Your 3-year-old timeline: Pitch perfect

Your 3-year-old now
Sometimes, when you watch your child playing, you might wonder whether he's headed for a future in the theater. Three-year-olds spend a great deal of time supplying dialogue to their dolls, imitating adults' conversations, and using different kinds of voices for different characters — high little voices for babies and deep and powerful ones for superheroes, for example.

These sophisticated variations in speech are evidence your child is internalizing the ways people use language. Listen closely and you may hear familiar phrases or pitches. Your child is catching on that grownups talk differently to one another than to children, for example, or that you sound one way when talking to your mom compared with your boss. Then he unconsciously practices these various modes of speech in hisplay. It's another reason preschoolers are such chatterboxes!


Your life now
You probably have scrapbooks full of photos of your child by now. (Or at least in your camera waiting to be uploaded ... hey, at least you snapped them!) How many are fantastic? How many are ho-hum? Hmm ... we thought so. Some tips on getting great shots of your moving target:

• Turn off the flash. The light will be nicer and it's less distracting.


• Go outside for better light, simpler backdrops, and a happier child.


• Snap away. You need to take a lot to get that great expression — which is why the digital camera is God's gift to parents.


• Resist posing. Capturing your child while he's concentrating on a toy, running, singing — anything active is liable to catch a truer moment.


• Plan props. Bubbles are a great smile-producer and look terrific, too. Have a third person on hand to blow while you shoot.


• Keep the camera ready. Stow it in your purse: You never know when that magic moment will appear.

http://www.parentcenter.babycenter.com/

Your 3-year-old timeline: Preschooler proof

Your 3-year-old now
As your child becomes more physically capable, this is a good time to insist on some basic safety goals.
Enforce a helmet habit. If your child gets used to wearing one on her trike, she likely won't think twice about putting one on when she hops on her two-wheeler someday.
Make sure knives and other sharp objects are still out of reach now that your child is taller and more adept at climbing and opening drawers.
Continue to use the car seat every time as required by law. If your child has figured out how to unlatch herself, make it clear this is nonnegotiable and check to be sure she's snapped in before you start the engine and also while you're en route.
All medicines need to be locked up, as "up and away" may be just the temptation your child is looking for.
Be sure all playgrounds have safe surfaces under the climbing equipment.

Your life now
Firmness is great when it comes to discipline. But if you're sending your charge to time-out multiple times a day, something's not working. Either your expectations are too high or your rules are too numerous. Jumping on your child's case for every small infraction only leads to more defiance and power struggles. Generally three big rules are enough at this age, so sort your priorities. Rule of thumb: Limit time-outs to major infractions like hitting or breaking big household rules. You probably shouldn't need to resort to this punishment more than once a day. If she's spending half her life in time-out, readjust the rules, catch her being good, or consider whether boredom is setting in — maybe she needs a walk around the block or some new ideas for playtime.

www.parentcenter.babycenter.com

10 FAKTA SEPUTAR MIMISAN

Waspadai jika mimisan disertai gejala lain seperti demam dan sakit kepala.

Simaklah penjelasan dr. Najib Advani, Sp.A (K) M.Med.Paed., dalam bentuk tanya jawab berikut.

1. Apakah mimisan berbahaya?

Sebagian besar mimisan pada anak tidak berbahaya.
Jadi, tak perlu panik. Selama anak terlihat sehat dan aktif, juga tidak disertai gejala lain seperti demam, orangtua tak perlu kelewat khawatir.

2. Mengapa dari hidung sering keluar darah atau mimisan?

Maklum saja, hidung punya banyak pembuluh darah, terutama di balik lapisan tipis cupingnya.

3. Mengapa mimisan paling sering terjadi pada anak?

Selaput lendir dan pembuluh darah anak masih tipis dan sensitif, sehingga saat ada faktor pencetus seperti udara dingin atau trauma ringan, darah pun langsung mengucur keluar. Terjadinya pun umumnya spontan, ringan, dan mudah berhenti.

4. Apa saja faktor pencetus mimisan pada anak?

- Trauma
Seperti akibat benturan benda keras, kemasukan benda asing, atau dikorek-korek yang membuat selaput lendir dan pembuluh darah di hidung terluka dan menyebabkan perdarahan.

- Penggunaan AC tidak bijak
Cara kerja AC yang menyerap uap air di udara membuat kelembapan di ruangan jauh berkurang. Ditambah, suhu yang terlalu dingin membuat udara jadi makin kering.
Udara kering yang diisap anak akan membuat alat pernapasannya mengering, sehingga selaput lendirnya mudah pecah dan berdarah.

- Reaksi refluks
Khusus untuk bayi, mimisan bisa terjadi karena reaksi refluks. Ini terjadi saat bayi muntah atau gumoh.
Aliran balik makanan dari lambung ke mulut atau hidung dapat menyebabkan mimisan. Muntahan yang banyak mengandung zat asam itu bisa mengiritasi atau melukai hidung. Mimisan pada bayi umumnya juga sembuh sendiri dan tidak perlu penanganan khusus.

- Faktor keturunan
Anak-anak tertentu lahir dengan pembuluh darah di hidung yang gampang pecah dan berdarah. Jika kelembapan udara sangat rendah seperti di negeri subtropis dan suhunya sangat dingin, maka anak-anak seperti ini umumnya tidak sehingga hidungnya terus-menerus mengeluarkan darah. Padahal, banyak anak lain yang tidak merasakan gangguan serupa.
Pernah ada kasus seorang anak Indonesia batal melanjutkan sekolahnya selama musim dingin ke negeri empat musim "hanya" karena berbakat mimisan.

5. Bagaimana mengatasinya?

Pertolongan pertama yang bisa dilakukan adalah menghentikan perdarahan tanpa bantuan obat dan alat.

Cukup dengan duduk dengan posisi badan dan kepala agak maju ke depan. Lalu gunakan ibu jari dan telunjuk untuk menekan dan menutup hidung. Sedangkan mulut dibuka untuk bernapas. Lakukan selama 1-2 menit. Tak berapa lama kemudian biasanya darah langsung berhenti.

Dengan memajukan kepala berarti darah tidak akan mengalir kembali ke tenggorokan. Gunanya mencegah iritasi dan batuk, tersedak, atau muntah darah. Posisi duduk juga membuat aliran darah lebih lambat, karena posisi jantung sebagai pusat pompa darah berada di bawah hidung. Berbeda jika anak dibaringkan, karena posisi jantung berada sejajar dengan hidung, sehingga darah yang mengalir pun relatif lebih cepat.

Jika cara pertama belum berhasil, cobalah kompres hidung dengan es. Bungkuslah es dengan saputangan lalu tempelkan di antara kening dan hidung. Selain es, benda lain seperti makanan atau minuman beku bisa digunakan. Es dan benda dingin lainnya yang ditempelkan mampu mengecilkan pembuluh darah sehingga perdarahan pun cepat berhenti. Kompres bisa dilakukan saat perdarahan sedang berlangsung maupun berhenti.

Hal yang penting dilakukan, bersikaplah tenang saat si kecil mimisan. Kepanikan orangtua dapat membuat anak ikut panik dan menangis. Akhirnya, perdarahan sulit dihentikan.

6. Bagaimana kalau darah belum berhenti keluar?

Jika dalam waktu 15-20 menit perdarahan tidak kunjung berhenti, ulangi gerakan menutup dan menekan hidung seperti dijelaskan tadi. Segera datangi klinik dokter atau rumah sakit terdekat jika mimisan tidak berhenti.

Dokter akan membantu dengan memberikan obat tetes atau obat semprot yang mampu menghambat pecahnya pembuluh darah. Bahkan, boleh jadi bagian hidung yang berdarah dibakar (dikostik) agar darah tidak terus-menerus keluar, kemudian hidung dibersihkan. Kalau tidak berhasil, dokter akan memberi tampon atau kapas dengan salep vaselin selama 1-2 hari. Fungsinya menekan dan mengistirahatkan perdarahan.

7. Setelah darah berhenti keluar, apa yang harus dilakukan?

Usahakan anak tidak mengembuskan napas lewat hidung terlalu keras. Anak juga harus dijelaskan agar tidak mengorek-ngorek hidung atau bekas luka yang mengering.
Tindakan itu akan menyebabkan hidung mengalami perdarahan kembali.

8. Akankah kejadian mimisan reda selamanya?

Jika sudah diatasi maka gangguan mimisan pun akan berhenti. Mimisan karena demam berdarah, misalnya, tentu akan hilang setelah demam berdarahnya sembuh.
Demikian juga dengan mimisan karena penyakit infeksi, setelah diobati, mimisan pun segera pergi.

Gangguan mimisan umumnya berkurang sesuai dengan pertambahan usia. Semakin tambah usia, pembuluh darah dan selaput lendir di hidungnya sudah semakin kuat, hingga tak mudah berdarah.

9. Mimisan seperti apa yang perlu ditangani serius?

Meski mayoritas kasus mimisan tidak berbahaya, orangtua hendaknya waspada jika frekuensi mimisan itu cukup sering, tiap 1-2 hari. Ini karena ada kemungkinan si kecil mengidap penyakit berbahaya.

Penyakit seperti ITP (Idiopathic Thrombocytopenic Purpura), demam berdarah, leukemia, thalasemia berat, atau hemofilia, bisa juga menunjukkan gejala mimisan.

Ini karena kadar trombosit yang rendah bisa menyebabkan perdarahan di hidung. Anak hemofilia bisa saja memiliki kadar trombosit yang normal, tapi faktor pembekuan darahnya rendah sehingga sering mengalami perdarahan. Meski kasusnya sangat jarang, anak darah tinggi dan gagal ginjal pun memiliki risiko besar mengalami mimisan. Demikian juga anak dengan riwayat hipertensi (tekanan darah tinggi).

Perhatikan gejala-gejala yang mungkin menyertai. Jika disertai demam, kemungkinan penyebabnya penyakit infeksi seperti demam berdarah. Jika disertai munculnya bercak-bercak darah kemungkinan menjurus pada leukemia atau ITP. Sedangkan pada sinusitis umumnya mimisan disertai sakit kepala.

Berbeda dari mimisan normal yang umumnya bersumber pada bagian anterior (bagian depan rongga hidung), maka mimisan yang disertai penyakit berbahaya bersumber dari bagian dalam hidung (posterior). Tak heran, darah yang keluar banyak dan sulit dihentikan.

Perdarahan yang banyak bisa membuat anak kekurangan darah (anemia). Bahkan, bukan tidak mungkin menyebabkannya pingsan. Untuk mengatasinya, dokter akan memberikan vitamin dan mineral. Lain hal jika anak kehilangan darah cukup banyak. Sangat mungkin dia harus menjalani transfusi darah.

10. Apakah pemakaian obat-obat tertentu dapat menyebabkan mimisan?

Ya, penggunaan obat-obat tertentu pun bisa menyebabkan mimisan. Obat antipanas yang mengandung acetyl salicylic acid, misalnya, pada beberapa anak bisa menyebabkan mimisan. Segera konsultasikan pada dokter jika obat tertentu memberikan reaksi kurang baik seperti mimisan pada anak.

TIP CEGAH MIMISAN

• Gunakan AC dengan bijak dan aman. Jangan menyetel AC terlalu dingin dan lama. Selain boros energi, udara di ruangan akan menjadi sangat dingin dan kering. Untuk Indonesia, suhu 23-260C relatif cukup.


• Hindari anak dari paparan asap rokok. Selain dapat mengiritasi saluran pernapasan, rokok juga bisa mengeringkan saluran hidung. Ini jelas akan membuat anak mudah mengalami mimisan.


• Saat gatal, pilek, atau membersihkan kotoran hidung, ajari anak untuk menggunakan tisu maupun saputangan. Hindari kebiasaan mengorek-ngorek hidung atau mengembuskan udara lewat hidung terlalu keras.


• Usahakan banyak makan sayur dan buah guna memperkuat selaput lendir hidung.


• Jauhkan anak dari benda-benda pencetus alergi di rumah. Barang-barang berbahaya juga sebaiknya disingkirkan agar tidak sampai mencederai anak.
  

Arsip: http://www.freelists.org/archives/ak93-feua

3-year-old timeline: tantrum tamers

Your 3-year-old now
She's 3, but still having tantrums. Although she's older, when she's upset she's every bit as emotionally primitive as she was as a toddler. (And, brace yourself — it's not unusual for occasional tantrums to pop up through the fours and beyond.) When your child is in full-meltdown mode, don't try to reason with her, no matter how advanced her language skills are. Stay calm, even detached. Raised voices and anger only escalate the situation. If you can, ignore her. If you're in public, try to remove her to your car or some other more private, less overwhelming place.

In one important way, handling a tantrum with a 3-year-old is different: Giving in is especially risky at this age because it sets a dangerous precedent — your child is able to remember that pitching a fit can work. For instance, she screams because she doesn't want to pick up her toys so you let it slide, or she flails when she can't have candy in the checkout aisle, so you give in "just this once" to hush her up. If you cave, you teach her that screaming works and that all limits are flexible — probably not the kind of discipline messages you're aiming for.

A great prevention technique: Reward your child when you see her handling frustration or disappointment in a mature way. "Wow, I like how you didn't fuss one bit when I asked you to help pick up the toys on the floor before going outside."


Your life now
Make reading interactive and your child will get even more out of the experience (and you'll ward off the boredom of reading the same story 900 times). Ask questions about the pictures to reinforce numbers, colors, and other skills: "Can you count the monkeys? ... What does a puppy say? ... Where's the red house?" Let your preschooler predict what will happen on the next page. Insert her name in place of the main character's.

source www.parentcenter.babycenter.com

Why so serious?

The follow-up to the action hit "Batman Begins," "The Dark Knight" reunites director Christopher Nolan and star Christian Bale, who reprises the role of Batman/Bruce Wayne in his continuing war on crime.

With the help of Lieutenant Jim Gordon and District Attorney Harvey Dent, Batman sets out to destroy organized crime in Gotham for good. The triumvirate proves to be effective, but they soon find themselves prey to a rising criminal mastermind known as the Joker, who thrusts Gotham into anarchy and forces the Dark Knight ever closer to crossing the fine line between hero and vigilante.

Academy Award nominee Heath Ledger ("Brokeback Mountain") stars as arch-villain The Joker, and Aaron Eckhart plays District Attorney Harvey Dent. Maggie Gyllenhaal joins the cast in the role of Rachel Dawes. Returning from "Batman Begins" are Gary Oldman as Lieutenant Jim Gordon; Oscar winner Michael Caine ("The Cider House Rules") as Alfred; and Oscar winner Morgan Freeman ("Million Dollar Baby") as Lucius Fox.

Warner Bros. Pictures presents, in association with Legendary Pictures, a Syncopy Production, a Christopher Nolan film, "The Dark Knight." Nolan directed the film from a screenplay written by Jonathan Nolan and Christopher Nolan, story by Christopher Nolan & David S. Goyer. Charles Roven, Emma Thomas and Christopher Nolan are the producers, with Benjamin Melniker, Michael E. Uslan, Kevin De La Noy and Thomas Tull serving as executive producers. "The Dark Knight" is based upon characters appearing in comic books published by DC Comics. Batman was created by Bob Kane.

source www.movieweb.com

3-year-old timeline: Name Writing

Your 3-year-old now
It's exciting when your child's scribbles begin to look more like real letters. Some threes even start writing their name, or a few letters of it. But writing is one of those developmental milestones that varies greatly from child to child. Don't stress out if your child isn't even interested in writing.

A lot depends on fine motor development. Your child may have a clear dominant hand by now (or it may not be clear for another year or so). But it's still hard to control a pencil to make letters with diagonal lines (M, N, K). Other letters may not look quite right either. The lines might not connect at the right place, or letters like E may have too many horizontal lines. What kids should be able to do at this age is copy a circle and make an "x."

Regardless of where your child is on the spectrum, encourage his writing by keeping paper, fat pencils, fat crayons, and chalk within easy reach. Another way to pique interest: Pour sand, salt, or sugar onto a tray and show him how to trace letters with a finger.

Your life now
Some clever bedtime resisters prolong the routine by asking you to kiss not only them, but an ever-increasing cast of stuffed animals. If your child tries luring you into a 20-minute kissing party, put your foot down. What seems fun at first will get tiresome fast. Say, "You have too many animals for me to kiss. Let's pick three, and then I'll blow a big kiss to all the rest when I walk out the door."

Source http://www.parentcenter.babycenter.com/

Journey to the Center of the Earth

Journey to the Center of the Earth
Opened July 11, 2008
Runtime:1 hr. 32 min.

Intense adventure action and some scary moments. On a quest to find out what happened to his missing brother, a scientist, his nephew and their mountain guide discover a fantastic and dangerous lost world in the center of the earth.

During a scientific expedition in Iceland, visionary scientist Trevor Anderson (Brendan Fraser), his nephew Sean (Josh Hutcherson) and their beautiful local guide, Hannah (Anita Briem), are unexpectedly trapped in a cave from which their only escape is to go deeper and deeper into the depths of the Earth.

Traveling through never-before-seen worlds, the trio comes face-to-face with surreal and unimaginable creatures--including man-eating plants, giant flying piranha, glow birds and terrifying dinosaurs from days past.

The adventurers soon realize that as volcanic activity increases around them, they must find a way back to the Earth's surface before it is too late.

Take the Journey in RealD 3D – RealD 3D is the world’s leading 3D cinema experience. It’s all digital, so the visuals will blow you away! Check out the RealD 3D theater near you.

Cast: Brendan Fraser, Anita Briem, Josh Hutcherson Director: Eric Brevig Genres: Fantasy Adventure, Prehistoric Fantasy, Adventure, Fantasy

Source : fandango.com, imdb.com

No history of commodity computer clusters would be complete without noting the pivotal role played by the development of Parallel Virtual Machine (PVM) software in 1989. This open source software based on TCP/IP communications enabled the instant creation of a virtual supercomputer -- a high performance compute cluster -- made out of any TCP/IP connected systems. Free form heterogeneous clusters built on top of this model rapidly achieved total throughput in FLOPS that greatly exceeded that available even with the most expensive "big iron" supercomputers.

PVM and the advent of inexpensive networked PCs led, in 1993, to a NASA project to build supercomputers out of commodity clusters. In 1995 the invention of the "beowulf"-style cluster -- a compute cluster built on top of a commodity network for the specific purpose of "being a supercomputer" capable of performing tightly coupled parallel HPC computations. This in turn spurred the independent development of Grid computing as a named entity, although Grid-style clustering had been around at least as long as the Unix operating system and the Arpanet, whether or not it, or the clusters that used it, were named.

Kiat Utama Tatalaksana Asma Anak ( Bag 2 - habis)

sambungan ...

Orang tua pasien seringkali melaporkan eratnya kaitan makanan tertentu dengan timbul atau memburuknya gejala asma pada anaknya. Selain zat makanannya itu sendiri bisa menjadi pencetus, suhu dingin dari makanan/minumannya juga dapat menjadi pencetus. Misalnya air putih tidak dingin tidak menjadi faktor pencetus, tapi air putih dingin dapat menjadi pencetus.

• Es, makanan-minuman dingin, termasuk air dingin, buah dingin
• Permen, dengan segala variasinya
• Coklat, dalam segala macam bentuknya: susu coklat, kue coklat, wafer, misis, selai, dan semua makanan/minuman yang mengandung coklat
• Vetsin, semua makanan bervetsin: snack gurih, fried chicken, mie instant, nugget, sosis, dan lain-lain
• Kacang tanah, dalam segala macam bentuknya: selai, biskuit, somay, sate, pecal, gado-gado, ketoprak
• Gorengan, terutama yang menggunakan minyak goreng bekas
• Buah tertentu, anggur, tomat, klengkeng, rambutan
• Zat pewarna, zat pengawet. Makanan anak-anak seringkali dibuat dalam warna warni mencolok untuk menarik perhatian. Seringkali pewarna atau pengawet dalam makanan menjadi faktor pencetus.

Faktor pencetus serbaneka adalah yang di luar dua kelompok sebelumnya.

• Infeksi respiratori akut (IRA), berupa salesma atau common cold yang sering keliru disebut dengan flu. IRA sebagian besar disebabkan oleh virus, sehingga sebagian besar IRA tidak memerlukan antibiotik. IRA senidiri dapat dimanifestasi sebagai batuk &/ pilek, sebagaimana asma (batuk alergi) dan rintis alergika (pilek alergi). Namun karena infeksi virus bersifat self limiting, biasanya paling lama 1 minggu batuk-pilek karena IRA akan menghilang. Jika lewat seminggu, apalagi jika lebih dari 2 minggu batuk/pileknya masih berlangsung, sangat mungkin asma/rintis alergikanya sudah tercetus oleh IRA.
• Aktivitas fisis (exercise), termasuk di dalamnya berlarian, teriak-teriak, menangis, tertawa berlebihan
• Kelelahan/stress, baik jasmani (fisis) maupun rohani (psikis), emosi berlebihan (sedih, marah, gembira)
• Hawa dingin, suhu dini hari/pagi hari, termasuk suhu AC yang terlalu dingin
• Perubahan musim/cuaca/suhu: kemarau-penghujan, panas-dingin

Faktor pencetus ini bersifat individual, dalam arti belum tentu sama untuk tiap pasien. Oleh karena itu pasien/orang tuanya, perlu apa saja yang berperan sebagai faktor pencetus. Yang perlu mendapat perhatian juga, biasanya faktor pencetus ini tidak berperan tunggal, namun kombinasi dari berbagai faktor pencetus, sehingga bersifat kumulatif.

Sebagaimana halnya keadaan tubuh kita mengalami fluktuasi irama (bioritmik), sifat alergi seseorang juga mengalami irama naik turun. JIka sifat alerginya sedang 'tenang', pasien tidak terlalu sensitif, dan sampai batas tertentu masih dapat mentoleransi faktor pencetus. Tapi jika sedang 'kumat', dengan pencetus tunggal yang sederhana saja dapat timbul gejala penyakitnya.

Jadi sekali lagi kiat utama tatalaksana asma anak adalah penghindaran, bukan obat saja. Penghindaran pencetus in memang mudah untuk dikatakan, tapi sangat sulit pelaksanaannya. Namun dalam penanggulangan asma anak hal ini tidak dapat ditawar-tawar. Seberapa banyak atau betapapun canggihnya obat asma, jika penghindaran faktor pencetus in tidak dilaksanakan, dapat dijamin asmanya tidak akan terkendali (batuk tetap ada/timbul lagi).

Bekasi, 2 Mei 2008
Dr. Darmawan Budi Setyanto, SpA(K)
Spesialis Anak Konsultan Respirologi
Fak. Kedokteran UI
Pusat Asma Anak SUDDHAPRANA RSCM

Kiat Utama Tatalaksana Asma Anak ( Bag 1)

Asma merupakan penyakit kronik (menahun) pada anak yang paling sering dijumpai. Berbeda dengan asma pada orang dewasa yang gejalanya sesak disertai bunyi ngik-ngik, pada anak seringkali gejalanya berupa batuk yang 'bandel'. Dasar penyakit ini adalah faktor alergi yang bergejala di saluran napas. Penyakit ini tidak bisa disembuhkan dalm arti dihilangkan sama sekali dari seorang pasien, namun penyakit ini dapat dikendalikan. Jika terkendali, gejalanya tidak ada, sehingga praktis 'sembuh'. Dalam mengendalikan asma kiat utamanya adalah penghindaran, penghindaran dan sekali lagi penghindaran faktor pencetus. Faktor pencetus adalah hal/keadaan yang bisa menyebabkan gejala asma yang tadinya tidak ada menjadi timbul, atau gejala tidak kunjung membaik, atau yang gejala awalnya ringan menjadi lebih berat.

Hal ini seringkali tidak dipahami oleh pasien/keluarganya. Banyak orang mengira dengan pemberian obat, asma dapat disembuhkan bahkan dihilangkan sama sekali. Keadaan ini yang sering membuat orang tua pasien menjadi frustasi, karena umumnya mereka sudah berkeliling ke banyak dokter, diberi berbagai macam obat, tapi batuk sebagai gejala utama asma tidak kunjung reda/hilang. Ataupun jika membaik sebentar kemudian gejalanya timbul lagi.

Bila digali sedikit lebih dalam, biasanya peran faktor pencetus in belum mendapat perhatian, dan tentunya belum dihindari. Padahal penghindaran faktor pencetus ini merupakan kiat utama dalam tata laksana asma. Pada kebanyakan kasus, dengan penghindaran yang adekuat, asmanya dapat dikendalikan, bahkan bisa tanpa obat. Bila sesekali timbul gejala asma karena faktor pencetus yang tidak terhindarkan, baru diperlukan pemberian obat asma.

Faktor pencetus in biasanya merupakan hal-hal yang lazim dijumpai dalam kehidupan sehari-hari seorang anak. Faktor pencetus ini dapat dibagi menurut beberapa pengelompokan, namun secara praktis dapat dibagi tiga kelompok, yaitu:

• Lingkungan
  
• Makanan
• Serbaneka

Faktor pencetus di >lingkungan ini biasanya berbentuk zat yang dapat terhirup melalui saluran respiratori/napas (aeroinhalan). Ini bisa dijumpai di dalam rumah (indoor), di lingkungan sekitar rumah, di lingkungan sekolah, maupun di lingkungan luar (outdoor pollution). Faktor pencetus hirupan ini antara lain:

• Debu rumah dan tungau debu rumah

Ini banyak terdapat dalam perabot rumah yang potensial menyimpan debu, apalagi bila jarang dibersihkan, misalnya:
- Karpet bulu, boneka bulu, sofa kain bulu
- Korden yang lama tidak dicuci (sebaiknya paling lama setiap 2minggu)
- Koran & majalah bekas, buku-buku tua

• Kapuk: kasur, bantal, guling boneka
• Asap, merupakan salah satu pencetus utama yang sering dijumpai
  - Rokok: termasuk merokok di halaman, teras, garasi, KM/WC, dapur, terlebih dalam rumah
  - Obat nyamuk (bakar, semprot, elektrik), asap hio/dupa
  - Dapur: kayu bakar, minyak tanah, gas
  - Kosmetik: hairspray, parfum, deodorant
  - Bakaran sampah, bakaran hutan
  - Polusi kendaraan, polusi pabrik

• Renovasi rumah: debu puing bangunan, debu semen, bahan kimia (cat, terpentin, dllI)
• Rontokan binatang (animal dander): rontokan bulu, serpihan kulit, air liur, dan kotoran binatang
  - Ayam, burung
  - Anjing, kucing, kelinci, hamster

• Industri rumah tangga (home industry): konveksi, percetakan, bengkel (cat, motor, las)
• Jamur bisa tumbuh subur di lingkungan kamar kita, misalnya
  - dalam AC yang jarang diservice
  - dinding kamar yang lembab
  - rumah yang lama tidak ditinggali

bersambung ...

Hellboy 2: The Golden Army

Believe it or not, he’s the good guy.

With a signature blend of action, humor and character-based spectacle, the saga of the world’s toughest, kitten-loving hero from Hell continues to unfold in “Hellboy 2: The Golden Army.” Bigger muscle, badder weapons and more ungodly villains arrive in an epic vision of imagination from Oscar®-nominated director Guillermo del Toro (”Pan’s Labyrinth,” “Hellboy”).

After an ancient truce existing between humankind and the invisible realm of the fantastic is broken, hell on Earth is ready to erupt. A ruthless leader who treads the world above and the one below defies his bloodline and awakens an unstoppable army of creatures. Now, it’s up to the planet’s toughest, roughest superhero to battle the merciless dictator and his marauders. He may be red. He may be horned. He may be misunderstood. But when you need the job done right, it’s time to call in Hellboy (Ron Perlman).

Along with his expanding team in the Bureau for Paranormal Research and Development–pyrokinetic girlfriend Liz (Selma Blair), aquatic empath Abe (Doug Jones) and protoplasmic mystic Johann–the BPRD will travel between the surface strata and the unseen magical one, where creatures of fantasy become corporeal. And Hellboy, a creature of two worlds who’s accepted by neither, must choose between the life he knows and an unknown destiny that beckons him.

source www.movieweb.com

The Incredible Hulk

“The Incredible Hulk” kicks off an all-new, explosive and action-packed epic of one of the most popular superheroes of all time. In this new beginning, scientist Bruce Banner (Edward Norton) desperately hunts for a cure to the gamma radiation that poisoned his cells and unleashes the unbridled force of rage within him: The Hulk.

Living in the shadows–cut off from a life he knew and the woman he loves, Betty Ross (Liv Tyler)–Banner struggles to avoid the obsessive pursuit of his nemesis, General Thunderbolt Ross (William Hurt), and the military machinery that seeks to capture him and brutally exploit his power.

As all three grapple with the secrets that led to The Hulk’s creation, they are confronted with a monstrous new adversary known as The Abomination (Tim Roth), whose destructive strength exceeds even The Hulk’s own. And on June 13, 2008, one scientist must make an agonizing final choice: accept a peaceful life as Bruce Banner or find heroism in the creature he holds inside–The Incredible Hulk.

source www.movieweb.com

Indiana Jones and The Kingdom of The Crystal Skull

Steven Spielberg says that the film will feature all of Jones’ former babes in various cameo roles including Karen Allen and other Indy girls who had smaller roles. It is still up in the air whether or not Kate Capshaw, Spielberg’s wife, will make an appearance. The film is set in the early ’50s.

source www.movieweb.com

Hancock

There are heroes. There are superheroes. And then there’s…

There are heroes… there are superheroes… and then there’s Hancock (Will Smith). With great power comes great responsibility - everyone knows that - everyone, that is, but Hancock. Edgy, conflicted, sarcastic, and misunderstood, Hancock’s well-intentioned heroics might get the job done and save countless lives, but always seem to leave jaw-dropping damage in their wake. The public has finally had enough - as grateful as they are to have their local hero, the good citizens of Los Angeles are wondering what they ever did to deserve this guy. Hancock isn’t the kind of man who cares what other people think - until the day that he saves the life of PR executive Ray Embrey (Jason Bateman), and the sardonic superhero begins to realize that he may have a vulnerable side after all. Facing that will be Hancock’s greatest challenge yet - and a task that may prove impossible as Ray’s wife, Mary (Charlize Theron), insists that he’s a lost cause.

source www.movieweb.com

Kung Fu Panda

Prepare for awesomeness.

Jack Black heads the voice cast as Po the Panda, the laziest of all the animals in the Valley of Peace. With powerful enemies at the gates, all hope has been pinned on an ancient prophesy that a hero will rise to save the day. But among all the martial arts masters who come forward, none has shown the mark of The Chosen One … until now. When Po unwittingly shows up in the midst of the competition, the masters are shocked to see that this unmotivated panda bears the mark. Now it is up to them to turn this gentle giant into a kung fu fighter before it’s too late.

Dustin Hoffman will voice the role of Shifu, the by-the-book and tough-as-nails Kung Fu master, who has been given the unenviable task of turning the undisciplined Po into a kung fu fighter.

Jackie Chan will lend his voice to Master Monkey, a strong, agile and dedicated kung fu warrior, who serves as a daily reminder to Po of everything he is not … yet.

Ian McShane (Deadwood) will be the voice of the villainous Tai Lung, a ferociously powerful snow leopard, who breaks out of prison, intent on using his kung fu skills to destroy the Valley of Peace.

Lucy Liu is in discussions to be the voice of Master Viper, another of Po’s teachers, who can be coy and feminine when she needs to be, but can then uncoil the lethal kung fu warrior within.

source www.movieweb.com

3-year-old timeline: Can-Do Kid

Your 3-year-old now
"Look at me! Mom, look at me!" your preschooler calls as she zooms down the slide — headfirst. Her growing bravery on the playground may make you wince sometimes, not that she notices. She loves showing off new skills. As well she should — she's enormously proud of them.

At 3, children walk on tiptoe, try to stand on one foot (and might even succeed for a few seconds), gallop and try to skip, and pedal a tricycle. To keep these gross motor skills developing, shoot for at least an hour of physical activity a day. Unstructured play offers plenty of practice running and jumping. More organized games like tag, hopscotch, and simple ball games build endurance and coordination. To work on balance, encourage your child to walk next to you along a curb or follow a line on the driveway. Obstacle courses set up inside or outside help children grasp spatial relations: "Climb over the chair. Now skip around the cone." Better yet, show her yourself — you can get some exercise, too.

Your life now
If your child has a beloved blankie or stuffed animal, you've probably had to retrieve it from afar more than once. Maybe it was left at Grandma's and you had to fetch it in the middle of the night. Or you had to ask a hotel to FedEx it across the country after leaving it behind. You might be wondering when the jig will be up.

Whatever you do — don't do anything! Children let go of security objects at different ages. Some may be ready when they start preschool; some like to carry theirs to preschool in their backpack and leave it in their cubby by day. Others continue to sleep with a special pal well into elementary school and beyond. Most children wean themselves eventually.

To avoid losing a lovey, if you haven't already, establish some rules about where the blankie or bear can and can't go. For 3-year-olds who once had unrestricted limits on where to bring a lovey, make new "big kid" rules. If it never leaves the house, it's a lot easier to find. Obviously, doctor's appointments and vacations are reasonable exceptions. (By 3, a child's chosen object is usually so well-loved and tattered it may be too late to try the ol' buy-a-replacement ruse.)

source www.parentcenter.babycenter.com

3-year-old timeline: Magical Thinking

Your 3-year-old now
Learning to distinguish between fantasy and reality is a gradual process. During this year, your child is at an interesting juncture. He still practices what developmental psychologists refer to as "magical thinking," assigning traits to objects or people that are impossible but seem logical to your child's early reasoning abilities.

So, your child might believe that a letter dropped in the mailbox immediately flies right to Grandpa's mailbox. He might think that tigers live in trees, that birds can talk to him, and that there really is a man on the moon. Sometimes things grownups say are taken literally because they sound plausible to your child: "The mosquitoes are eating us alive." "You're killing me!"

At the same time your child is, bit by bit, figuring out that certain flights of fancy probably are not real: His toy airplane doesn't really fly. The Wiggles don't live inside the TV. This process takes years — witness 8-year-old tooth fairy and Santa Claus believers. No rush: It's wonderful to retain a little bit of magical thinking right into adulthood.

Your life now
Do mealtimes ever feel tense because your child won't touch a bite on his plate? Most experts advise against forcing a child to eat anything. Food should be a source of pleasure and nourishment, not power struggles. Research suggests that coercive feeding practices can lead to weight problems or eating disorders later in life. The child learns to associate food with control. Wait until the next regular snack or meal and offer food again then; if he's hungry he'll eat — or he may not, and that's fine, too. Most experts say it's best not to start the habit of preparing special meals for a finicky eater. But neither should you punish him for not eating. Just let it go.

source www.parentcenter.babycenter.com

Top 10 Country in Internet Subscribers

The Organization for Economic Cooperation and Development (OECD) regularly conducts studies of 30 nations to measure broadband penetration. Broadband penetration refers to the number of broadband Internet subscribers compared to the overall population. The OECD usually breaks this down in a simple ratio: the number of broadband subscribers per 100 inhabitants.

­­­The OECD includes DSL, cable modem, fiber-optic and local area network (LAN) connections in its calculations. It doesn’t include dialup modem users, because those users don’t qualify as broadband subscribers.

According to the OECD, the top 10 most wired countries are:

• Denmark
• Netherlands
• Switzerland
• Korea
• Norway
• Iceland
• Finland
• Sweden
• Canada
• Belgium

Each of these countries has at least 23 subscribers per 100 inhabitants — Denmark has 34.3. In comparison, the United States has 22.1 subscribers for every 100 inhabitants. Despite this relatively small discrepancy, the U.S. ranks 15th on OECD’s list.

So why is it that these countries have proportionally more broadband subscribers than the United States? There are several factors to consider:

• Population size: The United States has more than 300 million inhabitants. Denmark, the top-ranked country on the OECD’s list, has a population of 5.5 million. Out of the top 10 countries listed, Korea has the largest population (49 million) and Iceland has the smallest (301,931) [source: CIA].
• The size of the countries: The United States has an area of 9,826,630 square kilometers. Denmark has an area of 43,094 square kilometers. Out of all the countries on the top 10 list, only Canada is larger than the United States [source: CIA]. It’s more difficult and expensive to implement a broadband network in a larger country than a smaller one.
• The price of subscriptions: Out of the 30 countries the OECD examines in its studies, the United States ranked 18th in average monthly subscription price.
• National policies: The governments in the countries that make up the top 10 have a national broadband strategy. These countries consider broadband access a political priority and provide a framework for the Internet infrastructure. The United States does not have a comprehensive broadband strategy, leaving such decisions to corporations and utility companies [source: Foreign Affairs].

Source : howstuffworks

3-year-old timeline: Facing Fears

Your 3-year-old now
Bedtime fears are common for preschoolers. But children can be frightened of anything from loud noises to the idea of being abandoned by Mom and Dad. This makes sense: Now that they're more independent and can leave you, they also begin to realize that you can leave them.

Parents must walk a fine line here. You want to calm your child. But you don't want to fuel the fear. How to tread depends a bit on your child's personality. Some kids may be soothed if you check under the bed for monsters or squirt special "monster spray" (air freshener or water). Those with a scientific bent may see your monster hunt as proof that the creatures exist, so if your child only seems more upset, back off and try talking more directly about the fear: "I know a dark room can be scary. I was scared when I was your age, too." Offer a practical solution such as a night-light or a special back rub to calm her.

However you proceed, don't minimize your child's fears. Bluntly stating there's "no such thing" or "nothing to be afraid of" isn't logic she's going to buy into. Those monsters are very real to her. Your job is to help her cope, reassure her, and make sure she feels comfortable confiding in you.

Some don'ts:

• Don't threaten that a monster will get her if she doesn't behave. Her literal little brain will believe you.
• Don't force her to confront her fears. She isn't equipped to do that at this age.
• Don't tell her that "big kids aren't afraid." That doesn't take the fear away. It just adds pressure and makes it more difficult for her to come to you.
  

Your life now
When your child throws a tantrum, don't automatically assume she's tired. Other common triggers for 3-year-olds: Hunger, sickness, frustration over being unable to do something physical, and wilting from expectations that are too mature for her. Often the best response is no response: Give the tantrum a little time to burn itself out or, if you feel like you have to respond, hold your child (if you can) or rub her back. Realize, though, that her emotional state is much too primitive during a tantrum to respond to logical arguments or much other conversation.

source www.parentcenter.babycenter.com

3-year-old timeline: Your Little Storyteller

Your 3-year-old now
As your child's language skills evolve, he'll start to tell you more elaborate stories. Hooray! Storytelling is a great step in a preschooler's development.

It's happening now because at 3, your child is capable of a complex chain of events: He can experience something, think about it, and then tell a story about it. These stories — real or fictional or a mix of both — help little kids make sense of everyday events and the people they meet.

You may see your child telling stories to himself or his toys. They can be completely fantastical, or they can combine several real-life events into one narrative. If you're the audience, listen appreciatively. Encourage him with questions as he spins yarns about the picture he drew or the book he's reading. Invite him to add details to stories you tell.

To help keep the creative juices flowing, make sure your child hears stories of all kinds — fairy tales, anecdotes from your own life, fables, picture-book tales. Acting these stories out will also strengthen his imagination and storytelling abilities.

Your life now
Ever urge your child to hurry, only to see it have the opposite effect, as if molasses had just been poured over his head? Badgering a child to move faster can make him anxious. Better to try cajoling with a game or a race: "Let's see who can put on their shoes faster, me or you?" Or, "I'll race you to the car, ready, set, go!"

source www.parentcenter.babycenter.com

Asthma (Part 3 of 3)

What are the treatments for asthma?

For most people with asthma, most of the symptoms can be prevented with treatment. So, you are able to get on with normal life, school, work, sport, etc.

Inhalers
Most people with asthma are treated with inhalers. Inhalers deliver a small dose of drug directly to the airways. The dose is enough to treat the airways. However, the amount of drug that gets into the rest of your body is small so side-effects are unlikely, or minor. There are various inhaler devices made by different companies. Different ones suit different people. A doctor or nurse will advise on the different types. See a separate leaflet called ‘Asthma - Inhalers‘.

Inhalers can be grouped into ‘relievers’, ‘preventers’ and ‘long acting bronchodilators’.

• A reliever inhaler is taken ‘as required’ to ease symptoms. The drug in a reliever inhaler relaxes the muscle in the airways. This makes the airways open wider, and symptoms usually quickly ease. These drugs are also called ‘bronchodilators’ as they dilate (widen) the bronchi (airways). There are several different reliever drugs. For example, salbutamol and terbutaline. These come in various brands made by different companies. If you only have symptoms every ‘now and then’, then the occasional use of a reliever inhaler may be all that you need. However, if you need a reliever inhaler three times a week or more to ease symptoms, a preventer inhaler is usually advised.
  
• A preventer inhaler is taken every day to prevent symptoms from developing. The drug commonly used in preventer inhalers is a steroid. There are various brands. Steroids work by reducing the inflammation in the airways. When the inflammation has gone, the airways are much less likely to become narrow and cause symptoms. It takes 7-14 days for the steroid in a preventer inhaler to build up it’s effect. Therefore, it will not give any immediate relief of symptoms. However, after a week or so of treatment, the symptoms have often gone, or are much reduced. It can take up to six weeks for maximum benefit. You should then not need to use a reliever inhaler very often, (if at all).
  
• A long acting bronchodilator may be advised in addition to a steroid inhaler. One may be needed if symptoms are not fully controlled by the steroid inhaler alone. The drugs in these inhalers work in a similar way to ‘relievers’, but work for up to 12 hours after taking each dose. They include salmeterol and formoterol. (Some brands of inhaler contain a steroid plus a long acting bronchodilator for convenience.)

Tablets to open up the airways
Most people do not need tablets as inhalers usually work well. However, in some cases a tablet (or in liquid form for children) is prescribed in addition to inhalers if symptoms are not fully eased by inhalers alone. Some young children use liquid medication instead of inhalers.

Steroid tablets
A short course of steroid tablets (such as prednisolone) is sometimes needed to ease a severe or prolonged attack of asthma. Steroid tablets are good at reducing the inflammation in the airways. For example, a severe attack may occur if you have a cold or chest infection.

Some people worry about taking steroid tablets. However, a short course of steroid tablets (for a week or so) usually works very well, and is unlikely to cause side-effects. Most of the side-effects caused by steroid tablets occur if you take them for a long time (more than several months), or if you take frequent short courses of high doses.

What are the dosages of treatment?

Everyone is different. The correct dose of a preventer inhaler is the lowest dose that prevents symptoms. A doctor may prescribe a high dose of a preventer inhaler at first, to quickly “get on top of symptoms”. When symptoms have gone, the dose may then be reduced by a little every few weeks. The aim is to find the lowest regular dose that keeps symptoms away.

Some people with asthma put up with symptoms. They may think that it is normal to still have some symptoms even when they are on treatment. A common example is a night time cough which can cause disturbed sleep. But if this occurs and your symptoms are not fully controlled - tell your doctor or nurse. Symptoms can often be prevented. For example, by adjusting the dose of your preventer inhaler, or by adding in a long acting bronchodilator.

A ‘typical’ treatment plan

A common treatment plan for a ‘typical’ person with moderate asthma is:

• A preventer inhaler (usually a steroid inhaler), taken each morning and at bedtime. This usually prevents symptoms throughout the day and night.
• A reliever inhaler may be needed now and then if breakthrough symptoms occur. For example, if symptoms flare up when you have a cough or cold.
• If exercise or sport causes symptoms, then a dose of a reliever inhaler just before the exercise usually prevents symptoms.
• The dose of the preventer inhaler may need to be increased for a while if you have a cough or cold, or during the hay fever season.
• Some people may need to add in a long acting bronchodilator, or tablets, if symptoms are not controlled with the above.

At first, adjusting doses of inhalers is usually done on the advice of a doctor or nurse. In time, you may agree an ‘asthma action plan’ with your doctor or nurse. This means that you make adjustments to the dose of your inhalers, depending on your symptoms and/or peak flow readings.

Does asthma go away?

There is no once-and-for-all cure. However, about half of the children who develop asthma ‘grow out of it’ by the time they are adults. For many adults, asthma is variable with some good spells and some spells that are not so good. Some people are worse in the winter months, and some worse in the hay fever season. Although not curable, asthma is treatable. Stepping up the treatment for a while during bad spells will often control symptoms.

Some other general points about asthma

• It is vital that you learn how to use your inhalers correctly. In some people, symptoms persist simply because they do not use their inhaler properly, and the drug from the inhaler does not get into the airways properly. See your practice nurse or doctor if you are not sure if you are using your inhaler properly.
• See a doctor or nurse if symptoms are not fully controlled, or if they are getting worse. For example, if:
  • a night time cough or wheeze is troublesome.
  • sport is being affected by symptoms.
  • your peak flow readings are lower than normal.
  • you need a reliever inhaler more often than usual.

  An adjustment in inhaler timings or doses may control these symptoms.

• See a doctor urgently if you develop severe symptoms that are not eased by a reliever inhaler. In particular, if you have difficulty talking due to shortness of breath. You may need emergency treatment with high dose reliever drugs and other treatments, sometimes in hospital. A severe asthma attack can be life-threatening.
• You should have an influenza immunisation every autumn (the annual ‘flu jab’) if you require regular treatment for asthma or if you have had a previous severe episode of asthma. Flu tends to be more serious if you have asthma.

Source www.patient.co.uk

Asthma (Part 2 of 3)

How is asthma diagnosed?

Sometimes symptoms are typical, and the diagnosis is easily made by a doctor. If there is doubt then some simple tests may be arranged. A peak flow meter is commonly used to help confirm that symptoms are due to asthma (see below). Sometimes a test called spirometry may be done to confirm the diagnosis. This involves breathing into a machine that measures the rate and volume of airflow in and out of your lungs.

What is the the peak flow meter?

This is a small device that you blow into. A doctor or nurse will show you how. It measures the speed of air that you can blow out of your lungs. No matter how strong you are, if your airways are narrowed, your peak flow reading will be lower than expected for your age, size, and sex. If you have untreated asthma, then you will normally have low and variable peak flow readings. Also, peak flow readings in the morning are usually lower than the evening if you have asthma.

You may be asked to keep a diary over two weeks or so of peak flow readings. Asthma is usually confirmed if you have low and variable peak flow readings over several days. Peak flow readings improve when the narrowed airways are opened up with treatment. Regular peak flow readings can be used to help assess how well treatment is working.

What are the treatments for asthma?

For most people with asthma, most of the symptoms can be prevented with treatment. So, you are able to get on with normal life, school, work, sport, etc.

Inhalers
Most people with asthma are treated with inhalers. Inhalers deliver a small dose of drug directly to the airways. The dose is enough to treat the airways. However, the amount of drug that gets into the rest of your body is small so side-effects are unlikely, or minor. There are various inhaler devices made by different companies. Different ones suit different people. A doctor or nurse will advise on the different types. See a separate leaflet called ‘Asthma - Inhalers‘.

Inhalers can be grouped into ‘relievers’, ‘preventers’ and ‘long acting bronchodilators’.

• A reliever inhaler is taken ‘as required’ to ease symptoms. The drug in a reliever inhaler relaxes the muscle in the airways. This makes the airways open wider, and symptoms usually quickly ease. These drugs are also called ‘bronchodilators’ as they dilate (widen) the bronchi (airways). There are several different reliever drugs. For example, salbutamol and terbutaline. These come in various brands made by different companies. If you only have symptoms every ‘now and then’, then the occasional use of a reliever inhaler may be all that you need. However, if you need a reliever inhaler three times a week or more to ease symptoms, a preventer inhaler is usually advised.
  
• A preventer inhaler is taken every day to prevent symptoms from developing. The drug commonly used in preventer inhalers is a steroid. There are various brands. Steroids work by reducing the inflammation in the airways. When the inflammation has gone, the airways are much less likely to become narrow and cause symptoms. It takes 7-14 days for the steroid in a preventer inhaler to build up it’s effect. Therefore, it will not give any immediate relief of symptoms. However, after a week or so of treatment, the symptoms have often gone, or are much reduced. It can take up to six weeks for maximum benefit. You should then not need to use a reliever inhaler very often, (if at all).
  
• A long acting bronchodilator may be advised in addition to a steroid inhaler. One may be needed if symptoms are not fully controlled by the steroid inhaler alone. The drugs in these inhalers work in a similar way to ‘relievers’, but work for up to 12 hours after taking each dose. They include salmeterol and formoterol. (Some brands of inhaler contain a steroid plus a long acting bronchodilator for convenience.)

Tablets to open up the airways
Most people do not need tablets as inhalers usually work well. However, in some cases a tablet (or in liquid form for children) is prescribed in addition to inhalers if symptoms are not fully eased by inhalers alone. Some young children use liquid medication instead of inhalers.

Steroid tablets
A short course of steroid tablets (such as prednisolone) is sometimes needed to ease a severe or prolonged attack of asthma. Steroid tablets are good at reducing the inflammation in the airways. For example, a severe attack may occur if you have a cold or chest infection.

Some people worry about taking steroid tablets. However, a short course of steroid tablets (for a week or so) usually works very well, and is unlikely to cause side-effects. Most of the side-effects caused by steroid tablets occur if you take them for a long time (more than several months), or if you take frequent short courses of high doses.

Asthma (Part 1 of 3)

Asthma is a common condition that affects the airways. The typical symptoms are wheeze, cough, chest tightness, and shortness of breath. Symptoms can range from mild to severe. Asthma cannot be ‘cured’, but treatment usually works well to ease and prevent symptoms. Treatment is usually with inhalers.

This leaflet gives a general overview of asthma. There are other leaflets in this series called ‘Inhalers for Asthma‘, ‘Peak Flow Meters‘ and ‘Asthma - a Picture Summary‘.

What is asthma and who does it affect?

Asthma is a condition that affects the airways (bronchi) of the lungs. From time to time the airways constrict (become narrow) in people who have asthma. This causes the typical symptoms. The extent of the narrowing, and how long each episode lasts, can vary greatly.

Asthma can start at any age, but it most commonly starts in childhood. At least 1 in 10 children, and 1 in 20 adults, have asthma. Asthma runs in some families, but many people with asthma have no other family members affected.

What are the symptoms of untreated asthma?

The common symptoms are cough and wheeze. You may also become breathless, and develop a feeling of chest tightness. Symptoms can range from mild to severe between different people, and at different times in the same person. Each episode of symptoms may last just an hour or so, or persist for days or weeks unless treated.

What are the typical symptoms if you have mild (untreated) asthma?
You tend to develop mild symptoms from time to time. For example, you may develop a mild wheeze and a cough if you have: a cold, a chest infection, in the hay fever season, or when you exercise. For most of the time you have no symptoms. A child with mild asthma may have an irritating cough each night, but is often fine during the day.

What are the typical symptoms if you have moderate (untreated) asthma?
Without treatment: you typically have episodes of wheezing and coughing from time to time. Sometimes you become breathless. You may have spells, sometimes long spells, without symptoms. However, you tend to be wheezy for some of the time on most days. Symptoms are typically worse at night, or first thing in the morning. You may wake up some nights coughing or with a tight chest. Young children may not have typical symptoms. It may be difficult to tell the difference between asthma and recurring viral chest infections in young children.

What are the typical symptoms of a severe attack of asthma?
You become very wheezy, have a ‘tight’ chest, and have difficulty in breathing. You may find it difficult to talk because you are so breathless. Severe symptoms may develop from time to time if you normally have moderate symptoms. Occasionally, severe symptoms develop ‘out of the blue’ in some people who normally have just mild symptoms.

What causes asthma?

Asthma is caused by inflammation in the airways. It is not known why the inflammation occurs. The inflammation irritates the muscles around the airways, and causes them to squeeze (constrict). This causes narrowing of the airways. It is then more difficult for air to get in and out of the lungs. This leads to wheezing and breathlessness. The inflammation also causes the lining of the airways to make extra mucus which causes cough and further obstruction to airflow.

The following diagram aims to illustrate how an episode of asthma develops.

What can make asthma symptoms worse?

Asthma symptoms may flare up from time to time. There is often no apparent reason why symptoms flare up. However, some people find that symptoms are triggered, or made worse, in certain situations. It may be possible to avoid certain triggers which may help to reduce symptoms. Things that may trigger asthma symptoms include the following.

• Infections. Particularly colds, coughs, and chest infections.
• Pollens and moulds. The hay fever season is a common time for asthma to get worse.
• Exercise. However, sport and exercise are good for you if you have asthma. If necessary, you can use an inhaler before exercise to prevent symptoms from developing.
• Certain drugs. For example, about 1 in 50 people with asthma are allergic to aspirin which can trigger symptoms. Other drugs that may cause asthma symptoms include: anti-inflammatory painkillers, and beta-blockers such as propranolol, atenolol, or timolol. This includes beta-blocker eye-drops used to treat glaucoma.
• Smoking and cigarette fumes. If you smoke and have asthma, you should make every effort to stop. See a practice nurse for help if you find it difficult. ‘Passive’ smoking can make asthma worse too. All children deserve to live in a smoke-free home, in particular children with asthma.
• Other fumes and chemicals. For example, fumes from paints, solvents and pollution. The increase in air pollution may be a reason why asthma is becoming more common.
• Emotion. Asthma is not due to ‘nerves’, but such things as stress, emotional upset, or laughing may trigger symptoms.
• Allergies to animals. Such as pet cats, dogs, and horses. Animals do not trigger symptoms in most cases, but some people notice that their symptoms become worse when close to certain animals.
• House dust mite. This is a tiny creature that lives in mattresses and other fabrics around the home. If you are allergic to it, it may make symptoms worse. It is impossible to get rid of house dust mite completely. To greatly reduce their number takes a lot of time and effort and involves: using special mattress covers, removing carpets, removing or treating soft toys, etc. However, if symptoms are difficult to control with treatment, and you are confirmed to be allergic to house dust mite, then it may be worth considering trying to reduce their number. See separate leaflet called ‘Allergy to House Dust Mite and Pets‘.
• Certain foods. This is uncommon, and food is not thought to be a trigger in most cases.

Some people only develop symptoms when exposed to a certain ‘trigger’. Two examples are:

• Occupational asthma. Some people only develop symptoms when exposed to specific substances at work. They have no symptoms at other times.
• Exercise-induced asthma. As mentioned above, exercise can make symptoms worse for many people with asthma. But, some people only develop symptoms when they exercise, and are fine the rest of the time.

Obat Asma Hirupan

Meski layanan kesehatan dewasa ini sudah tersebar cukup merata, patut diketahui masih banyak penderita serangan asma yang datang ke rumah sakit dalam keadaan terlambat. Bahkan ada juga penderita yang meninggal dalam perjalanan ke rumah sakit. Karena itu, amat penting untuk mengenal faktor pencetus serta apa yang harus dilakukan jika ada serangan asma.

Pada penyakit asma terjadi proses radang kronis di pipa saluran napas. Peradangan kronis ini dapat menyebabkan pipa saluran napas menjadi sensitif, mudah terangsang oleh alergen maupun iritan. Sebagai contoh, jika sekelompok siswa masuk ke gudang sekolah, maka siswa yang mempunyai penyakit asma mungkin akan mengalami bersin, batuk, bahkan sesak karena terpajan oleh debu yang merangsang pipa saluran napas. Siswa lain juga terpajan, tetapi karena pipa saluran napasnya tidak peka (normal), mereka tidak mengalami serangan.

Akibat peradangan kronis, pipa saluran napas penderita asma mudah terangsang dan menyempit. Selain itu, pada pipa saluran napas penderita asma sering terbentuk sekret yang menyebabkan udara yang masuk dan keluar pipa saluran napas terhalang sehingga penderita menjadi sesak.

Nah, pengobatan asma ditujukan untuk melebarkan kembali pipa saluran napas yang menyempit (untuk ini digunakan obat bronkodilator) dan obat untuk menghentikan inflamasi kronis (untuk tujuan ini digunakan obat anti-inflamasi berupa steroid). Sekarang tersedia baik obat bronkodilator maupun obat anti-inflamasi dalam bentuk hirupan. Keunggulan obat hirupan adalah masa mulai kerjanya (onset) cepat karena obat ditujukan langsung ke pipa saluran napas serta pada umumnya kurang berpengaruh pada organ tubuh lain seperti jantung.

Pada obat asma yang diminum, setelah diserap usus, obat akan masuk ke sirkulasi dan beredar di sirkulasi terlebih dahulu baru sampai ke pipa saluran napas sehingga masa mulai kerjanya lebih lama. Selain itu, karena bersifat sistemik, maka dapat menimbulkan berbagai efek samping.

Salah satu efek samping yang perlu diperhatikan pada penggunaan obat secara sistemik ini adalah efek samping steroid. Obat steroid merupakan obat anti-inflamasi yang ampuh, tetapi penggunaan jangka panjang dapat menimbulkan beberapa kerugian pada pemakai. Kelainan pada kulit dapat berupa jerawat, muka dapat sembab, tekanan darah dapat meningkat, juga gula darah dapat meninggi. Selain itu juga dapat timbul katarak pada mata. Pada penggunaan lama tulang juga dapat menipis (osteoporosis). Karena itulah jika dapat digunakan obat steroid topikal dalam bentuk hirupan akan lebih aman bagi penderita.

Jadi, penggunaan obat asma dalam bentuk hirupan mempunyai beberapa keuntungan. Tetapi, untuk menggunakan obat asma dalam bentuk hirupan ini perlu penjelasan cara menggunakannya dengan baik. Bahkan diperlukan latihan agar obat dapat masuk pipa saluran napas secara benar. Selain itu, yang agak memberatkan untuk pasien adalah obat ini tersedia dalam jumlah yang cukup banyak, yaitu 100 atau 200 hirupan (sekitar penggunaan sebulan) sehingga harganya mahal. Namun, sebenarnya jika dihitung per kali pengobatan, harganya menjadi lebih murah.

Sekarang bahkan obat asma hirupan tidak hanya mengandung obat bronkodilator atau steroid topikal saja, tetapi juga sudah ada dalam bentuk campuran bronkodilator dan steroid topikal sehingga lebih hemat dan nyaman. Penggunaan obat hirupan asma tidak hanya digunakan pada asma yang telah berat, bahkan sekarang digunakan juga pada asma dini.

dr Samsuridjal Djauzi

Sumber : Kompas Cybers Media

Alergi Penyebab Utama Asma pada Anak

Jumat, 6 Februari, 2004 oleh: Siswono

Saat ini alergi merupakan salah satu faktor penting penyebab berkembangnya penyakit asma. Terbukti, 75%-90% anak dengan asma di dunia mengidap alergi.

“Oleh karena itu, pengendalian lingkungan harus dilakukan untuk setiap anak asma,” kata dr Rina Triasih, pada seminar Diagnosis dan Tata Laksana Asma pada Anak di RS Cakra Husada, Klaten (Jateng), kemarin.

Untuk itu, lanjut Rina, menghindari asap rokok juga merupakan rekomendasi penting dari bagian pengendalian lingkungan. Dianjurkan pula keluarga yang memiliki anak dengan asma tidak memelihara binatang berbulu, seperti kucing, anjing, dan burung.

Satu hal penting yang juga perlu mendapat perhatian dari kalangan orang tua, menurut spesialis anak dari Bagian Ilmu Kesehatan Anak FK Universitas Gadjah Mada/RS dr Sardjito, Yogyakarta, ini adalah perbaikan ventilasi ruangan dan penghindaran kelembaban kamar. Kondisi ruangan yang sehat itu mutlak dijaga, terutama bagi keluarga dengan anak asma yang sensitif terhadap debu rumah dan tungaunya.

“Perlu diingat, anak asma acapkali menderita rinitis alergika atau sinusitis yang membuat asma sulit dikendalikan. Deteksi dan diagnosis kedua kelainan itu, yang diikuti dengan terapi adekuat akan memperbaiki gejala asma anak,” ujar Rina Triasih.

Kurangnya pengetahuan tentang asma dan tata laksananya, tambah Rina, berpengaruh terhadap peningkatan morbiditas dan mortalitas penyakit tersebut. Hal ini bukan saja terjadi pada pasien dan keluarganya, tapi juga pada tenaga kesehatan, bahkan dokternya.

Sebab, banyak dokter tidak mengikuti perkembangan dan perubahan konsep tentang asma dan tata laksananya. Lebih jauh lagi mereka tidak mempunyai keterampilan praktis penggunaan alat-alat inhalasi. Sehingga, bahkan, ada dokter yang sampai melarang pasien yang sudah menggunakannya.

“Di banyak tempat di dunia, baik negara berkembang maupun negara maju, asma anak masih banyak yang underdiagnosed dan undertreatment,” tegasnya.

Dengan demikian, lanjut Rina, pendidikan asma sangat perlu dilakukan terhadap tenaga kesehatan, pasien, dan keluarganya serta guru sekolah. Selain kemitraan keluarga dan gurunya, keterlibatan unsur lain juga penting, misalnya lembaga swadaya masyarakat (LSM) dan media massa.

Menurut dia, media massa dapat berperan konstruktif dalam menyebarkan informasi tentang asma dan penanggulangannya kepada masyarakat luas. Sedangkan peran orang tua dalam penanggulangan asma anak cukup penting dibandingkan peran orang lain termasuk dokter. (JS/V-4)

Sumber: Media Indonesia, Kamis, 05 Februari 2004

Apakah Anak saya Asma?

Penulis: Darmawan Budi S

Banyak anak asma yang tak terdiagnosis penyakitnya sehingga ditangani sebagai penyakit lain dan keluhannya tak kunjung reda. Mengapa ? Dalam hal kesehatan dan penyakit, banyak di antara kita menilai anak seperti orang dewasa. Inilah pangkal masalahnya. Anak bukan orang dewasa dalam ukuran kecil, jadi berbeda dengan orang dewasa. Banyak aspek kesehatan dan penyakit yang berbeda pada anak dibanding orang dewasa.

Untuk penyakit sama, gejalanya yang menonjol bisa berbeda antara pasien anak dan dewasa. Sebaliknya, gejala yang sama, misalnya batuk, bisa mengarah ke penyakit yang berbeda anatara anak dan dewasa. Karena itu, orang tua perlu memahami gejala pada anak yang patut dipikirkan kemungkinan ke arah asma.

Asma pada anak tidak selalu memberi gejala sesak dan napas berbunyi (mengi) seperti orang dewasa. Sering kali gejala yang menonjol hanya batuk, tapi bukan sembarang batuk. Lalu, batuk seperti apa yang patut diduga asma? Batuk yang “bandel”.

Pengertian “bandel” mencakup beberapa keadaan yang mirip, yaitu batuk berlangsung lama (dua minggu lebih), sulit sembuh, timbul berulang dalam jangka pendek, atau membaik sebentar namun timbul lagi. Biasanya pasien dengan batuk bandel sudah berkeliling berobat ke banyak dokter umum maupun spesialis.

Pada orang dewasa, jika ditemukan gejala batuk yang bandel, dugaan penyakit penyebab pertama adalah tuberkulosis (tb). Dugaan ini sering diterapkan pada anak juga.

Pemeriksaannya berupa foto rontgen dengan penafsiran sangat subyektif. Kemudian, bisa diduga ada “flek” dalam parunya sehingga diterapi tb. Jika ternyata asma, maka usia pengobatan tb, batuknya akan tetap ada.

Perlu mengubah paradigma pemikiran jika menemui anak dengan batuk yang bandel. Pertama, pikirkan kemungkinan ke arah asma, bukan Tb. Tb. pada anak bisa memberi gejala batuk, namun bukan utama. Hal yang mendukung ke arah asma diantaranya :

Batuk timbul jika terpajan dengan faktor pencetus yang banyak sekali bentuk dan macamnya. Ada yang dari lingkungan rumah, berupa debu, asap rokok, kapuk, atau bulu binatang. Faktor lain yang biasanya teramati orang tua berbentuk makanan, misalnya permen, cokelat, makanan ringan mengandung vetsin, gorengan, es, atau kacang. Pencetus lainnya adalah flu, aktivitas fisik berlebihan hingga lelah, atau perubahan cuaca.

Batuk asma pada anak memberikan ciri lain yang lebih berat pada malam atau dini hari. Terkadang, perbedaan intensitas batuk pada siang dan malam hari, demikian ekstrem. Siang, tanpa batuk sama sekali, lalu malam justru hebat sampai anak tidak bisa tidur. Tentu orang tua ikut terganggu tidurnya. Akibatnya anak mengantuk di sekolah, dan orang tuanya mengantuk saat bekerja.

Sebagian besar asma didasari faktor alergi. Jadi, asma merupakan satu bentuk penyakit alergi. Dalam riwayat keluarga, biasanya ditemui asma, serta bentuk lain penyakit alergi, seperti eksim, pilek alergi, atau alergi obat maupun makanan. Kalau perlu, ditelusuri riwayat keluarga besar sampai buyut, kakek, paman, sepupu, dan seterusnya.

Hal yang diturunkan adalah bakat alerginya, namun manifestasinya bisa berbeda. Warisan bakat ini pun bisa lompat generasi. Misalnya, kakek mengidap alergi obat, anaknya mungkin tak memiliki manifestasi alergi, baru pada cucunya timbul penyakit tersebut.

Hal lain yang memperkuat diagnosis asma ialah respons yang baik dengan obat asma. Sering karena tidak terdiagnosis asma, pasien dengan batuk bandel diberikan obat penekan batuk, tapi bentuknya malah kian menjadi. Pasien asma memang tidak boleh diberikan obat tadi. Pasien akan mereda batuknya jika diberikan obat asma.

Untuk mengonfirmasi diagnosis asma, perlu dilakukan pemeriksaan khusus berupa uji fungsi paru. Untuk melaksanakannya, pasien perlu melakukan jurus yang cukup kompleks. Biasanya, anak berusia dibawah tujuh tahun belum mampu melakukannya sehingga pemerikssaan ini terbatas digunakan pada anak kecil.

Apabila ditemukan anak dengan batuk yang bandel disertai beragam fakta yang menunjang seperti di atas, anak dapat didiagnosis sebagai asma. Jika diagnosisnya tepat, tinggal masalah manajemennya.

Sumber www.idai.or.id/

Apakah Anak saya Asma?

Penulis: Darmawan Budi S

Banyak anak asma yang tak terdiagnosis penyakitnya sehingga ditangani sebagai penyakit lain dan keluhannya tak kunjung reda. Mengapa ? Dalam hal kesehatan dan penyakit, banyak di antara kita menilai anak seperti orang dewasa. Inilah pangkal masalahnya. Anak bukan orang dewasa dalam ukuran kecil, jadi berbeda dengan orang dewasa. Banyak aspek kesehatan dan penyakit yang berbeda pada anak dibanding orang dewasa.

Untuk penyakit sama, gejalanya yang menonjol bisa berbeda antara pasien anak dan dewasa. Sebaliknya, gejala yang sama, misalnya batuk, bisa mengarah ke penyakit yang berbeda anatara anak dan dewasa. Karena itu, orang tua perlu memahami gejala pada anak yang patut dipikirkan kemungkinan ke arah asma.

Asma pada anak tidak selalu memberi gejala sesak dan napas berbunyi (mengi) seperti orang dewasa. Sering kali gejala yang menonjol hanya batuk, tapi bukan sembarang batuk. Lalu, batuk seperti apa yang patut diduga asma? Batuk yang “bandel”.

Pengertian “bandel” mencakup beberapa keadaan yang mirip, yaitu batuk berlangsung lama (dua minggu lebih), sulit sembuh, timbul berulang dalam jangka pendek, atau membaik sebentar namun timbul lagi. Biasanya pasien dengan batuk bandel sudah berkeliling berobat ke banyak dokter umum maupun spesialis.

Pada orang dewasa, jika ditemukan gejala batuk yang bandel, dugaan penyakit penyebab pertama adalah tuberkulosis (tb). Dugaan ini sering diterapkan pada anak juga.

Pemeriksaannya berupa foto rontgen dengan penafsiran sangat subyektif. Kemudian, bisa diduga ada “flek” dalam parunya sehingga diterapi tb. Jika ternyata asma, maka usia pengobatan tb, batuknya akan tetap ada.

Perlu mengubah paradigma pemikiran jika menemui anak dengan batuk yang bandel. Pertama, pikirkan kemungkinan ke arah asma, bukan Tb. Tb. pada anak bisa memberi gejala batuk, namun bukan utama. Hal yang mendukung ke arah asma diantaranya :

Batuk timbul jika terpajan dengan faktor pencetus yang banyak sekali bentuk dan macamnya. Ada yang dari lingkungan rumah, berupa debu, asap rokok, kapuk, atau bulu binatang. Faktor lain yang biasanya teramati orang tua berbentuk makanan, misalnya permen, cokelat, makanan ringan mengandung vetsin, gorengan, es, atau kacang. Pencetus lainnya adalah flu, aktivitas fisik berlebihan hingga lelah, atau perubahan cuaca.

Batuk asma pada anak memberikan ciri lain yang lebih berat pada malam atau dini hari. Terkadang, perbedaan intensitas batuk pada siang dan malam hari, demikian ekstrem. Siang, tanpa batuk sama sekali, lalu malam justru hebat sampai anak tidak bisa tidur. Tentu orang tua ikut terganggu tidurnya. Akibatnya anak mengantuk di sekolah, dan orang tuanya mengantuk saat bekerja.

Sebagian besar asma didasari faktor alergi. Jadi, asma merupakan satu bentuk penyakit alergi. Dalam riwayat keluarga, biasanya ditemui asma, serta bentuk lain penyakit alergi, seperti eksim, pilek alergi, atau alergi obat maupun makanan. Kalau perlu, ditelusuri riwayat keluarga besar sampai buyut, kakek, paman, sepupu, dan seterusnya.

Hal yang diturunkan adalah bakat alerginya, namun manifestasinya bisa berbeda. Warisan bakat ini pun bisa lompat generasi. Misalnya, kakek mengidap alergi obat, anaknya mungkin tak memiliki manifestasi alergi, baru pada cucunya timbul penyakit tersebut.

Hal lain yang memperkuat diagnosis asma ialah respons yang baik dengan obat asma. Sering karena tidak terdiagnosis asma, pasien dengan batuk bandel diberikan obat penekan batuk, tapi bentuknya malah kian menjadi. Pasien asma memang tidak boleh diberikan obat tadi. Pasien akan mereda batuknya jika diberikan obat asma.

Untuk mengonfirmasi diagnosis asma, perlu dilakukan pemeriksaan khusus berupa uji fungsi paru. Untuk melaksanakannya, pasien perlu melakukan jurus yang cukup kompleks. Biasanya, anak berusia dibawah tujuh tahun belum mampu melakukannya sehingga pemerikssaan ini terbatas digunakan pada anak kecil.

Apabila ditemukan anak dengan batuk yang bandel disertai beragam fakta yang menunjang seperti di atas, anak dapat didiagnosis sebagai asma. Jika diagnosisnya tepat, tinggal masalah manajemennya.

Sumber www.idai.or.id/

Asma

Asma adalah suatu gejala yang ditimbulkan oleh kelainan saluran nafas yang berupa kepekaan yang meningkat terhadap rangsangan dari lingkungan sebagai pemicu.

Pemicu gejala ini dapat berupa kelelahan pikiran (gangguan emosi), kelelahan jasmani, perubahan lingkungan hidup yang tidak diharapkan (cuaca, kelembaban, temperatur, asap (terutama rokok) dan bau-bauan yang merangsang), infeksi saluran nafas terutama penyakit influenza tertentu, dan reaksi alergi dari bahan yang terhirup atau dimakan.

Tingkat gejala kepekaan saluran nafas ini diawali dari gejala yang ringan (berupa pilek/bersin atau batuk yang sering berulang/kambuh) sampai dengan gejala yang berat berupa serangan asma (kesulitan bernafas). Keadaan ini sebenarnya ditandai adanya latar belakang reaksi alergi.

Timbulnya beberapa tingkatan gejala kepekaan yang terekam/bisa diutarakan oleh penderita biasanya diawali sejak masa kanak. Sekitar 50% gejala akan sembuh dengan sendirinya, walaupun pada suatu saat gejala ini akan muncul lagi pada tingkat gejala yang lebih berat yang sering diberi istilah asma. Sekitar 55-6-% penyakit alergi pernafasan in dapat diturunkan ke anak atau cucu dan sisanya diakibatkan karena adanya polusi lingkungan hidup yang kurang atau masih belum mendapatkan perhatian, karena itu gejala baru muncul setelah dewasa bukan karena merupakan hal yang aneh.

Penyebab

Dasar permasalah pada penyakit asma terletak pada kelainan saluran nafas yang berpa proses reaksi/keradangan (akibat reaksi alergi) yang disebabkan oleh paparan bahan-bahan antara lain:

• Debu yang ada di dalam rumah yaitu debu yang berasal dari kasur kapuk (terutama yang sudah lama), karpet, sofa, pakaian yang disimpan lama di dalam lemari, langit-langit atap rumah, buku-buku/kertas arsip yang lama, dll.
• Bahan makanan terutama jenis ikan laut, susu sapi, telur, coklat, kacang-kacangan, dll. (sedang kelompok bahan makann yang mempunyai ciri yang mengiritasi a.l. pedas, dingin, bergetah, rasa manis/asam, asin, dll. bukan penyebab tapi pemicu).
• Lingkungan hidup antara lain bulu yang berasal dari bahan pertanian (tepung sari, jerami, rumput-rumputan, ampas tebu, dll.), bahan yang berasal dari bulu dan kotoran unggas serta binatang piaraan.

Sumber http://nusaindah.tripod.com/tipsasma.htm

Gejala Asma

June 17, 2008 at 1:58 pm

Batuk-batuk tertama pada malam dan dini hari memang biasa ditemukan pada penderita alergi. alergi atau atopi merupakan penyakit gen sehingga diturunkan. Umumnya penderita atopi, alergi terhadap debu rumah atau udara dingin.

Di luar negeri yang mempunyai 4 musim, alergi biasanya terjadi pada musim semi saat bunga berkembang dan banyak banyak tepung sari yang beterbangan. Penelitian di luar negeri menyebutkan bahwa alergi pada anak paling banyak disebabkan oleh zat tambahan atau pengawet pada makanan.

Gejala alergi bermacam-macam, mulai dari bersin-bersin, pilek dengan ingus encer, gatal-gatal, sesak napas sampai mengancam jiwa. Anak-anak penderita alergi besar kemungkinan untuk menderita asma. Pada malam dan dini hari merupakan saat paling sering seorang penderita alergi atau asma mendapat serangan bisa sesak atau batuk-batuk.

Hal ini disebabkan karena pada saat itu, kadar kortisol (semacam hormone yang menjaga supaya tidak terjadi peradangan pada saluran napas) berada pada nilai terendah. Pada penderita asma hal ini tidak dapat ditoleransi sehingga mereka akan sering mendapat serangan pada waktu-waktu tersebut.

Pemeriksaan untuk mengetahui apakah anak ibu asma atau tidak bisa dengan pemeriksaan fungsi paru melalui alat spirometer atau dengan uji provokasi bronkus. Asma bukan penyakit menular sehingga ibu tidak perlu khawatir anak ibu akan menularkan penyakitnya pada orang lain. Apakah asma bisa sembuh?

Asma hanya dapat dikontrol, yaitu dengan pengobatan dan menghindari faktor yang mencetuskan serangan asma. Obat asma yang saat ini dianjurkan adalah obat semprot atau hisap karena mempunyai efek samping relative lebih kecil dibandingkan obat makan atau suntik.

dr. Risa F Musawaris

Sumber : Pontianak Post Online

Nortel ditches WiMax to focus on G4

Telecom equipment maker Nortel Networks is dumping its WiMax business to focus on a more popular 4G wireless technology.

The company said earlier this week that it’s focusing its money and development efforts on long-term evolution or LTE. Even though LTE hasn’t yet been standardized, it has more support from major carriers around the world than WiMax. The two largest U.S. operators, AT&T and Verizon Wireless, have already announced they plan to use LTE to build their 4G wireless networks. Vodafone, the largest worldwide wireless operator, also plans to use LTE for its next generation network.

Sprint Nextel is the only major U.S. operator using WiMax. The company earlier this year joined forces with Clearwire and several other companies including Comcast, Time Warner Cable and Intel in a $12 billion joint venture to build a nationwide WiMax network.

Sprint, which has already been testing its WiMax network in some places, did not choose Nortel as one of its major vendors to build the new network. This was a major blow for the telco equipment maker, which instead has been forced to focus on carriers in emerging markets. Relative to LTE, this WiMax opportunity is much smaller, which likely contributed to the company’s decision to ditch it.

Instead of sinking a lot of research and development into WiMax, Nortel plans to address this market through a relationship with Alvarion.

Source : http://news.cnet.com

Is this actually mean that 4G have better bussiness prospect than wimax?

No- Key Keyboard

Typing on a flat surface is one of those ideas for future computing that never seems to completely go away. Currently there’s Bluetooth laser virtual keyboards, which project “keys” onto any flat surface. Recently the X0 model 2.0 (the next One Laptop Per Child) coming in 2010 was revealed to have two touch screens, one where the keyboard would usually be.

The latest is the No-Key Keyboard designed by Kong Fanwen. It features flat “keys” on flat glass. It’s probably useless for real typing, but who cares? It looks cool.

The only details known are that it’s made of glass, uses cameras and motion capture to figure out what keys you’re pushing, and has some lights in it. You may be able to run it through the dishwasher, top rack only I assume. (Sadly, all the pictures show a connection cable… no Bluetooth?) No idea what it would cost or if it will ever even come to market in the U.S., or even elsewhere.

Considering the reports on how much creeping crud we all store under the keys of our existing keyboards maybe it’s a design worth considering. But without tactile feedback - a response for each key touched - it will likely remain an oddity for us touch-typists. Though it’s an oddity I’m willing to try.

Source : Gearlog.com

Nenen malem tdk bikin gigi bolong

Hohohoho… kayanya yang bikin statement “nenen bikin gigi bolong” gak pernah nenenin anaknya deh…

“Lho kan ASI juga mengandung laktosa dok?? laktosa kan salah satu karbohidrat?? jadi memiliki sifat kariogenik dong??

“Ya ya ya…. so please check this out”
1. ASI baru akan keluar dari payudara ibu bila dihisap (eh, kecuali kalo lagi LDR ya?)
2. Tuhan telah menciptakan air ludah yang mampu menetralkan asam hasil fermentasi karbohidrat setelah 1-2jam

Nah, asal giginya rajin dibersihkan… jarang deh sampe karies
Kalopun sampe karies, pasti ada sebab lain…

Saya sendiri BELOM PERNAH denger “breastfed caries…”
Tapi kalo “bottle caries…” SERING!!

So…. “nenen yuk nak!!!”

sumber http://hprimaywati.multiply.com/reviews/item/11

Obat Semprot Bikin Ketagihan?

Asma adalah penyakit radang kronik saluran napas yang menyebabkan saluran napas hipersensitif terhadap berbagai allergen (zat/bahan yang menyebabkan alergi). Asma bukan penyakit menular dan asma terjadi karena faktor keturunan yang disebabkan oleh gen yang jumlahnya ratusan. Alergen atau zat yang mencetuskan asma bervariasi tiap individu.

Gejala serangan asma yaitu sesak napas, rasa berat di dada, batuk dan napas yang berbunyi (mengi, bengek). Frekuensi dan beratnya serangan asma bervariasi. Beberapa penderita lebih sering terbebas dari gejala dan hanya mengalami serangan serangan sesak nafas yang singkat dan ringan, yang terjadi sewaktu-waktu.

Tujuan pengobatan penyakit asma adalah membebaskan penderita dari serangan penyakit asma. Hal ini dapat dicapai dengan jalan mengobati serangan penyakit asma yang sedang terjadi atau mencegah serangan penyakit asma jangan sampai terjadi.

Mengobati disini bukan berarti menyembuhkan penyakitnya, melainkan menghilangkan gejala-gejala yang berupa sesak, batuk, atau mengi. Keadaan yang sudah bebas gejala penyakit asma ini selanjutnya harus dipertahankan agar serangan penyakit asma tidak sering kambuh. Obat-obatan bisa membuat penderita penyakit asma menjalani kehidupan normal.

Obat obat asma terbagi 2 yaitu pelega yang bertujuan untuk mengendalikan serangan penyakit asma segera dan obat yang berfungsi untuk mengontrol supaya serangan asma tidak sering terjadi. Pengobatan berbeda tergantung beratnya, biasanya obat semprot lebih cepat. Obat golongan Beta-2 Agonis (bronkodilator) dan steroid lebih kuat.

Sebaiknya gunakan obat semprot karena lebih aman bila dibandingkan obat minum atau suntik. Cuma karena kurangnya informasi dari dokter, banyak informasi salah yang menyebutkan bahwa obat semprot malah membuat ketagihan.

Obat semprot atau hirup relative lebih aman karena dosisnya lebih kecil dibandingkan obat minum atau suntik serta langsung ke saluran napas si penderita. Selain itu karena dosis kecil jadi efek samping juga relative lebih kecil dibandingkan obat minum atau suntik. Bila serangan asma hampir tiap hari, obat yang dipergunakan adalah kombinasi obat pelega dan pengontrol. Sebagian besar bronkodilator bekerja dalam beberapa menit, tetapi efeknya hanya berlangsung selama 4-6 jam.

Bronkodilator per-oral (ditelan) dan dipergunakan bila serangan asma tidak dapat diatasi dengan obat semprot atau hirup dan memiliki efek samping dan mula kerjanya cenderung lebih lambat. Pada serangan penyakit asma yang berat, bisa diberikan secara intravena (melalui pembuluh darah). Hal lain untuk mengontrol serangan asma anda adalah dengan mengenal pencetus yang menyebabkan timbulnya serangan asma serta hindari pencetus tersebut.

Pasien asma juga dianjurkan untuk memeriksakan diri secara teratur ke dokter. Karena bisa saja kondisi penyakit bertambah ringan atau sebaliknya sehingga baik obat maupun cara hidup perlu disesuaikan. Selain itu untuk menjaga kebugaran tubuh, anda dapat juga mengikuti senam asma yang bertujuan untuk melatih otot-otot pernapasan.

Team Pengasuh

Sumber : Pontianak Post Online