Angina Pectoris

Definition
Angina pektoris is a clinical condition marked by malaise or
pain in the chest due to heart muscle iskemia network.
The clinical form of angina divided in two forms, namely stable angina and
not stable. Angina is an unstable form of a more serious that can be
become and / or is a form of early infark miokard so
people need to be examined further and observasi in the hospital.
Causes
Iskemia this happens because the oxygen supply brought about by coronary blood flow
inadequate oxygen miokardium needs. This occurs when the demand
oxygen miokardium increased (eg because of physical, emotional, tirotoksikosis,
hypertension), or when the coronary blood flow is reduced (for example, or on spasme
trombus coronary) or when both occur.
Clinical picture
- People complain of chest pain and various forms of location.
- Started as a painful feeling , feeling squeezed or feel the burn
spread to the inside of the left arm and sometimes up to the neck, shoulder
neck and left, even to the left pinkie.
- The can also spread to the shoulders, throat, jaw and teeth
also have to submit the right arm.
- Men do not feel can be felt also in the epigastrium, but rarely felt in the region
apeks kordis.
- Pain may be accompanied by pain or some of the following symptoms: sweating
cold, nausea, and vomiting, feeling faint, feeling the pulse and fainting (fainting).
- Angina usually arise when performing physical activity (stable angina).
- This attack will be lost when people stop physical activity is
and rest.
- The attack lasted only a few minutes (1 - 5 minutes) but can be up to
more than 20 minutes.
- Angina pain is constant. When changes occur, for example long
attacks increased, more intense pain, the incidence of threshold

- Decreased or when the attack came up to bed, then the interference is necessary to
a. This change attention may be a sign prainfark (angina not
stable).
- A form of change (variant) angina called Prinzmetal usually arise
when people are resting.
- Angina said gain weight when the attack occurred after the next
physical work that is lighter, for example, after eating. This is also classified
unstable angina.
- Check out the physical attack does not generally show a deviation
means. At the time of attacks, increased heart rate, blood pressure
increased in the region and the heart feels prekordium hard bop.
- On auskultasi, sound heart sounds far away, heard the loud sistolik
mid or late sistol and heard the sound of the fourth.
- Usually found risk factors: hypertension, diabetes or melitus Obesity.
Diagnosis
- Retrosternal chest pain
- Checking EKG
Treatment
- Deviation preference angina pektoris be searched, then
reduced or treated. Factors that make such as smoking, body weight
excessive, and coffee drinking habits should be avoided.
- High blood pressure treated.
- Stress is
- Angina unstable should be treated in the hospital.
1. Treatment of acute
- Acute attacks with the rest in order to overcome the heart activity is reduced.
Vasodilator work to improve the provision of oxygen and reduce
oxygen consumption of the heart.
- Sublingual nitroglycerine 0.15 - 0.6 mg is very effective. Tablet can be
used several times each day without side effects except headaches.
When the tablet 1 may be repeated not help, but when repeated after 3
times symptoms do not diminish the possibility has occurred infark.
- Isosorbid dinitrat (ISDN) sublingual 2.5 - 5 mg can also be repeated
oral tablet or 5 - 30 mg.

2. Prevention of attacks
- Propranolol for angina pektoris effective because it can reduce the work
heart muscle so that the heart needs oxygen. Effect clinic
propranolol achieved when the heart rate in the rest 60 - 70
times / minute.
Initial dose: 20 mg 2 x day.
Maximum dose: 120 mg a day.
This medicine should not be used in angina Prinzmetal.
- Nitrate of old: ISDN oral tablet 10 - 20 mg 2 x day.
- Nifedipin 10 - 20 mg 4 x day,
diltiazem or 30 - 60mg x 3 a day,
verapamil or 40 - 80mg x 3 a day.
- Angina unstable: need special care.
- Angina variants: strong dilator: nitrate, calcium antagonis, prazosin 0.5 - 1mg
3 x per day with titrasi.

Baby bath Tips

contents into the cold water bath, then mixed with hot water until the temperature reaches 40 degrees Celsius for a baby aged up to 2 days, and lowering the temperature to 27 degrees Celsius for the baby on the 2 days.Put bathtub with water at approximately 7.5 cm from the primary vessel.

For newborn babies, clean first with both eyes that has been soaked cotton water. Clean the baby's eyes to the tip of the nose, cotton Use different for each eye.

Clean the hole with the nose of the small cotton buds that have been first to put in clean water. Replace the cotton for each nostril. Be careful, do not insert cotton buds in too.

Then clean the leaves of the small ear buds with cotton that has been given the baby oil. Do not put cotton buds in your ear hole, clean the outside of the ear.

Before cleaning the body, baby clothes, open gradually. Firstly go to the top of the shirt, then pants or nappies for babies.

Clean the genitals and buttocks with a baby that has unanimously cotton wet with water. Clean each fold.

Then start washing the hair and give the entire body of the baby, especially the folding legs, thigh, neck and hands with soap for babies.

Measure return air temperature in the bath. Then slip your left hand down to the small bunch, and freeze to hold the axilla. grasp the cervix with a small wrist mother, and hold the body with the right hand of Mother.

Poppet and lift into the bathtub. While the left hand supporting your head and hold the axilla, the body partially submerged in water. Use the right hand soap to clean the mother in the ear, neck, and entire body. Let the small playground in the water for about 2-5 minutes. If the small is big enough already, give toys or horny-ships in the bath so that the event enjoyable.

To clean up the back of the body, turning the small body, and then hold the body with your left hand and hold the freeze axilla. Then, with the right hand, clean back.

Bath after the event finished, lift the small body of water, then wrapped her body with a towel. While chatting on, dried baby's body by pressing a towel to a baby's body.

After a dry body, Wipe baby powder in the chest, stomach and back, so that the body fragrant and fresh. Note the indentation of each fold and especially in the area genetalia. wipe fold in the genitals with a small baby oil.

Finally, wear nappies and baby clothes, and comb the hair with a special comb for the hair baby. When the weather allows, call the small roads or bask in the sun the morning

Tips treated teeth

Most of us are quite problematic if the guard of oral health. According to research, one of four people have a problem smelling mouth, gum disease are also a problem so many people. Small koloni live bacteria and live in the mouth change us, from the teeth, gum, lips and tongue. Although polish teeth every day, it did not guarantee success all the bacteria. So no wonder if those that are not diligent to keep the teeth often with toothache. depending on each person to do business to save the teeth from disease and still make it shine. Here we show you some tips for your dental health treath:

For Dental Health
Eating nuts is full every day, such as rice, oatmeal, wheat bread and cereals not pure, such as white bread and rice. Eating healthy vegetables, including green and the fruits of the orange.

Various Types of Eating Fruit
If you drink alcoholic beverages, do not do excessive. Enter dense fruits such as apple and pear and vegetables in the food Andan. All types of food has natural sugar, but the actual water flux on natural effects of sugar. Avoid consuming soft drink, or drink that has sugar contents, such as tea or coffee throughout the day.

Prevent Dental Damage
Limit between meal and snack. Foods that are acid can cause demineralisasi (missing oxygen excessive salt) and erosion on the teeth. Toothbrush after meals at least twice a day. Without chewing gum containing xylitol sugar (natural sugar) can help reduce the risk of perforated teeth. Stop smoking and use a product tembako in any form.

If you ever have a toothache, must feel very very sick and do not want the incident again. Although dental pain is not a very dangerous disease of the soul, but he certainly does not want to suffer because of illness affected teeth.

Pain relief dental treatment can be started from a lack of good dental and gum care. Here are tips for caring for your teeth to prevent dental disease occurs very torment that:

* For five years, and children, teach how to polish the teeth properly.

* Brush teeth correct, at least two times a day is better if after the meal. Because the rest of the remaining food and can not be cleaned nest bacteria and will damage the teeth.
* Clean the teeth with the dental Floss, once a day.
* Smoking can cause damage to the teeth, to get rid of the bad habits is to keep your teeth, other than to maintain your health.
* Check your mouth and teeth regularly to the doctor at least 6 months.
* If there are problems in the tooth or gum, please feel free to immediately to your dentist.
* Replace your toothbrush at least three months.

smile interesting, with intact teeth healthy and white, may not be obtained without effort. Try these tips that we give up and enjoy in the mouth and teeth healthy and ready to smile with full confidence

gastritis treatment

Gastritis, an inflammation or irritation of the lining of the stomach, is not a single disease. Rather, gastritis is a condition that has many causes. Common to all people with gastritis is pain or discomfort in the upper part of the belly (abdomen), sometimes called dyspepsia.

Gastritis can be a brief and sudden illness (acute gastritis), a longer-lasting condition (chronic gastritis), or a special condition, perhaps as part of another medical illness.

* An example of acute gastritis is stomach upset that may follow the use of alcohol or aspirin.
* Helicobacter pylori is a type of bacteria that infects the stomach. Infection with this bacteria may lead to chronic gastritis.

Gastritis is a common medical problem. Up to 10% of people who come to a hospital emergency department with abdominal pain have gastritis.
Gastritis Causes

Gastritis is associated with various medications, medical and surgical conditions, physical stresses, social habits, chemicals, and infections. Some of the more common causes of gastritis are listed here.


Medications

Histamine (H2) blockers: Four histamine blockers are available in the United States. Some are available without a prescription; others require a prescription.

* All work by blocking the release of acid from specialized glands in your stomach.
* The idea is that producing less acid allows your stomach to heal.
* Once healed, the previously inflamed stomach then causes no further symptoms.
* Commonly prescribed H2-blockers include cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), and ranitidine (Zantac).

Proton pump inhibitors (PPIs): These medications are very powerful blockers of the stomach's ability to secrete acid.

* A health care provider who prescribes one of these medications to treat your gastritis may be doing so in consultation with a gastroenterologist.
* These medications include lansoprazole (Prevacid) and omeprazole (Prilosec, Losec).

Coating agents: These medications protect the stomach's lining.

* Sucralfate (Carafate) - Coats and protects the stomach lining
* Misoprostol (Cytotec) - Also protects the stomach lining, used as a preventive measure for people taking NSAIDs who are at high risk for developing stomach damage

Antibiotics: An antibiotic may be prescribed if H pylori is demonstrated to be the cause of your gastritis.

Antiemetics: These medications help control nausea and vomiting. A number of different antiemetics can be used in the emergency department to control those symptoms. Some these medications are available by prescription for home use as well.

Diabetes Diet Tips

Contrary to what you may have heard, there is no ” diabetes diet,” per se — and that’s good news! The foods recommended for a diabetes diet to control blood glucose (or sugar) are good for those with diabetes — and everyone else. This means that you and your family can eat the same healthy foods at mealtime. However, for people with diabetes, the total amounts of carbohydrates consumed each day must be monitored carefully. Of the different components of nutrition — carbohydrates, fats, and proteins — carbohydrates have the greatest influence on blood sugar levels. Most people with diabetes also have to monitor total fat consumption and protein intake, too.

To keep your blood sugar levels in check, you need to make healthy food choices, exercise regularly, and take the medicines your health care provider prescribes. A dietitian can provide in-depth nutrition education to help you develop a personalized meal plan that fits your lifestyle and activity level, and meets your medical needs.

Learn the ABCs of a Diabetes Diet

The goal of nutrition for people with diabetes is to attain the ABCs of diabetes. The A stands for the A1c or hemoglobin A1c test, which measures average blood sugar over the previous 3 months. B is for blood pressure, and C is for cholesterol. People with diabetes should attain as near as normal blood glucose control (HbA1c), blood pressure, and healthy cholesterol level.
Alcohol and Diabetes

Use discretion when drinking alcohol on a diabetes diet. Alcohol is processed in the body very similarly to the way fat is processed, and alcohol provides almost as many calories as fat. If you choose to drink alcohol, only drink it occasionally and when your blood sugar level is well-controlled. It’s a good idea to check with your doctor to be sure drinking alcohol is acceptable.
Diabetes and Glycemic Index

For years, researchers have tried to determine what causes blood sugar levels after meals to soar too high in those with diabetes. Potential culprits have included sugar, carbohydrates, and starches, among other foods. The glycemic index is a ranking that attempts to measure the influence that each particular food has on blood sugar levels. It takes into account the type of carbohydrate in a meal and its effect on blood sugars.

Foods that are low on the glycemic index appear to have less of an impact on blood sugar levels after meals. People who eat a lot of low glycemic index foods tend to have lower total body fat levels. High glycemic index foods generally make blood sugar levels higher. People who eat a lot of high glycemic index foods often have higher levels of body fat, as measured by the body mass index (BMI).

Talk to your doctor, a registered dietitian, or a diabetes educator and ask if the glycemic index might work to help gain better control of your blood sugar levels.

The glycemic load takes into account the effect of the amount of carbohydrates in a meal. Both the type of carbohydrate and the amount have an effect on blood sugars.

Stroke guide

Symptoms

If you have symptoms of a stroke, seek emergency medical care. General symptoms of a stroke include sudden onset of:

* Numbness, weakness, or paralysis of the face, arm, or leg, typically on one side of the body.
* Trouble seeing in one or both eyes, such as dimness, blurring, double vision, or loss of vision.
* Confusion, trouble understanding.
* Slurred or garbled speech.
* Trouble walking, dizziness, loss of balance or coordination.
* Severe headache.

Symptoms vary depending on whether the stroke is caused by a clot or bleeding. The location of the blood clot or bleeding and the extent of brain damage can also affect symptoms.

* Symptoms of an ischemic stroke (caused by a clot blocking a blood vessel) usually occur in the side of the body opposite from the side of the brain where the clot occurred. For example, a stroke in the right side of the brain affects the left side of the body.
* Symptoms of a hemorrhagic stroke (caused by bleeding in the brain) can be similar to those of an ischemic stroke but may be distinguished by symptoms relating to higher pressure in the brain, including severe headache, nausea and vomiting, neck stiffness, dizziness, seizures, irritability, confusion, and possibly unconsciousness.

Symptoms of a stroke may progress over minutes, hours, or days, often in a stepwise fashion. For example, mild weakness may progress to an inability to move the arm and leg on one side of the body.

* If a stroke is caused by a large blood clot (ischemic stroke) or bleeding (hemorrhagic stroke), symptoms occur suddenly, within seconds.
* When an artery that is narrowed by atherosclerosis becomes blocked, stroke symptoms usually develop gradually over minutes to hours, or (in rare cases) days.
* If several smaller strokes occur over time, the person may have a more gradual change in walking, balance, thinking, or behavior (multi-infarct dementia).

It is not always easy for people to recognize symptoms of a small stroke. They may mistakenly think the symptoms can be attributed to aging, or the symptoms may be confused with those of other conditions that cause similar symptoms

Tips Treat New Born Baby

So new parents often feel nervous and like I do not know when it should start caring for the small new born. Following 4 main things the new born baby care that often make parents nervous.

Clearing the strap Center
Objects attached navel poppet is often clumsy make us all. treat fear and harm the baby. Things the rest of the rope is that the center will be separated itself around 7 - 14 days
(Although there is also up to nearly a month) after the baby is born. No one is frightening, which is how we treat to avoid infection ..
How to properly treat the center of the small strap.

* Try the central belt and the surrounding area is always dry and clean. Central belt of humid and fungi can provoke infection, also make long apart.
* If the small defecate, release and folding popoknya backwards, so that the center strap to avoid backwards, so that the rope off the center of urine and faeces.
Each time a bath, give special attention to the central belt.
1. After all the baby's body (including the central belt) dried with a soft towel, clean the rest of the central belt with cotton that has been dyed water. Do with the soft start from the base (attached at the stomach) until the end.
2. Wrapped with dry gauze. No need binding, simply folded, so that still remain out of the air entrance.
* Always monitor the condition of the central belt. When visible signs of irritation, redness, bleeding or not savory smell, check to see a doctor immediately.

Shear Nail Care
Baby nail look really pretty, thin and soft. Hence, many parents cringe cut nails baby, for fear of the small finger wound.

In fact, the attack nail more resistant germs. However, if the nails are always in a state of lembap, fungi and bacteria happy nest there. Not if clean less awake, while the baby is like entering the mouth of the fingers to make nails constantly moist. Therefore, the small nails should always be dry. Note a few things at the small cut nails.

* looki always long nails poppet, remember the baby nail growth far faster than adults.
* Cut or trim the length and look sharp. Although thin and weak, long nails that could scratch the face of the small.
* Cut or small nail scissors after the bath, because it is still soft, so easy digunting. However, if you include the baby can not be silent, do lelap when he sleeps during the day.

How:

1. Use a cutter or nail clippers designed specifically for babies.
2. Before use, harmless first cleaned with alcohol 70%.
3. Hold one of the small palm with your left hand (vice versa if you're lefty), and distance between the finger-finger.
4. The small nail scissors with your right hand slowly.
5. Clean the dirt in the back with a claw cotton drabble warm water.

* Do not cut nails too often the baby, because it will facilitate the occurrence of damage to the skin around the nail.
* Although super careful, sometimes there is also slightly injured in the baby's skin when you cut nails. No need to panic. Immediately clean the blood with cotton and let antiseptic medicine. If necessary, wearing gloves.

Ear cleaning.
Clean the baby's ear that you do not serumit guess. Important that you remain calm despite the small move always move his head. You do not need to enter a cotton ball or cotton chain in the hole to the ears. Simply clean the outside of the helix and the small.
Baby's ear should be clear in the following manner:

* Make it a bath at the same time.
* waslap wet with warm water and soap give it a little baby. Lift the head slightly smaller, and Wipe lobe and the back of the ears. Rinse until clean.
* Use cotton or cotton rounded a chain of dyed warm water, then clean the outside of the ear hole to the small, including niche-niche (indentation) on the leaf ears.
* Small dry with soft towel.

Liquid wax in the ears of the small actual normal, even useful as a barrier outside the entrance of dirt. So, no need too about, except to solidify the dirt and cover the small ear hole.

Eye clean.
Occasionally, the eyes look small and there is a dim patch of dirt sheath . Do not worry, I cleared easily.

* Clean the eyes with the same small time mandinya, or every morning and evening.
Before cleaning, clean your hands first so that if there are germs in there, do not move to the small eye.
* Use cotton that is dyed rounded warm water.
* wipe slowly the small eye (do from the middle to the outside). Do not go back and forth.
* Replace the cotton Wipe each time. In addition to the eye so that the dirt in the cotton patch no longer on the eyes, the eyes are also small so that no bacteria contaminated from one mat to another yan.

Sometimes a small tear out continuously. This is because there block channel water in the eye. solve massage with the smooth part of the small base of the nose.
Important note! If the dirt is also missing a small although not always cleaned, take it to the doctor immediately, because the eyes can be infected with bacteria.

Anemia

Definition
Anemia can be classified according to several criteria, but the most
is a practical grouping based on how the occurrence of post-Anemia
bleeding, anemia hemolitik, defisiensi anemia, anemia and anemia aplastik
because of violence.
Causes
Production of blood that is not enough (because defisiensi or bone marrow failure),
excessive blood loss, excessive destruction of blood or a combination
of these factors.
Loss of blood and chronicles the blind, for example, on ankilostomiasis,
cause anemia defisiensi Fe, while the other occurred between hemolisis
defisiensi on G6PD and talasemia.
Clinical picture
- Anemia due to a sudden loss of blood and many will drive the
homeostatis compensation body. Acute blood loss of 12 - 15%
will give symptoms of pale, takikardia with normal blood pressure or
low. Lost 15 - 20% cause the blood pressure started to go down
shock, and loss of 20% could result in death.
- Anemia defisiensi marked with a limp, often pulsatile, tired and hot -
headache. Papil tongue atrofi appear. Heart swell and sometimes there
murmur sistolik. Edge appears in the blood picture and anemia hipokrom
mikrositer, while a low serum iron womb.
- Defisiensi acid and vitamin B12 anemia folat cause megaloblastik
which may be accompanied by symptoms of neurologi.
- Anemia hemolitik can be followed by increased blood bilirubin (ikterus).
Spleen generally swell.
- Anemia aplastik visible from a low level of Hb and other systemic symptoms,
without organ enlargement.
Diagnosis
Examination and blood Hb level edge.
general Hb <12 g / dl.
Treatment
- The success of treatment depends on the ability to enforce
diagnosis on the initial level.
- Anemia agter bleeding overcome with blood transfusion as much as 10 - 20
ml / kgBB, or plasma expander. If you do not have both, liquid intravena
other can also be used.
- Impact can be slow with packed red cell transfusion.
- Anemia defisiensi fe can solve with meal, sulfas ferosus
10 mg / day kgBB 3 x Metal or rudimentary 1mg/kgBB/day
- Anemia megaloblastik treated specific, because it must be
cause, defisiensi vitamin B12 or defisiensi acid folat.
Dose of vitamin B12 100 mcg / day im, for 5 - 10 days as initial therapy
rumat therapy followed by 100-200 mcg / month until Remisi achieved.
Dose folat acid 0,5 - 1mg/hari the oral for 10 days, followed
with 0.1 - 0.5 mg / day.
Use of oral vitamin B12 is not useful in anemia pernisiosa.
Besides oral sediaan more expensive.
- Hemolisis autoimun overcome with prednison 2 - 5 mg / kgBB / day peroral and
testosteron 1 - 2 mg / kgBB / day iv, for the long term.
- Blood transfusion given only when needed only.
- Refer to hospital