Senin, 04 Mei 2009

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Re-emergence of chikungunya: epidemiology and roles of vector in the transmission of the disease

By Suriptiastuti
Chikungunya (CHIK) fever is a disease caused by virus of the genus Alphavirus in the family Togaviridae which is transmitted to human by the bite of infected mosquito. The vector of this disease is the Aedes aegypti and Ae. albopictus. The disease was first described by Robinson and Lumsden in 1955 following an outbreak on the Makonde Plateau in 1952. Like malaria and dengue, CHIK has been endemic in Africa and Asia and has caused epidemics in those places. The clinical features of CHIK fever include sudden onset of fever, arthralgia, and rash. CHIK is a self-limiting disease. There is no specific drug therapy available, treatment of CHIK fever is supportive. Therefore, controlling the vector is an effective mean to prevent the disease.


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Prevention and Control of Typhoid Fever

By : Soeharyo Hadisaputro

Typhoid fever (TF) is still an important public health problem in many developing countries. In Indonesia, the incidence of TF is estimated about 300 – 810 cases per 100.000 population per year or about 600.000 to 1.500.000 cases per year. The case fatality of TF is estimated 50.000 per year.
Typhoid fever is a systemic infection characterized by continued fever, involvement of lymphoid tissue especially Peyer's patches, spleen enlargement, rose spot on trunk and constipation which is more common than diarrhea.
Mode of transmission of TF is by indirect or direct contact with patients or carriers. The main vehicle of spreading is contaminated water and food. Row fruits and vegetables are important factors in some parts of the world, milk or milk products and shellfish are in others. Transmission to new host occurs through contaminated foods, fluid, fingers, vomites and flies. All ages and both sexes are equally susceptible to infection, however, males are more frequent than female.
Prevention of TF based on epidemiologic factors which act. The prevention of TF includes agent approach, environment strategies and host approach. Prevention strategies and control of TF are : disease surveillance, vaccination of persons at risk, detection and treatment of cases (acute and convalescent), detection and control of chronic carriers, sanitation improvement, protection of animal stocks, promotion of food hygiene and prevention from contaminated food production. Health education in the community has an important role in prevention of TF, particularly about personal hygiene such as washing hands before meal, and providing clean water for washing hand in the public services.


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The benefits and risks of Echinacea in treatment of common cold and influenza

By Yenny* and Zunilda Djanun

The common cold is one of the world’s most prevalent illnesses in adults and children. This upper respiratory tract infection is caused by different kinds of agents. Effects on health, well-being, and productivity are significant. Preparations made from plants of the genus Echinacea are widely used for the prevention and treatment of colds. Three species of Echinacea used for medicinal purposes are Echinacea purpurea, Echinacea angustifolia, and Echinacea pallida. The beneficial effects of Echinacea are thought to be due to its immunomodulatory activity, most notably activation of macrophages, polymorphonuclear leukocytes and natural killer cells. Many clinical trials, including a number of blind randomized trials, have reported health benefits. Although these studies show beneficial effects, recommendations on Echinacea use cannot be made due to lack of product standardization and variability in dosage, sample size and methodological quality used in the trials. Therefore, well-designed studies with consistent standardized measures are required for assessment of the efficacy of Echinacea in treatment of common cold and influenza.


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The role of tea in cardiovascular disease

By Fajar Arifin Gunawijaya

Tea is an infusion of the leaves of the Camellia sinensis plant, which is not to be confused with so-called ‘herbal’ teas. Some biologically active chemicals in tea include flavonoids, caffeine and fluoride. For as long as people have been drinking tea, there have been health benefits associated with it. However, it has only been within the past 20 to 30 years that scientific studies have been conducted to investigate the validity of these claims. Many animal studies, and recently an increasing number of human studies, including epidemiological studies and clinical trials, have examined the relationship between tea drinking and health. Overall, observational studies in humans suggest that daily consumption of at least 3 cups of tea may be associated with a risk reduction of mortality (44%) after myocardial infarction compared with non-tea drinkers. The possibility that tea consumption reduces the risk of cardiovascular events remains open to the need for further clinical trials to clarify the effects of tea polyphenols in humans in order to recommend their use against cardiovascular diseases.


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Clinical and laboratory aspect of leptospirosis in humans

By I Made Setiawan

Leptospirosis is a world-wide zoonotic disease, especially in tropical and subtropical regions. The disease is found in rural and urban areas with poor environmental conditions. The spectrum of human disease ranges from subclinical infection to severe clinical disease with multi-organ failure (Weil’s disease) and high mortality rate, and depends both on the host and the infecting serovar. Leptospirosis may occur either sporadically or in the context of an outbreak and is commonly related to occupational or recreational activities that involve direct or indirect contact with the urine of animal species that are reservoirs of the disease. The disease infects man through contact with contaminated environments or direct contact with carrier animals such as rats, dogs, cattle, pigs, etc. Leptospirosis has clinical symptoms similar to such diseases as dengue, malaria, typhoid, influenza, thus laboratory methods are required for early detection to facilitate appropriate treatment of patients. The diagnosis of leptospirosis should be considered in any patient presenting with an abrupt onset of fever, chills, conjunctival suffusion, headache, myalgia, and jaundice. Suspicion is further increased if there is a history of occupational or recreational exposure to infected animals or to an environment potentially contaminated with animal urine. Treatment commonly consists of administration of antibiotics such as penicillin, ampicillin, amoxicillin, tetracycline and doxycycline. Prevention by immunization is uncommon, as the available vaccines are ineffective in preventing the disease. In general, prevention is by avoiding environmental exposure.


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Thiazolidinedione and cardiovascular risk in type 2 diabetes mellitus

By Yenny

Cardiovascular disorders are the most common complications encountered in patients with type 2 diabetes mellitus (DM). The relationship is likely to be multifactorial and may also involve a specific, though ill-defined, diabetic cardiomyopathy. Patients with heart failure accompanied by DM have a reduced cardiac output compared with patients without DM. Thiazolidinediones (TZDs) are agonists of peroxisome proliferator-activated receptor gamma (PPARã) and have beneficial effects in the control of blood glucose and cardiovascular parameters, but the ability of these drugs to induce retention of plasma has to be taken into consideration in prescribing them for patients with DM at high risk of cardiovascular disease. The molecular mechanism of fluid retention by TZDs has not been fully elucidated. Available evidence indicate a possible role of epithelial sodium channels (ENaC) in causing the side effects of TZDs. This paper will discuss the mechanism of ENaC in inducing fluid retention and the management to be applied for anticipating these side effects.


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A P I T H E R A P Y (Venom of Apis cerana mellifera)

Rosdiana Natzir
Department of Biochemistry,Faculty of Medicine,Hasanuddin University

Bee venom consists of some pharmacologically or enzimatically active components, and its complete biochemical and pharmacological analyzed. The main anti-inflamatory pharmacological components are peptides: mellitin; apamin; peptide 401; adolapin and protease inhibitors. Honeybee venom has a variety of immunological effects leading to its wide use for degenerative disorders, as well as arthritis and related diseases. Now, most recently Indonesia and others have used bee venom to treat various chronic inflammatory diseases,but there are no scientific guidelines for using this substance. So,this review paper is an attempt to explain the efficacy and safety of honeybee venom in apitherapy.(J Med Nus. 2004; 25:103-107)


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The role of polyphenols in causing cardiovascular disease

By Yenny and Elly Herwana

Research on flavonoids has increased since the discovery of the French Paradox, the low cardiovascular mortality rate observed in Mediterranean population in association with red wine consumption and a high saturated fat intake. Plant polyphenol (flavonoid) occurs naturally in fruits, vegetables, and beverages such as tea and wine. Epidemiologic studies suggest that higher polyphenol intake from fruits and vegetables is associated with decreased risk for cardiovascular disease. The mechanisms explaining this observation remain unclear. The vascular endothelium is a critical regulator of vascular homeostasis, and endothelial dysfunction contributes to the pathogenesis and clinical expression of coronary artery disease. Platelet aggregation is a central mechanism in the pathogenesis of acute coronary syndromes, including myocardial infarction and unstable angina. There are numerous reports suggesting that plant polyphenols improve endothelial function and inhibit platelet aggregation in humans. Keywords: Polyphenol, flavonoid, cardiovascular


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PERIOPERATIVE MANAGEMENT OF HEAD INJURY

Muh Ramli Ahmad
Department of Anesthesilogy Faculty of Medicine Hasanuddin University Makassar

SUMMARY
The incidences of head injury in the United State reached 500.000 cases yearly. Ten percents or them died before reach the hospital. Management of head injury has to be started on the spot of the accident (prehospital) in order to avoid secondary brain damage. The secondary brain damage might be caused either by systemic disorder or intracranial. The systemic disorders are hypoxemia, hypercapnia, hypotension, anemia, hypovolemia, hyponatremia, hyperthermia, sepsis, and coagulopathies. Intracranial factors are epidural/ subdural hematoma, cerebral contusion, intracerebral infection, and post-trauma epilepsy. Preoperative evaluations are included: Anamnesis the history of accident and the mechanism of injury, which can help to determine the prognosis. The vital signs have to be examine, hypotension could be caused by injury in others place. Hypertension especially accompanied by bradycardia showed elevated of intracranial pressure by mass lesion that needs surgical procedure. The principal management of head injury are optimize of cerebral perfusion, avoid secondary ischemia and administration of drugs/ techniques which can caused elevation of intracranial pressure. Premedication in head injury usually is unnecessary. However, if general anesthesia is the alternative for ideal induction require maneuver to avoid hypotension, elevation of both blood pressure or intracranial pressure. Penthotal is an ideal induction agent if there no contraindications where it can reduce the cerebral blood flow (CBF) and intracranial pressure (ICP); while if there any contraindication propofol is the choice. The maintenance of anesthesia used drugs, which less affected to the CBF, CBV, CMRO2 and auto regulation, usually using the combination of barbiturate, narcotic, N2O, volatile anesthetic with, low MAC and muscle relaxant.(J Med Nus. 2004; 25:50-54)


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ACTIVE TIMES AND BITING HABITS OF COMMON MOSQUITOES

Isra Wahid,1 Abdullah Tahir,2 Ilhamuddin,3 Ira Fitriani,3 Sudarman,3 Ambo Tuo Nurdin.3
1Dept. Parasitology Hasanuddin University School of Medicine, 2 Dept. Public Health and Preventive
Medicine Hasanuddin University School of Medicine; 3 Students of Hasanuddin University School of Medicine

SUMMARY
In the filariasis and malaria endemic area, Mamuju, South Sulawesi, the only vector recognized for limphatyc filariasis (elephantiasis) is the mosquito Mansonia uniformis. However, in the recent survey (2001-2002), other mosquitoes that can potencially spread the filarial helminth were found such as Anopheles, Culex, Aedes, and Ochlerotatus. On October 2003, we conducted a survey on the mentioned genera and other mosquitoes as well, to see how their active times and biting habits can be a pontencial mean to spread mosquito borne diseases, especially filariasis, in the region. (J Med Nus. 2004; 25:7-12)


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