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Digest #19967
Messages
Dear all,
Mau tanya dokter spesialis penyakit dalam di bogor atau di jakarta siapa ya?
Makasih
Idah
Sent from my BlackBerry® smartphone from Sinyal Bagus XL, Nyambung Teruuusss...!
Mau tanya dokter spesialis penyakit dalam di bogor atau di jakarta siapa ya?
Makasih
Idah
Sent from my BlackBerry® smartphone from Sinyal Bagus XL, Nyambung Teruuusss...
Jeng Idah, kalau mau di list banyak banget tuh. Silakan ke rumah sakit terdekat, minta daftar praktek dokter, dapat deh siapa aja dokter spesialis penyakit dalamnya. Rumah sakitnya yang di Bogor dan di Jakarta ya.
Rgds,
Marcella
*mpok bawel - senyum
Sent from my BlackBerry®
powered by Sinyal Kuat INDOSAT
Rgds,
Marcella
*mpok bawel - senyum
Sent from my BlackBerry®
powered by Sinyal Kuat INDOSAT
Ralat :
Silakan datang ke rumah sakit di Jakarta atau Bogor, he2, kali aja jeng Idah gak di Jakarta.
Tambahan :
Browsing pakai kata kunci dokter spesialis penyakit dalam di Jakarta dan dokter spesialis penyakit dalam di Bogor.
Menghemat waktu dan tenaga bila jeng Idah ada diluar pulau Jawa
Rgds,
Marcella
*mpok bawel
Sent from my BlackBerry®
powered by Sinyal Kuat INDOSAT
Silakan datang ke rumah sakit di Jakarta atau Bogor, he2, kali aja jeng Idah gak di Jakarta.
Tambahan :
Browsing pakai kata kunci dokter spesialis penyakit dalam di Jakarta dan dokter spesialis penyakit dalam di Bogor.
Menghemat waktu dan tenaga bila jeng Idah ada diluar pulau Jawa
Rgds,
Marcella
*mpok bawel
Sent from my BlackBerry®
powered by Sinyal Kuat INDOSAT
Mon May 20, 2013 5:57 pm (PDT) . Posted by:
"Ghozansehat" ghozansehat
fyi
mirip2 pcv dan rota gak yah :)
Influenza
Influenza: marketing vaccine by marketing disease
BMJ 2013; 346 doi: http://dx.doi.
2013)
Cite this as: BMJ 2013;346:f3037
* Infectious diseases
<http://www.bmj.
* Immunology (including allergy)
<http://www.bmj.
* Vaccination programs
<http://www.bmj.
* Epidemiologic studies
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* Article <http://www.bmj.
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* Read responses (2)
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1. Peter Doshi, postdoctoral fellow
Author Affiliations
1. pdoshi@post.
The CDC pledges "To base all public health decisions on the highest
quality scientific data, openly and objectively derived." But *Peter
Doshi* argues that in the case of influenza vaccinations and their
marketing, this is not so
Promotion of influenza vaccines is one of the most visible and
aggressive public health policies today. Twenty years ago, in 1990, 32
million doses of influenza vaccine were available in the United States.
Today around 135 million doses of influenza vaccine annually enter the
US market, with vaccinations administered in drug stores,
supermarkets-
been fueled by popular demand but instead by a public health campaign
that delivers a straightforward,
who-in-their-
serious disease, we are all at risk of complications from influenza, the
flu shot is virtually risk free, and vaccination saves lives. Through
this lens, the lack of influenza vaccine availability for all 315
million US citizens seems to border on the unethical. Yet across the
country, mandatory influenza vaccination policies have cropped up,
particularly in healthcare facilities,1
<http://www.bmj.
everyone wants the vaccination, and compulsion appears the only way to
achieve high vaccination rates.2
<http://www.bmj.
influenza vaccine policies shows that although proponents employ the
rhetoric of science, the studies underlying the policy are often of low
quality, and do not substantiate officials' claims. The vaccine might be
less beneficial and less safe than has been claimed, and the threat of
influenza appears overstated.
Now we are all "at risk" of serious complications
Influenza vaccine production has grown parallel to increases in the
perceived need for the vaccine. In the US, the first recommendations for
annual influenza vaccination were made in 1960 (table1).?
<http://www.bmj.
objective of this policy was to reduce excess mortality. Because most of
influenza deaths occurred in the older population, vaccines were
directed at this age group. But since 2000, the concept of who is "at
risk" has rapidly expanded, incrementally encompassing greater swathes
of the general population (box 1). As one US Centers for Disease Control
and Prevention (CDC) poster picturing a young couple warns: "Even
healthy people can get the flu, and it can be serious."
<http://www.bmj.
guidelines call for everyone 6 months of age and older to get
vaccinated. Now we are all "at risk."
View this table:
* View Popup
<http://www.bmj.
* View Inline <http://www.bmj.
Table 1. Expansion of influenza vaccination recommendations, 1960 to present
Box 1. A policy without an objective
Despite the enormous sums of money spent fighting the perceived threat
of influenza, there are surprisingly few instances of unambiguous
statements describing the objectives of influenza vaccination policy.
Here is a sampling, drawn from more than five decades of influenza
vaccination policies in the United States, that demonstrates the
changing purpose of the campaign---from one with a clear objective of
saving older people's lives, to one without any stated objective.
In 1964, four years after annual influenza vaccination policies were
first instituted, CDC influenza branch chief Alexander Langmuir and
colleagues wrote that the recommendation "was based on three broad
assumptions: 1. That excess mortality was the most important consequence
of epidemic influenza. 2. That polyvalent virus vaccines had been at
least partially effective in preventing clinical illness during most
epidemics and therefore presumably would reduce the risk of death among
the aged and chronically ill. 3. That epidemics cannot be predicted with
sufficient accuracy to permit confident planning of control measures on
a year to year basis."
In 1984, recommendations from the Advisory Committee on Immunization
Practices stated: "Because of the increasing proportion of elderly
persons in the United States and because age and its associated chronic
diseases are risk factors for severe influenza illness, the future toll
from influenza may increase, unless control measures are used more
vigorously than in the past. . . . For about 20 years, efforts to reduce
the impact of influenza in the United States have been aimed primarily
at immunoprophylaxis [vaccination] of persons at greatest risk of
serious illness or death."
<http://www.bmj.
recommendations do not even mention the effect the policy aims to
achieve.6 <http://www.bmj.
Box 2: Deciphering the numbers
As concern surged this January over a worse than usual influenza season,
members of the media seemed unsure whether the CDC's announcement that
"vaccine effectiveness (VE) was 62%"7
<http://www.bmj.
disappointing news.8 <http://www.bmj.
NBC anchor Brian Williams: "I worry about this number. I woke up to
reports of this number. It can disincentivize people to go get that flu
shot which all of you are saying is still so important."
Chief medical editor Nancy Snyderman: "And I had the same concern when
you see 62%, because I'm afraid people will say 'well, it's half and
half.' But remember, if you have a 62% less chance of getting of getting
the flu, it means less chance of being on antibiotics, less chance of
ending up in an intensive care unit, and as we've seen from this uptick
in numbers, 62% less chance of dying."
<http://www.bmj.
Although the study never tested more severe outcomes such as
hospitalizations and death, the logic is nonetheless tempting: if 62%
fewer people get influenza, then would not one expect 62% fewer of all
of influenza'
62% reduction statistic almost certainly does not hold true for all
subpopulations. In fact, there are good reasons to assume it does not.
It is well known that influenza infections are more severe for certain
groups of people, such as the frail older population, compared with
others like healthy young adults. The CDC study did not present the
statistics by age or health status, but an update of the study released
one month later showed 90% of participants were younger than 65 years,
and for older people, there was no significant benefit (vaccine
effectiveness was 27%; 95% confidence interval, 31% to 59%).10
<http://www.bmj.
Not to worry: officials say influenza vaccines save lives
Risk of serious illness is a problem---but, according to the official
narrative, a tractable problem, thanks to vaccines. As another CDC
poster, this time aimed at seniors, explains: "Shots aren't just for
kids. Vaccines for adults can prevent serious diseases and even
death."
more technical guidance document, CDC musters the evidence to support
its case. The agency points to two retrospective, observational studies.
One, a 1995 peer-reviewed meta-analysis published in /Annals of Internal
Medicine/, concluded: "many studies confirm that influenza vaccine
reduces the risks for pneumonia, hospitalization, and death in elderly
persons during an influenza epidemic if the vaccine strain is identical
or similar to the epidemic strain."
<http://www.bmj.
reduction of "27% to 30% for preventing deaths from all causes"
is, a 30% lower risk of dying from any cause, not just from influenza.
CDC also cites a more recent study published in the/New England Journal
of Medicine/, funded by the National Vaccine Program Office and the CDC,
which found an even larger relative reduction in risk of death: 48%.13
<http://www.bmj.
If true, these statistics indicate that influenza vaccines can save more
lives than any other single licensed medicine on the planet. Perhaps
there is a reason CDC does not shout this from the rooftop: it's too
good to be true. Since at least 2005, non-CDC researchers have pointed
out the seeming impossibility that influenza vaccines could be
preventing 50% of all deaths from all causes when influenza is estimated
to only cause around 5% of all wintertime deaths.14
<http://www.bmj.
<http://www.bmj.
So how could these studies---both published in high impact, peer
reviewed journals and carried out by academic and government researchers
with non-commercial funding---get it wrong? Consider one study the CDC
does not cite, which found influenza vaccination associated with a 51%
reduced odds of death in patients hospitalized with pneumonia (28 of 352
[8%] vaccinated subjects died versus 53 deaths among 352 [15%]
unvaccinated control subjects).16
<http://www.bmj.
are similar to those of the studies CDC does cite, an unusual aspect of
this study was that it focused on patients outside of the influenza
season---when it is hard to imagine the vaccine could bring any benefit.
And the authors, academics from Alberta, Canada, knew this: the purpose
of the study was to demonstrate that the fantastic benefit they expected
to and did find---and that others have found, such as the two studies
that CDC cites---is simply implausible, and likely the product of the
"healthy-
to be more likely to get vaccinated than less healthy people). Others
have gone on to demonstrate this bias to be present in other influenza
vaccine studies.17 <http://www.bmj.
<http://www.bmj.
threatens to render the observational studies, on which officials'
scientific case rests, not credible.
Yet for most people, and possibly most doctors, officials need only
claim that vaccines save lives, and it is assumed there must be solid
research behind it. But for those that bother to read the CDC's national
guidelines19 <http://www.bmj.
page document of 33 360 words and 552 references--
evidence cited is these observational studies that the agency itself
acknowledges may be undermined by bias. The guidelines state:
". . . studies demonstrating large reductions in hospitalizations and
deaths among the vaccinated elderly have been conducted using medical
record databases and have not measured reductions in
laboratory-confirme
challenged because of concerns that they have not controlled adequately
for differences in the propensity for healthier persons to be more
likely than less healthy persons to receive vaccination.
<http://www.bmj.
CDC does not rebut or in any other way respond to these criticisms. It
simply acknowledges them, and leaves it at that.
If the observational studies cannot be trusted, what evidence is there
that influenza vaccines reduce deaths of older people---the reason the
policy was originally created? Virtually none. Theoretically, a
randomized trial might shine some light---or even settle the matter. But
there has only been one randomized trial of influenza vaccines in older
people---conducted two decades ago---and it showed no mortality benefit
(the trial was not powered to detect decreases in mortality or any
complications of influenza). This means that influenza vaccines are
approved for use in older people despite any clinical trials
demonstrating a reduction in serious outcomes. Approval is instead tied
to a demonstrated ability of the vaccine to induce antibody production,
without any evidence that those antibodies translate into reductions in
illness.
Perhaps most perplexing is officials' lack of interest in the absence of
good quality evidence. Anthony Fauci, director of the US National
Institute of Allergy and Infectious Diseases, told the/Atlantic/ that it
"would be unethical" to do a placebo controlled study of influenza
vaccine in older people.20
<http://www.bmj.
recipients would be deprived of influenza vaccines---that is, the
standard of care, thanks to CDC guidelines.
This is not to say influenza vaccines have no proven benefit. Many
randomized controlled trials of influenza vaccines have been conducted
in the healthy adult population, and a systematic review found that,
depending on vaccine-virus strain match, vaccinating between 33 and 100
people resulted in one less case of influenza.21
<http://www.bmj.
however, to show that this reduction in risk of symptomatic influenza
for a specific population--
into any reduced risk of serious complications from influenza such as
hospitalizations or death in another population (complications largely
occur among the frail, older population). This fact seems hard for many
health commentators to grasp, who seem all too ready to take the largest
statistic and apply it to all outcomes for all populations. At a press
briefing this winter, CDC director Thomas Frieden said a preliminary CDC
study had found "the overall vaccine effectiveness to be 62%," He
explained that this estimate of relative risk reduction: "means that if
you got vaccinated you're about 60% less likely to get the flu that
requires you to go to your doctor." On the evening news, the CDC's
message was translated into a claim that influenza vaccines will cut the
risk of death by 62%, despite the fact that the CDC study did not even
measure mortality (box 2). Reflecting on the same CDC study, two authors
editorialized in the /Journal of the American Medical Association/ that
there exists an irrational pessimism about influenza vaccine: "A
prevention measure that reduced the risk of a serious outcome by 60% in
most instances would be a noted achievement; yet for influenza vaccine,
it is seen as a 'failure.
the CDC study they cite did not measure any "serious outcome" like
pneumonia, only medically attended acute respiratory illness with
influenza confirmed by the laboratory.
Officials say influenza vaccines are safe
The CDC's universal influenza vaccination recommendation carries the
implicit message that, beyond those for whom the vaccine is
contraindicated, influenza vaccine can only do good; there is no need to
weigh risks against benefits. In October 2009, the US National
Institutes of Health produced a promotional YouTube video featuring
Fauci. Urging US citizens to get vaccinated against the H1N1 influenza,
Fauci stressed the vaccine'
adverse events is very good. It's very, very, very rare that you ever
see anything that's associated with the vaccine that's a serious event."
Months later, Australia suspended its influenza vaccination program in
under five year olds after many (one in every 110 vaccinated) children
had febrile convulsions after vaccination. Another serious reaction to
influenza vaccines---and also unexpected--
Finland, where H1N1 influenza vaccines were associated with a spike in
cases of narcolepsy among adolescents (about one in every 55 000
vaccinated). Subsequent investigations by governmental and
non-governmental researchers confirmed the vaccine'
serious events.22 <http://www.bmj.
<http://www.bmj.
<http://www.bmj.
<http://www.bmj.
Selling sickness: what's in a name?
Drug companies have long known that to sell some products, you would
have to first sell people on the disease. Early 20th century advertising
for the mouthwash Listerine, for example, warned readers of the problem
of "halitosis&quo
concern.26 <http://www.bmj.
in the 1950s and 1960s, Merck launched an extensive campaign to lower
the diagnostic threshold for hypertension, and in doing so enlarging the
market for its diuretic drug, Diuril (chlorothiazide)
<http://www.bmj.
suggest that we have underdiagnosed epidemics of erectile dysfunction,
social anxiety disorder, and female sexual dysfunction, each with their
own convenient acronym and an approved medication at the ready. Could
influenza---
etiology, diagnosis, and prognosis---
mongering? I think it is. But unlike most stories of selling sickness,
here the salesmen are public health officials, worried little about
which brand of vaccine you get so long as they can convince you to take
influenza seriously.
Marketing influenza vaccines thus involves marketing influenza as a
threat of great proportions. The CDC's website explains that "Flu
seasons are unpredictable and can be severe," citing a death toll of
"3000 to a high of about 49 000 people." However, a far less volatile
and more reassuring picture of influenza seems likely if one considers
that recorded deaths from influenza declined sharply over the middle of
the 20th century, at least in the United States, all before the great
expansion of vaccination campaigns in the 2000s, and despite three
so-called "pandemics&quo
<http://www.bmj.
<http://www.bmj.
View larger version:
* In a new window
<http://www.bmj.
* Download as PowerPoint Slide
<http://www.bmj.
Fig 1 Crude mortality per 100 000 population, by influenza season (July
to June of the following year), for seasons 1930-31 to 2009-10, US. Data
sources: Doshi P. /Am J Pub Health/ 2008;98:939-
But perhaps the cleverest aspect of the influenza marketing strategy
surrounds the claim that "flu" and "influenza&quo
distinction seems subtle, and purely semantic. But general lack of
awareness of the difference might be the primary reason few people
realize that even the ideal influenza vaccine, matched perfectly to
circulating strains of wild influenza and capable of stopping all
influenza viruses, can only deal with a small part of the "flu" problem
because most "flu" appears to have nothing to do with influenza. Every
year, hundreds of thousands of respiratory specimens are tested across
the US. Of those tested, on average 16% are found to be influenza
positive. (fig 2).? <http://www.bmj.
All influenza is "flu," but only one in six "flus" might be influenza.
It's no wonder so many people feel that "flu shots" don't work: for most
flus, they can't.
<http://www.bmj.
View larger version:
* In a new window
<http://www.bmj.
* Download as PowerPoint Slide
<http://www.bmj.
Fig 2 Proportion of specimens testing positive for influenza at World
Health Organization (WHO) Collaborating Laboratories and National
Respiratory and Enteric Virus Surveillance System (NREVSS) laboratories
through the United States. Data are compiled and published by CDC.^28-43
Notes
*Cite this as:* /BMJ/ 2013;346:f3037
Footnotes
*
Acknowledgements: I am grateful to Yuko Hara, Tom Jefferson, and
Edward Davies, for their comments.
*
Competing interests: I have read and understood the BMJ Group policy
on declaration of interests and declare the following interests: PD
is a co-recipient of a UK National Institute for Health Research
grant to carry out a Cochrane review of neuraminidase inhibitors
(http://www.hta.
Respiratory Society in support of his travel to the society'
September 2012 annual congress where he gave an invited talk on
oseltamivir. He is funded by an institutional training grant from
the Agency for Healthcare Research and Quality (AHRQ) #T32HS019488.
AHRQ had no role in study design, data collection and analysis,
decision to publish, or preparation of the manuscript.
*
Provenance and peer review: commissioned: not externally peer reviewed.
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isolated by WHO/NREVSS Collaborating Laboratories 2012-13 season.
www.cdc.gov/
<http://www.cdc.
44.
Harper SA, Fukuda K, Uyeki TM, Cox NJ, Bridges CB. Prevention and
control of influenza: recommendations of the Advisory Committee on
Immunization Practices (ACIP). MMWR Recomm Rep. 2004;53(RR-6)
45.
Harper SA, Fukuda K, Uyeki TM, Cox NJ, Bridges CB. Prevention and
control of influenza. Recommendations of the Advisory Committee on
Immunization Practices (ACIP). MMWR Recomm Rep. 2005;54(RR-8)
46.
Smith NM, Bresee JS, Shay DK, Uyeki TM, Cox NJ, Strikas RA.
Prevention and Control of Influenza: recommendations of the Advisory
Committee on Immunization Practices (ACIP). MMWR Recomm Rep.
2006;55(RR-10)
47.
Fiore AE, Shay DK, Haber P, Iskander JK, Uyeki TM, Mootrey G, et al.
Prevention and control of influenza. Recommendations of the Advisory
Committee on Immunization Practices (ACIP), 2007. MMWR Recomm Rep.
2007;56(RR-6)
48.
Fiore AE, Shay DK, Broder K, Iskander JK, Uyeki TM, Mootrey G, et
al. Prevention and control of influenza: recommendations of the
Advisory Committee on Immunization Practices (ACIP), 2008. MMWR
Recomm Rep. 2008;57(RR-7)
49.
Osterholm MT. Influenza vaccine efficacy and effectiveness: a
comprehensive review. 2011.
www.preventinfluenz
<http://www.preventi
50.
Layton C, Robinson T, Honeycutt A. Influenza vaccine demand: the
chicken and the egg. 2005.
http://web.archive.
http://www.bmj.
[Non-text portions of this message have been removed]
Jeng, nambah ya.
Yang namanya kerjaan atau kondisi apapun di depan kita, kadang gak bisa kita kendalikan.
Baru aja baca posting, dari Komar Hidayat, yang menulis : seleksilah apa yang dikonsumsi mata dan telinga, karena anak sangat mempengaruhi tindakan dan pikiran.
Jadi kalau ada "pemandangan" yang bikin mata tegang dan ujung2nya jadi Tick atau Eye Twitching (*udah baca artikel yang linknya udah dikasih jeng Monik kan ?), singkirkan sebisanya dari depan mata.
Kalau itu manusia, coba hindari papasan bila gak perlu. Kalau itu email, dan gak perlu buat ditanggapi, DELETE aja, he2. Yang terakhir itu sering saya lakukan, untuk orang2 tertentu, biar mata saya gak terkontaminasi, dan tetap sedapat mungkin, berpikiran postif nantinya terhadap orang itu, suatu saat nanti, bila "badai" masalah sudah usai.
Sebagai manusia, kita berhak untuk bahagia. Jadi Tick dan Eye Twitching, kadang jadi indikasi, jiwa kita mulai kasih indikasi, untuk kita mulai menghentikan hal2 yang bikin kita sebaliknya.
Gitu aja ya jeng, semoga Tick dan Eye Twitching segera pergi dan gak kembali lagi.
Rgds,
Marcella
*hugs
Sent from my BlackBerry®
powered by Sinyal Kuat INDOSAT
Yang namanya kerjaan atau kondisi apapun di depan kita, kadang gak bisa kita kendalikan.
Baru aja baca posting, dari Komar Hidayat, yang menulis : seleksilah apa yang dikonsumsi mata dan telinga, karena anak sangat mempengaruhi tindakan dan pikiran.
Jadi kalau ada "pemandangan&q
Kalau itu manusia, coba hindari papasan bila gak perlu. Kalau itu email, dan gak perlu buat ditanggapi, DELETE aja, he2. Yang terakhir itu sering saya lakukan, untuk orang2 tertentu, biar mata saya gak terkontaminasi, dan tetap sedapat mungkin, berpikiran postif nantinya terhadap orang itu, suatu saat nanti, bila "badai" masalah sudah usai.
Sebagai manusia, kita berhak untuk bahagia. Jadi Tick dan Eye Twitching, kadang jadi indikasi, jiwa kita mulai kasih indikasi, untuk kita mulai menghentikan hal2 yang bikin kita sebaliknya.
Gitu aja ya jeng, semoga Tick dan Eye Twitching segera pergi dan gak kembali lagi.
Rgds,
Marcella
*hugs
Sent from my BlackBerry®
powered by Sinyal Kuat INDOSAT
Mon May 20, 2013 7:17 pm (PDT) . Posted by:
dhandmade
Sudah bertemu dokter
Beliau bilang : batuk, pilek, radang tenggorokan
Saya tanya : common cold dok?
Dokter : iya...tapi ada radang tenggorokan
*sambil nulis resep
1. Sanmol drops
2. Puyer : amoxan, luminal, ctm, asetosal
Saya : antibiotik untuk apa dok? Sakitnya ini karena virus atau bakteri?
Dokter : radang karena bakteri, jd butuh antibiotik
Saya : tonsilnya radang dok? Warna apa?
Dokter : merah, belum kena tonsil
Saya *bingung *mau nidurin dulu anaknya baru ngubek2 milis lagi
Bismillah, semoga saya bisa ttap rasional dan bisa tenang baca2 lagi
Saya tebus sanmol, suhu terkini 38,8 dercel
Ambar Kurniastuti
bundanya NajmiNamiraNadira
Mon May 20, 2013 7:21 pm (PDT) . Posted by:
dhandmade
Ralat suhu 38,3 dercel
*maap ga potek
Ambar Kurniastuti
bundanya NajmiNamiraNadira
-----Original Message-----
From: dhandmade@yahoo.
Sender: sehat@yahoogroups.
Date: Tue, 21 May 2013 02:17:04
To: <sehat@yahoogroups.
Reply-To: sehat@yahoogroups.
Subject: Re: [sehat] Demam pada bayi 9W
Sudah bertemu dokter
Beliau bilang : batuk, pilek, radang tenggorokan
Saya tanya : common cold dok?
Dokter : iya...tapi ada radang tenggorokan
*sambil nulis resep
1. Sanmol drops
2. Puyer : amoxan, luminal, ctm, asetosal
Saya : antibiotik untuk apa dok? Sakitnya ini karena virus atau bakteri?
Dokter : radang karena bakteri, jd butuh antibiotik
Saya : tonsilnya radang dok? Warna apa?
Dokter : merah, belum kena tonsil
Saya *bingung *mau nidurin dulu anaknya baru ngubek2 milis lagi
Bismillah, semoga saya bisa ttap rasional dan bisa tenang baca2 lagi
Saya tebus sanmol, suhu terkini 38,8 dercel
Ambar Kurniastuti
bundanya NajmiNamiraNadira
[Non-text portions of this message have been removed]
Mon May 20, 2013 7:46 pm (PDT) . Posted by:
"yoga pranata" doyogh
>
> Beliau bilang : batuk, pilek, radang tenggorokan
> Saya tanya : common cold dok?
> Dokter : iya...tapi ada radang tenggorokan
> *sambil nulis resep
>
> 1. Sanmol drops
> 2. Puyer : amoxan, luminal, ctm, asetosal
>
kl saya yah...saya akan browsing tuh isi puyernya, mungkin saya mulai di
drugs.com
setelah saya tau isinya apa, saya evaluasi lagi perlu apa engga sih
sebenarnya...kan dokternya uda bilang diagnosisnya common cold, maka saya
akan cari tuh guideline yg dipake di seluruh dunia terkait common cold kaya
apa sih? apa antibiotik masuk dlm guideline? apa luminal, ctm dan asetosal
masuk dlm guideline?
silakan dipelajari dan diputuskan bersama suami :)
saya cuma mo ikutan nanya sama yg lebih kompeten: bedanya puyer racikan dgn
isi di atas sama obat batuk pilek yg dijual bebas yg uda dilarang sama FDA
untuk diberikan pada anak kurang dari 6 tahun itu apa ya? kira2 kl FDA tahu
ada puyer racikan berisi obat2 di atas, pendapatnya apa ya?
kl pengalaman mba monik yg sekarang lagi tinggal di amerika gmn mba? adakah
puyer racikan berisi obat2 di atas di amerika? apa kata FDA?
thx for sharing...maaf kl kurang berkenan :)
[Non-text portions of this message have been removed]
> Beliau bilang : batuk, pilek, radang tenggorokan
> Saya tanya : common cold dok?
> Dokter : iya...tapi ada radang tenggorokan
> *sambil nulis resep
>
> 1. Sanmol drops
> 2. Puyer : amoxan, luminal, ctm, asetosal
>
kl saya yah...saya akan browsing tuh isi puyernya, mungkin saya mulai di
drugs.com
setelah saya tau isinya apa, saya evaluasi lagi perlu apa engga sih
sebenarnya..
akan cari tuh guideline yg dipake di seluruh dunia terkait common cold kaya
apa sih? apa antibiotik masuk dlm guideline? apa luminal, ctm dan asetosal
masuk dlm guideline?
silakan dipelajari dan diputuskan bersama suami :)
saya cuma mo ikutan nanya sama yg lebih kompeten: bedanya puyer racikan dgn
isi di atas sama obat batuk pilek yg dijual bebas yg uda dilarang sama FDA
untuk diberikan pada anak kurang dari 6 tahun itu apa ya? kira2 kl FDA tahu
ada puyer racikan berisi obat2 di atas, pendapatnya apa ya?
kl pengalaman mba monik yg sekarang lagi tinggal di amerika gmn mba? adakah
puyer racikan berisi obat2 di atas di amerika? apa kata FDA?
thx for sharing...maaf kl kurang berkenan :)
[Non-text portions of this message have been removed]
Mon May 20, 2013 7:59 pm (PDT) . Posted by:
dhandmade
Saya berkenan dok
Alhamdulillah, skrg baby anteng. Emaknya siap2. Browsing
Ambar Kurniastuti
bundanya NajmiNamiraNadira
Selamat pagi SP n Dokter
Mohon saran utk keluhan mama sy , usia 65thn BB 35kg TB 148cm
Mengeluhkan:
1. Jari2 kaki kiri terkadang keram
2. Lutut kaki kiri bila di balik kekanan sakit dan bila akan menaiki tangga melangkah, jika kaki kanan lebih dulu kaki kiri di angkat tidak bisa di labuhkan malah terasa sakit
3. Kaki kanan bagian lutut tdk dpt lama2 bersujud, krn sakit jadi harus cpt2 di luruskan
4. Cepat lelah dan sering nyeri di bagian punggung / belikat dan tengkuk leher
5. Tgn sebelah kiri bagian ibu jari ada pembengkakan , bila tersentuh terasa sakit.
Maaf kalau bahasanya susah di mengerti ,
Sy mohon bantuan link atau saran ke dokter apa mama saya harus konsultasi..
makasih
*diza*
Sent from my BlackBerry®
powered by Sinyal Kuat INDOSAT
Mohon saran utk keluhan mama sy , usia 65thn BB 35kg TB 148cm
Mengeluhkan:
1. Jari2 kaki kiri terkadang keram
2. Lutut kaki kiri bila di balik kekanan sakit dan bila akan menaiki tangga melangkah, jika kaki kanan lebih dulu kaki kiri di angkat tidak bisa di labuhkan malah terasa sakit
3. Kaki kanan bagian lutut tdk dpt lama2 bersujud, krn sakit jadi harus cpt2 di luruskan
4. Cepat lelah dan sering nyeri di bagian punggung / belikat dan tengkuk leher
5. Tgn sebelah kiri bagian ibu jari ada pembengkakan , bila tersentuh terasa sakit.
Maaf kalau bahasanya susah di mengerti ,
Sy mohon bantuan link atau saran ke dokter apa mama saya harus konsultasi..
makasih
*diza*
Sent from my BlackBerry®
powered by Sinyal Kuat INDOSAT
Kalau ke dr umum dulu, biar dilihat klinisnya gimana baru dirujuk ke dokter spesialis yang sesuai juga bisa.
Kalau baca kondisi ibu, terpikir dokter sp orthopedi sih.
Rgds,
Marcella
*mpok bawel
Sent from my BlackBerry®
powered by Sinyal Kuat INDOSAT
Kalau baca kondisi ibu, terpikir dokter sp orthopedi sih.
Rgds,
Marcella
*mpok bawel
Sent from my BlackBerry®
powered by Sinyal Kuat INDOSAT
Mon May 20, 2013 7:58 pm (PDT) . Posted by:
"nancy batu" nancybatu
Dear All,
4 tahun yang lalu, mama teman saya dinyatakan kanker payudara stadium 2. Setelah dioperasi, kondisi kesehatan mamanya baik dan mampu beraktifitas normal. Namun, kemarin saya mendapat kabar bahwa mamanya dirawat di salah satu rumah sakit karena kondisinya drop. Menurut dokter, kankernya menyerang paru-paru.
Mohon bantuan, adakah rekomendasi dokter spesialis untuk kanker paru?
Terimakasih untuk bantuannya.
salam
nancy
[Non-text portions of this message have been removed]
4 tahun yang lalu, mama teman saya dinyatakan kanker payudara stadium 2. Setelah dioperasi, kondisi kesehatan mamanya baik dan mampu beraktifitas normal. Namun, kemarin saya mendapat kabar bahwa mamanya dirawat di salah satu rumah sakit karena kondisinya drop. Menurut dokter, kankernya menyerang paru-paru.
Mohon bantuan, adakah rekomendasi dokter spesialis untuk kanker paru?
Terimakasih untuk bantuannya.
salam
nancy
[Non-text portions of this message have been removed]
Mon May 20, 2013 7:59 pm (PDT) . Posted by:
ni.nugroho
Dear mbak nancy,
Kanker payudara yg meluas ke paru2 jatuhnya jadi metastase kanker payudaranya mbak....
Cmiiw ya all
Salam,
Rini
Powered by Telkomsel BlackBerry®
Kanker payudara yg meluas ke paru2 jatuhnya jadi metastase kanker payudaranya mbak....
Cmiiw ya all
Salam,
Rini
Powered by Telkomsel BlackBerry®
Mon May 20, 2013 8:00 pm (PDT) . Posted by:
"yazid keisha"
Thanx sharingnya
Anaknya pilih infus.saat disuntik masukan jarum jg ga nangis.dia mau makan
nasiputih aja,yg lain ga mau,minum susah,susu ga mau.karna suhunya 38C.kalo
udah 39,ga mau apa2,lemes aja+muntah.saat sehatpun minum susah,hy mau
susu,airputih susah bgt.
AB udah butuh belum?udah masuk cefotaxim dr infus + antimuntah.obat batuk
mau masuk,saya tolak karna ga ada batuk pilek.ingusan ada,tp karna nangis
disuruh minum ga mau.
Tes darah udah.NS-1: negatif
Hb:10,2(11-15)
Leukost:11,3(5-13,5)
Basofl:0(0-1)
Eosinofl:0(2-4)
Neutrofl:56(32-52)
Limfst:23(30-60)
Monost:21(2-8)
Lj endp darah:15(0-10)
Lain-lain:tdk ditemukan
Eritrost:4,55(4,10-5,50)
Hemotokrit:31,6(34-45)
MCV:69,5(73-91)
MCH:22,4(24-30)
MCHC:32,3(33-37)
Trombosit:271(150-400)
Ada yg perlu dikhawatirkan dgn hsl lab di atas?manage demam itu selain obat
penurun panas apa?gimana nyembhin penyakitnya ya?
Ini lg ajak anak pulang,tp bingung ngobatin penyebab panasnya
gimana?diagnosa dok jg blm ada karna dsa blm visit
Pada Selasa, 21 Mei 2013, menulis:
> Jeng Ami, anaknya usia 3th6bln
>
> Setuju sama jeng Ami
> Nambahin ya
>
> Si Keisha udah diinfus kan ?
> Udah umur segitu ngerti diajak ngomong, kan bisa nurut sama dokter, mesti
> dimarahi mamanya, jadi kesimpulannya, anaknya udah bisa diskusi 2 arah
> dengan sederhana.
>
> Nah, tanya sama Keisha, pilih diinfus atau mau minum aja ? Dia yang suruh
> pilih, sehingga bisa termotivasi nantinya.
>
> Anak normal nih ya, biasanya pilih minum daripada diinfus. Infus itu
> sakit, pegel bagian ditusuk, terikat sama botol infus dan kadand sama tiang
> infus juga (kemana2 dibawa, bahkan sampai ke wc), beberapa hari sekali
> ganti lokasi tusukan, ditusuk2 lagi, cari pembuluh dara, sengsara lagi,
> nangis lagi, "direjeng"; lagi biar gak gerak2...dsb dll dst
>
> Kalau gambaranya so real and so detail, dijamin anak bakal manut minta
> minum lewat mulut aja daripada ditusuk2.
>
> Cairan, utama buat jadi asupan.
> Jadi makanan juga kalau bisa cair yang masuk, ya gak apa.
>
> Buat bubur cair, dari beras, kacang ijo, buah pure dikasih air, kaldu
> dengan daging yang halus (serat2 yang lembut, cincang saring nanti jadinya
> kayak bubur) tinggal hirup telan, bayam kan gampang lembut, bisa ikut jadi
> campuran juga. Apel dijus, dinginkan, minum pakai sedotan, and masih banyak
> lagi cara asupan supaya gak perlu menyakitkan saat melewati tenggorokan
> yang memang lagi gak nyaman itu.
>
> Saya nambah itu aja ya. Kalau anak sakit memang otak suka blank mendadak,
> saya bantu bagian biar gak mati gaya, dalam mendokrak asupan gizi dan
> cairannya.
>
> Rgds,
> Marcella
> *mpok bawel - mendekat kantor
> Sent from my BlackBerry®
> powered by Sinyal Kuat INDOSAT
>
> ------------------------------------
>
> Milis SEHAT mengucapkan terima kasih kepada HANSAPLAST selaku sponsor
> kegiatan PESAT Balikpapan (4-5 Mei 2013), PESAT SUA Bali (18-19 Mei 2013),
> dan PESAT SUA Bandung, Juni 2013.
> Hansaplast, "Sembuh Lebih Cepat, Ceria Setiap Saat"
>
> Terima kasih & penghargaan sedalam-dalamnya kepada HBTLaw dan PT.Intiland
> yang telah dan konsisten mensponsori program kami, PESAT (Program Edukasi
> Kesehatan Anak Untuk Orang Tua)."
>
> "Milis SEHAT didukung oleh : CBN Net Internet Access & Website.
> =================================================================
> Milis Sehat thanks to HANSAPLAST as sponsor for PESAT Balikpapan (May 4-5,
> 2013), PESAT SUA Bali (May 18-19, 2013), dan PESAT SUA Bandung in June 2013.
> Hansaplast, "Sembuh Lebih Cepat, Ceria Setiap Saat"
>
> Our biggest gratitude to HBTLaw and PT. Intiland, who have consistently
> sponsored our program, PESAT (Program Edukasi Kesehatan Anak Untuk Orang
> Tua)."
> "SEHAT mailing list is supported by CBN Net for Internet Access &Website.
>
> Kunjungi kami di (Visit us at):
> Official Web : http://milissehat.web.id/
> FB : http://www.facebook.com/pages/Milissehat/131922690207238
> Twitter : @milissehat <http://twitter.com/milissehat/ >
> ==================================================================
> Donasi (donation):
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> Bank Mandiri
> Cabang Kemang Raya Jakarta
> Account Number: 126.000.4634514
> ==================================================================Yahoo!
> Groups Links
>
>
>
>
[Non-text portions of this message have been removed]
Anaknya pilih infus.saat disuntik masukan jarum jg ga nangis.dia mau makan
nasiputih aja,yg lain ga mau,minum susah,susu ga mau.karna suhunya 38C.kalo
udah 39,ga mau apa2,lemes aja+muntah.saat sehatpun minum susah,hy mau
susu,airputih susah bgt.
AB udah butuh belum?udah masuk cefotaxim dr infus + antimuntah.obat batuk
mau masuk,saya tolak karna ga ada batuk pilek.ingusan ada,tp karna nangis
disuruh minum ga mau.
Tes darah udah.NS-1: negatif
Hb:10,2(11-15)
Leukost:11,3(
Basofl:0(0-1)
Eosinofl:0(2-
Neutrofl:56(
Limfst:23(30-
Monost:21(2-
Lj endp darah:15(0-10)
Lain-lain:tdk ditemukan
Eritrost:4,55(
Hemotokrit:31,
MCV:69,5(73-
MCH:22,4(24-
MCHC:32,3(33-
Trombosit:271(
Ada yg perlu dikhawatirkan dgn hsl lab di atas?manage demam itu selain obat
penurun panas apa?gimana nyembhin penyakitnya ya?
Ini lg ajak anak pulang,tp bingung ngobatin penyebab panasnya
gimana?diagnosa dok jg blm ada karna dsa blm visit
Pada Selasa, 21 Mei 2013, menulis:
> Jeng Ami, anaknya usia 3th6bln
>
> Setuju sama jeng Ami
> Nambahin ya
>
> Si Keisha udah diinfus kan ?
> Udah umur segitu ngerti diajak ngomong, kan bisa nurut sama dokter, mesti
> dimarahi mamanya, jadi kesimpulannya, anaknya udah bisa diskusi 2 arah
> dengan sederhana.
>
> Nah, tanya sama Keisha, pilih diinfus atau mau minum aja ? Dia yang suruh
> pilih, sehingga bisa termotivasi nantinya.
>
> Anak normal nih ya, biasanya pilih minum daripada diinfus. Infus itu
> sakit, pegel bagian ditusuk, terikat sama botol infus dan kadand sama tiang
> infus juga (kemana2 dibawa, bahkan sampai ke wc), beberapa hari sekali
> ganti lokasi tusukan, ditusuk2 lagi, cari pembuluh dara, sengsara lagi,
> nangis lagi, "direjeng"
>
> Kalau gambaranya so real and so detail, dijamin anak bakal manut minta
> minum lewat mulut aja daripada ditusuk2.
>
> Cairan, utama buat jadi asupan.
> Jadi makanan juga kalau bisa cair yang masuk, ya gak apa.
>
> Buat bubur cair, dari beras, kacang ijo, buah pure dikasih air, kaldu
> dengan daging yang halus (serat2 yang lembut, cincang saring nanti jadinya
> kayak bubur) tinggal hirup telan, bayam kan gampang lembut, bisa ikut jadi
> campuran juga. Apel dijus, dinginkan, minum pakai sedotan, and masih banyak
> lagi cara asupan supaya gak perlu menyakitkan saat melewati tenggorokan
> yang memang lagi gak nyaman itu.
>
> Saya nambah itu aja ya. Kalau anak sakit memang otak suka blank mendadak,
> saya bantu bagian biar gak mati gaya, dalam mendokrak asupan gizi dan
> cairannya.
>
> Rgds,
> Marcella
> *mpok bawel - mendekat kantor
> Sent from my BlackBerry®
> powered by Sinyal Kuat INDOSAT
>
> ------------
>
> Milis SEHAT mengucapkan terima kasih kepada HANSAPLAST selaku sponsor
> kegiatan PESAT Balikpapan (4-5 Mei 2013), PESAT SUA Bali (18-19 Mei 2013),
> dan PESAT SUA Bandung, Juni 2013.
> Hansaplast, "Sembuh Lebih Cepat, Ceria Setiap Saat"
>
> Terima kasih & penghargaan sedalam-dalamnya kepada HBTLaw dan PT.Intiland
> yang telah dan konsisten mensponsori program kami, PESAT (Program Edukasi
> Kesehatan Anak Untuk Orang Tua)."
>
> "Milis SEHAT didukung oleh : CBN Net Internet Access & Website.
> ============
> Milis Sehat thanks to HANSAPLAST as sponsor for PESAT Balikpapan (May 4-5,
> 2013), PESAT SUA Bali (May 18-19, 2013), dan PESAT SUA Bandung in June 2013.
> Hansaplast, "Sembuh Lebih Cepat, Ceria Setiap Saat"
>
> Our biggest gratitude to HBTLaw and PT. Intiland, who have consistently
> sponsored our program, PESAT (Program Edukasi Kesehatan Anak Untuk Orang
> Tua)."
> "SEHAT mailing list is supported by CBN Net for Internet Access &Website.
>
> Kunjungi kami di (Visit us at):
> Official Web : http://milissehat.
> FB : http://www.facebook
> Twitter : @milissehat <http://twitter.
> ============
> Donasi (donation):
> Rekening Yayasan Orang Tua Peduli
> Bank Mandiri
> Cabang Kemang Raya Jakarta
> Account Number: 126.000.4634514
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Mon May 20, 2013 8:06 pm (PDT) . Posted by:
"hennie"
Bunda Wati,
Trmksh banyak atas responnya :)
Sy coba runutkan cerita insisinya bayi sy kmrn...
Bayi kami sdh disarankan utk diinsisi dr umur 1 minggu, ketika sy datang ke klinik laktasi dgn maksud evaluasi pelekatan. Saya menolak. Ketika di minggu kedua mereka menyarankan lg utk insisi pun sy msh menolak mentah2, krn sy yakin masalah menyusui saya hanya di pelekatan, aplg sy memiliki puting datar.
Tapi...krn semakin hari smkn terasa sakit luar biasa ketika menyusui, jg krn pertambahan BB bayi sy yg super irit, dan juga krn para konselor laktasi di tempat sy konsul itu selalu menyarankan utk insisi dgn tujuan menghilangkan rasa sakit saya dan spy BB bayi saya bs naik signifikan... Akhirnya di umur 1 bulan kurang 1 hari (sabtu, 18 mei kmrn), sy dan suami memutuskan utk mengikuti saran mereka. Sy dtg ke ketua Tim Laktasi di RS tersebut yg jg seorang DSA. Sbnrnya msh utk mendapatkan jawaban yg meyakinkan apakah memang insisi tongue tie bayi kami ini adlh solusi terbaik.
Dan eng ing eng...ketika bertemu beliau sy dan suami lgsg dimarahi habis2an. Knp baru setuju insisi saat bayi kami sdh 1 bulan? Knp tdk dr umur 1 minggu ketika pertama kali didiagnosa? Menurut beliau, udah sy puting datar, tongue tienya parah, komplit deh! Saya, yg sdh dalam kondisi babak belur berjibaku dgn urusan menyusui selama sebulan, juga sambil mengurusi kedua anak saya lainnya yg msh balita, rasanya sedih sesedih-sedihnya. Berasa sbg orangtua yg bodoh dimata beliau yg DSA dan (katanya) pakar laktasi tsb.
Hari ini adalah hari ke 3 stlh insisi, saya blm tahu apakah BBnya sdh naik/blm. Yg jelas ketika diinsisi BB bayi saya 3050gr (1 bln), dan BB lahir 3000gr.
Stlh sy posting ttg mencari donor asi disini, cukup banyak yg merespon dan menawarkan. untungnya ada tetangga dan sodara yg jg menawarkan, jd ga perlu jauh2. Tapi pada akhirnya kmrn saya dan suami sepakat utk tdk jd memakai donor asi dulu. Sy mau jor2an ngasih asi sy sendiri dulu dgn dibantu sufor khusus utk slow weight gain.
Begitulah 'cerita' saya Bun...maaf ya utk smua kalau kepanjangan :)
Salam,
Henie
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Trmksh banyak atas responnya :)
Sy coba runutkan cerita insisinya bayi sy kmrn...
Bayi kami sdh disarankan utk diinsisi dr umur 1 minggu, ketika sy datang ke klinik laktasi dgn maksud evaluasi pelekatan. Saya menolak. Ketika di minggu kedua mereka menyarankan lg utk insisi pun sy msh menolak mentah2, krn sy yakin masalah menyusui saya hanya di pelekatan, aplg sy memiliki puting datar.
Tapi...krn semakin hari smkn terasa sakit luar biasa ketika menyusui, jg krn pertambahan BB bayi sy yg super irit, dan juga krn para konselor laktasi di tempat sy konsul itu selalu menyarankan utk insisi dgn tujuan menghilangkan rasa sakit saya dan spy BB bayi saya bs naik signifikan..
Dan eng ing eng...ketika bertemu beliau sy dan suami lgsg dimarahi habis2an. Knp baru setuju insisi saat bayi kami sdh 1 bulan? Knp tdk dr umur 1 minggu ketika pertama kali didiagnosa? Menurut beliau, udah sy puting datar, tongue tienya parah, komplit deh! Saya, yg sdh dalam kondisi babak belur berjibaku dgn urusan menyusui selama sebulan, juga sambil mengurusi kedua anak saya lainnya yg msh balita, rasanya sedih sesedih-sedihnya. Berasa sbg orangtua yg bodoh dimata beliau yg DSA dan (katanya) pakar laktasi tsb.
Hari ini adalah hari ke 3 stlh insisi, saya blm tahu apakah BBnya sdh naik/blm. Yg jelas ketika diinsisi BB bayi saya 3050gr (1 bln), dan BB lahir 3000gr.
Stlh sy posting ttg mencari donor asi disini, cukup banyak yg merespon dan menawarkan. untungnya ada tetangga dan sodara yg jg menawarkan, jd ga perlu jauh2. Tapi pada akhirnya kmrn saya dan suami sepakat utk tdk jd memakai donor asi dulu. Sy mau jor2an ngasih asi sy sendiri dulu dgn dibantu sufor khusus utk slow weight gain.
Begitulah 'cerita&#
Salam,
Henie
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Bank Mandiri
Cabang Kemang Raya Jakarta
Account Number: 126.000.4634514
==================================================================
Hansaplast, "Sembuh Lebih Cepat, Ceria Setiap Saat"
Terima kasih & penghargaan sedalam-dalamnya kepada HBTLaw dan PT.Intiland yang telah dan konsisten mensponsori program kami, PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."
"Milis SEHAT didukung oleh : CBN Net Internet Access & Website.
=================================================================
Milis Sehat thanks to HANSAPLAST as sponsor for PESAT Balikpapan (May 4-5, 2013), PESAT SUA Bali (May 18-19, 2013), dan PESAT SUA Bandung in June 2013.
Hansaplast, "Sembuh Lebih Cepat, Ceria Setiap Saat"
Our biggest gratitude to HBTLaw and PT. Intiland, who have consistently sponsored our program, PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."
"SEHAT mailing list is supported by CBN Net for Internet Access &Website.
Kunjungi kami di (Visit us at):
Official Web : http://milissehat.web.id/
FB : http://www.facebook.com/pages/Milissehat/131922690207238
Twitter : @milissehat <http://twitter.com/milissehat/>
==================================================================
Donasi (donation):
Rekening Yayasan Orang Tua Peduli
Bank Mandiri
Cabang Kemang Raya Jakarta
Account Number: 126.000.4634514
==================================================================