- Hermina Depok<\/a><\/li>
- 29 March 2023<\/li><\/ul><\/div>
Tuberculosis and smoking habits<\/a><\/h3>
World Tuberculosis Day (World TB Day) is celebrated every March 24th. The theme for commemorating World TB Day in 2023 is "Yes! We Can End TB". "Let's End TB Together, Indonesia Can." This theme is a form of optimism by all parties as well as a joint commitment to eliminate TB by 2030, which is contained in the global commitment to the End TB Strategy. \n\n The Global TB Report released by WHO in 2022 shows that 10.6 million people suffer from tuberculosis in the world. TB is one of the deadliest infectious killers. The death rate from TB globally reaches 1.6 million, meaning that more than 4,300 people die from TB every day. The incidence of TB in Indonesia in 2021 will reach 969,000 cases, or 354 cases per 100,000 population, with a mortality rate of 144,000 people (52 per 100,000 population). This figure is still far from the target of RI Presidential Regulation Number 67 of 2021, which states that Indonesia is committed to reducing the incidence of tuberculosis cases to 65 per 100,000 people by 2030 and the target of reducing the death rate from TB to 6 per 100,000 people. \n\n Another problem and challenge is the emergence of cases of drug-resistant tuberculosis (RO TB), child TB, TB-HIV, and TB with comorbidities, with an increasing incidence of cases. The bacteria Mycobacterium tuberculosis (M. tb.) contained in saliva or sputum splashes spread rapidly through the air from an active tuberculosis sufferer to someone who is healthy, either when talking, sneezing, or coughing. The high number of TB cases in Indonesia is inseparable from the risk factors that are closely related to daily habits, one of which is smoking. Several other risk factors for easy infection with tuberculosis are co-morbidities such as diabetes, hypertension, malnutrition, and people with HIV/AIDS (PLWHA). \n\n Traditions And Trends Of Today's Cigarettes \n\n As social beings, humans always interact and stay in touch, whether for economic transactions or just hanging out together over a cup of coffee. For some groups of people, smoking is a tradition that accompanies daily activities. No matter how much evidence there is about the dangers of cigarette smoke or vapor for health, they don't care. \n\n If we examine cigarettes from the past to the present, they continue to innovate and adapt to meet the needs of all age groups. Conventionally, cigarettes are rolled tobacco wrapped in nipa leaves or paper, while smoking is the act of smoking cigarettes or the process of enjoying burned tobacco. Current technological developments cause the meaning of the word cigarettes to expand. There is an electric cigarette (E-Cigarette) in which the smoking activity includes the activity of inhaling chemical liquid vapors using a special tool called a vape. \n\n The use of electronic cigarettes, commonly calledvaping, is increasing among teenagers and young adults. This electric cigarette is also known by various names, such as "e-cigs", "vapes", "mods", "tank systems", "e-hookahs", "vape pens", and "electronic nicotine delivery systems (ENDS). Some of the factors that support the rapid development of vaping are the perception of electronic cigarettes as a healthier alternative to conventional cigarettes because the levels of toxic substances and carcinogens tend to be lower. Apart from that, some communities also promote vaping as a tool for smoking cessation therapy. Massive and aggressive vape marketing opens up new business opportunities; shops selling vaping devices and refill liquids are mushrooming everywhere. Vaping is considered cooler for young people, becoming a new lifestyle and culture. \n\n An electronic cigarette consists of several parts, namely a lithium battery, a heating component, and a container filled with liquid. Liquid will be converted into vapor for inhalation. Vape liquid contains solvents (propylene glycol, vegetable glycerin), flavors (fruits, mint, etc.), as well as the active ingredient nicotine. These substances cause symptoms similar to upper respiratory tract infections, have the potential to become cancer-causing substances, cause irritation to the eyes, lungs, and esophagus, and can cause a decrease in lung function capacity. \n\n The Centers for Disease Control and Prevention (CDC) released a case of acute respiratory failure due to vaping, namely EVALI (e-cigarette or vaping, product use associated lung injury). The main cause of EVALI is thought to be due to vitamin E acetate, which contains tetrahydrocannabinol (THC), which enters the body when using vapes. EVALI complications include acute respiratory distress syndrome and respiratory failure, so some patients need intubation and mechanical ventilation. \n\n Nicotine addiction \n\n Smoking is a fun activity because, in several cycles of friendship, smoking is socially considered a symbol of friendship and intimacy, while personally smoking is addictive. \n\n Conventional cigarettes contain substances such as tar, nicotine, carbon monoxide, etc., as well as e-cigarettes. Nicotine in cigarettes, when inhaled, reaches the brain within seven seconds and binds to the nicotinic acetylcholine receptors (nAChR). Activation of these nerves causes the production of dopamine. Dopamine is able to strengthen brain stimulation and activate reward pathways, namely the regulation of feelings and behavior, through certain mechanisms in the brain. Dopamine is a chemical compound that is responsible for feelings of pleasure, calm, motivation, and pain relief. The release of dopamine is only temporary, so smokers will repeat their smoking habit to get the same sensation but with an increased dose or number of cigarettes. A person can be said to be suffering from nicotine addiction if they experience symptoms of tolerance and withdrawal symptoms after quitting smoking. \n\n Impact of cigarettes \n\n Cigarette smoke consists of more than 7,000 chemical compounds, and there are 69 carcinogenic substances that cause cancer. The Central Statistics Agency (BPS) in 2022 noted that the percentage of smokers aged 15 years in Indonesia was 28.6% and smokers aged 18 years was 3.44%. Most children become passive smokers. The 2018 Riskesdas recorded 39 million children aged 0-14 years who were exposed to cigarette smoke at home, 13 million of whom were toddlers. Not only passive smokers or secondhand smokers who inhale cigarette smoke directly are third-hand smokers, our children, who inhale cigarette smoke particles or vape vapor particles that stick to surrounding objects (such as hair, clothes, walls, etc.) and carpet. \n\n If the activity of smoking freely is left alone without clear rules, then we have the potential to destroy the child's future. The tradition of smoking weakens all aspects of life. Because cigarette toxins not only damage the body's defense system, they are susceptible to disease. Even socio-economically, smoking is very detrimental to the family budget when it comes to meeting basic needs. \n\n Smokers are more vulnerable to suffering from TB. \n\n One of the studies conducted by Roya Alavi-Naini et al. in Iran proved that smokers have a three times higher risk of suffering from tuberculosis than non-smokers in the control samples. A cross-sectional study conducted by Altet-Gomez found that M. tuberculosis replicated more quickly in smokers because smokers had more cavitary lesions and positive smear results were obtained from sputum microscopy more often. \n\n Smoking damages the structure and function of the airways and reduces the activity of the immune system. The occurrence of TB has been shown to be associated with an altered immune response and several defects in immune cells such as macrophages, monocytes, and CD-4 lymphocytes. Other mechanisms, such as mechanical disturbance of ciliary function and hormonal effects, may also occur secondary to smoking. Furthermore, smokers have a lower ability of alveolar macrophage phagocytosis, which increases the risk of pathogenic germs being active. A study by Qiu et al. in 2017 said that smoking stimulates macrophages to produce more IL-8, which causes excessive inflammation. Results of research by Kalra et al. also found that exposure to cigarette smoke can affect T-cell responsiveness, decrease T-cell proliferation, and decrease antibody response. \n\n The effect of e-cigarettes on the risk of tuberculosis is the same as that of conventional cigarettes. Andromeda-Celeste Go´mez In the publication of her research results, "E-cigarettes: Effects in Phagocytosis and Cytokines Response against Mycobacterium tuberculosis, she states that electronic cigarettes stimulate pro-inflammatory cytokine responses and interfere with phagocyte function and cytokine responses to M. tuberculosis. \n\n Therefore, all of these factors can contribute to increasing the susceptibility of individual smokers to suffering from TB disease, accelerating the onset of active TB, increasing the risk of TB recurrence, and reducing the effectiveness of TB treatment. \n\n Let's stop smoking from now on; together, we can end TB. Indonesia can! \n<\/p><\/div><\/div><\/div>
<\/a><\/div>- Hermina Pandanaran<\/a><\/li>
- 21 November 2022<\/li><\/ul><\/div>
Know the Facts about TB Disease, Avoid the Myths!<\/a><\/h3>
TB or tuberculosis is an infectious disease that usually attacks the lungs, although it can affect any organ in the body. TB infection develops when the bacteria enter through airborne droplets. TB can be fatal, but in most cases it can be prevented and treated. In the past, tuberculosis was the leading cause of death worldwide. After improvements in therapy and the development of antibiotics, the prevalence of TB fell dramatically in industrialized countries. \n\n \n\n What is TB? \nA person can become infected with TB after inhaling the bacteria Mycobacterium tuberculosis (M. tuberculosis). When TB affects the lungs, it becomes highly contagious, but a person will usually only become sick after close contact with someone who has pulmonary TB. \n\n Causes of TB disease \nThe bacterium M. tuberculosis causes tuberculosis. They can be spread through the air in droplets when someone with pulmonary tuberculosis coughs, sneezes, spits, laughs, or talks. Only people with active TB can transmit the infection. However, most people with this disease are no longer infectious after they have received appropriate therapy for at least 2 weeks. \n\n Symptoms of TB disease \nThe next facts about TB disease that you need to know are the symptoms that usually arise when someone has TB, namely: A person with TB disease can experience a cough that produces phlegm, fatigue, fever, chills, and loss of appetite and weight. Symptoms usually get worse over time, but may come and go. \n\n \n\n Myths and Facts of TB Disease \n\n The large number of TB cases is also accompanied by the public's misunderstanding of this disease. For that, we need to understand some facts about TB as explained below: \n\n Myth: TB only affects the lungs \n\n Fact: TB can attack other organs, including the brain \n\n Most TB infections do occur in the lungs, but can develop and spread to other organs through the bloodstream if not handled properly. Other types of tuberculosis to watch out for are tuberculosis of the bones, seed lymph nodes, and intestines. In rare cases, Myctobacterium tuberculosis can attack the human heart and brain. Types of tuberculosis other than pulmonary are usually not contagious. \n\n Myth: TB cannot be cured \n\n Fact: TB can be cured with at least 6-9 months of treatment \n\n Although the death rate of this disease is high, TB can be cured. TB treatment takes a long time and must be consistent, that is, at least 6-9 months. If not consistently done, the bacteria can temporarily weaken and reappear until they become resistant (known as multidrug-resistant tuberculosis or MDR-TB). \n\n Myth: TB is a disease of people with a lower middle class economy \n\n Fact: Everyone is at risk of getting TB \n\n Social status is one that is often associated with this disease. In fact, TB does not discriminate and can affect anyone, able or less able and educated or not. \n\n \n\n The following are some conditions that allow a person to get TB: \n\n \n Have a weak immune system, for example people with diabetes, chemotherapy patients, or people with HIV/AIDS. \n Experiencing malnutrition or malnutrition. \n Active smoking. \n Using alcohol and illegal drugs. \n Actively dealing directly with TB sufferers for a long period of time. \n Living in a humid environment and not exposed to sunlight. \n \n\n \nWe cannot deny that TB is a contagious and dangerous disease. Thus, it is important for the public to understand the facts about TB properly so that awareness of this disease can be further increased, as well as its prevention. If Hermina's friends have family or friends who have TB, support them to get treatment completely. Don't forget to maintain your health and personal hygiene and the environment. Get checked immediately if you experience symptoms of TB, you can consult a pulmonary specialist at Hermina Pandanaran Hospital. \n<\/p><\/div><\/div><\/div>
<\/a><\/div>- Hermina OPI Jakabaring<\/a><\/li>
- 22 September 2022<\/li><\/ul><\/div>
MENGENAL VIRUS YANG MENYEBABKAN INFEKSI SALURAN PERNAPASAN<\/a><\/h3>
Pulmonary Tuberculosis (pulmonary TB) is a disease caused by systemic mycobacterium tuberculosis bacteria so that it can affect all organs of the body with the most locations in the lungs which are usually the site of primary infection. Pulmonary tuberculosis is a lower respiratory tract infection that attacks lung tissue or the lung parenchyma by Mycobacterium tuberculosis bacilli. \n\n Transmission and Risk Factors : \n\n Tubercolosis is passed from person to person by airborne transmission. Individuals become infected by talking, coughing, sneezing, laughing or singing, releasing large (larger than 100 u) and small (1 to 5 u) droplets. Large droplets remain, while smaller droplets are suspended in the air and blown away by susceptible individuals. Individuals who are at high risk for contracting tuberculosis are: \n\n \n Those in close contact with someone who has active TB \n Immunosuppressed individuals (Including the elderly, patients with cancer, those on corticosteroid therapy or those infected with HIV) \n IV drug users and alcoholics \n Any individual without adequate health care (homeless, detainees, ethnic and racial minorities especially children under the age of 15 years or young adults between the ages of 15-44 years) \n Any individual with pre-existing medical disorders (e.g. diabetes, chronic renal failure, silicosis, nutritional disorders) \n Any individual living in an institution (e.g. long-term care facility, psychiatric institution, prison) \n Individuals living in substandard slum housing areas \n Health workers \n \n\n Common symptoms \n\n \n Fever is not too high that lasts a long time, usually felt at night accompanied by night sweats. Sometimes fever attacks are like influenza and are intermittent. \n Decreased appetite and weight. \n Cough for more than 3 weeks (may be accompanied by blood). \n Feeling unwell (malaise), weakness. \n If there is fluid in the pleural cavity (wrapping the lungs), it can be. accompanied by complaints of chest pain. \n \n\n Things that need to be considered \n\n \n If there is cough ≥ 2 weeks \n Chest pain \n Out of breath \n Fever \n \n\n If you have any of the above symptoms, immediately consult an Internal Medicine Specialist or Lung Specialist \n\n Pulmonary TB Treatment \n\n \n Regular control according to schedule \n Medication is taken according to the rules \n If there are complaints after taking TB drugs, do not stop yourself. Immediately consult a doctor. Because there may be side effects of drugs \n When coughing, cover the mouth with a tissue or handkerchief. \n If there is a cough of fresh blood, consult a doctor and avoid foods that stimulate coughing (dry food / too oily) \n \n\n Diet (Food) \n\n \n Foods containing carbohydrates (rice, tubers, flour, bread) \n Animal Protein: eggs, fish, meat, milk. \n Vegetable Protein: tofu, tempeh, beans \n Fat (oil, butter/margarine) \n Vitamins and minerals (vegetables and fruit) \n Water \n \n\n The things that need to be considered by patients with pulmonary TB: \n\n \n Pay attention to the cleanliness of the food you eat. \n Cook perfectly the food you cook, preferably food is stored in a closed state and wash your hands before eating. \n Just eat vegetables and fruit. However, avoid sour and gas-producing fruits such as: kedondong, pineapple, durian, jackfruit. \n Consumption of foods that contain high protein (eggs, milk, chicken, beef, and the addition of vegetable protein) to replace damaged cells. \n OAT (Anti Tuberculosis Drug) is taken on an empty stomach (related to food that has been metabolized approximately 2 hours after eating). \n There are no special taboos/bans for patients with pulmonary TB against food except for patients with pulmonary TB accompanied by other diseases (such as: Diabetes Mellitus, Liver Disease and others). In this situation, immediately consult nutrition. \n In patients with pulmonary TB who are breastfeeding, breast milk is still given to their babies by wearing masks / mouth coverings. \n \n\n Do not hesitate to consult an Internal Medicine Specialist or Lung Specialist, nurses and other health workers regarding the cure for Pulmonary TB. \n<\/p><\/div><\/div><\/div>
<\/a><\/div>- Hermina Pasteur<\/a><\/li>
- 07 March 2022<\/li><\/ul><\/div>
Until now, tuberculosis is still the most dangerous infectious disease in the world, see more!<\/a><\/h3>
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Until now, tuberculosis is still the most dangerous infectious disease in the world. The World Health Organization (WHO) reports that as many as 1.5 million people died of TB (1.1 million with HIV negative results and 400,000 people with HIV positive) with details of 89,000 men, 480,000 women and 140,000 children. In 2015, the number of TB case finding was 330,910 cases. This number increased from 2014, which was 324,539 cases.\n\nThe number of new TB cases in Indonesia was 420,994 cases in 2017 (data as of May 17, 2018). Based on gender, the number of new TB cases in 2017 was 1.4 times greater for men than in women, as was the case in other countries. This may be because men are more exposed to TB risk factors, such as smoking and lack of medication adherence in patients who have been diagnosed with TB.\n\nMost TB disease (active TB) occurs in the lungs. However, in a person with HIV infection, nearly half of TB cases have disease in another part of the body. In contrast to latent TB (asymptomatic TB disease) a person with TB disease in the lungs usually has a cough and sometimes coughs up blood. Common symptoms of TB disease or also known as active TB include fever, night sweats, loss of appetite, weight loss, and fatigue. TB disease can be cured with standard therapy, even in patients with HIV infection. Untreated tuberculosis is often fatal, especially in patients with HIV infection. Sputum smears are often negative in patients with TB and HIV. \n\n Currently, active TB disease is treated with combination therapy consisting of three or more drugs (usually four). The duration of therapy for new TB cases is six months, consisting of the first two months of the intensive phase, followed by four months of the follow-up phase to destroy remaining bacteria that have entered a dormant state (sleep). Currently, standard therapy for drug-sensitive TB infection is highly effective in bacterial clearance. Monitoring the progress of treatment outcomes in adults is carried out by microscopic re-examination of sputum. Microscopic examination of sputum is better than radiological examination in monitoring the progress of treatment. To monitor the progress of treatment, sputum examination was carried out 2 times (during and in the morning). The results of the examination were declared negative if both sputum specimens were negative. If one or both specimens are positive, the results of the sputum examination are positive.\n\nPatient discovery activities consist of screening of suspects, diagnosis, determination of disease classification, and type of patient. The discovery of patients is the first step in the activities of the TB control program. The discovery and cure of infectious TB patients will significantly reduce TB morbidity and mortality, TB transmission in the community and at the same time be the most effective TB transmission prevention activity in the community. The main focus of DOTS (Directly Observed Treatment Shortcourse) is the discovery and cure of patients, priority is given to patients with infectious types of TB. This strategy will stop the transmission of TB and thereby reduce the incidence of TB in the community. Finding and curing patients is the best way to prevent TB transmission.\n\nPulmonary tuberculosis is caused when the body's immune system decreases. In an epidemiological perspective that sees disease incidence as a result of interactions between the three components of the host (host), agent (agent), and the environment (environment) the risk factors of these nodes can be studied. On the host side, susceptibility to Mycobacterium tuberculosis infection is strongly influenced by a person's immune system at that time. People with HIV AIDS or people with poor nutritional status are more easily infected and contracted TB. \n\n Steps to prevent transmission and prevent TB disease are to always apply cough etiquette, namely;\n\n1. When you are coughing, wear a mask\n\n2. When not wearing a mask and coughing, cover your mouth with your elbows and then wash the exposed area with soap and running water or cover it with a tissue and throw it in the trash.\n\n3. If you want to expel phlegm, throw the phlegm in the toilet \n\n In addition to these 3 steps, which can reduce the risk of transmission of pulmonary TB disease is to pay attention to the supporting infrastructure at home such as lighting the entry of sunlight into the house, ventilation and preventing the house from being humid. Then so that we do not contract TB disease, namely by increasing our immunity by getting enough sleep, eating according to appropriate nutritional needs, diligently exercising and avoiding other risk factors that can trigger TB infection.\n\nCreated by : dr. Ghifary AL Ashafaahary Gumelar\n\nReviewed by : dr.Hery Irawan,Sp.P\n\nReference:\n\nWorld Health Organization, 2015, WHO Global Tuberculosis Report 2015\n\nCDC, 2016, Transmission and Pathogenesis of Tuberculosis \n<\/p><\/div><\/div><\/div>
- 07 March 2022<\/li><\/ul><\/div>
- 22 September 2022<\/li><\/ul><\/div>
- 21 November 2022<\/li><\/ul><\/div>
- 29 March 2023<\/li><\/ul><\/div>