Friday, October 14, 2011

[sehat] Digest Number 16264

Milis SEHAT Group

Messages In This Digest (25 Messages)

1.
Campak Jerman (urgent) From: imel1405@gmail.com
2a.
Re: Campak jerman (urgent) From: asihmahayanti@yahoo.co.id
2b.
Re: Campak jerman (urgent) From: imel1405@gmail.com
3a.
Re: Pls help : bumil kembar keputihan From: yulianto
3b.
Re: Pls help : bumil kembar keputihan From: vanny.unmehopa@gmail.com
4a.
Re: (Ask) kelupaan Hib dan DPT ulangan From: yulianto
5a.
Re: RUM meeting w/ Prof.Noel-Prof Garry From: ninik.sinaga@gmail.com
5b.
Re: RUM meeting w/ Prof.Noel-Prof Garry From: mrsbenyamin@gmail.com
5c.
Re: RUM meeting w/ Prof.Noel-Prof Garry From: RlynAmien
5d.
Re: RUM meeting w/ Prof.Noel-Prof Garry From: F.B.Monika
5e.
Re: RUM meeting w/ Prof.Noel-Prof Garry From: siti amatullah mutmainah
5f.
Re: RUM meeting w/ Prof.Noel-Prof Garry From: fitri.barokah@gmail.com
5g.
Re: RUM meeting w/ Prof.Noel-Prof Garry From: rosshy77@yahoo.com
5h.
Re: RUM meeting w/ Prof.Noel-Prof Garry From: tristanathan.amadeo@gmail.com
5i.
Re: RUM meeting w/ Prof.Noel-Prof Garry From: nia2R
5j.
Re: RUM meeting w/ Prof.Noel-Prof Garry From: angel.encis@gmail.com
5k.
Re: RUM meeting w/ Prof.Noel-Prof Garry From: tika tk
6a.
Re: OOT film royal pains From: kusuma_ayu3@yahoo.com
6b.
Re: OOT film royal pains From: echy0312@yahoo.com
7a.
Batita ngmg agak gagap From: LiNa
7b.
Re: Batita ngmg agak gagap From: Nandia Nugrahani
8a.
Re: parkinson From: Laksmi Purwitosari
9a.
Re: ask: penanganan anak yg demam tinggi sebelum ada kepastian diagn From: Putri
9b.
Re: ask: penanganan anak yg demam tinggi sebelum ada kepastian diagn From: siti amatullah mutmainah
10a.
Re: Tanya: anak asi mau ditinggal From: Pamelia Yulianto

Messages

1.

Campak Jerman (urgent)

Posted by: "imel1405@gmail.com" imel1405@gmail.com   imel_1405

Thu Oct 13, 2011 7:48 am (PDT)



Dear dr Windhi n bu Nia,

Tks unt penjelasannya
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2a.

Re: Campak jerman (urgent)

Posted by: "asihmahayanti@yahoo.co.id" asihmahayanti@yahoo.co.id   asihmahayanti

Thu Oct 13, 2011 8:16 am (PDT)



Sekalian nanya...untuk mengetahui kl pasien terkena campak jerman,apakah dokter cukup melihat scra kasat mata ato hrs dgn pemeriksaan laboratorium.?

Trima ksh

Asih
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2b.

Re: Campak jerman (urgent)

Posted by: "imel1405@gmail.com" imel1405@gmail.com   imel_1405

Thu Oct 13, 2011 5:01 pm (PDT)



Tks bu Risma
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-----Original Message-----
From: "risma" <bunda_fazil@yahoo.com>
Sender: sehat@yahoogroups.com
Date: Thu, 13 Oct 2011 13:46:09
To: Milis sehat<sehat@yahoogroups.com>
Reply-To: sehat@yahoogroups.com
Subject: Re: [sehat] Campak jerman (urgent)


Mba imel,
Campak jerman atau rubella penyebabnya virus
So, udah tau dong ya klo virus gak ada obatnya
Paling parset doang klo demam...

Menular...

Klo bisa sih baby nya kasih asip aja dulu (cmiiw)

-risma-

Sent from the bottom of my heart®
powered by believing in You

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3a.

Re: Pls help : bumil kembar keputihan

Posted by: "yulianto" yuliantosk@gmail.com   anto_sk

Thu Oct 13, 2011 8:22 am (PDT)



dear bu vanny,
keputihan karena bakteri (Bacterial vaginosis) atau karena jamur, atau
parasit bisa meningkatkan risiko prematur.
bisa diambil swab keputihan lalu diperiksa di bawah mikroskop, maka bisa
diketahui penyebabnya, sehingga pengobatan sesuai penyebab.

bisa cek vaginal discharge di mayoclinic

semoga keputihan diketahui penyebabnya dan diatasi.

salam,
-anto-

3b.

Re: Pls help : bumil kembar keputihan

Posted by: "vanny.unmehopa@gmail.com" vanny.unmehopa@gmail.com

Thu Oct 13, 2011 8:56 am (PDT)



Terimakasih banyak dr anto :)

Regards,
Vanny
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4a.

Re: (Ask) kelupaan Hib dan DPT ulangan

Posted by: "yulianto" yuliantosk@gmail.com   anto_sk

Thu Oct 13, 2011 8:33 am (PDT)



dear bu ainuraini,
untuk jadwal kalau di CDC bisa brows immunization schedule cdc

jadwal catch-up juga ada bila tertinggal jadwal imunisasinya. Jadwal
IDAI bisa dilihat di buku paspor kesehatan anak

salam,
-anto-

5a.

Re: RUM meeting w/ Prof.Noel-Prof Garry

Posted by: "ninik.sinaga@gmail.com" ninik.sinaga@gmail.com

Thu Oct 13, 2011 8:41 am (PDT)



Dokter windhi...kita semua mendukung...semangat yaaa...!

Ninik
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5b.

Re: RUM meeting w/ Prof.Noel-Prof Garry

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

Thu Oct 13, 2011 10:13 am (PDT)



Ganbatte!!!
Dokter dan Smart Parent disini adalah pejuang yang menjadi pahlawan bagi saya dan keluarga.
*peluksatu-satu*

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-----Original Message-----
From: Windhi Kresnawati <dr.windhi@gmail.com>
Sender: sehat@yahoogroups.com
Date: Thu, 13 Oct 2011 21:17:54
To: sehat<sehat@yahoogroups.com>
Reply-To: sehat@yahoogroups.com
Subject: [sehat] RUM meeting w/ Prof.Noel-Prof Garry

Selamat malam,

Gak tahan mau nulis ini.. :)
Baru pulang dari great dinner dengan bunda wati, prof.Noel, Prof Garry dan
dokter-dokter YOP,
mungkin bunda wati yang paling kompeten menjelaskan siapa mereka,
(sedikit info: mereka salah satu orang yang "mengelus dada" dengan praktek
puyer dan polifarmasi di Indonesia).

Beberapa hal penting hasil pembicaraan dengan mereka:
1. Zink pada diare akut, sebenarnya tidak selalu diperlukan. Pada anak
dengan gizi baik, sebenarnya tidak perlu. rekomendasi WHO lebih ditunjukkan
kepada anak-anak dengan gizi kurang di negara berkembang.

2. sekali lagi : tidak butuh obat batuk. obat batuk pada anak hanya
meningkatkan efek samping.

3. Antibiotik tidak perlu pada pencabutan gigi. kecuali dengan pasien
kelainan jantung.

4. Antibiotik tidak punya peran dalam operasi caesar, kalaupun mau diberikan
sebagai profilaksis cuma satu kali dosis, gak perlu berhari-hari apalagi
lebih dari satu jenis AB dan dibawa pulang.

Mereka antusias dengan proyek AB2 kita ...(dalam hati: windhiiiiii ayo
kerjain modul AB2 nyaaaaa)

dalam perjalanan pulang:

Prof Garry: saya penasaran bagaimana kamu bisa bergabung dengan YOP dan
bertemu dengan dr.wati?

W: dikenalin anto :) keberuntungan dari surga.. ketemu dokter hebat yang
menggembleng kami dokter-dokter muda utk menjadi dokter yang rasional.

Prof.Garry : saya tahu persis bagaimana PESAT itu berkembang, dari awal Wati
membentuknya dan mengembangkan yayasan ini, banyak rintangan dan hambatan
juga tekanan dari banyak pihak. tapi konsistensinya beliau membuat saya
kagum, terus berjuang untuk masyarakat. menurut saya, dia seorang pahlawan.

windhi : setuuujuuuuu dia juga pahlawan buat kamiii..

thanks bunda..
cut nyak dien modern ;)

ayo kita teruskan perjuangan ini, for patient safety, for patient's right,
for our children and generation

Windhi
"ngerjain AB modul dulu ahh, udah dikejar2 anto"


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



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

5c.

Re: RUM meeting w/ Prof.Noel-Prof Garry

Posted by: "RlynAmien" e2osalyn@yahoo.com   e2osalyn

Thu Oct 13, 2011 1:00 pm (PDT)



Salut dg dokter2 RUM....
Izin copaste ya dr. Windhi......terutama point2 penting itu....

Tks & Rgrds,
@RlynAmien
bunda Rayyan & Rania

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5d.

Re: RUM meeting w/ Prof.Noel-Prof Garry

Posted by: "F.B.Monika" f_monika_b@yahoo.com   f_monika_b

Thu Oct 13, 2011 2:04 pm (PDT)



Dear dr Windy,

TFS ya..Semoga Allah memberkati smua tujuan n usaha mulia Bunda, para dr yg memperjuangkan RUM dan smua orang (para pengurus YOP include all smart parents)..

Hug..
*Terharu , bahagia, bangga
F.B.Monika

5e.

Re: RUM meeting w/ Prof.Noel-Prof Garry

Posted by: "siti amatullah mutmainah" amianakbinus@yahoo.com   amianakbinus

Thu Oct 13, 2011 2:46 pm (PDT)



Nambahin do'anya ceu mon..

Semoga akan ada lagi dokter yg spt bunda, juga dokter2 muda spt dirimu mpok windhi .. (Mas apin, mas anto, etc )..
Dan semoga niat dan usahanya dipermudah Allah ta'ala..amiin

Big Hug,
Ami

Maaf ga potek
Sent from AmiBerry® via Smart 1x / EVDO Network.

-----Original Message-----
From: "F.B.Monika" <f_monika_b@yahoo.com>
Sender: sehat@yahoogroups.com
Date: Thu, 13 Oct 2011 21:11:25
To: Milis Sehat<sehat@yahoogroups.com>
Reply-To: sehat@yahoogroups.com
Subject: Re: [sehat] RUM meeting w/ Prof.Noel-Prof Garry

Dear dr Windy,

TFS ya..Semoga Allah memberkati smua tujuan n usaha mulia Bunda, para dr yg memperjuangkan RUM dan smua orang (para pengurus YOP include all smart parents)..

Hug..
*Terharu , bahagia, bangga
F.B.Monika



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

5f.

Re: RUM meeting w/ Prof.Noel-Prof Garry

Posted by: "fitri.barokah@gmail.com" fitri.barokah@gmail.com

Thu Oct 13, 2011 3:49 pm (PDT)



Prof.Garry : --> menurut saya, dia seorang pahlawan

Setuju banget, tanpa milis ini mungkin Tama blm lengkap vaksin-nya, mungkin masih konsumsi obat batuk, AB utk com colds, GE, mungkin masih panikan panas dikit bawa ke dokter *tutup mata*.

Your a true Hero bunda, semoga perjuangan bunda and semua SP disini membawa harapan baru untuk pengobatan yg lebih baik dimasa anak-cucu kita nanti.

Salam,
Fitri


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5g.

Re: RUM meeting w/ Prof.Noel-Prof Garry

Posted by: "rosshy77@yahoo.com" rosshy77@yahoo.com   mommynyaarion

Thu Oct 13, 2011 4:45 pm (PDT)



Terharu banget dok,
Bener, kadang ketika aku share ttg RUM dan YOP, banyak yg sinis dan meragukan kebenarannya.
Dan pasti jauh dahsyat tantangan dan kesulitan yg bunda n YOP hadapi.
Seandainya pemerintah kita, khususnya dinkes mau terbuka matanya pasti musibah2 kesehatan yg umum terjadi di negri kita bisa diminimalisir.
Tapi setidaknya, kami2 yg sdh tau sdh menerapkan dan menggulirkan bola RUM ini dr lingkungan terkecil kami yakni keluarga kami.

Terima kasih ya bunda, kl bunda ga concern dan mau bertahan entah apa kami dan anak2 skkrg.

Aku bisa bangga kr anak2ku bisa di track yg benar kr mengenal milis ini.

Semoga makin banyak nakes2 muda yg bergabung dan muramnya dunia kesehatan Indonesia dpt disibakkan.

Tuhan memberkati bunda dan dokter2 sehat semuanya.

Maaf kepanjangan, tp haruu banget

Salam sayang
Rusmina hutapea
Mamanya abang ogie (4.7y)& adek josh (1.1y)
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5h.

Re: RUM meeting w/ Prof.Noel-Prof Garry

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

Thu Oct 13, 2011 5:21 pm (PDT)



Horreee.. Seneng banget bacanya...
Bikin semangat naik nih
Makasih atas sharingnya ya tante dokter :)

-ria-

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5i.

Re: RUM meeting w/ Prof.Noel-Prof Garry

Posted by: "nia2R" niea_152@yahoo.com   niea_152

Thu Oct 13, 2011 6:02 pm (PDT)



Semangat pagi-pagibaca ini..semalam cuma di tandai dulu.

Mudah2an pesat marathonnya bisa lancar jaya..

"thanks bunda..
cut nyak dien modern ;)" ~â–¸ like it!!







-nia-ibunya Razan Ragha
@nieafardina
5j.

Re: RUM meeting w/ Prof.Noel-Prof Garry

Posted by: "angel.encis@gmail.com" angel.encis@gmail.com   indahlife

Thu Oct 13, 2011 6:07 pm (PDT)



Iya nih.salut sama Bunda dan dokter2 muda disini.beruntung aku ikut milis ini meskipun diluaran aku masih dianggap cemen sama ilmu RUMku.malah dibilang ga pernah "ngobat" ya (⌣́_⌣̀)

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5k.

Re: RUM meeting w/ Prof.Noel-Prof Garry

Posted by: "tika tk" tika_ktk@yahoo.com   tika_ktk

Thu Oct 13, 2011 6:09 pm (PDT)



Huwwooww.. Hebaat!!
Alhamdulillah bisa kenal seorang dokter seperti bunda wati.
Bangga bisa tahu bahwa akan makin buanyakk "bunda wati" lainnya.
Semoga perjuangan bunda, dokter2 muda kece yang selalu me-RUM-kan masyarakat Indonesia selalu dapat ridho dr Yang Maha Kuasa. Amin :)

Warm Regards,
Tika
*bangga dan akan senang hati digembleng oleh SPs and Docs disini utk selalu RUM.
*ehh tadi malem mimpi Bunda wati masaaa..hihi.lucu mimpinya :))

6a.

Re: OOT film royal pains

Posted by: "kusuma_ayu3@yahoo.com" kusuma_ayu3@yahoo.com   kusuma_ayu3

Thu Oct 13, 2011 8:45 am (PDT)



Hi mom..mau nanya, klo yg royal pains 1,2, apakah mgnai stephen johnson (SJS) juga? Soalnya anak saya dapet alergi sulfa (menurun dr saya) dan sempet kena SJS ini. Jadi pengen nyari filmnya
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6b.

Re: OOT film royal pains

Posted by: "echy0312@yahoo.com" echy0312@yahoo.com   echy0312

Thu Oct 13, 2011 5:47 pm (PDT)



Oiya moms,sorry maksudnya star world bukan star movies hehe...
Mbak kusuma ayu,Film royal pains itu serial mbak,tiap minggu atau tiap episode dlm 1 season kasusnya beda2...kebetulan di serial yg kmrn menyinggung sedikit ttg SJS...tp ga dibahas mendalam sih...cuma lumayanlah utk membuka celah diskusi ttg ab kalo nontonnya brg2 keluarga...kmrn nntnya brg suami,jd kesempatan deh sekalian bahas ttg ab,abis kalo dsuruh baca susahnya minta ampun..

Thx
Desy
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7a.

Batita ngmg agak gagap

Posted by: "LiNa" lina.twin09@yahoo.com

Thu Oct 13, 2011 10:01 am (PDT)



Dear doct n sps,
Mau nanya neh, twin ku umur 2,5thn, tp kok cara dia ngmg kyk agak gagap y? Tp hanya adik ny bgtu, yg kakak ny nggak. Biasa ny kata dpn ny yg kyk gagap.

Misal, mama mau ngapain. Nah dia ngmg ny,
"Ma..ma...ma...ma mau ngapain" kata "mama" susah bgt keluar dr mulut ny. Kdg kata di blkg ny yg diulang. Misal. Мαмα, cc lg ngapain. Dia blg ny
" Мαмα, cc lg nga..nga...nga..ngapain"

Dia tau hrs ngmg apa, tp kykny susah bgt keluar dr mulut ny. Terkdg aku suruh diem dl. Trus ulangi pelan2, tp msh tetep bgtu.

Ada mom disni yg ngalamin hal sama gak? Share dong. Tkt ntr kebawa ampe gede.

*mudah2an bs berubah.


LiNa «Moммy si KeMbaR»
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7b.

Re: Batita ngmg agak gagap

Posted by: "Nandia Nugrahani" nandianugrahani@yahoo.com   nandianugrahani

Thu Oct 13, 2011 4:02 pm (PDT)



Bisa browsing pk keyword stuttering kidshealth atau arsip milis
http://www.kidshealth.org.nz/index.php/ps_pagename/contentpage/pi_id/382

 

Cheers,
Nanette

________________________________
From: LiNa <lina.twin09@yahoo.com>
To: Sehat <sehat@yahoogroups.com>
Sent: Friday, October 14, 2011 1:08 AM
Subject: [sehat] Batita ngmg agak gagap

 
Dear doct n sps,
Mau nanya neh, twin ku umur 2,5thn, tp kok cara dia ngmg kyk agak gagap y? Tp hanya adik ny bgtu, yg kakak ny nggak. Biasa ny kata dpn ny yg kyk gagap.

Misal, mama mau ngapain. Nah dia ngmg ny,
"Ma..ma...ma...ma mau ngapain" kata "mama" susah bgt keluar dr mulut ny. Kdg kata di blkg ny yg diulang. Misal. Мαмα, cc lg ngapain. Dia blg ny
" Мαмα, cc lg nga..nga...nga..ngapain"

Dia tau hrs ngmg apa, tp kykny susah bgt keluar dr mulut ny. Terkdg aku suruh diem dl. Trus ulangi pelan2, tp msh tetep bgtu.

Ada mom disni yg ngalamin hal sama gak? Share dong. Tkt ntr kebawa ampe gede.

*mudah2an bs berubah.

LiNa «Moммy si KeMbaR»
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8a.

Re: parkinson

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

Thu Oct 13, 2011 3:24 pm (PDT)



Mba Tyas,
Ada beberapa catatan mengenai parkinson,
http://emedicine.medscape.com/article/1831191-clinical

Onset of motor signs in Parkinson disease is typically asymmetric, with the most common initial finding being an asymmetric resting tremor in an upper extremity. Over time, patients notice symptoms related to progressive bradykinesia, rigidity, and gait difficulty. The first affected arm may not swing fully when walking, and the foot on the same side may scrape the floor. Over time, axial posture becomes progressively flexed and strides become shorter.

Some nonmotor symptoms commonly precede motor signs in Parkinson disease. Most Parkinson disease patients have a substantial reduction in olfactory function (smell) by the time motor signs emerge. However, this is often either not noticed by the patient or he or she may not realize that it is part of the disease. Another common premotor is rapid eye moved (REM) behavior disorder. In this disorder, individuals exhibit movements during REM sleep that are often described as hitting or kicking motions. There are also a number of midlife risk factors for the later development of Parkinson disease. These include constipation and excessive daytime sleepiness, although they are far from specific for Parkinson disease.

Initial clinical symptoms include the following:

Tremor
A subtle decrease in dexterity, such as a lack of coordination with activities such as playing golf or dressing (about 20% of patients first experience clumsiness in one hand)
Decreased arm swing on the first-involved side
Soft voice
Decreased facial expression
Sleep disturbances
REM behavior disorder (RBD), in which there is a loss of normal atonia during REM sleep: In one study, 38% of 50-year-old men with RBD and no neurologic signs went on to develop parkinsonism.[4]Patients “act out their dreams” and may kick, hit, talk, or cry out in their sleep.
Decreased sense of smell
Symptoms of autonomic dysfunction, including constipation, sweating abnormalities, sexual dysfunction, and seborrheic dermatitis
A general feeling of weakness, malaise, or lassitude
Depression or anhedonia
Slowness in thinking
Decreased swallowing, which may lead to excess saliva in the mouth and, ultimately, drooling
Regional pain, variously described as coldness, tingling, cramping, or aching; some patients complain of aching or tightness in the calf or shoulder region

Kalo untuk menentukan stagenya bisa digunakan ini
http://parkinsons.bsd.uchicago.edu/progression.html
The rate of disease progression varies from person to person. The Hoehn and Yahr stages are commonly used to describe disease progression. According to this scheme the disease may be staged as follows:

Stage Zero: No signs of disease.
Stage One: PD symptoms on one side of the body only.
Stage Two: PD symptoms on both sides of the body. No impairment of balance.
Stage Three: Balance impairment. Mild to moderate disease. Physically independent.
Stage Four: Severe disability, still able to walk or stand unassisted.
Stage Five: Wheelchair bound or bedridden unless assisted.

Tujuan manajemen parkinson disease adalah
The goal of medical management of Parkinson disease is to provide control of signs and symptoms for as long as possible while minimizing adverse effects. Studies demonstrate that a patient's quality of life deteriorates quickly if treatment is not instituted at or shortly after diagnosis.

Jadi maaf saja, belum ada metoda yang terbukti menyembuhkan (menghilangkan penyakit), obat obatan dan metoda lainnya hanya betujuan untuk mengontrol tanda dan gejala

Untuk mengendalikan gangguan non motorik (perilaku, perasaan dll), seorang neurolog dapat memberikan.

Dementia
Although no specific therapy exists for dementia, the American Academy of Neurology evaluated the evidence regarding the use of cholinesterase inhibitors in Parkinson disease dementia.[44] Based on their review, they suggested that rivastigmine (Exelon) and donepezil (Aricept) are probably effective in treating the dementia. The risk of potentially exacerbating motor symptoms may limit their widespread use. Anticholinergic drugs used for the treatment of motor manifestations of Parkinson disease may exacerbate memory impairment. When possible, avoid these medications.

Depression
Depression affects as many as 40% of patients with Parkinson disease. This may be due in large part to neurochemical changes associated with the disease. Limited studies suggest that tricyclic and selective serotonin reuptake inhibitor (SSRI) antidepressants have efficacy in depression in this setting.

Case reports exist of worsening of Parkinson disease motor features by SSRIs, but this has not been demonstrated in population studies. The combination of selegiline and an SSRI potentially can cause the serotonin syndrome, with symptoms of mental status changes, myoclonus, tremor, diaphoresis, incoordination, and possibly coma or death. This appears to be very rare and might be due to individual variations in metabolic pathways. The combination of selegiline at an oral dose of 10 mg/d or less and an SSRI generally is considered safe, although clinical monitoring is warranted.

Psychotherapy can play an important role in the treatment of depression,[45]and, in severe refractory cases, electroconvulsive therapy may be effective.[46] There is limited evidence showing any benefit with dopamine agonists[47] and monoamine oxidase inhibitors.[48] One study suggests that dopamine agonist treatment of Parkinson disease carries a substantial risk of pathological behaviors, which occurred in 16% of patients receiving these agonists.[49] The vast majority of affected cases (94%) were concurrently taking carbidopa/levodopa, suggesting concurrent therapy with a dopamine agonist appeared to be an important risk factor.

Anxiety
SSRIs and venlafaxine (Effexor) can be beneficial. Buspirone is well tolerated but has not been studied in this population. Benzodiazepines may help severe anxiety, but adverse effects such as cognitive impairment and balance problems may be concerning. Behavior modification techniques can play an important role in the treatment of anxiety.[50] However, the 2010 American Academy of Neurology practice parameter on the treatment of nonmotor symptoms in Parkinson disease found insufficient evidence to support or refute the treatment of anxiety in Parkinson disease with levodopa.[17]

Sleep disturbances
Benzodiazepines can be helpful in the treatment of rapid eye movement sleep behavior disorder (RBD), and obstructive sleep apnea can be treated with positive airway pressure with either continuous pressure or bilevel pressure. Sleep hygiene techniques include avoiding stimulants/fluids near bedtime, avoiding heavy late-night meals, and following a regular sleep schedule.[50, 51]

The 2010 American Academy of Neurology practice parameter found insufficient evidence to support or refute beneficial effects from the treatment of RBD in Parkinson disease. Other sleep disorders may benefit from treatment. Levodopa/carbidopa should be considered to treat periodic limb movements of sleep. Modafinil may improve patients’ subjective perceptions of excessive daytime somnolence (EDS), and methylphenidate may be considered in patients with fatigue.[17]

Hallucinations
Hallucinations usually occur in the presence of an underlying dementia. Mild, nonthreatening hallucinations may be tolerated, but an effort should be made to eliminate more severe or threatening hallucinations.

In patients who experience hallucinations, minor agents such as amantadine and anticholinergics should be titrated down and discontinued. If hallucinations are still present, dopamine agonists should be discontinued slowly, and levodopa/PDI should be titrated to see if hallucinations can be resolved while still maintaining adequate control of motor symptoms. If hallucinations persist, an atypical neuroleptic should be added. These agents reduce hallucinations and induce little or no worsening of parkinsonian motor features.

Quetiapine (Seroquel) is the most widely used medication to treat hallucinations in Parkinson disease. It is generally effective and does not require blood monitoring. It is introduced at a dose of 25 mg and increased to 50-300 mg/d as needed.

Clozapine (Clozaril) can be introduced using a chip (approximately one eighth) of a 25-mg tablet. The dose can be escalated slowly, and most patients experience good benefit at a dose of 12.5-25 mg/d. Weekly blood tests are required because of the risk of agranulocytosis.

Olanzapine (Zyprexa) and risperidone (Risperdal) appear to have slightly more parkinsonian adverse effects than clozapine or quetiapine.

Laksmi Purwitosari

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

9a.

Re: ask: penanganan anak yg demam tinggi sebelum ada kepastian diagn

Posted by: "Putri" uut_fight@yahoo.com   uut_fight

Thu Oct 13, 2011 4:39 pm (PDT)



Dear Mbak Niken, Mbak Marcella, Mbak Ami, thanks banget atas link-nya, jawabannya yang saling melengkapi. Maaf baru sempat balas, meski sudah dibaca cepat saat urgent kemarin.

Kalau ponakanku udah mulai turun panasnya sekarang (dan alhamdulillah, bundanya berani memutuskan tidak ngobati dg AB dulu)
Itu pun bukti alamiah, bahwa sebenarnya dia bukan typoid,kan,yahhhh...

Ohya satu lagiiiii

??? Kalau anak positif typoid, kemudian di-treat dengan AB, apakah panasnya bisa langsung turun dalam 1-2hari? atau tetap grafik panasnya akan sesuai siklus, dan penyakit baru akan reda dalam kurun waktu yang panjang (2minggu)?

thanks for respons. (dulu 4SD aku typoid, trus setelah itu jadi anak cengeng bbrp bulan. katanya ada efek dari penyakitnya... ga tahu bener apa ngga)

--- In sehat@yahoogroups.com, "siti amatullah mutmainah" <amianakbinus@...> wrote:
>
> Coba bantu dikiiit
>
> Q :
> mahal kah?
> A:
> Relatif ya, tergantung spending budgetnya
>
> ---> di lab swasta spt pro*** hrgnya 320rb.. Rs pemerintah mgkn ada tp tingkatan rsud blm ada
>
> Q:dan apa kebanyakan dokter akan menolak?
> A:
> Tergantung dokternya, gak bisa digeneralisir
>
> ---> akur dgn mpok bawel :p
> Tp umumnya mmg menolak, krn patokannya selalu tes widal dgn titer normal ..
> Kalau titer normal 1/160 tdk perlu gal culture.. Jika ada 4x kenaikan titernya, baru pertimbangkan utk teruskan ke gal..
> Krn mmg mahal
>
> Q:
> Terus, kan gall culture itu bisa makan waktu 2-7hari,ya. Nah, selama menunggu masa diagnosis, bagaimana tata laksana penanganan anaknya,ya?
> A:
> Dokter yang menetukan berdasarkan klinis anaknya (*tulung kureksi ya, kl salah)
>
> --->tetap jaga nutrisi , dijaga supaya tdk dehidrasi
>
> Q :apakah itu berarti anak tidak diberi obat penurun panas selama kisaran 1-2minggu observasi? bukankah penurun panas berfungsi untuk mengurangi rasa nyeri anak, dan juga mencegah resiko dehidrasi kalau panas terus (plus biasanya kan susah minum)
>
> A: ya kalau anaknya gak nyaman, ya jangan dong. Paracetamol ya, jangan ibuprofen. Kok bisa ada mencegah dehidrasi ya ? Mencegah dehidrasi dengan minum, kalau susah, sedikit tapi sering.
>
> ---> mencegah dehidrasi bukan dgn parset ato sejenisnya ya mba.. Tp dgn persering asupan cairan..
> Demam typhoid tdk bs diturunkan dgn parasetamol&kawan2nya..
> Knp? Penyebabya kan kuman patogen yg hrs dibasmi dgn ab ..
> Kalau demam krn infeksi virus, diberi penurun demam ataupun tidak bisa turun meski sebentar tp ada turunnya, tdk menetap..
> -cmiiw-
>
> Smoga membantu
>
> Rgds,
> Ami
>
>
>
>
>
> Sent from AmiBerry0…3 via Smart 1x / EVDO Network.
>

9b.

Re: ask: penanganan anak yg demam tinggi sebelum ada kepastian diagn

Posted by: "siti amatullah mutmainah" amianakbinus@yahoo.com   amianakbinus

Thu Oct 13, 2011 5:32 pm (PDT)



Stlh 3 hari konsumsi ab nya mba.. Bukan 1-2hari .. Itu jg tdk lgsg pulih, agak lama..krn yg diserang kan usus halus

Cmiiw,
Ami


Sent from AmiBerry® via Smart 1x / EVDO Network.
10a.

Re: Tanya: anak asi mau ditinggal

Posted by: "Pamelia Yulianto" hidupsehat.pam@gmail.com   pamelia_yulianto

Thu Oct 13, 2011 5:44 pm (PDT)



"minta nyokap buka nenennya buat anakku kalau aku ga ada"

Maaf ya mb.. Tp kl ini, sy pribadi krg setuju, krn mnrt sy yg dicarinya bkn semata2 puting payudara siapa aja

Maaf kl krg berkenan

- p a m e l i a -
"Stop Judging, Start Supporting"

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