Doctor MJ

Based on WHO data, Ebola outbreaks have occurred since 2018. Ebola outbreaks are classified as level 3 emergencies. Level 3 emergencies is the highest level emergencies where events in one or many countries with high consequences for public health require a large response from the World Customs Organization (WCO) and World Health Organization (WHO). The Ebola outbreak in the Democratic Republic of Congo was declared the Public Health Emergency of International Concern (PHEIC) on July 17, 2019. Besides Ebola, other serious diseases that are endemic in the Democratic Republic of Congo are measles and cholera, so Congo needs support to strengthen the health system. The course of Ebola disease. The Ebola virus, formerly known as the Ebola hemorrhagic fever, was first discovered in 1976 in the Ebola River. At that time Ebola appeared in 2 outbreaks simultaneously : Nzara. South Sudan. Yambuku. Democratic Republic of the Congo. The year 2014-2016 was the highest Ebo...

Various countries have conducted research to find effective treatments against the type of SARS-CoV-2 virus that causes COVID-19 infection. SARS-CoV-2 structure. Characteristics of SARS-CoV-2 RNA : Single stranded beta RNA virus Coronavirus. Enveloped, positive-sense. Produces protein : Non-structural proteins : 3-chymotrypsin-like proteases, papain-like proteases, helicases, RNA-dependent RNA polymerases. Structural protein : glycoprotein. Accessory protein. Potential treatment for SARS-CoV-2 virus. Neutralizing antibodies. The mechanism of attachment of SARS-CoV-2 through bonding between protein S and receptors on the cell surface ➡ neutralizing antibodies that target S protein on the surface is considered to be a therapeutic choice ➡ after the SARS-CoV-2 genome sequence is obtained ➡ a strategy using large animals (goats) , sheep, cattle) to make neutralizing antibodies ➡ after that polyclonal antibodies from these animals are purified ➡ for short-te...

Varicella Zoster Virus (VZV). Sub-family : alphaherpesviridae. Genus : varicelloriuses. Species : Human herpesvirus 3. Double stranded DNA virus. Heat sensitive. Varicella Zoster Virus (VZV) causes infections of Varicella Zoster (Varicella/Chickenpox) and Herpes Zoster (Shingles). In the first infection Varicella ➡ then the next infection becomes Herpes Zoster. Cases of Varicella in tropical countries generally occur in children, whereas cases of Shingles often occur in adulthood. This disease can be prevented by vaccination. Pathogenesis. Varicella Zoster Virus infection is transmitted through : Air from coughing / sneezing. Direct contact with fluids from vesicles. Lifecycle of the Varicella Zoster Virus.  Viral infection begins with replication of respiratory tract mucosal epithelial cells atas local replication followed by spread to tonsils and regional lymphoid tissue ➡ infected T cells will carry the virus to the replication site in...

Corona virus. Ordo : nidovirales. Family : coronaviridae. Genus : Alpha corona virus. Beta corona virus. Delta corona virus. Gamma corona virus. Group : Group IV ((+) ssRNA). Human coronaviruses (which cause out breaks). MERS-Cov : beta coronavirus causes Middle East Respiratory Syndrome (MERS). SARS-Cov : beta coronavirus that causes Severe Acute Respiratory Syndrome (SARS). 2019 Coronavirus Novel (COVID-19). Specimens for diagnosis. Specimen types and priorities for improving detection : Taking 3 types of specimens from the upper respiratory tract, lower respiratory tract and serum. Taking other specimens, such as urine and feces for further examination in the laboratory. Specimens must be taken as soon as the patient falls under the Patients Under Investigation criteria regardless of the symptom onset. Pay attention to infection prevention and control when taking specimens. Nasopharyngeal Swab and Oropharyngeal Swab. Nasopharyngeal Swab ➡ I...

Internet addiction. Addiction is a disorder that has a significant effect on physical and psychological health. Mobile is a physical object that is used to access the internet with all content. Mobile addiction is related to personality problems that are influenced by open technology. Diagnosis of Internet Gaming Disorder, which is a persistent and recurrent use of the internet, resulting in disturbances or distress with several criteria for 12 months. Nettox Watch. Nettox stands for Internet Detox, which is a device used on the wrist and functions to regulate the use of mobile phones. This tool has features to measure levels of oxygen and hemoglobin bonds, heart rate variability (HRV). Nettox Watch is a tool created by Indonesian University students Research shows that prolonged use of mobile phones has side effects on levels of Heart Rate Variability (HRV). If there are decreased HRV and oxygen levels and do not match normal values, Nettox will warn the us...

Kissing is one form of expression of affection that is often done. However, transmission of Stomatitis can occur due to kissing. Stomatitis indications in the form of oral cavity ulceration, include : Immune system deficiency. Cancer. Infection. Indigestion. Blood disorders. Side effects after taking certain drugs. There are two conditions that are often found, namely : Recurrent Aftose Stomatitis : immunological. Herpetic stomatitis : occurs due to herpes simplex virus infection. Recurrent Aftose Stomatitis. Clinical symptoms : Oval or round ulcerations. Shallow. Clear outline. Reddish colored. Ulceration is generally located in the non-keratinous part of the mouth, such as : Labial mucosa. Buccal mucosa. Ventral tongue. Recurrent Aftosa Stomatitis will cause burning pain when there is movement in the ulcer area and it is difficult to chew food. Recurrent Aftose Stomatitis has 3 clinical types, namely : Recurrent Minor Aftosa St...

Conditions ➡ Atopic dermatitis. Location : Face. Elbow. Knee. Form of lesion : Erythema plaque. Excoriation. Very dry skin. Scaly. Vesicular lesions. Special Characteristics : Petekie on the palate. Strawberry tongue (white). The CAN test is positive for streptococcal infection. Condition ➡ Tinea infection. Location : Can infect all areas of the skin. Form of lesion : Alopecia or damaged hair follicles on the scalp (tinea capitis). Patch or erythematous round plaque with raised edge and a clean center on the body (tinea corporis). Special Characteristics : Pityriasis rosea is often suspected. Microscopy examination with potassium hydroxide staining can help make the diagnosis. Condition ➡ Impetigo. Location : Nose and mouth. Form of lesion : Vesicles or pustules that form thick yellow crusts. Special Characteristics : Can be a primary or secondary infection. The shape of bullae is typical ...

Cases of Pneumonia 2019-nCoV can have mild to severe symptoms, with the following classifications : Uncomplicated Illness. Non specific ➡ Fever. Cough. Throat pain. Nasal congestion. Malaise. Headache. Muscle ache. Mild pneumonia. Adult : Mild pneumonia. Children : Cough. Out of breath. Tachypnea. Age < 2 months : ≥ 60 times/minute. Age 2-11 months : ≥ 50 times/minute. Age 1-5 years : ≥ 40 times/minute. Severe pneumonia. Adult ➡ fever/under surveillance of respiratory tract infections + one of the following signs : Breath rate > 30 times/minute. Heavy breathing distress. Saturation O² (SpO²) < 90%. Children ➡ cough/shortness of breath + one of the following symptoms : Central cyanosis / SpO² < 90%. Heavy breathing distress (snoring, retraction). Can not drink. Letargi. Awareness decreases. Convulsions. Chest wall retraction. Tachypnea. Age < 2 months : ≥ 60 times/minute. Age 2-11 months : ≥ 50 times/mi...

Examination of clinical symptoms. Gastrointestinal is to determine the cause of symptoms and infection with helicobacter pylori. The diagnostic test for helicobacter pylori infection is not recommended in children with functional abdominal pain. Helicobacter pylori examination should be considered in children with a family history of gastric cancer. Examination of helicobacter pylori infection can be considered in children with refractory zink deficiency anemia. There is no evidence that helicobacter pylori infection is causally related to : Otitis media. Upper respiratory tract infections. Periodontal disease. Food allergies. Sudden infant death syndrome (SIDS). Idiopathic thrombocytopenic purpura. Diagnosis. Gastric biopsy (antrum and corpus) for histopathological examination. Positive histopathology. The urea test is fast positive. Positive culture. Urea-13C (UBT) breath test : a non-invasive test to determine whether helicobacter pylori has be...

Acute transfusion reactions occur < 24 hours after transfusion. The symptoms. Fever. Shivering. Tachycardia. Hypertension. Hypotension. Passed out. Flushing. Urticaria. Bone pain. Muscle ache. Chest pain. Abdominal pain. Nausea. Breathlessness. Malaise.  Clinical check : Check the patient's identity. Check blood compatibility labels. Visible blood. Look for signs and evidence, such as : Airway Breathing Circulation which is life threatening. Mistaken blood type transfused. Blood contamination. Symptoms ➡ stop transfusion ➡ re-assessment ➡ is it deadly? ➡ yes ➡ call for assistance ➡ Airway Breathing Circulation resuscitation ➡ maintain IV line ➡ TTV monitor ➡ If bleeding is most likely NOT to cause hypotension ➡ stop transfusion ➡ check if there is a possibility of anaphylaxis or bacterial contamination ➡ start antibiotics ➡ report it to the blood bank or the nearest PMI. Symptoms ➡ stop transfusion ➡ re-assessment ➡ i...

Injection technique. No aspirations for intramuscular vaccine injections in individuals of all ages. The most painful vaccine must be the last (not the first) injection of vaccines of all ages. Body position and activity. Breastfeeding children is recommended during vaccine injection in children aged ≤ 2 years. Carrying position is recommended during vaccine injection in children aged ≤ 3 years. When injecting vaccines in children > 3 years old, the child must sit upright. Pain treatment. Topical anesthesia must be given before the vaccine is injected in children aged <12 years. It is recommended to give sucrose solution before injecting the vaccine to children aged ≤ 2 years. Education and implementation. Education from doctors who inject vaccines about pain management is recommended. Ensure the presence of parents during vaccine injection in children aged ≤ 10 years. Parents should be informed about pain management before the day of vaccinati...

Examination for HIV diagnosis by antibody testing uses strategy III (3 types of antibodies with different sensitivity and specificity). Chronology of HIV diagnosis. Available on HIV test A1 HIV antibody test A1 ➡ Non reactive ➡ A1 Non reactive ➡ HIV negative ➡ No risk. Available on HIV test A1 HIV antibody test A1 ➡ reactive ➡ HIV antibody test A2 ➡ Non reactive ➡ repeat HIV A1 and A2 tests ➡ Repeat results both Non reactive ➡ Repeat results A1 (NR) A2 (NR) ➡ HIV negative ➡ no risk. Available on HIV test A1 HIV antibody test A1 ➡ reactive HIV HIV antibody test A2 ➡ Non reactive ➡ repeat HIV A1 and A2 tests ➡ both reactive / reactive one ➡ HIV antibody test A3 ➡ Non reactive ➡ A1 (R) A2 (NR) A3 (NR) ➡ risk / no risk. Available on HIV test ➡ HIV antibody test A1 ➡ reactive ➡ HIV antibody test A2 ➡ reactive ➡ HIV antibody test A3 ➡ reactive ➡ A1 (R) A2 (R) A3 (NR) | A1 (NR) A2 (R) A3 (R) | A1 (R) A2 (NR) A3 (R) laboratorium laboratory reports ➡ intermediate ➡ ...

Case report. Girls aged 2 years, come to the emergency room with the main complaints: Eyes more prominent since 1 month before go to the hospital. Current medical history : Both eyes protrude, accompanied by swelling in the cheek area. Have a fever up and down for 2 months with a body temperature > 35°C. Repeated pale and ever got a transfusion. There is a bluish color on the skin. There is no history of vomiting and seizures. The patient becomes less active and does not want to play. Physical examination : The patient is conscious. Does not look crowded. TD 90/60 mmHg. Regular rate of pulse 100 times / minute. Breath rate 32 times / minute. There is no retraction. Body temperature 38,3°C. Pale conjunctiva. There is proptosis and mass on the cheeks. Feels lymphadenopathy in several locations, especially in the neck. There is hepatosplenomegaly in the stomach. The skin is ptakiae and ecchymosis. Movement equipment is not abnormal. There is n...

Darah arteri atau vena yang mengalir dalam tubuh manusia pada umumnya berwarna merah, namun terdapat kasus medis kelainan darah yang menyebabkan darah berwarna biru, yaitu Methemoglobinemia. Ditandai dengan adanya perubahan warna air liur, urin dan feses menjadi kebiruan. Laporan kasus. Seorang wanita berusia 25 tahun datang ke IGD dengan keluhan : Lemah. Pusing. Sesak nafas. Perubahan warna kulit.  Laju nafas : 22 kali/menit. Saturasi oksigen 88%.  Saturasi oksigen tidak meningkat dengan oksigen tambahan.  Pasien terlihat sianosis dan mempunyai darah arteri maupun vena berwarna gelap. Tekanan parsial oksigen arteri : 120 mmHg. Saturasi oksigen 100% namun pada CO-oksimetri saturasinya 67%. Persentase methemoglobin 44%.  Keterangan : Satu hari sebelumnya pasien mengaku menggunakan benzokain topikal dalam jumlah besar untuk sakit gigi. Methemoglobinemia adalah kelainan darah yang disebabkan gangguan kemampuan pengangkutan oksige...

Seorang pria usia 52 tahun datang dengan keluhan nyeri dada dan sesak nafas. Riwayat medis : Hipertensi dan diabetes yang baru terdiagnosis.  Pemeriksaan kardiopulmoner : pasien memiliki kadar lipase yang tinggi 4.900 unit/L.  Pemeriksaan lanjutan : Riwayat penyalahgunaan alkohol yang berat, 56 gram dan 84 gram alkohol setiap hari selama 8 tahun dengan riwayat minum terakhir < 24 jam.  CT scan abdomen menunjukkan : Edema pankreas tanpa nekrosis. Kolelitiasis. Koledokolitiasis atau penebalan kantung empedu. Kondisi klinis.  Kondisi klinis pasien menurun menjadi anuria dan membutuhkan intubasi karena sindrom gangguan pernapasan akut (ARDS) dan ensefalopati uremik. Tidak ada riwayat hiperlipidemia pribadi atau familial. Pada pemeriksaan laboratorium rawat inap menunjukkan : Hipertrigliseridemia 1181 mg/dL. Hipokalsemia terionisasi 0,71 mmol/L. Peningkatan lipase 1016 unit/ L. Fenofibrat diberikan karena pasien terintubasi...