Herpes Simplex

HERPES SIMPLEX
 Definition of Herpes Simplex
 Herpes simplex refers to a group of viruses that infect humans. H. Virus infection simplex is characterized by vesicles clustered in the mucocutaneous with reddened skin. The disorder can occur in both primary and secondary. Herpes simplex causes painful wounds on the skin.








Cause  of Herpes Simplex
 Herpes simplex virus type 1 (HSV-1) is a common cause for injuries fever (cold sores) around the mouth. HSV-2 usually causes herpes sex. However, HSV-1 can cause genital infections, and HSV-2 can infect the mouth area through sex.

Clinical- Infection with this virus is characterized local primary lesions, latency and the tendency of local recurrence- 2 agents cause, HSV types 1 and 2, generally cause the clinical syndrome clear, depending on the entryHSV type 1:- Primary infection may be mild and usually occurs in childhood Early before the age of 5 years.- Approximately 10% of primary infections cause a more severe form of the disease manifesting fever and malaise.- It can last for a week or more, and is associated with vesicular lesions in the mouth, eye infection or a generalized skin eruption that aggravate chronic eczema.- Reactivation of latent infection results in cold sores that appear as clear vesicles on an erythematous base, usually on the face and lips, which berkrusta and recovered within a few days.- Reactivation may be caused by trauma, fever or an illness Another is being suffered. 
 
HSV type 2:- The virus is the cause of genital herpes, although it can also be caused by virus type 1.- Genital Herpes occurs primarily in adults and transmitted Sexual- Primary and recurrent infections may occur, with or without symptoms.

Diagnosis of Herpes Simplex
Based on the clinical picture

ManagementTreatment of Herpes Simplex:- Therapy include:§ Idoksuridin for skin lesions§ ointment and povidone-iodine paint§ Acyclovir for initial and recurrent genital herpes, 5 times a day, 200-400 mg.§ i.v infusion acyclovir for encephalitis H. simplex and patients with immunosuppression.- Local Treatment for shingles should include cleaning wound with salt water and keep it dry. Gentian violet   can be applied to the wounds.- The standard treatment for HSV is acyclovir in pill form to five time basis at the health center.
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Hepatitis

HEPATITIS VIRUS

Definition Acute Viral Hepatitis is an inflammation of the liver due to infection by one of the five viral hepatitis (virus A, B, C, D or E); inflammation emergent arrived and lasted only for a few weeks.



CauseHepatitis A, B, C, D, E.Clinical- Symptoms usually appear suddenly, such as:§ decreased appetite§ feel unwell§ nausea§ vomiting§ fever.- Sometimes there arises joint pain and urticaria (itchy skin), especially if cause is infection by the hepatitis B virus- A few days later, the urine turns a darker color and raised yellow (jaundice). At this time the other symptoms disappeared and the patient feel better, despite worsening jaundice.- Can symptoms of cholestasis (bile flow interruption or reduction) in the form of pale stools and itching all over the body.- Jaundice usually peaked at week 1-2, then disappeared at week 2-4.

Diagnosis- The diagnosis is based on symptoms and the results of blood tests to liver function.- On physical examination, liver palpable soft and sometimes a bit bigger.- The diagnosis must be obtained if the blood tests found viral proteins or antibodies against the hepatitis virus.
ManagementTreatment:- In case of severe acute hepatitis, then the patient is treated at home sick, but usually hepatitis A do not require special treatment.- After a few days, appetite reappeared and the patient does not need undergo bed rest. Food and activities the patient does not need to be limited and do not need extra vitamins.- Most patients can return to work after the jaundice disappeared, although the results have not been completely normal liver function.

Prevention:- Good hygiene can help prevent the spread of viral hepatitis A. Highly infectious feces. On the other hand, the patient does not need to be sequestered; exile in few patients only help the spread of hepatitis A, butdid not prevent the spread of hepatitis B and C.- The possibility of transmission of infection through blood transfusion can be reduced using blood that has been filtered to hepatitis B and C.- Hepatitis B Vaccination stimulates the formation of immune and provide effective protection.- Hepatitis A vaccine is given to people who are at risk high, such as the travelers who visit areas where the disease are found.- For hepatitis C, D and E have not found a vaccine.- For those who have not been vaccinated but has been exposed to hepatitis, can get the preparation of antibodies for protection, the serum globulin. Provision of antibodies aimed at providing immediate protection against hepatitis virus.- To the infants born to mothers with hepatitis B immune granted globulin hepatitis B and hepatitis B. This combination can prevent occurrence of chronic hepatitis B in approximately 70% of infants.
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Glaucoma

Definition of Glaucoma
Glaucoma is a symptom of a collection of diseases that cause a the resultant increase in intra-ocular pressure is sufficient to cause degeneration of the optic disc or visual field abnormalities.






Cause of Glaucoma
Increased intra-ocular pressure.Must be distinguished from ocular hypertension is a condition in which the pressure elevated intraocular without damage to the optic disc and visual field abnormalities.


Clinical of Glaucoma
Glaucoma can be classified as follows:1. Primary Glaucomaa. Primary open angle glaucoma (glaucoma simple, wide angle glaucoma, chronic simple glaucoma) is the most common type of glaucoma found.b. Primary angle closure glaucoma (narrow angle glaucoma, closed-angle glaucoma, acute congestive glaucoma).

2. Congenital Glaucomaa. Primary congenital or infantile glaucoma (Buftalmos)b. Glaucoma accompanying congenital abnormalities3. Secondary Glaucoma4. Absolute GlaucomaIn acute congestive glaucoma (the attacks) should be given treatment as soon as possible because delayed treatment can accelerate the deterioration visual acuity and visual field.

Acute congestive glaucoma is often suspected / diagnosed as conjunctivitis because the eyes look red. In acute glaucoma will see the injection conjunctiva, ciliary injection, dilated pupils / mid dilated, reflexes lacking.

Examination of eye pressure measurement with tonometri be obtained high value (normal 10 -20 mmHg).
Diagnosis of Glaucoma
Red eyes, wide pupils, reflexes lacking, somewhat cloudy cornea, no eye dirt with complaints of headache and decreased visual acuity and one eye is usually

Glaucoma of Glaucoma
The disorder is not diagnosed as conjunctivitis. Signs of conjunctivitis is the red eye (usually two eyes), there is a dirt eyes, no headache, not decreased visual acuity, pupils are not wide and does not cause blindness.Acute congestive glaucoma is very dangerous and result in total blindness can not be treated.

Management of Glaucoma
With limited personnel and equipment, the prevention of glaucoma which may be done at the Health Center is an acute congestive glaucoma.

administration:a. Timolol 0.5% at a dose of 2 x dailyb. Pilocarpine 2-4% every 2 hoursc. Acetazolamide 250 mg 3 times a dayd. Systemic analgesicSymptomatic treatment with existing symptoms and immediately refer to specialists Eye for further action.
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Snakebite

Snakebite
Definition of SnakebiteA condition caused by the bite of a poisonous snake.

Cause of Snakebite
Broadly venomous snakes can be classified into 3 groups:Colubridae (Mangroce cat snake, Boiga dendrophilia, etc.)Elapidae (King cobra, Blue coral snake, Sumatran spitting cobra, etc.) Viperidae (Borneo green piton viper, Sumatran pit viper, etc.).

Clinical of Snakebite
- Generally not poisonous snake bites, such as water snakes and only requires governance is simple. However, when the snakes are not known, it should be prevention efforts with Snake Serum Anti Could polyvalent.- The possibility is suspected when there is a history of snakebite.- Patients may:§ Looks bluish§ Fainting§ Paralyzed§ Shortness of breath

Effects caused by snake bites can be divided into three:1. Local effects.Some species such as coral snakes, Krait will give the effect of a rather difficult to be detected and only minor but some species bite can produce substantial effects such as swelling, blisters, bleeding, bruising to necrosis. What must be aware of is secondary hypovolemic shock caused by the migration of vascular fluid into the tissue due to the systemic effects of the venom.

2. Systemic EffectsSnakebite will produce non-specific effects such as headache, nausea and vomiting, abdominal pain, diarrhea until the patient becomes collapsed. Symptom found such as an alarm for health workers to give help soon.
 
3. Specific systemic effects
      Specific systemic effects can be divided by: 
• coagulopathy 
Several species of snakes can cause coagulopathy. Signs clinical signs that can be found are continuous bleeding from the site of the bite, gums and venipuncture from when developing will cause hematuria, haematomesis, melena, and coughing up blood. 

• neurotoxic 
This snake bites can cause flaccid paralysis. This is usually Hazardous in case of respiratory paralysis. Usually the signs who first encountered was the cranial nerves such as ptosis, oftalmoplegia progressive when it did not receive anti-venom will happen limb weakness and respiratory paralysis. Usually full paralysisit will take 12 + hours, in some cases used to be faster, 3 hours after the bite. 

• Miotoksisitas 
Miotoksisitas only be found when someone is attacked or bitten by a sea serpent. Snakes on land that is normally not a miotoksisitas cause severe. Symptoms and signs are:muscle pain, tenderness, mioglobinuria and the potential for failure, kidney, hyperkalemia and cardiotoxicity.

Diagnosis of snake bites
A history of bites with symptoms / signs of venomous snake bites in the form of securities local (the bite) as well as systemic effects and specific systemic effects.

Management of snake bites
First aid in snake bite: 
- If the bitten limb, use a swivel cord cross next to the wound. Turn the rope so tight until the pulse at the end of the members almost not palpable. Ties loosened every 15 minutes for 1 minute. 
- If the bite occurs in less than half an hour, make an incision place cross bite until blood came out and suck it with vacuum, do not ever with mouth. 
- If available, injections of serum Anti Could Snake  and polyvalent iv around the wound
- ATS procain 900 000 IU of penicillin and can be considered as prophylaxis.
- The general symptoms such as shock, paralysis and shortness of breath, the patient should refer immediately to the hospital.
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gastritis

definition of gastritis
Epigastric pain that is intermittent / persistent may be accompanied by nausea /vomiting.

the causes of gastritis
The main cause of gastritis are stomach irritation such as by food stimulate gastric acid, alcohol, drugs or stress. In this situation occurs impaired balance between the production of gastric acid and mucosal resistance.Systemic diseases, smoking, infection of the bacteria Helicobacter pilori also role in this disease.
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Heart failure

definition of Heart failure
Heart failure is a clinical syndrome that arises because of the declining power the heart pumps. Why other kinds of anemia, hypertension, thyrotoxicosis, coronary heart disease or heart valve disorders.
Heart failure

 
cause of Heart failure
- anemia
- hypertension
- titotoksikemia
- Chronic heart disease
- Abnormalities of the heart valves
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