Enteric fever (typhoid) is a systemic disease

<div style="text-align: justify;"><span style="font-family: georgia; text-align: left;">By </span><b style="font-family: georgia; text-align: left;">Deden Sura Agung</b></div><div style="text-align: justify;"><b style="font-family: georgia; text-align: left;"><br /></b></div><div style="text-align: justify;">Enteric fever (typhoid) is a systemic disease characterized by fever and abdominal pain caused by the spread of Salmonella typhi or Salmonella paratyphi. At the beginning of this disease called typhoid fever because it has clinical symptoms similar to typhoid.</div><div style="text-align: justify;">But in the early 1800s, typhoid fever is clearly defined as pathological abnormalities in the form of a disease that is different (unique) because the basic rule of diseases associated with enlarged lymph nodes Plaque Peyeri and mesenterik. In 1869, based on the site of infection, enteric fever term proposed as an alternative term to distinguish typhoid fever from typhus. However, at present the two terms are often swap places.</div><div style="text-align: justify;"><br /> </div><div style="color: #bf9000; text-align: justify;"><b>EPIDEMIOLOGY</b></div><div style="text-align: justify;">Some things that affect the spread of typhoid fever in developing countries is to population density, source of drinking water, food production, antibiotic-resistant strains, difficulty determining the identification and management of careers, delay making a definite diagnosis, pathogenesis and virulence are not yet fully known, and there is no vaccine, effective safe and cheap.</div><div style="text-align: justify;"><br /> </div><div style="text-align: justify;">Bacteria S. typhi can survive in dried and frozen environments, sensitive to chlorination and pasteurization process at a temperature of 630 C. These organisms can survive several weeks in the ice, dust, dry waste, and clothes, able to survive on garbage for one week and can breed in milk, meat or its products without changing the color or shape.</div><div style="text-align: justify;">Humans are the only source of natural transmission via direct or indirect contact with a sufferer of chronic typhoid or career. Transmission of germs, especially with how to swallow food or water contaminated with human feces. Congenital transmission occurs from a mother who experienced bacteremia to the baby in the womb, or infected at birth by a mother is a career typhoid with faecal oral route.</div><div style="text-align: justify;"><br /> </div><div style="color: #bf9000; text-align: justify;"><b>ETIOLOGY </b></div><div style="text-align: justify;">Typhii Salmonella is a Gram negative, have flagella, no capsule, no spore-forming facultative anaerobes. Having a somatic antigen (O) consisting of oligosaccharides, flagelar antigen (H) consisting of protein and envelope antigen (K) consisting of polysaccharides. Having makromolekular lipopolysaccharide complexes that form the outer layer of the cell wall and called endotoxin. Typhi Salmonella can also obtain the R-factor plasmid associated with resistance to multiple antibiotics. </div><div style="text-align: justify;"><br /> </div><div style="text-align: justify;"><b><span style="color: #bf9000;">PATHOGENESIS</span></b> </div><div style="text-align: justify;">Path entry of bacteria into the body </div><div style="text-align: justify;">Infections acquired by swallowing contaminated food or drink and can also be by direct contact of contaminated fingers feces, urine, respiratory secretions, or with a pus-infected patients. To be able to cause clinical symptoms, is needed S. typhi in a dose of 106-109. In the early phase of typhoid fever are common symptoms of upper respiratory tract. It is possible that some of these germs into the bloodstream through the lymphoid tissue in the pharynx. At this early stage patients also often complain of pain swallow. The tongue was dirty white membrane closed to white to brown which is the result of epithelial cell death by the bacterium S. typhi. If there is an infection of the nasopharynx through the fallopian tubes into the ear of the middle eustachi and this can happen otitis media. </div><div style="text-align: justify;">In the stomach, organisms met with acidic pH and low in germs destroyed. Slow gastric emptying is a physiological protector. After going through the stomach acid barrier mikroorganiusme get to the small intestine and met two of the body's defense mechanisms, namely motility and normal intestinal flora. Decrease intestinal motility because of drugs or anatomical factors increase the degree of severity of disease and the incidence of complications, and to extend the state of konvalesens career.</div><div style="text-align: justify;"><br /> </div><div style="color: #bf9000; text-align: justify;"><b>CLINICAL MANIFESTATION</b></div><div style="text-align: justify;">In children, typhoid fever incubation period between 5-40 days with an average of 10-14 days. Clinical symptoms of typhoid fever varies from mild clinical symptoms and do not require special treatment to severe and should be treated. The variation of these symptoms are caused by strains of Salmonella factors, nutritional and immunological status of host and a long illness at his home. </div><div style="text-align: justify;">All patients with typhoid fever is always suffer in the early disease. In the era of antibiotic usage is not like today, the appearance of fever in typhoid fever cases have specific terms of the step ladder temperature chart that is marked by fever arising insidius, then rise gradually each day and reaches its highest point at the end of the first week, after that the fever will last high and at week-4 fever down slowly in lysis, except in the event the focus of infection such as cholecystitis, soft tissue abscess then the fever will settle. Many parents reported that patients with typhoid fever higher during the afternoon and evening than the morning premises. When fever is high, in the case of typhoid fever can be accompanied by symptoms of central nervous system, such as foggy consciousness or delirium or obtundasi, or decreased consciousness from apathy to coma.</div><div style="text-align: justify;">Other systemic symptoms that accompany the onset of fever are headache, malaise, anorexia, nausea, myalgia, abdominal pain, and sore throat. In cases of severe clinical-looking, high fever at the time would seem toxic / ill. Even can also ijumpai typhoid fever patients who come with hypovolemic shock due to lack of fluid intake and diet. Gastrointestinal symptoms in cases of typhoid fever vary widely. Patients may complain obstipasi, obstipasi then followed an episode of diarrhea, in some patients was dirty with a white tongue in the middle is reddish edges and ends. Many common symptoms meteorismus, in contrast to Western books on Indonesian children more prevalent than splenomegaly hepatomegaly. </div><div style="text-align: justify;"><br /> </div><div style="color: #bf9000; text-align: justify;"><b>MEDICATION</b></div><div style="text-align: justify;">The majority of patients with typhoid fever can be treated at home with bed rest, adequate insulation, fluid needs, nutrition and provision of antibiotics. As for severe cases should be treated in hospital for the fulfillment of fluid, electrolytes and nutrition in addition to observation of the possible complications can be done carefully. </div><div style="text-align: justify;">Chloramphenicol is still the first choice in the treatment of patients with typhoid disease. The dose given was 100 mg / kg body weight / day divided into 4 times the provision for 10 to 14 days being the case with malnutrition or disease, treatment can be extended to 21 days. Chloramphenicol One disadvantage is the high relapse rate and a career. But the child that it is rarely reported. </div><div style="text-align: justify;">Ampisilin respond less clinical improvement when compared with chloramphenicol. The recommended dose is 100-200 mg / kg body weight / day divided 4 by oral administration or intravenous injection. Amoxicillin with a dose of 100 mg / kg body weight / day divided 4 times giving equivalent results with chloramphenicol, although a decrease fever longer. Trimetophin sulfamethoxazole combination gives results that are less good than chloramphenicol. In several countries have reported cases of typhoid fever resistant to chloramphenicol. Ceftriaxone and sefoperazon can provide cure rates of 90% and 0-4% relapse. Lately cefixime oral 15-20 mg / kg / day of the first 10 times can be given as an alternative, especially if the number of leukocytes <2000 or encountered resistance S.typhi. </div><div style="text-align: justify;">In severe cases, such as typhoid fever, delirium, coma or shock, high-dose dexamethasone 1-3 mg / kg body weight / day in addition to appropriate antibiotics can reduce mortality. Typhoid fever typhoid edngan premises npenyulit intestinal bleeding sometimes require blood transfusion. Whereas if perforation is suspected, the fluid in the peritoneum and free air on abdominal x-ray can help establish the diagnosis. Immediate laparotomy should be performed on intestinal perfusion didertai addition of antibiotic metronidazole may improve prognosis.</div><div style="text-align: justify;"><br /> </div><div style="color: #bf9000; text-align: justify;"><b>PREVENTION</b></div><div style="text-align: justify;">In general, to minimize the possibility of contaminated S.typhi, then each individual must consider the quality of food and drinks they consume. Salmonella typhi in the water will die if heated setting of 57 ° C for several minutes or by the process of iodination / chlorination. </div><div style="text-align: justify;">Food, heating to a temperature 57 ° C a few minutes and can also be equally deadly germs like salmonella typhi. Decrease endemicity of a country / region depends on the merits of water supply and waste disposal arrangements and the level of individual awareness of personal hygiene. Active immunization can help reduce the incidence of typhoid fever. </div><div style="text-align: justify;">Typhoid Fever Vaccine </div><div style="text-align: justify;">Three kinds of vaccine for typhoid fever, namely that contains the germ that is turned off, the bacteria live and components Vi of Salmonella typhi. Vaccines containing salmonella bacteria tyhi, S. paratyphi A, S. paratyphi B are turned off (TAB vaccine) has been used for decades by giving subcutaneous injections, but these vaccines provide only limited immunity, in addition to local side effects at the injection site quite often. Vaccines that contain germs live attenuated Salmonella typhi (Ty-21a) was given orally three times with interval of hose a day, giving the 6-year protection. Ty-21a vaccine given to children aged over 2 years. On the result of research in the field of protection efficacy is inversely proportional to the degree of disease transmission. The vaccine contains components of the Salmonella typhi Vi given intramuscular injection provides protection 60-70%.</div>

By Deden Sura AgungEnteric fever (typhoid) is a systemic disease characterized by fever and abdominal pain caused by the spread of Salmonella typhi or Salmonella paratyphi. At the beginning of this disease called typhoid fever because it has clinical symptoms similar to typhoid.But in the early 1800…

Meeting The Needs Of Chiropractic Offices With Chiropractic Digital X-Ray Systems

<div id="body" style="text-align: justify;"><span style="font-family: georgia; text-align: left;">By </span><b style="font-family: georgia; text-align: left;">Deden Sura Agung</b></div><div id="body" style="text-align: justify;"><b style="font-family: georgia; text-align: left;"><br /></b></div><div id="body" style="text-align: justify;">Chiropractic offices, like all medical offices of a certain vintage, started out with radiology rooms outfitted with film x-ray systems. Because the equipment is expensive, many medical facilities, especially smaller ones, have held onto that film equipment because the cost of upgrading to a digital x-ray system has been too cost prohibitive.<br /> All of that has changed, however, with the prices of all types of electronic and computer technology dropping in recent years. Because of this, many small and mid-sized medical offices can now consider adding Chiropractic x-ray in a digital format. It is also possible to take digital imaging equipment and use it to retrofit your existing film x-ray equipment, turning it into a digital unit, and thus saving your office money on purchase costs.<br /> Chiropractic DR digital imaging systems are popular for several reasons. This form of digital imaging offers the highest resolution of all types of digital images currently available, and they produce the images in the shortest amount of time. Furthermore, they expose patients and physicians to the least amount of radiation as compared to other types of imaging systems. For these reasons, many medical offices, including chiropractic centers, turn to DR imaging systems.<br /> For added features and flexibility in use, many chiropractic offices use their DR image acquisition systems with other digital imaging components, which can include a PACS system. The PACS is a software and hardware appliance that allows you to view, distribute and store your digital medical images on a personal computer. You will likely also want to invest in a diagnostic monitor, which is a high-end graphics monitor suitable for use with medical digital images.<br /> A PACS system can also be used as a router. What this means is that if you are connected to an online local area network, wide area network or even a virtual private network, you will have several physicians utilizing several clinical workstations at several different facilities. The router allows multiple users of the system to send and receive images, and the appliance will make sure that everything goes where it needs to go quickly and efficiently, and it enables the simultaneous use of the system by multiple users as well, so you only need one PACS system for numerous locales to benefit.<br /> You can visit a medical digital imaging distributor's website for more information about Chiropractic digital x-ray solutions that will work well for your specific medical office's needs.</div><table border="0" cellpadding="0" cellspacing="0" style="margin-left: 0px; margin-right: 0px; text-align: left;"><tbody> <tr><td valign="top"><div class="sig" id="sig">Wayne Hemrick writes about-- <a href="http://www.dicomsolutions.com/" target="_new">chiropractic x-ray</a></div><div style="margin-bottom: 1em;">Article Source: <a href="http://ezinearticles.com/?expert=Wayne_Hemrick"> http://EzineArticles.com/?expert=Wayne_Hemrick </a> </div></td> <td><div style="background-color: white; border: 1px solid rgb(255, 255, 255); margin: 0pt 0pt 0pt 10px; padding: 5px;"></div></td></tr> </tbody></table>

By Deden Sura AgungChiropractic offices, like all medical offices of a certain vintage, started out with radiology rooms outfitted with film x-ray systems. Because the equipment is expensive, many medical facilities, especially smaller ones, have held onto that film equipment because the cost of…

Give the Gift of an Exotic Spa Getaway Without the Cost With Spa Gift Sets and Baskets

<div id="body" style="text-align: justify;"><span style="font-family: georgia; text-align: left;">By </span><b style="font-family: georgia; text-align: left;">Deden Sura Agung</b></div><div id="body" style="text-align: justify;"><b style="font-family: georgia; text-align: left;"><br /></b></div><div id="body" style="text-align: justify;">All things considered, it's amazing that more people don't suffer from shoulder muscle pain and joint problems.<br /> An Amazing Piece of Machinery<br /> In some ways, the shoulder is comparable to a mechanical universal joint. If you know anything about cars, you know that if it weren't for u-joints, your engine wouldn't be able to turn the wheels and you wouldn't be able to steer. A u-joint allows you to connect to shafts and allows them to rotate at any angle.<br /> The primate shoulder is similar; unlike most other animals, monkeys, apes and humans can have a shoulder joint that allows the arm to rotate in virtually every direction. Of course, our shoulder joint is much more complicated than a u-joint. It's a handy thing to have, and arguably, it is that incredibly flexible shoulder joint that, along with the primate's unique opposable thumb, allowed us to climb down from the trees and create something approximating civilization.<br /> However, it is the very complexity of this joint that causes shoulder muscle pain. Because the shoulder joint is very unstable, it requires an elaborate system of muscles and tendons to do its job. These muscles and tendons can easily get strained and injured from overuse, accident, and chronic stress. A lot of people internalize their stress and carry it in their shoulders. The use of a dominant hand also plays a part; for example, if you are right-handed, you are more likely to suffer from right shoulder pain, and vice-versa.<br /> Fortunately, you do not have to live with shoulder pain.<br /> Standard Treatments - And Alternatives<br /> Treating shoulder blade pain first requires diagnosis - and as you might imagine, with a complex piece of biological machinery like that there are a staggering number of things that can go wrong. Bones may be fractured or broken, arthritis may have set in, or it may be a simple case of muscular strain or a torn ligament.<br /> Although the use of analgesic drugs is common, people are increasingly rejecting this option. Acupuncture is another option, as is the use of heat and ice therapy. Recently, the use of magnetic energy, in combination with low vibration therapy, has shown to be highly effective in addressing the issue of shoulder blade pain as well as chronic pain related to a range of neuromuscular issues. These treatments are completely safe and have no side effects - so they are well worth investigating if you are seeking healthier alternatives to pharmaceutical chemicals.</div><table border="0" cellpadding="0" cellspacing="0" style="margin-left: 0px; margin-right: 0px; text-align: left;"><tbody> <tr><td valign="top"><div class="sig" id="sig">Wayne Hemrick writes about-- <a href="http://www.mvtrelief.com/neck-shoulder-pain.php" target="_new">shoulder blade pain</a></div><div style="margin-bottom: 1em;">Article Source: <a href="http://ezinearticles.com/?expert=Wayne_Hemrick"> http://EzineArticles.com/?expert=Wayne_Hemrick </a> </div></td> <td><div style="background-color: white; border: 1px solid rgb(255, 255, 255); margin: 0pt 0pt 0pt 10px; padding: 5px;"></div></td></tr> </tbody></table>

By Deden Sura AgungAll things considered, it's amazing that more people don't suffer from shoulder muscle pain and joint problems. An Amazing Piece of Machinery In some ways, the shoulder is comparable to a mechanical universal joint. If you know anything about cars, you know that if it weren't fo…