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Healthcare Communication

2010-12-27T06:54:00.003+08:00

Senarai Daftar Kuliah Blok Community Health Oriented Program - Communication (FK USU-Batch 2007)

Pengenalan Komunikasi

(1) Pengenalan Komunikasi:
- Definisi komunikasi (CHOPK K1.01)
- Prinsip dasar komunikasi (CHOPK K1.01)
- Tujuan komunikasi (CHOPK K1.01)
- Unsur-unsur komunikasi (CHOPK K1.01)
- Proses komunikasi (CHOPK K1.01)
- Bentuk-bentuk komunikasi (secara umum) verbal dan non verbal (CHOPK K1.01)

Faktor-faktor yang mempengaruhi proses komunikasi

(1) Faktor-faktor yang mempengaruhi proses komunikasi:
- Faktor yang mempercepatkan proses komunikasi (CHOPK K1.02a&K1.02b)
- Faktor yang membantut proses komunikasi (CHOPK K1.02a&K1.02b)
- Karakteristik individu yang mempengaruhi komunikasi (CHOPK K1.02a&K1.02b)

Komunikasi interpersonal

(1) Komunikasi interpersonal:
- Keterampilan mendengar (CHOPK K1.03a&K1.03b)
- Keterampilan bertingkah laku asertif (CHOPK K1.03a&K1.03b)
- Keterampilan menyelesaikan konflik (CHOPK K1.03a&K1.03b)
- Keterampilan menyelesaikan masalah bersama (CHOPK K1.03a&K1.03b)
- Keterampilan memilih situasi (CHOPK K1.03a&K1.03b)

Komunikasi Terapeutik

(1) Komunikasi Terapeutik:
- Pengertian dan Prinsip Komunikasi Terapeutik (CHOPK K1.04)
- Tujuan dan Manfaat (CHOPK K1.04)
- Fasa-fasa dalam Komunikasi Terapeutik (CHOPK K1.04)
- Teknik Komunikasi Terapeutik (CHOPK K1.04)
- Faktor yang Membantut Komunikasi Terapeutik (CHOPK K1.04)
- Pemutaran film (CHOPK F1.01)

Komunikasi Doktor dan Pesakit

(1) Komunikasi Doktor dan Pesakit:
- Pengertian Komunikasi Doktor dan Pesakit (CHOPK K1.05)
- Tujuan dan Manfaat (CHOPK K1.05)
- Ciri-ciri Pesakit (CHOPK K1.05)
- Ciri-ciri Doktor (CHOPK K1.05)
- Bentuk hubungan doktor-pesakit (CHOPK K1.05)
- Informed Consent (CHOPK K1.05)

Komunikasi Doktor dan Pesakit pada Kes-kes Tertentu

(1) Komunikasi Doktor dan Pesakit pada Kes-kes Tertentu:
- Komunikasi pada kes kanser (CHOPK K1.06)
- Komunikasi pada kes menuju kematian (CHOPK K1.06)
- Komunikasi ketika akan dilakukan tindakan radikal: Histerektomi, amputasi (CHOPK K1.06)

Komunikasi Massa

(1) Komunikasi Massa:
- Definisi komunikasi massa (CHOPK K1.07)
- Tujuan komunikasi massa (CHOPK K1.07)
- Manfaat komunikasi massa (CHOPK K1.07)
- Metode komunikasi massa (CHOPK K1.07)
- Alat bantu komunikasi massa (CHOPK K1.07)

Metode dan Alat bantu komunikasi

(1) Metode dan Alat bantu komunikasi:
- Metode pendidikan individual (CHOPK K1.08)
- Metode pendidikan kumpulan (CHOPK K1.08)
- Metode pendidikan massa (CHOPK K1.08)
- Alat bantu pendidikan kesihatan (CHOPK K1.08)

Community Health

2010-12-26T15:04:00.008+08:00

Senarai Daftar Kuliah Blok Community Health Oriented Program I (FK USU-Batch 2007)

Filosofi dan Perkembangan Kesihatan Masyarakat

(1) Pengenalan Kesihatan Masyarakat:
- Pengertian kesihatan (CHOP K1.01)
- Pengertian masyarakat (CHOP K1.01)
- Definisi Kesihatan Masyarakat (CHOP K1.01)
- Sejarah (CHOP K1.01)
- Definisi Perubatan Pencegahan (CHOP K1.01)
- Definisi Perubatan Komuniti (CHOP K1.01)
- Kegiatan kesihatan masyarakat (CHOP K1.01)
- Tujuan (CHOP K1.01)

Persekitaran dan Kesihatan

(1) Pendahuluan Kesihatan Persekitaran:
- Batasan kesihatan persekitaran (CHOP K1.02)
- Pengaruh persekitaran terhadap kesihatan (CHOP K1.02)
- Hygiene dan Sanitation (CHOP K1.02)
- Tujuan kesihatan persekitaran (CHOP K1.02)
- Kesihatan persekitaran di Indonesia (CHOP K1.02)

(2) Masalah Kesihatan Persekitaran:
- Masalah kesihatan persekitaran (CHOP K1.03)
- Penyebab masalah persekitaran (CHOP K1.03)
- Masalah air (CHOP K1.03)
- Masalah sampah (CHOP K1.03)
- Masalah air limbahan (CHOP K1.04)
- Masalah vektor penyakit (CHOP K1.04)
- Masalah perumahan (CHOP K1.04)

Faktor yang mempengaruhi penyakit dan pencegahannya

(1) Perkembangan Penyakit:
- Konsep terjadinya penyakit (CHOP K1.05a&K1.05b)
- Manusia dan persekitaran serta interaksinya (CHOP K1.05a&K1.05b)
- Persekitaran hidup (CHOP K1.05a&K1.05b)
- Usaha-usaha kesihatan dan faktor yang mempengaruhinya (CHOP K1.05a&K1.05b)
- Paradigma hidup sihat (CHOP K1.05a&K1.05b)

(2) Pencegahan Penyakit:
- Definisi (CHOP K1.05c)
- Tingkat pencegahan penyakit (CHOP K1.05c)
- Strategi pencegahan penyakit (CHOP K1.05c)
- Pengaruh faktor lain (CHOP K1.05c)

Administrasi Kesihatan

(1) Dasar-dasar administrasi dan manajemen kesihatan:
- Prinsip administrasi (CHOP K1.06)
- Prinsip manajemen (CHOP K1.06)
- Unsur-unsur administrasi (CHOP K1.06)
- Fungsi manajemen/ POAC (CHOP K1.06)

(2) Sistem Kesihatan Nasional (SKN):
- Pengertian SKN (CHOP K1.07)
- Landasan SKN (CHOP K1.07)
- Tujuan SKN (CHOP K1.07)
- Prinsip SKN (CHOP K1.07)
- Subsistem Upaya Kesehatan (CHOP K1.07)

(3) Five Star Doctor (FSD):
- Pengertian FSD (CHOP K1.08)
- Prinsip FSD (CHOP K1.08)
- Landasan FSD (CHOP K1.08)
- Dasar-dasar menjadi FSD (CHOP K1.08)

(4) Paradigma Sihat:
- Pengertian paradigma sihat (CHOP K1.08)
- Visi "Indonesia Sehat 2010" (CHOP K1.08)

(5) Pengenalan Pelayanan Kesihatan:
- Perkembanagan Program Perkhidmatan Kesihatan Masyarakat (CHOP K1.09)
- Struktur Organisasi Department Kesihatan di Indonesia (CHOP K1.09)
- Syarat asas perkhidmatan kesihatan (CHOP K1.09)
- Stratification perkhidmatan kesihatan dan sistem rujukan (CHOP K1.09)
- Beberapa perkhidmatan kesihatan di Indonesia (CHOP K1.09)

Pusat Kesihatan Masyarakat (PUSKESMAS) dan Promosi kesihatan

(1) Pusat Kesihatan Masyarakat (PUSKESMAS):
- Definisi PUSKESMAS (CHOP K1.10)
- Prinsip perkhidmatan PUSKESMAS (CHOP K1.10)
- Kegiatan PUSKESMAS (CHOP K1.10)

(2) Promosi Kesihatan:
- Pendidikan kesihatan (CHOP K1.11)
- Konsep promosi kesihatan (CHOP K1.11)
- Peranan pendidikan kesihatan dalam kesihatan masyarakat (CHOP K1.11)
- Promosi kesihatan di Indonesia (CHOP K1.11)
- Promosi kesihatan di tempat kerja (CHOP K1.11)
- Promosi kesihatan di hospital (CHOP K1.11)

Senarai Daftar Kuliah Blok Community Health Oriented Program II (FK USU-Batch 2007)

Organ Reproduksi Wanita dan Pengguguran

(1) Kesihatan Reproduksi:
- Konsep kesihatan reproduksi secara umum (CHOP K2.01)

Pengguguran

(1) Pemeliharaan Kesihatan Selama Kehamilan:
- Kesihatan ibu hamil (CHOP K2.02)

Sistem Reproduksi dan Gender

(1) Sistem Rujukan pada Masalah Persalinan:
- Kesihatan reproduksi remaja (CHOP K2.03)

Masalah Persalinan dan Pemilihan Makanan Selama Kehamilan dan Menyusui

(1) Sistem Rujukan pada Masalah Persalinan:
- Sistem rujukan dalam perkhidmatan kesihatan reproduksi (CHOP K2.04)

Kehamilan di Luar Cara Semula Jadi

(1) Peranan Seksologi dalam Kesihatan Reproduksi:
- Peranan seksologi dalam kesihatan reproduksi dan hubungan secara dua arah pada persekitaran (CHOP K2.05)

Pencegahan Kehamilan

(1) Obstetric and gynecologic implementation:
- Perancangan keluarga dan kehamilan (CHOP K2.06)

(2) Sosial dalam perkhidmatan kesihatan reproduksi:
- Sosial dalam perkhidmatan kesihatan reproduksi (CHOP K2.06)

Perilaku Sakit dan Model Perkhidmatan Kesihatan

(1) Pengurusan menyeluruh di PUSKESMAS:
- Masalah kesihatan ibu hamil, melahirkan, bayi, dan kanak-kanak di bawah umur lima tahun (CHOP K2.07)

Nutrisi dan Kanser

(1) Pos Perkhidmatan Terpadu (POSYANDU):
- Program POSYANDU kesihatan ibu hamil, melahirkan, bayi, dan kanak-kanak di bawah umur lima tahun (CHOP K2.08)

Nutrisi Kanak-kanak

(1) Susunan menu dengan memperhatikan keperluan tenaga untuk memenuhi nutrisi kanak-kanak:
- Dasar-dasar penyusunan menu yang cukup dan seimbang (CHOP K2.09)
- Daftar ukuran pengganti bahan makanan (CHOP K2.09)
- Daftar kecukupan yang dianjurkan: Dietary Reference Intake, Recommended Dietary Allowance, Adequate Intake, Tolerable Upper Intake Levels, dan Estimated Average Requirements (CHOP K2.09)
- Acceptable Macro Nutrient Distribution Range (CHOP K2.09)
- Penyusunan menu individu (CHOP K2.09)

(2) Penilaian status nutrisi masyarakat:
- Dasar-dasar penyelidikan diet pada masyarakat (CHOP K2.10)
- Pendekatan epidemiologi dalam pencegahan penyakit akibat kelainan nutrisi (CHOP K2.10)
- Surveillance masalah nutrisi (CHOP K2.10)

Fungsi-Sifat (faal) Kerja dan Ergonomi

(1) Faal kerja dan Ergonomi:
- Pengertian faal kerja (CHOP K2.11)
- Pengertian ergonomi (CHOP K2.11)
- Konsep dasar dan aplikasi (CHOP K2.11)
- Kelelahan dalam pekerjaan (CHOP K2.11)

Nutrisi Kerja

(1) Nutrisi Kerja:
- Pengertian (CHOP K2.12)
- Makanan dan zat nutrisi (CHOP K2.12)
- Nutrisi dan produktiviti (CHOP K2.12)
- Penentuan keperluan gizi pekerja (CHOP K2.12)

Psikologi Industri

(1) Psikologi Industri:
- Pengertian (CHOP K2.13)
- Motivasi Kerja (CHOP K2.13)
- Kepuasan Kerja (CHOP K2.13)

Senarai Daftar Kuliah Blok Community Health Oriented Program III (FK USU-Batch 2007)

POSYANDU LANSIA (warga emas)

(1) Faktor penyebab/ resiko kelainan/ penyakit sistem muskuloskeletal dalam masyarakat, Pencegahan primer dan sekunder, dan Kegiatan POSYANDU LANSIA:
- Menentukan besarnya masalah kelainan penyakit sistem muskuloskeletal dalam masyarakat (CHOP K3.01&K3.02)
- Menentukan faktor penyebab/ resiko kelainan/ penyakit sistem muskuloskeletal dan dapat menghubungi faktor tersebut dengan kelainan/ penyakit sistem muskuloskeletal yang didapat/ acquired (CHOP K3.01&K3.02)
- Membuat rencana pencegahan primer dan sekunder serta rancangan rehabilitasi kelainan/ penyakit sistem muskuloskeletal (CHOP K3.01&K3.02)

Pemberantasan Penyakit Kusta dan Pencegahan Penyakit Kulit Lainnya

(1) Program PUSKESMAS dalam pemberantasan penyakit kusta dan Pencegahan primer dan sekunder serta rancangan rehabilitasi kelainan penyakit kulit:
- Menentukan besarnya masalah kelainan/ penyakit dermatologi dalam masyarakat (CHOP K3.03&K3.04)
- Pencegahan primer dan sekunder serta rencana rehabilitasi kelainan penyakit kulit (CHOP K3.03&K3.04)

Sistem Pengurusan Kesihatan di POSYANDU LANSIA

(1) Kad Menilai Status warga emas (KMS USILA):
- Sistem pengurusan kesihatan di POSYANDU LANSIA (CHOP K3.05)

Pengurusan Kesihatan Penyakit-penyakit Geriatri dan Pecegahannya

(1) Penyakit geriatri dan Pencegahan penyakit geriatri:
- Sistem pencegahan penyakit geriatri dan mempertinggi kualiti hidup LANSIA/ warga emas (CHOP K3.06)

Pengurusan dalam contol TB

(1) Program Pencegahan TB di Masyarakat:
- Sistem pencegahan penyakit TB di masyarakat (CHOP K3.07)

Pengurusan Penyakit Paru Obstruktif Kronik (PPOK)

(1) Program pencegahan PPOK di masyarakat:
Sistem pencegahan penyakit PPOK di masyarakat (CHOP K3.08)

Senarai Daftar Kuliah Blok Community Health Oriented Program IV (FK USU-Batch 2007)

Hygiene Perindustrian dan Kesihatan Kerja

(1) Pengenalan hygiene perindustrian dan kesihatan kerja:
- Pengertian hygiene perusahaan dan kesihatan kerja (CHOP K4.01)
- Tujuan hygiene perusahaan dan kesihatan kerja (CHOP K4.01)
- Hal-hal yang mempengaruhi kesihatan kerja (CHOP K4.01)

Masalah Kesihatan pada Pekerjaan

(1) Penyakit akibat kerja:
- Pengertian (CHOP K4.02)
- Jenis gangguan kesihatan yang diakibatkan pekerjaan (CHOP K4.02)
- Langkah-langkah diagnosis penyakit akibat kerja (CHOP K4.02)
- Penyakit paru akibat kerja (CHOP K4.03)
- Penyakit kulit akibat kerja (CHOP K4.03)
- Penyakit mata akibat kerja (CHOP K4.04)
- Stress akibat kerja (CHOP K4.04)
- Keluhan musculoskeletal akibat kerja (CHOP K4.04)

(2) Pecegahan terjadinya penyakit akibat kerja:
- Pengertian (CHOP K4.05)
- Pencegahan penyakit akibat kerja (CHOP K4.05)
- Alat pelindung diri (CHOP K4.05)
- Jenis pekerjaan dan Alat pelindung diri (CHOP K4.05)
- Manfaat alat pelindung diri menurut jenisnya (CHOP K4.05)

(3) Kecelakaan kerja:
- Pengertian (CHOP K4.06)
- Hal-hal yang mengakibatkan kecelakaan kerja (CHOP K4.06)
- Pencegahan kecelakaan kerja (CHOP K4.06)
- Jenis alat pelindung diri untuk mencegah kecelakaan kerja (CHOP K4.06)

Toksikologi Industri

(1) Toksikologi industri:
- Pengertian (CHOP K4.07)
- Prinsip dan ruang lingkupan (CHOP K4.07)
- Absorbsi, Distribusi, dan Ekskresi (CHOP K4.07)
- Jenis-jenis toksikan (CHOP K4.07)
- Pengaruh toksikan pada kesihatan tubuh (CHOP K4.07)

Faktor fizik di tempat kerja

(1) Faktor fizik di tempat kerja:
- Kebisingan (CHOP K4.08)
- Penerangan (CHOP K4.08)
- Cuaca/ iklim kerja (CHOP K4.08)
- Getaran mekanik (CHOP K4.08)
- Radiasi (CHOP K4.08)

Fungsi-Sifat (faal) Kerja dan Ergonomi

(1) Faal kerja dan Ergonomi:
- Pengertian faal kerja (CHOP K4.09)
- Pengertian ergonomi (CHOP K4.09)
- Konsep dasar dan aplikasinya (CHOP K4.09)
- Kelelahan dalam pekerjaan (CHOP K4.09)

Nutrisi Kerja

(1) Nutrisi Kerja:
- Pengertian (CHOP K4.10)
- Makanan dan zat nutrisi (CHOP K4.10)
- Nutrisi dan produktiviti (CHOP K4.10)
- Penentuan keperluan gizi pekerja (CHOP K4.10)

Psikologi Industri

(1) Psikologi Industri:
- Pengertian (CHOP K4.11)
- Motivasi Kerja (CHOP K4.11)
- Kepuasan Kerja (CHOP K4.11)

Pengurusan keselamatan dan kesihatan kerja

(1) Pengurusan keselamatan dan kesihatan kerja:
- Pengertian (CHOP K4.12)
- Konsep pengurusan yang berjaya secara menyeluruh (CHOP K4.12)
- Pengurusan pengendalian kerugian (CHOP K4.12)
- Pengertian keselamatan dan kesihatan kerja dari sudut hukum (CHOP K4.12)
- Perundang-undangan keselamatan dan kesihatan kerja (CHOP K4.12)
- Mekanisme pengawasan keselamatan dan kesihatan kerja (CHOP K4.12)

Community Research

2010-12-26T06:22:00.008+08:00

Senarai Daftar Kuliah Blok Community Research Program I (FK USU-Batch 2007)

Pengenalan epidemiologi dan Konsep penyakit dalam epidemiologi

(1) Konsep Dasar Epidemiologi:
- Pengertian epidemiologi (CRP K1.01)
- Sejarah epidemiologi dalam bidang kesihatan (CRP K1.01)
- Kegunaan epidemiologi dalam bidag kesihatan (CRP K1.01)

(2) Konsep Dasar Timbulnya Penyakit:
- Konsep terjadinya penyakit (CRP K1.02)
- Segitiga epidemiologi (CRP K1.02)
- Jaring sebab akibat (CRP K1.02)
- Teori roda (CRP K1.02)

Konsep Pengukuran dalam epidemiologi

(1) Ukuran Kesakitan dan Kematian:
- Incidence Rate (CRP K1.03)
- Prevalence Rate (CRP K1.03)
- Period Rate (CRP K1.03)
- Crude Death Rate (CRP K1.03)
- Age Specific Death Rate (CRP K1.03)
- Case Fatality Rate (CRP K1.03)
- Infant Mortality Rate (CRP K1.03)
- Maternal Mortality Rate (CRP K1.03)

Epidemiologi Deskriptif

(1) Konsep Penyakit dan Kematian berdasarkan Orang, Tempat, dan Waktu:
- Kejadian Kesakitan/ Kematian berdasarkan Orang (CRP K1.04)
- Kejadian Kesakitan/ Kematian berdasarkan Tempat (CRP K1.04)
- Kejadian Kesakitan/ Kematian berdasarkan Waktu (CRP K1.04)

Konsep Statistik dalam Bidang Kesihatan

(1) Konsep statistik dalam bidang kesihatan:
- Pengertian statistik (CRP K1.05)
- Sejarah dan Perkembangan statistik (CRP K1.05)
- Peranan statistik kesihatan (CRP K1.05)

(2) Pengenalan kepada data:
- Pengertian data (CRP K1.06)
- Jenis data (CRP K1.06)
- Skala pengukuran (CRP K1.06)
- Populasi dan sampel (CRP K1.06)
- Penyajian data (CRP K1.06)
- Bentuk penyajian data (CRP K1.06)

Epidemiologi Surveilans

(1) Epidemiologi Surveilans:
- Pengertian epidemiologi surveilans (CRP K1.09)
- Beberapa kegiatan surveilans (CRP K1.09)
- Komponen surveilans (CRP K1.09)
- Alat bantu pelaksanaan surveilens (CRP K1.09)

(2) Wabak dan Kuarantin:
- Pengertian wabak (CRP K1.09)
- Jenis-jenis wabak (CRP K1.09)
- Hal-hal yang perlu dilakukan saat terjadinya wabak (CRP K1.09)
- Kuarantin (CRP K1.09)
- Undang-undang kuarantin (CRP K1.09)

(3) Penyakit Menular:
- Pengertian penyakit menular (CRP K1.10)
- Jenis-jenis penyakit menular (CRP K1.10)
- Epidemiologi penyakit demam denggi berdarah, malaria, dan tuberkulosis (CRP K1.10)

(4) Penyakit Tidak Menular:
- Pengertian penyakit tidak menular (CRP K1.10)
- Jenis-jenis penyakit tidak menular (CRP K1.10)
- Epidemiologi penyakit penyakit jantung koronari, penyakit stroke, penyakit diabetes mellitus, dan kanser (CRP K1.10)

(5) Tes Screening:
- Pengertian screening test (CRP K1.11)
- Tujuan dan sasaran (CRP K1.11)
- Pelaksanaan (CRP K1.11)
- Keuntungan (CRP K1.11)
- Kriteria penyusunan (CRP K1.11)
- Validiti dan reliabiliti (CRP K1.11)
- Darjat/ tingkatan screening (CRP K1.11)

(6) Statistik Deskriptif:
- Distribusi frekuensi (CRP K1.07&K1.08)
- Central tendency: Mean, Median, Mode (CRP K1.07&K1.08)
- Ukuran variasi: Range, Mean deviation, Varian, Standard deviation, dan Confident Value (CRP K1.07&K1.08)

Pengenalan kepada Penelitian Kesihatan

(1) Ilmu Pengetahuan dan Penelitian:
- Ilmu pengetahuan (CRP K1.12)
- Cara memperoleh pengetahuan (CRP K1.12)
- Kelebihan dan kelemahan metode ilmiah (CRP K1.12)
- Masyarakat ilmiah (CRP K1.12)
- Kaedah berfikir ilmiah (CRP K1.12)

(2) Pengenalan kepada Penelitian Kesihatan:
- Definisi penelitian kesihatan (CRP K1.13)
- Tujuan dan manfaat penelitian (CRP K1.13)
- Syarat-syarat penelitian (CRP K1.13)
- Langkah-langkah penelitian (CRP K1.13)

(3) Jenis Penelitian:
- Jenis penelitian kesihatan (CRP K1.14)
- Penelitian observasi: Case study, Serial case, Cross sectional, Case control, dan Cahort (CRP K1.14)
- Penelitian eksperimental: Uji klinik, Penelitian eksperimental pada pendidikan, perilaku, dan kesihatan masyarakat (CRP K1.14)

Senarai Daftar Kuliah Blok Community Research Program II (FK USU-Batch 2007)

Jenis/ Rancangan Penelitian

(1) Cross Sectional:
- Pengertian dasar penelitian cross sectional: agen, faktor resiko, dan efek (CRP K2.01&K2.02)
- Langkah-langkah penelitian cross sectional (CRP K2.01&K2.02)
- Kelebihan dan kekurangan penelitian cross sectional (CRP K2.01&K2.02)

(2) Case Control:
- Pengertian dasar case control (CRP K2.03&K2.04)
- Langkah-langkah penelitian case control (CRP K2.03&K2.04)
- Prinsip matching (CRP K2.03&K2.04)
- Perhitungan Odds Ratio (CRP K2.03&K2.04)
- Bias dalam penelitian case control (CRP K2.03&K2.04)
- Kelebihan dan kekurangan penelitian case control (CRP K2.03&K2.04)

(3) Cohort:
- Pengertian dasar cohort (CRP K2.05)
- Langkah-langkah penelitian cohort (CRP K2.05)
- Jenis-jenis rancangan cohort (CRP K2.05)
- Perhitungan Relative Risk (CRP K2.05)
- Bias dalam penelitian cohort (CRP K2.05)
- Kelebihan dan kekurangan penelitian cohort (CRP K2.05)
- Tugas meringkas penelitian cohort (CRP K2.06)

Statistik Kependudukan

(1) Demografi:
- Prinsip demografi (CRP K2.07&K2.08)
- Trasisi demografi (CRP K2.07&K2.08)
- Perkembagan kependudukan di Indonesia (CRP K2.07&K2.08)
- Komposisi penduduk (CRP K2.07&K2.08)
- Ukuran-ukuran demografi (CRP K2.07&K2.08)

Statistik Inferensial

(1) Teori Probability dan Distribusi Normal:
- Pengertian distribusi normal (CRP K2.09)
- Ciri-ciri distribusi normal (CRP K2.09)
- Luas daerah distribusi normal (CRP K2.09)
- Table distribusi normal (CRP K2.09)
- Aplikasi (CRP K2.09)

(2) Estimasi dan Uji hipotesis:
- Pengenalan pada statistik inferensial (CRP K2.10)
- Distribusi sampling/ central limit teorema (CRP K2.10)
- Pengertian estimasi (CRP K2.10)
- Ciri-ciri estimasi (CRP K2.10)
- Estimasi titik (CRP K2.10)
- Estimasi interval (CRP K2.10)
- Estimasi proporsi (CRP K2.10)
- Aplikasi estimasi (CRP K2.10)
- Pengertian uji hipotesis (CRP K2.11)
- Jenis hipotesis (CRP K2.11)
- Arah uji hipotesis (CRP K2.11)
- Kesalahan pengambilan keputusan (CRP K2.11)
- Langkah-langkah uji hipotesis (CRP K2.11)
- Aplikasi uji hipotesis (CRP K2.11)

(3) Uji Hipotesis dengan Chi Square Test:
- Pengertian chi square (CRP K2.12)
- Syarat-syarat chi square (CRP K2.12)
- Prinsip uji chi square (CRP K2.12)
- Penentuan darjat kebebasan (CRP K2.12)
- Penentuan nilai ekspektasi (CRP K2.12)
- Pengujian hipotesis dengan chi square (CRP K2.12)
- Aplikasi (CRP K2.12)

Senarai Daftar Kuliah Blok Community Research Program III (FK USU-Batch 2007)

Statistik Analitik

(1) Uji hipotesis dengan uji T:
- T independen (CRP K3.01a&K3.01b)
- Pengertian uji T independen (CRP K3.01a&K3.01b)
- Syarat uji T independen (CRP K3.01a&K3.01b)
- Langkah-langkah pengujian (CRP K3.01a&K3.01b)
- Uji T dependen (CRP K3.01a&K3.01b)
- Pengertian uji T dependen (CRP K3.01a&K3.01b)
- Langkah-langkah uji T depeden (CRP K3.01a&K3.01b)
- Syarat uji T dependen (CRP K3.01a&K3.01b)
- Aplikasi (CRP K3.01a&K3.01b)

(2) Korelasi dan Regresi:
- Pengertian korelasi (CRP K3.02a&K3.02b)
- Syarat korelasi (CRP K3.02a&K3.02b)
- Gambaran/ Scater plot (CRP K3.02a&K3.02b)
- Menentukan Kekuatan Hubungan (CRP K3.02a&K3.02b)
- Menentukan signifikansi (CRP K3.02a&K3.02b)
- Pengertian regresi (CRP K3.02a&K3.02b)
- Syarat regresi (CRP K3.02a&K3.02b)
- Menentukan nilai slope (CRP K3.02a&K3.02b)
- Menentukan nilai intercept (CRP K3.02a&K3.02b)
- Menentukan persamaan matematik (CRP K3.02a&K3.02b)
- Interpretasi (CRP K3.02a&K3.02b)

(3) Anova:
- Pengertian (CRP K3.03)
- Syarat (CRP K3.03)
- Langkah-langkah (CRP K3.03)
- Aplikasi (CRP K3.03)

(4) Non parametrik:
- Pengertian (CRP K3.04)
- Jenis-jenis non parametrik (CRP K3.04)
- Kelebihan dan kekurangan (CRP K3.04)

Epidemiologi Klinik

(1) Pengenalan epidemiologi klinik:
- Pengertian (CRP K3.05)
- Prinsip dasar epidemiologi klinik (CRP K3.05)
- Pertanyaan klinik (CRP K3.05)
- Kejadian klinik (CRP K3.05)
- Bias (CRP K3.05)
- Jenis Bias (CRP K3.05)

(2) Abnormality:
- Fenomena klinik (CRP K3.06)
- Skala pengukuran (CRP K3.06)
- Kualiti pengukuran (CRP K3.06)
- Variasi pengukuran (CRP K3.06)
- Definisi normal (CRP K3.06)

(3) Diagnosis:
- Pengertian (CRP K3.07)
- Gold standard (CRP K3.07)
- Sensitive dan Spesifik (CRP K3.07)
- Predictive Value (CRP K3.07)
- Ketepatan/ Accuracy (CRP K3.07)
- Likelihood Ratio (CRP K3.07)
- Multiple test (CRP K3.07)

(4) Screening:
- Pengertian (CRP K3.08)
- Tujuan dan Sasaran (CRP K3.08)
- Bentuk pelaksanaan screening (CRP K3.08)
- Keuntungan (CRP K3.08)
- Kriteria penyusunan (CRP K3.08)
- Validiti dan Reliabiliti (CRP K3.08)
- Darjat screening (CRP K3.08)

(5) Frequency:
- Jenis Ukuran Kesakitan (CRP K3.09)
- Karakteristik Prevalance dan Incidence (CRP K3.09)
- Aplikasi (CRP K3.09)

(6) Risk:
- Pengertian risk (CRP K3.10)
- Penelitian menentukan resiko (CRP K3.10)
- Pengertian etiologi (CRP K3.10)
- Kriteria hubungan causal (CRP K3.10)
- Pengertian temporality, strength, dose, response, intervention, consistent, koheren, dan biological plausibility (CRP K3.10)

(7) Prognosis:
- Pengertian (CRP K3.11)
- Perbezaan risk dan prognosis (CRP K3.11)
- Penelitian prognosis (CRP K3.11)
- Ukuran prognosis menurut lama penyakit (CRP K3.11)

(8) Clinical Decision Making:
- Pengertian (CRP K3.12)
- Tujuan dan manfaat (CRP K3.12)
- Langkah-langkah (CRP K3.12)
- Contoh aplikasi (CRP K3.12)

Senarai Daftar Kuliah Blok Community Research Program IV (FK USU-Batch 2007)

Pengenalan kepada Evidence Based Medicine (EBM)

(1) Pengenalan kepada Evidence Based Medicine (EBM):
- Latar belakang EBM (CRP K4.01)
- Peranan EBM (CRP K4.01)
- Pengertian dan tujuan EBM (CRP K4.01)
- Komponen EBM (CRP K4.01)
- Langkah-langkah EBM (CRP K4.01)
- Level evidence (CRP K4.01)
- Pengenalan Main Area: Diagnosis, Therapy, Prognosis, dan Harm (CRP K4.01)

(2) Asking Answerable Questions Klinik:
- Tahapan EBM (CRP K4.02)
- Pengertian asking answerable questions klinik (CRP K4.02)
- Fore Ground dan Back Ground (CRP K4.02)
- Pemahaman tentang Patient problems/ population, Intervention, Comparison, dan Outcome (PICO) (CRP K4.02)

(3) Searching Literature:
- Tahapan EBM (CRP K4.03)
- Pemahaman tentang PICO (CRP K4.03)
- Mencari literature (keyword) (CRP K4.03)
- Syarat sumber bacaan/ EBM yang ideal (CRP K4.03)
- Pemilihan literatur (CRP K4.03)

(4) Sumber-sumber EBM:
- Sumber-sumber EBM (CRP K4.04)

Diagnosis EBM

(1) Diagnosis EBM:
- Pengertian diagnosis EBM (CRP K4.05&K4.06)
- Work sheet diagnosis (CRP K4.05&K4.06)
- Komponen validity (CRP K4.05&K4.06)
- Komponen important: Sensitivity, Specificity, PPV, NPV, LR, Pre test, Post test Odds (CRP K4.05&K4.06)
- Komponen applicability (CRP K4.05&K4.06)

Critical Appraisal

(1) Critical Appraisal:
- Data dan bukti pengkajian ilmiah untuk menilai relevancy dan validity nya (CRP T01&T02)
- Metode penelitian dan statistik untuk menilai kebenaran informasi ilmiah (CRP T01&T02)
- Dasar pengelolaan informasi untuk menghimpun data relevan menjadi arkib peribadi (CRP T01&T02)
- Dasar dalam menilai data untuk melakukan validation informasi ilmiah secara sistematik (CRP T01&T02)

Senarai Daftar Kuliah Blok Community Research Program V (FK USU-Batch 2007)

Therapy

(1) Therapy EBM:
- Pengertian therapy EBM (CRP K5.01)
- Work sheet therapy (CRP K5.01)
- Komponen validity (CRP K5.01)
- Komponen important: CER, EER, ARR, dan NNT (CRP K5.01)
- Komponen applicability (CRP K5.01)

(2) Work sheet therapy:
- Pengertian therapy (CRP K5.02)
- Work sheet therapy (CRP K5.02)
- Komponen validity (CRP K5.02)
- Komponen important (CRP K5.02)
- Komponen applicability (CRP K5.02)

(3) Critical Appraisal:
- Data dan bukti pengkajian ilmiah untuk menilai relevancy dan validity nya (CRP T03&T04)
- Metode penelitian dan statistik untuk menilai kebenaran informasi ilmiah (CRP T03&T04)
- Dasar pengelolaan informasi untuk menghimpun data relevan menjadi arkib peribadi (CRP T03&T04)
- Dasar dalam menilai data untuk melakukan validation informasi ilmiah secara sistematik (CRP T03&T04)
- Merangkum dan menyimpan arkib (CRP T03&T04)

Prognosis

(1) Prognosis EBM:
- Pengertian prognosis EBM (CRP K5.03)
- Work sheet prognosis (CRP K5.03)
- Komponen validity (CRP K5.03)
- Komponen important (CRP K5.03)
- Komponen applicability (CRP K5.03)

(2) Work sheet prognosis:
- Pengertian prognosis (CRP K5.04)
- Work sheet prognosis (CRP K5.04)
- Komponen validity (CRP K5.04)
- Komponen important (CRP K5.04)
- Komponen applicability (CRP K5.04)

(3) Critical Appraisal:
- Data dan bukti pengkajian ilmiah untuk menilai relevancy dan validity nya (CRP T05&T06)
- Metode penelitian dan statistik untuk menilai kebenaran informasi ilmiah (CRP T05&T06)
- Dasar pengelolaan informasi untuk menghimpun data relevan menjadi arkib peribadi (CRP T05&T06)
- Dasar dalam menilai data untuk melakukan validation informasi ilmiah secara sistematik (CRP T05&T06)
- Merangkum dan menyimpan arkib (CRP T05&T06)

Harm

(1) Harm EBM:
- Pengertian harm EBM (CRP K5.05)
- Work sheet harm (CRP K5.05)
- Komponen validity (CRP K5.05)
- Komponen important (CRP K5.05)
- Komponen applicability (CRP K5.05)

(2) Work sheet harm:
- Pengertian harm (CRP K5.06)
- Work sheet harm (CRP K5.06)
- Komponen validity (CRP K5.06)
- Komponen important (CRP K5.06)
- Komponen applicability (CRP K5.06)

(3) Critical Appraisal:
- Data dan bukti pengkajian ilmiah untuk menilai relevancy dan validity nya (CRP T07&T08)
- Metode penelitian dan statistik untuk menilai kebenaran informasi ilmiah (CRP T07&T08)
- Dasar pengelolaan informasi untuk menghimpun data relevan menjadi arkib peribadi (CRP T07&T08)
- Dasar dalam menilai data untuk melakukan validation informasi ilmiah secara sistematik (CRP T07&T08)
- Merangkum dan menyimpan arkib (CRP T07&T08)

Meta analysis

(1) Systemic Review:
- Pengertian sysmetic review EBM (CRP K5.07)
- Komponen validity (CRP K5.07)
- Komponen important: CER, EER, AAR, dan NTT (CRP K5.07)

(2) Meta analysis:
- Pengertian meta analysis EBM (CRP K5.08)
- Komponen validity (CRP K5.08)
- Komponen important: CER, EER, AAR, dan NTT (CRP K5.08)

(3) Review Diagnostic, Therapy, Prognosis, dan Harm:
- Feedback dan permasalahan seputar Diagnostik, Therapy, Prognosis, Harm, dan Meta analysis (CRP PP01)

Senarai Daftar Kuliah Blok Community Research Program VI (FK USU-Batch 2007)

Konsep Pembuatan Proposal Penelitian

(1) Pendahuluan Pembuatan Proposal Penelitian:
- Pendahuluan alur pembuatan penelitian/ Karya Tulis Ilmiah (CRP K6.01)
- Langkah-langkah penelitian (CRP K6.01)
- Formula pembuatan proposal penelitian (CRP K6.01)
- Teknik penulisan proposal penelitian (CRP K6.01)
- Prinsip pembuatan tajuk penelitian (CRP K6.01)

Pembuatan Pendahuluan Penelitian

(1) Perumusan masalah, Tujuan penelitian, Hipotesis, dan Manfaat penelitian:
- Pentingnya perumusan masalah (CRP K6.02)
- Definisi masalah (CRP K6.02)
- Rumusan masalah yang adekuat (CRP K6.02)
- Sumber perumusan masalah (CRP K6.02)
- Definisi tujuan penelitian (CRP K6.02)
- Tujuan umum dan khusus (CRP K6.02)
- Definisi hipotesis (CRP K6.02)
- Ciri hipotesis yang baik (CRP K6.02)
- Definisi manfaat penelitian (CRP K6.02)
- Jenis-jenis manfaat penelitian (CRP K6.02)

Pembuatan Tinjauan Pustaka

(1) Tinjauan pustaka dan Kerangka konsep:
- Definisi tinjauan pustaka (CRP K6.03)
- Sumber bacaan (CRP K6.03)
- Teknik pemilihan sumber bacaan (CRP K6.03)
- Teknik penulisan literatur (CRP K6.03)
- Definisi kerangka konsep (CRP K6.03)
- Pembuatan kerangka konsep (CRP K6.03)

Pembuatan metode penelitian

(1) Penentuan design penelitian:
- Penentuan design penelitian (CRP K6.04)
- Pentingnya design penelitian (CRP K6.04)
- Jenis-jenis penelitian (CRP K6.04)

(2) Pengukuran dalam penelitian:
- Jenis-jenis variabel (CRP K6.04)
- Skala pengukuran (CRP K6.04)
- Langkah-langkah pengolahan data (CRP K6.04)
- Hubungan statistik dalam penelitian (CRP K6.04)
- Pemilihan uji statistik pada penelitian (CRP K6.04)

Instrumen Penelitian

(1) Merangcang kuesioner:
- Definisi kuesioner (CRP K6.05)
- Prinsip pembuatan kuesioner (CRP K6.05)
- Unsur-unsur dalam kuesioner (CRP K6.05)
- Uji kuesioner: validity dan reliability (CRP K6.05)
- Aplikasi uji kuesioner (CRP K6.05)

Etika dalam Penelitian

(1) Etika dalam penelitian dan Inform Consent:
- Definisi etika penelitian kesihatan (CRP K6.06)
- Etika penelitian pada penelitian klinik (CRP K6.06)
- Etika penelitian pada penelitian epidemiologi (CRP K6.06)
- Etika penelitian pada haiwan eksperimen (CRP K6.06)
- Inform consent (CRP K6.06)
- Pentingnya ethical clearance (CRP K6.06)

Feedback Proposal Penelitian

(1) Pembahasan tajuk dan ringkasan penelitian yang sudah diserahkan kepada pensyarah penilai dan Revision Tajuk Proposal Penelitian:
- Pembahasan tajuk dan ringkasan penelitian yang sudah diserahkan kepada team pensyarah penilai (CRP K6.07&K6.08)
- Revision Tajuk Proposal Penelitian (CRP K6.07&K6.08)

Kegiatan Pembuatan Proposal Penelitian

(1) Minggu 1-3: Kuliah Pembuatan Proposal
(2) Minggu 1-8: Pembincangan dengan pensyarah pembimbing
(3) Minggu 3: Penyerahan tajuk dan ringkasan proposal penelitian kepada team pensyarah penilai
(4) Minggu 3 dan 4: Pembahasan tajuk dan ringkasan penelitian yang sudah diserahkan kepada team pensyarah penilai
(5) Minggu 4: Makmal komputer (Prinsip epidemiologi informasi, pembuatan file qes, rec, dan chk)
(6) Minggu 5: Makmal komputer SPSS (Prinsip SPSS, pembuatan variable, pemasukan data, transform, sort, dan select)
(7) Minggu 6: Pembahasan tajuk dan ringkasan penelitian yang sudah diserahkan kepada team pensyarah penilai dan Revision tajuk proposal penelitian
(8) Minggu 7: Sidang proposal penelitian
(9) Minggu 7 dan 8: Revision proposal sesuai advice semasa sidang proposal penelitian dan pemberian surat izin penelitian ke institusi-institusi terkait (berdasarkan lokasi pengambilan sampel penelitian)
(10) Minggu 8: Sidang proposal penelitian (repeat sidang proposal penelitian)

Senarai Daftar Kuliah Blok Community Research Program VII (FK USU-Batch 2007)

Pengolahan dan Analisis Data

(1) Pengolahan dan Analisis Data:
- Aplikasi prinsip yang berkaitan dengan data (CRP K7.01)
- Penerapan statistik dalam penelitian (CRP K7.01)
- Statistik deskriptif (CRP K7.01)
- Statistik analitik (CRP K7.01)

Pengolahan dan Analisis Data Perilaku

(1) Pengolahan dan Analisis Data Perilaku
- Aplikasi prinsip analisis data perilaku (CRP K7.02)
- Skala sikap (CRP K7.02)
- Analisis data perilaku (CRP K7.02)

Penulisan Laporan Penelitian

(1) Penulisan Laporan Penelitian:
- Bentuk umum laporan ilmiah
- Prinsip pembuatan abstrak
- Prinsip pembuatan hasil penelitian: Teks, Table, Grafik, dan Perhitungan
- Prinsip pembuatan pembahasan, kesimpulan, dan saranan
- Penulisan laporan hasil penelitian/ karya tulis ilmiah secara sistematik

Kegiatan Penulisan Laporan Penelitian/ Karya Tulis Ilmiah

(1) Minggu 1 dan 2: Kuliah Penulisan Laporan Penelitian/ Karya Tulis Ilmiah
(2) Minggu 1-8: Pengumpulan data dan bimbingan dari pensyarah pembimbing
(3) Minggu 3: Makmal komputer (Memasukkan data, Analisis statistik deskriptif, Analisis dengan chi square)
(4) Minggu 4: Makmal komputer (Analisis uji T independen, T dependen, dan Anova)
(5) Minggu 9 dan 10: Penulisan hasil penelitian dan bimbingan dari pensyarah pembimbing
(6) Minggu 11: Sidang laporan hasil penelitian/ Karya Tulis Ilmiah
(7) Selepas minggu 11: Revision laporan hasil sesuai advice semasa sidang laporan penelitian dan penyerahan hasil akhir laporan/ Karya Tulis Ilmiah kepada team penyarah penguji.
(8) Selepas minggu 11: Sidang laporan hasil penelitian (repeat sidang laporan hasil penelitian)

Pregnant Robot Trains Students

2010-11-30T01:57:00.002+08:00

Coma

2010-11-20T12:05:00.011+08:00

Definition of "coma"

Coma is a state of unconsciousness whereby a patient cannot react with the surrounding environment. The patient cannot be wakened with outside physical or auditory stimulation. The inability to waken differentiates coma from sleep. Patients can have different levels of unconsciousness and unresponsiveness depending upon how much or how little of the brain is functioning.

Measuring the depth of coma

The Glasgow Coma Scale was developed to provide health-caregivers a simple way of measuring the depth of coma based upon observations of eye opening, speech, and movement. Patients in the deepest level of coma:

- Do not respond with any body movement to pain,
- Do not have any speech, and
- Do not open their eyes.

Those in lighter comas may offer some response, to the point they may even seem wake, yet meet the criteria of coma because they do not respond to their environment.

The scale is used as part of the initial evaluation of a patient, but does not assist in making the diagnosis as to the cause of coma. Since it "scores" the level of coma, the GCS can be used as a standard method for any health-caregiver to assess change in patient status.

Glasgow Coma Scale:
Eye Opening
Spontaneous 4
To loud voice 3
To pain 2
None 1

Verbal Response
Oriented 5
Confused, Disoriented 4
Inappropriate words 3
Incomprehensible words 2
None 1

Motor Response
Obeys commands 6
Localizes pain 5
Withdraws from pain 4
Abnormal flexion posturing 3
Extensor posturing 2
None 1

Interpretation to GCS
Individual elements as well as the sum of the score are important. Hence, the score is expressed in the form "GCS 9 = E2 V4 M3 at 07:35".

Generally, brain injury is classified as:
Severe, with GCS ≤ 8
Moderate, GCS 9 - 12
Minor, GCS ≥ 13.

Tracheal intubation and severe facial/eye swelling or damage make it impossible to test the verbal and eye responses. In these circumstances, the score is given as 1 with a modifier attached e.g. 'E1c' where 'c' = closed, or 'V1t' where t = tube. A composite might be 'GCS 5tc'. This would mean, for example, eyes closed because of swelling = 1, intubated = 1, leaving a motor score of 3 for 'abnormal flexion'. Often the 1 is left out, so the scale reads Ec or Vt.

The GCS has limited applicability to children, especially below the age of 36 months (where the verbal performance of even a healthy child would be expected to be poor). Consequently the Pediatric Glasgow Coma Scale, a separate yet closely related scale, was developed for assessing younger children.

Pediatric Glasgow Coma Scale

There are many causes of coma, but to understand unconsciousness, we need to know why a person is awake. The brain is a large organ with many parts. There are two main portions when separated down the middle (right and left cerebral hemispheres) containing the frontal, parietal, temporal and occipital lobes, where movement, sensation, speech and thought are housed. The cerebellum sits under the cerebral hemispheres and is where balance and coordination are located. The brain stem is where automatic responses to the body including heart rate, blood pressure, and breathing are controlled. The reticular activating system (RAS) is located within the brain stem and is the important "on/off" switch of the brain.

To be awake, the reticular activating system (RAS) must be functioning, as well as at least one cerebral hemisphere.

If a person loses consciousness, either the RAS has stopped working, or both cerebral hemispheres have shut down.

The reticular activating system stops working in two situations:
1. Brain stem stroke: cells in that area of the brain stem have lost oxygen and glucose supplied by blood flow, then function stops. This is either ischemic (where blood supply is lost) or hemorrhagic (where bleeding occurs and the structures fail).

2. A pre-death event: increased swelling in the brain pushes down on the brain stem and causes it to fail. To have both cerebral hemispheres fail requires the blood supply to the brain be compromised, or some sort of toxic insult has occurred to all brain tissue.

Causes of Coma

Generally, coma is commonly a result of trauma, bleeding and/or swelling affecting the brain. Inadequate oxygen or blood sugar (glucose) and various poisons can also directly injure the brain to cause coma.

Trauma
Minor head injuries can cause brief loss of consciousness, but the brain is able to turn itself back on. Similarly, patients with seizures become unconscious - but gradually waken relatively quickly. Those people who cannot respond after head injury usually have had significant force applied to their head and brain.

The skull is a rigid box that protects the brain. Unfortunately, if the brain is injured and begins to swell (edema), there is no room for the additional fluid. This causes the brain to push up against the sides of the skull and it then compresses. Unless the pressure is relieved, the brain will continue to swell until it pushes down onto the brain steam, which then damages the RAS, which subsequently affects blood pressure and breathing control centers.

The affect of trauma on the brain is not predictable. It may or may not cause significant injury. If the brain is shaken, shear injury may occur, where the nerve connections within the brain are damaged. Coma may occur even with a normal CT scan in this situation. Similarly, head trauma may cause swelling of the brain without any bleeding, and coma may be the result.

Head trauma can cause different types of brain injury. The injury can occur to the brain tissue itself or may cause bleeding to occur between the brain and the skull. Computerized Tomography (CT) of the head can identify most bleeding from trauma.

Bleeding (Hemorrhage)
Intracerebral hemorrhage (intra= within + cerebral=brain + hemorrhage=bleeding) may be small, but it is associated swelling that may cause damage.

Epidural, subdural, and subarachnoid hemorrhages
The lining of the brain has multiple layers, and these layers can act as potential spaces where bleeding can occur. Epidural (epi= outside the dura= an outer layer of brain lining) and subdural (sub=below the dura) may not cause coma immediately, but as the bleeding continues, it compresses the injured side of the brain and shifts it to the unaffected side. Now both cerebral hemispheres are affected and loss of consciousness or coma may occur; the more swelling, the deeper the coma.

Subarachnoid hemorrhage (below the arachnoid layer) is in the layer of the brain lining where cerebrospinal fluid (CSF) is. CSF is the nutrient fluid that bathes the brain and spinal cord. Bleeding here may be without symptoms or it may cause significant problems, such as paralysis.

Bleeding can occur within the skull or brain without trauma. Blood accumulating in areas it should not b,e result with the same problem. Some medical causes include:

Hypertension (high blood pressure): when blood pressure is too high, and not controlled, blood vessels in the brain may not be able to tolerate the high pressure and may leak blood.

Cerebral aneurysm, or an area in a blood vessel that is congenitally weak and ruptures. Some people are born with blood vessels that have a weak wall and it gradually balloons, like a weak spot in an inner tube. At some time in their life, or perhaps never, the weak spot gives way and blood is spilled into the brain.

Arteriovenous malformations (AVMs) are abnormal blood vessels where arteries connect to veins and cause potential weak spots that can leak blood. Normally, arteries branch into smaller and smaller vessels until they form the smallest set of vessels called capillaries. Capillaries form meshes where chemicals, nutrients, oxygen and carbon dioxide are exchanged from the blood stream to individual cells. The capillaries then merge to form larger blood vessels, the veins. In AVMs, this relationship of artery to capillary to vein is abnormal.

Tumors, either benign or malignant, can be very vascular (composed of many veins and capillaries) and have significant bleeding potential.

Swelling
While trauma can make the brain swell, other types of injury or insult can cause cerebral edema (cerebral=brain + edema=swelling due to increased fluid). Whether the insult is lack of oxygen, abnormal electrolytes, or hormones, it may ultimately result in edema of the brain tissue. As with bleeding, the skull limits the space available for brain swelling to occur; thus the brain tissue is damaged and its function decreases the more it is compressed against the bones of the skull.

Lack of oxygen
The brain requires oxygen to function; and without it the brain shuts down. There is a very short time to get oxygen back to brain tissue before there is permanent damage. Most research suggests that the time window is four to six minutes.

The body provides oxygen to the brain through the lungs. The lungs extract oxygen from the air, hemoglobin in red blood cells pick up the oxygen, and the heart pumps blood through normal blood vessels to cells in the body. If any part of the system fails, the oxygen supply to the brain can be interrupted.

The most common failure occurs with heart rhythm disturbances. The coordinated electrical beat of the heart is lost and the heart muscle doesn't squeeze blood adequately; no blood is pumped to the brain and it stops functioning almost immediately.

Lungs can also fail; examples include pneumonia, emphysema, or asthma. In each case, inflammation in the lung tubes (bronchi or bronchioles) or lung tissue makes it difficult for oxygen to get into the lungs and transferred into the blood stream.

Hemoglobin, a molecule in the red blood cell, attaches oxygen from the lungs and delivers it to cells for use in metabolism. Anemia, or low red blood cell count, can cause the brain to fail directly, or more likely it causes other organs like the heart to fail. The heart, like any other muscle requires oxygen to function. Anemia can occur chronically or it can be due to an acute blood loss (examples include trauma, bleeding from the stomach). If the blood loss is slow, the body is better able to adapt and tolerate low hemoglobin levels; if the bleeding occurs quickly, the body may be unable to compensate, the result being inadequate oxygen supply to tissues such as the brain.

Diabetic coma
Severe hypoglycemia
People with type 1 diabetes mellitus who must take insulin in full replacement doses are most vulnerable to episodes of hypoglycemia. It is usually mild enough to reverse by eating or drinking carbohydrates, but blood glucose occasionally can fall fast enough and low enough to produce unconsciousness before hypoglycemia can be recognized and reversed. Hypoglycemia can be severe enough to cause unconsciousness during sleep. Predisposing factors can include eating less than usual, prolonged exercise earlier in the day, and heavy drinking. Some people with diabetes can lose their ability to recognize the symptoms of early hypoglycemia.

Unconsciousness due to hypoglycemia can occur within 20 minutes to an hour after early symptoms and is not usually preceded by other illness or symptoms. Twitching or convulsions may occur. A person unconscious from hypoglycemia is usually pale, has a rapid heart beat, and is soaked in sweat: all signs of the adrenaline response to hypoglycemia. The individual is not usually dehydrated and breathing is normal or shallow. A meter or laboratory glucose measurement at the time of discovery is usually low, but not always severely, and in some cases may have already risen from the nadir that triggered the unconsciousness.

Unconsciousness due to hypoglycemia is treated by raising the blood glucose with intravenous glucose or injected glucagon.

Advanced diabetic ketoacidosis
Diabetic ketoacidosis (DKA), if it progresses and worsens without treatment, can eventually cause unconsciousness, from a combination of severe hyperglycemia, dehydration and shock, and exhaustion. Coma only occurs at an advanced stage, usually after 36 hours or more of worsening vomiting and hyperventilation.

In the early to middle stages of ketoacidosis, patients are typically flushed and breathing rapidly and deeply, but visible dehydration, pallor from diminished perfusion, shallower breathing, and rapid heart rate are often present when coma is reached. However these features are variable and not always as described.

If the patient is known to have diabetes, the diagnosis of DKA is usually suspected from the appearance and a history of 1–2 days of vomiting. The diagnosis is confirmed when the usual blood chemistries in the emergency department reveal hyperglycemia and severe metabolic acidosis.

Treatment of DKA consists of isotonic fluids to rapidly stabilize the circulation, continued intravenous saline with potassium and other electrolytes to replace deficits, insulin to reverse the ketoacidosis, and careful monitoring for complications.

Nonketotic hyperosmolar coma
Nonketotic hyperosmolar coma usually develops more insidiously than DKA because the principal symptom is lethargy progressing to obtundation, rather than vomiting and an obvious illness. Extreme hyperglycemia is accompanied by dehydration due to inadequate fluid intake. Coma from NKHC occurs most often in patients who develop type 2 or steroid diabetes and have an impaired ability to recognize thirst and drink. It is classically a nursing home condition but can occur in all ages.

The diagnosis is usually discovered when a chemistry screen performed because of obtundation reveals extreme hyperglycemia (often above 1800 mg/dl (100 mM)) and dehydration. The treatment consists of insulin and gradual rehydration with intravenous fluids.

Poisons
There are two sources of poisons that can affect the brain, those that we take in (through ingestion or inhaling) and those that the body generates and cannot dispose of in some way.

If the body can be considered a factory, it needs to have the ability to get rid of the waste products that are made when the body generates energy. These waste products can cause different organs in the body to fail, including the brain.

The liver performs many functions including glucose and protein manufacturing. It also breaks down and metabolizes chemicals in the body. When the liver fails different chemicals like ammonia can accumulate and can cause brain cells to stop functioning. Hepatic encephalopathy (hepatic=liver + encephalo=brain + pathy=disease) or hepatic coma occurs when the liver fails because of an acute or chronic injury. The most common is cirrhosis due to alcoholism.

The kidneys filter blood to rid the body of waste products. When the kidneys fail, a variety of waste products can accumulate in the bloodstream and cause direct or indirect damage to the brain. An example of indirect causes would be an elevated potassium level affecting heart electrical activity. Direct causes include uremia, where blood urea levels rise and are directly toxic to brain cells. Common causes of kidney failure include poorly controlled diabetes and high blood pressure.

The thyroid acts as the thermostat for the body and regulates the speed at which the body functions. If thyroid levels drop too low, gradually, over a period of time myxedema coma can occur because of profound hypothyroidism.

Ingestions can cause the brain to slow down, speed up or alter its perception of the world. Some ingestions may cause coma in an indirect way. Acetaminophen is a prime example, an overdose may cause the liver to fail and few days later subsequent hepatic coma occurs.

Alcohol is probably the most common cause of ingested poison or toxin, leading to altered mental status and coma. In acute alcohol intoxication, the brain is directly poisoned. Blood alcohol levels fall when metabolized by the liver, but depth of intoxication can be so great it shuts off many of the involuntary brain activities that control breathing and maintain muscle function. Opiates like pain pills or heroin can cause similar slowing of brain function.

Cocaine and amphetamines are the common "uppers" or brain stimulants. These brain stimulants cause an adrenaline-like body response, thus blood pressure and heart rate spiral out of control and the risk of heart attack, heart rhythm disturbances, or bleeding in the brain occur.

Assessing coma

When a patient presents in coma, diagnosis and treatment begin simultaneously. Initial treatment is aimed at addressing immediate life-threatening issues:

Are the ABCs intact? Is the patient's airway open? Are they breathing? Do they have good circulation (a heart beat and blood pressure)?

Is the patient hypoglycemic? The blood sugar is checked by a quick fingerstick bedside test and if it is low, glucose is administered.

Did the patient ingest a narcotic? Naloxone (Narcan) may be given intravenously to reverse an overdose situation.
History remains the important key to the diagnosis. Since the patient cannot be the source of information, questions are asked of family, friends, bystanders, and rescue personnel. For example, a person sitting at a bar fell down, hit his head and is in coma. While it might be easy to jump to the conclusion that he was intoxicated, fell, and bled in his brain, other scenarios need to be considered. Did he have a heart attack, did he suffer a stroke, or was this a diabetic medication reaction and the blood sugar is low.

Once the patient has been stabilized with acceptable vital signs, physical examination will include a complete neurologic assessment. From head to toe, this may include examination of the eyes, pupils, face movements to assess cranial nerves including facial movement and gag reflex, extremity movement and reaction to stimulation, tendon reflexes and other testing of spinal cord function. There is special attention paid to symmetry in the neurology exam, since lack of movement or response on one side of the body may be caused by bleeding inside the skull or by stroke. General examination surveys the skin for cuts, scrapes, wounds, etc.

The GCS score will be documented; the deeper the coma, the lower the score. Please appreciate that a person with a "normal" GCS of 15 still can be in coma. Once the initial screening physical examination complete, a more detailed exam will likely occur to include the lungs, the heart, and the abdomen. Repeated neurologic assessment is key to monitoring the status of the patient and decide if the coma is lightening or getting worse.

Tests for coma

The strategy to decide which tests will help provide a diagnosis will depend upon the suspected cause. Many times, the cause involves many factors and the sequence of events will require serious detective work. Blood tests, electrocardiogram and CT scan of the head are most often obtained.

Outcome and prognosis for a patient in a coma

Depending upon the diagnosis, the evaluation may be no more than assessing blood sugar, treating hypoglycemia, and having complete resolution of the situation. On the other hand, the cause of coma may be a catastrophic brain hemorrhage without hope for significant recovery. The outlook very much depends on the cause of the coma and the ability to correct the particular situation.

Doa untuk mengubati kanser

2010-11-19T12:04:00.004+08:00

Doa untuk mengubati kanser

Dan kami turunkan dari Al-Quran (sesuatu) yang menjadi PENAWAR dan RAHMAT bagi orang yang beriman..":QS Al-Israk:82

Mungkin ramai di luar sana yang telah didiagnosa menghidap KANSER, satu penyakit yang begitu menakutkan sesiapa sahaja.

Di Malaysia, penyakit kanser adalah satu dari 10 penyebab kematian.Dianggarkan terdapat 150 kes bagi setiap 100,000 penduduk Malaysia.Manakala dari segi bilangan kes baru yang dikesan dianggarkan dalam lingkungan 27,000 kes setahun.

Rasanya setiap orang tahu 'setiap penyakit ada ubatnya kecuali mati'.Tahukah anda satu surah dari Al-Quran untuk menghancurkan sel-sel kanser?

Sebenarnya ini adalah ilmu yang saya ingin kongsikan melalui tulisan Saudara Raflis Sabirin (semoga Allah memberi ganjaran setimpal atas ilmu yang dikongsikan) yang diterbitkan dalam Majalah Milenia edisi Februari 2010.

Penulis telah berkongsi pengalaman beliau merawat kanser selama 27 tahun dengan menggunakan ayat-ayat Al-Quran, terutama dari Surah al-Fil.

Maksudnya:

Dengan nama Allah, Yang Maha Pemurah, lagi Maha Mengasihani

Tidakkah engkau mengetahui bagaimana Tuhanmu telah melakukan kepada angkatan tentera (yang dipimpin oleh pembawa) Gajah, (yang hendak meruntuhkan Kaabah)? (1)

Bukankah Tuhanmu telah menjadikan rancangan jahat mereka dalam keadaan yang rugi dan memusnahkan mereka? (2)

Dan Dia telah menghantarkan kepada mereka (rombongan) burung berpasuk-pasukan; (3)

Yang melontar mereka dengan batu-batu dari sejenis tanah yang dibakar keras; (4)

Lalu Dia menjadikan mereka hancur berkecai seperti daun-daun kayu yang dimakan ulat. (5)

Demikian mukjizat ayat-ayat suci Al-Quran.Jika diletakkan di sebuah gunung, nescaya gunung akan hancur lenyap kerana takut kepada Allah. Demikian juga jika diletakkan atas apa-apa penyakit, nescaya penyakit tersebut akan hancur dan lenyap.

Cara Pengamalan

Selepas solat lima waktu, bacalah Surah Fatihah sekali, diikuti Surah Al-Ikhlas (tiga kali), selawat ke atas Nabi (tiga kali) lalu teruskan membaca Surah al-Fil (21 kali)

Setiap kali baca Surah Al-Fil, hendaklah tiup dan hembuskan pada tempat penyakit kanser tersebut. Setiap kali menghembuskan nafas itu, hendaklah ingat maksud dalam hati, supaya Allah hancur lenyapkan penyakit kanser tersebut sebagaimana hancur dan lenyapnya pasukan tentera bergajah seperti dalam ayat terakhir Surah Al-Fil itu.

Lakukan 21 kali baca dan tiup selama 21 hari selepas solat lima waktu.

Dan sekiranya penyakit kanser itu berada dalam organ badan seperti di dalam usus, limpa, buah pinggang dan di dalam kepala, maka caranya seperti tersebut di atas itu juga. Cuma tambahannya hendaklah tarik nafas perlahan-lahan seakan-akan kita memasukkan amalan surah itu ke dalam tubuh badan, teruatamanya ke tempat kanser tersebut.Lakukan tarik nafas tersebut sehingga 21 kali juga selama 21 hari setiap lepas solat lima waktu.

Dr.H: Lakukan dengan penuh keyakinan dan sabar.Harus diingat, yang menyembuhkan ialah Allah Taala. Ayat Al-Quran tersebut hanya sebagai asbab atau wasilah untuk mencapai maksud.

Introduction to Human Anatomy

2010-11-15T15:58:00.024+08:00

Introduction to Human anatomy

Human anatomy (gr. ἀνατομία, "dissection", from ἀνά, "up", and τέμνειν, "cut"), which, with human physiology and biochemistry, is a complementary basic medical science, is primarily the scientific study of the morphology of the human body.

History

The development of anatomy as a science extends from the earliest examinations of sacrificial victims to the sophisticated analyses of the body performed by modern scientists. It has been characterized, over time, by a continually developing understanding of the functions of organs and structures in the body. The field of Human Anatomy has a prestigious history, and is considered to be the most prominent of the biological sciences of the 19th and early 20th centuries. Methods have also improved dramatically, advancing from examination of animals through dissection of cadavers to technologically complex techniques developed in the 20th century.

Anatomy is one of the cornerstones of a doctor’s medical education. Despite being a persistent portion of teaching from at least the renaissance, the format and the amount of information being taught has evolved and changed along with the demands of the profession. What is being taught today may differ in content significantly from the past but the methods used to teach this have not really changed that much. For example all the famous public dissections of the Middle Ages and early renaissance were in fact prosections. Prosection is the direction in which many current medical schools are heading in order to aid the teaching of anatomy and some argue that dissection is better. However looking at results of post graduate exams, medical schools (specifically Birmingham) that use prosection as opposed to dissection do very well in these examinations. This would suggest that prosection can fit very well into the structure of modern medical training.

Ancient anatomy
Charaka is referred to as the Father of Anatomy.

1. Egypt
The study of anatomy begins at least as early as 1600 BCE, the date of the Edwin Smith Surgical Papyrus. This treatise shows that the heart, its vessels, liver, spleen, kidneys, hypothalamus, uterus and bladder were recognized, and that the blood vessels were known to emanate from the heart. Other vessels are described, some carrying air, some mucus, and two to the right ear are said to carry the "breath of life", while two to the left ear the "breath of death". The Ebers papyrus (c. 1550 BCE) features a treatise on the heart. It notes that the heart is the center of the blood supply, with vessels attached for every member of the body. The Egyptians seem to have known little about the function of the kidneys and made the heart the meeting point of a number of vessels which carried all the fluids of the body – blood, tears, urine and sperm.

2. Greece
The earliest medical scientist of whose works any great part survives today is Hippocrates, a Greek physician active in the late 5th and early 4th centuries BCE (460 - 377 BCE). His work demonstrates a basic understanding of musculoskeletal structure, and the beginnings of understanding of the function of certain organs, such as the kidneys. Much of his work, however, and much of that of his students and followers later, relies on speculation rather than empirical observation of the body.

One of the greatest achievements of Hippocrates was that he was the first to discover the tricuspid valve of the heart and its function which he documented in the treatise On the Heart in the Hippocratic Corpus. Later anatomists knew the function of the tricuspid valve after reading the Hippocratic Corpus.

In the 4th century BCE, Aristotle and several contemporaries produced a more empirically founded system, based animal dissection. Around this time, Praxagoras is credited as the first to identify the difference between arteries and veins, and the relations between organs are described more accurately than in previous works.

The first use of human cadavers for anatomical research occurred later in the 4th century BCE when Herophilos and Erasistratus gained permission to perform live dissections, or vivisection, on criminals in Alexandria under the auspices of the Ptolemaic dynasty. Herophilos in particular developed a body of anatomical knowledge much more informed by the actual structure of the human body than previous works had been.

3. Galen
The final major anatomist of ancient times was Galen, active in the 2nd century. He compiled much of the knowledge obtained by previous writers, and furthered the inquiry into the function of organs by performing vivisection on animals. Due to a lack of readily available human specimens, discoveries through animal dissection were broadly applied to human anatomy as well. His collection of drawings, based mostly on dog anatomy, became the anatomy textbook for 1500 years. The original text is long gone, and his work was only known to the Renaissance doctors through the careful custody of Arabic medicine.

Medieval anatomy
After the fall of the Roman Empire, the study of anatomy became stagnant in Christian Europe but flourished in the medieval Islamic world, where Muslim physicians and Muslim scientists contributed heavily to medieval learning and culture. The Persian physician Avicenna (980-1037) absorbed the Galenic teachings on anatomy and expanded on them in The Canon of Medicine (1020s), which was very influential throughout the Islamic world and Christian Europe. The Canon remained the most authoritative book on anatomy in the Islamic world until Ibn al-Nafis in the 13th century, though the book continued to dominate European medical education for even longer until the 16th century.

The Arabian physician Ibn Zuhr (Avenzoar) (1091–1161) was the first physician known to have carried out human dissections and postmortem autopsy. He proved that the skin disease scabies was caused by a parasite, a discovery which upset the theory of humorism supported by Hippocrates and Galen. The removal of the parasite from the patient's body did not involve purging, bleeding, or any other traditional treatments associated with the four humours.

In the 12th century, Saladin's physician Ibn Jumay was also one of the first to undertake human dissections, and he made an explicit appeal for other physicians to do so as well. During a famine in Egypt in 1200, Abd-el-latif observed and examined a large number of skeletons, and he discovered that Galen was incorrect regarding the formation of the bones of the lower jaw and sacrum.

Ibn al-Nafis
The Arabian physician Ibn al-Nafis (1213–1288) was one of the earliest proponents of human dissection and postmortem autopsy, and in 1242, he was the first to describe the pulmonary circulation and coronary circulation of the blood, which form the basis of the circulatory system, for which he is considered the father of the theory of circulation. Ibn al-Nafis also described the earliest concept of metabolism, and developed new systems of anatomy and physiology to replace the Avicennian and Galenic doctrines, while discrediting many of their erroneous theories on the four humours, pulsation, bones, muscles, intestines, sensory organs, bilious canals, esophagus, stomach, and the anatomy of almost every other part of the human body.

Early modern anatomy
1. 14th to 16th centuries
The works of Galen and Avicenna, especially The Canon of Medicine which incorporated the teachings of both, were translated into Latin, and the Canon remained the most authoritative text on anatomy in European medical education until the 16th century.

The first major development in anatomy in Christian Europe, since the fall of Rome, occurred at Bologna in the 14th to 16th centuries, where a series of authors dissected cadavers and contributed to the accurate description of organs and the identification of their functions. Prominent among these anatomists were Mondino de Liuzzi and Alessandro Achillini.

The first challenges to the Galenic doctrine in Europe occurred in the 16th century. Thanks to the printing press, all over Europe a collective effort proceeded to circulate the works of Galen and Avicenna, and later publish criticisms on their works. Vesalius was the first to publish a treatise, De humani corporis fabrica, that challenged Galen "drawing for drawing" travelling all the way from Leuven to Padua for permission to dissect victims from the gallows without fear of persecution. His drawings are triumphant descriptions of the, sometimes major, discrepancies between dogs and humans, showing superb drawing ability. Many later anatomists challenged Galen in their texts, though Galen reigned supreme for another century.

A succession of researchers proceeded to refine the body of anatomical knowledge, giving their names to a number of anatomical structures along the way. The 16th and 17th centuries also witnessed significant advances in the understanding of the circulatory system, as the purpose of valves in veins was identified, the left-to-right ventricle flow of blood through the circulatory system was described, and the hepatic veins were identified as a separate portion of the circulatory system. The lymphatic system was also identified as a separate system at this time.

2. 17th and 18th centuries
The study of anatomy flourished in the 17th and 18th centuries. The advent of the printing press facilitated the exchange of ideas. Because the study of anatomy concerned observation and drawings, the popularity of the anatomist was equal to the quality of his drawing talents, and one need not be an expert in Latin to take part.

Many famous artists studied anatomy, attended dissections, and published drawings for money, from Michelangelo to Rembrandt. For the first time, prominent universities could teach something about anatomy through drawings, rather than relying on knowledge of Latin. Contrary to popular belief,the church neither objected to nor obstructed anatomical research despite its antagonism towards other scientific practices.

The increase in demand for cadavers, though, led to rumors about anatomy murder.
Only certified anatomists were allowed to perform dissections, and sometimes then only yearly. These dissections were sponsored by the city councilors and often charged an admission fee, rather like a circus act for scholars. Many European cities, such as Amsterdam, London, Copenhagen, Padua, and Paris, all had Royal anatomists (or some such office) tied to local government. Indeed, Nicolaes Tulp was Mayor of Amsterdam for three terms. Though it was a risky business to perform dissections, and unpredictable depending on the availability of fresh bodies, attending dissections was perfectly legal. Many anatomy students traveled around Europe from dissection to dissection during the course of their study - they had to go where a fresh body was available (e.g. after a hanging) because before refrigeration, a body would decay rapidly and become unsuitable for examination.

Many Europeans interested in the study of anatomy traveled to Italy, then the center of anatomy. Only in Italy could certain important research methods be used, such as dissections on women. M. R. Columbus and Gabriele Falloppio were pupils of Vesalius, the 16th century anatomist. Columbus, as his immediate successor in Padua, and afterwards professor at Rome, distinguished himself by rectifying and improving the anatomy of the bones, by giving correct accounts of the shape and cavities of the heart, of the pulmonary artery and aorta and their valves, and tracing the course of the blood from the right to the left side of the heart, by a good description of the brain and its vessels, and by correct understanding of the internal ear, and the first good account of the ventricles of the larynx. Osteology at nearly the same time found an assiduous cultivator in Giovanni Filippo Ingrassias.

3. 19th century anatomy
During the 19th century, anatomists largely finalised and systematised the descriptive human anatomy of the previous century. The discipline also progressed to establish growing sources of knowledge in histology and developmental biology, not only of humans but also of animals. Extensive research was conducted in more areas of anatomy.

Great Britain was particularly important in this research. Demand for cadavers grew so great there that body-snatching and even anatomy murder came into use as a means of obtaining them. In response, the English Parliament passed the Anatomy Act 1832, which finally provided for an adequate and legitimate supply of corpses by allowing dissection of destitutes. The relaxed restrictions on dissection provided a suitable environment for Gray's Anatomy, a text that was a collective effort and became widely popular. Now seen as unwieldy, Gray's Anatomy was born out of a need to create a single volume on anatomy for the traveling doctor.

The shift from the largely public displays of dissection in anatomy theatres to dissections carried out in classrooms meant that there was a drastic change in who could observe a dissection. Females for example, who at this time were not allowed to attend medical school, could broaden their knowledge by attending the anatomy theatres. So the shift from prosection to dissection meant a reduction in the number of people that could benefit from a single cadaver.

At this point as well tighter regulation of the medical profession and donations of bodies resulted in various implications for carrying out dissections. Private medical schools which offered summer schools and various other courses involving cadaveric dissection allowed one route into gaining membership to the Royal College of Surgeons. However from 1822 the Royal College of surgeons would no longer accept these qualifications, this as result would see these largely unregulated schools begin to close. Not only as a result of this, but the Anatomy Act 1832 made it much harder (more bureaucracy) to obtain bodies for dissection.

The act resulted in only the large teaching hospitals feasibly being able to continue teaching anatomy courses due to agreements with patients that if they donated their body they would receive free treatment. So towards the end of 19th century anatomy courses had been largely professionalised at established medical schools and public dissection was no longer common place.

Another source of anatomy teaching began with the foundation of many medical schools (particularly within the provincial medical schools) and the medical museums found within them. A large portion of training occurred within these up until and for some time after the Second World War. The medical museum was very important and a lot of effort was put into creating something impressive. This was particularly so in provincial medical schools which were just being established that needed credibility not only from other medical schools (namely Oxford and the London teaching hospitals) but also from the public. The museums were not only for students but also members of the public paid to see the exhibits within the museum. This brought not only much needed income but prestige as well. The more exhibits within the museum the more established the medical school appeared to be (at least to the public).

Significant amounts of teaching occurred in the museum as well with students claiming they learnt far more in the museum than they ever did in the lecture theatre. The decline of the museums within medical schools was largely due to the demand in floor space for teaching and new disciplines and less importantly the great improvements in photography and colour texts. For example the museum at Birmingham Medical School is now a computer cluster and teaching rooms, the only remains of the museum are the preserved specimens decorating the walls around the computer cluster.

Modern anatomy
Anatomical research in the past hundred years has taken advantage of technological developments and growing understanding of sciences such as evolutionary and molecular biology to create a thorough understanding of the body's organs and structures.

Disciplines such as endocrinology have explained the purpose of glands that anatomists previously could not explain; medical devices such as MRI machines and CAT scanners have enabled researchers to study the organs of living people or of dead ones. Progress today in anatomy is centered in the development, evolution, and function of anatomical features, as the macroscopic aspects of human anatomy have been largely catalogued. The subfield of non-human anatomy is particularly active as modern anatomists seek to understand basic organizing principles of anatomy through the use of advanced techniques ranging from finite element analysis to molecular biology.

With increasing demands on the healthcare system and what could be deemed chronic under-training of doctors (numbers of doctors per capita compared to other industrialised countries) during the latter half of the 20th century, medical schools are now facing massive pressure to train as many doctors as possible. This has meant in recent years cohort sizes have doubled and more in size, in order to try and meet the demand. This has resulted in increased pressure of the facilities at all medical schools in the country.

Anatomy is one department in particular that has had to evolve to accommodate the number of students. At Birmingham dissection was once essential to the teaching of anatomy but since the end of the 1980s the medical school has adopted prosection over dissection. At the time new directives from the General Medical Council (GMC) on the direction medical education was the major factor according the current head of anatomy.

There are also many other reasons why prosection maybe favoured (discussed below). It has probably now become near impossible to restart dissection at Birmingham even if one wanted to. This is due to the fact that current prosection uses a very similar number of cadavers as dissection previously did. If dissection was to be brought back the number of cadavers would be very large due the current cohort size. To increase provision of prosection the medical school is currently investing in the region of £800,000-900,000 on a new prosectorium. This will allow up to about 40 students to observe prosected material in any one session. The vast amount of money required just to increase the amount of prosection demonstrates that it is no longer possible to carry out dissection at Birmingham (and is the case for many other universities).

Prosection makes more efficient use of a cadaver when compared to dissection. A single cadaver when dissecting would be used by up to 5 students whereas prosection allows if necessary and entire cohort to observe the prosected cadaver. Prosection also allows students to observe more than one cadaver whereas in dissection you would tend to just use a single one. Logistically prosection allows more flexibility than dissection as there is no commitment to provide a cadaver per a certain number of students, this in fact create opportunities for cadavers to be used, for example at Birmingham, for Special Study Modules (SSMs) and postgraduate teaching.

Also there are many more aids to teaching anatomy then merely the prosectorium; improvements over the last century in colour images and photographs means that an anatomy text is no longer an aid to dissection but rather a central material to learn from. Plastic models are also regularly used in anatomy teaching sessions and they offer a good substitute to the real thing. One argument against plastic models is that they may provide a false sense of conformity in the human body; there is no doubt quite a difference between a plastic model and a prosected cadaver. Use of living models for anatomy demonstration is once again becoming popular within teaching of anatomy. Anatomy is dynamic, for example the anatomy of the musculoskeletal system is by definition the anatomy of movement.

So to provide an example of this to the audience (students) and be able to demonstrate the possible movements is beneficial. Surface landmarks that can be palpated on another individual also provide practice for future clinical situations. It is possible to do this on oneself and a good example of this being implemented is Integrated Biology at the University of Berkeley; students are encouraged to “introspect” on themselves and link what they are being taught to their own body. This may seem like a relatively obvious idea but to formally link it into teaching of anatomy should aid memory recall.

Donations of bodies have also declined in recent years with a marked decline of public confidence in the medical profession. With scandals such as Alder hay and Bristol, people are less confident that their wishes on what will happen to their body will be carried out, so instead have not donated to medical science when in the past they may have.

The resultant legislation from these scandals (namely the Human Tissue Act 2004) has tightened up the availability of resources to anatomy departments. Another factor facing body donations is the problems arising from the outbreaks of Bovine Spongiform Encephalitis (BSE) in the late 80s and early 90s and the restrictions of handling of brain tissue that resulted from this.

The exact pathology of the human form, variant Creutzfeldt–Jakob disease (vCJD) has meant that patients donating their body who suffered from Alzheimer’s or dementia and of course vCJD means their brains cannot be handled. As the method of transmission of these diseases and the link between them (i.e. is Alzheimer’s vCJD and vice versa) is not fully understood these precautions have to be taken.

Very symptomatic patients are also not normally accepted for cadavers. However this means that students are more limited on what they can dissect within the head, this is particularly a problem in medical schools where dissection is still carried out. It is less of a problem where prosection is carried out as the specimen will have already been dissected.

Conclusion:
Anatomy teaching has changed considerably over the last 1000 years though it is still very much at the heart of the philosophy of western medicine. Western medicine seeks to find a cause to all disease and attempt to cure it; very much cause and effect.

Without a good understanding of the arrangement of the human body then this becomes somewhat challenging. Western medicine is in fact taking a more holistic approach today, with the psychosocial biomedical model of disease. However most practicing doctors if it was proven that there was a biological cause to all the various idiopathic diseases then they would readily adapt their thoughts and treatments accordingly. Anatomy is often regarded as being little left to discover, in that we know what and where most of the body is and does, but there is still many mysteries left to work out. Public awareness of anatomy cannot be detrimental if it sparks interest in the discipline.

The recent controversies with Gunther von Hagens and public displays of dissection may divide opinions on what is ethical even the legality of a public dissection but this surely at least gets people thinking about how doctors learn anatomy and why in some it inspires them to pursue a career. The future of dissection may be uncertain and indeed if pressure on cadavers continues even the few medical schools that continue to do dissection may have to halt. This hopefully however will not reduce the number of people able to benefit from a single cadaver if current prosection methods become the prevalent method of demonstrating gross anatomy.

Branches of anatomy

1. Gross anatomy:
Gross anatomy is the study of anatomy at the macroscopic level. The term gross distinguishes it from other areas of anatomical study, including microscopic anatomy, which must be studied with the aid of a microscope.

Techniques of study
Gross anatomy is studied using both invasive and noninvasive methods with the goal of obtaining information about the macroscopic structure and organization of organs and organ systems.

Among the most common methods of study is dissection, in which the body of an animal is surgically opened and its organs studied.

Endoscopy, in which a video camera-equipped instrument is inserted through a small incision in the subject, may be used to explore the internal organs and other structures of living animals. The anatomy of the circulatory system in a living animal may be studied noninvasively via angiography, a technique in which blood vessels are visualized after being injected with an opaque dye.

Other techniques of study include X-ray and MRI.
Many types of multimedia exist for the study of gross anatomy, including textbooks and educational CDs and DVDs.

In education
Most doctoral health profession schools, such as medical and dental schools, require that students complete a course in gross human anatomy. Such courses aim to educate students in basic human anatomy and seek to establish anatomical landmarks that may later be used to aid medical diagnosis. Many schools provide students with cadavers for investigation by dissection, aided by dissectors such as Grant's Dissector, as well as cadaveric atlases (e.g. Rohen's).

Approaches to Studying Gross Anatomy
There are 3 main approaches to studying gross anatomy:
a. Regional and Surface anatomy:
- Regional anatomy or topography anatomy is the method of studying the body's structure by focusing attention on a specific part (e.g., the head), region (the face), or subregion (the nose); examining the arrangement and relationships of the various systemic structures (muscles, nerves, arteries, etc) within it; and then usually continuing to study adjacent regions in an ordered sequence.
- Surface anatomy is an essential part of the study of regional anatomy. Regional anatomy also recognizes the body's organization by layers: skin, subcutaneous tissue, and deep fascia covering the deeper structures of muscles, skeleton, and cavities, which contain viscera (internal organs). Many of these deeper structures are partially evident beneath the body's outer covering and may be studied and examined in living individuals via surface anatomy. Surface anatomy requires a thorough understanding of the anatomy of the structures beneath the surface. In people with stab wounds, for example, a physician must be able to visualize the deep structures that might be injured.

b. Systemic anatomy:
Systemic anatomy is a sequential study of the functional systems of the body. It is recognizes the organization of the body's organs into systems or collective apparatuses that work together to carry out complex functions. The basic systems and the field of study or treatment of each (in parentheses) are:
- Dermatology: The study of the integumentary system. Consists of the skin and its appendages-hair, nails and sweat glands.
- Osteology: The study of the skeletal system. Consists of bones and cartilage.
- Syndesmology: The study of ligaments.
- Myology: The study of the muscular system.
- Angiology: The study of the circulatory system. Consists of Cardiology (The Cardiovascular system-consists of the heart and blood vessels) and the Lymphatic system (a network of lymphatic vessels).
- Neurology: The study of the nervous system. Consists of the central nervous system (brain and spinal cord) and the peripheral nervous system (nerves and ganglia, together with their motor and sensory endings).
- Splanchnology: A branch of anatomy concerned with the viscera (internal organs). Consists of Gastroenterology (the study of the digestive or alimentary system-consists of the organs and glands associated with ingestion, mastication/ chewing, deglutition/ swallowing, digestion, and absorption of food and the elimination of feces), Pulmonology (the study of the respiratory system-consists of the air passages and lungs, diaphragm and larynx), Urology (the study of the urinary system-consists of the kidneys, ureters, urinary bladder and urethra), Gynecology (the study of the female's reproductive or genital system), Andrology (the study of the male's reproductive or genital system), and Endocrinology (the study of the endocrine/ hormones system).

c. Clinical anatomy:
- Clinical anatomy or Applied anatomy emphasizes aspects of bodily structure and function important in the practice of medicine, dentistry, and the allied health sciences. It incorporates the regional and systemic anatomy and stresses clinical application.

2. Microscopic anatomy:
Known among medical students simply as "micro", microscopic anatomy is the study of the form of normal structures seen under the microscope, as opposed to gross anatomy which involves structures that are big enough to be observed with the naked eye.

Microscopic anatomy means sitting looking at slides, slides, and more slides under the microscope. Microscopic anatomy consists of Cytology and Histology.

a. Cytology means "the study of cells". Cytology is that branch of life science, which deals with the study of cells in terms of structure, function and chemistry.

Based on usage it can refer to:
- Cytopathology: the study of cellular disease and the use of cellular changes for the diagnosis of disease.
- Cell biology: the study of (normal) cellular anatomy, function and chemistry.

b. Histology is the study of the microscopic anatomy of cells and tissues. It is performed by examining a thin slice (section) of tissue under a light microscope or electron microscope. The ability to visualize or differentially identify microscopic structures is frequently enhanced through the use of histological stains. Histology is an essential tool of biology and medicine.

Histopathology, the microscopic study of diseased tissue, is an important tool in anatomical pathology, since accurate diagnosis of cancer and other diseases usually requires histopathological examination of samples. Trained medical doctors, frequently board-certified as pathologists, are the personnel who perform histopathological examination and provide diagnostic information based on their observations.

The trained scientists who perform the preparation of histological sections are histotechnicians, histology technicians (HT), histology technologists (HTL), medical scientists, medical laboratory technicians, or biomedical scientists. Their field of study is called histotechnology.

3. Developmental anatomy:
Developmental anatomy is the branch of anatomy that studies structural changes of an individual from fertilization to maturity. Developmental anatomy is also called Embryology.

4. Comparative anatomy:
Comparative anatomy is the study of similarities and differences in the anatomy of organisms. It is closely related to evolutionary biology and phylogeny (the evolution of species).

Two major concepts of comparative anatomy are:
a. Homologous structures - structures (body parts/anatomy) which are similar in different species because the species have common descent. They may or may not perform the same function. An example is the forelimb structure shared by cats and whales.
b. Analogous structures - structures which are similar in different organisms because they evolved in a similar environment, rather than were inherited from a recent common ancestor. They usually serve the same or similar purposes. An example is the torpedo body shape of porpoises and sharks. It evolved in a water environment, but the animals have different ancestors.

The rules for development of special characteristics which differ significantly from general homology were listed by Karl Ernst von Baer (the Baer laws).

Anatomical position

As a standard point or frame of reference, the human body is described as being in the anatomical position when it is standing erect, head, gaze (eyes), toes directed anteriorly (forward), arms adjacent to the sides with the palms facing anteriorly, lower limbs close together with the feet together flat on the floor.

Anatomical planes

To study anatomy, we will spend time studying not only the surface anatomy of many organs, but we will also have to look at the interior anatomy of many organs. For example, the brain has a lot of interesting internal anatomy. In order to see these internal structures we will have to cut, or section, the various organs or parts of the body. Now three dimensionally there would have to be three different directions, or planes, that we can cut something.

Tranverse plane:
The first direction, or sectional plane, that we may use to cut a specimen could be to cut it in a horizontal plane. This type of cut would leave you with a top piece and a bottom piece. This type of section is called a transverse section or plane.

Vertical plane:
A different type of cut would be to cut, or section, a specimen in a vertical direction so that you are left with a front piece and a back piece. This type of section is called a coronal section or plane. For example, if you wanted to look at the interior structures of the brain and how their shapes vary as you move from front to back inside the brain, you would need to make a series of coronal sections to follow the changes in the shape of the internal structures.

Median plane:
The third direction that you may wish to cut a specimen, or the entire body, is to cut it into a right piece and a left piece. This type of section is also called as a sagittal section or plane. Now be careful, sagittal section does not always have to be right down the middle. To cut a specimen right down the middle producing equal right and left halves is called a midsagittal section. To section a secimen into right and left pieces that are not necessarily equal (on off-center cut in the sagittal plane) is to make a parasagittal section.

*Remember, we are cutting up a organ or part of the body in order to better visualize the internal structures of that organ or area of the body. You will have to then use your imagination to visualize in your mind how it looks uncut.

Terms of Relationship and Comparison

Superficial, intermediate, and deep describe the position of structures relative to the surface of the body or the relationship of one structure to another underlying or overlying structure.
- Superficial: Closer to the surface
- Intermediate: Between a superficial and a deep structure
- Deep: Farther down below the surface

Medial and lateral
- Medial: Nearer the midline of the body or a structure
- Lateral: Farther away from the midline of the body or a structure

External and internal mean farther from and nearer to the center of an organ or cavity, respectively, regardless of direction.
- External: Farther from to the center of an organ or cavity, respectively, regardless of direction.
- Internal: Nearer to the center of an organ or cavity, respectively, regardless of direction.

Posterior (dorsal), anterior (ventral), and rostral
- Anterior (Ventral): At the fronts
- Rostral: Often used instead of anterior when decribing parts of the brain; it mean toward the rostrum (L. from beak); however, in humans it denotes nearer the anteriorpart of the head (e.g., the frontal lobe of the brain is rostral to the cerebellum)
- Posterior (Dorsal): At the back

Inferior, Caudal, Superior, and Cranial
- Superior: Structure that is nearer the vertex, the top-most point of the cranium
- Cranial (Cephalic): Toward the head
- Inferior: Structure that is situated nearer the sole of the foot
- Caudal: Toward the tail (coccyx)

Proximal and distal are used when contrasting positions nearer to or farther from the attachment of a limb or the central aspect of a linear structure, respectively.
- Proximal: Closer to a structure
- Distal: Further away from a structure

Dorsum, Palm (hand), and Sole (foot)
- Dorsum: Usually refers to the superior or posterior (back) surface of any part that protrudes anteriorly from the body, such as the dorsum of the tongue, nose, penis, or foot. It is also used to describe the back of the hand.
- Palm: The flat of the hand, exclusive of the thumb and other fingers, and is the opposite of the dorsum of the hand.
- Sole: The inferior aspect or bottom of the foot, much of which is in contact with the ground when standing barefoot.

Terms of Laterally

Bilateral and unilateral
- Bilateral: Paired structures having right and left members (e.g., the kidneys)
- Unilateral: Single structure (one side only)-e.g. spleen

Ipsilateral and Contralateral
- Ipsilateral: On the same side of the body or structure
- Contralateral: On the opposite side of the body or structure

Terms of Movement

Flexion, Dorsiflexion, and Plantarflexion
- Flexion: Bending or decreasing the angle between the bones or parts of the body
- Dorsiflexion: Flexion at the ankle joint (e.g., when walking uphill or lifting the toes off the ground)
- Plantarflexion: Turns the foot or toes toward the plantar surface (e.g., when standing on your toes)

Extension, and Hyperextension (overextension)
- Extension: Straightening or increasing the angle between the bones or parts of the body
- Hyperextension: Extension of a limb or part beyond the normal limit. Hyperextension can cause injury, such as "whiplash" (i.e., hyperextension of the neck during a rear-end automobile collision)

Abduction, Abduction of the digits (fingers or toes), Abduction of the neck and trunk, Adduction, and Adduction of the digits (fingers or toes)
- Abduction: Moving away from the median plane in the frontal plane (e.g., when moving an upper limb away from the side of the body)
- Abduction of the digits: Spreading them apart-moving the other fingers away from the naturally positioned 3rd (middle) finger or moving the other toes away from the naturally positioned 2nd toe. The 3rd finger and 2nd toe medially or laterally abduct away from the neutral position.
- Abduction of the neck and trunk: Special forms of abduction for only the neck and trunk. The face and upper trunk are directed anteriorly as the head and/or shoulders tilt to the right or left side, causing the midline of the body itself to become bent sideways. This is a compound movement occuring between many adjacent vertebrae.
- Adduction: Moving toward the median plane in a frontal plane (e.g., when moving an upper limb toward the side of the body)
- Adduction of the digits: Reapproximating the spread fingers or toes or moving the other digits toward the neutral position of the 3rd finger or 2nd toe. The medially or laterally abducted 3rd finger or 2nd toe adducts back to the neutral position. The thumb is rotated 90 degree relative to the other digits. Therefore, the thumb flexes and extends in the frontal plane, and abducts and adducts in the sagittal plane

Circumduction, and Rotation (medial/internal rotation & lateral/external rotation)
- Circumduction: A circular movement that is a combination of flexion, extension, abduction, and adduction occurring in such a way that the distal end of the part moves in a circle. Circumduction can occur at any joint at which all the above-mentioned movements are possible (e.g., the hip joint)
- Rotation: Turning or revolving a part of the body around its longitudinal axis, such as turning one's head to face sideways. Medial rotation brings the anterior surface of a limb closer to the median plane. Lateral rotation takes the anterior surface away from the median plane

Pronation, and Supination
- Supine: Lying face up
- Prone: Lying face down

Opposition, and Reposition
- Opposition: The movement by which the pad of the 1st digit (thumb) is brought to another digit pad. This movement is used to pinch, button a shirt, and lift a teacup by the handle
- Reposition: The movement of the 1st digit from the position of opposition back to its anatomical position

Protrusion, and Retrusion
- Protrusion: A movement anteriorly (forward) as in protruding the mandible (chin), lips, or tongue
- Retrusion: A movement posteriorly (backward) as in retruding the mandible (chin), lips, or tongue

Protraction, and Retraction
- Protraction: Use most commonly for anterior movements of the shoulder
- Refraction: Use most commonly for posterior movements of the shoulder

Elevation, and Depression
- Elevation: Raises or moves a part superior
- Depression: Lowers or moves a part inferiorly

Eversion, and Inversion
- Eversion: Moves the sole of the foot away from the median plane (turning the sole laterally). When the foot is fully everted it is also dorsiflexed
- Inversion: Moves the sole of the foot toward the median plane (facing the sole medially). When the foot is fully inverted it is also plantarflexed

Regional Terms in Anatomy

- Cephalic: Located on, in, or near the head.
- Vertebral: Located on, in, or near the vertebra (back bones).
- Thoracic: Located on, in, or near the chest.
- Appendicular: Relating to, or consisting of an appendage or appendages, especially the limbs.
- Brachial: Relating to, or resembling the arm or a similar or homologous part, such as the foreleg, wing, or other forelimb of a vertebrate.
- Lumbar: Near, or relating to the part of the body between the lowest ribs and the hipbones.

The body cavities

Body cavity divided into 4 cavities:
1. Dorsal cavity subdivided into cranial cavity (contains brain) and vertebral cavity (contains spinal cord).

2. Ventral cavity subdivided into thoracic cavity, and abdominopelvic cavity.
a.Thoracic cavity (contains heart and lungs) consists of 4 cavities:
- Superior mediastinum cavity
- Lungs and pleural cavity (left and right cavities)
- Mediastinum, with heart and pericardial cavity

b. Abdominopelvic cavity consists of 2 cavities:
- Abdominal cavity: Contains digestive viscera, kidneys, and peritonial cavity
- Pelvic cavity: Contains bladder, reproductive organs, rectum, and peritoneal cavity

3. Serous cavity: A narrow cavity lined by serous membrane and consists of:
- Parietal serous: forming the outer wall cavitas
- Visceral serous: covering the visceral organs

4. The other small cavities: In the head, and between the joints.

The serous membranes

How to place organs into these cavities and have them stay in place? Even trickier, how to place an organ that is always moving, such as the heart or the lungs or even intestines, into one of these hollow cavities and keep it in place without firmly attaching it to the inside walls of the cavity since the organ needs to be able to move freely?

Let's start with the heart as an example. Imagine a closed fist as the heart. As the 'fist/heart' push up against the balloon, one side of the balloon is in direct contact with the 'fist/heart' while the opposite side of the balloon is not touching the 'fist/heart'. As the 'fist/heart' continue to push into the balloon, by 'fist/heart' will become completely surrounded by the balloon.

Yet the other side of the balloon is not touching the 'fist/heart', but is separated from it by the air in the balloon. Assume that the balloon is stick on the outside so that when the 'fist/heart' push up against it farther and farther, the balloon sticks to the 'fist/heart'. If the other side of the balloon held with other hand, the 'fist/heart' will not fall to the ground since it is stuck to the sticky surface of the balloon (remember, the 'fist/heart' is not suppost to be attached at the wrist).
So the heart is free to beat and move, yet it won't fall down or wiggle loose since the other side of the balloon is attached to the insides of the ribs. Why this works so well is that it is just one single balloon. But one single balloon with two surfaces. One surface attached to the 'fist/heart' and the other surface attached to the insides of the ribs. This balloon is called the pericardium.

Instead of the balloon being filled with air, it is filled with fluid, the pericardial fluid. Now the pericaridium can be named according to what surface you are talking about, the surface stuck to the heart or the surface stuck to the insides of the ribs. This is anatomy, so we give a name to each surface of the pericardium.

The part of the pericardium that is stuck to the heart itself is called the visceral pericaridum while the other surface of the pericardium that is attached to the insides of the ribs is called the parietal pericardium. The pericardium has both the visceral portion and the parietal portion, but it is still one continuous balloon, one continuous membrane called the pericardium.

Abdominal Regions

Anatomy and Clinical physical examinations

Physical examination or clinical examination is the process by which a doctor investigates the body of a patient for signs of disease. It generally follows the taking of the medical history — an account of the symptoms as experienced by the patient. Together with the medical history, the physical examination aids in determining the correct diagnosis and devising the treatment plan. This data then becomes part of the medical record.

Format and interpretation
Although providers have varying approaches as to the sequence of body parts, a systematic examination generally starts at the head and finishes at the extremities.

After the main organ systems have been investigated by inspection, palpation, percussion and auscultation, specific tests may follow (such as a neurological investigation, orthopedic examination) or specific tests when a particular disease is suspected (e.g. eliciting Trousseau's sign in hypocalcemia).

With the clues obtained during the history and physical examination the healthcare provider can now formulate a differential diagnosis, a list of potential causes of the symptoms. Specific diagnostic tests (or occasionally empirical therapy) generally confirm the cause, or shed light on other, previously overlooked, causes.

While the format of examination as listed below is largely as taught and expected of students, a specialist will focus on their particular field and the nature of the problem described by the patient. Hence a cardiologist will not in routine practice undertake neurological parts of the examination other than noting that the patient is able to use all four limbs on entering the consultation room and during the consultation become aware of their hearing, eyesight and speech. Likewise an Orthopaedic surgeon will examine the affected joint, but may only briefly check the heart sounds and chest to ensure that there is not likely to be any contraindication to surgery raised by the anaesthetist. Non-specialists generally examine the genitals only upon request of the patient.

A complete physical examination includes evaluation of general patient appearance and specific organ systems. It is recorded in the medical record in a standard layout which facilitates others later reading the notes. In practice the vital signs of temperature examination, pulse and blood pressure are usually measured first.

Belongings Of The Prophet (SAW)

2010-11-13T12:34:00.000+08:00

Al Haram Mosque, Makkah

2010-11-13T12:32:00.001+08:00

Beautiful recitation of Surah Yaseen with translation

2010-11-13T12:29:00.001+08:00

Surah Rahman - Beautiful and Heart trembling Quran recitation by Syed Sadaqat Ali

2010-11-13T12:26:00.001+08:00

Al Sunna said...
Assalamu alaikum,

Nice blog, the content in this blog is very useful to the people who are looking out for islamic knowledge.
NOVEMBER 15, 2009 8:56 PM

Beautiful recitation of Surah Mulk with translation

2010-11-13T12:24:00.000+08:00

Atelectasis

2010-11-13T12:12:00.000+08:00

Sleep Apnea and CPAP

2010-11-13T12:11:00.001+08:00

Bronchitis

2010-11-13T12:06:00.000+08:00

Bronchiectasis

2010-11-13T12:04:00.000+08:00

Pneumonia

2010-11-13T12:02:00.001+08:00

What is pneumonia?

Pneumonia is an infection of one or both lungs which is usually caused by bacteria, viruses, or fungi. Prior to the discovery of antibiotics, one-third of all people who developed pneumonia subsequently died from the infection. Currently, over 3 million people develop pneumonia each year in the United States. Over a half a million of these people are admitted to a hospital for treatment. Although most of these people recover, approximately 5% will die from pneumonia. Pneumonia is the sixth leading cause of death in the United States.

How do people "catch pneumonia"?

Some cases of pneumonia are contracted by breathing in small droplets that contain the organisms that can cause pneumonia. These droplets get into the air when a person infected with these germs coughs or sneezes. In other cases, pneumonia is caused when bacteria or viruses that are normally present in the mouth, throat, or nose inadvertently enter the lung. During sleep, it is quite common for people to aspirate secretions from the mouth, throat, or nose. Normally, the body's reflex response (coughing back up the secretions) and immune system will prevent the aspirated organisms from causing pneumonia. However, if a person is in a weakened condition from another illness, a severe pneumonia can develop. People with recent viral infections, lung disease, heart disease, and swallowing problems, as well as alcoholics, drug users, and those who have suffered a stroke or seizure are at higher risk for developing pneumonia than the general population.

Once organisms enter the lungs, they usually settle in the air sacs of the lung where they rapidly grow in number. This area of the lung then becomes filled with fluid and pus as the body attempts to fight off the infection.

What are pneumonia symptoms and signs?

Most people who develop pneumonia initially have symptoms of a cold which are then followed by a high fever (sometimes as high as 104 degrees Fahrenheit), shaking chills, and a cough with sputum production. The sputum is usually discolored and sometimes bloody. People with pneumonia may become short of breath. The only pain fibers in the lung are on the surface of the lung, in the area known as the pleura. Chest pain may develop if the outer pleural aspects of the lung are involved. This pain is usually sharp and worsens when taking a deep breath, known as pleuritic pain.

In other cases of pneumonia, there can be a slow onset of symptoms. A worsening cough, headaches, and muscle aches may be the only symptoms. In some people with pneumonia, coughing is not a major symptom because the infection is located in areas of the lung away from the larger airways. At times, the individual's skin color may change and become dusky or purplish (a condition known as "cyanosis") due to their blood being poorly oxygenated.

Children and babies who develop pneumonia often do not have any specific signs of a chest infection but develop a fever, appear quite ill, and can become lethargic. Elderly people may also have few symptoms with pneumonia.

How is pneumonia diagnosed?

Pneumonia may be suspected when the doctor examines the patient and hears coarse breathing or crackling sounds when listening to a portion of the chest with a stethoscope. There may be wheezing, or the sounds of breathing may be faint in a particular area of the chest. A chest x-ray is usually ordered to confirm the diagnosis of pneumonia. The lungs have several segments referred to as lobes, usually two on the left and three on the right. When the pneumonia affects one of these lobes it is often referred to as lobar pneumonia. Some pneumonias have a more patchy distribution that does not involve specific lobes. In the past, when both lungs where involved in the infection, the term "double pneumonia" was used. This term is rarely used today.

Sputum samples can be collected and examined under the microscope. If the pneumonia is caused by bacteria or fungi, the organisms can often be detected by this examination. A sample of the sputum can be grown in special incubators, and the offending organism can be subsequently identified. It is important to understand that the sputum specimen must contain little saliva from the mouth and be delivered to the laboratory fairly quickly. Otherwise, overgrowth of noninfecting bacteria may predominate.

A blood test that measures white blood cell count (WBC) may be performed. An individual's white blood cell count can often give a hint as to the severity of the pneumonia and whether it is caused by bacteria or a virus. An increased number of neutrophils, one type of WBC, is seen in bacterial infections, whereas an increase in lymphocytes, another type of WBC, is seen in viral infections.

Bronchoscopy is a procedure in which a thin, flexible, lighted viewing tube is inserted into the nose or mouth after a local anesthetic is administered. The breathing passages can then be directly examined by the doctor, and specimens from the infected part of the lung can be obtained.

Sometimes, fluid collects in the pleural space around the lung as a result of the inflammation from pneumonia. This fluid is called a pleural effusion. If the amount of this fluid that develops is large enough, it can be removed by inserting a needle into the chest cavity and withdrawing the fluid with a syringe in a procedure called a thoracentesis. In some cases, this fluid can become severely inflamed (parapneumonic effusion) or infected (empyema) and may need to be removed by more aggressive surgical procedures.

What are some of the organisms that cause pneumonia, and how are they treated?

The most common cause of a bacterial pneumonia is Streptococcus pneumoniae. In this form of pneumonia, there is usually an abrupt onset of the illness with shaking chills, fever, and production of a rust-colored sputum. The infection spreads into the blood in 20%-30% of cases, and if this occurs, 20%-30% of these patients die.

Two vaccines are available to prevent pneumococcal disease; the pneumococcal conjugate vaccine (PCV; Prevnar) and the pneumococcal polysaccharide vaccine (PPV; Pneumovax). The pneumococcal conjugate vaccine is part of the routine infant immunization schedule in the U.S. and is recommended for all children < 2 years of age and children 2-4 years of age who have certain medical conditions. The pneumococcal polysaccharide vaccine is recommended for adults at increased risk for developing pneumococcal pneumonia including the elderly, people who have diabetes, chronic heart, lung, or kidney disease, those with alcoholism, cigarette smokers, and in those people who have had their spleen removed.

Antibiotics often used in the treatment of this type of pneumonia include penicillin, amoxicillin and clavulanic acid (Augmentin, Augmentin XR), and macrolide antibiotics including erythromycin, azithromycin (Zithromax, Zmax), and clarithromycin (Biaxin). Penicillin was formerly the antibiotic of choice in treating this infection. With the advent and widespread use of broader-spectrum antibiotics, significant drug resistance has developed. Penicillin may still be effective in treatment of pneumococcal pneumonia, but it should only be used after cultures of the bacteria confirm their sensitivity to this antibiotic.

Klebsiella pneumoniae and Hemophilus influenzae are bacteria that often cause pneumonia in people suffering from chronic obstructive pulmonary disease (COPD) or alcoholism. Useful antibiotics in this case are the second- and third-generation cephalosporins, amoxicillin and clavulanic acid, fluoroquinolones (levofloxacin [Levaquin], moxifloxacin-oral [Avelox], gatifloxacin-oral [Tequin], and sulfamethoxazole and trimethoprim [Bactrim, Septra]).

Mycoplasma pneumoniae is a type of bacteria that often causes a slowly developing infection. Symptoms include fever, chills, muscle aches, diarrhea, and rash. This bacterium is the principal cause of many pneumonias in the summer and fall months, and the condition often referred to as "atypical pneumonia." Macrolides (erythromycin, clarithromycin, azithromycin, and fluoroquinolones) are antibiotics commonly prescribed to treat Mycoplasma pneumonia.

Legionnaire's disease is caused by the bacterium Legionella pneumoniae that is most often found in contaminated water supplies and air conditioners. It is a potentially fatal infection if not accurately diagnosed. Pneumonia is part of the overall infection, and symptoms include high fever, a relatively slow heart rate, diarrhea, nausea, vomiting, and chest pain. Older men, smokers, and people whose immune systems are suppressed are at higher risk of developing Legionnaire's disease. Fluoroquinolones are the treatment of choice in this infection. This infection is often diagnosed by a special urine test looking for specific antibodies to the specific organism.

Mycoplasma, Legionnaire's, and another infection, Chlamydia pneumoniae, all cause a syndrome known as "atypical pneumonia." In this syndrome, the chest x-ray shows diffuse abnormalities, yet the patient does not appear severely ill. These infections are very difficult to distinguish clinically and often require laboratory evidence for confirmation.

Pneumocystis carinii pneumonia is another form of pneumonia that usually involves both lungs. It is seen in patients with a compromised immune system, either from chemotherapy for cancer, HIV/AIDS, and those treated with TNF (tumor necrosis factor), such as for rheumatoid arthritis. Once diagnosed, it usually responds well to sulfa-containing antibiotics. Steroids are often additionally used in more severe cases.

Viral pneumonias do not typically respond to antibiotic treatment. These infections can be caused by adenoviruses, rhinovirus, influenza virus (flu), respiratory syncytial virus (RSV), and parainfluenza virus (that also causes croup). These pneumonias usually resolve over time with the body's immune system fighting off the infection. It is important to make sure that a bacterial pneumonia does not secondarily develop. If it does, then the bacterial pneumonia is treated with appropriate antibiotics. In some situations, antiviral therapy is helpful in treating these conditions.

Fungal infections that can lead to pneumonia include histoplasmosis, coccidiomycosis, blastomycosis, aspergillosis, and cryptococcosis. These are responsible for a relatively small percentage of pneumonias in the United States. Each fungus has specific antibiotic treatments, among which are amphotericin B, fluconazole (Diflucan), penicillin, and sulfonamides.

Major concerns have developed in the medical community regarding the overuse of antibiotics. Most sore throats and upper respiratory infections are caused by viruses rather than bacteria. Though antibiotics are ineffective against viruses, they are often prescribed. This excessive use has resulted in a variety of bacteria that have become resistant to many antibiotics. These resistant organisms are commonly seen in hospitals and nursing homes. In fact, physicians must consider the location when prescribing antibiotics (community-acquired pneumonia, or CAP, versus hospital-acquired pneumonia, or HAP).

The more virulent organisms often come from the health-care environment, either the hospital or nursing homes. These organisms have been exposed to a variety of the strongest antibiotics that we have available. They tend to develop resistance to some of these antibiotics. These organisms are referred to as nosocomial bacteria and can cause what is known as nosocomial pneumonia when the lungs become infected.

Recently, one of these resistant organisms from the hospital has become quite common in the community. In some communities, up to 50% of Staph aureus infections are due to organisms resistant to the antibiotic methicillin. This organism is referred to as MRSA (methicillin-resistant Staph aureus) and requires special antibiotics when it causes infection. It can cause pneumonia but also frequently causes skin infections. In many hospitals, patients with this infection are placed in contact isolation. Their visitors are often asked to wear gloves, masks, and gowns. This is done to help prevent the spread of this bacteria to other surfaces where they can inadvertently contaminate whatever touches that surface. It is therefore very important to wash your hands thoroughly and frequently to limit further spread of this resistant organism.

Conclusions

Pneumonia can be a serious and life-threatening infection. This is true especially in the elderly, children, and those that have other serious medical problems, such as COPD, heart disease, diabetes, and certain cancers. Fortunately, with the discovery of many potent antibiotics, most cases of pneumonia can be successfully treated. In fact, pneumonia can usually be treated with oral antibiotics without the need for hospitalization.

Pneumonia At A Glance

Pneumonia is a lung infection that can be caused by different types of microorganisms, including bacteria, viruses, and fungi.

Symptoms of pneumonia include cough with sputum production, fever, and sharp chest pain on inspiration (breathing in).

Pneumonia is suspected when a doctor hears abnormal sounds in the chest, and the diagnosis is confirmed by a chest x-ray.

Bacteria causing pneumonia can be identified by sputum culture.

A pleural effusion is a fluid collection around the inflamed lung.

Bacterial and fungal (but not viral) pneumonia can be treated with antibiotics.

Bronchial Asthma

2010-11-13T11:59:00.000+08:00

Bronchial Asthma

Ever hear the term "bronchial asthma" and wonder what it means? When people talk about bronchial asthma, they are really talking about asthma, a chronic inflammatory disease of the airways that causes periodic "attacks" of coughing, wheezing, shortness of breath, and chest tightness.

According to the CDC, more than 22 million Americans, including 6.5 million children under 18, suffer with asthma today. Allergy clearly plays an important role in many asthma cases but not in all. As with allergy, you can blame your family history; there's certainly a strong genetic component for asthma.

Because of asthma symptoms, asthma is associated with mast cells, eosinophils, and T lymphocytes. Mast cells are the allergy-causing cells that release chemicals like histamine. Histamine is the substance that causes nasal stuffiness and dripping in a cold or hay fever, constriction of airways in asthma, and itchy areas in a skin allergy. Eosinophils are a type of white blood cell associated with allergic disease. T lymphocytes are also white blood cells associated with allergy and inflammation.

These cells, along with other inflammatory cells, are involved in the development of airway inflammation in asthma that contributes to the airway hyperresponsiveness, airflow limitation, respiratory symptoms, and chronic disease. In certain individuals, the inflammation results in the feelings of chest tightness and breathlessness that's felt often at night (nocturnal asthma) or in the early morning hours. Others only feel symptoms when they exercise (called exercise-induced asthma). Because of the inflammation, the airway hyperresponsiveness occurs as a result of specific triggers.

Allergies are strongly linked to bronchial asthma and to other respiratory diseases such as chronic sinusitis, middle ear infections, and nasal polyps. Most interestingly, a recent analysis of people with asthma showed that those who had both allergies and asthma were much more likely to have nighttime awakening due to asthma, miss work because of asthma, and require more powerful medications to control their symptoms.

Bronchial Asthma Triggers
Asthma triggers may include:

Tobacco smoke
Infections such as colds, flu, or pneumonia
Allergens such as food, pollen, mold, dust mites, and pet dander
Exercise
Air pollution and toxins
Weather, especially extreme changes in temperature
Drugs (such as aspirin, NSAID, and beta-blockers)
Food additives (such as MSG)
Emotional stress and anxiety
Singing, laughing, or crying
Smoking, perfumes, or sprays
Acid reflux

Signs and Symptoms of Bronchial Asthma
With bronchial asthma, you may have one or more of the following signs and symptoms:

Shortness of breath
Tightness of chest
Wheezing
Excessive coughing or a cough that keeps you awake at night

Diagnosing Bronchial Asthma
Because asthma does not always happen at the doctor's visit, it's important for you to describe your asthma signs and symptoms to your doctor. You might also notice when the symptoms occur such as during exercise, with a cold, or after smelling smoke. Asthma tests may include:

Spirometry: A pulmonary function test (PFT) to measure your breathing capacity and how well you breathe. You will breathe into a device called a spirometer.

Peak Expiratory Flow (PEF): Using a device called a peak flow meter, you forcefully exhale into the tube to measure the force of air you can expend out of your lungs. Peak flow monitoring can allow you to monitor your how well your asthma is doing at home.

Chest X-Ray: Your doctor may do a chest X-ray to rule out any other diseases that may be causing similar symptoms.

Treating Bronchial Asthma
Once diagnosed, your asthma doctor will recommend asthma medication (which can include asthma inhalers and pills) and lifestyle changes to treat and prevent asthma attacks. For example, long-acting anti-inflammatory asthma inhalers are often necessary to treat the inflammation associated with asthma. These inhalers deliver low doses of steroids to the lungs with minimal side effects if used properly. The fast-acting or "rescue" bronchodilator inhaler works immediately on opening airways during an asthma attack.

If you have bronchial asthma, make sure your doctor shows you how to use the inhalers. Be sure to keep your rescue inhaler with you in case of an asthma attack or asthma emergency. While there is no asthma cure yet, there are excellent asthma medications that can help with preventing asthma symptoms and asthma support that can help you live a normal, active life.

Thoracic ultrasound for Pneumothorax

2010-11-13T11:56:00.000+08:00

Kill mosquitoes with a new laser system

2010-11-13T11:47:00.001+08:00

A new laser system can kill mosquitoes without harming other insects, as shown in slowmotion video. It's all part of the effort to combat malaria.

Source:
National Geographic
February 17, 2010

Urinary Tract Infection

2010-11-13T11:36:00.000+08:00

Kelebihan beberapa ayat dan surah dalam Al-Quran

2010-11-12T22:37:00.003+08:00

SURAH AL-FATIHAH (Pembukaan)

Barangsiapa membacanya sebanyak 41 kali di antara sembahyang sunatnya, nescaya permintaannya diperkenankan, jika sakit lekas sembuh dan nescaya dikasihi oleh makhluk dan ditakuti oleh musuh. Barang siapa membaca 20 kali sesudah tiap-tiap sembahyang fardhu, nescaya rezekinya dilapangkan oleh Tuhan dan bertambah baik keadaannya, serta bercahaya rohaninya.

AYAT AL-KURSI (Kekuasaan Allah)

Barangsiapa membacanya sekali selepas setiap sembahyang fardhu, nescaya terpelihara dari tipu daya dan ganguan syaitan. Dengan membacanya, seorang yang miskin akan menjadi kaya, dan jika dibaca ketika hendak tidur nescaya akan terselamat dari kecurian, kebakaran dan kekaraman. Barangsiapa sentiasa membaca ayat Al-Kursi, nescaya Allah akan kurniakan kepada ahli rumahnya kebaikan yang tidak terhitung banyaknya. Barangsiapa berwudhuk lalu membaca sekali, nescaya Allah akan meninggikan darjatnya setinggi 40 darjat dan Allah akan mendatangkan para malaikat menurut bilangan hurufnya, seraya berdoa untuk si pembaca hinggalah ke hari Qiamat.

Dan tersebut dalam hadis yang lain: "Barangsiapa membacanya ketika hendak tidur, nescaya Allah akan membuka pintu rahmat baginya hingga ke subuh dan mengurniakan kota nur menurut bilangan rambut di badannya. Jika si pembacanya meninggal dunia pada malam itu, ia dikira mati syahid".

Hadis yang lain mengatakan: "Barangsiapa membacanya selepas setiap sembahyang fardhu, nescaya akan terpelihara dari kekerasan malakul-maut dan dia akan dibangkitkan bersama para Mujahid yang berjihad beserta para Anbiya hingga ia gugur mati Syahid".

Imam Jaafar Shadiq r.a. mengatakan: "Barangsiapa membaca sekali, nescaya Allah akan menghindar darinya 1,000 kesukaran duniawi, yang terkecil sekali ialah kemiskinan dan kepapaan dan 1,000 kesukaran ukhrawi, yang terkecil sekali ialah azab neraka".

SURAH AL-BAQARAH (Sapi Betina)

Barangsiapa membaca dua ayat terakhir dari surah ini (Amanarrasulu) sebelum tidur, ia akan terselamat dari segala bala bencana dan mara bahaya.

SURAH ALI-IMRAN (Keluarga Imran)

Barangsiapa membaca tiga ayat yang pertama dari surah ini, nescaya ia akan mencapai kesihatan dari segala penyakit dan terselamat dari gangguan jin.

SURAH AN-NISSA' (Perempuan)

Barangsiapa yang membaca ayat yang ke 75 dari surah ini, nescaya ia akan terselamat dari kejahatan para penjahat.

SURAH AL-MAIDAH (Hidangan)

Barang siapa membaca ayat yang ke 7 dari surah ini, sebanyak yang mungkin selama 3 hari berturut-turut, insya Allah akan terselamat dari was-was semasa wudhu dan sembahyang. Barang siapa membaca ayat 89 hingga ayat 101 dari surah ini ke atas air lalu diberi minum kepada orang yang bercakap dusta, nescaya ia tidak akan bercakap dusta lagi.

SURAH AL-AN'AM (Binatang Ternak)

Barang siapa membacanya sebanyak 7 kali, nescaya akan terhindar dari segala bala bencana. Jika ayat 63 dan 64 dari surah ini dibaca oleh penumpang kapal, ia akan terselamat dari karam dan tenggelam.

SURAH AL-A'RAAF (Benteng Tinggi)

Barang kali membaca ayat 23 dari surah ini, selepas tiap-tiap sembahyang fardhu, lalu beristighfar kepada Allah, nescaya akan terampun segala dosanya. Barang siapa membaca ayat 47 dari surah ini, ia akan terpelihara dari kekacauan para penzalim serta ia akan mendapat rahmat Allah.

SURAH AL- ANFAL (Rampasan)

Barang siapa membaca ayat 62 dan 63 dari surah ini, nescaya dia akan dicintai dan dihormati oleh sekalian manusia.

SURAH AL-BARAAH (AT-TAUBAH) (Pemutus perhubungan)

Barangsiapa membacanya, nescaya akan terselamat dari kemunafiqan dan akan mencapai hakikat iman. Barang siapa membaca ayat 111 dari surah ini, di kedai atau di tempat-tempat perniagaan, nescaya akan maju perniagaannya itu.

SURAH YUNUS (Yunus)

Barangsiapa membaca ayat 31 dari surah ini ke atas Perempuan yang hamil, nescaya ia melahirkan anak dalam kandungannya itu dengan selamat. Barangsiapa membaca ayat 64 dari surah ini, nescaya ia akan terhindar dari mimpi-mimpi yang buruk dan mengigau.

SURAH AL-HUD (Hud)

Barang siapa membaca, nescaya ia akan mendapat kekuatan dan kehebatan serta ketenangan dan ketenteraman jiwa. Barang siapa membaca ayat 56 dari surah ini pada setiap masa, nescaya ia akan terselamat dari gangguan manusia yang jahat dan binatang yang liar. Barang siapa membaca ayat 112 dari surah ini, sebanyak 11 kali selepas tiap-tiap sembahyang, nescaya akan mencapai ketetapan hati.

SURAH YUSUF (Yusuf)

Barang siapa membacanya, akan dimurahkan rezekinya dan diberikan kemuliaan kepadanya. Barang siapa membaca ayat 64 dari surah ini, ia akan terhindar dari kepahitan dan kesukaran hidup. Barang siapa membaca ayat 68 dari surah ini, nescaya Allah akan mengurniakan kesalehan kepada anak-anaknya.

SURAH AR-RA'D (Petir)

Barang siapa membaca ayat 13 dari surah ini, ia akan terselamat dari petir. Dan barangsiapa membaca ayat 28 dari surah ini, nescaya penyakit jantungnya akan sembuh.

SURAH IBRAHIM (Ibrahim)

Barang siapa membaca ayat-ayat 32 hingga 34 dari surah ini, nescaya anak-anaknya akan terhindar dari perbuatan-perbuatan syirik dan bida'ah.

SURAH AL-IIIJ'R (Batu Gunung)

Barang siapa membaca 3 ayat yang terakhir dari surah ini ke atas perempuan yang selalu anak kandungannya gugur, nescaya anak kandungannya itu akan terselamat dari gugurnya.

SURAH BANI ISRAIL (Anak-anak Israil)

Barang siapa membacanya ke atas air, lalu diberi minum kepada orang yang bercakap gagap insya Allah akan hilang gagapnya itu. Barang siapa membaca ayat 80 dari surah ini ketika ia pulang dari perjalanan, nescaya dia akan dimuliakan dan dihormati oleh orang-orang yang setempat dengannya.

SURAH AL-KAHF (Gua)

Barang siapa membacanya, akan terhindar dari kemiskinan dan kepapaan. Barang siapa membacanya pada malam Jumaat, nescaya dia akan mendapat rezeki yang murah.

SURAH MARYAM (Maryam)

Barang siapa membacanya, nescaya akan mendapat kejayaan di dunia dan di akhirat.

SURAH THAAHAA (Hai Manusia)

Barang siapa membacanya, nescaya Allah akan mengurniakan kepadanya ilmu pengetahuan dan akan tercapai segala maksudnya. Barang siapa membaca ayat-ayat 25 hingga 28 sebanyak 21 kali tiap-tiap hari selepas sembahyang subuh nescaya otaknya akan cerdas dan akalnya akan sempurna.

SURAH AL-ANBIYA (Nabi-Nabi)

Barang siapa membaca ayat 83 dari surah ini, nescaya dia akan mendapat sebesar-besar pangkat di sisi Allah S.W.T .

SURAH AL-HAJ (Haji)

Barang siapa membacanya, Allah akan membinasakan musuh-musuhnya.

SURAH AL-MU'MINUN (Orang-orang Mukmin)

Barang siapa membacanya ke atas air lalu diberi minum kepada orang yang selalu minum minuman keras, nescaya dia tidak akan meminumnya lagi. Barang siapa membaca ayat 28 dari surah ini, nescaya perahunya akan terselamat daripada karam dan rumahnya akan terselamat dari kecurian dan serangan musuh.

SURAH AN-NUUR (Cahaya)

Barang siapa membacanya, nescaya ia akan terhindar dari mimpi-mimpi yang buruk. Barang siapa membaca ayat 35 dari surah ini pada hari Jumaat sebelum sembahyang Asar, nescaya dia akan disegani oleh orang ramai.

SURAH AL-FURQAN (Pembaca)

Barang siapa membacanya sebanyak 3 kali ke atas air yang bersih lalu air itu dipercikkan di dalam rumah, nescaya rumah itu akan terselamat dari gangguan binatang-binatang yang liar dan ular-ular yang bisa.

SURAH ASY-SYUA'RA (Ahli-ahli Syair)

Barang siapa membaca ayat 130 dari surah ini sebanyak 7 kali dengan senafas ke atas orang-orang yang digigit oleh binatang-binatang yang berbisa, nescaya akan hilang bisa-bisa itu.

SURAH AN-NAML (Semut)

Barang siapa membacanya nescaya nikmat-nikmat Allah akan kekal kepadanya.

SURAH AL-QA-SHASH (Cerita)

Barang siapa membacanya ke atas pekerja-pekerjanya, nescaya mereka tidak akan mencuri dan mengkhianat. Barang siapa membaca ayat-ayat 51 hingga 55 dari surah ini, nescaya otaknya akan cergas, akalnya akan sempurna dan budi pekertinya akan halus.

SURAH AL-ANKABUT (Labah-labah)

Barang siapa membacanya, nescaya demamnya akan sembuh, ia akan terhindar dari gelisah dan keluh kesah.

SURAH AR-RUM (Rum)

Barang siapa membacanya, nescaya Allah akan membinasakan orang yang hendak menzaliminya.

SURAH LUQMAN (Luqman)

Barang siapa membacanya, nescaya ia akan terhindar dari segala penyakit terutama dari penyakit-penyakit perut. Barang siapa membaca ayat 31 dari surah ini, nescaya akan terselamat dari bencana banjir.

SURAH AS-SAJDAH (Sujud)

Barang siapa membaca ayat-ayat 7 hingga 9 dari surah ini ke atas kanak-kanak yang baru lahir, nescaya ia akan terhindar dari sega la penyakit rohani dan jasmani.

SURAH AL-AHZAB (Golongan-golongan)

Barang siapa membaca ayat-ayat 45 hingga 48 dari surah ini, nescaya ia akan mendapat kemuliaan dan kehormatan sejati. Dan barang siapa membaca ayat-ayat 60 hingga 66 dari surah ini, nescaya Allah akan membinasakan musuh-musuhnya.

SURAH SABA' (Saba')

Dengan membacanya, terselamatlah ia dari segala-gala bala bencana terutamanya dari rosaknya tanam-tanaman.

SURAH FAATHIR (Pencipta)

Barang siapa membaca ayat-ayat 29 dan 30, nescaya Allah akan memberkati perniagaannya.

SURAH YAASIIN (Hai Manusia)

Nabi kita Muhammad S.A.W bersabda: "Tiap-tiap sesuatu mempunyai hati dan hati Al-Quran ialah surah Yaasiin. Yaasiin kerana Allah, nescaya akan terampun segala dosanya kecuali dosa syirik".

Dalam satu hadis yang lain Baginda S.A.W. bersabda: "Hendaklah kamu membaca surah Yaasiin ke atas pesakit-pesakitmu yang menghadapi sakaratul-maut, nescaya Allah S.W.T. akan meringankan kekerasan sakaratul-maut itu".

Dalam satu hadith yang lain pula Baginda S.A.W. bersabda: "Aku ingin benar, agar surah Yaasiin ini dihafaz oleh tiap-tiap umatku".

Barang siapa membacanya sebanyak 41 kali, pasti akan tercapai segala hajat dan cita-citanya. Barang siapa membacanya sebanyak 21 kali pada malam Jumaat lalu berdoa istighfar untuk kedua ibu bapanya, nescaya dosa kedua ibu bapanya akan diampunkan oleh Tuhan.

Barang siapa membaca sekali ketika membuka kedai atau perniagaan, nescaya akan maju perniagaannya itu. Barang siapa membacanya sekali pada awal malam, andai kata ia mati pada malam itu, mesti ia mati syahid. Barang siapa membacanya sekali selepas tiap-tiap sembahyang Jumaat, nescaya ia akan diselamatkan dari siksa kubur.

Jika dibacanya oleh seorang askar ketika ia hendak turun ke medan peperangan, Allah akan mengurniakan kepadanya keberanian dan kegagahan serta naiklah ketakutan pada musuh-musuhnya.

Hikmat-hikmat dan khasiat-khasiat surah Yaasiin ini banyak benar di dapati di dalam kitab-kitab hadis tetapi cukuplah setakat ini untuk diamal oleh anda sekalian.

SURAH ASH-SHAAFFAAT (Yang Berbaris)

Barang siapa membacanya, insya Allah ia akan terpelihara daripada gangguan jin.

SURAH SHAAD (Shaad)

Dengan membaca ayat 42 dari surah ini, nescaya akan mendapat kebahagiaan sejati.

Insyallah rakan-rakan semua akan mendapat berkat. Praktikkanlah surah-surah ini.

Cara Masuk Syurga Tanpa Hisab

2010-11-09T19:44:00.004+08:00

Cara Masuk Syurga Tanpa Hisab
Januari 13, 2010 — Eza reza

Orang yang masuk syurga ada 3 macam, iaitu: Langsung masuk syurga tanpa hisab (hisab: dihitung kebaikan dan keburukannya), masuk syurga setelah dihisab, dan masuk syurga setelah diazab terlebih dahulu di neraka. Tentunya semua orang akan mengidam-idamkan masuk syurga tanpa perlu masuk neraka. Tapi bagaimana caranya? Mungkin ini adalah pertanyaan yang terlintas di benak setiap orang secara spontan begitu membaca judul ini.

Sempurnakan Tauhid !

Agar masuk syurga tanpa hisab, syarat yang perlu dipenuhi adalah membersihkan tauhid dari noda-noda syirik, bid’ah, dan maksiat. Allah berfirman, “Sesungguhnya Ibrahim adalah seorang imam yang dapat dijadikan teladan lagi patuh kepada Allah dan hanif (lurus). Dan sekali-kali bukanlah dia termasuk orang-orang yang mempersekutukan (Rabb).” (An Nahl: 120). Dalam ayat ini, Allah memuji nabi Ibrahim dengan menyebutkan empat sifat, yang apabila keempat sifat ini ada pada diri seorang insan, maka dia berhak mendapatkan balasan yang tertinggi, iaitu masuk syurga tanpa hisab dan tanpa azab.

Mencontoh Para Nabi Dalam Bertauhid

Di dalam Al Qur’an Allah memberikan uswah (teladan) kepada kita pada dua sosok manusia iaitu Nabi Ibrahim dan Nabi Muhammad ‘alaihimashsholaatu was salaam. Allah berfirman, “Sesungguhnya telah ada suri teladan yang baik bagimu pada Ibrahim dan orang-orang yang bersama dengan dia; ketika mereka berkata kepada kaum mereka, ‘Sesungguhnya kami berlepas diri dari kamu dan dari apa yang kamu sembah selain Allah, kami ingkari (kekafiran) mu dan telah nyata antara kami dan kamu permusuhan dan kebencian buat selama-lamanya sampai kamu beriman kepada Allah saja’.” (Al Mumtahanah: 4)

Perhatikanlah, Ibrahim ‘alaihis salam menjadi teladan dengan memurnikan tauhid dengan cara berlepas diri dari kesyirikan. Dalam ayat selanjutnya, Allah berfirman, “Sesungguhnya pada mereka itu (Ibrahim dan umatnya) ada teladan yang baik bagi kalian (iaitu) bagi orang yang mengharap (pahala) Allah dan (keselamatan pada) hari kemudian.” (QS. Al Mumtahanah: 6). Tidak diragukan lagi, balasan yang paling besar dan keselamatan yang dimaksud adalah masuk syurga tanpa hisab dan tanpa azab. Itulah keselamatan yang hakiki yang dinanti oleh setiap jiwa yang pasti akan merasakan mati.

Allah juga berfirman tentang Nabi kita Muhammad shollallohu ‘alaihi wa sallam, “Sesungguhnya telah ada pada (diri) Rasulullah itu suri teladan yang baik bagimu (iaitu) bagi orang yang mengharap (rahmat) Allah dan (kedatangan) hari kiamat dan dia banyak menyebut Allah.” (Al Ahzab: 21). Nabi Muhammad adalah orang yang paling paham tentang tauhid, maka orang yang hendak mengamalkan tauhid dalam dirinya perlu mencontohi ajaran beliau. Ya Allah, masukkanlah kami dalam golongan orang yang mengharap rahmat-Mu dan banyak menyebut-Mu.

Patuh Terhadap Perintah Allah

Nabi Ibrahim adalah seorang yang sangat patuh kepada Allah, teguh dalam ketaatannya dan senantiasa berada dalam ketundukannya, apapun keadaannya. Buktinya ketika beliau diuji dengan perintah untuk menyembelih putera kesayangannya, beliau pun tetap patuh melaksanakannya (Qoulul Mufid karya Syaikh Al Utsaimin). Begitu juga keturunannya, pemimpin para Nabi, Muhammad shollallohu ‘alaihi wa sallam, hamba Allah yang paling taat. Allah berfirman, “(Apakah kamu hai orang musyrik yang lebih beruntung) ataukah orang yang beribadah di waktu-waktu malam dengan sujud dan berdiri, sedang dia takut kepada (azab) akhirat dan mengharapkan rahmat Rabbnya?” (Az Zumar: 9)

Keluar dari Kegelapan Syirik Menuju Cahaya Tauhid

Ibnul Qoyyim mengatakan, “Hanif adalah menujukan ibadah hanya kepada Allah (tauhid) dan berpaling dari peribadatan kepada selain-Nya (syirik).” (Fathul Majid). Inilah sifat orang yang akan masuk surga tanpa hisab dan tanpa azab, iaitu betul-betul menjaga kemurnian tauhidnya dengan berpaling sejauh-jauhnya dari kesyirikan dengan segala macam pernak-perniknya. Mujahid berkata, “Nabi Ibrahim adalah seorang imam walaupun beliau beriman seorang diri di tengah kaumnya yang kafir.” (Tafsir Ibnu Katsir, An Nahl: 120). Maksudnya beliau adalah sosok yang selamat dari kesyirikan baik dalam perkataan, perbuatan, mahupun keyakinan.” (Al Jadid karya syaikh Al Qor’awi). Maka untuk memurnikan tauhid, kita harus berpaling dari syirik dan pelakunya.

Tawakkal Kepada Allah, Itu Kuncinya

Mari kita semak sabda Nabi yang paling kita cintai dan sangat mencintai umatnya, Muhammad sholallohu ‘alaihi wa sallam tentang masuk syurga tanpa hisab dan tanpa azab. Beliau bersabda, “Beberapa umat ditampakkan kepadaku, lalu kulihat seorang nabi bersama beberapa orang, ada seorang nabi bersama satu atau dua orang, dan ada seorang nabi yang tidak disertai siapapun. Tiba-tiba ditampakkan kepadaku satu golongan dalam jumlah yang amat banyak, sehingga aku mengira mereka adalah umatku. Maka ada yang memberitahukan kepadaku, ‘Ini adalah Musa dan kaumnya.’ Aku melihat lagi, ternyata di sana ada jumlah yang lebih banyak lagi. Ada yang memberitahukan kepadaku, ‘Itulah umatmu, tujuh puluh ribu orang di antara mereka masuk surga tanpa hisab dan tanpa azab.’ Kemudian beliau bangkit dan masuk rumah. Maka orang-orang berkumpul bersama orang-orang yang sudah berkumpul. Sebagian mereka mengatakan, ‘Barangkali mereka adalah para sahabat Rasulullah shalallohu ‘alaihi wa sallam.’ Sebagian yang lain mengatakan, ‘Boleh jadi mereka adalah orang-orang yang dilahirkan dalam Islam dan tidak menyekutukan sesuatu pun beserta Allah.’ Mereka pun mengatakan banyak hal. Lalu Rasulullah shalallohu ‘alaihi wa sallam keluar menemui mereka dan mereka memberitahukan kepada beliau. Maka beliau bersabda, ‘Mereka adalah orang-orang yang tidak meminta ruqyah, tidak meminta untuk (berobat dengan cara) disundut dengan api, dan tidak melakukan tathayyur, serta mereka bertawakal kepada Alloh.’ Lalu ‘Ukkasyah bin Mihshon berdiri dan berkata, ‘Berdo’alah kepada Allah agar Dia menjadikan aku termasuk golongan mereka.’ Beliau bersabda, ‘Engkau termasuk golongan mereka.’ Kemudian ada orang lain berdiri dan berkata, ‘Berdo’alah kepada Alloh agar Dia menjadikan aku termasuk golongan mereka.’ Beliau bersabda, ‘Engkau sudah didahului ‘Ukasyah.’” (HR. Al Bukhori dan Muslim)

Di antara pelajaran paling berharga yang bisa dipetik dari hadits ini adalah bahawa tidak meminta ruqyah, tidak berobat dengan cara disundut dengan besi panas (kayy), dan tidak menganggap akan mengalami kesialan setelah mendengar atau melihat sesuatu (tathoyyur) merupakan wujud dan realisasi dari tawakkal kepada Allah. Kerana itulah Rasulullah menganjurkan kepada umatnya agar tidak melakukan ketiga hal tersebut, kerana pengaruh ruqyah dan kayy yang sangat kuat sehingga dikhawatirkan seorang hamba menggantungkan harapan kesembuhannya kepada cara pengobatan tersebut dan bukannya bersandar kepada Allah. Khusus untuk tathoyyur maka hukumnya tidak diperbolehkan. Kesimpulannya, keadaan orang yang akan masuk syurga sangat tergantung dari kadar tawakkal setiap orang, semakin tinggi tingkat tawakkalnya semakin tinggi pula tingkat kesempurnaan tauhidnya. Allahlah tempat kita bersandar dan menyerahkan urusan.

Wallahu a’lam.

(Disarikan dari kajian Kitab Tauhid bersama Al Ustadz Abu Isa -hafizhohullah-)

Basics Biomedical Sciences in Elective

2010-11-09T17:37:00.005+08:00

Senarai Daftar Kuliah Blok Basics Biomedical of Sciences in Elective (FK USU-Batch 2007)

(1) Pendahuluan Anatomi:
- Posisi anatomi (BBS E K01-Anatomy)
- Arah dan bidang anatomi (BBS E K01-Anatomy)
- Istilah dalam osteologi (BBS E K01-Anatomy)
- Persendian (BBS E K01-Anatomy)

(2) Cranium:
- Anatomi Cranium (BBS E K02-Anatomy):
*Nama bahagian-bahagian tulang cranium
*Nama-nama lubang pada tulang cranium serta bahagian penting yang melaluinya

(3) Kepala dan leher:
- Anatomi kepala dan leher (BBS E K03-Anatomy):
*Regio yang terdapat di leher
*Pembahagian Trigonum colli
*Alat-alat penting yang terdapat/ melalui pada Trigonum colli
*Thyroid gland
*Parathyroid gland
*Otot-otot kepala
*Origo dan insertio otot kepala
*Otot-otot muka
*Origo dan insertio otot muka
*Otot-otot leher
*Origo dan insertio otot-otot leher
*Vaskularisasi pada leher dan kepala
*Persarafan oleh otot-otot kepala, muka dan leher

(4) Ekstremiti:
- Dinding fossa axillaris (BBS E K04-Anatomy)
- Isi fossa axillaris (BBS E K04-Anatomy)
- Plexus Brachialis (BBS E K04-Anatomy)
- Nervus Axillaris (BBS E K04-Anatomy)
- Nervus Radialis (BBS E K04-Anatomy)
- Nervus Medianus (BBS E K04-Anatomy)
- Nervus Ulnaris (BBS E K04-Anatomy)
- Nervus Musculocutaneus (BBS E K04-Anatomy)
- Perjalanan pembuluh arteri, vena, dan limfa (BBS E K04-Anatomy)
- Persarafan sensorik dan motorik paha depan dan belakang (BBS E K04-Anatomy)
- Persarafan sensorik dan motorik cruris dan pedis (BBS E K04-Anatomy)

(5) Batang tubuh, thoraks, dan abdomen:
- Vertebra Cervical (BBS E K05-Anatomy)
- Vertebra Thorax (BBS E K05-Anatomy)
- Vertebra Lumbar (BBS E K05-Anatomy)
- Os Sacrum (BBS E K05-Anatomy)
- Os Coccyx (BBS E K05-Anatomy)
- Os Sternum (BBS E K05-Anatomy)
- Articulatio pada Condylus occipitalis, os Atlas, os Episthropheus, vertebra lainnya (BBS E K05-Anatomy)
- Ligamentum pada Articulatio (BBS E K05-Anatomy)
- Atlanto-occipitalis, Atlanto-axialis, dan Collumna vertebralis (BBS E K05-Anatomy)
- Gerakan-gerakan pada sendi tersebut (BBS E K05-Anatomy)
- Lengkungan pada Collumna vertebralis (BBS E K05-Anatomy)
- Articulatio Costo-vertebralis (BBS E K05-Anatomy)
- Ligamentum pada Articulatio Costo-vertebralis (BBS E K05-Anatomy)
- Perdarahan dan persarafan dinding thoraks (BBS E K05-Anatomy)
- Arteri Coronaria dengan percabangannya (BBS E K05-Anatomy)
- Sistem konduktiviti (BBS E K05-Anatomy)
- Persarafan otot jantung (BBS E K05-Anatomy)
- Otot-otot dinding perut (BBS E K05-Anatomy)
- Vagina musculus rectus abdominis, Linea alba, Linea semilunaris, Linea semicircularis, Trigonum lumbale (BBS E K05-Anatomy)
- Ligamentum inguinal (BBS E K05-Anatomy)
- Ligamentum interoveolare (BBS E K05-Anatomy)
- Anulus inguinalis superficialis (BBS E K05-Anatomy)
- Anulus inguinalis profundus (BBS E K05-Anatomy)
- Canalis inguinalis (BBS E K05-Anatomy)
- Vaskularisasi dinding perut (BBS E K05-Anatomy)
- Innervasi sensorik dan motorik otot-otot dinding perut (BBS E K05-Anatomy)
- Peritoneum parietale (BBS E K05-Anatomy)
- Peritoneum viscerale (BBS E K05-Anatomy)

(6) Susunan Saraf Pusat:
- Medulla Spinalis dan medulla oblongata (BBS E K06-Anatomy):
*Penampang melintang medulla spinalis dan medulla oblongata
*Tractus Ascendens
*Tractus Descendens
*Pembuluh darah
*Ganglion Spinalis dan Radices spinalis
*Pembungkus Medulla Spinalis
*Persarafan Radikularis
- Cerebellum dan Pons (BBS E K06-Anatomy):
*Pedunculus Cerebellaris
*Cortex cerebellaris
*Sirkuit Neuronal
- Tractus saraf (BBS E K06-Anatomy)
- Diencephalon (BBS E K06-Anatomy):
*Epithalamus dan Pineal
*Thalamus
*Hypothalamus
*Hypophysis
- Telencephalon (BBS E K06-Anatomy):
*Organisasi hemispheri cerebri
*Lobus cerebri
*Basal ganglia
*Projeksi saraf
- Sistem pembuluh darah: Arteri dan Vena (BBS E K06-Anatomy)
- Sistem Liquor Cerebrospinalis (BBS E K06-Anatomy):
*Meningen
*Ventrikel
*Sinus duramatriks

(7) Susunan Saraf Tepi:
- Nervi spinalis (BBS E K07-Anatomy)
- Plexus Cervical (BBS E K07-Anatomy):
*Rami Posterior
- Plexus Brachialis (BBS E K07-Anatomy):
*Pars Supraclavicularis
*Pars Infraclavicularis
- Fasciculus Lateralis (BBS E K07-Anatomy)
- Fasciculus Medialis (BBS E K07-Anatomy)
- Fasciculus Posterior (BBS E K07-Anatomy):
*Saraf batang tubuh
*Plexus lumbosacral
- Plexus Sacral (BBS E K07-Anatomy)
- Sistem saraf vegetatif (BBS E K07-Anatomy):
*Truncus symphatheticus
*Saraf-saraf vegetatif

(8) General characteristics and profiles of parasites, hosts, and vectors:
- General characteristics and profiles of parasites, hosts, and vectors (BBS E K08-Parasitology)

(9) General pathogenesis of various important parasitic infections in human, a wrap up:
- General pathogenesis of various important parasitic infections in human, a wrap up (BBS E K09-Parasitology)

(10) Cara pengambilan dan pengiriman spesimen mikrobiologi:
- Cara pengambilan dan pengiriman spesimen mikrobiologi (BBS E K10-Parasitology)

(11) Uji kepekaan antimikrob dan resistensi antimikrob:
- Uji kepekaan antimikrob dan resistensi antimikrob (BBS E K11-Parasitology)

(12) Jangkitan Nosokomial:
- Jangkitan nosokomial (BBS E K12-Parasitology)

(13) Imuniti terhadap bakteria, virus, dan kulat:
- Imuniti terhadap bakteria, virus, dan kulat (BBS E K13-Parasitology)

(14) The Basics of Histology:
- Histologi dasar (BBS E K14-Histology):
*Langkah-langkah mempelajari sel
*Berbagai jenis mikroskop, cara kerja dan manfaat
*Metode mempelajari sel dengan pemprosesan jaringan dan pewarnaan, dan manfaat pewarnaan terhadap sel dan jaringan
*Istilah-istilah yang digunakan dalam pengamatan preparat histologi dan histopatologi

(15) Cell junction and cell communication:
- Cell junctions classification (BBS E K15-Histology)
- Occluding junction and its role in epithelial tissue (BBS E K15-Histology)
- Anchoring junction (Adherens junctions and Hemidesmosomes) and its role on connecting the cell with another cell or extracellular matrix (BBS E K15-Histology)
- Communicating junctions and its role on forming a communication network among cells (BBS E K15-Histology)

(16) Cell Cycle:
- Siklus sel dan regulasinya (BBS E K16-Histology):
*Siklus sel sebagai sebuah rangkaian yang teratur yang menyebabkan replikasi sel
*Regulasi siklus sel

(17) DNA Replication:
- Replikasi DNA (BBS E K17-Histology):
*Komponen-komponen sistem kontrol siklus sel
*Kontrol intraselular siklus sel
*Kontrol ekstraseluler
*Meiosis, Mitosis, dan Sitokinesis
*Replikasi sel

(18) Proliferation and differentiation of cell:
- Proliferasi dan diferensiasi sel (BBS E K18-Histology):
*Differensiasi embriologis
*Mekanisme diferensiasi
*Diferensiasi Ektoderm
*Diferensiasi Mesoderm
*Diferensiasi Endoderm
*Proliferasi sel

(19) Apoptosis:
- Pengertian apoptosis (BBS E K19-Histology)
- Perkembangan apoptosis (BBS E K19-Histology)
- Perbezaan apoptosis dengan nekrosis (BBS E K19-Histology)
- Mekanisme apoptosis (BBS E K19-Histology)
- Morfologi sel apoptosis (BBS E K19-Histology)

(20) Fisiologi Sistem Saraf:
- Pengaturan gerak (BBS E K20-Physiology):
*Prinsip umum kontrol gerakan motorik
*Struktur korteks serebri dan jalur untuk kontrol motorik
*Peranan ganglia basalis, batang otak, serebellum, dan medulla spinalis dalam kontrol motorik
*Mekanisme pengaturan postur
- Sistem Saraf Autonom (BBS E K21-Physiology):
*Fungsi dan divisi saraf autonom
*Karakteristik persarafan simpatis dan parasimpatis
*Mekanisme kontrol saraf autonom
*Contoh-contoh refleks autonom
- Fisiologi saraf kranialis (BBS E K22-Physiology):
*Pembahagian dan fungsi sistem saraf perifer
*Struktur dan fungsi 12 pasang nervus kranialis
- Fisiologi nyeri (BBS E K23-Physiology):
*Patofisiologi terjadi nyeri
*Mekanisme sensasi dan persepsi nyeri
*Teori gate control, referred pain, dan visceral pain
*Sistem analgesia saraf

(21) Fisiologi Sistem Kardiovaskuler:
- Kardiodinamik dan hemodinamik (BBS E K24-Physiology):
*Cardiac cycle
*Stroke volume dan Cardiac output pada pelbagai keadaan
*Faktor-faktor yang mengatur cardiac output
*Aliran darah dan Tekanan darah
*Faktor-faktor yang mempengaruhi/ menentukan tahanan perifer
*Perubahan tekanan darah pada pelbagai keadaan
*Tekanan vena
*Faktor-faktor yang mempengaruhi tekanan darah vena sentralis
- Dasar peristiwa elektrik jantung dan ECG (BBS E K25&K26-Physiology):
*Eksitatorik khusus dan sistem konduksi jantung
*Pacemaker ektopik
*Karakteristik ECG normal
*Lead electrocardiographic
*Prinsip analisis vektorial pada ECG
*Mean electrical axis dari QRS ventrikel
*Interpretasi aritmia jantung dari ECG

(22) Fisiologi dan Patofisiologi Sistem Respirasi:
- Patofisiologi edema pulmonal (BBS E K27-Physiology)
- Physiologic shunt & physiologic dead space (BBS E K27-Physiology)
- Abnormality ratio ventilasi-perfusi (BBS E K27-Physiology)
- Regulasi respirasi dan faktor yang mempengaruhi (BBS E K27-Physiology)
- Keganjilan fisiologi pada beberapa keadaan abnormal pulmonal (BBS E K27-Physiology)

(23) Fisiologi dan Patofisiologi Sistem Pencernaan:
- Patofisiologi gangguan menelan dan esofagus (BBS E K28-Physiology)
- Patofisiologi gangguan pada perut (BBS E K28-Physiology)
- Patofisiologi gangguan pada usus (BBS E K28-Physiology)
- Gangguan pada usus besar (BBS E K28-Physiology)
- Gangguan umum (BBS E K28-Physiology)

(24) Fisiologi dan Patofisiologi Ginjal:
- Fisiologi pembentukan urin (BBS E K29-Physiology):
*Faktor-faktor yang mempengaruhi aliran darah ginjal dan GFR
*Faktor-faktor yang mempengaruhi pemrosesan filtrat pada tubulus
- Patofisiologi ginjal (BBS E K30-Physiology):
*Efek fisiologis dari gagal ginjal akut
*Efek gagal ginjal terhadap cairan tubuh
*Hypertension dan penyakit ginjal

(25) Hubungan dose-response:
- Peengertian hubungan dose-response (BBS E K31-Pharmacology)
- Pengertian dose lethal, dose toxic, dose therapy (BBS E K31-Pharmacology)
- Kaitan dose dengan reaksi ubat (BBS E K31-Pharmacology)
- Dose dan lama kerja ubat (BBS E K31-Pharmacology)

(26) Cara Pemberian Ubat:
- Pengertian cara pemberian ubat (BBS E K32-Pharmacology)
- Hubungan bentuk sediaan ubat dengan cara pemberian (BBS E K32-Pharmacology)

(27) Efek non terapi:
- Pengertian efek non terapi (BBS E K33-Pharmacology)
- Efek non terapi yang dapat diramalkan (BBS E K33-Pharmacology)
- Efek non terapi yang tidak dapat diramalkan (BBS E K33-Pharmacology)

(28) Interaksi farmakokinetik:
- Pengertian interaksi farmakokinetik (BBS E K34-Pharmacology)
- Interaksi farmakokinetik yang menguntungkan (BBS E K34-Pharmacology)
- Interaksi farmakokinetik yang merugikan (BBS E K34-Pharmacology)

(29) Interaksi farmakodinamik:
- Pengertian interaksi farmakodinamik (BBS E K35-Pharmacology)
- Interaksi farmakodinamik yang menguntungkan (BBS E K35-Pharmacology)
- Interaksi farmakodinamik yang merugikan (BBS E K35-Pharmacology)

(30) Farmakologi sistem saraf autonom simpatis dikaitkan dengan keluhan gejala klinis (BBS E K36-Pharmacology)

(31) Farmakologi sistem saraf autonom simpatis dikaitkan dengan keluhan gejala klinis (BBS E K37-Pharmacology)

(32) Faktor yang mempengaruhi farmakologi ubat (BBS E K38-Pharmacology)

Arrhythmia

2010-11-08T22:28:00.005+08:00

Warning: The informations contained in this blog are not medical advices. Please consult your medical doctor before making decision or taking any action on your health or the health of your family.

What Is an Arrhythmia?

An arrhythmia (ah-RITH-me-ah) is a problem with the speed or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm. A heartbeat that is too fast is called tachycardia. A heartbeat that is too slow is called bradycardia.

Most arrhythmias are harmless, but some can be serious or even life threatening. When the heart rate is too slow, too fast, or irregular, the heart may not be able to pump enough blood to the body. Lack of blood flow can damage the brain, heart, and other organs.

Understanding the Heart’s Electrical System
The heart has an internal electrical system that controls the speed and rhythm of the heartbeat. With each heartbeat, an electrical signal spreads from the top of the heart to the bottom. As it travels, the electrical signal causes the heart to contract and pump blood. The process repeats with each new heartbeat.

Each electrical signal begins in a group of cells called the sinus node, or sinoatrial (SA) node. The SA node is located in the right atrium (AY-tree-um), which is the upper right chamber of the heart. In a healthy adult heart at rest, the SA node fires off an electrical signal to begin a new heartbeat 60 to 100 times a minute.

From the SA node, the electrical signal travels through special pathways to the right and left atria. This causes the atria to contract and pump blood into the heart’s two lower chambers, the ventricles (VEN-trih-kuls). The electrical signal then moves down to a group of cells called the atrioventricular (AV) node, located between the atria and the ventricles. Here, the signal slows down just a little, allowing the ventricles time to finish filling with blood. The electrical signal then leaves the AV node and travels along a pathway called the bundle of His. This pathway divides into a right bundle branch and a left bundle branch. The signal goes down these branches to the ventricles, causing them to contract and pump blood out to the lungs and the rest of the body. The ventricles then relax, and the heartbeat process starts all over again in the SA node.

A problem with any part of this process can cause an arrhythmia. For example, in atrial fibrillation, a common type of arrhythmia, electrical signals travel through the atria in a fast and disorganized way. This causes the atria to quiver instead of contract.

For more information on the heart’s electrical system and a detailed animation, go to the Diseases and Conditions Index article on How the Heart Works.

Overview

There are many different types of arrhythmia. Most arrhythmias are harmless but some are not. The outlook for a person with an arrhythmia depends on the type and severity of the arrhythmia. Even serious arrhythmias can often be successfully treated. Most people with arrhythmias are able to live normal, healthy lives.

How the Heart Works
The heart is a muscle about the size of your fist. The heart works like a pump and beats about 100,000 times a day.

A healthy adult heart generally beats 60 to 100 times a minute, but it can beat faster or slower at times. For example, physical activity, strong emotion, certain medicines, fever, or infection can make the heart beat faster. A person’s heart rate generally slows down during sleep. Some very fit athletes always have heart rates below 60 beats a minute because their hearts work so well.

The heart has two sides, separated by an inner wall called the septum. The right side of the heart pumps blood to the lungs to pick up oxygen. Then, oxygen-rich blood returns from the lungs to the left side of the heart, and the left side pumps it to the body.

The heart has four chambers and four valves and is connected to various blood vessels. Veins are the blood vessels that carry blood from the body to the heart. Arteries are the vessels that carry blood away from the heart to the body.

Heart Chambers
The heart has four chambers or “rooms”—two on the left side of the heart and two on the right.

The atria are the two upper chambers that collect blood as it comes into the heart.
The ventricles are the two lower chambers that pump blood out of the heart to the lungs or other parts of the body.

Heart Valves
Four valves control the flow of blood from the atria to the ventricles and from the ventricles into the two large arteries connected to the heart.

The tricuspid (tri-CUSS-pid) valve is in the right side of the heart, between the right atrium and the right ventricle.
The pulmonary (PULL-mun-ary) valve is in the right side of the heart, between the right ventricle and the entrance to the pulmonary artery that carries blood to the lungs.

The mitral (MI-tral) valve is in the left side of the heart, between the left atrium and the left ventricle.

The aortic (ay-OR-tik) valve is in the left side of the heart, between the left ventricle and the entrance to the aorta, the artery that carries blood to the body.
Valves are like doors that open and close. They open to allow blood to flow through to the next chamber or to one of the arteries, and then they shut to keep blood from flowing backward.

When the heart’s valves open and close, they make a “lub-DUB” sound that a doctor can hear using a stethoscope.

The first sound—the “lub”—is made by the mitral and tricuspid valves closing at the beginning of systole (SIS-toe-lee). Systole is when the ventricles contract, or squeeze, and pump blood out of the heart.
The second sound—the “DUB”—is made by the aortic and pulmonary valves closing at beginning of diastole (di-AS-toe-lee). Diastole is when the ventricles relax and fill with blood pumped into them by the atria.

Arteries
The arteries are major blood vessels connected to your heart.

The pulmonary artery carries blood pumped from the right side of the heart to the lungs to pick up a fresh supply of oxygen.
The aorta is the main artery that carries oxygen-rich blood pumped from the left side of the heart out to the body.

The coronary arteries are the other important arteries attached to the heart. They carry oxygen-rich blood from the aorta to the heart muscle, which must have its own blood supply to function.

Veins
The veins are also major blood vessels connected to your heart.

The pulmonary veins carry oxygen-rich blood from the lungs to the left side of the heart so it can be pumped out to the body.
The vena cava is a large vein that carries oxygen-poor blood from the body back to the heart.

For more information on how a healthy heart works, see the Diseases and Conditions Index article on How the Heart Works. This article contains animations that show how your heart pumps blood and how your heart’s electrical system works.

Types of Arrhythmia

There are four main types of arrhythmia: premature (extra) beats, supraventricular arrhythmias, ventricular arrhythmias, and bradyarrhythmias.

Premature (Extra) Beats
Premature beats are the most common type of arrhythmia. They are harmless most of the time and often don’t cause any symptoms. When symptoms do occur, they usually feel like a fluttering in the chest or a sensation of a skipped beat. Most of the time, premature beats need no treatment, especially in healthy people.

Premature beats that occur in the atria are called premature atrial contractions, or PACs. Premature beats that occur in the ventricles are called premature ventricular contractions, or PVCs.

In most cases, premature beats occur naturally, not due to any heart disease. But certain heart diseases can cause premature beats. They also can happen because of stress, too much exercise, or too much caffeine or nicotine.

Supraventricular Arrhythmias
Supraventricular arrhythmias are tachycardias (fast heart rates) that start in the atria or the atrioventricular node (cells located between the atria and the ventricles). Types of supraventricular arrhythmias include atrial fibrillation (AF), atrial flutter, paroxysmal supraventricular tachycardia (PSVT), and Wolff-Parkinson-White (WPW) syndrome.

Atrial Fibrillation
AF is the most common type of serious arrhythmia. It’s a very fast and irregular contraction of the atria. AF occurs when the heart’s electrical signal begins in a different part of the atrium than the sinoatrial (SA) node or when the signal is conducted abnormally. When this happens, the electrical signal doesn’t travel through the normal pathways in the atria, but instead may spread throughout the atria in a fast and disorganized manner. This causes the walls of the atria to quiver very fast (fibrillate) instead of beating normally. As a result, the atria aren’t able to pump blood into the ventricles the way they should.

In AF, electrical signals can travel through the atria at a rate of more than 300 per minute. Some of these abnormal electrical signals can travel to the ventricles, causing them to beat too fast and with an irregular rhythm. AF is not usually life threatening, although it can be dangerous when it causes the ventricles to beat very fast.

The two most serious complications of chronic (long-term) AF are stroke and heart failure. Stroke can happen when a blood clot travels to an artery in the brain, blocking off blood flow. In AF, blood clots can form in the atria because some of the blood “pools” in the fibrillating atria instead of flowing into the ventricles. If a piece of a blood clot in the left atrium breaks off, it can travel to the brain, causing a stroke. People with AF are often treated with blood-thinning medicines to reduce the chances of developing blood clots.

Heart failure is when the heart can’t pump enough blood to meet the needs of the body. AF can cause heart failure when the ventricles beat too fast and don’t have enough time to fill with blood to pump out to the body. Heart failure causes tiredness, leg swelling, and shortness of breath.

AF and other supraventricular arrhythmias can occur for no apparent reason. Most of the time, however, they are caused by an underlying condition that damages the heart muscle and its ability to conduct electrical impulses. These conditions include high blood pressure (hypertension), coronary artery disease, heart failure, or rheumatic heart disease.

Other conditions also can lead to AF, including overactive thyroid gland (too much thyroid hormone produced) and heavy alcohol use. AF also becomes more common as people get older.

Atrial Flutter
Atrial flutter is similar to atrial fibrillation, but instead of the electrical signals spreading through the atria in a fast and irregular rhythm, they travel in a fast and regular rhythm. Atrial flutter is much less common than atrial fibrillation, but has similar symptoms and complications.

Paroxysmal Supraventricular Tachycardia
PSVT is a very fast heart rate that begins and ends suddenly. PSVT occurs due to problems with the electrical connection between the atria and the ventricles. In PSVT, electrical signals that begin in the atria and travel to the ventricles can reenter the atria, causing extra heartbeats. This type of arrhythmia is not usually dangerous and tends to occur in young people. It can happen during vigorous exercise.

A special type of PSVT is called Wolff-Parkinson-White syndrome. WPW syndrome is a condition in which the heart’s electrical signals travel along an extra pathway from the atria to the ventricles. This extra pathway disrupts the timing of the heart’s electrical signals and can cause the ventricles to beat very fast. This type of arrhythmia can be life threatening.

Ventricular Arrhythmias
These are arrhythmias that start in the ventricles. They can be very dangerous and usually need immediate medical attention. Ventricular arrhythmias include ventricular tachycardia and ventricular fibrillation (v-fib). Coronary artery disease, heart attack, weakened heart muscle, and other problems can cause ventricular arrhythmias.

Ventricular Tachycardia
Ventricular tachycardia is a fast, regular beating of the ventricles that may last for only a few seconds or for much longer. A few beats of ventricular tachycardia often don’t cause problems, but ventricular tachycardia episodes that last for more than just a few seconds can be dangerous. Ventricular tachycardia can turn into other, more dangerous arrhythmias, such as v-fib.

Ventricular Fibrillation
V-fib occurs when disorganized electrical signals make the ventricles quiver instead of pump normally. Without the ventricles pumping blood out to the body, a person will lose consciousness within seconds and will die within minutes if not treated. To prevent death, the condition must be treated immediately with defibrillation, an electric shock to the heart. V-fib may happen during or after a heart attack, or in a heart that is already weak because of another condition. Health experts think that most of the sudden cardiac deaths that occur every year (about 335,000) are due to v-fib.

Torsades de pointes (torsades) is a specific form of v-fib with a unique pattern on an EKG (electrocardiogram). Certain medicines and imbalanced amounts of potassium, calcium, or magnesium in the bloodstream can cause this condition. People with a particular finding on an EKG test, called prolonged QT interval, are at increased risk of developing torsades. People with prolonged QT interval need to be careful about taking certain antibiotics, heart medicines, and over-the-counter medicines.

Bradyarrhythmias
Bradyarrhythmias are arrhythmias in which the heart rate is slower than normal. If the heart rate is too slow, not enough blood reaches the brain, and the person can lose consciousness. In adults, a heart rate slower than 60 beats per minute is considered a bradyarrhythmia. Some people normally have slow heart rates, especially people who are very physically fit. For them, a heartbeat slower than 60 beats per minute is not dangerous and doesn’t cause symptoms. But in other people, bradyarrhythmia can be due to a serious disease or other condition.

Bradyarrhythmias can be caused by heart attack, conditions that harm or change the heart’s electrical system (such as underactive thyroid gland or aging), an imbalance of chemicals or other substances (such as potassium) in the blood, or even some medicines (such as beta blockers).

Bradyarrhythmias also can happen as a result of severe bundle branch block. Bundle branch block is a condition in which the electrical signal traveling down either or both of the bundle branches is delayed or blocked. When this happens, the ventricles don’t contract at exactly the same time, as they should, and the heart has to work harder to pump blood to the body. The cause of bundle branch block is often an existing heart condition.

Arrhythmias in Children

Normally, a child’s heart beats between 70 and 100 times a minute. A newborn’s heart beats about 140 times a minute. A baby or child’s heart can beat faster or slower than normal for many reasons. As is true for adults, when children are active, their hearts will beat faster. When they are sleeping, their heart will beats slower. Their heart rates can speed up and slow down as they breathe in and out. All of these changes are normal.

Some children are born with heart defects that cause arrhythmias. In other children, arrhythmias can develop later in childhood. Doctors do the same kinds of tests in children and adults to diagnose arrhythmias.

Treatments for children with arrhythmias include medicines, electric shock (defibrillation), surgically implanted devices that control the heartbeat, and other procedures that fix distorted electrical signals in the heart.

Other Names for Arrhythmia: Dysrhythmia

What Causes an Arrhythmia?

An arrhythmia can occur when the electrical signals that control the heartbeat are delayed or blocked. This can happen when the special nerve cells that produce the electrical signal don't work properly or when the electrical signal doesn't travel normally through the heart. An arrhythmia also can occur when another part of the heart starts to produce electrical signals, adding to the signals from the special nerve cells and disrupting the normal heartbeat.

Stress, smoking, heavy alcohol use, heavy exercise, use of certain drugs (such as cocaine or amphetamines), use of certain prescription or over-the-counter medicines, and too much caffeine or nicotine can lead to arrhythmia in some people.

A heart attack or an underlying condition that damages the heart's electrical system also can cause an arrhythmia. These conditions include high blood pressure (hypertension), coronary artery disease, heart failure, overactive or underactive thyroid gland (too much or too little thyroid hormone produced), and rheumatic heart disease.

For some arrhythmias, such as Wolff-Parkinson-White syndrome, the underlying heart defect that causes the arrhythmia is present at birth (congenital). Sometimes, the cause of an arrhythmia can't be found.

Who Is At Risk for an Arrhythmia?

Populations Affected

Millions of Americans have arrhythmias. They are very common in older adults. About 2.2 million Americans have atrial fibrillation (a common type of arrhythmia that can cause problems).

Most serious arrhythmias happen in adults older than 60. This is because older adults are more likely to have heart disease and other health problems that can lead to arrhythmias. Older adults also tend to be more sensitive to the side effects of medicines, some of which can cause arrhythmias. Some medicines used to treat arrhythmias can cause arrhythmias as a side effect.

Some types of arrhythmia happen more often in children and young adults. Paroxysmal supraventricular tachycardias (a fast heart rate that begins and ends suddenly), including Wolff-Parkinson-White syndrome, are more common in young people.

Major Risk Factors

Arrhythmias are more common in people who have a disease or condition that weakens the heart, such as:

Heart attack

Heart failure or cardiomyopathy, which weakens the heart and changes the way electrical signals move around the heart

Heart tissue that is too thick or stiff or that hasn't formed normally
Leaking or narrowed heart valves, which make the heart work too hard and can lead to heart failure

Congenital problems (problems that are present at birth) with the heart's structure or function
Other conditions also can increase the chances of arrhythmia, such as:

High blood pressure

Infections that damage the heart muscle or the sac around the heart
Diabetes, which increases the risk of high blood pressure and coronary artery disease

Sleep apnea (when breathing becomes shallow or stops during sleep), which can stress the heart because it doesn't get enough oxygen
Overactive or underactive thyroid gland (too much or too little thyroid hormone in the body)

In addition to certain diseases and conditions, several other risk factors increase a person's chance of having an arrhythmia. Heart surgery, certain drugs (such as cocaine or amphetamines), or an imbalance of chemicals or other substances (such as potassium) in the bloodstream can increase a person's chance of having an arrhythmia.

What Are the Signs and Symptoms of Arrhythmias?

Many arrhythmias cause no signs or symptoms. When signs or symptoms are present, the most common ones are:

Palpitations (a feeling that your heart has skipped a beat or is beating too hard)

A slow heartbeat
An irregular heartbeat
Feeling of pauses between heartbeats

More serious signs and symptoms include:

Anxiety
Weakness
Dizziness and light-headedness
Fainting or nearly fainting
Sweating
Shortness of breath
Chest pain

How Are Arrhythmias Diagnosed?

Arrhythmias can be hard to diagnose, especially types that only cause symptoms every once in a while. Doctors use several methods to help diagnose arrhythmias, including family and medical history, physical exam, and diagnostic tests and procedures.

Specialists Involved
Doctors who specialize in the diagnosis and treatment of heart diseases include:

Cardiologists (doctors who take care of adults with heart problems)
Pediatric cardiologists (doctors who take care of babies and children with heart problems)

Electrophysiologists (e-LEK-tro-fiz-e-OL-o-jists) (cardiologists or pediatric cardiologists who specialize in arrhythmias)

Family and Medical History

To diagnose an arrhythmia, your doctor will ask questions about:

Symptoms.
What symptoms are you having? Is there a feeling of fluttering in your chest? Do you feel dizzy or lightheaded?

Medical history, including other health problems, such as a history of heart disease, high blood pressure, diabetes, or thyroid problems.

Family medical history. Does anyone in your family have a history of arrhythmias? Has anyone in your family ever had heart disease or high blood pressure? Has anyone died suddenly? Are there other illnesses or health problems in your family?

Medicines you're taking, including over-the-counter medicines and vitamin or mineral or nutritional supplements.

Health habits, such as physical activity, smoking, or using alcohol or drugs (for example, cocaine).

Physical Exam

Your doctor will listen to the rate and rhythm of your heart and for a heart murmur (an extra or unusual sound heard during your heartbeat). The doctor also will:

Check your pulse to find out how fast your heart is beating

Check for swelling in your legs or feet, which could be a sign of an enlarged heart or heart failure

Look for signs of other diseases (such as thyroid disease) that could be causing the problem

Diagnostic Tests and Procedures

An EKG (electrocardiogram) is the most common test used to diagnose arrhythmias. An EKG is a simple test that detects and records the electrical activity of your heart. It shows how fast the heart is beating and its rhythm (steady or irregular). It also records the strength and timing of the electrical signals as they pass through each part of the heart.

A standard EKG test only records the heartbeat for a few seconds. It won't detect arrhythmias that don't happen during the test. To diagnose arrhythmias that come and go, your doctor may have you wear a portable EKG monitor that can record the heartbeat for longer periods of time. The two most common types of portable EKGs are:

Holter monitor.
This device records the heart's electrical activity continuously over a 24-hour period.

Event monitor.
Event monitors are useful to diagnose arrhythmias that only occur once in a while. The device is worn continuously, but only records the heart's electrical activity when you push a button on the device. You push the button on the device when you feel symptoms. Event monitors can be worn for 1 to 2 months, or as long as it takes to get a recording of the heart during symptoms.
Other tests used in the diagnosis of arrhythmias include:

Blood tests.
These tests check the level of substances in the blood, such as potassium or thyroid hormone, that can increase your chances of having an arrhythmia.

Chest x ray.
A chest x ray takes a picture of your heart and lungs. It can show whether the heart is enlarged.

Echocardiogram.
This test uses sound waves to create a moving picture of your heart. Echocardiogram provides information about the size and shape of your heart and how well your heart chambers and valves are functioning. The test also can identify areas of poor blood flow to the heart, areas of heart muscle that are not contracting normally, and previous injury to the heart muscle caused by poor blood flow.

There are several different types of echocardiograms, including a stress echocardiogram. During this test, an echocardiogram is done both before and after your heart is stressed either by having you exercise or by injecting a medicine into your bloodstream that makes your heart beat faster and work harder. A stress echocardiogram is usually done to find out if you have decreased blood flow to your heart (coronary artery disease).

Transesophageal (trans-e-SOF-ah-ge-al) echocardiography, or TEE.
This is a special type of echocardiogram that takes pictures of the back of the heart through the esophagus (the tube leading from your mouth to your stomach).

Stress test.
Some heart problems are easier to diagnose when your heart is working harder and beating faster than when it's at rest. During stress testing, you exercise (or are given medicine if you are unable to exercise) to make your heart work harder and beat faster while heart tests are performed.

During exercise stress testing, your blood pressure and EKG readings are monitored while you walk or run on a treadmill or pedal a bicycle. Other heart tests, such as nuclear heart scanning or echocardiography, also can be done at the same time. These would be ordered if your doctor needs more information than the exercise stress test can provide about how well your heart is working.

If you are unable to exercise, a medicine can be injected through an intravenous line (IV) into your bloodstream to make your heart work harder and beat faster, as if you are exercising on a treadmill or bicycle. Nuclear heart scanning or echocardiography is then usually done.

During nuclear heart scanning, radioactive tracer is injected into your bloodstream, and a special camera shows the flow of blood through your heart and arteries. Echocardiography uses sound waves to show blood flow through the chambers and valves of your heart and to show the strength of your heart muscle.

Electrophysiologic study (EPS).
This test is used to assess serious arrhythmias. During an EPS, a thin, flexible wire is passed through a vein in your groin (upper thigh) or arm up to the heart. The wire records the heart's electrical signals. Your doctor uses the wire to electrically stimulate your heart and trigger an arrhythmia.

This allows the doctor to see whether an antiarrhythmia medicine can stop the problem. Radiofrequency ablation, a procedure used to fix some types of arrhythmia, may be done during an EPS.

Tilt table testing.
This test is sometimes used to help determine the cause of fainting spells. You lie on a table that moves from a lying down to an upright position. The change in position can bring on loss of consciousness. The doctor monitors your symptoms, heart rate, EKG, and blood pressure throughout the test. The doctor also may give you a medicine and then monitor your response to the medicine.

Coronary angiography.
This test is an x-ray exam of the heart and blood vessels. The doctor passes a catheter (thin, flexible tube) through an artery in your leg or arm up to the heart.

The catheter measures the pressure inside the heart and blood vessels. A dye that can be seen on x ray is injected into the blood through the tip of the catheter. The dye lets the doctor study the flow of blood through the heart and blood vessels, which helps to diagnose blockages that can cause a heart attack.

How Are Arrhythmias Treated?

Common arrhythmia treatments include medicines, medical procedures, and surgery. Treatment is needed when an arrhythmia causes serious symptoms, such as dizziness, chest pain, or fainting, or when it increases your chances of developing complications, such as heart failure, stroke, or sudden cardiac death.

Medicines
Medicines can be used to speed up a heart that's beating too slow, or slow down a heart that's beating too fast. They also can be used to convert an abnormal heart rhythm to a normal steady rhythm. Medicines can be used to control an underlying medical condition, such as heart disease or a thyroid condition, that might be causing an arrhythmia. Medicines used to convert an abnormal rhythm are called antiarrhythmics.

Some of the medicines used to slow a fast heart rate are beta blockers (such as metoprolol and atenolol), calcium channel blockers (such as diltiazem and verapamil), and digoxin (digitalis). These medicines are often used to slow the heart rate in people with atrial fibrillation.

Some of the medicines used to restore an abnormal heartbeat to a normal rhythm are amiodarone, sotalol, flecainide, propafenone, dofetilide, ibutilide, quinidine, procainamide, and disopyramide. These medicines often have side effects. Some of the side effects can make an arrhythmia worse or even cause a different kind of arrhythmia.

People with atrial fibrillation and some other arrhythmias are often treated with blood-thinning medicines (anticoagulants) to reduce the chances of developing blood clots. Aspirin, warfarin (Coumadin®), and heparin are commonly used blood thinners.

Medical Procedures
Some arrhythmias are treated with a device called a pacemaker. The pacemaker is a small device that's surgically placed under the skin at the collarbone; wires lead from it to the atrium and ventricle(s). The pacemaker sends small electric signals through the wires to control the speed of the heartbeat. Most pacemakers contain a sensor that activates the device only when the heartbeat is abnormal.

Some arrhythmias are treated with a jolt of electricity delivered to the heart. This type of treatment is called cardioversion or defibrillation, depending on which type of arrhythmia is being treated.

Some people who are at risk for ventricular fibrillation are treated with a device called an implantable cardioverter defibrillator (ICD). This device is surgically implanted in the chest and connected to the heart with wires. It continuously monitors the heartbeat. If it senses a dangerous ventricular arrhythmia, it sends an electric shock to the heart to restore a normal heartbeat.

A procedure called radiofrequency ablation is sometimes used to treat certain types of arrhythmias when medicines don't work. In this treatment, a special wire is inserted through a vein in the arm or leg and threaded up to the heart. Radiowave energy is sent through the wire to destroy abnormal tissue in the heart that's interrupting the normal flow of electric signals. Radiofrequency ablation is usually done in the hospital as part of an electrophysiologic study.

Surgery
Sometimes, surgery is used to treat arrhythmia. Often this is done when surgery is already being performed for another reason, such as repair of a heart valve. One type of surgery for atrial fibrillation is called "maze" surgery. In this operation, the surgeon makes small cuts or burns in the atria, which prevent the spread of disorganized electrical signals.

Coronary artery bypass surgery may be needed for arrhythmias caused by coronary artery disease. The operation improves blood supply to the heart muscle.

Other Treatments
Vagal maneuvers are another arrhythmia treatment. These are simple exercises that sometimes can stop or slow down certain types of supraventricular arrhythmias. They stop the arrhythmia by affecting the vagus nerve, which is one factor that controls the heart rate. Some vagal maneuvers include:

Gagging
Holding your breath and bearing down (Valsalva maneuver)
Immersing your face in ice-cold water
Coughing
Putting your fingers on your eyelids and pressing down gently
Vagal maneuvers aren't an appropriate treatment for everyone. Discuss with your doctor whether vagal maneuvers are safe and effective for you to try.

Living With an Arrhythmia

Many arrhythmias are harmless. It's common to have an occasional extra heartbeat and not even be aware of it, or to only have mild palpitations. People with harmless arrhythmias can live healthy lives and usually don't need treatment for their arrhythmias.

Even people with serious types of arrhythmia are often treated successfully and lead normal lives.

Ongoing Health Care Needs

If you have an arrhythmia that requires treatment, you should:

Keep all your medical appointments.

Always bring all medicines you're taking to all of your doctor visits. This helps ensure that all of your doctors know exactly what medicines you're taking, which can help prevent medication errors.

Follow your doctor's instructions for taking medicines.

Check with your doctor before taking over-the-counter medicines, nutritional supplements, or cold and allergy medicines.

Tell your doctor if you are having side effects from your medicines.

Side effects could include depression and palpitations. These side effects can often be treated.
Tell your doctor if arrhythmia symptoms are getting worse or if you have new symptoms.

Allow your doctor to monitor you regularly if you're taking blood-thinning medicines.

If you have an arrhythmia, taking care of yourself is important.

If you feel dizzy or faint, you should lie down. Don't try to walk or drive. Tell your doctor about it.

Many arrhythmias are caused by underlying heart disease. Keep your heart healthy by following a healthy diet, getting regular physical activity, quitting smoking, maintaining a healthy weight, and keeping your blood cholesterol and blood pressure at healthy levels.

Your doctor may want you to avoid certain things if they make your heart beat too fast. These things can include alcohol and cold and cough medicines.

Ask your doctor about learning how to do vagal maneuvers. These are exercises that people with certain arrhythmias can do that may help to stop an episode of rapid heartbeat.

Learn how to take your pulse. Discuss with your doctor what pulse rate is normal for you. Keep a record of changes in your pulse rate and share this information with your doctor.

Key Points

An arrhythmia is a change in the heart's rhythm that causes the heart to beat too fast, too slow, or irregularly. A heartbeat that is too fast is called tachycardia. A heartbeat that is too slow is called bradycardia.

An arrhythmia happens when some part of the heart's electrical system doesn't function as it should.
Most arrhythmias are harmless, but some can be serious or even life threatening.

Millions of Americans have arrhythmias, and arrhythmias are especially common among older adults. About 2.2 million Americans have atrial fibrillation. Health experts think that most of the sudden cardiac deaths that occur every year (about 335,000) are due to ventricular fibrillation.

Arrhythmias have many causes. Heart disease is a common cause of serious arrhythmias. Stress, smoking, heavy alcohol use, heavy exercise, some drugs (such as cocaine or amphetamines), and some medicines can lead to arrhythmias in some people.

Signs and symptoms of an arrhythmia include:

- Palpitations (an unpleasant feeling that your heart is skipping beats or beating too hard)
- A fast or racing heartbeat, a slow heartbeat, or an irregular heartbeat
- Weakness, dizziness, light-headedness, sweating, and fainting
- Shortness of breath
- Chest pain
- Anxiety

Usually the first test used to diagnose an arrhythmia is an EKG (electrocardiogram).
Arrhythmias can be treated with medicines, medical procedures (for example, electrical energy delivered to the heart), and surgery.

Serious arrhythmias can often be successfully treated. Most people with arrhythmias are able to live normal lives.

Viral-Oncogene

2010-11-01T23:03:00.004+08:00

Senarai Daftar Kuliah Blok Elective Viral-Oncogene (FK USU-Batch 2007)

(1) Introduction of Cancer Biology:
- Perspective oncology (EO K01-Surgery)
- The future of oncology (EO K01-Surgery)

(2) Cancer and Epidemiology:
- Pendekatan epidemiology, penentuan epidemiologi kanser dan klasifikasi kanser (EO K02-Paediatric)

(3) Viruses and Cancer:
- Virus sebagai penyebab tumor/ kanser pada manusia (EO K03-Paediatric):
*Retrovirus: Human T-cell Leukemia Virus 1 (HTLV-1)
*Human Papilloma virus
*Herpes virus: Epstein Bar Virus (EBV)
*Virus Hepatitis B dan C

(4) Oncogenes and tumor supressor genes:
- Protoonkogen (EO K04-Biochemistry):
*Pengertian Protoonkogen
*Jenis-jenis Protoonkogen
- Tumor supressor gen (EO K04-Biochemistry)
- Onkogen (EO K04-Biochemistry):
*Pengertian Onkogen
- Jenis mutasi sehingga terjadi onkogen (EO K04-Biochemistry)
- Mutasi gen oleh virus (EO K04-Biochemistry)
- Produk onkogen (EO K04-Biochemistry):
*Protein yang berubah akibat aktivasi onkogen

(5) Cellular signaling:
- Intracellular signaling pathway pada onkogen (EO K05-Biochemistry):
*Proses pengaktifan viral-onkogen
*Kesan buruk aktiviti viral-onkogen pada beberapa pathway
*Kesan buruk aktiviti onkoprotein pada tingkat seluler
*Neoplasma yang timbul akibat onkoprotein

(6) Cell proliferation and tumor growth:
- Differentiation and anaplastia rates of growth cancer stem cells and cancer cell lineages (EO K06-Anatomical Pathology)

(7) Cell death:
- Necrosis and apoptosis (EO K06-Anatomical Pathology)
- Evasion of apoptosis (EO K06-Anatomical Pathology)
- Host defense against tumors-tumor immunity (EO K06-Anatomical Pathology)

(8) Tumor progression and metastasis:
- Cellular, molecular, and microenvironmental factors (EO K07-Anatomical Pathology):
*Molecular basis of cancer
*Essential alterations for malignant transformation
*Self sufficiency in growth signals: Oncogene insensitivity to growth inhibition and escape from senescence: Tumor suppressor genes
*Invasion and metastasis
*Stromal microenvironment and carcinogenesis
- Angiogenesis (EO K07-Anatomical Pathology)

(9) Grading and Staging of tumors:
- Histologic and Cytologic methods (EO K08-Anatomical Pathology)
- Immunohistochemistry (EO K08-Anatomical Pathology)
- Flow cytometry (EO K08-Anatomical Pathology)

(10) Laboratory diagnosis of cancer:
- Molecular diagnosis (EO K08-Anatomical Pathology)
- Molecular profiles of tumors (EO K08-Anatomical Pathology)

(11) Imaging in oncology:
- Penunjang diagnostik radiologis pada tumor (EO K09-Radiology):
*Peranan radiologi imaging untuk diagnostik HCC, Ca cervix, NPC
*Peranan radiologi imaging untuk staging
- Peranan radiologi pada tumor (EO K09-Radiology):
*Peran radiologi intervensi pada penanganan HCC
*Peran radioterapi pada penanganan Ca cervix dan NPC

(12) Laboratory test in oncology:
- Pemeriksaan pendukung laboratorium (darah) terhadap tumor/ kanser (EO K10-Clinical Pathology):
*Tumor marker

(13) Pharmacology of anticancer drugs:
- Penanganan tumor/ kanser dengan ubat "targeting therapy" (EO K11-Pharmacology):
*Farmakologi "targeting therapy of cancer": ENT, Obstetric Gynaecology, Gastrohepatologic, Limfoma.

(14) Terapi kanser dengan kemoterapi:
- Filosofi kemoterapi dan terapi kanser dengan kemoterapi (EO K12-Internal Medicine):
*Definisi kemoterapi
*Setting kemoterapi
*Tujuan kemoterapi
*Syarat kemoterapi
*Persetujuan pesakit setelah penjelasan (informed consent) untuk kemoterapi
*Cara kerja kemoterapi
*Efek samping kemoterapi
*Targeted therapy sebagai modaliti terapi terbaru

(15) Hepatocellular Carcinoma (HCC):
- Jenis tumor hati & differential diagnosis (EO K13-Internal Medicine):
*Primary Hepatocellular Carcinoma
*Metastasis kanser lainnya
*Tumor benign (hemangioma)
*Kerosakan-kerosakan lain (liver abcess, kista)
- Etiologi HCC (EO K13-Internal Medicine):
*Viral hepatitis B dan C
*Taksin (aflatoksin, toksin pada air minum)
*Hepatitis kronis dan sirosis hati kerana sebab lain
*Iron overload pada hereditary hemochromatosis
- Patogenesis (EO K13-Internal Medicine):
*Patogenesis terjadinya HCC terutama berkaitan dengan hepatitis viral B dan C
- Symptom & sign (EO K13-Internal Medicine):
*Gejala serupa dengan gejala sirosis hati dengan peningkatan intensiti.
*Gejala kerana tumor mass: Benjolan, pain, icterus.
*Gejala kerana metastasis: Paru -> dyspnoe, Tulang -> Pain pada tulang
*Gejala paraneoplastic syndrome: Hipoglikemia, erythrocytosis, hipercalcemia
- Diagnosis (EO K13-Internal Medicine):
*Radiologi: USG, CT scan, triphasic liver scan.
*Biopsi hati pada kes yang diragukan secara radiologi.
*Lab: AFP, PIVKA

(16) Karsinoma nasofaring:
- Jenis tumor/ kanser pada nasofaring (EO K14-ENT):
*Jenis-jenis karsinoma nasofaring menurut WHO
- Mekanisme timbulnya tumor/ kanser pada nasofaring (EO K14-ENT):
*Patogenesis karsinoma nasofaring akibat jangkitan Ebsten-Barr Virus
- Sign dan Symptom tumor/ kanser pada nasofaring (EO K14-ENT):
*Gejala dan tanda karsinoma nasofaring pada peringkat awal dan lanjut

(17) Kanser Cervix:
- Tumor/ kanser pada cervix uteri akibat terjangkit HPV (EO K15-Obstetric and Gynecologic):
*Jenis tumor/ kanser pada cervix uteri
*Mekanisme timbulnya Utero-Cervical carcinoma akibat HPV
*Perubahan epitel cervix akibat jangkitan HPV
*Sign and symptom serta terapi kanser cervix uteri
*Peranan vaksin dalam mencegah terjadinya kanser cervix

(18) Burkitt lymphoma dan leukemia:
- Kaitan antara jangkitan virus dengan tumor/ kanser pada manusia (EO K16-Pediatric):
*Kaitan antara HTLV-1 dengan leukemia
*Epstein Barr Virus (EBV) dengan karsinoma nasofaring dan limfoma Burkitt's

(19) Tumor solid:
- Peranan bedah pada tumor solid (EO K17-Surgery):
*Pengertian tumor solid
*Peranan bedah sebagai tindakan profilaksis pada tumor solid
*Peranan bedah sebagai diagnostik pada tumor solid
*Peranan bedah sebagai terapi pada tumor solid (kuratif, paliatif)
*Peranan bedah sebagai tindakan rehabilitasi pada tumor solid

(20) Medical Nutrition Therapy for Cancer:
- Nutrition in the etiology of cancer (EO K18-Dietary):
*Goals of nutrition care
*Nutrition screening and risk assessment
*Medical nutrition therapy:
a. Energy intake, body weight, obesity, and physical activity
b. Fat
c. Protein
d. Soy and phytoestrogens
e. Carbohydrate: fibers, sugars, and glycemic index
f. Fruits and vegetables
g. Non nutritive sweeteners
h. Alcohol
i. Coffee and tea
j. Methods of food preparation and preservation
k. Cancer chemoprevention
l. The role of antioxidant

Infection

2010-11-01T18:49:00.004+08:00

Senarai Daftar Kuliah Blok Elective Infection (FK USU-Batch 2007)

(1) Intestinal Parasites:
- Ascariasis (EI K01-Parasitology):
*Diagnosis secara parasitologis
*Penyuluhan sebagai upaya pencegahan dan pemberantasan
- Trikuriasis (EI K01-Parasitology):
*Diagnosis secara parasitologis
*Penyuluhan sebagai upaya pencegahan dan pemberantasan
- Ankilostomiasis (EI K02-Parasitology):
*Diagnosis secara parasitologis
*Penyuluhan sebagai upaya pencegahan dan pemberantasan
- Taeniasis (EI K02-Parasitology):
*Diagnosis secara parasitologis
*Penyuluhan sebagai upaya pencegahan dan pemberantasan
- Amubiasis (EI K03-Parasitology):
*Diagnosis secara parasitologis
*Penyuluhan sebagai upaya pencegahan dan pemberantasan
- Giardiasis (EI K03-Parasitology):
*Diagnosis secara parasitologis
*Penyuluhan sebagai upaya pencegahan dan pemberantasan

(2) Lymphatic Parasites:
- Filariasis (EI K04-Parasitology):
*Diagnosis secara parasitologis
*Penyuluhan sebagai upaya pencegahan dan pemberantasan

(3) Plasmodium sp:
- P. falciparum (EI K05-Parasitology):
*Diagnosis secara parasitologis
*Cara penilaian efikasi ubat antimalaria
- P. vivax (EI K05-Parasitology):
*Diagnosis secara parasitologis
*Cara penilaian efikasi ubat antimalaria
- P. ovale (EI K05-Parasitology):
*Diagnosis secara parasitologis
*Cara penilaian efikasi ubat antimalaria
- P. malariae (EI K05-Parasitology):
*Diagnosis secara parasitologis
*Cara penilaian efikasi obat antimalaria

(4) Antimalaria:
- Aspek farmakologi antimalaria (EI K06-Pharmacology):
*Penggolongan antimalaria
*Sifat kimia dan farmakokinetik antimalaria
*Mekanisme kerja dan resistensi
*Penggunaan klinis
*Reaksi yang tidak diinginkan
*Kontraindikasi
*Interaksi ubat

(5) HIV:
- Epidemiologi HIV (EI K08-Internal Medicine)
- Transmisi infeksi HIV (EI K08-Internal Medicine)
- Perjalanan infeksi HIV (EI K08-Internal Medicine)

(6) Antiretroviral (ARV):
- Aspek farmakologi ARV (EI K07-Pharmacology):
*Tapak kerja ARV
*Pharmacologic classes and agents:
a. Inhibition of viral attachment and entry
b. Inhibition of viral uncoating
c. Inhibition of viral genome replication
d. Inhibition of viral maturation
e. Inhibition of viral release
*Farmakokinetik ARV
*Reaksi yang tidak diinginkan
*Penggunaan klinis
*Kontraindikasi
*Interaksi ubat

(7) Jangkitan Oportunistik:
- Jangkitan oportunistik tersering di Indonesia (EI K09-Internal Medicine)
- Gejala klinis dan Diagnosis jangkitan oportunistik (EI K09-Internal Medicine)
- Pengubatan jangkitan oportunistik (EI K09-Internal Medicine)
- Pengubatan jangkitan oportunistik pada HIV (EI K10-Internal Medicine)

(8) Determinan Definisi Kes TB:
- Empat dasar determinan definisi kes TB-klasifikasi dan jenis (EI K11-Microbiology):
*Berdasarkan organ tubuh yang terjangkit
*Berdasarkan mikroskopis bakteriologi
*Berdasarkan tingkat keparahan penyakit
*Berdasarkan riwayat pengubatan yang sebelumnya, kes baru, terjadi kembali, lalai, gagal, perpindahan, dan lain-lain (TB kronik)

(9) Penemuan dan Penentuan klasifikasi dan Jenis kes pesakit TB:
- Penemuan kes TB (EI K12-Microbiology):
*Passive promotive case finding
*Klasifikasi kasus TB
*Tipe kasus TB

(10) Terapi pesakit TB yang berubat tidak teratur:
- Pemantauan hasil pengubatan TB dengan pemeriksaan BTA (EI K13-Microbiology):
*Tindak lanjut pengubatan pesakit TB berdasarkan jenis pesakit TB
*Tindakan pada pesakit TB yang putus berubat
*Hasil pengubatan pesakit TB BTA positif

(11) Tindakan pada pesakit TB dengan keadaan khusus:
- Pengubatan TB pada keadaan khusus (EI K14-Microbiology):
*TB dengan kehamilan
*TB pada ibu menyusui bayinya
*TB pada wanita yang sedang menggunakan teknik kontrasepsi
*TB pada pesakit HIV/ AIDS
*TB pada pesakit hepatitis akut
*TB pada pasien dengan kelainan hati kronik
*TB pada gagal ginjal
*TB pada DM
*TB pada pengguna kortikosteroid
*TB pada pesakit indikasi operasi
*TB dengan keadaan terjadinya efek samping ubat anti-TB oral

(12) Pencatatan dan Pelaporan Program Nasional Penanggulangan TB:
- Pemantauan dan Evaluasi Program TB (EI K15-Microbiology):
*Borang yang digunakan dalam pencatatan dan pelaporan TB
*Borang TB.01-TB-13

(13) Indikator Program TB dan Cara analisa Indikator :
- Indikator yang dapat digunakan untuk menilai kemajuan dan keberhasilan penanggulangan TB (EI K16-Microbiology):
*Case Detection Rate dan Success Rate

BBS AO K01&K02: Osteology Terms; MSS K01: Osteology; BBS E K01: Istilah dalam Osteologi

2010-10-30T00:24:00.025+08:00

Osteology Terms (BBS AO) , Osteology (MSS), dan Istilah dalam osteologi (BBS E)

Introduction

The framework of the body is built upon a series of bones, supplemented in certain regions by cartilage; the bony part of the framework constitutes the skeleton.

The skeletal system serves several functions, among them are:
1. Protection and support:
The ribs protect the organs of the thorax and the skull protects the brain. The legs support the weight of the entire body. The vertebrae also support the upper body.

2. Movement:
Most skeletal muscles attach to the bones of the skeletal system and use them as leverage points for movement of the body.

3. Production of blood cells:
The bone marrow produces blood cells in a process known as hematopoiesis.

4. Storage:
"Yellow bone marrow" or adipose tissue stores fat in the medullary cavity of long bones. Bones can also be broken down to release inorganic calcium and phosphorus stored in the non cellular matrix of the bone.

In the skeleton of the adult there are generally 206 distinct bones:
a. Axial Skeleton:
- Vertebral column: 26
- Skull: 22
- Hyoid bone: 1
- Ribs and sternum: 25
- Auditory ossicles: 6
Total: 80

b. Appendicular Skeleton:
- Upper extremities: 64
- Lower extremities: 62
Total: 126

Total: 206

Parts of the human body:

1. Head
2. Neck
3. Trunk:
- Chest (Thorax)
- Stomach (Abdomen)
- Hip (Pelvis)
4. Upper Extremities:
- Arm and Forearm
- Wrist
5. Lower Extremities:
- Thigh
- Leg
- Foot

Types of Bones

Bones are divisible into four classes: Long, Short, Flat, and Irregular.

1. Long Bones are found in the limbs and function as levers, they are longer than they are wide.

2. Short Bones transfer forces of movement and are cube shaped as in the carpus and tarsus.

3. Flat Bones are used for either extensive protection or the provision of broad surfaces for muscular attachment. The bones expand into broad, flat plates, as in the skull and the scapula.

4. Irregular Bones have peculiar forms, cannot be grouped under the preceding heads, and are used for muscle attachement and articulation. Some irregular bones include the vertebræ, sacrum and coccyx.

LONG BONE

Long bones consists of a body or shaft and two extremities. The body, or diaphysis is cylindrical, with a central cavity termed the medullary cavity. The wall consists of dense, compact tissue of considerable thickness in the middle part of the body, but becoming thinner toward the extremities. Within the medullary cavity is adipose tissue or "yellow bone marrow".

The extremities are refered to as the epiphysis. Within the epiphysis is the "spongy bone" also known as "red bone marrow". It is within this marrow that red blood cells are produced at an average rate of 2.5 million per second. Running horizontally across the spongy bone of this region is the Epiphyseal line which is a region of cell growth responsible for lateral bone growth during youth, when growth is complete this line calcifies and becomes known as the epiphyseal plate.

Nutrient foramen run through the compact bone and allow the passage of nutrients in and out of the bone. There is a thin outer layer of connective tissue called the PERIOSTEUM which is highly vascular and allows for muscle and tendon attachment, it is bound to the bone itself by PERFORATING FIBERS which are composed of collagen.

This layer does not cover the articulating regions of the bone. The bones belonging to this class include: the clavicle, humerus, radius, ulna, femur, tibia, fibula, metacarpals, metatarsals, and phalanges.

SHORT BONE

Short bones are generally equal in length, width, and thickness. They are found in the wrists and ankles. Aside from points of insertion and vascular areas, short bones are almost completely covered by articular surfaces.

FLAT BONE
These bones are composed of two thin layers of compact tissue enclosing between them a variable quantity of spongy bone. They generally offer protection, as is the case with the bones of the cranium and with the ribs and sternum. The flat bones are: the occipital, parietal, frontal, nasal, lacrimal, vomer, scapula, os coxæ (hip bone), sternum, ribs, and, according to some, the patella.

IRREGULAR BONE
The irregular bones are such as, from their peculiar form, cannot be grouped under the preceding heads. They consist of cancellous tissue enclosed within a thin layer of compact bone. The irregular bones are: the vertebræ, sacrum, coccyx, temporal, sphenoid, ethmoid, zygomatic, maxilla, mandible, palatine, inferior nasal concha, and hyoid.

Surfaces of Bones

If the surface of a bone be examined, certain eminences and depressions are seen. These eminences and depressions are of two kinds: articular and non-articular.

Well-marked examples of articular eminences are found in the heads of the humerus and femur; and of articular depressions in the glenoid cavity of the scapula, and the acetabulum of the hip bone.

Non-articular eminences are designated according to their form. Thus, a broad, rough, uneven elevation is called a tuberosity, protuberance, or process, a small, rough prominence, a tubercle; a sharp, slender pointed eminence, a spine; a narrow, rough elevation, running some way along the surface, a ridge, crest, or line. Non-articular depressions are also of variable form, and are described as fossæ, pits, depressions, grooves, furrows, fissures, notches, etc. These non-articular eminences and depressions serve to increase the extent of surface for the attachment of ligaments and muscles, and are usually well-marked in proportion to the muscularity of the subject. A short perforation is called a foramen, a longer passage a canal.

Structural classification of Joints
(according to how the bones are connected to each other)

There are three structural classifications of joints:
1. Fibrous joint - joined by fibrous connective tissue
2. Cartilaginous joint - joined by cartilage
3. Synovial joint - not directly joined

FIBROUS JOINT

- Fibrous joints are connected by dense connective tissue, consisting mainly of collagen.
- Types of Fibrous joints: Sutures, Syndesmosis, and Gomphosis.
These joints are also called "fixed" or "immoveable" joints, because they do not move. These joints have no joint cavity and are connected via fibrous connective tissue. The skull bones are connected by fibrous joints.

a. Sutures are found between bones of the skull. In fetal skulls the sutures are wide to allow slight movement during birth. They later become rigid (synarthrodial).

b. Syndesmosis are found between long bones of the body, such as the radius and ulna in forearm and the fibula and tibia in leg. Unlike other fibrous joints, syndesmoses are moveable (amphiarthrodial), albeit not to such degree as synovial joints.

c.Gomphosis is a joint between the root of a tooth and the sockets in the maxilla or mandible.

CARTILAGINOUS JOINT

- Cartilaginous joints are connected entirely by cartilage (fibrocartilage or hyaline). Cartilaginous joints allow more movement between bones than a fibrous joint but less than the highly mobile synovial joint.
- An example would be the joint between the manubrium and the sternum. Cartilaginous joints also forms the growth regions of immature long bones and the intervertebral discs of the spinal column.
- Cartilaginous joints can be divided into 2 types: Primary cartilaginous joints and Secondary cartilaginous joints.

a. Primary cartilaginous joints
Known as "synchondroses". Bones are connected by hyaline cartilage or fibrocartilage, sometimes occurring between ossification centers. This cartilage may ossify with age.
Examples in humans are the "growth plates" between ossification centers in long bones. These joints here allow for only a little movement, such as in the spine or ribs.

b. Secondary cartilaginous joints
Known as "symphyses". Fibrocartilaginous joints, usually occurring in the midline.
Examples in human anatomy would be the manubriosternal joint (between the manubrium and the sternum), intervertebral discs, and the pubic symphysis.
Articulating bones at a symphysis are covered with hyaline cartilage and have a thick, fairly compressible pad of fibrocartilage between them.

SYNOVIAL JOINT

- A Synovial joint, also known as a diarthrosis, is the most common and most movable type of joint in the body of a mammal. As with most other joints, synovial joints achieve movement at the point of contact of the articulating bones.
- Structural and functional differences distinguish synovial joints from cartilaginous joints (synchondroses and symphyses) and fibrous joints (sutures, gomphoses, and syndesmoses). The main structural differences between synovial and fibrous joints is the existence of capsules surrounding the articulating surfaces of a synovial joint and the presence of lubricating synovial fluid within that capsule (synovial cavity).
- There are seven types of synovial joints. Some are relatively immobile, but are more stable. Others have multiple degrees of freedom, but at the expense of greater risk of injury. In ascending order of mobility, they are:

a. Gliding joints (or planar joints): These joints allow only gliding or sliding movements. Example: The carpals of the wrist, acromioclavicular joint

b. Hinge joints: These joints act like a door hinge, allowing flexion and extension in just one plane. Example: The elbow (between the humerus and the ulna)

c. Pivot joints: One bone rotates about another. Example: Atlanto-axial joint, proximal radioulnar joint, and distal radioulnar joint

d. Condyloid joints (or ellipsoidal joints): A condyloid joint is where two bones fit together with an odd shape (e.g. an ellipse), and one bone is concave, the other convex. Some classifications make a distinction between condyloid and ellipsoid joints. Example: The wrist joint (radiocarpal joint)

e. Saddle joints: Saddle joints, which resemble a saddle, permit the same movements as the condyloid joints. Example: Carpometacarpal or Trapeziometacarpal Joint of thumb (between the metacarpal and carpal - the trapezium ) , sternoclavicular joint

f. Ball and socket joints: These allow a wide range of movement. Example: The shoulder(glenohumeral), and hip joints

g. Compound joints: Condylar joint(condyles of femur join with condyles of tibia) and Saddle joint(lower end of femur joins with patela). Example: The knee joint

FM K01: Prinsip-prinsip Kedokteran Keluarga

2010-10-29T03:50:00.003+08:00

PRINSIP-PRINSIP KEDOKTERAN KELUARGA
Oleh: dr. Isti Ilmiati Fujiati, MSc. (CM-FM), MPd.Ked.

Area Kompetensi (Area of competence) - 4
Keterampilan pengelolaan masalah kesehatan pada individu, keluarga, ataupun masyarakat dengan cara yang komprehensif, holistik, bersinambung, koordinatif, dan kolaboratif dalam konteks pelayanan kesehatan tingkat primer

Lulusan dokter mampu:
Mengelola penyakit, keadaan sakit dan masalah pasien sebagai individu yang utuh, bagian dari keluarga dan masyarakat:

1.1 Menerapkan prinsip-prinsip pelayanan dokter keluarga secara holistik, komprehensif, koordinatif, kolaboratif, dan berkesinambungan dalam mengelola penyakit dan masalah pasien

Pelayanan Dokter Keluarga
Pelayanan kedokteran yang menyeluruh yang memusatkan pelayanannya kepada keluarga sebagai suatu unit, dimana tanggungjawab dokter terhadap pelayanan kesehatan tidak dibatasi oleh golongan umur, jenis kelamin, juga tidak oleh organ tubuh atau jenis penyakit tertentu saja. (The American Academy of Family Physician)

Pelayanan Kesehatan Tempo Doeloe
… the traditional symbol of medical care the kindly old family doctor with big heart and little bag, part healer, part priest, part family counselor. (Somers and Somer)

PRINSIP KEDOKTERAN KELUARGA

1. CONTINUITY OF CARE (PELAYANAN YANG BERKESINAMBUNGAN)
2. COMPREHENSIVE OF CARE (PELAYANAN YANG MENYELURUH)
3. COORDINATION OF CARE (PELAYANAN YANG TERKOORDINASI)
4. COMMUNITY (MASYARAKAT)
5. PREVENTION (PENCEGAHAN)
6. FAMILY (KELUARGA)

1. PRINSIP PELAYANAN BERKESINAMBUNGAN

Adalah pelayanan kesehatan dimana satu dokter bertemu pasiennya dalam keadaan sakit maupun keadaan sehat, dan mengikuti perjalanan penyakit dari pasiennya hingga ia sembuh.
Dengan pelayanan yang berkesinambungan akan terbentuk hubungan yang didasari kepercayaan terhadap dokternya, dan perjalanan waktu akan membentuk kepercayaan ini.

PENTING DIINGAT
Apakah kita mengetahui riwayat pasien sebelum kita membuat sebuah keputusan?
Apakah kita sudah menjelaskan kepada pasien betapa pentingnya tindak lanjut (follow-up) dalam perawatan penyakitnya?

Apakah pasien percaya kepada dokternya?
Bila kita melihat rekam medik pasien tersebut, apakah dia selalu dirawat oleh dokter yang sama? Hal ini penting khususnya untuk kasus-kasus penyakit khronik.

DISKUSI KASUS
Marni, perempuan 45 tahun masuk IGD sebuah RS dengan keluhan sesak nafas. Ini bukan yang pertama kali Marni masuk IGD. Karena Marni tinggal 40 km dari RS, maka perawatannya terpisah-pisah. Tidak ada tercantum dalam rekam medisnya nama dokter umum yang merawatnya.

Setiap kali dia pulang dari RS, dokter umumnya selalu berganti. Para dokter spesialis yang merawatnya juga selalu berbeda-beda dari waktu ke waktu. Juga, bila kita tanyakan apakah ada kesepakatan untuk rencana kesehatan jangka panjang, kita tidak akan menemukan di dalam rekam medisnya.

2. PRINSIP PELAYANAN YANG MENYELURUH

Artinya kita memandang pasien tidak hanya dari sisi biologis saja tetapi juga dari sisi sosial dan psikologisnya.
Oleh sebab itu, seorang dokter keluarga memandang pasiennya secara keseluruhan, dalam konteks memperhatikan keseluruhan kebutuhan mereka.

PENTING DIINGAT
Lihat rekam medisnya, apakah tertulis daftar masalah (problem list) dan daftar pengobatan (medication list) yang sedang dilakukan.
Lihat rekam medisnya apakah cukup informatif untuk dapat digunakan.
Apakah ada petunjuk yang menunjukkan bahwa dokternya mengerti arti keluhan pasien terhadap pasien tersebut? (patient centered care)

Apakah dokternya tahu kemampuan pasiennya dalam membayar obat maupun pemeriksaan yang dianjurkan?
Waspadai apakah pasien dalam keadaan depresi, atau keluhannya hanya psikosomatik saja. Seringkali pasien yang datang dengan keluhan nyeri dada, lebih sering didiagnosa karena kepanikan bukan karena coronary artery disease.

Bila kita melihat kembali pada kasus Marni, dia mendapat perawatan yang baik untuk masalah biologisnya. Dilakukannya pemeriksaan fungsi paru, pemeriksaan darah, dsb. Tidak ada tertulis mengenai tanda-tanda depresi ataupun kecemasan (anxiety). Bahkan seorang dokter mengatakan, “kita harus menangani penyakitnya dulu baru kita memikirkan masalah psikososialnya”.

Sangat penting bagi dokter untuk berani membuat double diagnosis. Seorang pasien bisa saja depresi dan sekaligus menderita kanker. Adalah penting bagi dokter untuk mengenali keduanya dan mengobati keduanya.

3. PRINSIP PELAYANAN YANG TERKOORDINASI

Dokter keluarga itu seperti orkestrator pelayanan kesehatan bagi pasiennya, yang mengkoordinasi-kan semua pelayanan kesehatan yg dibutuhkan pasien seperti para dokter spesialis, dan pelayanan kesehatan lain diluar praktek dokter keluarga.
Dokter keluarga bertanggung jawab dan menjadi guide bagi pasiennya.

PENTING DIINGAT
Apakah kita mendiskusikan pasien yang kita rujuk dengan konsultan, baik melalui telephone ataupun secara langsung?
Apakah kita pernah bersama-sama dengan pasien bertemu dengan konsultan?

Apakah kita mengajarkan staf atau perawat kita hal-hal yang dapat dilakukannya untuk membantu kita dalam mengkoordinasikan pelayanan kesehatan pasien?
Bila perawatan pasien melibatkan banyak dokter, siapa yang menjelaskan kepada pasien mengenai diagnosa penyakitnya?

Mari kita lihat apakah dalam kasus Marni diterapkan koordinasi. Dari rekam medisnya baik rawat jalan maupun rawat inap ditemukan bahwa sedikit sekali komunikasi antara dokter yang merawatnya.Dokter yang merawat jalan tidak memperhatikan berapa kali sudah Marni keluar masuk RS atau hal-hal yang terjadi di rumah sakit.

Yang menarik, beberapa pemeriksaan sudah dilakukan di dokter yang satu, tetapi diulang kembali di dokter lainnya karena tidak adanya koordinasi antar dokter. Kurangnya komunikasi dan koordinasi ini tentu saja akan memberatkan pasien dan keluarganya dalam hal pembiayaan.

4. PRINSIP PELAYANAN MASYARAKAT

Pekerjaan, budaya, dan lingkungan adalah aspek-aspek dalam komunitas (masyarakat) yang dapat mempengaruhi penatalaksanaan seorang pasien.
Berbagai pihak dalam masyarakat dapat digunakan oleh dokter keluarga dalam rangka memberikan pelayanan kesehatan yang optimal.

PENTING DIINGAT
Apakah sebagai dokter kita tahu apa pekerjaan pasien kita, dan tahu jenis pekerjaan atau tempatnya bekerja, yang mungkin dapat memberikan informasi tentang penyakitnya?

Apakah kita menggunakan sumber-sumber yang tersedia di masyarakat, seperti support group untuk penderita Asthma, adanya Senam Asthma yang dilakukan secara rutin oleh Medan Asthma Center, klub Osteoporosis, dsb.

Apakah kita tahu frekuensi kejadian penyakit yang sama di lingkungan tempat tinggal pasien? Misalnya seperti pasien yang menderita Demam Berdarah, apakah juga didapati orang lain yang terkena DHF di daerah tersebut?

Dalam kasus Marni, jelas sekali orang yang mempunyai masalah pernafasan, lingkungan rumah dan pekerjaannya bisa saja mempunyai hubungan yang erat dengan penyakitnya. Sayangnya, dalam kasus Marni tidak ditemukan di rekam medisnya keterangan apakah dia bekerja atau tidak, atau kondisi dari rumahnya.

5. PRINSIP PENCEGAHAN

Prinsip pencegahan memiliki multi aspek, termasuk mencegah penyakit menjadi lebih berat, mencegah orang lain tertular, pengenalan faktor resiko dari penyakit, dan promosi kesehatan (gaya hidup sehat).
Pencegahan juga termasuk mengantisipasi masalah-masalah yang mungkin mempunyai efek terhadap kesehatan emosional pasien dan keluarganya.

PENTING DIINGAT
Apakah faktor-faktor resiko pasien terhadap penyakit tertentu, tertulis di dalam rekam medisnya?
Apakah faktor-faktor resiko tersebut didiskusikan dengan pasien?
Apakah ada kesepakatan dengan pasien untuk mengurangi faktor resiko?

Apakah kita sudah melakukan antisipasi terhadap masalah-masalah yang secara normal memang terjadi dalam siklus kehidupan sebuah keluarga? Contohnya masalah yang bisa terjadi pada pasangan suami istri yang menikah dan baru memiliki anak (the emptiness syndrome).

Selain pencegahan untuk asthma Marni , tidak ada program pencegahan lainnya yang ditemukan dalam rekam medisnya. Pap’s smear tidak dilakukan dalam 5 tahun terakhir. Pemeriksaan payudara sendiri juga tidak diajarkan. Tidak ada pencegahan terhadap osteoporosis atau anjuran diet untuk mencegah penyakit jantung. Kesimpulannya, perawatan terhadap kasus Mariam adalah contoh yang baik untuk perawatan penyakit dan bukan perawatan pasien.

6. PRINSIP PELAYANAN KELUARGA

Seorang dokter keluarga memandang pasiennya sebagai bagian dari keluarganya dan memahami pengaruh penyakit terhadap keluarga dan pengaruh keluarga terhadap penyakit.
Dokter keluarga juga mengenali keluarga yang berfungsi baik dan keluarga yang disfungsi.

PENTING DIINGAT
Apakah di dalam rekam medisnya tercantum genogram, family circle, family Apgar, dan memuat informasi mengenai Siklus Kehidupan Keluarga?
Family circle dan family Apgar biasanya digunakan untuk kasus-kasus tertentu, tetapi genogram dan Siklus Kehidupan Keluarga harus ada di dalam catatan setiap pasien.

Apakah support system dalam keluarga dicatat?
Apakah kita mengevaluasi pengaruh penyakit terhadap keluarga dan pengaruh keluarga terhadap penyakit pasien?

2010-10-17T04:42:00.002+08:00

Autonomic Nervous System and Pharmacology

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Hypotension

2010-10-10T00:11:00.008+08:00

What Is Hypotension?

Hypotension (HI-po-TEN-shun) is low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood.

Blood pressure is measured as systolic (sis-TOL-ik) and diastolic (di-a-STOL-ik) pressures. Systolic blood pressure is the pressure when the heart beats while pumping blood. Diastolic blood pressure is the pressure when the heart is at rest between beats.

You will most often see blood pressure numbers written with the systolic number above or before the diastolic, such as 120/80 mmHg. (The mmHg is millimeters of mercury—the units used to measure blood pressure.)

Normal blood pressure in adults is lower than 120/80 mmHg. Hypotension is blood pressure that’s lower than 90/60 mmHg.

Overview

Blood pressure changes during the day. It lowers as you sleep and rises when you wake up. It also can rise when you’re excited, nervous, or active.

Your body is very sensitive to changes in blood pressure. Special cells in the arteries can sense if your blood pressure begins to rise or fall. When this happens, the cells trigger your body to try to bring blood pressure back to normal.

For example, if you stand up quickly, your blood pressure may drop. The cells will sense the drop and will quickly take action to make sure that blood continues to flow to your brain, kidneys, and other important organs.

Most forms of hypotension happen because your body can’t bring blood pressure back to normal or can’t do it fast enough.

Some people have low blood pressure all of the time. They have no signs or symptoms, and their low blood pressure is normal for them. In other people, certain conditions or factors cause blood pressure to drop below normal.

Hypotension is a medical concern only if it causes signs or symptoms, such as dizziness, fainting, or, in extreme cases, shock.

Outlook

In a healthy person, low blood pressure without signs or symptoms usually isn’t a problem and needs no treatment. If low blood pressure causes signs or symptoms, your doctor will try to find and treat the underlying condition that’s causing it.

Hypotension can be dangerous. It can make a person fall because of dizziness or fainting. Shock, a severe form of hypotension, is a condition that’s often fatal if not treated right away. With prompt and proper treatment, shock can be successfully treated.

Types of Hypotension

There are several types of hypotension. People who always have low blood pressure have chronic asymptomatic hypotension. They have no signs or symptoms and need no treatment. Their low blood pressure is normal for them.

Other types of hypotension occur only sometimes, when blood pressure suddenly drops too low. The symptoms and effects on the body range from mild to severe.

The three main types of this kind of hypotension are orthostatic (OR-tho-STAT-ik) hypotension, neurally mediated hypotension (NMH), and severe hypotension linked to shock.

Orthostatic Hypotension

This type of low blood pressure occurs when standing up from a sitting or lying down position. It can make you feel dizzy or lightheaded, or even make you faint.

Orthostatic hypotension occurs if your body isn't able to adjust blood pressure and blood flow fast enough for the change in position. This type of low blood pressure usually lasts for only a few seconds or minutes after you stand up. You may need to sit or lie down for a short time while your blood pressure returns to normal.

Orthostatic hypotension can occur in all age groups. However, it's more common in older adults, especially those who are frail or in poor health. It can be a symptom of other medical conditions, and treatment often focuses on treating the underlying condition(s).

Some people have orthostatic hypotension, but also have high blood pressure when lying down.

A form of orthostatic hypotension called postprandial hypotension is a sudden drop in blood pressure after a meal. This type of low blood pressure mostly affects older adults. It’s also more likely to affect people who have high blood pressure or a central nervous system disorder, such as Parkinson’s disease.

Neurally Mediated Hypotension

With NMH, blood pressure drops after you’ve been standing for a long time. You may feel dizzy, faint, or sick to the stomach as a result. This type of low blood pressure also can occur if you have an unpleasant, upsetting, or scary experience.

NMH affects children and young adults more often than people in other age groups. Children often outgrow NMH.

Severe Hypotension Linked to Shock

People may say a person has “gone into shock” as a result of an upsetting event. But to doctors, the word “shock” has a different meaning.

Shock is a life-threatening condition in which blood pressure drops so low that the brain, kidneys, and other vital organs can't get enough blood to work properly. Blood pressure drops much lower in shock than in other types of hypotension.

Many factors can cause shock, such as major blood loss, certain severe infections, severe burns and allergic reactions, and poisoning. Shock can be fatal if it’s not treated right away.

Other Names for Hypotension

- Low blood pressure
- Neurally mediated hypotension
- Neurogenic orthostatic hypotension
- Orthostatic hypotension
- Postprandial hypotension
- Postural hypotension
- Shock

What Causes Hypotension?

Factors or conditions that disrupt the body’s ability to control blood pressure cause hypotension. The different types of hypotension have different causes.

Orthostatic Hypotension

Orthostatic hypotension has many causes. Sometimes two or more factors combine to cause this type of low blood pressure.

Dehydration (de-hi-DRA-shun) is the most common cause of orthostatic hypotension. Dehydration occurs when the body loses more water than it takes in. You may become dehydrated if you don’t drink enough fluids or if you sweat a lot during physical activity. Fever, vomiting, and severe diarrhea also can lead to dehydration.

Orthostatic hypotension may occur during pregnancy, but it generally goes away after the birth.

Because an older body doesn’t manage changes in blood pressure as well as a younger body, getting older also can lead to this type of hypotension.

Postprandial hypotension (a type of orthostatic hypotension) mostly affects older adults. Postprandial hypotension is a sudden drop in blood pressure after a meal.

Certain medical conditions can raise your risk for orthostatic hypotension, including:

- Heart conditions, such as heart attack, heart valve disease, bradycardia (a very low heart rate), and heart failure. These conditions prevent the heart from pumping enough blood to the body.
- Anemia (uh-NEE-me-eh).
- Severe infections.
- Endocrine conditions, such as thyroid disorders, Addison’s disease, low blood sugar, and diabetes.
- Disorders of the central nervous system, such as Parkinson’s disease.
- Pulmonary embolism.

Some medicines used to treat high blood pressure and heart disease can raise your risk for orthostatic hypotension. These medicines include:

- Diuretics, or “water pills”
- Calcium channel blockers
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin II receptor blockers
- Nitrates
- Beta blockers

Medicines used to treat conditions such as anxiety, depression, erectile dysfunction, and central nervous system disorders (like Parkinson’s disease) also can increase your risk for orthostatic hypotension.

Other substances, when taken with high blood pressure medicines, also can lead to orthostatic hypotension. These substances include alcohol, barbiturates, and some prescription and over-the-counter medicines.

Finally, other factors or conditions that can trigger orthostatic hypotension include being out in the heat or being immobile (not being able to move around very much) for a long time.

Neurally Mediated Hypotension

Neurally mediated hypotension (NMH) occurs when the brain and heart don’t communicate with each other properly.

For example, when you stand for a long time, blood begins to pool in your legs. This causes your blood pressure to drop. In NHM, the body mistakenly tells the brain that blood pressure is high. In response, the brain slows the heart rate. This makes blood pressure drop even more, causing dizziness and other symptoms.

Severe Hypotension Linked to Shock

Many factors and conditions can cause severe hypotension linked to shock. Some of these factors also can cause orthostatic hypotension. In shock, though, blood pressure drops very low and doesn’t return to normal on its own.

Shock is an emergency and must be treated right away. If a person has signs or symptoms of shock, someone should call 9–1–1 right away.

Certain severe infections can cause shock. This is known as septic shock. It can occur when bacteria enter the bloodstream. The bacteria release a toxin (a poison) that leads to a dangerous drop in blood pressure.

A severe loss of blood or fluids from the body also can cause shock. This is known as hypovolemic (HI-po-vo-LE-mik) shock. Hypovolemic shock can happen as a result of:

- Major external bleeding (for example, from a severe cut or injury)
- Major internal bleeding (for example, from a ruptured blood vessel or injury that causes bleeding inside the body)
- Major loss of body fluids from severe burns
- Severe swelling of the pancreas (an organ that produces enzymes and hormones, such as insulin)
- Severe diarrhea
- Severe kidney disease
- Overuse of diuretics

A major decrease in the heart’s ability to pump blood also can cause shock. This is known as cardiogenic (KAR-de-o-JEN-ik) shock. Heart attack, pulmonary embolism, or arrhythmia (an irregular heartbeat) can cause this type of shock.

A sudden and extreme widening of the arteries and drop in blood pressure also can cause shock. This is known as vasodilatory (VA-so-DI-la-tory) shock. It can occur due to:

- A severe head injury
- A reaction to certain medicines
- Liver failure
- Poisoning
- A severe allergic reaction (called anaphylactic (AN-a-fi-LAK-tik) shock)

Who Is At Risk for Hypotension?

Hypotension can affect people of all ages. However, people in certain age groups are more likely to have certain types of low blood pressure.

Older adults are more likely to have orthostatic and postprandial hypotension. Children and young adults are more likely to have neurally mediated hypotension.

People who take certain medicines, such as high blood pressure medicines, are at higher risk for low blood pressure. People who have central nervous system disorders (such as Parkinson’s disease) or some heart conditions also are at higher risk for low blood pressure.

Other risk factors for hypotension include being immobile (not being able to move around very much) for long periods and pregnancy. Hypotension during pregnancy is normal and goes away after birth.

What Are the Signs and Symptoms of Hypotension?

Orthostatic Hypotension

The signs and symptoms of orthostatic hypotension may happen within a few seconds or minutes of standing up after you’ve been sitting or lying down. You may feel that you’re going to faint, or you may actually faint. Signs and symptoms include:

- Dizziness or feeling lightheaded
- Blurry vision
- Confusion
- Weakness
- Nausea (feeling sick to your stomach)
- These signs and symptoms go away if you sit or lie down for a few minutes until your blood pressure adjusts to normal.

Neurally Mediated Hypotension

The signs and symptoms of neurally mediated hypotension (NMH) are similar to those of orthostatic hypotension. They occur after standing for a long time or in response to an unpleasant, upsetting, or scary experience.

The drop in blood pressure with NMH doesn’t last long and often goes away after sitting down.

Severe Hypotension Linked to Shock

In shock, not enough blood flows to the major organs, including the brain.

The early signs and symptoms of reduced blood flow to the brain include lightheadedness, sleepiness, and confusion. In the earliest stages of shock, it may be hard to detect any signs or symptoms. In older people, the first symptom may only be confusion.

Over time, as shock worsens, a person won’t be able to sit up without passing out. If the shock continues, the person will lose consciousness. Shock is often fatal if not treated right away.

Other signs and symptoms of shock vary, depending on what’s causing the shock. When low blood volume (from major blood loss, for example) or poor pumping action in the heart (from heart failure, for example) causes shock:

- The skin becomes cold and sweaty. It often looks blue or pale. If pressed, the color returns to normal more slowly than usual. A bluish network of lines appears- under the skin.
- The pulse becomes weak and rapid.
- The person begins to breathe very quickly.
- When extreme widening or stretching of blood vessels (such as in septic shock) causes shock, a person feels warm and flushed at first. Later, the skin becomes cold and clammy, and the person feels very sleepy.

Shock is an emergency and must be treated right away. If a person has signs or symptoms of shock, someone should call 9–1–1 right away.

How Is Hypotension Diagnosed?

Hypotension is diagnosed based on your medical history, a physical exam, and results from tests. Your doctor will want to know:

The type of low blood pressure you have and how severe it is
Whether an underlying condition is causing the low blood pressure
Specialists Involved
A primary care doctor or specialist may diagnose and treat hypotension. The type of specialist most commonly involved is a cardiologist (heart specialist).

Other specialists also may be involved, such as surgeons, nephrologists (kidney specialists), neurologists (brain and nerve specialists), or others.

Diagnostic Tests

When a person is in shock, someone should call 9–1–1 right away because emergency treatment is needed.

For other types of hypotension, your doctor may order tests to find out how your blood pressure responds in certain situations. The results will help your doctor understand why you’re fainting or having other symptoms.

Blood Tests

During a blood test, a small amount of blood is taken from your body. It’s usually drawn from a vein in your arm using a thin needle. The procedure is quick and easy, although it may cause some short-term discomfort.

Blood tests can show whether anemia or low blood sugar is causing your hypotension.

EKG (Electrocardiogram)

An EKG is a simple test that detects and records the heart’s electrical activity. It shows how fast the heart is beating and the heart’s rhythm (steady or irregular). An EKG also shows the strength and timing of electrical signals as they pass through each part of the heart.

Holter and Event Monitors

Holter and event monitors are medical devices that record the heart's electrical activity. These monitors are similar to an EKG. However, a standard EKG only records the heartbeat for a few seconds. It won't detect heart rhythm problems that don't occur during the test.

Holter and event monitors are small, portable devices. You can wear one while you do your normal daily activities. This allows the monitor to record your heart longer than an EKG can.

Echocardiography

Echocardiography is a test that uses sound waves to create a moving picture of your heart. The picture shows how well your heart is working and its size and shape.

There are several different types of echocardiography, including a stress echocardiogram, or “stress echo.” This test is done as part of a stress test (see below). A stress echo usually is done to find out whether you have decreased blood flow to your heart, a sign of coronary artery disease.

Stress Test

Some heart problems are easier to diagnose when your heart is working hard and beating fast. During stress testing, you exercise (or are given medicine if you’re unable to exercise) to make your heart work hard and beat fast while heart tests are done.

These tests may include nuclear heart scanning, echocardiography, and magnetic resonance imaging (MRI) and positron emission tomography (PET) scanning of the heart.

Valsalva Maneuver

This is a simple test of the part of your nervous system that controls functions such as your heartbeat and the narrowing and widening of your blood vessels. If something goes wrong with this part of the nervous system, blood pressure problems may occur.

During this test you take a deep breath and then force the air out through your lips. You will do this several times. Your heart rate and blood pressure will be checked during the test.

Tilt Table Test

This test is used if you have fainting spells for no known reason. For the test, you lie on a table that moves from a lying down to an upright position. Your doctor checks your reaction to the change in position.

Doctors use a tilt table test to diagnose orthostatic hypotension and neurally mediated hypotension (NMH). People who have NMH usually faint during this test. The test can help your doctor find any underlying brain or nerve condition.

How Is Hypotension Treated?

Treatment depends on the type of hypotension you have and how severe your signs and symptoms are. The goals of treatment are to relieve signs and symptoms and manage any underlying condition(s) causing the hypotension.

Your response to treatment depends on your age, overall health, and strength. It also depends on how easily you can stop, start, or change medicines.

In a healthy person, low blood pressure without signs or symptoms usually needs no treatment.

If you have signs or symptoms of low blood pressure, you should sit or lie down right away. Put your feet above the level of your heart. If your symptoms don’t go away quickly, you should seek medical care right away.

Orthostatic Hypotension

There are a number of treatments for orthostatic hypotension. If you have this type of low blood pressure, your doctor may advise making lifestyle changes such as:

- Drinking plenty of fluids, like water
- Drinking little or no alcohol
- Standing up slowly
- Not crossing your legs while sitting
- Gradually sitting up for longer periods if you’ve been immobile (not able to move around much) for a long time due to a medical condition
- Eating small, low-carbohydrate meals if you have postprandial hypotension (a form of orthostatic hypotension)

Talk to your doctor about using compression stockings. These stockings apply pressure to your lower legs. They help move blood throughout your body.

If medicine is causing your low blood pressure, your doctor may change the medicine or adjust the dose you take.

Several medicines also are used to treat orthostatic hypotension. These medicines, which raise blood pressure, include fludrocortisone and midodrine.

Neurally Mediated Hypotension

If you have neurally mediated hypotension (NMH), you may need to make lifestyle changes. These may include:

Avoiding situations that trigger symptoms. For example, don’t stand for long periods. Try to avoid unpleasant, upsetting, or scary situations.

Drinking plenty of fluids, like water.

Increasing your salt intake (as your doctor advises).

Learning to recognize symptoms that occur before fainting and taking action to raise blood pressure. For example, sitting down and putting your head between your knees can help raise blood pressure.

If medicine is causing your low blood pressure, your doctor may change the medicine or adjust the dose you take. He or she also may prescribe a medicine to treat NMH.

Children who have NHM often outgrow it.

Treating Severe Hypotension Linked to Shock

Shock is a life-threatening emergency. People who have shock usually need to be treated in a hospital or by emergency medical personnel. If a person has signs or symptoms of shock, someone should call 9–1–1 right away.

The goals of treating shock are to:

Restore blood flow to the organs as quickly as possible to prevent organ damage
Find and reverse the cause of shock
Special fluid or blood injected into the bloodstream is often used to restore blood flow to the organs. Medicines can be used to raise blood pressure or make the heartbeat stronger. Depending on the cause of the shock, other treatments, such as antibiotics or surgery, may be needed.

Living With Hypotension

Doctors often can successfully treat hypotension. Many people who have the disorder live normal, healthy lives.

If you have low blood pressure, you can take steps to prevent or limit symptoms, such as dizzy spells and fainting.

If you have orthostatic hypotension, get up slowly after sitting or lying down. Eat small, low-carbohydrate meals if you have postprandial hypotension (a form of orthostatic hypotension).

If you have neurally mediated hypotension, don’t stand for long periods. Also, drink plenty of fluids and try to avoid unpleasant or scary situations. Learn to recognize symptoms and take action to raise your blood pressure. Children who have NMH often outgrow it.

Other lifestyle changes also can help you control low blood pressure. For more information, talk to your doctor and see “How Is Hypotension Treated?”

Ask your doctor about learning how to measure your own blood pressure. This will help you find out what a normal blood pressure reading is for you. Keeping a record of blood pressure readings done by health professionals also can help you learn more about your blood pressure.

Severe hypotension linked to shock is an emergency. Shock can cause death if it’s not treated right away. If a person has signs or symptoms of shock, someone should call 9–1–1 right away.

Key Points

Hypotension is low blood pressure. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood.

Normal blood pressure in adults is lower than 120/80 mmHg. Hypotension is blood pressure that’s lower than 90/60 mmHg.

Some people have low blood pressure all the time. They have no signs or symptoms and their low readings are normal for them. In other people, certain conditions or factors cause blood pressure to drop below normal.

In a healthy person, low blood pressure without signs or symptoms usually isn’t a problem and needs no treatment.

The three main types of hypotension that causes signs and symptoms are orthostatic hypotension, neurally mediated hypotension (NMH), and severe hypotension linked to shock.

Orthostatic hypotension is low blood pressure that occurs after standing up from a sitting or lying down position. With NMH, blood pressure drops after you’ve been standing for a long time or due to severe emotional stress. Shock is a life-threatening condition in which blood pressure drops so low that the brain, kidneys, and other vital organs can’t get enough blood to work properly. Many factors can cause shock, such as major blood loss, certain severe infections, severe burns and allergic reactions, and poisoning. Shock can be fatal if not treated right away.

Factors or conditions that disrupt the body’s ability to control blood pressure cause hypotension. The different types of hypotension have different causes.

Hypotension can affect people of all ages. Older adults are more likely to have orthostatic and postprandial hypotension. Children and young adults are more likely to have NMH.

The signs and symptoms of orthostatic hypotension and NMH include dizziness or feeling lightheaded, blurry vision, confusion, weakness, and nausea (feeling sick to your stomach). You may feel as though you’re going to faint, or you may actually faint. Both of these types of hypotension can be dangerous if a person falls because of the dizziness or fainting.

Signs and symptoms of shock include lightheadedness, sleepiness, and confusion. Over time, if shock worsens, a person won’t be able to sit up without passing out. If the shock continues, the person can lose consciousness. Other signs and symptoms of shock include cold and sweaty skin, a weak and rapid pulse, and rapid breathing. If a person has signs or symptoms of shock, someone should call 9–1–1 right away.

Hypotension is diagnosed based on your medical history, a physical exam, and results from tests.

Treatment depends on the type of hypotension you have and how severe your signs and symptoms are. The goals of treatment are to relieve signs and symptoms and manage any underlying condition causing the hypotension. Treatments may include lifestyle changes, compression stockings, procedures, and medicines.
Doctors often can successfully treat hypotension. Many people who have the disorder live normal, healthy lives.

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Tib An Nabawi - Prophet Muhammad (S.A.W.) attached great importance to dental care

2010-10-10T00:11:00.005+08:00

From: http://www.harunyahya.com/

The mouth is the easiest place in the body for germs to reach. This means that oral hygiene is no less important than bodily hygiene.

Our Prophet attached great importance to dental care.

Toothbrush

He was the first person in history to use a stick of wood with suitable fibers, known as a miswak, as a toothbrush.

In describing our beloved Prophet the companions report that his teeth were spotlessly clean, immaculately white, and bright like pearls.

Dental cleanliness

Our Prophet served as a role model for a pre-Islamic society that knew nothing about cleanliness and educated them in the best possible way by giving them information inspired by Almighty God.

Circular brushing

Jabir relates: “The Prophet (saas) said, ‘Performing “khilal” on the teeth cleans them, makes them white, strengthens their roots and makes the mouth smell sweet.” (Onder CAGIRAN, Tibbi Nebevi [Al-Tib Al-Nabawi], 1st edition, Bogazici Publications, Istanbul, 1996)

Information about how the teeth should be brushed is also provided in this hadith.

The method described as “khilal” is the brushing of the teeth in a circular manner, in the form of a crescent moon.

This technique is different to side-to-side brushing, which damages the enamel and can lead to abrasion of the teeth.

Circular brushing is also recommended in current-day dental practice and is described as the best way of preventing food particles accumulating between the teeth.

Frequent brushing

We all know that the teeth should be brushed after every meal.

Our Prophet also recommended frequent brushing (Click here for more detail).

*In addition, check-ups every six months are essential for healthy teeth.

Basics Biomedical Sciences (Physiology)

2010-10-06T07:51:00.005+08:00

Senarai Daftar Kuliah Blok Basics Biomedical Sciences: Physiology (FK USU-Batch 2010)

Penghantar Fisiologi

(1) Homeostasis dan mekanisme regulasi homeostasis:
- Konsep homeostasis dan arti pentingnya untuk organisme (BBS FL K01-Physiology)
- Aspek-aspek yang dipertahankan dalam homeostasis (BBS FL K01-Physiology)
- Feedback positif dan negatif, feedforward dan refleks berperanan untuk meregulasi homeostasis, beserta contohnya (BBS FL K01-Physiology)

(2) Proses khusus yang berkaitan dengan homeostasis:
- Erti dan efek aklimatisasi terhadap proses homeostasis (BBS FL K02-Physiology)
- Pengaruh irama biologis terhadap respon homeostasis (BBS FL K02-Physiology)
- Peranan apoptosis dalam homeostasis (BBS FL K02-Physiology)
- Efek aging terhadap kemampuan sistem kontrol homeostasis (BBS FL K02-Physiology)

Sistem Kontrol

(1) Sistem kontrol saraf dan endokrin:
- Level Organisasi dalam organisme (BBS FL K03-Physiology)
- Sistem organ dalam tubuh manusia dan komponen utama setiap sistem (BBS FL K03-Physiology)
- Sistem kontrol oleh saraf dan endokrin, dan karakteristiknya masing-masing (BBS FL K03-Physiology)

Sistem saraf

(1) Gambaran umum sistem saraf:
- Organisasi sistem saraf (BBS FL K04-Physiology)
- Peranan neuron sebagai unit fungsional (BBS FL K04-Physiology)
- Bahagian sensorik dan motorik pada sistem saraf (BBS FL K04-Physiology)
- Pengertian sensasi dan persepsi (BBS FL K04-Physiology)
- Peranan integratif sistem saraf (BBS FL K04-Physiology)

(2) Fungsi sistem saraf terhadap berbagai sistem organ:
- Peranan kontrol sistem saraf terhadap sistem lainnya dalam tubuh manusia (BBS FL K05-Physiology)

(3) Komunkasi antara sel & Mekanisme transduksi signal:
- Mekanisme komunikasi antara sel, secara gap junction, paracrine, autocrine, signal elektrik, hormon, neurohormon, dan cytokine (BBS FL K06-Physiology)
- Jenis reseptor pada membran dan mekanisme transduksi signal (BBS FL K06-Physiology)
- Respon sel yang terjadi (BBS FL K06-Physiology)

(4) Bioelektrik:
- Prinsip dasar keelektrikan sel dan potensial membran istirehat (BBS FL K07-Physiology)
- Efek stimulus terhadap potensial membran (BBS FL K07-Physiology)
- Pembentukan graded potential dan action potential pada excitable cell (BBS FL K07-Physiology)
- Faktor-faktor yang mempengaruhi eksitasi neuron (BBS FL K07-Physiology)
- Struktur neuron dan organisasi fungsionalnya (BBS FL K08-Physiology)
- Mekanisme konduksi di neuron (BBS FL K08-Physiology)
- Jenis dan fungsi serat saraf (BBS FL K08-Physiology)

(5) Sinaps:
- Struktur dan fungsi sinaps (BBS FL K09-Physiology)
- Mekanisme aktivasi neuron post sinaps, pembentukan eksitatoriatau inhibitori post sinaps (BBS FL K09-Physiology)
- Prinsip neurotransmitter dan neuromodulator (BBS FL K10-Physiology)
- Lokasi neurotransmitter asetilkolin, amin, serta jenis dan lokasi neurotransmitter yang bersifat inhibitor dan eksitator (BBS FL K10-Physiology)
- Mekanisme transmisi neurovaskular (BBS FL K10-Physiology)

(6) Fisiologi reseptor:
- Jenis-jenis reseptor (BBS FL K11-Physiology)
- Pembentukan potensial reseptor (BBS FL K11-Physiology)
- Mekanisme adaptasi reseptor (BBS FL K11-Physiology)
- Mekanisme penentuan jenis, lokasi, dan intensiti stimulus (BBS FL K11-Physiology)

(7) Struktur fugsional korteks serebri:
- Hemisfer korteks serebri dan penghubung antara kedua hemisfer (BBS FL K12-Physiology)
- Area korteks serebri menurut Brodmann dan berdasarkan lobus (BBS FL K12-Physiology)
- Area-area somatosensorik dan motorik (BBS FL K12-Physiology)
- Area-area asosiasi (BBS FL K12-Physiology)

(8) Struktur fungsional ganglia basalis, talamus, dan hipotalamus:
- Struktur daerah-daerah subkorteks yaitu basal nuclei (ganglia basalis), talamus, dan hipotalamus (BBS FL K13-Physiology)
- Peranan ganglia basalis dalam kontrol motorik (BBS FL K13-Physiology)
- Peranan talamus untuk sensorik dan motorik (BBS FL K13-Physiology)
- Struktur dan fungsi umum sistem limbik (BBS FL K13-Physiology)
- Peranan hipotalamus dalam mengatur banyak fungsi homeostatik (BBS FL K13-Physiology)

(9) Struktur fungsional batang otak dan serebellum:
- Struktur dan fungsi serebellum (BBS FL K14-Physiology)
- Struktur dan fungsi nuklei-nuklei yang berada di medulla oblongata dan pons (BBS FL K14-Physiology)

(10) Struktur fungsional medulla spinalis:
- Struktur medulla spinalis secara vertikal dan potongan melintang (BBS FL K15-Physiology)
- Penyambungan antara serat saraf perifer dengan neuron yang berada di medulla spinalis (BBS FL K15-Physiology)
- Letak dan fungsi 3 tract asenden/ sensorik (BBS FL K15-Physiology)
- Letak dan fungsi 2 tract desenden/ motorik (BBS FL K15-Physiology)

(11) Mekanisme sensasi somatik:
- Pengertian sensasi, sensasi umum, dan persepsi (BBS FL K16-Physiology)
- Jenis-jenis reseptor untuk sensasi umum (BBS FL K16-Physiology)
- Organisasi jalur sensorik dan fungsi setiap jalur (BBS FL K16-Physiology)
- Pemetaan somatosensorik pada korteks serebri (BBS FL K16-Physiology)
- Mekanisme dan fungsi indra posisi (BBS FL K16-Physiology)
- Patofisiologi terjadinya pain (BBS FL K17-Physiology)
- Mekanisme sensasi dan persepsi pain (BBS FL K17-Physiology)
- Teori gate control, referred pain, dan visceral pain (BBS FL K17-Physiology)
- Sistem analgesic saraf (BBS FL K17-Physiology)

(12) Mekanisme kontrol motorik somatik dan refleks:
- Prinsip umum kontrol gerakan motorik volunter, involunter, dan refleks (BBS FL K18-Physiology)
- Struktur korteks serebri dan jalur untuk kontrol motorik (BBS FL K18-Physiology)
- Peranan ganglia basalis, batang otak, serebellum, dan medulla spinalis dalam kontrol motorik (BBS FL K18-Physiology)
- Mekanisme pengaturan postur (BBS FL K19-Physiology)
- Peristiwa refleks dan jenis refleks (BBS FL K19-Physiology)
- Refleks-refleks medulla spinalis (BBS FL K19-Physiology)

(13) Fisiologi cranial nerve:
- Pembahagian dan fungsi sistem saraf perifer (BBS FL K20-Physiology)
- Struktur dan fungsi 12 pasaf saraf kranial (BBS FL K20-Physiology)

(14) Fisiologi sistem saraf autonom:
- Fungsi dan pembahagian saraf autonom (BBS FL K21-Physiology)
- Karakteristik persarafan simpatis dan parasimpatis (BBS FL K21-Physiology)
- Mekanisme kontrol saraf autonom (BBS FL K21-Physiology)
- Refleks autonom (BBS FL K21-Physiology)

Sistem endokrin

(1) Prinsip regulasi endokrin:
- Karakteristik dan fungsi hormon (BBS FL K22-Physiology)
- Reseptor hormon (BBS FL K22-Physiology)
- Regulasi sekresi hormon (BBS FL K22-Physiology)
- Pola interaksi hormon pada stress, pertumbuhan, dan aging (BBS FL K22-Physiology)

(2) Fungsi berbagai hormon:
- Fungsi hormon-hormon yang dihasilkan hipotalamus, hipofise, dan pineal (BBS FL K23-Physiology)
- Fungsi hormon yang dihasilkan kelenjar tiroid dan paratiroid (BBS FL K23-Physiology)
- Menjelaskan fungsi hormon dari kelenjar adrenal (BBS FL K23-Physiology)
- Fungsi hormon dari jaringan endokrin pada usus, ginjal, jantung, timus, pankreas, dan gonad (BBS FL K23-Physiology)

Cairan tubuh

(1) Keseimbangan Cairan, Elektrolit, dan Acid-Base:
- Fungsi cairan tubuh (BBS FL K24-Physiology)
- Input dan Output cairan (BBS FL K24-Physiology)
- Kompartemen cairan intrasel dan ekstrasel (BBS FL K24-Physiology)
- Komposisi elektrolit dan zat terlarut lain dalam kompartemen (BBS FL K24-Physiology)
- Osmolariti dan tekanan osmotik cairan tubuh (BBS FL K24-Physiology)
- Peranan elektrolit dalam mempertahankan homeostasis pH cairan tubuh (BBS FL K24-Physiology)

Sistem kardiovaskular

(1) Fisiologi kardiovaskular:
- Fungsi jantung dan pembuluh darah (BBS FL K25-Physiology)
- Struktur, fungsi, dan karakteristik sirkulasi sistemik dan pulmonal (BBS FL K25-Physiology)
- Fungsi kapilari darah dan sinusoid (BBS FL K25-Physiology)
- Karakteristik dan fungsi sirkulasi portal (BBS FL K25-Physiology)
- Sirkulasi cairan tubuh (BBS FL K25-Physiology)
- Struktur dan fungsi pembuluh limfatik (BBS FL K25-Physiology)

Sistem respirasi

(1) Fisiologi respirasi:
- Peranan sistem pernafasan dalam mempertahankan homeostasis (BBS FL K26-Physiology)
- Makna respirasi internal dan eksternal (BBS FL K26-Physiology)
- Fungsi nonrespirasi sistem pernafasan (BBS FL K26-Physiology)
- Struktur fungsional saluran pernafasan (BBS FL K26-Physiology)

Sistem Pencernaan

(1) Fisiologi pencernaan:
- Struktur fungsional saluran cerna (BBS FL K27-Physiology)
- 4 proses pencernaan dasar: Motilitas, Sekresi, Digesti, dan Absorpsi (BBS FL K27-Physiology)

Keutamaan sebahagian surah-surah dan ayat-ayat Al-Quran

2010-10-05T11:52:00.005+08:00

By Toto Sugianto (http://totosugianto.blogspot.com)

Sebelumnya saya ingin berterima kasih kepada Toto Sugianto karena telah menulis sebuah post di dalam blog nya. Saya re-post salah satu isi blog anda yang bertajuk "Keutamaan surah-surah dan ayat-ayat tertentu" di dalam blog ini karena saya ingin post anda sentiasa ada dalam simpanan saya, agar saya dapat mengamalkannya. Semoga kita sentiasa dirahmati dan diredhai oleh Allah. Amin...

Isi post:
1. Dari Abi Said Rafi´´ bin Al Mu´alla ra. ia berkata, "Rasulullah SAW. bersabda kepadaku, ´Maukah saya ajarkan kepadamu surah yang paling agung dalam Al Qur´an, sebelum kamu keluar dari mesjid? ´Lalu beliau memegang tanganku, dan ketika kami hendak keluar, saya bertanya : ´Ya Rasulullah! Engkau berkata bahwa engkau akan mengajarkan surah yang paling agung dalam Al Qur ´an kepadaku´

Beliau menjawab : ´Alhamdu lillahi rabbil ´alamiin (Al Faatihah), adalah tujuh ayat yang dibaca pada setiap salat dan Al Qur´an yang agung yang diberikan kepadaku´. (Bukhari)

2. Dari Ibnu Abbas ra., ia berkata, "Ketika Jibril a.s. sedang duduk di sisi Rasulullah SAW., beliau mendengar suara dari atas, lalu beliau mendongakkan kepala dan bersabda, ´Ini adalah pintu langit yang dibuka pada hari ini, dan tidak pernah dibuka kecuali hari ini´ Lalu seorang malaikat turun dari pintu tersebut. Kemudian beliau bersabda, ´Ini adalah malaikat yang turun ke bumi dan dia tidak pernah turun kecuali hari ini´. Lalu dia (malaikat) memberi salam seraya berkata, ´Aku membawa berita gembira dengan dua cahaya yang diturunkan kepada engkau dan tidak pernah diberikan kepada nabi sebelummu, yaitu : Surah Al Faatihah dan beberapa ayat terakhir Surah Al Baqarah. Tidaklah kamu membaca satu huruf daripadanya kecuali kamu mendapat karunia ´". (Muslim)

3. Dari Abu Hurairah ra., bahwa Rasulullah SAW. bersabda, "Janganlah kau jadikan rumah-rumahmu seperti kuburan, sesungguhnya setan akan lari dari rumah yang di dalamnya dibaca surah Al Baqarah." (Muslim)

4. Dari Ubai bin Kaab ra., ia berkata, "Rasulullah SAW. bersabda, "Wahai Abu Munzir! Tahukah engkau ayat mana dalam Kitab Allah yang paling agung?" Saya menjawab, ´Allahu laailaaha illa huwal hayyul qoyyuum (ayat kursi)´, Lalu beliau menepuk dadaku dan bersabda, ´Semoga Allah memudahkan ilmu bagimu, wahai Abu Munzir´. (Muslim)

5. Dari Abi Mas´ud Al Badri ra., dari Rasulullah SAW. beliau bersabda, "Barangsiapa membaca dua ayat terakhir surah Al Baqarah pada waktu malam, niscaya ia akan mencukupinya." (Disepakati oleh Bukhari dan Muslim)

6. Dari Abu Umamah Al Bahili, ia berkata, "Saya mendengar Rasulullah SAW. bersabda, ´Bacalah Al Qur´an, karena di hari kiamat kelak ia akan memberikan syafaat bagi pembacanya, bacalah zahrawaen, yaitu : surah Al Baqarah dan surah Ali ´Imran. Sesungguhnya pada hari kiamat nanti keduanya akan datang bagaikan dua awan atau dua kawanan burung yang berbaris yang siap membantu orang-orang yang pernah membacanya. Dan bacalah surah Al Baqarah karena membacanya adalah suatu berkat dan meninggalkannya adalah suatu kerugian. Tukang sihir tak akan sanggup menghasutnya." (Muslim)

7. Dari Abu Darda ´ ra., bahwa Rasulullah SAW. bersabda, "Barang siapa menghafal sepuluh ayat pertama dari surah Al Kahfi, maka ia akan terjaga dari dajal." Dalam riwayat lain, "...sepuluh ayat terakhir dari surah Al-Kahf..." (Muslim)

8. Dari Abu Said Al Khudri ra., bahwa Rasulullah SAW. bersabda, "Barangsiapa membaca surah Al Kahfi pada hari Jumat, maka dia akan diterangi cahaya antara dua Jum ´at." (Hakim dan Baihaqi. Hadis ini adalah hadis sahih)

9. Dari Ibnu Masud ra., ia berkata, "Rasulullah SAW. bersabda, "Surah Tabarak (Al Mulk) adalah penjaga dari azab kubur.". (Hakim dan Abu Naim, Hadis di atas adalah hadis sahih)

10. Dari Ibnu Umar ra., dia berkata, "Rasulullah SAW. bersabda, "Siapa yang suka melihat saya di hari kiamat dengan sebenar-benar penglihatan, maka hendaklah ia membaca surah At Takwiir, Al Infithaar dan Al Insyiqaq." (Ahmad, Tirmizi dan Hakim)

11. Dari Abu Said Al Khudri ra. bahwa Rasulullah SAW. bersabda tentang Qul Huwallahu Ahad, "Demi Allah ~Yang diriku berada di dalam genggamanNya~, sesungguhnya ia (Al Ikhlash) menyamai sepertiga Al Qur´an. "Pada riwayat lain, Rasulullah SAW. bersabda kepada para sahabatnya, "Adakah di antara kamu yang tidak sanggup membaca sepertiga Al Qur´an dalam satu malam?" Hal ini memang berat bagi mereka, lalu mereka bertanya, "Siapakah di antara kami yang mampu, wahai Rasulullah?" Beliau bersabda, "Qul Huwallahu Ahad Allahush-Shamad, adalah sepertiga Al Qur´an." (Bukhari)

12. Dari Muaz bin Anas ra., bahwa Rasulullah SAW. bersabda, "Siapa yang membaca Qul Huwallahu Ahad sebanyak sepuluh kali, niscaya Allah akan membangun rumah baginya di surga." (Ahmad)

13. Dari ´Uqbah bin ´Amir ra., bahwa Rasulullah SAW. bersabda, "Adakah kau lihat ayat-ayat yang diturunkan pada malam ini dan selainnya tidak dapat dilihat sepertinya?, dialah, ´Qul a´udzu birabbil falaq´ dan ´Qul a´udzu birabbin-naas´. (Muslim)

14. Dari Aisyah ra., bahwa Rasulullah SAW. apabila akan berangkat tidur setiap malam, beliau mengumpulkan kedua telapak tangannya, kemudian meniupkannya seraya membaca surah Al Ikhlash, Al Falaq dan An-Naas. Kemudian beliau mengusapkannya ke seluruh tubuhnya, sebatas yang bisa dicapai. Dimulai dari kepala, lalu wajah, kemudian bagian depan dari badan. Beliau melakukannya sebanyak tiga kali. (Disepakati oleh Bukhari dan Muslim)

15. Kami diceritai oleh Abdullah bin Yusuf : Kami diberitahu oleh Malik dari Ibnu Syihab, dari Urwah, dari ´Aisyah ra., bahwa Rasulullah SAW. bila merasa sakit beliau membaca sendiri Al Mu´awwizaat ´ (Al Ikhlash, Al Falaq dan An-Naas) kemudian meniupkannya. Apabila rasa sakitnya bertambah saya yang membacanya kemudian saya usapkan ke tangannya mengharap keberkatan darinya." (Bukhari)

SUMBER PENULISAN:

1. Hadits Riwayat Bukhari Muslim.

2. Hadits Riwayat Ahmad, Tirmizi dan Hakim.

3. Beberapa catatan forum kajian Al Qur´an dan Hadits

Ayat 1000 Dinar diturunkan bukan untuk digantung/ ditampal di dinding tetapi untuk dikaji, dihayati & diamalkan

2010-10-05T11:23:00.007+08:00

Dipetik dari http://isuhangat.blogspot.com

Ayat 1000 dinar ini adalah sebahagian dari ayat kedua dan dari ayat ketiga Surah At-Talaq. Ramai orang menganjurkan supaya mengamalkan ayat ini untuk memperolehi kejayaan atau keuntungan. Ramai peniaga menampalkan pelekat ayat 1000 dinar ini di premis perniagaan mereka, dengan harapan supaya perniagaan bertambah maju. Ramai pula yang menghafal ayat ini untuk dibaca dimasa-masa yang sesuai, seperti selepas solat.

Memang kita tidak boleh menafikan kelebihan ayat 1000 dinar. Malangnya, pendekatan sebahagian orang mengenai ayat ini, adalah sesat dan tidak betul. Jika kita lihat terjemahan ayat ini, ia mengandungi dua pengajaran iaitu supaya kita bertaqwa dan bertawakkal. Oleh itu, pendekatan yang betul untuk mengamalkan ayat 1000 dinar ini ialah dengan bertaqwa dan bertawakkal. Kenalah kita pelajari bab bertaqwa dan bertawakkal. Kalau menampalkan pelekat ayat 1000 dinar ini di premis perniagaan, tapi solat tidak dikerjakan, amalan tidak jujur dalam perniagaan terus dibuat atau sebagainya, ini tidak bermakna kita mengamalkan ayat 1000 dinar. Tujuan menampalkan pelekat itu hanyalah sebagai cara supaya kita selalu beringat untuk bertaqwa dan bertawakkal. Begitu juga kalau kita baca ayat ini beribu-ribu kali dalam sehari, sedangkan kita tidak bertaqwa dan bertawakkal, itu juga bukan cara yang betul mengamalkan ayat 1000 dinar.

Penulis pernah menguji seorang peniaga yang menampal banyak pelekat ayat 1000 dinar di sekitar meja juruwang di kedainya, apa yang dia faham mengenai ayat itu. Peniaga itu menjawab, dia tidak tahu apa maksud ayat 1000 dinar itu, tetapi dia menampal pelekat ayat itu dengan harapan akan beroleh keuntungan besar. Pada hari Jumaat, peniaga itu tidak sembahyang Jumaat kerana sibuk melayan pelanggan dikedainya. Adakah itu cara yang betul mengamalkan ayat 1000 dinar?

Bagi penulis, mengamalkan ayat 1000 dinar ini adalah dengan mengikuti dan menta'ati ajaran yang terkandung di dalam nya, iaitu bertaqwa dan bertawakkal. Maka jika kita berhajat untuk mengamalkan ayat 1000 dinar, maka kita hendaklah mempelajari dengan lebih mendalam apakah yang dimaksudkan taqwa dan tawakkal, kemudian kita mengamalkan taqwa dan tawakkal pada setiap masa dalam hidup kita. Tak perlu nak tampal pelekat atau mengulang-ulang menyebutnya, sedangkan pengajaran yang dianjurkan dalam ayat 1000 dinar itu tidak diikuti.

High Blood Pressure

2010-10-05T01:13:00.007+08:00

Warning: The informations contained in this blog are not medical advices. Please consult your medical doctor before making decision or taking any action on your health or the health of your family.

What Is High Blood Pressure?

High blood pressure (HBP) is a serious condition that can lead to coronary heart disease, heart failure, stroke, kidney failure, and other health problems.

"Blood pressure" is the force of blood pushing against the walls of the arteries as the heart pumps out blood. If this pressure rises and stays high over time, it can damage the body in many ways.

Overview

About 1 in 3 adults in the United States has HBP. HBP itself usually has no symptoms. You can have it for years without knowing it. During this time, though, it can damage the heart, blood vessels, kidneys, and other parts of your body.

This is why knowing your blood pressure numbers is important, even when you're feeling fine. If your blood pressure is normal, you can work with your health care team to keep it that way. If your blood pressure is too high, you need treatment to prevent damage to your body's organs.

Blood Pressure Numbers

Blood pressure numbers include systolic (sis-TOL-ik) and diastolic (di-a-STOL-ik) pressures. Systolic blood pressure is the pressure when the heart beats while pumping blood. Diastolic blood pressure is the pressure when the heart is at rest between beats.

You will most often see blood pressure numbers written with the systolic number above or before the diastolic, such as 120/80 mmHg. (The mmHg is millimeters of mercury—the units used to measure blood pressure.)

Below shows normal numbers for adults. It also shows which numbers put you at greater risk for health problems. Blood pressure tends to goes up and down, even in people who have normal blood pressure. If your numbers stay above normal most of the time, you're at risk.

Categories for Blood Pressure Levels in Adults (in mmHg, or millimeters of mercury)

Category
Normal: Less than 120 (Systolic) And Less than 80 (Diastolic)
Prehypertension: 120–139 (Systolic) Or 80–89 (Diastolic)
High blood pressure:
Stage 1: 140–159 (Systolic) Or 90–99 (Diastolic)
Stage 2: 160 or higher (Systolic) Or 100 or higher (Diastolic)

The ranges in the table apply to most adults (aged 18 and older) who don't have short-term serious illnesses.

All levels above 120/80 mmHg raise your risk, and the risk grows as blood pressure levels rise. "Prehypertension" means you're likely to end up with HBP, unless you take steps to prevent it.

If you're being treated for HBP and have repeat readings in the normal range, your blood pressure is under control. However, you still have the condition. You should see your doctor and stay on treatment to keep you blood pressure under control.

Your systolic and diastolic numbers may not be in the same blood pressure category. In this case, the more severe category is the one you're in. For example, if your systolic number is 160 and your diastolic number is 80, you have stage 2 HBP. If your systolic number is 120 and your diastolic number is 95, you have stage 1 HBP.

If you have diabetes or chronic kidney disease, HBP is defined as 130/80 mmHg or higher. HBP numbers also differ for children and teens.

Outlook

Blood pressure tends to rise with age. Following a healthy lifestyle helps some people delay or prevent this rise in blood pressure.

People who have HBP can take steps to control it and reduce their risks for related health problems. Key steps include following a healthy lifestyle, having ongoing medical care, and following the treatment plan that your doctor prescribes.

Other Names for High Blood Pressure

High blood pressure (HBP) also is called hypertension.

When HBP has no known cause, it may be called essential hypertension, primary hypertension, or idiopathic hypertension.

When another condition causes HBP, it's sometimes called secondary high blood pressure or secondary hypertension.

In some cases of HBP, only the systolic blood pressure number is high. This condition is called isolated systolic hypertension (ISH). Many older adults have this condition. ISH can cause as much harm as HBP in which both numbers are too high.

What Causes High Blood Pressure?

Blood pressure tends to rise with age, unless you take steps to prevent or control it.

Certain medical problems, such as chronic kidney disease, thyroid disease, and sleep apnea, may cause blood pressure to rise. Certain medicines, such as asthma medicines (for example, corticosteroids) and cold-relief products, also may raise blood pressure.

In some women, blood pressure can go up if they use birth control pills, become pregnant, or take hormone replacement therapy.

Women taking birth control pills usually have a small rise in both systolic and diastolic blood pressures. If you already have high blood pressure (HBP) and want to use birth control pills, make sure your doctor knows about your HBP. Talk to him or her about how often you should have your blood pressure checked and how to control it while taking the pill.

Taking hormones to reduce the symptoms of menopause can cause a small rise in systolic blood pressure. If you already have HBP and want to start using hormones, talk to your doctor about the risks and benefits. If you decide to take hormones, find out how to control your blood pressure and how often you should have it checked.

Children younger than 10 years who have HBP often have another condition that's causing it (such as kidney disease). Treating the underlying condition may resolve the HBP.

The older a child is when HBP is diagnosed, the more likely he or she is to have essential hypertension. This means that doctors don't know what's causing the HBP.

Who Is At Risk for High Blood Pressure?

In the United States, about 72 million people have high blood pressure (HBP). This is about 1 in 3 adults.

Certain traits, conditions, or habits are known to raise the risk for HBP. These conditions are called risk factors. This section describes the major risk factors for HBP.

Older Age

Blood pressure tends to rise with age. If you're a male older than 45 or a female older than 55, your risk for HBP is higher. Over half of all Americans aged 60 and older have HBP.

Isolated systolic hypertension (ISH) is the most common form of HBP in older adults. ISH occurs when only systolic blood pressure (the top number) is high. About 2 out of 3 people over age 60 who have HBP have ISH.

HBP doesn't have to be a routine part of aging. You can take steps to keep your blood pressure at a normal level. (For more information, see "How Is High Blood Pressure Treated?")

Race/Ethnicity

HBP can affect anyone. However, it occurs more often in African American adults than in Caucasian or Hispanic American adults. In relation to these groups, African Americans:

- Tend to get HBP earlier in life
- Often have more severe HBP
- Are more likely to be aware that they have HBP and to get treatment
- Are less likely than Caucasians and about as likely as Hispanic Americans to achieve target control levels with HBP treatment
- Have higher rates than Caucasians of premature death from HBP-related complications, such as coronary heart disease, stroke, and kidney failure
- HBP risks vary among different groups of Hispanic American adults. For instance, Puerto Rican American adults have higher rates of HBP-related death than all other Hispanic groups and Caucasians. But, Cuban Americans have lower rates than Caucasians.

Overweight or Obesity

You're more likely to develop prehypertension or HBP if you're overweight or obese. Overweight is having extra body weight from muscle, bone, fat, and/or water. Obesity is having a high amount of extra body fat.

Gender

Fewer adult women than men have HBP. But, younger women (aged 18–59) are more likely than men to be aware of and get treatment for HBP.

Women aged 60 and older are as likely as men to be aware of and treated for HBP. However, among treated women aged 60 and older, blood pressure control is lower than it is in men in the same age group.

Unhealthy Lifestyle Habits

A number of lifestyle habits can raise your risk for HBP, including:

- Eating too much sodium (salt)
- Drinking too much alcohol
- Not getting enough potassium in your diet
- Not doing enough physical activity
- Smoking

Other Risk Factors

A family history of HBP raises your risk for the condition. Long-lasting stress also can put you at risk for HBP.

You're also more likely to develop HBP if you have prehypertension. Prehypertension means that your blood pressure is in the 120–139/80–89 mmHg range.

Risk Factors for Children and Teens

Overweight is on the rise in youth younger than 18 years. As a result, prehypertension and HBP also are becoming more common in this age group.

African American and Mexican American youth are more likely to have HBP and prehypertension than Caucasian youth. Also, boys are at higher risk for HBP than girls.

Like adults, children and teens need to have routine blood pressure checks. This is even more important if a young person is overweight.

What Are the Signs and Symptoms of High Blood Pressure?

High blood pressure (HBP) itself usually has no symptoms. Rarely, headaches may occur.

You can have HBP for years without knowing it. During this time, HBP can damage the heart, blood vessels, kidneys, and other parts of the body.

Some people only learn that they have HBP after the damage has caused problems, such as coronary heart disease, stroke, or kidney failure.

Knowing your blood pressure numbers is important, even when you're feeling fine. If your blood pressure is normal, you can work with your health care team to keep it that way. If your numbers are too high, you can take steps to lower them and control your blood pressure. This helps reduce your risk for complications.

Complications of High Blood Pressure

When blood pressure stays high over time, it can damage the body. HBP can cause:

The heart to get larger or weaker, which may lead to heart failure. Heart failure is a condition in which the heart can't pump enough blood throughout the body.

Aneurysms (AN-u-risms) to form in blood vessels. An aneurysm is an abnormal bulge or "ballooning" in the wall of an artery. Common spots for aneurysms are the main artery that carries blood from the heart to the body; the arteries in the brain, legs, and intestines; and the artery leading to the spleen.

Blood vessels in the kidney to narrow. This may cause kidney failure.
arteries throughout the body to narrow in some places, which limits blood flow (especially to the heart, brain, kidneys, and legs). This can cause a heart attack, stroke, kidney failure, or amputation of part of the leg.

Blood vessels in the eyes to burst or bleed. This may lead to vision changes or blindness.

How Is High Blood Pressure Diagnosed?

Your doctor will diagnose high blood pressure (HBP) using the results of blood pressure tests. These tests will be done several times to make sure the results are correct. If your numbers are high, your doctor may have you return for more tests to check your blood pressure over time.

If your blood pressure is 140/90 mmHg or higher over time, your doctor will likely diagnose you with HBP. If you have diabetes or chronic kidney disease, a blood pressure of 130/80 mmHg or higher is considered HBP.

The HBP ranges in children are different. (For more information, see below.)

How Is Blood Pressure Tested?

A blood pressure test is easy and painless. This test is done at a doctor's office or clinic.

To prepare for the test:

- Don't drink coffee or smoke cigarettes for 30 minutes prior to the test. These actions may cause a short-term rise in your blood pressure.
- Go to the bathroom before the test. Having a full bladder can change your blood pressure reading.
- Sit for 5 minutes before the test. Movement can cause short-term rises in blood pressure.
- To measure your blood pressure, your doctor or nurse will use some type of a gauge, a stethoscope (or electronic sensor), and a blood pressure cuff.

Most often, you will sit or lie down with the cuff around your arm as your doctor or nurse checks your blood pressure. If he or she doesn't tell you what your blood pressure numbers are, you should ask.

Diagnosing High Blood Pressure in Children and Teens

Doctors measure blood pressure in children and teens the same way they do in adults. Your child should have routine blood pressure checks starting at 3 years of age.

Blood pressure normally rises with age and body size. Newborn babies often have very low blood pressure numbers, while older teens have numbers similar to adults.

The ranges for normal blood pressure and HBP are generally lower for youth than for adults. These ranges are based on the average blood pressure numbers for age, gender, and height.

To find out whether a child has HBP, a doctor will compare the child's blood pressure numbers to average numbers for his or her age, height, and gender.

For more information, see the National Heart, Lung, and Blood Institute's "A Pocket Guide to Blood Pressure Measurement in Children."

What Does a Diagnosis of High Blood Pressure Mean?

If you're diagnosed with HBP, you will need treatment. You also will need to have your blood pressure tested again see how treatment affects it.

Once your blood pressure is under control, you will need to stay on treatment. "Under control" means that your blood pressure numbers are normal. You also will need regular blood pressure tests. Your doctor can tell you how often you should be tested.

The sooner you find out about HBP and treat it, the better your chances to avoid problems like heart attack, stroke, and kidney failure.

How Is High Blood Pressure Treated?

High blood pressure (HBP) is treated with lifestyle changes and medicines.

Most people who have HBP will need lifelong treatment. Sticking to your treatment plan is important. It can prevent or delay the problems linked to HBP and help you live and stay active longer.

For more tips on controlling your blood pressure, see the National Heart, Lung, and Blood Institute's (NHLBI's) "Your Guide to Lowering Blood Pressure."

Goals of Treatment

The treatment goal for most adults is to get and keep blood pressure below
140/90 mmHg. For adults who have diabetes or chronic kidney disease, the goal is to get and keep blood pressure below 130/80 mmHg.

Lifestyle Changes

Healthy habits can help you control HBP. Healthy habits include:

- Following a healthy eating plan
- Doing enough physical activity
- Maintaining a healthy weight
- Quitting smoking
- Managing your stress and learning to cope with stress
- If you combine these measures, you can achieve even better results than taking single steps. Making lifestyle changes can be hard. Start by making one healthy lifestyle change and then adopt others.

Some people can control their blood pressures with lifestyle changes alone, but many people can't. Keep in mind that the main goal is blood pressure control. If your doctor prescribes medicines as a part of your treatment plan, keep up your healthy habits. This will help you better control your blood pressure.

Follow a Healthy Eating Plan

Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have HBP. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and lower in sodium (salt).

This eating plan is low in fat and cholesterol. It also features fat-free or low-fat milk and dairy products, fish, poultry, and nuts. The DASH eating plan suggests less red meat (even lean red meat), sweets, added sugars, and sugar-containing beverages. The plan is rich in nutrients, protein, and fiber.

To help control HBP, you should limit the amount of salt that you eat. This means choosing low-salt and "no added salt" foods and seasonings at the table or when cooking. The Nutrition Facts label on food packaging shows the amount of sodium in the item. You should eat no more than about 1 teaspoon of salt a day.

You also should try to limit alcoholic drinks. Too much alcohol will raise your blood pressure. Men should have no more than two alcoholic drinks a day. Women should have no more than one alcoholic drink a day.

For more information on limiting salt and alcohol in your diet, see the Your Guide to Lowering High Blood Pressure Web site.

Do Enough Physical Activity

Regular physical activity can lower HBP and also reduce your risk for other health problems.

Check with your doctor about how much and what kinds of activity are safe for you. Unless your doctor tells you otherwise, try to get at least 30 minutes of moderate-intensity activity on most or all days of the week. You can do it all at once or break it up into shorter periods of at least 10 minutes each.

Moderate-intensity activities include brisk walking, dancing, bowling, riding a bike, working in a garden, and cleaning the house.

If your doctor agrees, you also may want to do more intense activities, such as jogging, swimming, and playing sports. For more information, see the NHLBI's "Your Guide to Physical Activity and Your Heart."

Maintain a Healthy Weight

Staying at a healthy weight can help control blood pressure and also reduce your risk for other health problems.

If you're overweight or obese, aim to reduce your weight by 7 to 10 percent during your first year of treatment. This amount of weight loss can lower your risk for health problems related to HBP.

After the first year, you may have to continue to lose weight so you can lower your body mass index (BMI) to less than 25.

BMI measures your weight in relation to your height and gives an estimate of your total body fat. A BMI between 25 and 29 is considered overweight. A BMI of 30 or more is considered obese. A BMI of less than 25 is the goal for keeping blood pressure under control.

You can measure your BMI using the NHLBI's online calculator, or your health care provider can help.

For more information on losing weight and keeping it off, see the Diseases and Conditions Index Overweight and Obesity article.

Quit Smoking

Smoking can damage your blood vessels and raise your risk for HBP. It also can worsen health problems related to HBP. Smoking is bad for everyone, especially those who have HBP.

If you smoke or use tobacco, quit. Talk to your doctor about programs and products that can help you quit. The U.S. Department of Health and Human Services has information on how to quit smoking. Also, take steps to protect yourself from secondhand smoke.

Managing Stress

Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.

Physical activity helps some people cope with stress. Other people listen to music or focus on something calm or peaceful to reduce stress. Some people learn yoga, tai chi, or how to meditate.

Medicines

Today's blood pressure medicines can safely help most people control their blood pressures. These medicines are easy to take. The side effects, if any, tend to be minor.

If you have side effects from your medicines, talk to your doctor. He or she may be able to adjust the doses or prescribe other medicines. You shouldn't decide on your own to stop taking your medicines.

Blood pressure medicines work in different ways to lower blood pressure. Some remove extra fluid and salt from the body to lower blood pressure. Others slow down the heartbeat or relax and widen blood vessels. Often, two or more medicines work better than one.

Diuretics

Diuretics are sometimes called water pills. They help your kidneys flush excess water and salt from your body. This lessens the amount of fluid in your blood, and your blood pressure goes down.

Diuretics often are used with other HBP medicines and sometimes combined into one pill.

Beta Blockers

Beta blockers help your heart beat slower and with less force. Your heart pumps less blood through your blood vessels, and your blood pressure goes down.

ACE Inhibitors

ACE inhibitors keep your body from making a hormone called angiotensin II. This hormone normally causes blood vessels to narrow. ACE inhibitors prevent this, so your blood pressure goes down.

Angiotensin II Receptor Blockers

Angiotensin II receptor blockers (ARBs) are newer blood pressure medicines that protect your blood vessels from angiotensin II. As a result, blood vessels relax and widen, and your blood pressure goes down.

Calcium Channel Blockers

Calcium channel blockers (CCBs) keep calcium from entering the muscle cells of your heart and blood vessels. This allows blood vessels to relax, and your blood pressure goes down.

Alpha Blockers

Alpha blockers reduce nerve impulses that tighten blood vessels. This allows blood to flow more freely, causing blood pressure to go down.

Alpha-Beta Blockers

Alpha-beta blockers reduce nerve impulses the same way alpha blockers do. However, they also slow the heartbeat like beta blockers. As a result, blood pressure goes down.

Nervous System Inhibitors

Nervous system inhibitors increase nerve impulses from the brain to relax and widen blood vessels. This causes blood pressure to go down.

Vasodilators

Vasodilators relax the muscles in blood vessel walls. This causes blood pressure to go down.

Treatment for Children and Teens

If another condition is causing your child's HBP, treating it often resolves the HBP. When the cause of a child or teen's HBP isn't known, the first line of treatment is lifestyle changes (as it is for adults).

If lifestyle changes don't control blood pressure, children and teens also may need to take medicines. Most of the medicines listed above for adults have unique doses for children.

How Can High Blood Pressure Be Prevented?

If You Have Normal Blood Pressure

- If you don't have high blood pressure (HBP), you can take steps to prevent it. Lifestyle measures can help you maintain normal blood pressure.
- Follow a healthy eating plan. This includes limiting the amount of sodium (salt) and alcohol that you consume. An example of a healthy eating plan is the National Heart, Lung, and Blood Institute's Dietary Approaches to Stop Hypertension (DASH).
- Lose weight if you're overweight or obese.
- Do enough physical activity.
- Quit smoking.
- Manage your stress and learn to cope with stress

Many people who take one or more of these steps are able to prevent or delay HBP. The more steps you take, the more likely you are to lower your blood pressure and avoid related health problems.

If You Have High Blood Pressure

If you have HBP, you can still take steps to prevent the long-term problems it can cause. Lifestyle measures (listed above) and medicines can help you live a longer, more active life.

Follow the treatment plan your doctor prescribes to control your blood pressure. It can help you prevent or delay coronary heart disease, stroke, kidney disease, and other health problems.

Children and Teens

A healthy lifestyle also can help prevent HBP in children and teens. Key steps include having a child:

- Follow a healthy eating plan that focuses on plenty of fruits, vegetables, and, for children older than 4 years, low-fat dairy products. The plan also should be low in saturated and trans fats and salt.
- Be active for at least 1 to 2 hours per day. Limit screen time in front of the TV or the computer to 2 hours per day at most.
- Maintain a healthy weight. If your child is overweight, ask his or her doctor about how your child can safely lose weight.
- Make these habits part of a family health plan to help your child adopt and maintain a healthy lifestyle.

Living With High Blood Pressure

If you have high blood pressure (HBP), you will need to treat and control it for life. This means making lifestyle changes, taking prescribed medicines, and getting ongoing medical care.

Treatment can help control blood pressure, but it will not cure HBP. If you stop treatment, your blood pressure and risk for related health problems will rise. For a healthy future, follow your treatment plan closely. Work with your health care team for lifelong blood pressure control.

Lifestyle Changes

Following a healthy lifestyle is an important step for controlling HBP. A healthy lifestyle includes following a healthy eating plan, losing weight (if you're overweight or obese), doing regular physical activity, and not smoking. (For more information, see "How Is High Blood Pressure Treated?")

Medicines

You should take all blood pressure medicines that your doctor prescribes. Be sure you know the names and doses of your medicines and how to take them. If you have questions about your medicines, talk to your doctor or pharmacist.

Make sure you refill your medicines before they run out. Take your medicines exactly as your doctor directs—don't skip days or cut pills in half.

If you're having side effects from your medicines, talk to your doctor. He or she may need to adjust the doses or prescribe other medicines. You shouldn't decide on your own to stop taking your medicines.

Ongoing Care

Go for medical checkups or tests as your doctor advises. Your doctor may need to change or add medicines to your treatment plan over time. Regular checkups allow your doctor to change your treatment right away if your blood pressure goes up again.

Keeping track of your blood pressure is vital. Have your blood pressure checked on the schedule your doctor advises. You may want to learn how to check your blood pressure at home. Your doctor can help you with this. Each time you check your own blood pressure, you should write down your numbers and the date.

The National Heart, Lung, and Blood Institute's (NHLBI's) "My Blood Pressure Wallet Card" can help you track your blood pressure. You also can write down the names and doses of your medicines and keep track of your lifestyle changes with this handy card.

During checkups, you can ask your doctor or health care team any questions you have about your lifestyle or medicine treatments.

High Blood Pressure and Pregnancy

Many pregnant women who have HBP have healthy babies. However, HBP can cause problems for both the mother and the fetus. It can harm the mother's kidneys and other organs. It also can cause the baby to be born early and with a low birth weight.

If you're thinking about having a baby and you have HBP, talk to your health care team. You can take steps to control your blood pressure before and while you're pregnant.

Some women get HBP for the first time while they're pregnant. In the most serious cases, the mother has a condition called preeclampsia (pre-e-KLAMP-se-ah).

This condition can threaten the lives of both the mother and the unborn child. You will need special care to reduce your risks. With such care, most women and babies have good outcomes.

See the NHLBI's Your Guide to Lowering High Blood Pressure Web site for more information about HBP and pregnancy.

Key Points

High blood pressure (HBP) is a serious condition that can lead to coronary heart disease, heart failure, stroke, kidney failure, and other health problems.

"Blood pressure" is the force of blood pushing against the walls of the arteries as the heart pumps out blood. When this pressure rises and stays high over time, it can damage the body in many ways.

Blood pressure numbers include systolic and diastolic pressures. Systolic blood pressure is the pressure when the heart beats while pumping blood. Diastolic blood pressure is the pressure when the heart is at rest between beats.

All blood pressure levels above 120/80 mmHg increase your risk for the health problems related to HBP. A blood pressure level of 140/90 mmHg or higher is considered HBP for most adults. If you have diabetes or chronic kidney disease, a blood pressure of 130/80 mmHg or higher is considered HBP.

Blood pressure tends to rise with age. Certain medical problems and medicines may cause blood pressure to rise. In some women, blood pressure can go up if they use birth control pills, become pregnant, or take hormone replacement therapy.

Children younger than 10 years who have HBP often have another condition that's causing it (such as kidney disease). Treating the underlying condition may resolve HBP.

In the United States, about 72 million people have HBP. This is about 1 in 3 adults.

Certain traits, conditions, or habits may raise your risk for HBP. These include older age, race/ethnicity, overweight or obesity, gender, unhealthy lifestyle habits, a family history of HBP, long-lasting stress, and having prehypertension (blood pressure levels between 120–139/80–89).

HBP itself usually has no symptoms. Rarely, headaches may occur. Some people only learn that they have HBP after it causes health problems, such as coronary heart disease, stroke, or kidney failure.

Your doctor will diagnose HBP using the results of a blood pressure test. This test is easy and painless. It may be done several times to make sure the results are correct.

Doctors measure blood pressure in children and teens the same way they do in adults. However, the ranges for normal blood pressure and HBP are different for youth than for adults. These ranges are based on the average blood pressure levels for a child or teen's age, gender, and height.

HBP in adults and children is treated with lifestyle changes and medicines.

Lifestyle changes include following a healthy eating plan, doing enough physical activity, maintaining a healthy weight, quitting smoking, and managing and coping with stress.

If you have normal blood pressure, you can take steps to prevent or delay HBP.

Healthy lifestyle habits can help you maintain normal blood pressure.

If you have HBP, you can take steps to prevent the long-term problems it can cause.

Adopt healthy lifestyle habits and follow the treatment plan your doctor prescribes.

Children and teens can prevent HBP and its related problems in the same ways.

Tib An Nabawi - Eating habits that can help you keep healthy

2010-10-01T20:01:00.006+08:00

1. Sitting while eating food

Way of sitting while eating food
Sitting at infront of food in the manner of Rasullah s.a.w. sunnah:
a. With the left bent leg on the ground and the right leg over the left leg
b. Sitting on one's knees like the sitting in salat

The first two ways helps stomach constrict (become smaller in size) thus one does not feel much hungry. This helps reduce food intake.

Muslims are to eat in moderation. Sitting in the above proper manner helps us take lesser food. Those who show moderation in eating find greater pleasure in their food than those who overindulge. When they become addicted and habituated to their indulgence, they find no great pleasure in it anymore, though they might suffer for want of it when they do not have it and endure ill health because of it.

Sitting cross-legged is not allowed. Sitting crossed-legged helps stomach stretch and expand, thus we feel like eating more food, and overeating is a known cause of several diseases like diabetes, B.P., high cholesterol, to name only a few.

2. Do not recline while eating food

Do not recline while eating food, this delays digestion.

3. Do not eat very fast

Do not eat very fast, eating slowly helps build up your blood sugar level slowly, by eating fast the blood sugar level shoots up suddenly and this can cause irritability and mood swings.

4. Talk of good things while eating and always keep chatting while having meals

Talk of good things while eating and always keep chatting while having meals. Social collaborations and communications increase your level of serotonin which lifts up the spirits and keeps one in happy mood.

5. Do not skip meals

Do not skip meals, this makes you grown older and affects your sleep.

6. Do not Eat too Much

In today’s times, many people follow a lifestyle in which they over indulge in food. They eat large quantities until it is difficult for them to breathe and they can almost feel the food rising to their throats. We have been taught by the Prophet, that we should do all things in moderation, including eating. The Prophet, said: “A Believer eats in one intestine, whereas a non-believer eats in seven intestines” [Muslim]

Therefore, we should not eat until we are completely satiated; rather we should eat an amount of food that eliminates the hunger and does not satisfy us to our fullest.

Tib An Nabawi - 12 favorite foods of Rasulullah s.a.w.

2010-09-30T21:54:00.017+08:00

12 favorite foods of Rasulullah s.a.w (as mentioned in At Tib-an Nabawi book)

Rasullah’s s.a.w. life had been most comprehensive and perfect and can serve as an ideal for men and women of all ages, at all times. His habits and advice have been absolutely perfect and shows moderate way of life and meets all the needs of man.

Barley

Good in fever, use in a soup form.

Dates

Rasulullah s.a.w. said that a house without dates has no food. It should also be eaten at the time of childbirth.

Figs

It is a complete fruit and a cure for piles.

Grapes

Rasulullah s.a.w. was very fond of grapes - it purifies the blood, provides vigor and health, strengthens the kidneys and clears the bowels.

Honey

Considered the best remedy for diarrhea when mixed in hot water. It is the food of foods, drink of drinks and drug of drugs. It is used for creating appetite, strengthening the stomach, eliminating phlegm; as a meat preservative, hair conditioner, eye soother and mouthwash. It is extremely beneficial in the morning in warm water.

Melon

Rasulullah s.a.w. said: "None of your women who are pregnant and eat of watermelon will fail to produce off spring that is good in countenance and good in character."

Milk

Rasulullah s.a.w. said that milk wipes away heat from the heart just as the finger wipes away sweat from the brow. It strengthens the back, improved the brain, renews vision and drives away forgetfulness.

Mushroom

Rasulullah s.a.w. said that mushroom is a good cure for the eyes; it also serves as a form of birth control and arrests paralysis. Not all mushroom are edible.

Olive Oil

Excellent treatment for skin and hair, delays old age, and treats inflammation of the stomach. Good in patients with heart diseases.

Pomegranate

Rasulullah s.a.w. said it cleanses you of Satan and evil aspirations for 40 days.

Vinegar

A food Rasulullah s.a.w. used to eat with olive oil. [That's now a fashion in elite Italian Restaurants]

Water

Rasulullah s.a.w said the best drink in this world is water, when you are thirsty drink it by sips and not gulps, gulping produces sickness of the liver.

Malaria vaccine closer than ever, scientists say

2010-09-29T17:36:00.001+08:00

AFP - Wednesday, September 29 2010

WASHINGTON (AFP) - Scientists are closer than ever to rolling out the first malaria vaccine, which could be available in Africa by 2015, a co-inventor of the shot against the killer disease said Tuesday.

Advanced trials of the RTS,S vaccine against falciparum malaria, the deadliest strain of the disease, are under way in seven African countries and going "very well," said GlaxoSmithKline researcher Joe Cohen, who has been working on developing the vaccine for over 20 years.

"We believe we'll have the first data coming out of the trials in 2012, and, to make a long story short, we could have the first implementation in Africa between 2015 and 2016," he told AFP.

Cohen was speaking at a conference in Washington examining ways to beat malaria.

Some 12,000 children have already been enrolled in the Phase III trials in Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique and Tanzania, which have an enrollment target of 16,000 children.

The trial protocol varies from country to country -- even from village to village -- to take into account cultural sensitivities, but the basics are the same, said Ghana clinical epidemiologist Kwaku Poku Asante and Ally Olutu, a clinician from Kenya. The pair are working on the vaccine trials.

Children have to be in good health to join the trial, and will be followed up for 32 months, Asante said.

The results of smaller-scale phase II trials, which were announced in 2008, showed RTS,S was 53 percent effective against clinical falciparum malaria in young children and up to 65 percent effective in infants, the two groups most at-risk from the parasitic disease.

If RTS,S passes muster in the phase III trials and is licensed, it "will save many, many hundreds of thousands of lives in Africa," even if it is only partially effective against malaria, said Cohen.

But completing the vast trial in Africa and rolling out the vaccine will not signal an end to the process to develop malaria vaccines, he and other researchers warned.

RTS,S is only a stepping stone to wiping out the disease that threatens more than a third of the world's population and kills some 900,000 people a year, most of them in Africa.

According to organizers of the Washington conference, some 200 people die of malaria every hour of every day every year, most of them children in Africa.

Malaria is one of the main obstacles to socio-economic development in Africa, and developing effective vaccines against the disease would have an enormous effect on reducing its negative impact, they said.

"We must look ahead to an even better second generation vaccine, one that is maybe 80 percent effective," said Cohen.

"That vaccine could address the malaria parasites that are prevalent elsewhere in the world, such as Asia and Latin America, where the plasmodium vivax parasite predominates."

But he worried the global economic slump could put the brakes on malaria vaccine research.

"The financial crisis has had a big impact on the package of money that's available," said Cohen.

"Vaccines against other diseases that are ready to be implemented in Africa are being delayed because financing is not available," he added, warning the same could happen to RTS,S if there is no money available for a wide-scale roll-out after it is approved.

PATH Malaria Vaccine Initiative (MVI) director Christian Loucq urged investors from the public and private sectors who teamed up to help make the RTS,S more than just a glint in Cohen's eye to keep investing in malaria research even after the first vaccine becomes reality.

Funding is needed, for instance, to develop a way to "protect the mosquito," said Loucq.

Mosquitoes get the malaria parasite when they bite an infected person, and then pass it back into the human chain when they bite someone else, Loucq explained.

"If you can effectively and widely prevent transmission from human to mosquitoes, you will prevent transmission of the disease. We believe that is our biggest hope for achieving our ultimate goal -- eliminating malaria -- but that's not going to happen before 2025," he said.

"In the meantime, if we forget to keep investing in research we might, like we did in the '60s, once again lose the battle against malaria."

Senarai Daftar Kuliah Anatomi FK USU

2010-09-28T19:50:00.011+08:00

Kuliah Anatomi Blok Basics Biomedical Sciences: Anatomy (FK USU-Batch 2010)

Osteologi

(1) Anatomi tulang ekstremitas superior:
- Istilah dalam osteologi (BBS AO K01&K02-Anatomy)
- Tulang ekstremitas superior dan tulang pada sendi bahu (BBS AO K01&K02-Anatomy):
*Tulang-tulang yang termasuk gelang bahu
*Tulang brachium
*Tulang-tulang antebrachium
*Tulang-tulang carpal
*Tulang-tulang metacarpal & phalanges manus
- Articulatio (BBS AO K01&K02-Anatomy):
*Articulatio humeri, ligamentum & pergerakannya
*Articulatio cubiti, ligamentum & pergerakannya
*Articulatio carpo-metacarpal, ligamentum & pergerakannya
*Articulatio carpo-phalangeal, ligamentum & pergerakannya
*Articulatio interphalangea, ligamentum & pergerakannya

(2) Anatomi tulang ekstremitas inferior:
- Tulang-tulang ekstremitas inferior (BBS AO K03&K04-Anatomy):
*Os Femur
*Os Patella
*Os Tibia
*Os Fibula
*Os Tarsalia
*Os Metatarsalia
*Os Phalanges pedis
- Articulatio (BBS AO K03&K04-Anatomy):
*Articulatio Coxae, ligamentum & pergerakannya
*Articulatio Genu, ligamentum & pergerakannya
*Articulatio Tarso-metatarsal, ligamentum & pergerakannya
*Articulatio Metatarsal-phalangea, ligamentum & pergerakannya terutama pada ibu jari

(3) Anatomi Cranium:
- Pembagian cranium (BBS AO K05&K06-Anatomy):
*Nama bagian-bagian tulang cranium
*Nama-nama lubang pada tulang cranium serta bagian penting yang melaluinya

(4) Anatomi tulang truncus:
- Columna vertebralis & tulang thoraks (BBS AO K07&K08-Anatomy):
*Vertebra Cervicalis
*Vertebra Thoracalis
*Vertebra Lumbalis
*Os Sacrum
*Os Coccygeus
*Os Sternum
- Persendian (BBS AO K07&K08-Anatomy):
*Articulatio pada Condylus occipitalis, os Atlas, os Episthropheus & vertebra lainnya
*Ligamentum pada articulatio Atlanto-occipitalis, Atlanto-axialis & Collumna vertebralis
*Gerakan-gerakan pada sendi tersebut
*Lengkungan pada Collumna vertebralis
*Articulatio Costo-vertebralis
*Ligamentum pada articulatio Costo-vertebralis

Ekstremitas Superior

(1) Anatomi ekstremitas superior:
- Otot-otot (BBS AO K09&K10-Anatomy):
*Otot-otot Trunco-cingulo
*Otot-otot Cingulo-extremitatum
*Otot-otot Trunco-extremitatum
*Otot-otot pada Antebrachium
*Otot-otot, tendon & jaringan ikat pada carpus
*Otot-otot, tendon & jaringan ikat pada manus
*Otot-otot, tendon & jaringan ikat pada digitum manus

(2) Vaskularisasi dan inervasi:
- Regio Axilla (BBS AO K11&K12-Anatomy):
*Dinding fossa axillaris
*Isi fossa axillaris
- Innervasi (BBS AO K11&K12-Anatomy):
*Plexus Brachialis
*Nervus Axillaris
*Nervus Radialis
*Nervus Medianus
*Nervus Ulnaris
*Nervus Musculocutaneus
- Vaskularisasi (BBS AO K11&K12-Anatomy):
*Perjalanan pembuluh ateri, vena & lymph

Extremitas inferior

(1) Anatomi ekstremitas inferior:
- Batas regio femoris (BBS AO K13&K14-Anatomy):
*Batas atas (depan, belakang), bawah
*Regio subinguinal
*Regio femoris posterior
*Regio femoris anterior
*Regio poplitea
- Otot-otot (BBS AO K13&K14-Anatomy):
*Otot-otot yang berasal dari os Ischii serta insertionya
*Otot-otot paha yang berasal dari bagian abdomen/ pelvis serta insertionya
*Otot-otot paha yang berasal dari os pubis serta insertionya
*Otot-otot paha yang berasal dari os femur serta insertionya
*Tendon & otot-otot pada fossa poplitea & regi Genu
*Otot-otot ventral cruris
*Otot-otot dorsal cruris
*Tendon & ligamentum pada pergelangan kaki
*Tendon & otot-otot pada pedis bagian dorsal & plantar sampai digitae

(2) Vaskularisasi dan inervasi:
- Innervasi (BBS AO K15&K16-Anatomy):
*Persarafan sensorik & motorik paha depan & belakang
*Persarafan sensorik & motorik cruris & pedis
- Vaskularisasi (BBS AO K15&K16-Anatomy):
*Perjalanan pembuluh arteri, vena & lymph

Kepala dan Leher

(1) Anatomi kepala dan leher:
- Regio di leher (BBS AO K17&K18-Anatomy):
*Regio yang terdapat di leher
*Pembagian Trigonum colli
*Alat-alat penting yang terdapat/ melalui pada Trigonum colli
*Thyroid glang
*Parathyroid gland
- Otot-otot kepala (BBS AO K17&K18-Anatomy):
*Otot-otot kepala
*Origo & insertio otot kepala
- Otot-otot muka (BBS AO K17&K18-Anatomy):
*Otot-otot muka
*Origo & insertio otot muka
- Otot-otot leher (BBS AO K17&K18-Anatomy):
*Otot-otot leher
*Origo & insertio otot-otot leher

(2) Vaskularisasi dan inervasi:
- Vaskularisasi (BBS AO K19&K20-Anatomy):
*Vaskularisasi pada leher dan kepala
- Inervasi (BBS AO K19&K20-Anatomy):
*Persarafan oleh otot-otot kepala, muka & leher

Thorax

(1) Dinding thoraks:
- Otot dinding thoraks (BBS AO K21&22-Anatomy):
*Otot-otot intercostalis
*Otot-otot dinding dada
- Perdarahan dan persarafan dinding thoraks (BBS AO K21&K22-Anatomy)

(2) Jantung:
- Pericardium (BBS AO K21&K22-Anatomy):
*Struktur pericardium
*Cavum pericardium
- Struktur jantung (BBS AO K21&K22-Anatomy):
*Pembagian ruang jantung
*Otot jantung
*Proyeksi jantung pada dinding thorax
- Vaskularisasi jantung (BBS AO K23&K24-Anatomy):
*Arteri coronaria dengan percabangannya
*Vena cordis dengan percabangannya
- Innervasi jantung (BBS AO K23&K24-Anatomy):
*Sistem konduktiviti
*Persarafan otot jantung

(3) Paru & mediastinum:
- Pleura (BBS AO K23&K24-Anatomy):
*Struktur pleura
*Cavum pleura
*Vaskularisasi pleura
*Inervasi pleura
*Aliran lymphe pleura
- Hilus pulmonalis (BBS AO K23&K24-Anatomy):
*Struktur dan alat-alat yang dilaluinya
- Pulmo (BBS AO K23&K24-Anatomy):
*Bagian-bagian pulmo
*Vaskularisasi pulmo
*Inervasi pulmo
*Aliran lymphe pulmo
- Proyeksi paru pada dinding thorax (BBS AO K23&K24-Anatomy)

(4) Thymus:
- Anatomi thymus (BBS AO K23&K24-Anatomy):
*Struktur thymus
*Thymus sebagai organ endokrin

Abdomen

(1) Anatomi abdomen:
- Otot-otot (BBS AO K25&K26-Anatomy):
*Otot-otot dinding perut
*Vagina musc. rectus abdominis
*Linea alba
*Linea semilunaris
*Linea semicircularis
*Trigonum lumbale
- Tisu Penghubung (BBS AO K25&K26-Anatomy):
*Ligamentum inginale
*Ligamentum interoveolare
*Anulus inguinalis superficialis
*Anulus inguinalis profundus
*Canalis inguinalis
- Vaskularisasi dinding perut (BBS AO K25&K26-Anatomy)
- Innervasi sensorik & motorik otot-otot dinding perut (BBS AO K25&K26-Anatomy)
- Peritoneum (BBS AO K25&K26-Anatomy):
*Peritoneum parietale
*Peritoneum viscerale

(2) Organ abdomen:
- Gaster (BBS AO K25&K26-Anatomy):
*Anatomi gaster
- Intestinum (BBS AO K25&K26-Anatomy):
*Intestinum tenue & crassum
- Pancreas (BBS AO K25&K26-Anatomy):
*Anatomi pancreas
- Hepar (BBS AO K25&K26-Anatomy):
*Anatomi hepar
- Lien (BBS AO K25&K26-Anatomy):
*Anatomi lien

Pelvis

(1) Embryology (Organogenesis):
- Pembentukan & Perkembangan alat kencing (BBS AO K27&K28-Anatomy):
*Pembentukan ginjal
*Pembentukan ureter & vesica urinaria
*Kelainan perkembangan ginjal

(2) Renal:
- Struktur renal (BBS AO K27&K28-Anatomy):
*Bentuk renal
*Letak renal
*Bagian-bagian renal
*Pembungkus renal
- Hubungan renal dengan alat sekitarnya (BBS AO K27&K28-Anatomy):
*Tisu penghubung yang menghubungkan renal dengan alat sekitar
*Vaskularisasi, persarafan & aliran limfa renal

(3) Ureter:
- Struktur (BBS AO K27&K28-Anatomy):
*Panjang ureter
*Diameter ureter
*Tempat-tempat penyempitan pada lumen ureter
*Vaskularisasi, persarafan & aliran limfa ureter

(4) Vesica urinaria:
- Struktur vesica urinaria (BBS AO K27&K28-Anatomy):
*Bentuk vesica urinaria
*Ukuran vesica urinaria
*Letak vesica urinaria
*Bagian-bagian vesica urinaria
- Otot-otot (BBS AO K27&K28-Anatomy):
*Arah serabut otot pada dinding vesica urinaria
- Vaskularisasi, persarafan & aliran limfa vesica urinaria (BBS AO K27&K28-Anatomy)

(5) Urethra:
- Urethra laki-laki & perempuan (BBS AO K27&K28-Anatomy)

(6) Adrenal gland:
- Pembagian zona kelenjar adrenal (BBS AO K27&K28-Anatomy)

Susunan Saraf Pusat

(1) Medulla spinalis & Medulla oblongata:
- Penampang melintang medulla spinalis & medulla oblongata (BBS AO K29&K30-Anatomy)
- Tractus Ascendens (BBS AO K29&K30-Anatomy)
- Tractus Descendens (BBS AO K29&K30-Anatomy)
- Pembuluh darah (BBS AO K29&K30-Anatomy)
- Ganglion spinalis & Radices spinalis (BBS AO K29&K30-Anatomy)
- Pembungkus Medulla spinalis (BBS AO K29&K30-Anatomy)
- Persarafan radikularis (BBS AO K29&K30-Anatomy)

(2) Cerebellum & Pons:
- Pedunculus cerebellaris (BBS AO K29&K30-Anatomy)
- Cortex cerebellaris (BBS AO K29&K30-Anatomy)
- Neuronal Circuit (BBS AO K29&K30-Anatomy)
- Tractus saraf (BBS AO K29&K30-Anatomy)

(3) Diencephalon:
- Epithalamus & Pineal (BBS AO K29&K30-Anatomy)
- Thalamus (BBS AO K29&K30-Anatomy)
- Hypothalamus (BBS AO K29&K30-Anatomy)
- Hypophysis (BBS AO K29&K30-Anatomy)

(4) Telencephalon:
- Organisasi hemispheri cerebri (BBS AO K29&K30-Anatomy)
- Lobus cerebri (BBS AO K29&K30-Anatomy)
- Basal ganglia (BBS AO K29&K30-Anatomy)
- Proyeksi saraf (BBS AO K29&K30-Anatomy)

(5) Sistem pembuluh darah:
- Arteri (BBS AO K29&K30-Anatomy)
- Vena (BBS AO K29&K30-Anatomy)

(6) Sistem Liquor Cerebrospinalis:
- Meningen (BBS AO K29&K30-Anatomy)
- Ventrikel (BBS AO K29&K30-Anatomy)
- Sinus duramatriks (BBS AO K29&K30-Anatomy)

Susunan saraf tepi

(1) Nervi spinalis:
- Plexus Cervicalis (BBS AO K31&K32-Anatomy):
*Rami Posterior
- Plexus Brachialis (BBS AO K31&K32-Anatomy):
*Pars Supraclavicularis
*Pars Infraclavicularis
- Fasciculus Lateralis (BBS AO K31&K32-Anatomy)
- Fasciculus Medialis (BBS AO K31&K32-Anatomy)
- Fasciculus Posterior (BBS AO K31&K32-Anatomy)
- Saraf batang tubuh (BBS AO K31&K32-Anatomy)
- Plexus Lumbosacralis (BBS AO K31&K32-Anatomy)
- Plexus Sacralis (BBS AO K31&K32-Anatomy)

(2) Sistem saraf vegetatif:
- Truncus symphateticus (BBS AO K31&K32-Anatomy)
- Saraf-saraf vegetatif (BBS AO K31&K32-Anatomy)

Kuliah Anatomi Blok Control System (FK USU-Batch 2007)

Central Nervous System

(1) Anatomical Structure of Central Nervous System:
- Medulla Spinalis (CS K03-Anatomy):
*Substansia Grisea
*Tractus Ascendens
*Tractus Descendens
*Pembuluh darah
*Ganglion spinalis & Radices Posterior
*Pembungkus Medulla Spinalis
*Persarafan Radikularis
- Cerebellum (CS K04-Anatomy):
*Pedunculus Cerebellaris
*Cortex Cerebellaris
*Sirkuit Neuronal
*Tractus Nervus
- Diencephalon (CS K04-Anatomy):
*Perkembangan Proencephalon
*Epithalamus
*Thalamus dorsalis
*Thalamus ventralis/ subthalamus
*Hypothalamus
*Hypophysis
- Telencephalon (CS K05-Anatomy):
*Organisasi hemispheri
*Corpus amygdala
*Cortex hippocampus
*Cortex striatum
*Insula
*Neocortex
*Lobus frontalis
*Lobus parietalis
*Lobus temporalis
*Lobus occipitalis
- Sistem Pembuluh Darah (CS K06-Anatomy):
*Arteri
*Vena
- Sistem Liquor Cerebrospinalis (CS K06-Anatomy):
*Plexus choroideus
*Ependyma
*Meningen

Peripheral Nervous System

(1) Anatomical Structure of Peripheral Nervous System:
- Nervi Spinalis (CS K18-Anatomy):
*Saraf tepi
*Plexus
*Plexus cervicalis: Rami posterior
*Plexus brachialis: Pars supraclavicularis, Pars infraclavicularis
*Fasciculus lateralis
*Fasciculus medialis
*Fasciculus posterior
*Saraf batang tubuh
*Plexus lumbosacralis
*Plexus sacralis
- Sistem Saraf Vegetatif (CS K19-Anatomy):
*Truncus symphatheticus
*Saraf-saraf vegetatif

Endocrine System

(1) Anatomical Structure of Endocrine Organs:
- Organs of Endocrine (CS K28-Anatomy):
*Hypophysis & Pituitary
*Thyroid gland
*Parathyroid gland
*Pineal gland
*Pancreas
*Adrenal gland

Kuliah Anatomi Blok Reproductive System (FK USU-Batch 2007)

Struktur Organ dan Fisiologi Sistem Reproduksi serta Kehamilan Normal

(1) Struktur Organ Reproduksi Lelaki dan Wanita:
- Anatomi Organ Reproduksi Wanita (RS K01-Anatomy):
*Embriologi dari organ reproduksi wanita
*Anatomi pelvis: Tulang pelvis, sendi dan otot pelvis, bidang dan diameter pelvis, bentuk pelvis, ukuran pelvis dan estimasi klinis
*Otot-otot diaphragma pelvis
*Celah-celah pinggul: Rongga peritoneum, celah sub peritoneal, fossa ischiorectalis
*Organ reproduksi wanita eksternal: Mons pubis, labia mayora, labia minora, clitoris, glandula vestibuli mayor, perineum
*Organ reproduksi wanita internal: Uterus, vagina, tuba falopii, ovarium
*Vaskularisasi dan persarafan organ reproduksi
*Payudara: Anatomi, vaskularisasi, kelenjar lymph
- Anatomi Organ Reproduksi Lelaki (RS K03-Anatomy):
*Embriologi/ perkembangan organ reproduksi lelaki
*Gonad: Testis
*Saluran: Ekstratestikular, intratestikular
*Kelenjar: Epidydimis, vesikula seminalis, prostat, vestibula bulbourethralis (cowperi)

Kuliah Anatomi Blok Growth and Development (FK USU-Batch 2007)

Tumbuh kembang neonatus dan perinatal

(1) Pertumbuhan dan perkembagan:
- Perkembangan tulang dan sistem saraf (GDS K04&K05-Anatomy):
*Osifikasi tulang tengkorak
*Osifikasi tulang panjang
*Perkembangan otak

Kuliah Anatomi Blok Musculo-Skeletal System (FK USU-Batch 2007)

Struktur Organ Muskulo-Skeletal

(1) Anatomi alat gerak:
- Anatomi Umum (MSS K01-Anatomy):
*Osteologi: Tulang dan jenis-jenisnya, istilah bangunan tulang, jenis-jenis hubungan antara tulang.
*Arthrologi: Prinsip mekanik gerakan pada persendian, jenis-jenis persendian, struktur persendian dan bahagian-bahagiannya.
*Myologi: Otot dan jenis-jenisnya, struktur jaringan otot skelet, selubung dan perlekatannya, morfologi otot skelet, jenis-jenis otot skelet menurut bentuk, susunan serabut dan bahagiannya, bentuk dan fungsi bursa mukosa dan vagina tendinosa.
- Anatomi ekstremiti superior (MSS K02-Anatomy):
*Tulang-tulang pada ekstremiti superior: Tulang-tulang yang termasuk gelang bahu, tulang-tulang antebrachium, tulang-tulang carpal, metacarpal dan phalanges manus.
*Articulatio: Articulatio pada ekstremiti superior.
*Otot-otot: Otot-otot pada ekstremitas superior.
*Region Axilla: Dinding fossa axillaris dan isi fossa axillaris.
*Innervasi: Persarafan pada ekstremiti superior.
*Vaskularisasi: Perjalanan arteri, vena, dan limfe pada ekstremitas superior.
- Anatomi ekstremiti Inferior (MSS K02-Anatomy):
*Batas region femoris: Batas atas regio femoris, batas belakang regio femoris, batas depan regio femoris dan batas bawah regio femoris. Regio subinguinal, regio femoris inferior dan posterior, regio poplitea.
*Tulang-tulang pada ekstremiti inferior: Tulang-tulang pada ekstremiti inferior.
*Articulatio: Articulatio pada ekstremiti inferior.
*Otot-otot: Otot-otot pada ekstremiti inferior.
*Innervasi: Persarafan pada ekstremiti inferior.
*Vaskularisasi: Perjalanan arteri, vena, dan limfe pada ekstremitas inferior.

Kuliah Anatomi Blok Cardio-Vascular System (FK USU-Batch 2007)

Struktur Anatomi, Histologi Dan Fisiologi Kardio-Vaskular

(1) Struktur Sistem Kardiovaskular:
- Embriologi dan Anatomi Sistem Kardio-Vaskular (CVS K01.1&K01.2-Anatomy):
*Embriologi cardio-vascular system: Pembentukan tube/ saluran jantung.
*Embriologi cardio-vascular system: Pembentukan loop/ simpul jantung; Truncus arteriosus; Bulbus/conus cordis; ventricle; atrium; sinus venosus.
*Embriologi cardio-vascular system: Pembentukan septum/ sekat jantung; Septum pada atrium-septum primum-septum spurium-septum sekundum; septum ventrikel; septum pada trunkus dan konus; septum atrioventricular canal.
*Embriologi cardio-vascular system: Pembentukan katup bikuspid, trikuspid, katup semilunar. Fisiologi otot jantung, Siklus jantung/ Cardiac cycle, otot jantung sebagai pompa/ pengepam.
*Perubahan sistem sirkulasi janin menjadi sistem sirkulasi normal.
*Anatomi cardio-vascular system: Letak jantung, ruang, sekat, dan katup-katup jantung dan hubungannya dengan organ lain didalam rongga toraks.
*Anatomi cardio-vascular system: Sistem konduksi jantung.
*Anatomi cardio-vascular system: Sistem sirkulasi darah besar dan sirkulasi kecil, serta sistem arteri, sistem vena, sistem limfatik, dan hubungan antara ketiganya.
*Anatomi cardio-vascular system: Sistem pembuluh darah arteri koroner dan vena jantung.

Kuliah Anatomi Blok Respiratory System (FK USU-Batch 2007)

Struktur Anatomi, Histologi Dan Fisiologi Sistem Respirasi

(1) Organogenesis:
- Pembentukan & Perkembangan Tracheobronchi dengan cabang-cabangnya (RTS K01-Anatomy)

(2) Anatomi saluran nafas:
- Pembentukan dan perkembangan paru (RTS K01-Anatomy)
- Trachea (RTS K01-Anatomy):
*Struktur trachea
*Percabangan trachea
- Bronchus (RTS K01-Anatomy):
*Struktur broncus
*Percabangan broncus sampai ke alveolus
- Pleura (RTS K01-Anatomy):
*Struktur pleura
*Cavum pleura
*Vaskularisasi, inervasi, dan aliran limfe pleura
- Hilus Pulmonalis (RTS K01-Anatomy):
* Organ-organ yang dilaluinya

(3) Anatomi Paru:
- Pulmo (RTS K01-Anatomy):
*Bahagian-bahagian pulmo
*Vaskularisasi, inervasi, dan aliran limfe pulmo
*Proyeksi paru pada dinding thorax
*Menentukan batas dan bentuk dada
- Struktur Anatomi Dinding Dada (RTS PR01-Anatomy):
*Letak dan struktur kulit, fascia dan otot-otot pada dinding dada
*Struktur diafragma
- Struktur Anatomi Paru (RTS PR03-Anatomy):
*Struktur trachea dan main bronchus kiri dan kanan serta struktur-struktur pendukungnya.
*Struktur pleura visceralis dan lanjutannya.
*Struktur paru dan struktur-struktur pendukungnya.

Kuliah Anatomi Blok Genito-Urinary System (FK USU-Batch 2007)

Struktur Organ Sistem Genito-urinari

(1) Embryologi (organogenesis):
- Pembentukan dan perkembangan alat kencing (GUS K01-Anatomy):
*Pembentukan ginjal
*Pembentukan ureter dan vesica urinaria
*Kelainan perkembangan ginjal

Kuliah Anatomi Blok Gastro-Intestinal System (FK USU-Batch 2007)

Struktur Organ Sistem Gastro-Intestinal

(1) Embryologi (Organogenesis):
- Pembentukan dan perkembangan alat-alat saluran cerna (GIS K01-Anatomy):
*Perkembangan alat-alat yang berasal dari foregut
*Perkembangan alat-alat yang berasal dari midgut
*Perkembangan alat-alat yang berasal dari hindgut

(2) Struktur anatomi sistem gastro-intestinal:
- Pembahagian rongga mulut (GIS K01-Anatomy):
*Cavum oris propil
*Vestibulum oris
- Struktur anatomi gigi (GIS K01-Anatomy):
*Bahagian-bahagian dari gigi
*Jenis-jenis gigi
- Struktur anatomi kelenjar liur (GIS K01-Anatomy):
*Jenis-jenis kelenjar liur
*Bahagian-bahagian dari kelenjar liur major
- Struktur anatomi articulatio dan otot-otot mastikasi (GIS K01-Anatomy):
*Bahagian-bahagian dari articulatio temporo-mandibularis
*Otot-otot yang berperanan pada proses mastikasi
- Struktur anatomi pharynx dan oesophagus (GIS K01-Anatomy):
*Batas-batas pharynx
*Bahagian-bahagian pharynx
*Otot-otot yang membentuk dinding pharynx
*Bahagian-bahagian oesophagus
- Struktur anatomi dinding perut dan peritoneum (GIS K01-Anatomy):
*Otot-otot dinding perut
*Vagina musc. recti abdominis
*Linea alba
*Linea semilunaris
*Linea semicircularis
*Trigonum lumbale
*Umbilicus
*Ligamen inguinal
*Ligamen interfoveolare
*Anulus inguinalis superficialis
*Anulus inguinalis profundus
*Canalis inguinale
*Inervasi motorik dan sensorik
*Vaskularisasi dinding perut
*Peritoneum parietale dan visceral
*Alat-alat intraperitoneal & retroperitoneal
*Mesenterium
*Mesocolon transversum
*Messosigmoideum
*Omentum major
*Omentum minor
*Ligamen phrenicolienale
*Ligamen gastrolienale
*Bursa omentalis
*Foramen epiploicum
- Struktur anatomi gaster (GIS K02-Anatomy):
*Gaster, bentuknya, letaknya, dan alat penggantungannya
*Bahagian permukaan dalamdan permukaan luar gaster, spincter pada gaster
*Hubungan gaster dengan alat sekitarnya
- Struktur anatomi intestinum (GIS K02-Anatomy):
*Duodenum, bahagian-bahagiannya, dan gambaran permukaan dalamnya
*Hubungan duodenum dengan alat sekitarnya
*Jejunum dan ileum
*Pembagian intestinum, hubungan dengan peritoneum dan lapisan-lapisannya
*Perbezaan jejunum dan ileum
*Caecum, appendix vermicularis, colon ascenden, colon descenden, colon sigmoid, dan rectum
*Perbezaan intestinum tenue & crassum
- Hepar, vesica vellea, pancreas, & lien (GIS K02-Anatomy):
*Permukaan dan tepi hepar, lobus & segmentum
*Kedudukan hepar dengan alat-alat sekitarnya
*Sirkulasi darah di hepar dan pembuluh darah yang keluar masuk hepar
*Porta hepatis dan alat-alat yang melaluinya
*Bahagian dan letak vesica fellea serta salurannya
*Bahagian dan letak pancreas serta salurannya
*Bahagian lien, letak dan alat penggantungnya
- Vascularisasi, innervasi & aliran lymph alat-alat dalam perut (GIS K02-Anatomy):
*Cabang-cabang aorta abdominalis dan distribusinya
*Vena porta dan pembuluh darah vena lain di abdomen
*Saraf simpatis dan parasimpatis di perut
*Aliran limfe abdomen

Kuliah Anatomi Blok Special Sense System (FK USU-Batch 2007)

Struktur makroskopik dan mikroskopik sistem penglihatan

(1) Anatomi sistem penglihatan:
- Embriologi/ Organogenesis (SSS K01-Anatomy):
*Perkembangan komponen-komponen bola mata
*Pembentukan dan perkembangan glandula lacrimalis
*Kelainan perkembangan bola mata dan glandula lacrimalis

Struktur organ pada sistem Telinga Hidung dan Tekak (THT)

(1) Anatomi THT:
- Pembentukan dan perkembangan auris externa, media & interna serta kelainan perkembangan alat pendengaran (SSS K22-Anatomy)
- Jenis pengecapan dan lokasi pengecapan (SSS K23-Anatomy):
*Jenis pengecapan yang umum dan lain-lain
*Lokasi pengecapan
*Penyebaran pengecapan
*Saraf pengecapan
*Jenis pucuk pengecapan dan spesifikasinya
- Struktur anatomi daerah tempat penghiduan (SSS K23-Anatomy):
*Besar daerah hidung tempat penghiduan
*Saraf penghiduan
*Lokasi dan penyebarannya
*Bentuk pucuk penghidu
*Pucuk penghidu dan penyebarannya

Kuliah Anatomi Blok Brain and Mind System (FK USU-Batch 2007)

Struktur dan Fungsi Sistem Saraf Pusat dan Perifer

(1) Formatio Reticularis:
- Dasar-dasar struktural formatio retikularis (BMS K01&P01-Anatomy):
*Daerah formatio reticularis
*Posisi columna lateralis, medialis & mediana formatio reticularis di dalam batang otak
*Proyeksi aferen dan eferen formatio reticularis

(2) Sistem Limbik:
- Dasar-dasar struktural sistem limbik (BMS K01&P01-Anatomy):
*Daerah sistem limbik
*Gyrus subcalosus, gyrus cinguli, parahippocampalis, formatio hippocampi, nucleus amygdala, gyrus corpus mammilare, dan nucleus anterior thalami
* Jaras penghubung sistem limbik, alveus, fimbria, fornix, tractus mammilothalamicus, dan stria terminalis

Senarai Daftar Kuliah Blok Basics Biomedical of Sciences in Elective (FK USU-Batch 2007)

(1) Pendahuluan Anatomi:
- Posisi anatomi (BBS E K01-Anatomy)
- Arah dan bidang anatomi (BBS E K01-Anatomy)
- Istilah dalam osteologi (BBS E K01-Anatomy)
- Persendian (BBS E K01-Anatomy)

(2) Cranium:
- Anatomi Cranium (BBS E K02-Anatomy):
*Nama bahagian-bahagian tulang cranium
*Nama-nama lubang pada tulang cranium serta bahagian penting yang melaluinya

(3) Kepala dan leher:
- Anatomi kepala dan leher (BBS E K03-Anatomy):
*Regio yang terdapat di leher
*Pembahagian Trigonum colli
*Alat-alat penting yang terdapat/ melalui pada Trigonum colli
*Thyroid gland
*Parathyroid gland
*Otot-otot kepala
*Origo dan insertio otot kepala
*Otot-otot muka
*Origo dan insertio otot muka
*Otot-otot leher
*Origo dan insertio otot-otot leher
*Vaskularisasi pada leher dan kepala
*Persarafan oleh otot-otot kepala, muka dan leher

(4) Ekstremiti:
- Dinding fossa axillaris (BBS E K04-Anatomy)
- Isi fossa axillaris (BBS E K04-Anatomy)
- Plexus Brachialis (BBS E K04-Anatomy)
- Nervus Axillaris (BBS E K04-Anatomy)
- Nervus Radialis (BBS E K04-Anatomy)
- Nervus Medianus (BBS E K04-Anatomy)
- Nervus Ulnaris (BBS E K04-Anatomy)
- Nervus Musculocutaneus (BBS E K04-Anatomy)
- Perjalanan pembuluh arteri, vena, dan limfa (BBS E K04-Anatomy)
- Persarafan sensorik dan motorik paha depan dan belakang (BBS E K04-Anatomy)
- Persarafan sensorik dan motorik cruris dan pedis (BBS E K04-Anatomy)

(5) Batang tubuh, thoraks, dan abdomen:
- Vertebra Cervical (BBS E K05-Anatomy)
- Vertebra Thorax (BBS E K05-Anatomy)
- Vertebra Lumbar (BBS E K05-Anatomy)
- Os Sacrum (BBS E K05-Anatomy)
- Os Coccyx (BBS E K05-Anatomy)
- Os Sternum (BBS E K05-Anatomy)
- Articulatio pada Condylus occipitalis, os Atlas, os Episthropheus, vertebra lainnya (BBS E K05-Anatomy)
- Ligamentum pada Articulatio (BBS E K05-Anatomy)
- Atlanto-occipitalis, Atlanto-axialis, dan Collumna vertebralis (BBS E K05-Anatomy)
- Gerakan-gerakan pada sendi tersebut (BBS E K05-Anatomy)
- Lengkungan pada Collumna vertebralis (BBS E K05-Anatomy)
- Articulatio Costo-vertebralis (BBS E K05-Anatomy)
- Ligamentum pada Articulatio Costo-vertebralis (BBS E K05-Anatomy)
- Perdarahan dan persarafan dinding thoraks (BBS E K05-Anatomy)
- Arteri Coronaria dengan percabangannya (BBS E K05-Anatomy)
- Sistem konduktiviti (BBS E K05-Anatomy)
- Persarafan otot jantung (BBS E K05-Anatomy)
- Otot-otot dinding perut (BBS E K05-Anatomy)
- Vagina musculus rectus abdominis, Linea alba, Linea semilunaris, Linea semicircularis, Trigonum lumbale (BBS E K05-Anatomy)
- Ligamentum inguinal (BBS E K05-Anatomy)
- Ligamentum interoveolare (BBS E K05-Anatomy)
- Anulus inguinalis superficialis (BBS E K05-Anatomy)
- Anulus inguinalis profundus (BBS E K05-Anatomy)
- Canalis inguinalis (BBS E K05-Anatomy)
- Vaskularisasi dinding perut (BBS E K05-Anatomy)
- Innervasi sensorik dan motorik otot-otot dinding perut (BBS E K05-Anatomy)
- Peritoneum parietale (BBS E K05-Anatomy)
- Peritoneum viscerale (BBS E K05-Anatomy)

(6) Susunan Saraf Pusat:
- Medulla Spinalis dan medulla oblongata (BBS E K06-Anatomy):
*Penampang melintang medulla spinalis dan medulla oblongata
*Tractus Ascendens
*Tractus Descendens
*Pembuluh darah
*Ganglion Spinalis dan Radices spinalis
*Pembungkus Medulla Spinalis
*Persarafan Radikularis
- Cerebellum dan Pons (BBS E K06-Anatomy):
*Pedunculus Cerebellaris
*Cortex cerebellaris
*Sirkuit Neuronal
- Tractus saraf (BBS E K06-Anatomy)
- Diencephalon (BBS E K06-Anatomy):
*Epithalamus dan Pineal
*Thalamus
*Hypothalamus
*Hypophysis
- Telencephalon (BBS E K06-Anatomy):
*Organisasi hemispheri cerebri
*Lobus cerebri
*Basal ganglia
*Projeksi saraf
- Sistem pembuluh darah: Arteri dan Vena (BBS E K06-Anatomy)
- Sistem Liquor Cerebrospinalis (BBS E K06-Anatomy):
*Meningen
*Ventrikel
*Sinus duramatriks

(7) Susunan Saraf Tepi:
- Nervi spinalis (BBS E K07-Anatomy)
- Plexus Cervical (BBS E K07-Anatomy):
*Rami Posterior
- Plexus Brachialis (BBS E K07-Anatomy):
*Pars Supraclavicularis
*Pars Infraclavicularis
- Fasciculus Lateralis (BBS E K07-Anatomy)
- Fasciculus Medialis (BBS E K07-Anatomy)
- Fasciculus Posterior (BBS E K07-Anatomy):
*Saraf batang tubuh
*Plexus lumbosacral
- Plexus Sacral (BBS E K07-Anatomy)
- Sistem saraf vegetatif (BBS E K07-Anatomy):
*Truncus symphatheticus
*Saraf-saraf vegetatif

Buah Jering

2010-09-28T18:53:00.007+08:00

Buah Jering

General

Jering, is a species of flowering tree in the pea family, Fabaceae, that is native to Southeast Asia. Its beans are a popular food in Indonesia (where they are known as jengkol), and are also consumed in Malaysia (where they are known as jering), Myanmar (where they are called da nyin thee) and in Southern Thailand, where it is called luk-nieng or luk neang. The large brown legumes are very popular and cooked as satay or curry, especially rendang, in Indonesia.

The beans are mildly toxic due to the presence of djenkolic acid, an amino acid, which causes djenkolism (jengkol bean poisoning). It causes "spasmodic pain, gout, urinary obstruction and acute renal failure". The condition mainly affects men, and is not determined by how the beans are prepared, and individuals can consume the beans on multiple occasions without incident, to develop renal failure on another occasion.

Scientific classification

- Kingdom: Plantae
- Phylum: Magnoliophyta
- Class: Magnoliopsida
- Order: Fabales
- Family: Fabaceae
- Genus: Archidendron
- Species: A. jiringa

Binomial name
Archidendron pauciflorum
(Benth.) I.C.Nielsen

Synonyms
Archidendron jiringa
Pithecellobium jiringa
Pithecellobium lobatum

Botanical name for buah jering is Archidendron Jiringa. Buah jering originated in Southeast Asia, it grows wild and also cultivated in Southeast Asia. Rarely grown outside Southeast Asia.

Jering are medium-sized trees that can reach 20 m in height. The bark is smooth and light grey in color. The leaves are compound, two pinnate up to 25 cm long, leaf stalks up to 6 cm long.

The leaflets are 8-25 cm ling, 4-5 cm wide, ovate to booing in shape, light green, shiny.

Young leave are soft, purplish red in color. Young leaf are normally produced on the whole tree at the same time.

Fruit is a legume, 5 cm wide, twisted in a spiral, purplish brown in color. Seeds large, testa yellowish when young, reddish brown when mature, the edible cotyledons are yellowish when young, becoming orange brown when mature.

Health benefits

Leaves are pounded and applied in chest pains, pains, skin ailments. Ashes obtained by burning the old leaves are applied on itch. Ashes obtained by burning the young leaves are applied on cuts, wounds.

Bark are pounded and applied on chest pains, pains, skin ailments, made into a gargle for treating gum pains, toothache.

Fruits are eaten at meal tome to treat diabetes, hypertension.