Doctor MJ

Salam sehat Indonesia. Pada era pandemi saat ini, kesehatan menjadi hal yang sangat mahal. Segala upaya dilakukan untuk menjaga kesehatan keluarga, salah satunya dengan imunisasi lengkap. Imunisasi merupakan langkah awal untuk mencegah penularan penyakit berbahaya. Pentingnya imunisasi bertujuan untuk menurunkan angka kesakitan, kecacatan dan kematian akibat penyakit yang dapat dicegah dengan imunisasi (PD3I). Dikutip dari Peraturan Menteri Kesehatan RI No 12 Tahun 2017, tentang penyelenggaraan imunisasi, pasal 1 ayat 1 : "Imunisasi adalah upaya untuk menimbulkan / meningkatkan kekebalan seseorang secara aktif terhadap suatu penyakit, sehingga bila suatu saat terpajan dengan penyakit tersebut tidak akan sakit atau hanya mengalami sakit ringan." Singkatnya, imunisasi adalah upaya meningkatkan kekebalan tubuh terhadap suatu penyakit dengan memberikan vaksin.  Penyakit - penyakit yang dapat dicegah dengan imunisasi (PD3I), antara lain : Hepatitis B Tuberkulosis  Poliomyelitis Di...

Drug abuse is a global problem and includes organized crime. Narcotics are substances that when used can relieve pain, decrease or change consciousness and can cause dependence. Narcotics classification. Narcotics class I ️ may not be used for health services. It should only be used for the development of science, technology, and research reagents. Narcotics class I ➡️ has a very high potential for addiction. Example: cannabis plants, heroin, methamphetamine. Narcotics class II ️ ➡️ can be used as a final treatment option and has a high potential for dependence. Example: morphine. Narcotics class III ️➡️ for treatment and has a mild potential for dependence. Example: codeine. Narcotic effects on the central nervous system. Depressants ️➡️ reduce the activity of the central nervous system, heart rate and respiratory rate. Examples: alcohol, barbiturates, benzodiazepines, Gamma-Hydroxy Butyrate (GHB). Stimulants ️➡️ increase the activity of the central nervous system, heart rate, res...

Monkeypox virus (MPXV) was discovered in a monkey colony in 1958 and the first case of monkeypox infects humans in 1970 in the Republic of the Congo. Monkeypox virus belongs to the family p oxviridae , genus o rthopoxvirus. Until now, sporadic cases of monkeypox have occurred in 10 countries in Africa. Monkeypox is a rare disease that can heal itself. Transmission of monkeypox through direct contact with the virus from animals, humans or objects contaminated with the virus. Viruses enter the body through : Respiratory tract. Contact with blood. Skin lesions. Mucous membrane. Eating the meat of animals infected with the virus. Monkeypox virus reservoirs other than monkeys, including : Rat. Squirrel. Other types of rodents. Animal-to-human transmission occurs through : Bites or scratches. Consumption of African wild animal meat. Direct or indirect contact with body fluids or lesions. Human-to-human transmission occurs via : Respiratory droplets. Direct or indirect contact with body fluid...

Gonorrhea infection is a sexually transmitted infection caused by the bacteria neisseria gonorrhoeae. In addition to having sex, gonorrhea infection can also be transmitted through mouth-to-mouth kissing. Kissing is one of the major risks of gonorrhea transmission, especially for couples who often have oral sex. Gonorrhea infection in the mouth, especially the oropharynx does not show symptoms, but can be contagious. Kissing can transmit Neisseria gonorrhoeae bacteria through saliva (saliva). Each person produces saliva with a different volume. The average saliva produced is 0.3-0.4 ml/min without being stimulated. When chewing food, saliva will be produced 4-5 ml / minute. To prevent transmission of gonorrhea infection, avoid oral sex. Make sure your partner is in good health and clean their vital organs. To prevent transmission of gonorrhea through kissing, keep your teeth and mouth healthy. Regularly brush your teeth and rinse your mouth with an antiseptic solution.

Antibiotic resistance is the ability of bacteria to become resistant to antibiotics. Occurs due to changes in the nature of bacteria so that they can no longer be killed. The process of healing the disease becomes difficult, takes a long time and the disease is more easily spread. Gonorrhea infection is a sexually transmitted infection caused by the bacteria neisseria gonorrhoeae . Antibiotic resistance in n eisseria gonorrhoeae has been around for 80 years. Gonorrhea is one of the pathogens that is threatened with antibiotic resistance. Epidemiology. Gonorrhea infection is curable, but its prevalence continues to increase. Gonorrhea infection is caused by : Don't use condoms. Increased urbanization. Lack of education. Failed therapy in infected persons. Gonorrhea infection can cause localized outbreaks and spread rapidly. WHO no longer recommends the use of these antibiotics as a treatment for gonorrhea infections : Penicillin. Tetracycline. Ciprofloxacin. Azithromycin. Extende...

Testicular Torsion is a condition where the spermatic cord (cord) that carries blood to the testicle is twisted. This condition causes the blood flow to the testicles to be disrupted, so there is a risk of testicular tissue dying. The twisting of the spermatic cord causes : Occlusion and strangulation of venous or arterial vasculature to the testis and epididymis. Causes infarction. Testicular Torsion is an emergency that requires surgery to avoid testicular damage. If this condition is not treated within 4-6 hours after the onset of pain, it can lead to infarction of the testes, followed by testicular atrophy. Epidemiology. Testicular Torsion can occur at any age between 10-30 years. The left testicle is more frequently torsion than the right testicle, because normally the left spermatic cord is longer. Etiology. Testicular Torsion occurs when the testicles can move very freely. Long mesorchium. The testes are in a horizontal position. The epididymis is located at one of the poles of...

Fixed drug eruption (FDE) is an allergic skin reaction or mucocutaneous area due to the use of certain drugs. Characterized by the emergence of repeated lesions in the same location. Drugs are generally harmless if used according to the dosage and indications. A drug allergy occurs when there is an abnormal response of the immune system to a substance. General symptoms of drug allergy : Red patches on the skin. Itchy. Swollen. Dizzy. Out of breath. Anaphylaxis. Disease equation : Fixtum exanthema. Fixed exanthem. Etiopathogenesis. Drugs that often cause Fixed drug eruption (FDE) : Oral contraceptives. Barbiturates. Phenolphthalein. Phenacetin. Salicylates. Naproxen. Nystatin. Minocycline. Sulfonamides. Tetracycline. Metronidazole. Curtain. Sulindac. Tolmetin. Malate. Bleomycin. Busulfan. Zidovudine. Chlorpromazine. Hydantoin. Cyclophosphamide. Clofacimine. Antimalarial. Procarbacin. Doxorubicin. Skin reactions to drugs can occur through immunologic or non-immunological mechanisms. Dru...

Pituitary adenomas is tumors of the central nervous system that attack the pituitary gland. This type of tumor often occurs and attacks adults aged 30-40 years. Pituitary adenomas are benign neoplasms in 10%-15% of intracranial masses. The pituitary gland consists of an anterior and a posterior part. Pituitary adenomas originate from one of the anterior cell types. Symptoms depend on which anterior pituitary cells are affected.  Types of anterior pituitary cells : Corticotrope. Thyrotrope. Gonadotropes. Somatotrope. Lactotrope. Pituitary adenomas is generally slow growing and rarely develop into malignant tumors. Genetic mutations are one of the causes of this disease, including : Germline mutation. Somatic mutation. Mosaic mutation. Pituitary adenomas depend on which cells are affected. Corticotrope cell type ️➡️ Secretion of hormones : Adrenocorticotropic hormone Clinical syndrome : Cushing Symptom : Unstable mood Weak proximal muscles Changes in facial characteristics Gaining ...

Glioblastoma Multiforme is a malignant brain cancer originating from astrocytes and oligodendrocytes. Glioblastoma Multiforme cases most often occur in adults 40-70 years. The cause of Glioblastoma Multiforme is not yet known, but it is thought to have something to do with radiation exposure. Primary Glioblastoma ➡️ Other name : IDH-WILDTYPE Average age : 62 years Disease course : Fast Location : Supratentorial Necrosis : Extensive Surgery + Radiotherapi : 9.9 months Surgery + Radiotherapy + Chemotherapy : 15 months Etiopathogenesis : Epidermal Growth Factor Receptor overexpression/amplification.  Loss of heterozygosity of Ch. 10q.  Phospataste and Tensine Homologous Deletions in Ch. 10.  P16 deletion.  Secondary Glioblastoma ️➡️ Other name : IDH-MUTANT Average age : 44 years old Disease course : Slow Location : Frontal Necrosis : Limited Surgery + Radiotherapy : 24 months Surgery + Radiotherapy + Chemotherapy : 31 months Etiopathogenesis : Platelet-driven Growth...

Lambda variant was first detected in Peru in August 2020. Lambda variant is classified as a variant of concern which has mutations with higher transmission rates and severity and has been detected in various countries. Lambda variant is thought to be more infectious because of the potential to increase antibody resistance given by the vaccine and previous exposure to the virus. Three mutations of the Lambda protein : RSYLTPGD246-253N 260 L452Q F490S The three mutations help this variant resist neutralization of the vaccine-induced antibody. The results of the Rockefeller University study in bioRxiv, booster vaccines with Pfizer/BioNTech or Moderna mRNA vaccines can increase antibody levels in quantity, but the quality has not been confirmed as antibodies that can neutralize new virus variants. So far, the results of studies have shown that the vaccine still helps prevent the worsening of COVID-19 disease in the Lambda variant. If vaccination is not expedited it will increase the risk t...

Probiotics are good microorganisms in the intestines. Intestinal microorganisms are very important in the systemic immune response and the immune response in the mucous membranes of the lungs. About 70% of the immune system is in the gastrointestinal tract, in the form of intestinal lymphoid tissue. Probiotics affect the immune system to fight foreign objects that enter the body. Through many studies, one of the benefits of probiotics in the human digestive tract is to stimulate the immune system. Benefits of probiotics : Boost immunity. Keep people's digestion healthy. Optimizing bone growth. Decreases faecal enzymes. Decreases blood cholesterol levels. Probiotic strains can balance proinflammatory and immunoregulatory cytokines for viral clearance and reduce the risk of impaired immune response in the lung.

Tuberculosis of the breast is a rare manifestation of localized extrapulmonary disease. Generally occurs in women of reproductive age, multipara, breastfeeding and occurs because of resistance of breast tissue to mycobacterium tuberculosis. Tuberculosis of the breast is rare because the organs or breast tissue are more resistant to infection, making multiplication of tubercle bacilli difficult. But the disease must remain aware. Immunodeficiencies such as HIV infection are at risk of causing breast tuberculosis. Tuberculosis of the breast usually affects women aged 20-50 years with an increased risk in breastfeeding women. Breastfeeding women have an increased blood supply to the breast and dilated ducts, making the breast tissue more susceptible to lacerations and infection. Tuberculosis of the breast is classified into three types : Nodular variety. Disseminated. Sclerosis. Classification of breast tuberculosis (McKeown and Wilkinson) : Nodular tubercular mastitis. Disseminated or co...

Meningiomas are brain tumors of the meninges that line the central nervous system (brain and spinal cord). Intracranial tumors are the most common in adults. Meningiomas are most common at the age of 30-70 years. There are 3 classifications of meningiomas based on their pathology : Grade I (benign) ️➡️ Meningiothelial. Fibrous (fibroblastic). Transitional (mixed). Psammomatous. Angiomatous. Microcystic. Secretory. Lymphoplasmacyte-rich. Metaplastic. Grade II (atypical) ️➡️ Choroid. Clear lear cells. Atypical. Grade III (malignant) ️➡️ Papillary. Rhabdoid. Anaplastic. Meningiomas etiology. The cause of meningiomas is still undecided. Gene mutations associated with meningiomas : NF2 deletion and inactivation on chromosome 22. Other genes (NF1, PTCH, CREBBP, VHL, PTEN and CDKN2A). Risk factors : Radiation (ionizing radiation). Hormone. Head trauma. Cellphone use. Family history of meningiomas. Signs and symptoms : Headache. Sleepy. Seizures. Loss of hearing. Tinnitus. Progressive focal n...

The highest mortality rate for HIV-infected infants is due to the rapid progression of HIV infection in infants <1 year of age. Infants infected with perinatal HIV will mostly die before the age of 2 years, but the risk of death begins to decline at the age of > 5 years. Indications for starting antiretroviral therapy in children < 10 years. Several studies have shown that early initiation of antiretroviral therapy in children can reduce mortality by up to 75%. Antiretroviral therapy should be given to all HIV-infected children regardless of clinical stage and immunosuppressed status : HIV-infected children diagnosed before 1 year of age. HIV-infected children aged > 1-10 years. Antiretroviral therapy in children. Antiretroviral therapy in children is divided into : Age < 3 years. Age 3-10 years. The pathogenesis of perinatal HIV infection is different from that in adults. The viral load-set point in perinatally infected infants can be many times higher, therefore optimi...

Mucormycosis is an infection of the Mucormycetes group of fungi in the order mucorales. Mucormycetes fungal species that infect humans : Rhizopus species and Mucor species. Rhizomucor species. Syncephalastrum species. Cunninghamella bertholletiae. Apophysomyces. Lichtheimia/Absidia. Saksenaea. Mucormycetes natural habitat : Soil. Rotten material. Leaf.  Compost. Rotting wood. 70%-80% of Mucormycosis infections in humans are caused by the genus Rhizopus and are followed by Mucor and Lichtheimia. Based on the clinical, Mucormycosis is divided into 5 major clinical : Rhinocerebral mucormycosis. Pulmonary mucormycosis. Cutaneous mucormycosis. Gastrointestinal mucormycosis. Disseminated mucormycosis. Symptoms of Mucormycosis infection depend on the location of the infection. Symptoms of Rhinocerebral Mucormycosis (sinuses and brain) : Swollen face on one side. Headache. Nasal and sinus congestion. Black lesions on the bridge of the nose or the inside of the mouth that develop progressiv...

Fasting during Ramadan is useful for removing toxins from the body, improving brain performance and avoiding the risk of dangerous diseases. However, changing the time you eat while fasting also causes complaints, such as dizziness, stomach pain and dehydration. Gastric pain. Gastric pain is caused by an increase in stomach acid due to an empty stomach during fasting. Increased stomach acid causes the following reactions : Nausea to vomiting. Abdominal pain. Sweating. Heartburn. To avoid stomach disease when fasting, do the following : Sahur. Avoid acidic, spicy, greasy and caffeine foods. Eat foods that are easy to digest so that digestion works properly. Eat little by little during break fasting to avoid rising stomach acid due to eating too much. Dehydration. Dehydration during fasting often occurs due to lack of fluid intake into the body. Dehydration causes reactions : Dizzy. Nausea. Fatigue. Dry mouth. Halitosis. To avoid dehydration while fasting, do the following : Set the patt...

Can diabetic patients fast in Ramadan? Diabetes mellitus is a condition of excess sugar levels in the body due to a lack of the hormone insulin. In normal conditions, the body produces the hormone insulin to store excess sugar in the blood to the muscles / liver as a backup. When blood sugar decreases due to fasting, the body will release the hormone glucagon which functions to remove sugar from the muscles / liver to be used for energy. In diabetic patients, the use of insulin and glucagon is not optimal so that they are at risk of : Hypoglycemia ➡️ lack of blood sugar because no food is consumed when fasting. Hyperglycemia ➡️ excess blood sugar due to insufficient consumption of diabetes drugs when fasting or consuming sugary foods when breaking fast and suhoor. Diabetic ketoacidosis ➡️ high waste substances in the form of ketones in the blood which are dangerous. Dehydration ➡️ lack of fluids during fasting and high urinary frequency in diabetic patients. Diabetes patients who are n...

Healthy tips during fasting. Adjust your routine and lifestyle ➡️ healthy behavior in the month of Ramadan must be done so that the quality of health is better and you don't get sick easily. Eating at dawn is very important ➡️ Don't smoke. Eat lots of fruits and vegetables. Greasy food can cause blockage of blood vessels, resulting in reduced oxygen flow and resulting in drowsiness during the day. Morning, afternoon, until evening ➡️ Do daily activities. Break fasting and dinner ➡️ During break fasting drink warm water and sweet foods without added sugar. Dinner according to a balanced nutrition menu and do not smoke. Physical activity ➡️ Perform physical activity for at least 30 minutes. Set sleep patterns ➡️ Get enough sleep for at least 9 hours every day. Healthy food during fasting in pandemic conditions : Fruit 3-4 servings. Vegetables 2-3 servings. Water ¾ glass (100 grams). Complex carbohydrates to slow down hunger (brown rice and corn). Choose protein with less fat (ski...

During the month of Ramadan, Muslims fast from Subuh to Maghrib. What about patients who have to take drugs? Ensure that the patient is safe to fast and does not take medication during the time of fasting. Drugs that must be taken several times a day, consider changing the type of drug, the regimen is changed to a dose of once or twice a day. (example: katopril 2 × 1 becomes lisinopril 1 × 1).  If the drug regimen cannot be changed, adjust the time to take medication from break fasting to dawn. Example : 3 × 1 ➡️ 6 PM (break fasting) - 11 PM (near midnight) - 4 AM (sahur). Patients of type 2 diabetes.  In patients with type 2 diabetes, be careful with the risk of hypoglycemia. Educate the patient to adequate portion of suhoor, adequate hydration after break fasting until bedtime. The use of the first generation sulfonylurea and SGLT2 needs more attention. Metformin 3 × 500 mg can be changed to a dose of 2 × 1000 mg. For insulin use, use long-acting insulin at night and fast-ac...

At the time of break fasting, the food consumed must meet the requirements, consisting of : Appetizers. Drink. The main food. Avoid foods that are high in fat and very sweet from added sugars. WHO recommends drinking plenty of water (at least 10 glasses) and hydrating foods. Menu for adults with normal nutritional status (± 2100 kcal / day) : Appetizer 210 calories ➡️ ± 7 peace of date seeds or salad. Main food 840 calories ➡️ Rice, animal protein, vegetable protein, vegetables, orange fruits. Dessert (before take a bed) ➡️ avocado fruit.