Rabies

Rabies or also known as hydrophobia is a disease acute infection in the central nervous system caused by a virus rabies. Acute lethal viral encephalomyelitis that strikes carnivores and bats, although it can also infect humans mammals.

The disease is caused by the bullet-shaped virus Rhabdovirus berkapsula the size of 70x170 nm. Capsule that envelops his peplomer glycoprotein composed of materials, protein (protein matrix) and lipoproteins. This virus has a capsid nukleo with helical symmetry, linear genomic sRNA minus polarity, 11-12 kb.

Rhabdovirus replicate in the cytoplasm, transkiptrase virus RNA transcribes five subgenom were translated into five proteins namely transcriptase (150 K), nucleoprotein (50-62 K), matrix protein (20-30 K), peplomer glycoprotein (70-80 K) and protein not structured (40-50 K). This virus maturation through peak penetrate membrane (Fenner, 1987). Rhabdovirus has an incubation period of 10 days - 6 months however, usually 3-8 weeks.

According to the mode of transmission of rabies include direct zoonosis group (Direct zoonosis) are zoonotic which requires only one type of vertebrate alone for survival, and disease-causing agent is only slightly changed or even no change at all during transmission.

Meanwhile, according to the main reservoir of rabies classified in antropozoonosis, the disease develops in nature freely among wild animals and domestic. Humans only occasionally become infected and are the end point of infection. According to the cause of rabies is a zoonotic agent movement viral. Rabies can be transmitted by wild animals (wild life zoonoses), animal foster (Domesticated Animal zoonosis) and animals that live human in settlement (Domiciliated zoonosis).

Risk factors are the obstacles and opportunities for the spread of rabies are: attacking wild animals (especially skunks, Raccon, bats, and foxes), lack of sufficient anti-rabies vaccination and bite / scratches from dogs, cats or wild animals that have not been vaccinated.

Rabies Transmission usually occurs through the bite of an infected animal, contamination of fresh wounds or mucous membranes with saliva or brain of animals been infected. In some cases, transmission may also occur through air (Schnurrenberger, 1991). These viruses multiply in the salivary glands. Very sensitive to the solvent is alkaline such as soap, disinfectant, alcohol, etc. The system is attacked nervous system or nervous system: clinical encephalitis can be paralytic / furious and glands salivarius: contains a large number of viral particles in saliva

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Leukemia

What is Leukemia? 
Leukemia is a type of cancer that Affects the bone marrow and lymphatic tissues. All cancers begin in cells that make-blood and other tissues. Normally, cells grow and divide to form new cells that the body needs. When cells grow old, the cells die and new cells take their place.However, sometimes this orderly process goes wrong, New cells form when the body does not need them, and old cells do not die when they should. This discrepancy is called leukemia, roomates in the bone marrow produces abnormal white blood cells are cells eventually persuaded the other.

What Causes It? 
Doctors can not always explain why one person develops leukemia while others avoid the disease. However, we know that people with certain risk factors are more Likely to develop leukemia.The study found that people who are exposed to very high radiation and industrial chemicals (such as benzene and formaldehyde) are at a greater risk of leukemia.In addition, Patients treated with anti-cancer drugs (such as materials alkylation) sometimes develop leukemia several years. And Patients infected with the virus of human T-cell leukemia (T-cell leukemia virus HTLV-I/Human-I) are also susceptible to this disease. Other risk factors include people with certain genetic (eg, Down syndrome) or certain blood disorders (such as myelodysplastic syndrome).

Symptom 
Like all blood cells, leukemia cells travel through the body. Depending on the number of abnormal cells and where these cells collect, Patients with leukemia have a number of common symptoms include: 
• Fever or night sweats
• Frequent infections 
• Feeling weak or tired 
• Headache 
• Easy bleeding and bruising (bleeding gums, purplish patches in the skin, or tiny red spots under the skin) 
• Pain in the bones or joints 
• Swelling or discomfort in the abdomen (from an enlarged spleen)• Swelling, especially in the neck or armpit 
• Losing weight

Diagnosis 
If you have a symptom or screening results leading to leukemia, doctors must Determine whether it originates from cancer or other health conditions. You will be asked to undergo blood tests and diagnostic procedures following:

• Physical examination - the doctor will check for swelling in the lymph nodes, lymph nodes, spleen and liver.
• Blood tests - laboratory will examine the number of blood cells. Leukemia causes white blood cells to very high levels, and platelet counts and hemoglobin in red blood cells decreases. Laboratory tests will also examine Whether there blood for signs of abnormalities in the liver and / or kidneys.
• Biopsy - The doctor will lift the bone marrow from the hipbone or another large bone. The pathologist will then examine the sample under a microscope to look for cancer cells. This method is called a biopsy, roomates is the best way to find out if there are leukemia cells in the bone marrow.
• Cytogenetics - laboratory will examine the chromosomes of cells from samples of peripheral blood, bone marrow, or lymph nodes.
• processus spinosus - using a long, thin needle, the doctor will slowly take the cerebrospinal fluid (the fluid that fills the spaces in the brain and spinal cord). This procedure takes about 30 minutes and is performed under local anesthesia. The patient must lie flat for several hours afterward to keep from getting a headache. The lab checks the fluid cells if there are signs of leukemia or other diseases.
• chest x-ray - X-rays can reveal signs of disease in the chest.

 as to how the treatment of leukemia please read here

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What Treatments are Offered for Patients With Leukemia?

many ways in which to treat leukemia one of which is as follows


Chemotherapy

Most Patients with leukemia undergoing chemotherapy. Type of cancer treatment uses drugs to kill leukemia cells. Depending on the type of leukemia, Patients may receive a single drug or a combination of two or more drugs.Leukemia may receive chemotherapy in several different ways:

• Through the mouth
• By injection directly into a vein (intravenous or)
• Through a catheter (a small flexible tube) is placed in a large vein, Often in the upper chest - nurse injects   drugs into the catheter, to avoid the need for multiple injections. This Reduces the discomfort and / or injury to the vein / skin.
• By injection directly into the cerebrospinal fluid - If the pathologist finds leukemia cells in the fluid that fills the spaces in the brain and spinal cord, the doctor may order intrathecal chemotherapy. The doctor injects drugs directly into the cerebrospinal fluid. This method is used Because drugs given by IV injection or taken by mouth Often do not reach cells in the brain and spinal cord.

Biological Therapy

People with certain types of leukemia have biological therapy to Enhance the body's natural defenses against cancer. The therapy is given by injection in the vein.For Patients with chronic lymphocytic leukemia, the type of biological therapy used is a monoclonal antibody that binds to the leukemia cells. This therapy Enables the immune system to kill leukemia cells in the blood and bone marrow. For Patients with chronic myeloid leukemia, the biological therapy used is a natural substance called interferon to slow the growth of leukemia cells.

Radiation Therapy

Radiation therapy (also called radiotherapy) uses high-energy rays to kill leukemia cells. For most Patients, a large machine directs radiation at the spleen, brain, or other parts of the body where leukemia cells. Some Patients receive radiation that is directed to the whole body. (Total-body irradiation is usually given before abone marrow transplant.)Stem Cell Transplant (Stem Cell)Some Leukemia Patients undergoing stem cell transplant (stem cell). Stem cell transplants allow Patients treated with high doses of drugs, radiation, or both. The high doses destroy both leukemia cells of normal blood cells in the bone marrow.

Then, the patient receives stem cells (stem cells) healthy through a flexible tube placed in a large vein in the neck or chest area. Blood cells will be grown from stem cells (stem cell) transplant outcome.After a stem cell transplant (stem cell), Patients usually stay in the hospital for several weeks.  

The health care team to Protect Patients from infection to stem cells (stem cell) transplant outcomes Began to produce white blood cells in adequate amounts.What kind of support is available?Can hope is a support team ParkwayHealth initiated along with the multi-disciplinary team of physicians who seek a holistic approach to cancer care at no extra cost.

The advisory runs cancer counseling service through a hotline and email, to provide emotional support and psycho-social services to all Patients and caregivers to assist them to cope Effectively with cancer. Face to face counseling can also be arranged.Patients, health professionals and the public can also get the latest cancer information, screening tests are related, treatment and referral to NAMAs cancer services, resources for further rehabilitation and support services, advice about side effects of cancer treatment, coping strategies of cancer, patterns eating and nutrition.

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Smallpox Disease (herpes)

Smallpox disease or so-called 'Herpes' by the medical community is an inflammatory disease of the skin Characterized by the formation of bubbles of water in groups. Smallpox disease or Herpes There are two kinds of groups, and Herpes Zoster Herpes Genetalis.

Genetalis Herpes is an infection or inflammation (bubble blister) on the skin especially genital (vagina, penis, Including door rectum / anus and Buttocks and groin / groin) by the caused by the herpes simplex virus (VHS), while Herpes Zoster or by any other name 'shingles' is a skin infection by the caused by the varicella-zoster virus that causes bubbles in the liquid almost the entire body.Herpes zoster is also said infectious disease of the skin roomates is a continuation of the chickenpox (chicken pox) Because of a virus that attacks are the same, only there is a difference with the chicken pox. Herpes zoster is Characterized smallpox larger bubbles and clusters in certain parts of the body, can in the back, forehead or chest.

• Modes of Transmission Disease Chickenpox (Herpes)In general, all types of herpes can be transmitted through direct contact. However, in herpes zoster, roomates Occurs in diseases such as smallpox (chickenpox), the transmission can be through sneezing, coughing, Contaminated clothing and touch up bubbles / blisters that burst. In genital herpes disease (genetalia), Occurs transmission through sexual behavior. So the disease is sometimes Suffered section Genetalis mouth herpes due to oral sex. Symptoms will arise in the period 7-21 days after the person is in contact (infected) varicella-zoster virus.

Someone who never had chicken pox and then recovers, the virus is actually not 100% lost from the body, but hiding in the dorsal ganglion cells, the sensory nervous system of the patient. When the immune system (immune) Weakened, the virus will return in the form of herpes zoster attack roomates by the caused symptoms similar to smallpox (chickenpox). For someone who has never had chicken pox, when the varicella-zoster virus is not directly experienced herpes zoster but had chicken pox first.

• Signs and Symptoms of Chickenpox (Herpes)Signs and symptoms resulting from herpes viruses in general are fever, chills, shortness of breath, pain orin the joints stiffness in one section collapsed, appearance of reddish spots on the skin that eventually form a liquid bubble. Another complaint is that sometimes the patient felt abdominal pain. 

• Handling and Treatment of Disease Chickenpox (Herpes)In Patients with smallpox are the most important thing is to keep the liquid bubbles do not break so as not to leave a mark and Become the entrance for other bacteria (secondary infection), among others, the provision of talcum powder that helps lubricate the skin . Patients can not stand if the cold conditions recommended not to bathe, Because it can cause shock. 

The drugs are given to Patients with smallpox is intended to reduce the symptoms of existing complaints such as pain and fever, given paracetamol for example. Giving Acyclovir tablets (Desciclovir, famciclovir, valacyclovir, and penciclovir) as antiviral aims to reduce fever, pain, Complications and Protects a person from the inability of the immune system against the herpes virus. Should Acyclovir medication at the onset of pain or burning feeling on the skin, no need to wait for the Emergence of a bubble of fluid (blisters). 

On a serious condition in roomates a person's immune system is very weak, people with smallpox (herpes) should get treatment terapy intravenous (IV) Acyclovir. In an effort to Prevent a person should receive varicella zoster vaccine Immunization. In healthy children aged 1-12 years is given one time. Imunasasi can be given once again at puberty to establish immunity to 60% - 80%. After that, to improve, give immunizations once again as an adult. This acquired immunity can last up to 10 years.

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Clinical Symptoms of Rabies on Animals

Relatively younger dogs are more sensitive than adult animals. The incubation period is an average of 3 to 6 weeks with high variation, could be 10 days or 6 months, rarely less than 2 weeks or more than 4 months. The rabies virus is found in the saliva of the dog immediately after the clinical symptoms Appear. 

There are three forms of rabies in animals are:a) Furious rabies (an aggressive form)b) Dumb rabies (calm form)c) Asymptomatic rabiesIn dogs and cats are usually malignant. The incubation period is 10-60 days but can be longer. Sick animal saliva containing the virus transmit the virus through bites or scratches.Clinical signs of rabies in animals three forms:1. Aggressive form (Furious rabies)Long excitation period, most will die within 2-5 days after the signs look.  

Often the signs that are seen:

•     Animals to be timid or to be fierce;
•     Good hiding places are cold, dark and aloof but can be aggressive;
•     Not According to the employer's orders;
•     Appetite lost;
•     Saliva melt uncontrollably;
•     Animals will attack objects around it and consuming goods, foreign objects such as stones, wood,  etc.;
•     Attacking and biting anything that moves goods found;
•      Followed by convulsions paralysis; tails between 2 (two) thigh.

 
2. Shape silent (Dumb Rabies)Short period of excitation, paralysis Occurs sooner. Often the signs that are seen:

•     Hiding in a dark and cool;
•     Convulsions lasted very Briefly, Often not even visible;
•     Paralyzed, Unable to swallow, mouth open;
•     Salivary out continuously (redundant);
•     Dead.

3. Asymptomatic ShapeAnimals do not show symptoms of illness and or animals Suddenly died Rabies In Cats have symptoms or signs of a Similar with symptoms in dogs, such as hiding, many meowing, scratching the floor and be aggressive. At 2-4 days after the first symptoms of paralysis is common, especially in the rear. The following phases roomates through the animals are exposed to rabies when malignant forms (furious rabies), namely:

• Prodormal phase (early phase): Characterized by being not normal, hiding in a dark, restless, Unable to sleep, the reflex Increased activity, anorexia, pain in the bite, the temperature Increased slightly.
• Phase excitation: after 1-3 days, aggressive, growing niche to bite goods, animals and people Including the owner himself. Sometimes even biting him itself. Animals experiencing hypersalivation Because animals can not swallow his saliva Themselves due to paralysis of the muscles to swallow, barking changed since paralysis
• Part of the vocal nerves, the animals growing niche to leave the house and run away, Often attack dogs and other animals.
• Phase paralysis: convulsions, muscular incoordination and paralysis Followed. In addition to malignant forms may also present with symptoms of rabies silent form of paralysis, excitation phase is very short sometimes no, paralysis from the muscles of the head and neck. Animals difficult to swallow was Followed in totally and ended with death.

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Pulmonary Tuberculosis

Tuberculosis is an infectious disease caused by bacteria Mikobakteriumtuberculosis (and sometimes by M. bovis and africanum). These organisms there is also a mention as the acid-fast bacilli. Transmission occurs through the air of "droplet" infection.

Source of infection in patients with pulmonary tuberculosis found in cough sputum, which on examination of sputum smear positive sputum smear is commonly found. Cough will produce droplet infection (droplet nuclei). At once coughs, droplets expelled 3000. Transmission usually occurs in the room with less ventilation. Sunlight can kill germs quickly, being in a dark room germs can live. Risk of transmission of infection will lebihtinggi on BTA (+) than smear (-).

Tuberculosis is a chronic disease, a person can even lifetime hidup.Setelah infected tuberculosis germs, nearly 90% of patients are not clinically sick, just got a positive tuberculin test, 10% will be sick. Patients who are ill, if without treatment, after 5 years, 50% of patients will die of pulmonary tuberculosis, 25% healthy with a good defense and 25% become chronic and infectious.
Clinical symptoms of tuberculosis is divided into 2 parts:

       - Respiratory Symptoms:
Cough: a symptom of the earliest and most frequent complaint. Arise because of bronchial cough is involved. Cough lasting ≥ 3 weeks to think about the existence of pulmonary tuberculosis.
Coughing up blood: the blood that can be removed stripes, spots, or even in large quantities. Coughing up blood may also occur in bronchiectasis and lung tumors.
Shortness of breath: met if the disease is advanced and ample lung terdapatkerusakan.
Chest pain: occurs if subpleural lung parenchyma is involved.

        - Systemic symptoms:
Fever: is the most common symptom, usually occur in the afternoon and evening.
Systemic symptoms such as night sweats, anorexia, malaise, weight loss and decreased appetite.

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