryotherapy either alone or combined with LEEP (performed at referral centers) is the best choice for outpatient care.

Advantages Cryotherapy:

1. Effective for small and medium sized lesions (85-95% cure rate)
2. Not expensive
3. Can be performed by personnel other than physicians
4. No need local anesthesia
5. No need of electricity
6. Few complications / side effects
7. It can be done during pregnancy.

Women who test positive IVA (SSK Acetowhite visible lesions), including women with pregnancies less than 20 weeks, should receive cryotherapy treatment, if the lesion:

1. Not suspected cancer
2. Cervical cover no more than 75%
3. Does not extend to the vaginal or cervical canal beyond cryoprob
4. Extends no more than 2 mm of diameter prob of cryotherapy including prob end.

If it does not meet the above criteria, the patient should be referred to a health facility is better able to do the inspection and action further therapy (chemotherapy, radiotherapy or surgery).

Cryotherapy can be done in a clinic that has the equipment and facilities as follows:

1. Examining table
2. Adequate light source
3. Speculum Duck (Cusco or Graves)
4. Tray or container equipment
5. Cryotherapy Unit
6. Supply of CO2 or NO2 regular.

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Relief efforts for patients with coronary heart disease

Heart is one of body organs which has a strong layer of muscles and it's function is pumping bloods to transfer oxygen and nutrition to all parts of body. Consequence of not apply healthy life styles like as: smoking, unbalance nutrients (obesity) and less physical activity (sports) can cause many dangerous of diseases one of all are coronary heart disease.

Coronary heart disease is a certain heart disease that is occurred by presence anomaly of coronary vessel. This anomaly of coronary vessel is the constriction blood vessel as consequence of blood vessel wall not flexible by over fat accumulation. The prime etiology of Coronary heart disease is over fat accumulation on wall in of artery coronary until occur constriction and can obstruct blood circulations.

Predisposition factors of Coronary heart disease like as: Less consume vegetables and fruits, Smoking habit, Less physical activity or sports, Hypertension, Blood cholesterol more than normal, Obesity, Stress emotion, Diabetes Mellitus, Genetics.

Clinical signs of Coronary heart disease, included of: Suppressed sense at chest like as struck down by heavy load, chest pain, heartburn sense; These senses can spread to all chests, left shoulder, left arm, back, distal neck and lower jaw; Feeling like be throttled or chest crowd; Duration of above signs about thirty minutes; Cold sweat, weakness, palpitation; Some time until coma; Heart attacks often occur at morning day.

Community’s actions to help patient with Acute Heart attack can do some procedures like as: Lie down the patient; Loose of clothes and belt; Calling a doctor or reference to hospital.

Medical treatment that can be done, among others: Isosorbide dinitrate 5 mg sublingually every 5 minutes (to maximum of 3); or Glyceryl trinitrate sublingually spray: 1 to 2 sprays (to maximum of 3 in 15 minutes); or Nifedipine 5 mg capsule (suck or chew) if intolerant of nitrates (warn about possible hypotension and unpleasant taste).

Precautions of Heart Disease that can be done, among other: Make balance nutrients by consume more vegetables and fruits, poor fat with limited salt and sugar consumptions; Don’t smoking. All of cigarettes can cause coronary heart disease; be avoiding the stress by always positive thinking, quiet and be controlled; Keep blood pressure normally by regularly control; and please do regularly sport or physical activity.

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Knowledge of Guillain-Barre Syndrome

Guillain-Barre Syndrome (GBS) is a rare disease, characterized by a weak state of the body loses sensitivity can usually complete recovery within weeks, months or years. GBS takes its name from two French scientists, Guillain and Barré, who found the two soldiers in the year 1916 wars who suffered paralysis and recovered after receiving medical treatment. This disease affects 25 per 1 million populations each year. Can be contracted at all age levels ranging from children to adults, is rarely found in the elderly. More often found in men. Not a hereditary disease, it cannot be transmitted through birth, not contracted from someone else who developed GBS. However, could arise a week to two weeks after intestinal or throat infection.

The initial symptoms include: feeling like a needle pierced a finger tip or a hand or foot numbness in parts of the body. Legs feel heavy and stiff or hardened, the arm felt weak and could not hand clutching or play something well (unlock, open cans, etc.)

Early symptoms can disappear within a few weeks, the patient usually does not feel the need to care or hard to explain to the team doctor for further treatment because the symptoms will disappear at the time of inspection.

The next stage while the symptoms began to appear difficulties means, for example: hard-stepping foot, arm became weak pain, and then doctors found the nerve reflexes have lost the function of the arm.

Patients usually feel an acute pain at the time of GBS. Especially occur on the regions of the spine and arms and legs. But there are also patients who did not complain of pain which means that although they experienced severe paralysis. The pain comes from swelling of the affected nerve, or from a temporary loss of muscle energy supply, or from sitting or sleeping position of the patients who have difficulty to move or turn his body into a comfortable position. To combat the pain doctor will give painkillers and nurses will provide therapies to relocate parts of the body is attacked by specific therapies. The pain may come and go and it was very normal for people with GBS.

These diseases arise from inflammation of peripheral nerves, resulting in the absence of messages from the brain to make movements that can be accepted by the affected muscles.

Because many of the affected nerves, including of nerves immune system is causing our body's immune system would be chaotic. Without orders it would produce fluid immune system on places unwanted can attack the peripheral nerves.

With treatment the immune system will stop attacking the nervous and working properly.
GBS diagnosis obtained from history and medical test results of physical and laboratory tests. From the history of the disease, the usual medicine drunk, addicted to alcohol, infections have ever suffered, then tick bite doctor will conclude whether the patients included in the list of GBS patients. Do not forget the history of the disease the patient had suffered and the families of patients such as diabetes mellitus, diet done, everything will be checked carefully to the doctor can make a verdict whether patients affected by GBS or other diseases.

Patients suspected of suffering from GBS are required to test: 1) full blood, 2) Lumbar Puncture, 3) EMG (electromyogram). Order, the first test will be done and then test the two if the first test of GBS was not detected, and the next.

As the rotation time, the signs of the weakening of the nerves would appear more severe in 4 to 6 weeks. Some patients weakened in relatively short time until the point of total paralysis in a matter of days, but this situation is very rare.

Patients then entered the stage of helplessness in a few days. At this time the patient is usually advised to rest in the hospital total. Although conditions in the weak state of the patient's highly recommended to always moving the body parts are affected to avoid stiff muscles. Physiotherapy expert usually will be very necessary to train the patient with specific therapies and will provide directives to the patient's family and friends train ways GBS patients.

Patients usually would weaken within a few weeks, so from that intensive treatment is needed in the stages where GBS began detected. In accordance with the stage and level of disability the patient then the doctor will determine what patient needs care in the ICU or not.

Approximately 25% of patients will have difficulty GBS: breathing, swallowing ability and hard to cough. In above conditions, usually the patient will be given to the aid of a ventilator to help breathing.

After some time, numbness conditions will gradually improve. Patients must remain wary because only 80% of patients can recover fully, depending on the severity of the patient could walk within weeks or years. But statistics prove that the average patient will get better within 3 to 6 months. Patients will leave severe disabilities in the most severely afflicted, need therapy long enough to restore the functions of paralyzed muscles by GBS. Usually takes a maximum of 4 years.

It’s medications only a kind of GAMAMUNE (Imuno globuline) is worth about 5 hundred dollars / bottle, patients will need this medicine is calculated from body weight, to the size of an adult per day spent 5 bottles for 4 - 5 days of treatment. The way the provision made through intravenous infusion assembly.

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Virus Influenza and Imboost Force

Virus Influenza included in family of orthomyxoviridae, and it is divided become type A Influenza, type B Influenza, type C Influenza and thogotovirus. Thogotovirus is constituting tick borne virus or virus which it's transmission pass through of ticks. Virus Influenza type C does not cause appear a serious disease. Virus Influenza type B sometime cause appear regional epidemic on human populations. And Virus Influenza type A has related to fowl and it can cause pandemic on human populations, like as Avian Influenza (H5N1) and Swine Flu (H1N1).

Virus Influenza type A be categorized by base of variation structure of two glycoprotein: hemagglutinin (H) and neuraminidase (N) on virus surface. The function of hemagglutinin (H) is sticking the virus influenza to sialic acid receptor on human cell surface. After bundled, cell flu enter in host cell, and then RNA virus enter to nucleus cell, and RNA virus makes the particles of new virus. Whereas function of neuraminidase (N)is simple but important, i.e. make possible the new virus be shaped to separate from cell host and can free walk from one cell to other cell pass through respiratory tract.

As the problem here that virus influenza is RNA - based virus (virus which has RNA only and has not DNA). The function of RNA is for virus replication, whereas function of DNA is assuring the structure of new virus same precisely with it's origin. That mean if present the mistake in replication process, DNA can do correction or control. Virus Influenza because has RNA only often do some mistakes during replication. That can cause virus influenza often experience mutation. As the consequence specific antibody cannot recognize this new virus, until next occur pandemic. Like as what we know, antibodies need early recognize virus before killing off it. Thus if present new virus which unknown, the antibodies cannot kill it.

Of that cause, body immune system which the first time has function to kill off new virus as consequence of mutation is non specific body immune system like as IMBOOST FORCE, because non specific body immune system will kill off new virus directly without need to know the kind of that new virus. Imboost Force has spectacular power to against virus influenza because it has three active contents like as Black Elderberry 400 mg, Echinacea 250 mg, and Zinc Picolinate 10 mg.

Black Elderberry 400 mg with work mecanism: prevent virus replication by neutralize enzym neuraminidase virus and hamper activation of hemagglutinin virus; modulate body immune system by increase sitokin production (IL-1, IL-6, IL-8 and TNF alfa)

Echinacea 250 mg with work mecanism: modulate body immune system by increase phagocytosis macrophage, increase interferon, inteleukin and TNF alfa production; prevent infection transmission; as antiinflammatory; and accelerate wound healing.

Zinc Picolinate 10 mg with work mecanism: hamper virus replication; ICAM-1 inhibitor.

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Precaution of Swine Flu Transmission

Recently the world is scared by the happening of disease which is called “Swine Flu” on human. Swine Flu case on human the first time is found on March until beginning of April 2009 at south California area near of San Antonio, Texas. At mid of April 2009 happened outbreak in Mexico and USA. In Mexico about 1.500 person are infected by Swine Flu virus, 60 person were dead as consequence of be attacked by Swine Flu virus. Data on April 27, 2009 indicate that had happened incident cases distribution like as in California 7 cases, New York City 28 cases, Ohio 1 case and Texas 2 cases.

This condition will be able to spread to all worlds quickly as pandemic of fast movement of peoples from one state to other states, if haven’t been committed anticipation steps to prevent its transmission. It can be started by recognizing what is the swine flu and what can we do to prevent it.

Swine Flu is constitute an acute infectious disease of respiratory tract which be caused by type A of influenza virus, serotype H1N1. Main reservoir of this virus is swine; it could transmit from animal to human and from human to human, but it unknown how easy it’s transmission from human to human exactly.

The problems in facing this Swine Flu are:
This virus can attack human,
If a person suffers Swine Flu, the symptoms fast come to deteriorate.
High death rate,
It’s transmission very fast,
It can spread wide world and global,
It be transmitted by animal (swine) where it nearest with human life,
So it difficult to be prevented,

Incubation period of Swine Flu disease is 1 – 7 days, with clinical signs like common cold symptoms with clinical manifestation:
Higher fever,
Sore throat
Body pain,
Headache,
Weak,
Quickly breathing / breathing disorder,
Confusion,
Vomiting.

Swine Flu transmission same like the transmission which happened on seasonally:
It can transmit from human to human pass through of cough and sneeze,
Spreading of it happens by material contact or anything that is infected by H1N1 virus.

Terminology that be related in framework of vigilance and tackling effort of Swine Flu Infection:
That be proposed of contact is treat, live together in a home or direct relating with breathing secret or body fluid from probable case or confirms swine flu H1N1 / Flu Mexico.
That be proposed of transmission area is area or state that it has one or more confirm cases which be established by WHO.

Steps in anticipation and prevention framework:
Keep on guard against of all cases with influenza sign (Influenza like Illness) and immediately investigate the contact history with animal (swine) and or contact with peoples whose new come from the country which being infected by Swine Flu.
Increase surveillance activity toward Influenza like Illness and pneumonia, so report the case with swine flu suspect to regency health department.
Increase coordination with move across of program and sector, so information spreading is related with transmission of swine flu disease.
Community education about Life behavior with clean and healthy lifestyle like as wash hand by detergent antiseptic, so application of cough and sneeze ethics with close nose and mouth by handkerchief or Kleenex.
Use self protection tool, if we present in transmission area of swine flu.

Therapy of swine flu:
Symptomatic therapy and giving Oseltamivir, with distribution dose as below:
For adult and children > 13 years; twice 75 mg per day during 5 days,
For children <> 15 – 23 kg: 45 mg, twice a day; > 23 – 40 kg: 60 mg, twice a day; > 40 kg: 75 mg, twice a day.

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Combating of Dengue Hemorrhagic Fever Effectively

The accurate methods to combat Dengue Hemorrhagic Fever scourge are avoiding mosquito bite and fight against the mosquito nest. Because the mosquito spreader of Dengue Hemorrhagic Fever (DHF) be present our around, then the active mosquito nest fighting must be enforced by community by watching the cleaning house and environment continuously. DHF be spread pass through of mosquito bite of Aedes Aegypti and or Aedes Albopictus. These mosquitoes bite at daylight by increasing bite activity two hours after sunrise and some hours before sunset. DHF is not spread directly from person to person.

After a people is bitten by Aedes Aegypti or Aedes Albopictus mosquito approximately 3-14 days later (generally 4-7 days) a people will indicate the symptoms or signs of DHF like as: Fever with body temperature more than 38 degree Celsius, Weakness, Appear red spot on the body, Nervous, feeling cool on end of hand and foot, Stomach-ache and vomiting, Its can be followed by bleeding like nose bleeding and bowel bleeding, and Thrombocytopenia.

To help a person who already indicate the symptom of Dengue Hemorrhagic Fever disease can be did the action like: please give drinks cooked waters (tea or fruit) more and more, cooling compress on the body of sufferer, and please give medicine to decease hot of body and if a sufferer has convulsion history give anti convulsion medicine too.

Until at this time, there is not medicine or vaccine to prevent DHF yet. The potent methods to prevent this disease are avoiding mosquito bite and mosquito nest fighting. Mosquito nest fighting can be enforced to break reproduction chain of Aedes mosquito by some actions: Cleaning the water reservoir and place where the waters is filled minimal once a week like bath container, large water jar, flower vase, bird beverage place, and others. For big container by sow with abate powders; Dense cover all places where can intercept and retain falling rain water; graving ex-things like as: ex-ban, bottle ex-beverage, plastic that can intercept and retain falling rain water; plus other methods like substitution the water of flower vase once a week, repairing the water flow and gutter those have damaged, covering holes on a cut of bamboo / wood by earth.

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