Wednesday, September 21, 2011

[sehat] Digest Number 16085

Messages In This Digest (25 Messages)

1a.
batuk dah 3 minggu tdk sembuh sembuh From: Yenny Mastionery
1b.
Re: batuk dah 3 minggu tdk sembuh sembuh From: niken qinen
1c.
Re: batuk dah 3 minggu tdk sembuh sembuh From: Inta
1d.
Re: batuk dah 3 minggu tdk sembuh sembuh From: feby eboy
1e.
Bls: [sehat] batuk dah 3 minggu tdk sembuh sembuh From: Yenny Mastionery
1f.
Bls: [sehat] batuk dah 3 minggu tdk sembuh sembuh From: Yenny Mastionery
1g.
Re: Bls: [sehat] batuk dah 3 minggu tdk sembuh sembuh From: feby eboy
1h.
Re: Bls: [sehat] batuk dah 3 minggu tdk sembuh sembuh From: dyah prima
2a.
Re: Anak 1 th sering muntah From: rarassinthia@yahoo.com
3a.
Re: Milis Sehat di Social Media Festival From: hanny.prasetyo@gmail.com
3b.
Re: Milis Sehat di Social Media Festival From: Ida kusumawaty
3c.
Re: Milis Sehat di Social Media Festival From: Monik Bunda Neisha
3d.
Re: Milis Sehat di Social Media Festival From: estiyani_mm@yahoo.com
3e.
Re: Milis Sehat di Social Media Festival From: hanny prasetyo
4a.
Re: Suntik Pemutih From: Nike Yuwardi
4b.
Re: Suntik Pemutih From: Nike Yuwardi
4c.
Re: Suntik Pemutih From: Nike Yuwardi
4d.
Re: Suntik Pemutih From: aina
4e.
Re: Suntik Pemutih From: bunda_fazil@yahoo.com
4f.
Re: Suntik Pemutih From: Khonic
4g.
Re: Suntik Pemutih From: leafransisca
5a.
Re: OOT-masih harus Vaksin Rotavirus gk ya? From: amanda
6a.
Re: [ASK] Imunisasi Hep B-3 utk Bayi dgn ibu yg HbsAg Positif From: tristanathan
7a.
Fw: [sehat] [ASK] Imunisasi Hep B-3 utk Bayi dgn ibu yg HbsAg Positi From: Ganies
8a.
Re: Ask: anak ce 8 tahun mengeluh sering sakit kepala smp sakit bgt. From: Laksmi Purwitosari

Messages

1a.

batuk dah 3 minggu tdk sembuh sembuh

Posted by: "Yenny Mastionery" yenny_chayanx@yahoo.com   yenny_chayanx

Wed Sep 21, 2011 2:29 am (PDT)



mau share nih moms n DSA.....
anak saya umur 1 thn 2 bln udah 3 minggu batuk tdk sembuh2. saya udah kasi obat baby cough udah d mnm 5 hari dan akhrnya saya kasi antibiotik
cefadroxyl syr 2x1sdk teh karena d mgg k 2 sempat demam  dan pilek. antibiotk d mnm mulai senin kmrn.
tapi knp ya batuknya ngga juga sembuh. mana juga dah 3 hari ini susah makan.
saya bingung hrs gmn. tp saat ini msh mnm baby cough n antibiotikny. memang batuknya mendingan dr yg tadiny b'dahak sampe skrg dtk . tapi masih tetep batuk tdk sesring yg sblmnya.

tmn milis n DSA mohon pencerahanny... tindakan apa yg hrs saya lakukan

thanks b4,

[Non-text portions of this message have been removed]

1b.

Re: batuk dah 3 minggu tdk sembuh sembuh

Posted by: "niken qinen" nikenqinen@gmail.com   qinen_q9

Wed Sep 21, 2011 2:37 am (PDT)



Q: tindakan apa yg hrs saya lakukan

Me: Stop pemberian AB dan obat batuk babynya.Cari penyebab batuknya.
Perbanyak cairan (air putih+jus buah+syr jenis sop2an), matikan AC, ajak
anak jalan2 pagi agar terkena matahari pagi, beri transpulmin BB di pungung
dan di dada + stok sabar yang banyak utk ortunya.

Salam,
-Niken-

2011/9/21 Yenny Mastionery <yenny_chayanx@yahoo.com>

>
>

[Non-text portions of this message have been removed]

1c.

Re: batuk dah 3 minggu tdk sembuh sembuh

Posted by: "Inta" dini.maesarinta@gmail.com

Wed Sep 21, 2011 2:37 am (PDT)



Mba Yenny,

Pertama tarik napas panjang. Kedua, hentikan pemakaian obat batuk dan ab nya. Batuk pilek, demam pada anak2 mah penyebabnya virus saja. Obatnya hanya daya tahan tubuh yang membaik. Caranya: banyak makan, minum untuk melancarkan proses pengeluaran dahak, istirahat dan jaga kebersihan (sering cuci tangan untuk mencegah penularan). Obat batuk dan ab nya dibuang aja yah mba, gak diperlukan kok. Malah kasian nanti bakteri baiknya ikutan mati. Satu lagi coba cari2 apakah dilingkungan sekitar baik anak maupun orang dewasa ada juga yang sedang batuk pilek. Bisa jadi virusnya pingpong sehingga mempelambat proses penyembuhannya.

Cheers, Inta- oia sudah baca file common problems yang dikirim moderatorkah?
terkirim dari henponkuh

1d.

Re: batuk dah 3 minggu tdk sembuh sembuh

Posted by: "feby eboy" fetriplef@gmail.com

Wed Sep 21, 2011 2:43 am (PDT)



Kalo sya.. Buang obat batuk dan ab nya. Trus ganti sama minum yg banyak kalo
masih ASI, digaeber asi nya...

[Non-text portions of this message have been removed]

1e.

Bls: [sehat] batuk dah 3 minggu tdk sembuh sembuh

Posted by: "Yenny Mastionery" yenny_chayanx@yahoo.com   yenny_chayanx

Wed Sep 21, 2011 2:43 am (PDT)



batuknya sptny alergi krn wkt lebrn kmrn srg jln k luar sementara cuaca d luar tdk b'sahabat.
debu, angin, krn saat dia batuk sempet muncul bentol2 d bdnny b'arti alergi kan.
nah soal mknan sudah saya kasi bgtu. jln pagi jg.
cuma saya bingung napa batuk tdk jg b'henti. baru x ini anak saya mengalami spt ini

________________________________
Dari: niken qinen <nikenqinen@gmail.com>
Kepada: sehat@yahoogroups.com
Dikirim: Rabu, 21 September 2011 16:37
Judul: Re: [sehat] batuk dah 3 minggu tdk sembuh sembuh

 
Q: tindakan apa yg hrs saya lakukan

Me: Stop pemberian AB dan obat batuk babynya.Cari penyebab batuknya.
Perbanyak cairan (air putih+jus buah+syr jenis sop2an), matikan AC, ajak
anak jalan2 pagi agar terkena matahari pagi, beri transpulmin BB di pungung
dan di dada + stok sabar yang banyak utk ortunya.

Salam,
-Niken-

2011/9/21 Yenny Mastionery <yenny_chayanx@yahoo.com>

>
>

[Non-text portions of this message have been removed]

[Non-text portions of this message have been removed]

1f.

Bls: [sehat] batuk dah 3 minggu tdk sembuh sembuh

Posted by: "Yenny Mastionery" yenny_chayanx@yahoo.com   yenny_chayanx

Wed Sep 21, 2011 2:47 am (PDT)



iya mba mmg d rmh lg pada batuk pilek tp udah pd sembuh.
yg p1 kena batuk i2 anak saya tp msh biasa eh papa ny kena batpil dstlah makin nambah parah. nah, skrg yg lain dah pd sembuh saya dan anak saya ngga sembuh2. saya masih ASI kalo mlm

________________________________
Dari: Inta <dini.maesarinta@gmail.com>
Kepada: sehat@yahoogroups.com
Dikirim: Rabu, 21 September 2011 16:37
Judul: Re: [sehat] batuk dah 3 minggu tdk sembuh sembuh

 
Mba Yenny,

Pertama tarik napas panjang. Kedua, hentikan pemakaian obat batuk dan ab nya. Batuk pilek, demam pada anak2 mah penyebabnya virus saja. Obatnya hanya daya tahan tubuh yang membaik. Caranya: banyak makan, minum untuk melancarkan proses pengeluaran dahak, istirahat dan jaga kebersihan (sering cuci tangan untuk mencegah penularan). Obat batuk dan ab nya dibuang aja yah mba, gak diperlukan kok. Malah kasian nanti bakteri baiknya ikutan mati. Satu lagi coba cari2 apakah dilingkungan sekitar baik anak maupun orang dewasa ada juga yang sedang batuk pilek. Bisa jadi virusnya pingpong sehingga mempelambat proses penyembuhannya.

Cheers, Inta- oia sudah baca file common problems yang dikirim moderatorkah?
terkirim dari henponkuh

[Non-text portions of this message have been removed]

1g.

Re: Bls: [sehat] batuk dah 3 minggu tdk sembuh sembuh

Posted by: "feby eboy" fetriplef@gmail.com

Wed Sep 21, 2011 2:48 am (PDT)



Nah apalagi tahu batuknya krn alergi debu... Coba rumahnya di general
cleaning.. Terutama ac, kipas dll

[Non-text portions of this message have been removed]

1h.

Re: Bls: [sehat] batuk dah 3 minggu tdk sembuh sembuh

Posted by: "dyah prima" dyahprima@gmail.com   dyahprima

Wed Sep 21, 2011 3:04 am (PDT)



mbak yenny....
toss anak2 juga lagi bolak-balik batpil. lagi ping pong nih virusnya.
selama anak2 batpil yang kami lakukan adalah...... ngomporin anak2 biar mau
banyak minum.
makannya juga bikin sup sup dan sup yg anget kan nyaman di tenggorokan.
saat demam mendera, senjatanya cuman paracetamol (setelah 38 dercel dan
mereka mulai crancky).

kami sengaja ga stok obat batuk, ga banyak membantu juga, malah dapet bonus
efek sampingnya ntar.
antibiotik for common cold.... NO WAY....
antibiotik diberikan hanya dan hanya jika terbukti ada bakteri jahat yg
harus diperangi (misal krn ISK).
kalo batuknya udah ketemu penyebabnya krn alergi, makin ndak perlu lagi
antibiotiknya.
ya dihindari pencetusnya aja mbak.

--
salam,
Prima - mama gita & colin

"Prepare your mind to received the best that life has to offer." ~Ernest
Holmes~

http://mamagita.multiply.com/

[Non-text portions of this message have been removed]

2a.

Re: Anak 1 th sering muntah

Posted by: "rarassinthia@yahoo.com" rarassinthia@yahoo.com

Wed Sep 21, 2011 2:35 am (PDT)



Mba Resti

Kl lg batuk, trus muntah,biasanya krn anak gak bs mengeluarkan dahak..jd keluar lewat muntah...
Abis muntah lega deeh...

Rgds
Raras
Dikirim dari KeeBerry®
3a.

Re: Milis Sehat di Social Media Festival

Posted by: "hanny.prasetyo@gmail.com" hanny.prasetyo@gmail.com   nyai_loh

Wed Sep 21, 2011 2:39 am (PDT)



Mbak Amanda,



Silahkan bawa anaknya. Nanti disana bisa main-main di Cikal sementara mbak Amanda nya ngobrol-ngobrol di booth nya YOP.



Cheers,




Sent from my cuteBerry®

-----Original Message-----
From: "amanda" <amandaunique@yahoo.com.au>
Sender: sehat@yahoogroups.com
Date: Wed, 21 Sep 2011 07:21:07
To: <sehat@yahoogroups.com>
Reply-To: sehat@yahoogroups.com
Subject: [sehat] Re: Milis Sehat di Social Media Festival

Halo.. Aku anggota pasif yg lagi pengen mulai rajin nih hehe.. Pengen dateng deh kalo bs.. Boleh bawa anak gak ya..? Bawa apa aja ya? Bayar gak ya?

Amanda (Maminya Rasya)
Just learning how being an FTM..
Powered by Telkomsel BlackBerry®

------------------------------------

Milis SEHAT mengucapkan terimakasih kepada PT LG Electronics Indonesia atas partisipasinya sebagai Sponsor Tunggal FAMILY FUN DAY MILIS SEHAT 2011.

"Mailing-list SEHAT didukung oleh : CBN Net Internet Access&Website.
Terima kasih & penghargaan sedalam-dalamnya kepada : HBTLaw, PT.Intiland, dan PT. Permata Bank Tbk. yang telah dan konsisten mensponsori program kami, PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."
=================================================================
"SEHAT mailing list is supported by CBN Net for Internet Access&Website.
Our biggest gratitude to: HBTLaw, PT. Intiland, and PT. Permata Bank Tbk. who have consistently sponsored our programme, PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."

Kunjungi kami di (Visit us at):
Official Web : http://milissehat.web.id/
FB : http://www.facebook.com/pages/Milissehat/131922690207238
Twitter : @milissehat <http://twitter.com/milissehat/>
=========================================================================
Donasi
Rekening YOP
Yayasan Orang Tua Peduli
Bank Mandiri
Cabang Kemang Raya Jakarta
Account Number: 126.000.4634514
=========================================================================Yahoo! Groups Links

3b.

Re: Milis Sehat di Social Media Festival

Posted by: "Ida kusumawaty" ida.a.kusumawaty@gmail.com   ida_a_kusumawaty

Wed Sep 21, 2011 2:45 am (PDT)



Di lantai 5, nomor booth-nya berapa ya?

Salam,
Mama Nayla

2011/9/21 <hanny.prasetyo@gmail.com>

> Mbak Amanda,
>
>
>
> Silahkan bawa anaknya. Nanti disana bisa main-main di Cikal sementara mbak
> Amanda nya ngobrol-ngobrol di booth nya YOP.
>
>
>
> Cheers,
>
>
>
>
> Sent from my cuteBerry®
>
> -----Original Message-----
> From: "amanda" <amandaunique@yahoo.com.au>
> Sender: sehat@yahoogroups.com
> Date: Wed, 21 Sep 2011 07:21:07
> To: <sehat@yahoogroups.com>
> Reply-To: sehat@yahoogroups.com
> Subject: [sehat] Re: Milis Sehat di Social Media Festival
>
> Halo.. Aku anggota pasif yg lagi pengen mulai rajin nih hehe.. Pengen
> dateng deh kalo bs.. Boleh bawa anak gak ya..? Bawa apa aja ya? Bayar gak
> ya?
>
> Amanda (Maminya Rasya)
> Just learning how being an FTM..
> Powered by Telkomsel BlackBerry®
>
> ------------------------------------
>
> Milis SEHAT mengucapkan terimakasih kepada PT LG Electronics Indonesia atas
> partisipasinya sebagai Sponsor Tunggal FAMILY FUN DAY MILIS SEHAT 2011.
>
> "Mailing-list SEHAT didukung oleh : CBN Net Internet Access&Website.
> Terima kasih & penghargaan sedalam-dalamnya kepada : HBTLaw, PT.Intiland,
> dan PT. Permata Bank Tbk. yang telah dan konsisten mensponsori program kami,
> PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."
> =================================================================
> "SEHAT mailing list is supported by CBN Net for Internet Access&Website.
> Our biggest gratitude to: HBTLaw, PT. Intiland, and PT. Permata Bank Tbk.
> who have consistently sponsored our programme, PESAT (Program Edukasi
> Kesehatan Anak Untuk Orang Tua)."
>
> Kunjungi kami di (Visit us at):
> Official Web : http://milissehat.web.id/
> FB : http://www.facebook.com/pages/Milissehat/131922690207238
> Twitter : @milissehat <http://twitter.com/milissehat/>
> =========================================================================
> Donasi
> Rekening YOP
> Yayasan Orang Tua Peduli
> Bank Mandiri
> Cabang Kemang Raya Jakarta
> Account Number: 126.000.4634514
> =========================================================================Yahoo!
> Groups Links
>
>
>
>
>
> ------------------------------------
>
> Milis SEHAT mengucapkan terimakasih kepada PT LG Electronics Indonesia atas
> partisipasinya sebagai Sponsor Tunggal FAMILY FUN DAY MILIS SEHAT 2011.
>
> "Mailing-list SEHAT didukung oleh : CBN Net Internet Access&Website.
> Terima kasih & penghargaan sedalam-dalamnya kepada : HBTLaw, PT.Intiland,
> dan PT. Permata Bank Tbk. yang telah dan konsisten mensponsori program kami,
> PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."
> =================================================================
> "SEHAT mailing list is supported by CBN Net for Internet Access&Website.
> Our biggest gratitude to: HBTLaw, PT. Intiland, and PT. Permata Bank Tbk.
> who have consistently sponsored our programme, PESAT (Program Edukasi
> Kesehatan Anak Untuk Orang Tua)."
>
> Kunjungi kami di (Visit us at):
> Official Web : http://milissehat.web.id/
> FB : http://www.facebook.com/pages/Milissehat/131922690207238
> Twitter : @milissehat <http://twitter.com/milissehat/>
> =========================================================================
> Donasi
> Rekening YOP
> Yayasan Orang Tua Peduli
> Bank Mandiri
> Cabang Kemang Raya Jakarta
> Account Number: 126.000.4634514
> =========================================================================Yahoo!
> Groups Links
>
>
>
>

[Non-text portions of this message have been removed]

3c.

Re: Milis Sehat di Social Media Festival

Posted by: "Monik Bunda Neisha" email.mymilis@gmail.com   charlottequaneishaandinisiswanto

Wed Sep 21, 2011 2:54 am (PDT)



Mba Ida..

Kalau dari yg saya liat di denah pada link di email Pak'e..
Di Lt 5 hanya ada 4 booth..keluar lift belok kanan..jadi mungkin tidak susah
menemukan booth Milis SEHAT disana..

salam,

Monik

[Non-text portions of this message have been removed]

3d.

Re: Milis Sehat di Social Media Festival

Posted by: "estiyani_mm@yahoo.com" estiyani_mm@yahoo.com   estiyani_mm

Wed Sep 21, 2011 3:00 am (PDT)



Acaranya apa aja,lokasi di Cikal? Sampai kpn ya, n biayanya brapa?terimakasih....
Sent from BlackBerry® on 3
3e.

Re: Milis Sehat di Social Media Festival

Posted by: "hanny prasetyo" hanny.prasetyo@gmail.com   nyai_loh

Wed Sep 21, 2011 3:08 am (PDT)



Mbak Esti,

Acara nya di Fx mbak.. Maaf yak aku salah sebut, maksudnya selama ibu dan
bapaknya nongkrong di booth nya YOP, anak-anak bisa main-main di rumah main
cikal di fx juga..

Ditunggu kedatangan nya yah mbak Esti...

Cheers,

2011/9/21 <estiyani_mm@yahoo.com>

> Acaranya apa aja,lokasi di Cikal? Sampai kpn ya, n biayanya
> brapa?terimakasih....
> Sent from BlackBerry® on 3
>
> ------------------------------------
>
> Milis SEHAT mengucapkan terimakasih kepada PT LG Electronics Indonesia atas
> partisipasinya sebagai Sponsor Tunggal FAMILY FUN DAY MILIS SEHAT 2011.
>
> "Mailing-list SEHAT didukung oleh : CBN Net Internet Access&Website.
> Terima kasih & penghargaan sedalam-dalamnya kepada : HBTLaw, PT.Intiland,
> dan PT. Permata Bank Tbk. yang telah dan konsisten mensponsori program kami,
> PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."
> =================================================================
> "SEHAT mailing list is supported by CBN Net for Internet Access&Website.
> Our biggest gratitude to: HBTLaw, PT. Intiland, and PT. Permata Bank Tbk.
> who have consistently sponsored our programme, PESAT (Program Edukasi
> Kesehatan Anak Untuk Orang Tua)."
>
> Kunjungi kami di (Visit us at):
> Official Web : http://milissehat.web.id/
> FB : http://www.facebook.com/pages/Milissehat/131922690207238
> Twitter : @milissehat <http://twitter.com/milissehat/>
> =========================================================================
> Donasi
> Rekening YOP
> Yayasan Orang Tua Peduli
> Bank Mandiri
> Cabang Kemang Raya Jakarta
> Account Number: 126.000.4634514
> =========================================================================Yahoo!
> Groups Links
>
>
>
>

[Non-text portions of this message have been removed]

4a.

Re: Suntik Pemutih

Posted by: "Nike Yuwardi" Nike.Yuwardi@astragraphia.co.id

Wed Sep 21, 2011 2:42 am (PDT)



Dear Pak Anto,

Terimakasih atas komentarnya, tapi saya bukan gak bersyukur atas yg diberikan oleh Tuhan YME,
cuma diseluruh badan saya ada bekas koreng2 yang sedikit membuat saya agak risih, saya pengen badan saya kembali seperti saya gadis dulu. karena saya kurang pede klo kerja memakai rok.

Best Regards,
Nike Yuwardi
Sekretaris Cabang Batam
PT. Astra Graphia TBK
Phone : 0778 412173, Fax : 0778 412183
Email : Nike.Yuwardi@astragraphia.co.id<mailto:Nike.Yuwardi@astragraphia.co.id>

[Non-text portions of this message have been removed]

4b.

Re: Suntik Pemutih

Posted by: "Nike Yuwardi" Nike.Yuwardi@astragraphia.co.id

Wed Sep 21, 2011 2:45 am (PDT)



Mba Risma,

Aku juga gak tau yang terkandung di dalam obat suntik pemutih, makanya aku tanya ke milis.
Emang mba sudah pernah dengar tetang malash ini?

Best Regards,
Nike Yuwardi

[Non-text portions of this message have been removed]

4c.

Re: Suntik Pemutih

Posted by: "Nike Yuwardi" Nike.Yuwardi@astragraphia.co.id

Wed Sep 21, 2011 2:48 am (PDT)



Dear Mba Konic,

Mungkin kali mba, aq jg kurang tau penyebab jacko meninggal.

Best Regards,
Nike Yuwardi

[Non-text portions of this message have been removed]

4d.

Re: Suntik Pemutih

Posted by: "aina" aina.anwar@yahoo.com   aina.anwar

Wed Sep 21, 2011 2:56 am (PDT)



Mba nike, sy udah pernah coba, dl byk bekas luka garuk abis dgigit nyamuk, sy berendam diair blerang (ciater itu) hilang...mgkn bs mba coba.

Pengalaman tmn sy yg suntik pemutih, mmg abis disuntik baguuuussss bgt. Mulus deh..trus dia berenti pake (mahal soalnya) jd kusem sem sem, bgsn sebelum disuntik malahan.

merci beaucoup
wassalamu'alaikum wr wb,

aina f.

4e.

Re: Suntik Pemutih

Posted by: "bunda_fazil@yahoo.com" bunda_fazil@yahoo.com   bunda_fazil

Wed Sep 21, 2011 2:56 am (PDT)




Mba nike,
Selama tidak diketahui kandungannya apa, kita di milis sulit sekali membantu mba cari tau apa gimana nya si pemutih itu.
Krn disini kita belajar utk mengambil keputusan medis terutama setelah kita cari tau mendalam ttg suatu obat ato treatment.
Caranya kita mencari tau ya dgn browsing di web2 medis terpercaya.
Nah, klo gak tau nama medis si pemutih...gimana bisa kita gali informasinya?

Maaf klo gak berkenan

-risma-
Sent from my BlackBerry®
powered by Sinyal Kuat INDOSAT
4f.

Re: Suntik Pemutih

Posted by: "Khonic" khonic@gmail.com   khonic_ds

Wed Sep 21, 2011 3:00 am (PDT)



Mba Nike,
Maksud saya bukan gara2 suntik pemutih jacko meninggal tp kan dia juga jadi putih mungkin gara2 suntik pemutih juga tuh hehehe..
Maap jd kepanjangan oot-nya Ù¼


Khonic
Sent from my Freegift-Berry® supported by my lovely hubby (^__^)
4g.

Re: Suntik Pemutih

Posted by: "leafransisca" leafransisca@gmail.com   leafransisca

Wed Sep 21, 2011 3:53 am (PDT)



Berdsrkan wawancara jacko&oprah, jacko menderita penyakit kulit yg bernama vitiligo(cmiiw) yg menyebabkan kulitnya belang2
dia menggunakan kosmetik u meratakan warna kulitnya
oprah sdr menyaksikan kulit jacko transparant shg pembuluh darahnya kelihatan
sedangkan penyebab kematiannya adl over dosis obat tidur&penenang
tks
lea

5a.

Re: OOT-masih harus Vaksin Rotavirus gk ya?

Posted by: "amanda" amandaunique@yahoo.com.au   amandaunique

Wed Sep 21, 2011 2:49 am (PDT)



Aiyah.. Belum mba.. *blush.. Kelewat kali yaa.. Habis saya bacanya via BB aja.. Jarang bisa sempet duduk tenang depan PC.. :)
Tadi kubuka link milis sehat malah jadi bingung, cari di file kan ya?? Tar deh kusempet2in buka di PC.. Ato kuubek email lamanya. Mudah2an belum keapuss.. :)
Makasih ya Mba..

Amanda (maminya Rasya)
Still learning how 2 b FTM & SP
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6a.

Re: [ASK] Imunisasi Hep B-3 utk Bayi dgn ibu yg HbsAg Positif

Posted by: "tristanathan" tristanathan.amadeo@gmail.com   trinovi

Wed Sep 21, 2011 2:50 am (PDT)



emailnya masuk kok mbak :)

>> hep. b ada kekhususan pada bayi prematur dan berat <2000 gram, dan ibu
HbsAg positif"
----- Berarti DSA anak saya ingin memberikan Hep B-3 pas usia anak saya 2bln
karena saya positif HbsAg nya ya pak? <<

link yg dari dr anto udah dibuka mbak?
saya baca baru sekilas, dan gak nemu ttg kesimpulan yg mbak ambil, bisa
share halaman berapa?

copas dr link yg dr anto kasih ya mbak

Infants and Children
Hepatitis B vaccination is recommended for all infants soon after birth and
before hospital discharge. Infants and children younger than 11 years of age
should receive 0.5 mL (5 mcg) of pediatric or adult formulation Recombivax
HB (Merck) or 0.5 mL (10 mcg) of pediatric Engerix-B (GlaxoSmithKline).
Primary vaccination consists of three intramuscular doses of vaccine. The
usual schedule is 0, 1 to 2, and 6 to 18 months. Infants whose mothers are
HBsAg positive or whose HBsAg status is unknown should receive the last
(third or fourth) dose by 6 months of age (12 to 15 months if Comvax is
used).
Because the highest titers of anti-HBs are achieved when the last two doses
of vaccine are spaced at least 4 months apart, schedules that achieve this
spacing are preferable

>> ---- Berarti dosis 2 ke 3 utk anak saya sangat cepat sekali ya pak, yaitu
1 bulan..??? Apa saya perlu ganti DSA?? <<

kalau boleh usul, jangan pindah dsa mbak, hehe.. krn gak jaminan dsa yg lain
akan berpikiran lain :)
tapi coba ber-tango aja sama dsa yg sekarang
siapkan amunisi buat berdiskusi, gak usah dungkan buat nunjukin hasil
browsing yg mbak dapet.
dan gak usah ragu buat nolak, seandainya mbak yakin kalau jadwal skrg tll
cepat dan dokter insist buat kasih skrg.

goodluck!
be smarter be healthier

-ria-

2011/9/21 Ganies <ganies.suci@yahoo.com>

> **
>
>

[Non-text portions of this message have been removed]

7a.

Fw: [sehat] [ASK] Imunisasi Hep B-3 utk Bayi dgn ibu yg HbsAg Positi

Posted by: "Ganies" ganies.suci@yahoo.com   ganies.suci

Wed Sep 21, 2011 3:29 am (PDT)



Maap ya saya resend lagi..soale kok saya pantau e-mail saya ini blum masuk2..maap ya bapak/ibu moderator :)

Smoga yg sekarang masuk :D

------Original Message------
To: sehat@yahoogroups.com
Subject: Re: [sehat] [ASK] Imunisasi Hep B-3 utk Bayi dgn ibu yg HbsAg Positif
Sent: Sep 21, 2011 3:44 PM


Dear Pak Anto (Yulianto),

Terima kasih atas link nya..saya akan baca2 lagi..

Sbg info, bayi saya lahir di usia kehamilan 37minggu dengan berat badan 2,94kg pak. Lalu kurang dari 12jam di 24 Jul itu bayi saya langsung di imunisasi Hep B-1 dan HBIG (karena saya HbsAg positif).

Untuk imunisasi Hep B-2 dilakukan sebulan kemudian yaitu di 24 Agustus.
Kemarin saat usia bayi saya 40hari, berat badannya sudah naik menjadi 4,2kg pak.

Dari tulisan bapak yang terakhir:
"hep. b ada kekhususan pada bayi prematur dan berat <2000 gram, dan ibu HbsAg positif"

----- Berarti DSA anak saya ingin memberikan Hep B-3 pas usia anak saya 2bln karena saya positif HbsAg nya ya pak?

"ada alasannya kenapa antara dosis 2 ke dosis 3 paling cepat 4 bulan"

---- Berarti dosis 2 ke 3 utk anak saya sangat cepat sekali ya pak, yaitu 1 bulan..??? Apa saya perlu ganti DSA??

Sekali lg makasih ya pak Anto..smoga pak Anto bisa balas lg utk pertanyaan saya ini..ato ada dokter lainnya yg bisa bantu saya..saya benar2 khawatir kalau2 ada efek buruk dari pemberian dosis yang terlalu cepat ini.


Salam,
Ganies


8a.

Re: Ask: anak ce 8 tahun mengeluh sering sakit kepala smp sakit bgt.

Posted by: "Laksmi Purwitosari" laksmipurwitosari@yahoo.com   laksmipurwitosari

Wed Sep 21, 2011 3:40 am (PDT)



Dear all,
Ini ada review bagus mengenai Headaches in Children and Adolescents

walaupun udah jadul tapi dijamin masih relevan
http://www.aafp.org/afp/2002/0215/p625.html
DONALD W. LEWIS, M.D., Eastern Virginia Medical School, Norfolk, Virginia
Am Fam Physician. 2002 Feb 15;65(4):625-633.

Evaluation
The medical evaluation of a child or adolescent presenting with headache requires a thorough history followed by a complete physical and neurologic examination. A headache assessment (Table 1)5 should generate sufficient information to make a diagnosis. The questions contained in this assessment can guide the physician in assigning a patient's symptom complex to the appropriate temporal pattern (Table 2)5 and help identify patients who warrant further diagnostic testing.

TABLE 1
Assessment of Children and Adolescents with Headache
How and when did your headache(s) start?
Was this a sudden first headache? Have you had headaches like this before? Do you get a headache every day? Are your headaches getting worse than they used to be?
Do you have the same kind of headaches all the time? Do you get more than one kind of headache?
How often do you get a headache? How long do your headaches usually last?
Can you tell that you will be getting a headache? Are there any signs that a headache is going to start?
Where do you feel the headache pain? How does the headache pain feelâ€"pounding, squeezing, stabbing, or something else?
Do you get nausea, vomiting, dizziness, numbness, weakness, or other symptoms at the same time you have a headache?
What makes your headache feel better or worse? Is there anything you do that makes your headache worse? Does taking medicine or eating food give you a headache or make a headache worse?
What do you do when you get a headache? Do you have to stop whatever you are doing (playing, working, studying) when you get a headache?
Does anything special cause you to get a headache? Do you get headaches at any certain time?
Do you have other symptoms between headaches?
Are you taking any medicines for your headache or for any other reason?
Do you have any other health problems?
Does anyone else in your family get headaches?
What do you think might be causing your headaches?
Adapted with permission from Rothner AD. The evaluation of headaches in children and adolescents. Semin Pediatr Neurol 1995;2:109â€"18.
TABLE 2
Five Temporal Patterns of Headache in Children
Acute headache
Single episode of head pain without history of previous events

Acute-recurrent headache
Pattern of head pain separated by symptom-free intervals

Chronic-progressive headache*
Gradual increase in frequency and severity

Chronic-nonprogressive (or chronic-daily) headache
Frequent or constant headache

Mixed headache
Acute-recurrent headache (usually migraine) superimposed on a chronic-daily background pattern (represents a variant of chronic-daily headache)

*â€"Most ominous temporal pattern.
Adapted with permission from Rothner AD. The evaluation of headaches in children and adolescents. Semin Pediatr Neurol 1995;2:109â€"118.
The general physical examination must include determination of vital signs, including blood pressure and temperature. Careful palpation of the head and neck should be performed in a search for sinus tenderness, thyromegaly, or nuchal rigidity. Head circumference must be measured, even in older children, because slowly progressive increases in intracranial pressure cause macrocrania. The skin must be examined for signs of neurocutaneous syndrome, particularly neurofibromatosis and tuberous sclerosis, which are highly associated with intracranial neoplasms.

A detailed neurologic examination is essential. More than 98 percent of children with brain tumors have objective neurologic findings. Key features in children with intracranial disease include altered mental status, abnormal eye movements, optic disc distortion, motor or sensory asymmetry, coordination disturbances, and abnormal deep tendon reflexes.6 Careful physical and neurologic examinations can enable the physician to exclude organic causes.

The role of neuroimaging is controversial. Computed tomographic (CT) scanning or magnetic resonance imaging (MRI) is indicated in patients with a chronic-progressive headache pattern and those who have abnormal findings in the neurologic examination (Table 3). In the majority of patients with acute-recurrent headache or chronic-nonprogressive headache patterns and normal findings from neurologic examinations, no imaging is warranted. The overwhelming majority of studies evaluating the role of neuroimaging in young patients with headache have demonstrated no diagnostic abnormalities or incidental (nonpathologic) findings.7

TABLE 3
Indications for Neuroimaging in Children with Headache
High priority
Acute headache
Worst headache of life
Thunderclap headache
Chronic-progressive pattern (steadily worsening over time)
Focal neurologic symptoms
Abnormal neurologic examination
Papilledema
Abnormal eye movements
Hemiparesis
Ataxia
Abnormal reflexes
Presence of ventriculoperitoneal shunt
Presence of neurocutaneous syndrome (neurofibromatosis or tuberous sclerosis)
Age younger than three years
Moderate priority
Headaches or vomiting on awakening
Unvarying location of headache
Meningeal signs
Electroencephalography (EEG) is of limited use in the routine evaluation of headache in children. If the headache is associated with alteration of consciousness or abnormal involuntary movement, the differential diagnosis will include complex partial seizure disorders, and EEG may be required. Nonspecific abnormalities and benign epileptiform discharges are common findings that may be present in up to 10 percent of children with migraine, regardless of the diagnosis.8,9

Lumbar puncture to identify bacterial or viral meningitis is mandatory in a febrile patient with headache with nuchal rigidity and no alteration of consciousness, signs of increased intracranial pressure, or lateralizing features. If subarachnoid hemorrhage, acute or chronic meningitis, pseudotumor cerebri, or neuroborreliosis are suspected, lumbar puncture with measurement of the opening pressure and appropriate ancillary testing are indicated.

If the patient's mental status is altered or focal findings are evident, cranial imaging is warranted before lumbar puncture, although blood cultures should be drawn and antibiotic therapy empirically started before the patient is transported for neuroimaging. Sinus radiography may be indicated for the febrile patient with headache if the clinical history and physical examination suggest acute sinusitis, although clinical judgment may justify treatment without imaging.10,11

Psychologic evaluation may be of value in children and adolescents with chronic-daily and mixed-headache patterns to assess for stressful provocative influences and determine the role for psychologic therapies (e.g., biofeedback, stress management, relaxation techniques).

Referral for neurologic consultation depends on the physician's experience and confidence. Children younger than three years infrequently have primary headache syndromes, and the complete neurologic examination, including visualization of the fundus oculi, can be difficult. These younger patients probably should be referred. Children with acute evolution of headache accompanied by focal neurologic symptoms or signs (i.e., morning vomiting, headaches that awaken the patient) should be referred, and neuroimaging should be performed. Children or adolescents with chronic-progressive headaches, a pattern associated with increasing intracranial pressure, also should be referred.

Most young patients with migraine can be successfully managed by the primary care physician and referred only if treatment fails. Chronic-daily and mixed-pattern headaches are extremely time-consuming to manage and often require a team approach with the help of the primary care physician, a neurologist, a psychologist, and a behavior therapist.

Management of Specific Headaches in Children
Few, if any, drugs designed for treatment of headache are approved for use in children. Most of the drugs discussed here are used on an off-label basis in children.

ACUTE HEADACHE
Most acute, nontraumatic headaches in children are the result of self-limited, medically remediable conditions such as upper respiratory tract infection with fever, sinusitis, or migraine (Table 4).

In emergency departmentâ€"based studies of acute headache in children, all of the children with serious underlying conditions (e.g., intracranial hemorrhage, brain tumors, meningitis) had one or more objective findings on neurologic examination. These findings included alteration of consciousness, nuchal rigidity, papilledema, abnormal eye movements, ataxia, and hemiparesis.12,13Any of these abnormalities would be a principle indication for neuroimaging.

The most immediate therapeutic action should be to place the child in a quiet, dark room where he or she can rest with a cool, wet cloth on the forehead. Sleep is often the most effective treatment.

TABLE 4
Causes of Acute Headache in Children
Upper respiratory tract infection, with or without fever
Sinusitis
Pharyngitis
Meningitis (viral or bacterial)
Migraine
Hypertension
Substance abuse (e.g., cocaine)
Medication (e.g., methylphenidate [Ritalin], oral contraceptives, steroids)
Intoxicants (e.g., lead, carbon monoxide)
Ventriculoperitoneal shunt malfunction
Brain tumor
Hydrocephalus
Subarachnoid hemorrhage
Intracranial hemorrhage
ACUTE-RECURRENT HEADACHE
Migraine with or without aura is the most common form of acute-recurrent headache in children. The prevalence of migraine headache in children has been studied extensively by this author (Table 5)14,15 and others. Commonly used diagnostic criteria for childhood migraine are shown in Table 6.16

TABLE 5
Prevalence of Migraine Headaches in Children
Age 3 to 7 years 7 to 11 years 15 years
Prevalence (%)
1.2 to 3.2
4 to 11
8 to 23
Gender ratio
Boys > girls
Boys = girls
Girls > boys
Information from references14 and15.
TABLE 6
Criteria for Diagnosis of Migraine in Children
Five or more headache attacks that:
Last 1 to 48 hours (compared with a shorter duration in adults)
Have at least two of the following features:
Bilateral or unilateral (frontal/temporal) location (compared with bilateral location only in adults)
Pulsating quality
Moderate to severe intensity
Aggravated by routine physical activities
Are accompanied by at least one of the following:
Nausea and/or vomiting
Photophobia and/or phonophobia (do not occur simultaneously in adults)
Adapted with permission from Winner P, Wasiewski W, Gladstein J, Linder S. Multicenter prospective evaluation of proposed pediatric migraine revisions to the IHS criteria.
Treatment of childhood migraine is divided into two phases: general measures and pharmacologic management. The first general measure of treatment is to confidently reassure the patient and caregivers of the cause of the headache and the absence of serious neurologic disease. This step, which is frequently omitted, may be the most important therapeutic intervention.

Other general therapeutic measures include identifying and removing headache triggers, regulating lifestyle, and instituting behavioral therapies. Common triggers in children include disrupted sleep, skipped meals, analgesic overuse, and stress. Behavior therapies such as relaxation techniques, stress management, and biofeedback have proved efficacious.

The role of diet in the management of acute-recurrent headache is controversial. It is unrealistic to impose elimination diets in most children and even more so in adolescents. A rational approach is to provide caregivers with a list of potential dietary precipitants, including cheese, processed meats, chocolate, nuts, pickles, and monosodium glutamate, and ask them to watch for a possible temporal link between the child's headache and any of these dietary components. Banning any or all of these food items is unreasonable unless there is a clear association between a food item and the onset of headaches.

Caffeine, however, warrants special mention, and efforts should be made to moderate its use. If a child or adolescent is consuming many caffeinated soft drinks or several cups of coffee daily, consideration should be given to the possible role of caffeine as a contributing factor to headache. Caffeine abuse or withdrawal can precipitate headaches in adolescents. In addition, analgesic compounds with caffeine have a demonstrated association with rebound headache.17,18

Before beginning any pharmacologic treatment, the pattern, intensity, and cyclic nature of the patient's migraine must be clarified. The aggressiveness of management and choice of medications must be tailored to the patient's headache pattern, pain tolerance, and lifestyle. The daily use of prophylactic agents should be considered in patients with headaches that occur so frequently as to interfere with their normal lifestyle. Most young persons with migraine do not require daily medication; however, they do need access to reliable analgesia at home and at school.

Sleep
Once again, the best immediate therapeutic action is to place the patient in a quiet, dark room where he or she can rest with a cool, wet cloth across the forehead. Sleep is often the most effective treatment.

Analgesics
The mainstay of management of childhood migraine is the intermittent use of oral analgesics. Many children respond well to liquid ibuprofen (Children's Advil) in a dosage of 7.5 to 10 mg per kg. Children who fail to respond to the simple agents may require the use of other, more expensive agents (Table 7).

TABLE 7
Analgesics Used to Treat Migraine in Children
Drug Dose Forms used in children
Single agents
Acetaminophen (Tylenol)
10 to 15 mg per kg per dose
Chewable tablets: 80 mg
Tablets: 160, 325 mg
Elixir: 160 mg per 5 mL
Ibuprofen (Motrin)
10 mg per kg per dose
Syrup: 100 mg per 5 mL
Chewable tablets: 50, 100 mg
Tablets: 100, 200, 400, 600, 800 mg
Naproxen sodium (Anaprox)
2.5 to 5 mg per kg
Tablets: 220,* 250, 500 mg
Combination preparations
Aspirin-butalbital-caffeine (Fiorinal)
1 to 2 capsules or tablets four times daily
Capsules: 325â€"50â€"40 mg
Tablets: 325â€"50â€"40 mg
Isometheptene mucate-dichloralphenazone-acetaminophen (Midrin)
1 to 2 capsules; repeat hourly, up to 5 capsules per 12 hours
Capsules: 65â€"100â€"325 mg
5-HT1-receptor agonists
Sumatriptan (Imitrex)†
1 as needed
Tablets: 25, 50, 100 mg
Autoinjector: 6-mg vial
Nasal spray: 5, 10, 20 mg
Zolmitriptan (Zomig, Zomig ZMT)†
1 as needed
Tablets: 2.5, 5 mg
Dissolving wafers: 2.5 mg
Rizatriptan (Maxalt, Maxalt-MLT)†
1 as needed
Tablets: 5, 10 mg
Dissolving wafers: 5, 10 mg
*â€"Available over the counter as Aleve and as generic brands.
†â€"Not yet approved for childhood use (see text).
It is important that the patient remember to (1) take enough medication (often greater than antipyretic doses), (2) use the medication early in the course of the headache, and (3) have medication available at all times (especially at school).

Acetaminophen (Tylenol), ibuprofen and naproxen sodium (Anaprox), when taken as early in the course of the headache as possible, are usually effective. Ibuprofen, in a dosage of 10 mg per kg, is the most rigorously studied analgesic and shows more beneficial effects than acetaminophen.19Combination drugs containing isometheptene (Midrin) and butalbital (Fiorinal) are secondary choices if the initial agents fail. Butalbital contains aspirin along with sedating and potentially addictive barbiturates. Care must be taken to avoid the use of narcotics.

While none of the “triptan” agents are currently approved for use in children, extensive trials in adolescents have been completed, and early reports have demonstrated excellent safety profiles in patients 12 to 18 years of age.20 Off-label use of sumatriptan (Imitrex), using 25-mg tablets or a 20-mg nasal spray, rizatriptan (Maxalt, Maxalt-MLT), in a dosage of 5 to 10 mg administered via tablets or oral dissolving wafers, and zolmitriptan (Zomig), in a dosage of 2.5 to 5 mg, may be considered for use in adolescents with moderate to severe migraine headaches who are unresponsive to conventional analgesics.

Anti-emetics
Nausea and vomiting occur in up to 90 percent of children with migraines. Many children will identify vomiting as the most disabling feature of a migraine. In addition, vomiting and accompanying gastric stasis can inhibit the effectiveness of oral analgesics. Therefore, liberal use of anti-emetic agents provides substantial relief (Table 8). Often, anti-emetics alone are effective in eliminating all symptoms, including headache. A potential complication, dystonic reactions-oculogyric crisis, must be considered when prescribing anti-emetics.

TABLE 8
Anti-emetics Used in the Treatment of Nausea and Vomiting Accompanying Childhood Migraine
Agent Dosage in children Forms used in children
Promethazine (Phenergan)
0.25 to 0.5 mg per kg per dose three times daily
Tablets: 12.5, 25, 50 mg
Syrup: 6.25, 25 mg per 5 mL
Suppositories: 12.5, 25, 50 mg
Trimethobenzamide (Tigan)
100 to 200 mg three times daily
Capsules: 100, 250 mg
Suppositories: 100 mg
Prochlorperazine (Compazine)
0.25 to 0.5 mg per kg every 4 to 6 hours
Tablets: 5, 10, 25 mg
Syrup : 5 mg per 5 mL
Suppositories: 2.5, 5, 25 mg
Metoclopramide (Reglan)
1 to 2 mg per kg (<10 mg) every 4 hours
Tablets: 5, 10 mg
Syrup: 5 mg per 5 mL
Hydroxyzine (Vistaril)
10 to 25 mg two to three times daily
Syrup: 10 mg per 5 mL
Tablets: 10, 25, 50 mg
Prophylactic Agents
As stated earlier, daily use of prophylactic agents should be reserved for children with frequent and or disabling migraine headaches. To warrant use of a daily preventive medication, the headaches must occur with sufficient frequency, regularity, and severity, and must interfere with daily lifestyle and pose a functional disability. About one third of children with migraines require periodic courses of daily medication. When to begin use of daily medication and how long to continue its use are open to debate.

Very few of the drugs used to prevent migraine headache in children have been rigorously studied in children. Their use in this age group is based on anecdotal experience or reported usefulness in adult series.

In children younger than 10 to 12 years, cyproheptadine (Periactin), in a dosage of 2 to 8 mg at bedtime or divided twice daily, is a safe initial agent. If it fails to limit the frequency and severity of headaches in children in this age group, amitriptyline (Elavil), propranolol (Inderal), carbamazepine (Tegretol), or valproic acid (Depakene) can be used (Table 9).

TABLE 9
Options for Prophylactic Management of Frequent Migraine in Children and Adolescents
Agent Dosage in children Forms used in children
Antihistamine
Cyproheptadine (Periactin)
0.25 to 1.5 mg per kg (2 to 8 mg daily)
Syrup: 2 mg per 5 mL
Tablets: 4 mg
Antidepressant
Amitriptyline (Elavil)
10 to 50 mg daily at bedtime
Tablets: 10, 25, 50 mg
Beta blockers
Propranolol (Inderal)
2 to 4 mg per kg daily (10 to 40 mg three times daily)
Tablets: 10, 20, 40, 60, 80 mg
Extended-release capsules: 60, 80, 120, 160 mg
Metoprolol tartrate (Lopressor)
2 to 6 mg per kg daily
Tablets: 50, 100 mg
Anticonvulsants
Valproic acid (Depakene) (Depakote)
20 to 40 mg per kg per day (250 mg twice daily)
Syrup: 250 mg per 5 mL
Capsules: 250 mg
Sprinkles: 125 mg
Carbamazepine (Tegretol)
20 to 40 mg per kg per day (100 to 200 mg twice daily)
Suspension: 100 mg per 5 mL
Chewable tablets: 100 mg
Tablets: 200 mg
Topiramate (Topamax)
5 to 10 mg per kg per day
Sprinkles: 15, 25 mg
Tablets: 25, 100, 200 mg
NSAIDs
Naproxen sodium (Anaprox)
250 to 500 mg twice daily
Tablets: 250, 500 mg
NSAIDs = nonsteroidal anti-inflammatory drugs.
In older adolescents, amitriptyline, propranolol, naproxen sodium, valproic acid, carbamazepine, and calcium channel blockers are effective. In addition, interest in the newer anticonvulsants, gabapentin (Neurontin) and topiramate (Topamax), is growing; however, no studies of these agents have yet been conducted in children or adolescents.

Other acute recurrent headache syndromes in children and adolescents have varied causes and management programs.

Tension-Type Headache
Tension-type headache clearly occurs during childhood but has not been rigorously studied.21 In epidemiologic surveys, its reported frequency varies widely. The diagnostic criteria established by the International Headache Society22 are quite specific; however, their age sensitivity has not been studied. Management of these headaches involves the use of intermittent analgesics coupled with behavior interventions such as stress management.

Cluster Headache
Cluster headache is rare in children and uncommon in adolescents. The clinical characteristics and treatment options are similar to those of adult patients.

Temporomandibular Joint Disorder
Temporomandibular joint (TMJ) disorder, infrequently presents as headache and more typically presents as unilateral jaw pain just anterior or inferior to the ear. The pain is aggravated by eating, gum chewing, teeth clenching, or yawning. Patients may describe a clicking or locking of the jaw. Family members may describe bruxism, and there may be antecedent jaw trauma. Examination reveals tenderness over the TMJ and limitation of mouth opening. Treatment includes use of non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxation techniques, and avoidance of provocative processes like gum chewing or eating hard candy. Major oral surgery is rarely necessary.

Paroxysmal Hemicrania
Paroxysmal hemi-crania is characterized by attacks of intense periorbital pain lasting 5 to 30 minutes and occurring up to dozens of times a day. While similar to cluster headaches, there is no accompanying lacrimation or rhinorrhea. Perhaps the most striking feature of paroxysmal hemicrania is its exquisite responsiveness to indomethacin (Indocin) in a dosage of 25 to 50 mg per day, which has prompted the use of an alternative termâ€"“indomethacin-sensitive” headache.23

Occipital Neuralgia
Occipital neuralgia is characterized by a stabbing pain in the upper neck or occipital region that is often precipitated by neck flexion or head rotation. It may occur post-traumatically. Examination of the craniocervical region may disclose point tenderness, C2 distribution sensory changes, and limitation of motion. MRI of the craniocervical junction is warranted to exclude congenital or pathologic processes. Treatment includes the use of soft collars, NSAIDs, muscle relaxants, local injections, and physical therapy. The prognosis is generally good.

CHRONIC-PROGRESSIVE HEADACHE
The chronic-progressive headache pattern, the most ominous of the headache patterns, involves a gradual increase in the frequency and severity of pain over time. Intracranial pathology should be suspected (Table 10), especially when the headache is accompanied by altered mental status, abnormal eye movements, optic disc distortion, motor or sensory asymmetry, coordination disturbances, or abnormal deep tendon reflexes. Most patients with chronic-progressive headache warrant neuroimaging with MRI. Management is dependent on imaging results and diagnosis.

TABLE 10
Causes of Chronic-Progressive Headache in Children and Adolescents
Brain tumor
Hydrocephalus (obstructive or communicating)
Pseudotumor cerebri
Brain abscess
Hematoma (chronic subdural hematoma)
Aneurysm and vascular malformations
Medications (e.g., birth control pills, tetracycline, vitamin A [high doses])
Intoxication (lead poisoning)
CHRONIC-NONPROGRESSIVE HEADACHE (CHRONIC-DAILY HEADACHE)
The prevalence of chronic-nonprogressive (or chronic-daily) headache during adolescence is 0.2 to 0.9 percent.24,25 No specific diagnostic criteria have been established, although ongoing studies in children define chronic-nonprogressive headaches as those lasting four or more hours and occurring 15 or more times a month for a period of four or more months.5 Many adolescents have continuous, unremitting daily headache.

Management of headache in this population is challenging. In addition to the questions addressed inTable 1,5 education and psychologic dynamics must be fully explored. Provocative or exacerbating influences must be identified. Confident reassurance of the absence of life-threatening disease must be provided to the patient and caregivers.

A comprehensive therapeutic plan must be established. Analysis of sleep and exercise habits, and dietary patterns should be conducted. A lifestyle routine, which includes regular school attendance, must be mandated. Counseling, stress management, and behavior therapies such as biofeedback should be strongly considered.

It is essential to avoid the use of narcotics in patients with chronic-daily headache. Use of acetaminophen, aspirin, and ibuprofen also should be minimized because of their potential for causing “rebound” headache. The use of naproxen sodium (230 to 500 mg twice daily) is not generally associated with rebound headache, and the agent has no potential for abuse. Judicious use of antidepressants such as amitriptyline (10 mg orally every day at bedtime) or valproic acid (250 mg orally twice daily) as daily prophylaxis may temper the frequency and severity of this headache.

MIXED HEADACHE
A mixed-headache pattern implies migraine superimposed on a chronic-daily headache pattern. Treatment is the same as that for chronic-daily headache, combining psychologic and behavior therapies with the use of analgesic and prophylactic agents. The management of mixed headache can be challenging.

Salam,
Laksmi Purwitosari

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Twitter      : @milissehat <http://twitter.com/milissehat/>
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Donasi
Rekening YOP
Yayasan Orang Tua Peduli
Bank Mandiri
Cabang Kemang Raya Jakarta
Account Number: 126.000.4634514
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MARKETPLACE

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