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Archive for the ‘Charonic Diseases’ Category

Obesity is a major factor (be flexible) that affect blood pressure and also the development of hypertension. Approximately 46% of patients with a BMI of 27 are hypertensive. Framingham study has found that an increase of 15% body weight can cause an increase in systolic blood pressure by 18%. Compared with those who have normal weight, people who are overweight with excess body weight by 20% have a risk eight-fold greater against hypertension.

Hypercholesterolemia and Obesity
Abnormal levels of  blood lipids closely associated with obesity. Approximately 38% of patients with a BMI of 27 is patients with hypercholesterolemia. In this condition, the ratio between HDL (High Density Lipoprotein) and LDL (Low Density Lipoprotein), tends to decrease (which generally increased triglyceride levels) that increase the risk of Atherogenesis.
Framingham study showed that for every 10% increase in body weight there was an increase of plasma cholesterol by 12 mg / dL.
From NHANES II data also found that the risk of hypercholesterolemia (serum cholesterol 250 mg / dL) on Americans who are overweight is 1.5 times greater than in normal individuals aged 20 to 75 years.

Comorbidity

• Coronary Heart Disease (PKH): Approximately 40% of CHD events occur in someone with a BMI above 21, so the disease is actually preventable.
• Stroke: Overweight is a major risk factor for stroke. Obesity (especially around the stomach / abdomen) may increase the risk of stroke (this condition does not depend on the amount of BMI).
• Pouch Disease Gall: The obese tend to be more susceptible to gallstones.
• Osteoarthritis (OA): Overweight associated with OA in the hand and knee joints. However, the limited ability to exercise in patients with osteoarthritis also to the role of the incidence of overweight.
• Cancer: Obesity can increase the risk of certain cancers. A study conducted by the American Cancer Society explained that the deaths caused by prostate cancer and rectal-colon (colorectal) increased in obese men, whereas endometrial cancer, uterus, cervix (cervical), and ovary (ovaries) increases in obese women. Compared with normal weight women during the post-menousal, obese women have a higher risk of breast cancer.
• disorders (disorders) such as: Obesity is also associated with varieses vein, several hormonal disorders and infertility.

Overweight and Obesity is closely associated with an increased risk of several complications that can occur alone or concurrently. As mentioned earlier, it can be comorbid hypertension, dyslipidemia, cardiovascular disease, stroke, diabetes type II, gallblader disease, respiratory dysfunction, gout, osteoarthritis, and certain types of cancer. Chronic disease that most often accompanies obesity is type II diabetes, hypertension, and hypercholesterolemia. Data from NHANES (National Health and Nutrition Examination Survey) III, from 1988 to 1994, showed that two-thirds of adults overweight and obese patients (BMI 27) suffered from at least one of the many chronic illnesses and 27% of them suffer from two or more diseases.

Furthermore, the impact of obesity is growing komorboditas in line with the increase in BB patients, be it the risk of incidence, prevalence and severity, which generally deal directly with BMI. Epidemic studies have found a linear relationship between body weight and the risk of increased mortality and morbidity. In fact, comorbid chronic disease is a major risk.

Obesity and Type 2 Diabets

NHANES III states that approximately 12% of people with a BMI of 27 have Type 2 diabetes. Type 2 diabetes is a type of diabetes is most often encountered, which is about 85% – 90% of all diabetics. Obesity is a major risk factor in type 2 diabetes. As many as 80% of obese patients suffering from the disease.

“The prevalence rate (for diabetes type 2) increases with increase of age and increased BMI, both in women and in men.”

The level of risk also increases with increasing BMI in adult patients (see picture above). For example, one study in women aged 30 to 50 years – the age susceptible to type 2 diabetes – showed that the rate of type 2 diabetes risk in women with a BMI of 22 is 15.8, to 27.0 BMI is 28.9, and for BMI 31.0 – 32.9 is 40.3. Compare these figures in women with a BMI of 35.0 which is much higher, namely 93 times, against the promotion / development of type 2 diabetes.
For those who are overweight around the abdomen (abdominally obese), one of the mechanisms thought to be a predisposition to type 2 diabetes, is the release of free fatty acids rapidly, which originated from an enlarged visceral fat. This process describes the circulation of high levels of free fatty acids in the liver so the liver’s ability to bind and extract the insulin from the blood is reduced. This can lead to hyperinsulinemia. Another result is an increase in gluconeogenesis – which increase blood glucose.

The second effect of increased free fatty acids is inhibited by glucose-making muscle cells, thus, walalupun insulin levels increased, but remained abnormally high blood glucose. This explains a physiological resistance to insulin as found in type 2 diabetes.
The above situation is part of a complex metabolic disorder called insulin resistance syndrome, or syndrome X. In the case of insulin resistance, its features are hyperglycemia, hypertension and changes in lipoprotein levels and composition – which increases the risk of coronary heart disease.

Epilepsy or epilepsy is a disease characterized by a tendency to experience recurrent seizures. Epilepsy, derived from the Greek (Epilepsia), which means ‘attack’. Please note, epilepsy is not contagious, not a hereditary disease, and not identical with the people who experience mental ketebelakangan. In fact, many people with epilepsy who suffer from epilepsy without a known cause. And 2% of the adult population had experienced seizures. One third of these groups have epilepsy.

Our brain consists of millions of nerve cells (neurons), in charge of coordinating all activities of our body including feeling, seeing, thinking, moving the (muscle).

In patients with epilepsy, sometimes signals are not active as they should. This can be caused by various factors, among others; head trauma (injury once the head region), brain tumors, and many others.

Generally, epilepsy may be caused by brain damage in the process of birth, head injury, stroke, brain tumors, alcohol. Sometimes epilepsy may also be due to genetic, hereditary disease but not epilepsy. But the exact cause remains unknown.

Simplex partial seizures began with an electric charge in certain parts of the brain and this charge has remained limited in the area.
Patients experience a sensation, movement or abnormal psychological disorders, depending on the brain area affected.
If happens in the brain that controls muscle movement right arm, then the right arm will swing and suffered a jolt; if occurs in the anterior temporal lobe in, then the patient will smell very pleasant or very unpleasant.
In patients experiencing mental disorders can experience d? J? vu (feeling never experienced the present situation in the past).

Jacksonian seizure symptoms started in one specific body part (eg hand or foot) and then spreading to the members of the movement, in line with the spread of electrical activity in the brain.

Partial seizures (psychomotor) complex starts with a loss of patient contact with the surrounding environment for 1-2 minutes.
The patient became unsteady, moving arms and legs in strange ways, and without purpose, noises that nobody, not able to understand what other people say and refused assistance.
The confusion lasted several minutes, and followed by complete healing.

Konvulsif seizures (tonic-clonic seizures, grand mal) usually starts with abnormal brain electrical charge on a limited area. Electric charge was soon spread to other brain regions and lead to abnormal function of the entire region.
Primary generalized epilepsy characterized by abnormal electrical charges in the broad area of the brain, which causes the spread of early dysfunction.
In both types of epileptic seizures as this happens the body’s reaction to an abnormal load. In konvulsif seizures, decreased consciousness temporarily, severe muscle spasm and jerk-jerk in the whole body, head turned to one side, tightly clenched teeth and loss of bladder control.
Afterward the patient may experience headache, dazed while and feel very tired. Usually patients can not remember what happened during the seizure.

Grand mal

Petit mal seizures began in childhood, usually before the age of five years.
Not happening seizures and other dramatic symptoms of grand mal.
The patient just stared, trembling eyelids or face muscles twitching for 10-30 seconds.
The patient does not respond to its surroundings but not falling, fainting or shooting.

Epileptikus status is the most serious seizures, in which seizures occur continuously, not stopping.
Muscle contraction is very strong, could not breathe properly and electric charge in his brain was widespread.
If not immediately treated, can damage the heart and brain that can be settled and the patient died.

Symptoms of seizures based on the affected side of the brain

Side-feather-exposed Symptoms
Frontal-lobe specific to the muscle twitch
Hallucinations-lobe oksipitalis glint of light
Parietal lobe-Numb or tingling in certain parts of the body
Hallucinations-temporal lobe picture of complex and repetitive behavior
such as walking in circles
Anterior temporal-lobe chewing movements, lip movements kiss
Anterior temporal-lobe next to the Hallucinations of smell, both likable and who is not pleasant

Diagnosis

Diagnosis based on symptoms presented by the other people who witnessed the occurrence of epileptic seizures in patients.

EEG (electroencephalogram) is an examination that measures the electrical activity in the brain.
This examination is painless and has no risk. Electrodes placed on the scalp to measure electrical impulses in the brain.

Once diagnosed, other tests are usually conducted to determine the cause of which can be treated.
Routine blood tests conducted for:
- Measuring the sugar content, calcium and sodium in the blood
- Assess liver and kidney function
- Count the number of white blood cells (which increases the number indicates the existence of infection).

ECG (electrocardiogram) done to detect heart rhythm abnormalities as a result of inadequate blood flow to the brain, which can cause a person to experience fainting.

The CT scan and MRI was performed to assess the existence of tumors or brain cancer, strokes, scarring and damage due to head injury. Utnuk lumbar puncture is sometimes performed to know whether there has been a brain infection

Hippocrates was the first to successfully identify the symptoms of epilepsy as a problem in the brain, evil spirits, and so forth. Can someone diagnosed with epilepsy if that person has at least having a seizure which is not caused by alcohol and blood pressure is very low. Tools that are used normally are:

* MRI (Magnetic Resonance Imaging) Using a powerful magnet for mendapatkn picture in the body / brain someone. Not using X-Ray. MRI is more sensitive dripada CT-Scan.

* EEG (Electro Encephalo Graphy) tool to check the brain waves.

How to overcome the symptoms of epilepsy

Until now the drug is not yet known who truly efficacious to cure epilepsy. The most important parameter is the first effort causes that can lead to epileptic attacks, such as the remnants of syphilis, hardened veins, brain diseases, alcohol poisoning, the worms in the stomach and others. To attempt to reduce epileptic attacks occur and minimize the dangers for people with epilepsy are among others:

1. The patient should keep in daily life, body and do not be too heavy fikirannya in working order not to become tired. Do not allowed the patient to drink alcohol, coffee or tea is thick and not too much to eat meat. The patient should have a lot to eat vegetables and get enough rest and try to defecate regularly.

2. The patients do not in allowed to do something that works if it can endanger themselves like climbing trees or ladders, climbing the narrow bridge, standing riverside or pond, or a fire, swimming, cycling, walking alone in a big way and standing near the machine that was spinning and other forth. Because it all, endanger the patient if the epilepsy is recurrent.

3. If there are signs that the patient will be having an epileptic fit, then send him to swallow one or two teaspoons of salt and inhaling the smell of garlic that has been ground smooth. And also feet and hands may also be tied tightly, may wear a large cloth or rope. In this way, usually epileptic attacks can be avoided.

4. If the person has fainted, let laid back and his clothes slightly loosened, if necessary on the sidelines of the upper and lower teeth to enter a clean cloth that has been folded or a spoon, to avoid being bitten tongue and let it until he regained consciousness.

PREVENTION

Anti-seizure drugs can completely prevent the occurrence of grand mal on more than half of patients with epilepsy.

TREATMENT

If the cause was a tumor, infection or blood sugar or sodium is abnormal, then the situation should be treated first.
If the situation is resolved, then the kejangnya itself does not require treatment.

If the cause can not be cured or controlled in total, we need anti-seizure medication to prevent seizures continued.
About a third of patients experience recurrent seizures, the rest is usually only experience a time of attack. The drugs are usually given to patients experiencing recurrent seizures.

Status epileptikus an emergency, because it was anti-seizure drugs given in high doses intravenously.

Anti-seizure drugs is very effective, but also can cause side effects.
Among these was the cause drowsiness, whereas in children causes hyperactivity.
Blood tests are routinely performed to monitor kidney function, liver and blood cells.

Anti-seizure drugs taken by prescription from a doctor.
Use of other drugs along with anti-seizure medications have a doctor’s permission and consent, because it can change the amount of anti-seizure drugs in the blood.

Patients’ family should be trained to assist patients in case of epileptic seizures.
The important step is to keep patients from falling, loosening his clothes (especially in the neck) and put a pillow under the patient’s head.
If the patient was unconscious, his position should be tilted for easy breathing and should not be left alone until fully awake and could move normally.

If it is found that the brain abnormalities are limited, usually performed surgery to remove the nerve fibers that connect both sides of the brain (corpus kalosum).
Surgery is performed if the medicine is not managed to overcome epilepsy or intolerable side effects.

Drugs used to treat seizures

Type of epilepsy drug side effects that may occur
Carbamazepine generalized, partial number of white blood cells and red blood cells decreases
Etoksimid Petit mal number of white blood cells and red blood cells decreases
Neurontin Partial Quiet
Lamotrigine generalized, partial skin rash
Phenobarbital generalized, partial Calm
Phenytoin generalized, partial Swollen gums
Primidon generalized, partial Calm
Valproic Infantile seizures, petit mal Weight gain, hair loss

Diabetes Mellitus is defined as a disease in which the patient’s body can not automatically control the level of sugar (glucose) in their blood. Diabetics can not produce insulin in sufficient quantities, so there is excess sugar in body. Chronic excess of sugar in the blood (hyperglycemia), this becomes toxic to the body.

Diabetes Type
1. Type I diabetes (IDDM / insulin-dependent)
Someone said to type I diabetes, if your body needs insulin supply from outside. This is because the beta cells of Langerhans islands have been damaged, so the pancreas stops producing insulin. Beta cell damage can occur from childhood or as adults.

2. Diabetes Type II (NIDDM / non-insulin-dependent)
Type II diabetes occurs when pancreatic insulin production is not enough or the body fat and muscle cells become resistant to insulin, resulting in disruption of sugar delivery to cells. Usually people affected by this type of diabetes is an adult.

Symptoms – Symptoms of Diabetes
Type I diabetes appears suddenly at the age of children (under 20 years), as a result of genetic abnormalities, so the body can not produce insulin properly. Symptoms for type I diabetes, among others:
• Weight loss decreases
• Fatigue
• blurred vision
• Frequent urination
• Continuously hungry and thirsty
• Increased levels of sugar in the blood and urine

As for the symptoms of type II diabetes appears gradually until it becomes clear interference, and at the same stage as the beginning symptoms of diabetes type I.

Cause Diabetes
The main cause of diabetes in the era of globalization is the existence of lifestyle changes (diet is not balanced, less physical activity). In addition, the existence of stress, genetic disorders, the age of an increasingly elderly can also become one of the causes of diabetes.

Diabetes Prevention
Diabetes can be prevented by changing a balanced diet (avoiding foods that contain lots of protein, fat, sugar and salt), physical activity at least 30 minutes every day (swimming, cycling, jogging, brisk walking), and diligently checked sugar levels urine each year.

Diabetes Remedy
If it is positive diabetic, then you should consult your doctor and follow doctor’s advice with discipline. In addition, the need to go on a diet, because diet is the first step of an effort to control diabetes. However, we recommend that when a diet, it should also be accompanied by regular exercise. And lastly, a blood test to measure sugar levels Diabetes, which is an abnormal disruption of blood sugar levels due to destruction of pancreatic beta cells, so that needs to be controlled carefully.

A chronic illness is one that for a long period of time or over a longer period again and again occur. Some of the most common chronic illnesses are asthma and high blood pressure (hypertension).

# What are chronic diseases?
# The prevention and treatment at the level of primary
# Asthma: prevention, treatment and control
# Hypertension: prevention, treatment and control

WHAT IS CHRONIC DISEASES?

Chronic diseases can be hereditary, but it is known that various lifestyle and environmental factors such as smoking, inappropriate diet, lack of exercise and excessive alcohol consumption risks are significantly increased. These factors are to some extent within the control of a well-informed person, but there are often other factors such as poverty, malnutrition during pregnancy and the babajare, genetic susceptibility / predisposition and age, which the individual is little or no control not.

Besides early diagnosis, treatment and control of damage is the focus of the service largely on preventing disease and promoting healthy behavior.

Chronic diseases that priority is high blood pressure or hypertension, asthma, epilepsy, stroke, kidney disease, cancer, obstructive lung disease and Diabetes Type 2. (Diabetes Type 1, which are mostly in early childhood is diagnosed, are less common.) Most of these diseases is langtermynsiektes and, although many of them can be cured, they can be controlled.

People of all ages are affected by chronic diseases, but the risk of a chronic disease development is higher among the elderly, so the likelihood of chronic illness to physical disability may result.

PREVENTION AND TREATMENT ON THE LEVEL OF primary

At the level of primary health care service based on prevention, by people on the benefits of a healthy lifestyle to educate. Each clinic has a staff that has the skills to manage chronic conditions in patients of all ages to diagnose and to treat them. It is possible for patients to achieve the same nurse for follow-up visits to see if they will set the kliniekdag for diabetes, hypertension or asthma report. They receive a special card or sticker on their file that is used to ensure ongoing health. Counselling and pasiëntsamewerking also part of the service. Doctors / medical officers visit from time to time, clinics for patients with chronic diseases to evaluate.

Arrangements by the clinic patient taken to the minimum (especially for the elderly) through a stock means to write one to three months will hold. The staff often facilitate the formation of clubs and special support groups for people with chronic diseases. This is a patient the opportunity to learn about special care and health education about their condition, respectively.

If complications arise, be patient to the next level of health care related.

Examples of how chronic diseases management and treatment are given below