FILARIARIS DISEASE

MECHANISM OF DISEASE

Mikrofilaria W.bancrofti

FilariasisDefinition
 Filariasis (elephantiasis disease) is a chronic infectious disease caused by the filarial worm blockage in the gland / lymph channels, causing acute clinical symptoms such as recurrent fever, sore glands / lymph nodes,  edema and chronic symptoms such as elephantiasis.

Cause
 3 species in Indonesia determined filarial worms, including Wuchereria bancrofti, Brugia malayi and Brugia timori that each - each as the cause filariasi bancrofti, malayi filariasis and filariasis timori. Various species of mosquitoes can act as transmitters (vector) disease.Modes of TransmissionA person bitten by a mosquito infected with filariasis when infective larvae containing filarial worms. Mosquitoes that transmit filariasis is Anopheles, Culex, Mansonia, Aedes and Armigeres. Mosquitoes are widespread throughout Indonesia according to the state of their habitat (sewer / water lines, fields, marshes, woods).

Clinical
 1. Filariasis without symptoms
 Generally endemic areas, the physical examination is only found enlarged inguinal lymph nodes, especially in areas. In blood tests found microfilaria role in large quantities and eosinophilia. 

2. Filariasis by Inflammation
 Fever, chills, headache, vomiting, and weakness may last a few days to a few weeks. Organs affected mainly the lymph channels limbs and genitals. In the men - men generally are accompanied by thickening and funikulitis pain epididymitis, orchitis and scrotal swelling. Acute attacks can last a month or more. If the condition can lead to severe kidney abscesses, swelling epididymal, retroperitoneal tissue, and muscle ileopsoas inguinal glands.

3. Filariasis with Healing
 In the chronic stage occurs proliferative granulation tissue and extensive enlargement of lymph channels and elephantiasis arise. Torasikus duct blockage or abdominal lymph channels is affecting the scrotum and penis in males - males and the external genitalia in women. Inguinal gland infection can affect the limbs and external genitalia. Elefanthiasis typically affects the limbs and genitals and cause extensive changes. When the lymph channels bladder and kidney rupture will occur kiluria (lymph fluid discharge in the urine), whereas that of rupture of tunica vaginalis hydrocele or kilokel will happen, and if the rupture occurs peritoneal ascites lymph channels that contain kilus. The picture that appears is often hydrocele and lymphangitis genitals. Lymphangitis and elephantiasis can be exacerbated by secondary infections Streptococcus. 

Diagnosis
 Diagnosis can be established clinical filariasis. The diagnosis is confirmed by finding microfilaria in the peripheral blood were taken at night (22:00 to 02:00 o'clock midnight) and daubed with Giemsa staining. In the chronic state examination is often negative.

Management

1. General Care

• Rest in bed 
• Antibiotics for secondary infection and abscess
 • Treatment of elephantiasis with foot washing and wound care

2. Specific Treatment

For individual treatment given Carbamazine Diethyl Citrate (DEC) 6 mg / kg 3 times daily for 12 days.Side effects: nausea, dizziness and fever while using this medication.Treatment missal (WHO recommendations) are DEC 6 mg / kg and albendazole 400 mg (+ paracetamol) a single dose, once a year for 5 years. Implementation unit (IU) is a district / area of ​​work centers (population 8000-10000 people) 

Dose Table DEC for filariasis by age 
Age                      DEC (100 mg)              Albendazole (400 mg)   
2-6 years                     1 tablet                         1 tablet     
 7-12 years                  2 tablets                       1 tablet 
> 13 years                   3 tablets                       1 tablet

STROKE

Apakah stroke itu ?
 
Penyakit stroke adalah gangguan fungsi otak akibat aliran darah ke otak mengalami gangguan (berkurang). Akibatnya, nutrisi dan oksigen yang dbutuhkan otak tidak terpenuhi dengan baik. Penyebab stroke ada 2 macam, yaitu adanya sumbatan di pembuluh darah (trombus), dan adanya pembuluh darah yang pecah.
Umumnya stroke diderita oleh orang tua, karena proses penuaan menyebabkan pembuluh darah mengeras dan menyempit (arteriosclerosis) dan adanya lemak yang menyumbat pembuluh darah (atherosclerosis). Tapi beberapa kasus terakhir menunjukkan peningkatan kasus stroke yang terjadi pada usia remaja dan usia produktif (15 - 40 tahun). Pada golongan ini, penyebab utama stroke adalah stress, penyalahgunaan narkoba, alkohol, faktor keturunan, dan gaya hidup yang tidak sehat. 

The 5 Principles of Keeping Cellulite Away by: Kathleen LeRoi

Ask any lady what they dislike the most about their legs and they will say the same thing, CELLULITE! Almost every woman older than her teens is well aware of the fact that cellulite loves to accumulate around the upper legs, inner thighs, and buttocks.

Around my 32nd birthday my son innocently told me that my legs looked like jellyfish!I burst into tears. Once I regained my composure I realized enough was enough and set about ridding myself of cellulite for good. Fortunately the procedure was relatively straight forward as a friend of mine taught me the 5 principles of cellulite reduction. I would now like to share my lessons with you.

THE FUNDAMENTAL PRINCIPLES NEEDED TO REDUCE CELLULITE (http://www.bioskinrejuvenation.com/SKIN-REJUVENATION-TOPICS/566836-the-5-principles-of.php)

Rule #1 - Exercise

One of the simplest and most effective ways of loosing cellulite is to reduce body fat and increase your muscle mass. Thankfully this can be easily achieved with a bit of exercise. So if you haven't already, start going for vigorous walks, get that old bike out of the garage, hit the pool, or join the local gym.

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Cellulites are fat cells connected under the tissue of your skin. Therefore you should limit the amount of fat in your diet by reducing the amount of processed foods you ingest while increasing the amount of natural food you consume such as fruits, vegetables, and grains.

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Cellulite is not only the dimple you see, but the dry, damaged skin that surrounds it; effectively, highlighting its appearance. Through the daily application of a natural moisturizer such as a cellulite body cream (http://biocutis.com/), you can minimize this unwanted, accentuated appearance.

Rule #4 - Drink Water

Cellulite is also known to be formed by a collation of toxins under the skin's surface. Keeping well hydrated is the most effective way of assisting your body flush out such toxins. And it is no secret water is the healthiest and quickest method of hydration.

Rule #5 - Massage

A great technique for shifting these unwanted fat cell deposits is massage. So pamper yourself and have your body regularly massaged, paying extra attention to the regions with the greatest cell deposits. And don't fret, this does not need to be an expensive or elaborate procedure, simply soak yourself in a relaxing bath and have your partner gently massage you with an effective anti cellulite cream.