Are You Drug Addiction?

Drug addiction can be take place to every body who use whether to legal or illegal drug. It,s makes anybody use drug and drug again to meet his or her addiction of one drug addiction cause. When you stop taking it, you may have unpleasant physical reactions.

Many drug group such as narcotics and cocaine are cause drug addiction then are other drugs. The addiction drugs people could affect to himself or herself to doing negative social behaviour such as embarrassment, depressions, and other negative social behaviour can be do.
Breaking drug addiction is difficult, but not impossible. You may need support from your family, relatives, close friends, doctor and other who have been stopped from drug addiction . It,ll be helpful to you. If you have high motivation to stop it, certain you will be succes to quiet from it, and you will enjoy from your life again. Freedom yourself from these drgus.

What are signs and symptoms of drug addiction?
Before we go to sign and symptom of drug addiction, better first if we know, what are group of drug cause adiiction . These are drugs to which you can become addicted is wide, including:

Canabis compound: These compound are found in marijuana and hashish

Central nervous System Depressant: Barbiturates and benzodiazepines are examples of central nervous system depressant. Phenobarbital, amobarbital (Amytal) and secobarbital (Seconal) are examples are barbiturates. Benzodiazepines include tranquilizers such as Diazepam (Valium), Alprazolam (Xanax), Oxazepam (Serax), Lorazepam (Ativan), Clonazepam (Klonopin)and Chlordiazepoxide (Librium).

Central Nervous system stimulants : This class of drugs includeamphetamines, methaphentamines,cocaine, and methylphenidate (Ritalin).

Designer Drugs: Synthetic compounds such as Ectasy, which has both amphetamine- like and halluginogenic effects, are include in this category.

Hallucinogens: Incluse the group are LSD, phencyclidine (PCP) and ketamine (special K) are examples are halucinogens. Hallucinogens effect incluceed in this category.

Inhalant: Glue, paint, solvent and nitrious oxide can all be used as inhalant drugs.

Opioids: Opioids are narcotic, painkilling drugs product naturally from opium or mada shyntetically. This class of drugs including heroin, morphine,codeine, methadone and oxycodone (Oxycontin).

General signs and Symptoms
Addiction to any drug may include these general characteristics:

Feeling that you need the drug regulary and in some cases, many times a day.

Making certain that you maintain supply of the drug,

Failling repeatetedly in your attemps to stop using drug

Doing thing to obtain the drug that you normally wouldn't do, such as stealing

Feeling that you need the drug to deal your problems.

Driving or doing other activities that place you and others at risk of physical harm when you're under the influence of the drug.

The particular signs and symptoms of drug use dependence vary depending on the type of the drug.
Canabis compound signs and symptoms:

A sense of relaxtion and happiness.

A heightened sense of visual, auiditory, and taste perception

Poor memory

Increase blood pressure and heart rate

Red eyes

Decrease coordination

Difficulty concrentration

Increase appetite

Slowed reaction time

Paranoid thinking

Central nervous system depressant: Signs and symptoms:

Drowsiness

Slurred speech

Lack of coordination

Memory impairment

Confusion

Slowed breathing and decrease blood pressure

Dizziness

Depression

Central nervous system stimulant: Signs and symptoms

Euphoria

Decrease appetite

Rapid speech

Irritability

Restlesness

Depression as the drug wears off

Nasal congestion and damage to the mocous membrane of the nose in users who snort drug

Imsomnia

Weight loss

Increase heart rate, blood pressure and temperature

Paranoida

Designer drug: Signs and symptoms:
Sign and symptoms of using designer drugs vary depending on the drug. You might be able to tell that a family, member of friend is using or abusing a drug base on the physical and behavioural signs and symptoms assosiated with the drug. Ectasy produces a mild hallucinogenic effect and a feeling of euphoria. It also cause an increase heart rate, overheating, high blood pressure, kidney and liver toxicity and memory promlems.

Hallucinogen: Signs and symptoms:
Use of hallucinogens produce s different signs and symptoms depending on the drug. The most commond hallucinogens are LSD, PCP, and ketamine, a so-called"club drug".

Signs and symptoms of LSD use include:

Hallucinations

Greatly impaired perception of reality, for example, interpretating input from one of your sense as another,such hearing colors.

Permanent mental changes in perception

Rapid heart rate

High blood pressure

Tremors

Flashbacks, a re-experince of the hallucinations, even years later

Signs and symptoms of PCP use include:

Hallucination

Euphoria

Delusions

Panic

Loss of appetite

Depression

Agresive, possible violent behaviour

Signs and Symptoms of ketamine use include:

Increase heart rate

Nausea and vomiting

Numbness

Impaired motor funtion

Loss of memory

Inhalants: Signs and Symptoms:
The sign and symptom of inhalant use is vary depending on what subtance is inhaled. Some commonly inhaled subtance include glue, paint thinners, corretion fluid, felt tip marker fluid, gasoline, cleaning fluid,and household aerosol products. Whwn inhaled these products can cause brief intoxicication and a decreased feeling of inhibition. Long term use may cause seizures and damage to the brain, liver,and kidneys. Inhalants use can also cause death

Opioids: Signs and symptoms:

Reduce sense of pain

Sedation

Depression

Confusion

Constipation

Slowed breathing

Needle mark (if injection drugs)

Source of news from CNN.com

Obat Kuat Dan Minuman Stimulan, Amankah?

Oh, emang kuat sih, ya, itulah penggalan kata yang seringkali dipergunakan oleh beberapa iklan obat kuat dan minuman stimulant seperti stimulant seksual, sport, meningkatkan daya tahan, menjaga agar tidak cepat lelah dan mengantuk, dan masih banyak lagi jenis lainya yang tidak jelas kemanfaatanya serta tidak adanya rekomendasi dari Badan Pengawas Obat Dan Makanan (BPOM). Terkadang memang kita tergoda dengan pengiklanan yang begitu hebat melalui berbagai media serta bintang iklan yang mempesona sehingga karena kita tertarik atau sekedar mencobanya akhirnya tergoda juga untuk membeli, tanpa pernah kita mempertimbangkan akibat samping (side effect) dari reaksi obat tersebut terhadap kesehatan diri kita. Bagi produsen, mereka terkadang tidak memperhatikan tentang effect negative dari obat-obatan yang mereka produksi, yang terpenting adalah omset penjualan meningkat dan

untunglah yang mereka inginkan, tapi apakah mempunyai keuntungan yang signifikan buat kita juga.

Itulah pertanyaan yang seharusnya kita pertimbangkan sebelum mempertimbangkan untuk membelinya. Hal yang perlu kita perhatikan adalah, telitilah oabat-oabatan penguat yang akan anda beli, apakah aman buat diri kita, apakah ada effect samping terhadap kita , apalagi bagi mereka yang mempunyai penyakit-penyakit kronik, seperti Jantung, Ginjal,Liver (hati),Diabetes,dll. Mempertimbangkan sebelum membeli adalah hal yang paling bijaksana, jangan percaya saja pada "IKLAN", atau si penjual obat, karena mereka sekedar penjual, dan terkadang tidak mau tahu dengan barang yang dijualnya. Periksalah apakah obat-obat kuat tersebut memang diijinka oleh PBOM, legal, atau belum jelas statusnya, kalau perlu tanyakan terhadap beberapa orang yang pernah memakainya, atau kalau ragu tanyakan pada dokter atau orang yang mengetahui tentang obat-obat kuat tersebut.

Selamat memilih obat kuat, teliti sebelum membeli, gunakan obat-obatan sesuai dengan fungsinya, jangan meminum obat-obat kuat yang melebihi takaran dosis hanya ingin meningkatkan vitalitas anda.

Gonore (GO)

Gonore (GO) adalah penyakit menular seksual (PMS), yang disebabkan oleh kuman yang bernama Neisseria Gonorrhoaea yang menginfeksi lapisan dalam uretra, leher rahim, rektum (usus bagian bawah), tenggorokan maupun bagian putih mata (Gonorhoaea Conjugtiva). Gonore bisa menyebar melalui aliran darah kebagian tubuh lainya ,terutama kulit dan persendian, pada wanita, gonore bisa naik ke saluran kelamin dan menginfeksi selaput didalam panggul sehingga menimbulkan nyeri panggul dan gangguan reproduksi.

Gejala

Pada pria, gejala ini biasanya timbul setelah 2-7 hari setelah infeksi yang didapat dari pasangan seksualnya yang menderita Gonore. Gejalanya berawal dari rasa tidak nyaman pada daerah saluran kencing yang beberapa jam kemudian di ikuti rasa nyeri ketika berkemih yang disertai dengan keluarnya nanah . Penderita sering berkemih dan dan merasakan desakan berkemih, yang semakin memburuk ketika penyakit ini menjalar kebagian saluran kencing atas menyebabkan lubang penis tampak merah dan membengkak.

Pada wanita, gejala awal dapat timbul dalam waktu 7-21 hari setelah infeksi. Pada wanita biasanya tidak menunjukkan gejala selama beberapa minggu atau bulan, dan diketahui menderita penyakit ini ketika pasangan seksualnya tertular. Jika timbul gejala, biasanya bersifat lebih ringan, namun demikian beberapa penderita menunjukkan gejala yang berat, seperti desakan untuk berkemih, nyeri ketika buang air kecil, keluarnya cairan putih dari vagina dan demam.

Penjalaran infeksi ini bisa mencapai leher rahim, rahim, saluran telur, indung telur, uretra(saluran kencing bawah) dan rektum yang menyebabkan nyeri pinggul dalam atau nyeri ketika melakukan hubungan seksual. Pada wanita dan pria homoseksual yang melakukan hubungan seksual melalui dubur bisa menderita gonore pada usus bagian bawah. Melakukan oral sex dengan seorang penderita gonore juga dapat menyebabkan tertularnya gonore pada tenggorokan (faringitis gonocokal), yang terkadang tidak menunjukkan gejala, dan kadang gejalanya mirip seperti radang tenggorokan yang menyebabkan gangguan menelan. Gonore juga dapat menular ke mata jika cairang yang terinfeksi mengenai mata yang biasanya disebut dengan konjugtivbitis gonore. Bayi yang baru lahirpun dapat tertular gonore dari ibunya yang terjadi selama proses persalinan, yang menyebabkan pembengkkan kelopak matanya dan dari matanya mengeluarkan nanah.

Komplikasi Gonore

Biasanya komplikasi yang terjadi bisa mengenai persendian, yang mengakibatkan pembengkakan pada sendi dan menyebabkan nyeri sendi. Infeksi melaui aliran darah juga dapat menyebabkan bintik-bintik merah yang berisi nanah dikulit,demam rsa tidak enak pada badan atau nyeri dibeberapa persendian yang berpindah-pindah dari satu sendi ke sendi yang lainya.

Komplikasi juga dapat menyebar ke jantung yang menyebabkan endokarditis (peradangan pada jantung), serta dapat pula menginfeksi pada lapisan hati (perihepatitis) yang menyebabkan nyeri seperti penyakit kandung empedu.

Diagnosa

Untuk menentuka diagnosa dapat dilakukan dengan anamnesa melalui informasi yang diberitahukan oleh penderita, apakah penderita dalam beberapa hari ini melakukan kontak sexsual dengan orang lain. Data penunjang juga biasanya dibutuhkan seperti pemeriksaan nanah penderita untuk memastikan jenis kuman yang dilakukan melalui pembiakan kuman.

Pengobatan

Gonore dapat diobati dengan suntikan dosis tunggal setrifiakson yang diberikan secara deep intramuskuler (melaui otot), atau dapat juga mengunakan obat-obatan oral lainya selama 1 minggu, biasanya obat yang dipilih doksisiklin.

PENCEGAHAN

Mengunakan kondom dan menghindari oral seksual dengan pasangan yang tidak aman adalah cara sederhana yang dapat meminimalkan tertularnya penyakit ini, namun demikian cara pencegahan yang paling baik adalah jangan melakukan hubungan seksual dengan pasangan yang tidak resmi, MENCEGAH LEBIH BAIK DARI PADA MENGOBATI

Myocardial Infacrtion

Myocardial infarction reffers to the process by which myocardial tissue is destroyed in regions of the heart that are deprived of their blood supply after closure of the coronary artery or one of its branches, either by a trhombus or through obtruction of the vessel lumen by atherosclerosis. Arterial hypertention and diabetes are also underlying causes.

Preventive Measures
Epidemiological studies and observations by cardiologists reveal that there are coronary risk factors that tend to make an individual more prone to develope coronary heart disease. This information is important in the prevention of premature coronary heart disease as well as forestalling recurring episodes in patients with known atherosclerotic disease.
These factors include as a following:

Hypercholesterolemia, elevated blood lipid

Hypertension

Elevated Blood Glucose (Diabetes Mellitus)

Obwsity

Habitual dietary intake of excessive calories, total fats, cholesterol, carbohydrates and salt.

Physical inactivity

CAD

Thrombus formation

Cigarette smoking

Positive family history

Symptom and Sign

The patient with myocardial infarction is usually male, is over 40 and has arterosclerosis of coronary vessel and often arterial hypertention. However, the patient my be in his early 30's or even 20's. In typical patient, the pain start suddenly, usually over the lower sternal region and upper abdomen, and is continous more than 30 minutes with the pain character such as crushing, vise-like, griping, but it may increase steadily in severity until it become almost unbeareable.
It is heavy vise-like pain, which may radiate to the shoulders and down the arms, usually in the left arm. Unlike the pain of true angina, it become spontaneously (not following effort, emotional upset, etc), persist for hour of days, and is releived neither by rest nor by nitrites. The palse may become very rapid, irregular, and feeble, even imperceptible , and the heart may dilate. Gallp rhythm (accentualed third heart sound making the three heart sound similar to those of galloping horse) often developes.
The person with a severe occlusion may be in shock , his color is ashen, he break out in clammy sweat, vomiting is commond. In a few hours his temperature rises, blood presure falls to an unusually low point, the leucocyte count rises to 15,000 or 20,000 cu.mm.Serum enzymes are elevated and can be correlated with the patien's clinical corse. The creatinine phosphokinase (CPK) may rise 5 to 10 times or more and is especialy diagnostic for heart muscle damage. Changes may be seen in the electrocardiogram within 2 to 12 hours (but may take as long as 72 to 96 hours). When ECG change as eleveted S-T segment and inverted T waves confim that an acute myocardial infarction. Even the ECG is normal, elevation of serum enzymes reveal that caution is indicated in the handling of the patient.
Medical and Nursing management
The most critical period of the patient with myocardial infarction is durinh the first 48 hours following the attack. Cardiogenic shock, ventricular fibrillatio, and cardiac arrest are common cause of sudden deaths during this time period , therefore nurse care must be do as a following actions:

1. Acute condition, place patient in Ssemi Fowler Position, bed rest
2. Nasal O2 to reverse as much ischemia as possible
3. Establish a patient IV line
Provide pain relief, morphine sulfate IV(given IV because after in infarction there is poor peripheral perfusion and because serum enzymes would be affected by IM injection) as doctor orderMonitor ECG and haemodinamic procedures.
4. Administer antiarrhythmias as order.
5. Perform complete lung/cardiovasculer assesment
6. Monitor urine output and report output of less than 30 ml/hour; indicates decrease cardiac output.
7. Maintain full liquid diet with gradual increase to soft; low sodium.
8. Maintain quiet environment.
9. Administer stool softeners as ordered to fasilitate bowel evacuation and prevent straining.
10. Relieve associate with coronary care unit (CCU) environnment.
11. Administer anticoagulants as order>
12. Administer thrombolyitics (tissue -type plasminogen activator or t-pa and streptokinase) and monitor for side effects; bleeding.

If the doctor incharge permitted to the patient for discharge, the nurse must be take responsible as a below:

1. Teach about effects of MI, healing proces, and treatment regimen
2. Medication regimen including name, purpose, schedule, dosage, side effects.
3. Risk factors, with necessary lifestyle modification
4. Dietary restrictions; low sodium; cholesterol; avoidance of caffeine
5. Importance of participation in a progressive activity program
6. Resumption of sexsual activity according to physician's orders(usually 4-6 weeks)
7. Need to report the following symptom: increased persistent chest pain, dypsnea, weakness, fatigue, persisten palpitations, light-headedness
8. Enrollment of client in cardiac rehabilitation program

Tip-Tip Membeli Obat Bebas

Manusia hampir didalam hidupnya pernah menderita sakit, baik sekedar penyakit ringan maupun kronik yang harus memerlukan perawatan medis di Rumah Sakit, tetapi jika kita hanya menderita sakit ringan seperti batuk, pilek, diare ringan, demam ringan, sakit kepala ringan terkadang kita mengatasinya dengan membeli obat-obatan di toko-toko obat maupun di warung-warung obat tertentu yang tentunya dapat kita beli tanpa resep dokter atau biasanya di sebut sebagai obat bebas. Dimana obat bebas ini ada dua jenis yaitu obat bebas yang mana kemasanya ditandai dengan lingkaran hitam dengan warna hijau didalamnya, sedangkan obat bebas terbatas ditandai dengan lingkaran hitam dengan tanda biru didalamnya.

Bagaimanakah Cara-cara memilih obat bebas utuk penyakit-penyakit yang yang kita anggap ringan tersebut?
Memilih obat bebas memang tergantung kita dan kebiasaan atau kecocokan obat-obatan berdasarkan pengalaman yang pernah kita alami karena cocok dengan penyakit yang pernah diderita sebelumnya, namun dengan tumbuhnya perusahaan-perusaan Farmasi menjadikan macam jenis obat berkembang pesat baik jenis maupun kemesan obat. Hal ini terkadang mempersulit kita dalam memilih jenis obat bebas yang sesuai dengan tanda dan gejala, penyakit yang sedang kita derita, misalnya kita menderita batuk, tetapi jenis batuk kita tidak berdahak, karena ketidaktahuan kita akhirnya asal memilih obat batuk yang sembarangan ditambah pedagang obatnya juga tidak mengerti maka kesembuhan yang kita harapkan terkadang malah menyebabkan sakit batuk kita bertambah parah, Lalu bagaimanakah cara memilih obat bebas yang benar?
Dibawah ini ada beberapa tip-tip cara memilih obat bebas yang perlu anda ketahui diantaranya sebagai berikut:
Perhatikan Label
Setiap obat bebas pasti dikemas dengan label, dimana label tersebut memuat beberapa petunjuk seperti:

1. Nama Produk: Nama produk ini umunya berkaitan dengan merek
2. Bahan Aktif: Adalah bahan yang berkasiat dalam sediaan obat
3. Golongan: merupakan kategori produk seperti obat batuk, antihistamin (anti allergi), antipiretik(Penurun Panas),Antitusif (pereda batuk),dll.
4. Kegunaan: terhadap gejala atau penyakit yang akan diobati.
5. Peringatan: Perhatikan kapan boleh diminum, atau kapan harus dihentikan, kapan harus ke dokter, dan apa efek sampingnya, kadang-kadang jenis obat batuk mengandung antihistamin yang menyebabkan kantuk, maka hati-hati atau jangan diminum kalau anda sedang menjalankan kendaraan karena akan membahayakan anda dalam mengendarai kendaraan
6. Aturan pemakaian: berapa banyak takaran pengunaan,atau berapa tablet dalam sehari apakah 3X1/hari, 2X1/hari, dst, bagaimana cara pengunaan, apakah diminum sebelum makan,setelah makan atau bersama dengan makan, berapa lama obat harus diminum, apakah 3 hari,4 hari dst.
Informasi Lain : menyangkut cara penyimpanan, perhatikan cara penyimpanan obat gar tidak rusak, apakah harus disimpan dibawah suhu 30 derajad Celcius,atau harus disimpan didalam kulkas, atau bisa disimpan di udara bebas.Kedaluarsa: Hal ini sangat penting, jangan asal minum obat tanpa melihat masa kedaluarsa ( expire date) dari obat tersebut untuk menghindari ketidakefektifan obat maupun keracunan obat
7. Bahan Tambahan: Adalah bahan yang ditambahkan sebagai pengikat, pewarna, penambah rasa atau aroma.

Interaksi Obat.

Obat merupakan bahan kimia yang memungkinkan terjadinya interaksi bila tercampur dengan bahan kimia lain seperti obat-obatan, makanan maupun minuman. Interaksi juga dapat terjadi juga dengan berbagai jenis penyakit seperti Hipertensi, jantung, Diabetes, Ginjal, dll, oleh karena itu perhatikan pada saat anda membeli obat apakan obat bebas yang anda akan minum memiliki kontraindikasi dengan penyakit yang telah anda derita seperti Diabetes, Hipertensi, dll.

Dibawah ini ada beberapa petunjuk peringatan terhadap obat bebas umum yang harus dipakai:

Hindari alkohol jika mengunakan antihistamin,obat batuk yang mengandung dextromethorpan

Jangan gunakan pencahar jika lambung terasa nyeri, mual atau muntah.

Tanpa petunjuk dokter, jangan mengunakan obat pelega hidung (Nose drip) jika anda sedang dalam pengobatan Hipertensi, karena akan bereaksi menyebabkan tekanan darah tinggi anda semakin tinggi, jika deperesi, atau jika anda menderita penyakit jantung, diabetees, tiroid, maupun menderita gangguan prostat, konsultasikan dengan dokter kalau memang anda harus mengunakanya

Kehamilan dan menyusui

Berhati-hatilah dalam mengkomsumsi obat pada sat anda sedang hamil, apalagi pada saat Trisemester pertama usia kehamilan, karena pada saat usia kehamilan tersebut kondisi rahim masih sangat rapuh dan janin masih daklam perkembangan yang masih lemah, karena obat yang anda konsumsi dapat menembus rahim sampai ke janin. Obat yang sangat aman untuk ibu hamil menjadi menjadi sangat berbahaya terhadap janin, maka bacalah petunjuk didalam kemasan obat apakah obat bebas tersebut boleh diminum ibu-ibu hamil, atau lebih baik konsultasikan dengan dokter anda jika anda ragu, jangan mengambil keputusan sendiri.

Meskipun kebanyakan obat dapat keluar melalui ASI dalam kandungan atau konsentrasi yang rendah, yang dapat berefek terhadap bayi, maka dalam masa menyusui, sebaiknyya berhati-hatilah juga, lebih baik konsultasikan dengan dokter kalau memang ibu menyusui harus mengunakan obat sehubungan dengan penyakitnya.
Hati-Hati Pengunaan Obat Bebas Buat Anak-Anak

Usia anak-anak berbeda denga dewasa maka, berhati-hatilah jika membeli obat bebas untuk anak-anak anda, perhatikan hal-hal sebagai berikut:

1. Bacalah label kemasan obat dengan teliti
2. Ketahui beda antara sendok makan dengan sendok teh
3. Hati-hati terhadap intruksi obat sebagai contoh jika pada label obat dinyatakan 2 sendok teh, lebih baik gunakan gunakan sendok takar yang yang dibawakan, bukan sendok teh yang ada yang biasa anda pakai. Demikian pula dengan sendok makan, tidak sama dengan 15 ml.
4. Jangan mencoba memperbanyak dosis jika anak terlihat sakit parah, lebih baik konsultasilah dengan dokter jika dosis yangs sesuai pemakaian ditakaran masih belum memberikan efek yang diharapkan
5. 
   

Waspadalah Terhadap Kemasan

Beberapa hal yang harus anda perhatikan sebelum membeli obat:

Lihatlah kemasan maupun segel, apakah masih terlihat baik, kalau sudah rusak, segel terbuka lebih baik jangan dibeli

Periksalah apakah kemasan luar sama dengan kemasan didalamnya

Jangan membeli obat-obatan yang benar-benar anda tidak tahu cara mengunakanya

Jangan hanya percaya terhadap penjual obat tentang khasiat obat,karena penjual obat terkadang juga tidak peduli dengan manfaat obat itu sendiri, mereka hanya berpikir yang penting obatnya terjual

Jangan membeli obat-obatan yang telah berubah warnanyaLihatlah tanggal expire dari penggunaan obat, hal ini sangat penting, perhatikan sekali lagi tanggal expirenya sebelum anda bener-benar membelinya, dan jangan pernah beralasan membeli obat yang sudah expire dengan alasan harga yang murah
Untuk tambahan informasi anda dapat juga membaca artikel di SINI

Health Insurance

Why We Need Health Insurance?

Live is not always healthy, so we have to keep our healthy against many kind of diseases, but some time even we have protection ourself, we still getting sick. The disability or disease are health problem that we meet unexpected, unpredictable, they can come to us any time, how you will prepare anything to counter your health problem, no everybody ready to pay Hospital charge if the health problem taking place, Therefore we need Health Insurance to cover our healthy in order to protected our body from the illness.
How To Choose Health Insurance?
Before we are decided one Health Insurance that will be cover, we have to understanding about which Health Insurance well, reliable and what it covers. You may ask to insurance representative to explain about what benefit insurance for, and how to claim when customer getting problem, how long time must we reported to company, and many inquiry around Health Insurance. You can also ask to any customer that have been joined with Health Insurance so you can share experience which they have, because several Health Insurance some time is not reliable and have not high credibility, therefore looking Understanding about Health Insurance background is better than choose ones in order to avoid problem in the future.

Prostate Cancer

What is the prostate?

The prostate is a small gland that only men have. It is normally about the size of a walnut. The prostate is located underneath the bladder and in front of the rectum. Because the prostate is close to the rectum, it can be felt by a doctor during a digital rectal exam (the part of a physical where the doctor inserts a gloved, lubricated finger into a man's anus). The prostate makes and stores fluid that is part of semen, and this fluid is released from a man's penis during ejaculation. The prostate is signaled to do its job by the male hormone testosterone, which can influence the behavior of the prostate gland and prostate cancer. Nerves to the penis that are important in producing and maintaining an erection run very close to the prostate. The prostate completely encircles the tube that carriers urine from the bladder to the penis, called the urethra.
If the prostate enlarges, it can block the flow of urine from the bladder making it difficult for a man to urinate.
What is prostate cancer?
Prostate cancer happens when cells in the prostate begin to grow out of control and can then invade nearby tissues or spread throughout the body. Large collections of this out of control tissue are called tumors. However, some tumors are not really cancer because they cannot spread or threaten someone's life. These are called benign tumors. The tumors that can spread throughout the body or invade nearby tissues are considered cancer and are called malignant tumors. Usually, prostate cancer is very slow growing. However, sometimes it will grow quickly and spread to nearby lymph nodes. Lymph nodes are small, pea-sized pieces of tissue that filter and clean lymph, a clear liquid waste product. If prostate cancer has spread to your lymph nodes when it is diagnosed, it means that there is higher chance that it has spread to other areas of the body.

Am I at risk for prostate cancer?
Every man over the age of 45 is at risk for prostate cancer. Although prostate cancer can occasionally strike younger men, the risk of getting prostate cancer increases with age and more than 70% of men diagnosed with prostate cancer are over the age of 65. Prostate cancer is the most common cancer that men get in the United States behind skin cancer. It is estimated that there will be 189,000 new cases of prostate cancer and 30,200 deaths from prostate cancer in the year 2002 in the United States.

Although there are several known risk factors for getting prostate cancer, no one knows exactly why one man gets it and another doesn't. Some of the most important risk factors for prostate cancer include age, ethnicity, genetics and diet. Age is generally considered the most important risk factor for prostate cancer. The incidence of prostate cancer rises quickly after the age of 60, and the majority of men will have some form of prostate cancer after the age of 80. One of the sayings about prostate cancer is that older men (over the age of 80) die with prostate cancer not from prostate cancer. This saying means that many older men have microscopic disease that doesn't shorten their life expectancy because the cancer takes a long time to grow and become clinically important. However, this saying is only a generalization; sometimes prostate cancer can grow quickly even in older patients.

Another important risk factor for prostate cancer is ethnicity. No one knows exactly why, but prostate cancer is more common in African-American and Latino men than Caucasian men. African-American men have a 1.6 fold higher chance of getting and dying from prostate cancer than Caucasian men. Asian and Native American men have the lowest chances of getting prostate cancer. Some doctors believe that genetic differences are important in explaining the different rates of prostate cancer between different ethnic groups; however, there is some evidence that differences in diets may be the cause. When Asian men move to Western countries like the United States, their chances of getting prostate cancer rise. Men who live in the United States and Northern Europe have the highest rates of prostate cancer, while men who live in South America, Central America, Africa, and Asia all have much lower chances of developing prostate cancer.
There is some evidence that a man's diet may affect his risk of developing prostate cancer. The most common dietary culprit implicated in raising prostate cancer risk is a high fat diet, particularly a diet high in animal fats. Also, a few studies have suggested that a diet low in vegetables causes an increased risk of prostate cancer. There are a few foods that have been implicated in decreasing prostate cancer risk: a diet high in tomatoes (lycopene) has been suggested as well as diet high in omega-3-fatty acids (oils found in fish like salmon and mackerel). Doctors and scientists aren't in full agreement as to the usefulness of eating these foods when in comes to decreasing prostate cancer risk. Diets high in selenium, vitamin D, and soy have all been suggested to decrease prostate cancer risk; but a these are currently under study and data from large trials is needed before firm recommendations can be given about their use for this purpose.
A family history of prostate cancer increases a man's chances of developing the disease. This increase shows itself when a man has either a father or brothers (or both) with prostate cancer, and is even greater when his relatives develop prostate cancer at a young age. A variety of different genetic factors are currently being researched. Variations and mutations in certain genes may be responsible for some increases in prostate cancer rates in families. Men who carry mutations in genes known as BRCA1 or BRCA2 (these are genes implicated in breast and ovarian cancer in women) may have a 2 to 5 fold increase in prostate cancer risk. Men with high levels of testosterone or a hormone known as IGF-1 (insulin-like growth factor 1) seem to be at a higher risk for developing prostate cancer as well.
How can I prevent prostate cancer?
Because prostate cancer is a common disease and often has a very slow growing course, there is a lot of interest in trying to prevent prostate cancer with drugs, foods, or nutrients. Even a compound that could slow the progression of the disease could potentially decrease mortality from it. Right now, the best way to try and prevent prostate cancer is to modify the risk factors for prostate cancer that you have control over. You may want to try to eat a low fat diet that is rich in fruits and vegetables. Although certain foods, vitamins and minerals have been suggested to decrease your chances for getting prostate cancer, doctors still need more data before any particular food or supplement can be endorsed for preventing prostate cancer. Currently, there are studies looking at selenium, lycopen, vitamin A and other retinoids, vitamin D, vitamin E, and soy for prostate cancer prevention.

There is also interest in preventing prostate cancer by using drugs. We know that hormones like testosterone can cause prostate cancers to grow and develop, so there are experiments looking at drugs that can decrease the levels of testosterone in the prostate to attempt to stop prostate cancer from forming and growing. Drugs like Flutamide and Finasteride work in this manner, and they are currently under investigation for prostate cancer prevention. Another way to decrease testosterone in the prostate is to decrease the total amount of testosterone in the body. Drugs that decrease total body testosterone have a whole host of undesirable side effects (drugs that do this are currently used to treat men who have already developed prostate cancer and will be discussed later in the treatment section), so they aren't nearly as good choices for prostate cancer prevention.

What screening tests are available?
Whether or not men should be screened for prostate cancer is an intensely debated issue. We know that prostate cancer usually grows very slowly, so intuitively it would make sense that we could reduce mortality from prostate cancer by picking it up early so it could be treated before it spreads. However, in order for a screening test to be fully embraced, we need to prove that picking up a disease early actually does help reduce the number of deaths. Right now, there is no good data showing that screening for prostate cancer reduces deaths from prostate cancer. There are currently very large trials on-going to see which populations of men will benefit most.

Currently, there are two methods that physicians use to screen for prostate cancer. One of them is called a digital rectal exam (DRE). A digital rectal exam is done in your primary care physician's office. Because your prostate is so close to your rectum, your doctor can feel it by inserting a gloved, lubricated finger into your anus. Your doctor can feel if there are lumps, asymmetries, or if your prostate is enlarged. A digital rectal exam is uncomfortable, but not painful. It is a useful test, but it is not perfect because some small cancers can be missed and only the bottom and sides of the prostate can be examined in this manner. Although it isn't a perfect test, it becomes more useful when it is combined with another test called a PSA.

A PSA (prostate specific antigen) test is a blood test that looks for a protein that the prostate makes. Normal prostate tissue makes a little bit of PSA, but prostate cancer usually makes much more. By checking to see if your PSA is elevated, your doctor can screen you for prostate cancer. The PSA test isn't perfect either, because some tumors won't elevate the PSA and some other processes (like benign prostatic hyperplasia and prostatitis) can cause it to be falsely elevated. However, the higher your PSA is, the more likely the elevation is caused by a prostate cancer. The cut-off that your doctor usually uses is 4.0 ng/ml, meaning that anything below 4.0 ng/ml is normal and anything above it is abnormal. If your PSA is elevated, or you have an abnormal digital rectal exam, then you need to get further evaluation; however, this doesn't necessarily mean that you have prostate cancer. The only way to know for sure whether or not you have cancer is to get a sample of your prostate from a biopsy.

Both a digital rectal exam and a PSA are simple, non-invasive tests. Most physicians recommend screening for prostate cancer with these tests in men with a life expectance of 10 years or more. However, some doctors don't think screening for prostate cancer is worth doing. One of the downsides is that you may go through an extensive workup and treatment for a disease that never would have shortened your life. We know that some prostate cancers are very slow growing (often taking more than 10 years to become significant), so if your life expectancy is less than 10 years it may not be worthwhile to go through the process of screening, biopsy and treatment. The treatment options for prostate cancer are not completely benign, and all of them have the potential for side effects. However, it is difficult for physicians to determine which prostate cancers will progress versus those that will remain indolent in any individual patient. Another argument against prostate cancer screening is that it has never been proven to save lives in studies of large populations. However, many doctors think that newer treatments for early stage prostate cancers may make this argument obsolete. Data from large trials currently being carried out should help to settle this argument in the near future.

The American Cancer Society and the American Urological Society recommend regular prostate cancer screening. The American Cancer Society recommends that men start getting annual PSAs and digital rectal exams starting at age 50, unless they are high risk (meaning they have a family history of prostate cancer or are African-American), who should begin screening at age 45. However, they mention that screening should only be carried out if your life expectancy is greater than 10 years, so men in their 80s and 90s (especially if they have other serious medical problems) should probably not be screened. The most important thing is to discuss the issue with your doctor. Decisions about screening should be individualized and reached after hearing about the potential benefits and harms of screening, biopsy and treatment.

What are the signs of prostate cancer?
Most early prostate cancers are detected with PSA tests or digital rectal exams before they cause any symptoms. However, more advanced prostate cancers can cause a variety of symptoms including:

• trouble starting urination
• urinating much more frequently than usual
• the feeling that you can't release all of your urine
• pain on urination or ejaculation
• blood in your urine or semen
• impotence
• bone pain

All of these symptoms can be caused by a variety of things besides prostate cancer, so experiencing them doesn't necessarily mean you have prostate cancer. When older men have problems urinating, it is usually caused by process called benign prostatic hyperplasia (BPH) which is not prostate cancer. If you experience any of these symptoms, you need to see your doctor for evaluation.

1. Stage I - tumor cannot be felt during a digital rectal exam; it was detected by an elevated PSA blood test or incidentally found during another prostate procedure for a benign condition.
2. Stage II - tumor can be felt during a digital rectal exam, but it has not spread beyond the prostate and it hasn't spread to lymph nodes or other organs
3. Stage III - tumor extends outside the prostate and can be in the seminal vesicles, but not in any other organs or lymph nodes
4. Stage IV - tumor has spread to other organs or lymph nodes

There are many different ways to treat prostate cancer, and you will most likely be consulting multiple types of doctors before making a final decision. Physicians are not always in agreement as to the way to proceed because there haven't been enough large trials that compare the different treatment modalities. For prostate cancer, it is important that you get a second opinion and you should talk to both urologists and radiation oncologists to hear about the benefits and risks of surgery, hormonal therapy and radiation in your particular case. If your prostate cancer has already spread at the time of diagnosis, you will also need a medical oncologist to talk about chemotherapy. The most important thing is to discuss your options and make a decision that suits your lifestyle, beliefs and values.
Surgery is a common form of treatment for men with prostate cancer. Surgery attempts to cure prostate cancer by removing the entire prostate and getting all of the cancer out of the body. An attempt at a surgical cure for prostate cancer is usually done with early stage prostate cancers, but sometimes surgery will be used to relieve symptoms in advanced stage prostate cancers. Surgery for prostate cancer is generally felt to be equivalent to radiation for prostate cancer in terms of survival, especially in early stage, low to intermediate grade cancers. The decision to have surgery versus radiation is often made on the basis of the patient's age and health status; the two different approaches have different side effect profiles depending on the patient's age.
The most common surgical procedure for prostate cancer is known as a radical prostatectomy. Radical prostatectomy means that the entire prostate gland is removed from around the tube that connects the bladder to the penis (the urethra). This surgery can be done in two different ways, the retropubic approach and the perineal approach. The retropubic approach means that incision in made in the lower abdomen, while the perineal approach means that the incision is made between the scrotum and the anus. Often times during a retropubic approach, the surgeon will remove some lymph nodes in the area and have them quickly examined by a pathologist for signs of cancer. If the nodes have cancer, then the surgeon will not to proceed with the operation. This is the major reason a retropubic approach is used in most surgeries today.
Radical prostatectomies are very safe surgeries with few life threatening complications; however, there is a significant risk for other side effects. Both urinary incontinence (not being able to hold in your urine) and impotence (inability to achieve and maintain an erection) are commonly associated with this procedure. The risk for having either of these side effects increases with age; this is why younger men are often recommended to have surgery while older men are recommended to have radiation. The skill of your particular surgeon influences your chances of having these side effects during a radical prostatectomy. Talk to your surgeon about their complication rates before your operation. Sometimes, particularly with lower grade and smaller cancers, a nerve sparing prostatectomy can be performed. This type of prostatectomy can decrease the chances that you will be impotent after the procedure. However, there is always a risk and not every patient is a candidate for a nerve sparing prostatectomy. With surgery, urinary incontinence and impotence are often most severe right after the operation and get better with time. There are things that your doctors can recommend to help you with either of these problems. Talk to your urologist about your options.

Radiotherapy
Prostate cancer commonly is treated with radiation therapy. Radiation therapy uses high energy rays (similar to x-rays) to kill cancer cells. Radiation therapy is another option besides surgery for early stage prostate cancer; and when advanced stage prostate cancer needs to be treated, it is usually done with radiation therapy. Radiation helps avoid surgery in patients who are too ill to risk having anaesthesia. Radiation is usually offered to older patients in the case of early stage prostate cancer because of its side effect profile is less than surgery in the elderly. Radiation can have impotence rates similar to surgery, but the risk of urinary incontinence is very low. Impotence develops months to years after the radiation treatment, unlike with surgery, which tends to have the side effects occur immediately. Other side effects from radiation include bladder irritation, which can cause urinary frequency and urgency as well as bladder pain, and diarrhea or rectal bleeding. Your radiation oncologist tries to limit the amount of radiation to other organs, but often the bladder and rectum can get some dosage because they are in such close proximity to the prostate.

Radiation therapy for prostate cancer either comes from an external source (external beam radiation) or an internal source where small radioactive seeds are implanted into the patient's prostate (brachytherapy). External beam radiation therapy requires patients to come in 5 days a week for up 6-8 weeks to a radiation therapy treatment center. The treatment takes just a few minutes, and it is painless. Brachytherapy is done as a one-time insertion, in the operating room. Brachytherapy cannot be done in all patients and is usually reserved for early stage prostate cancers. Your radiation oncologist can answer questions about the utility, process, and side effects of both of these types of radiation therapy in your particular case.
Hormonal Therapy
Both normal prostate tissue and prostate cancers depend on male sex hormones, called androgens, to grow and replicate. Testosterone is an androgen very important to the prostate gland. Men make androgens in their testicles. One of the ways to treat prostate cancer is to remove androgens from the body, thus making the cancer shrink and then grow more slowly. There are a few different ways to remove androgens: you can remove a man's testicles (called an orchiectomy), you can give a man drugs that block the production of androgens (called LHRH agonists), you can give a man drugs that block androgen receptors (called anti-androgens) or you can give a man estrogens. Different methods of deceasing androgens are often used in the same patient: using LHRH agonists with anti-androgens can achieve what is known as a total androgen blockade. Hormone therapy can also be used in conjunction with other treatments, especially in the case of advanced stage prostate cancer being treated with radiation therapy. In that case, hormonal therapy is often given before the radiation and this is known as neoadjuvant hormonal therapy. Another use for hormones is in patients who present with metastatic disease. After a while, all prostate cancers will become resistant to hormonal therapy. However, this often takes many years and hormonal therapy can buy a lot of time in patients with extensive disease or patients who choose not to undergo surgery or radiation.

There are a number of side effects associated with hormonal therapy. Hormonal therapy will almost universally cause impotence and the loss of your sex drive. It can also cause breast enlargement, hot flashes, and muscle and bone loss (osteoporosis). There are some things your doctors can prescribe to help with bone loss and hot flashes, but little can be done about loss of libido and impotence.

Chemotherapy
Chemotherapy is the use of anti-cancer drugs that go throughout the entire body. Chemotherapy is prescribed by medical oncologists, who are experts at choosing appropriate regimens for particular patients. Chemotherapy for prostate cancer is generally only reserved for very advanced cancers that are no longer responsive to hormonal therapy. There are a number of chemotherapy drugs that can be used for prostate cancer, and they are often used in combinations. A common chemotherapy regimen is Mitoxantrone with Coritcosteroids; and other regimens that are becoming increasingly popular use a drug called Estramustane with drugs called Taxanes. The use of chemotherapy in prostate cancer is currently being studied and men who get chemotherapy are encouraged to talk to their doctors about experimental trials. There are advantages and disadvantages to each of the different regimens that your medical oncologist will discuss with you. Based on your own health, your personal values and wishes, and side effects you may wish to avoid, you can work with your doctors to come up with the best regimen for your lifestyle

Cryosurgery
Cryosurgery is a somewhat experimental approach to treating prostate cancer whereby probes with liquid nitrogen are implanted into the prostate and then the tissue is frozen. This freezing kills the cancer cells, and it can be repeated multiple times if needed. However, data to date has shown that cryosurgery is not as effective as radiation and surgery for treating prostate cancer. Cryosurgery also has a variety of side effects including urinary incontinence and impotence.

Watchful Waiting
Some patients choose to receive no therapy for their prostate cancer in the hopes that it will grow very slowly. By avoiding any therapy, they avoid the side effects that come along with surgery, radiation, or hormones. Watchful waiting is appropriate for older men with small, low-grade tumors, and slowly rising PSAs, and multiple other medical problems. Watchful waiting can be considered in patients who have a life expectancy less than 10 years as long as the cancer isn't large or of a high grade. Men who choose to undergo watchful waiting should have PSAs and digital rectal exams done every 3-6 months, and need to be re-biopsied at some point to make sure the grade hasn't become less favorable. However, it is never really clear what change in clinical status should institute treatment. Also, if the tumor has progressed, they may no longer be eligible for curative therapy.

Follow-up testing
>Once a patient has been treated for prostate cancer, they need to be closely followed for a recurrence. At first, you will have follow-up visits fairly often. The longer you are free of disease, the less often you will have to go for checkups. Your doctor will tell you when he or she wants follow-up visits, PSAs and x-rays or scans depending on your case. Your doctor will also probably do digital rectal exams regularly during your office visits. It is very important that you let your doctor know about any symptoms you are experiencing and that you keep all of your follow-up appointments.

Clinical trials are extremely important in furthering our knowledge of this disease. It is through clinical trials that we know what we do today, and many exciting new therapies are currently being tested. Talk to your doctor about participating in clinical trials in your area.

This article is meant to give you a better understanding of prostate cancer. Use this knowledge when meeting with your physician, making treatment decisions, and continuing your search for information. You can learn more about prostate cancer on OncoLink through the related links to the left., for complete information visit to Link Here

Detect Your Early Breast Cancer

Breast cancer is the second leading cause at the cancer death in women at the world. The early detection means will be help to save and easily to treatment,because if the problems was knew late cause so many difficulties cure and treatment. The early recognizing better than left it till worse and makes high cost charge for management.The following reason why, women supposed to be early recognize about their breast cancer as are:

Why Do The Breast SElf Exam?

There are many good reason for doing a breast self exam each month. One reason is that is easy to do and the more you do it, the better you will get at it. When you get to know how your breasts normally fell, you will quickly be able to fell any changed, and early detection is the key to successfull treatmen and cure.

When To Do Self Breast Self Exam ?

The best time to do breast self-exam is right after your period, when breasts are not tender or swollen, if you do not regular periods or something skip a month, do it on the some day every month.

Now, How To Breast Self-Exam.

1. Lie down and put a pillow under your right shoulder. Place your right arm behind your head
2. Use the fingers pads of your three middle fingers on your left hand to fell for lumps or thickening. Your finger pads are the top third of each finger
3. Press firmly enough to know how your breast feels. If you,re not sure how hard to press, ask your health care provider, or try to copy the way your health care provider uses the finger pads during a breasts exam. Learn what your breast fells like most of the time. A firm ridge in the lower curve of each breast is normal
4. Move around the breast in set a way. You can chose either the circle(on the breast), the up and down line,or the wedge. Do it the some way every time . It will be help you to make sure taht you,ve gone over the entire breast area, and to remember how your breast fells
5. Now examine your left breast using right hand fingers pads.
6. If you find any changes, see your doctor right away

For adding safety:

You should also check your breasts while standing in front of a mirror right after you do your breast self-exam each month. See if there are any changes in the way your breasts look; dimpling of the skin, changes in the nipple, or redness or swelling. You might also want to do breast self-exam while you are in the shower . Your soapy hands will glide over the wet skin making it easy to check how your breasts feel

REMEMBER: A breast self-exam could save your breast and save your life. Most breast lumps are found by women themselves, but in fact, most lumps in the breast are not cancer, Be save and be sure. If you need more information abaout breast cancer visit toenter here and also come to Demo Breas self-exam

PENTAYELEN, SI VAKSIN YANG MULTI FUNGSI

Baru-baru ini ada berita yang menarik dari Media Indonesia mengenai Vaksin PENTAYELEN, memang asing kedengaranya,tapi itu adalah vaksin tunggal yang disinyalir mampu mengantikan beberapa fungsi vaksin seperti Dipteri,Pertusis(batuk Rejan/batuk 100 hari),Hepatitis B dan Influensa tipe B. Dimana jika saat ini Vaksin yang digunakan adalah per jenis penyakit maka jika vaksin PENTAYELEN telah diluncurkan maka akan lebih efektif karena hanya sekali immunisasi saja, kelima jenis penyakit tersebut sudah dapat dicegah.

Kita tentunya berharap semoga dengan diketemukanya vaksin gabungan tersebut bermanfaat buat kita semua terutama bagi yang mempunyai anak-anak balita,karena jika dulu vaksinasi dilakukan sampai lima kali disamping balita merasa kesakitan,trauma dengan suntikan,maka PENTAYELEN mampu menjadi sahabat sekali saja buat para balita serta ibu-ibupun akan merasa senang karena balitanya hanya disuntik sekali saja.
Vaksin tersebut akan diluncurkan pada tahun 2007 mendatang, kata Bpk. Marzuki Abdullah, Direktur Utama ,PT Bio Farma. Rencanaya Pembuatan vaksin tersebut akan dikerjakan di Indonesia oleh PT Bio Farma bekerja sama dengan Perusahan dari Belanda . Dari pihak Indonesia, yang dalam hal ini PT Bio Farma hanya menyediakan fasilitas dan sumber daya manusia (SDM), sedangkan tenaga ahlinya akan didatangkan dari Belanda.

Untuk launching perdana kapasitas produksinya tergantung dari kebutuhan pemerintah,serta rencananya akan juga di ekspor ke negara-negara Asia dan Afrika, yang memang negara-negara tersebut masih membutuhkan vaksinasi, untuk dalam negeri vaksin tersebut akan didistribusikan ke 10 propinsi yang memerlukan vaksinasi.

Marilah kita tunggu hadirnya si "VAKSIN MULTIFUNGSI INI", sahabat anak Balita Anda.
(berita disadur dari Media Indonesia On-line "13/8/06",dengan gaya penyampaian bahasa yang berbeda,tanpa menguransi maksud dan tujuan dari penulis media indonesia :Eriez)

RECOGNIZE YOUR EARLY DIABETES

Inner health is a very important subject because 95% of life threatening diseases starts inside our bodies where we can't see what is happening. By ignoring symptoms we often allow the problem to increase until treatment become difficult or, in the worst cases, impossible. It is also true that one hour of prevention is far better than one year of treatment, therefore recognize your self when getting any abnormal condition especially to the Diabetes Mellitus.

What is Diabetes?

In the rural people called Diabetes is more over blood sugar is the blood flow, but in medical term Diabetes is condition associated with abnormality high level of glucose (sugar) in the blood (hyperglycemia).
Normally blood glucose level stay within narrow limit throughout the day was 4 to 7mmol/l before meal and will be increase till to less than 10mmol/l 90 minute after a meal, and around 8mmol/l at the bedtime.

Diabetes mellitus is a chronic hereditary disorder of carbohydrate ,protein, and fat metabolism . It is characterized by lack of insulin activity and the ability to regulate blood glucose level, resulting hyperglycemia and glucosuria. There are two types of Diabetes mellitus:
1. In type 1 diabetes, which usually starts in childhood or adolescence, the pancreas stop making insulin altogether. It is also called Insulin Dependent Diabetes Mellitus(IDDM).
2. In type 2 diabetes, which starts in adulthood (and in some teenagers, mainly after 40 years of age), the body still makes some insulin , but it doesn't make enough insulin,or the body can't use it properly. It also called Non-Insulin Dependent Diabetes Mellitus (NIDDM).
Etiology
Insulin deficiency may be due to abnormality of beta cell function in the manufacture or release of insulin ,autoimmunity factors ,insensitivity of body cell to insulin or the excessive demands for insulin in obesity ,pregnancy, periods of extreme stressor infection.

Pathophysiology
Glucose increases in the blood (hyperglycemia) ,because without insulin it can't be converted to glycogen or cross cell membranes. The conversion of fat and protein to glucose energy will occur.
This fault fat metabolism produces ketone bodies ,acetone, and low blood pH (metabolic acidosis). Hyperglycemia in a severe state causes ketoacidosis and diabetic coma.

Symptom and Causes

• Glycosuria (sugar in urine) : Excess glucose in the blood ultimately results in high levels of glucose being present of the urine
  
• Polyuria (excessive urinary output and dehydration) : This increase of urine output ,which leads to dehydration and increase thirst.
  
• Polydipsia (excessive thirst ) : to counter of dehydration makes the body need lot of water
  
• Polyphagia ( excessive hunger) : Loss of calorie (glucose excreted) and cell starvation makes the body need much of energy that supplied by ate over
  
• Weight loss : Causes by calorie loss via urine (urine glucose),cell starvation, catabolism of stored fat and protein
  
• Drowsiness,fatigue : Lack of energy from absence of glucose in cell, CNS (Central Nervous System),depression of ketone bodies, metabolism acidosis
  
• Electrolyte losses : Loss of electrolyte such as NA+,K+,Ca++,CL-,depletion with polyuria and increasing of acidosis
  
• Acidosis(metabolic) : Causes ketone bodies are acidic. Excessive H+ ions (Low pH) overwhelm and lower HCO3
  
• Kussmaul breathing (air hunger rapid,deep breathing) : Causes respiratory compensation which lowers carbonic acid "blow off" CO2 in acidosis state ,Acetone odor on breath may be present.

Diagnosis test
The blood studies measure the body's ability to clear excessive glucose from the blood in the fasting state or after an increased load. Usually test to FBS (Fasting Blood Sugar),2 hour Post Prandial Blood Sugar (PPBS),and also GTT ( Glucose Tolerance Test) should be done.

Diabetes Complication
A key of diabetes treatment is to prevent complications because, over time, diabetes can damage the heart, blood vessels ,eyes, kidneys, and nerves, although the person may not know damage is taking place. Complications are most likely to occur in someone who has had diabetes for many years.
If uncontrolled for many years ,diabetes mellitus can lead to more serious health problems as a below:

1. Heart Disease
   
Heart disease is the most common life-threatening disease linked to diabetes, and experts say diabetes doubles a person's risk of developing heart disease .In heart disease ,deposit of fat and cholesterol build-up in the arteries that supply the heart with blood. If this build-up blocks blood from getting to the heart a potentially fatal heart attack can occur.


2. Kidney Disease
   
People with diabetes are also more likely to develop kidney disease (nephropathy) or kidney failure than the other people.


3. Eye Problems
   
Diabetes can effect the eyes in several ways. Frequently, the effect are temporary and can be corrected with better diabetes control. However, long-term diabetes can cause changes in the eyes that threaten vision as cause by the blood vessel damage whitin the eyes (retinopathy).
Diabetes also may affect the function of the nerves that control eyesight causing blurred vision. Cataract and glaucoma are eye disease that occur more frequently in the people with diabetes.



4. Diabetic retinopathy
   
Retinopathy a disease of retina, the light sensing tissue at the back of the eye, is a common concern among people with diabetes. Diabetes retinopathy damages the tiny vessels that supply the retina with blood.


5. Legs and Feet
   
Leg and foot problems can arise in the people with diabetes due to changes in blood vessel and nerves in these areas. Peripheral vascular disease is condition in the which blood vessel become narrowed by fatty deposits ,reducing blood supply to the legs and feet. Diabetes also can dull the sensitivity of nerves . Someone with this condition, called peripheral neuropathy ,might not notice a sore spot caused by tight shoes or pressure from walking. If ignored, the sore can become infected, and because circulation blood is poor, may be affect to slow healing ability even can makes gangrene if there is no good treatment will be go to amputation.


6. Other effects of Diabetic Neuropathy
   
Someone who has had diabetes for some years and has other complications, may find that spells of indigestion or diarrhea are common. Diabetes also can affect the nerves that control penile erection in the men ,which can cause impotence that show up gradually ,without any loss of desire for sex.


7. Skin and Oral Infections
   
People with diabetes are more likely to develop infections, like boils and ulcers, than the average person. Women with diabetes may develop vaginal infection more often then the other women.


8. Emergencies

Someone whose blood glucose has become too low may feel nervous, shaky, and weak. The person may sweat, feel hungry, and have a headache. Severe hypoglycemia can cause loss of consciousness .A person with hypoglycemia who begins too feel weak and shaky should eat or drink something with sugar in immediately, like orange juice . If the person is unconscious, he or she should be taken to a hospital emergency room right way.

Very high glucose levels cause symptom that are hard to ignore . Frequent urination and excessive thirst .However, in someone who is elderly or in poor health these symptoms may go unnoticed. Without treatment a person with high blood glucose level or hyperglycemia can lose fluids ,become weak, confuse and even unconscious . Breathing will be shallow and the pulse rapid. The person's lips and tongue will be dry, and his or her hands and feet will be cool. If the condition is taking place, a doctor should be called immediately.

The opposite of high blood glucose ,very low blood glucose or hypoglycemia ,is also dangerous. Hypoglycemia can occur when someone hasn't eaten enough to balance the effects of insulin or medicine. Prolonged, strenuous exercise in someone taking oral diabetes drugs or insulin also can cause hypoglycemia ,as can alcohol.

INFECTION

Infection is an invasion of the body by pathogenic organisms that multiply and produce injurious effect. Communicable disease is an infectious disease that was be transmitted from one person to another.

Chain of transmitted event as a following:

1. Causative agent: invading organism (e.q,bacteria,virus)
   
2. Reservoir:environment in which the invading organism lives and multiplies
   
3. Portal of exit: mode of escape from reservoir (e.q, respiratory tract, gastro interitis tract)
   
4. Mode of transmission: methode by which invading organism is transported to new host (e.q, direct contact,air,food)
   
5. Portal of entry: means by which organism enter new host (e.q,respiratory tract,broken skin)
   
6. Susseptible host: sussebtibility determined by factors such as number of invading organisms,duration of exposure,age,state of health,nutrition status.

NURSING RESPONSIBILITIES IN PREVENTION OF SPREAD OF INFECTION

Nursing responsibilities to minimize any infection that will be spread to other patients, therefore nursing should be take action as soon as possible before infection spreading.The nursing action as a below:

1. Maintain environment that is clean,dry and well ventilation
   
2. Use proper hand washing before and after client contact and after contact with contaminated material
   
3. Disinfected and handle wastes and contaminated material properly
   
4. Prevent transmission of infectious droplets,
   
5. Institute proper isolation techniques as required by specific disease
   
6. Use surgical technique when appropriate,caring for open wound,irrigating,or entering sterile cavites
   
7. Practice universal precaution when caring for all clients regadless of their diagnosis in order to minimize contact whit the blood and body fluids and prevent the transmission of specific infections susch as Hepatitis and Human Immunodeficiency Virus (HIV).

SAFETY RULE WHO NURSES MUST BE DONE

Safety is one of way to protect nurses who working in Hospital,sometime that nurses work very busy or there is no any safety supervisor they do careless to themselves, so, tink safety first and protect to your self before do any help or assist to the patients. The following safety way nurses must be comply, as a below:

1. Hands must always be washed before and after contac with clients even when gloves have been used.
   
2. If hand come in contact with blood,body fluids,or tumor tissue they should be immediately washed with soap and water.
   
3. Gloves should be worn before touching blood or body fluids,mucous membranes,or nonintact skin

HARUSKAH PERAWAT INDONESIA BEKERJA DI LUAR NEGERI

Perawat sebagai pemberi pelayanan keperawatan sebagai bagian integral dari pelayanan kesehatan yang diberikan kepada masyarakat,keluarga,kelompok maupun individu . Hal ini menyebabkan perawat selalu menjadi pusat perhatian dari masyarakat maupun pasien yang dirawatnya. Mengikuti perkembangan perawatan dunia, para perawat menginginkan perubahan yang mendasar dalam kegiatan profesinya.Kalau tadinya hanya membantu tugas pelaksanaan tugas dokter ,yang menjadi bagian dari upaya pencapaian tujuan asuhan medis,kini mereka menginginkan pelayanan keperawatan mandiri sebagai upaya mencapai tujuan asuhan keperawatan.

Pola pendidikanpun mulai berkembang pesat,bilamana dulu perawat sebgaian besar adalah lulusan SPK(Sekolah Perawat Kesehatan) yang setara dengan tingkat pendidikan SMA, kini telah sejajar dengan pendidikan tinggi setara D III (Akademi Keperawatan), Sarjara(S1 Keperawatan) dan bahkan sampai pada tingkat Magister (S2,S3, Keperawatan).

Tuntutan tanggungjawab dan tugaspun mulai bergeser yang dulu perawat hanya sebagai perpanjangan tangan dari dokter untuk merawat pasien selama 24 jam , kini tuntutan itu sudah menjadi tanggungjawab profesi perawatan secara mandiri yang tentunya mempunyai konsekuensi terhadap perawat tentang tanggungjawab dan tanggung gugat, baik dari pasien,dokter,maupun profesi kesehatan lainya, dan bahkan kadang harus mempertanggungjawabkan dirinya baik secara perdata maupun pidana di pengadilan akibat kesalahan tindakan terhadap pasien maupun malpraktik yang terjadi atas diri perawat itu maupun bersama-sama dengan profesi kesehatan lainya,seperti dokter,X-ray technician,Laboratorium Technician.

Walaupun Perawat mempunyai Induk organisasi Keperawatan PPNI, namun jika terjadi kasus-kasus yang berhubungan dengan perawat ternyata masih belum mampu membantu banyak penyelesaian yang dihadapi perawat,hal ini memyebabkan perlindungan terhadap perawat masih sangat rendah, dikarenakan masih belum adanya Undang-undang yang mengatur perlindungan terhadap perawat.Ternyata resiko-resiko yang dihadapi oleh perawat tidak hanya berhenti sampai disitu saja tentunya karena perawat sebagai tenaga pelayanan keperawatan yang berada 24 jam disamping pasien juga menghadapi berbagai resiko kesehatan akan terjadinya infeksi silang berbagai macam penyakit dari pasien maupun kejadian kecelakaan kerja akibat pekerjaanya seperti tertusuk jarum,nyeri pungung sehubungan dengan pekerjaan mengangkat dan memindahkan pasien,bed making dan bahkan sampai HNP (Hernia Nucleous Pulposus) yang berakibat kelumpuhan.

Ternyata tanggungjawab dan resiko yang diemban perawat masih belum sebanding dengan upah yang yang mereka terima rata-rata berkisar antara 400rb-1jt rupiah,yang mana masih jauh dibawah UMP(Upah Minimum Propinsi) yang salah satu contoh untuk DKI Jakarta berkisar 711.843 rupiah(sumber Direktorat Pengupahan,jamsos&Kesejahteraan,2005),yang mana upah ini diberikan terhadap para pekerja yang bekerja dipabrik-pabrik. Sungguh ironis memang,sebuah profesi yang dituntuk memberikan pelayanan kesehatan yang maksimal ternyata mendapatkan penghargaan yang masih jauh dari harapan. Keadaan ini terjadi karena DEPKES sebagai Depatemen yang membawahi berbagai profesi kesehatan tidak memiliki standar upah yang diberikan terhadap tenaga kesehatan,akhirnya yang menjadi standar adalah rumah sakit maupun layanan kesehatan dimana perawat bekerja yang hal ini sangat bervariasi tergantung kemampuan keuangan rumah sakit maupun layanan kesehatan,yang berakibat semaunya saja mengaji para karyawan dan bahkan memberikan standar gaji yang sangat rendah ,lebih rendah dari standar UMP.

Ketidakcukupan upah inilah yang walaupun bukan faktor utama akhirnya para perawat terjebak dalam kegiatan "klinical practice",yang ilegal, yang mau tidak mau mereka harus melakukannya karenan tuntutan ekonomi dan kebutuhan sehari-hari yang memang harus dipenuhi yang tidak dapat dicukupi dari upah yang diterimanya.Lalu yang menjadi pertanyaan, sampai kapankah keadaan ini harus terjadi,padahal keperawatan diindonesia bahkan lebih dulu dari negara tetangga semisal malaysia yang sudah mampu memberikan upah yang memadai bagi tenaga profesional kesehatan. Haruskan perawat akan terjebak terus dengan"clinikal practice" yang ilegal, atau haruskah semua perawat Indonesia EXSODUS ke Luar Negeri seperti yang dilakukan oleh sebagaian perawat Philipine,yang menyebabkan kekurangan Perawat di Philipine

Tentunya tidak berharap demikian jika Departemen Kesehatan mampu memberikan standar upah yang lebih layak, sehingga mereka akan tetap bekerja di Indonesia dengan anak dan keluarganya yang akan mampu memenuhi program pemerintah dalam misinya SEHAT DI TAHUN 2010,namun seandainya pemerintah tidak mampu lagi,bekerja di LN tampaknya akan menjadi pilihan maupun trend Perawat Masa Depan Indonesia