Difference Between Primary and Secondary Tuberculosis

Primary tuberculosis is the initial infection / the first time Micobacterium tuberculosis infects our body. It happens usually in children. If the treatment of that infection is adequate, the bacterias will be totally removed from our body. However, if there is inadequate treatment, the active infection becomes latent infection (bacteria is dormant in our body).

Secondary tuberculosis is reactivation from the latent infection that already exist in our body for a long time. This infection usually happens in adult when their immunity is drop.

If you contact with any person that has tuberculosis infection OR you notice the symptoms (the picture above), PLEASE call your doctor ASAP. Tuberculosis can spread in all of your organ, not only your lung. Be aware !

Difference between tumor and cancer

Tumor is a abnormal mass. There are benign tumor and malignant tumor.  Tumor is one of the cardinal signs of inflammation. So, the term of “ tumor” is general.

Cancer is malignant tumor.  Based on the origin of the cancer, there are carcinoma and sarcoma. The origin of carcinoma is epithelial cell, e.g., breast, thyroid, etc. The origin of sarcoma is connective tissue, e.g., bone, muscle, ligament, fat, cartilage, etc.  The most important of cancer cell is the  ability to invade and metastasize.

References

Kummar, V., Abbas, A. K., Fausto, N. & Aster, J. C., 2010. Robbin and Cotran : Pathologic basis of disease. Philadelphia: Saunders Elsevier.

The Diagnosis of Your Disease is Diarrhea. Is It Correct ?

There are many misunderstandings about diarrhea. Diarrhea is a symptom, not a diagnosis of your disease. The most important thing if you have diarrhea is the degree of dehydration.  Dehydration is very dangerous because human body can’t maintain the homeostasis state without enough water.  Severe dehydration is fatal complication of diarrhea.

If your body temperature is more than 37,5 C, it means that you have fever. Diarrhea and fever are the sign of infection in your gastrointestinal tract ( Gastroenteritis ). Now, what is the cause ?

You can check your feces. The pathogen is Vibro cholerae if your feces is like rice water. Shigella dysentriae is the cause, if you can see blood in the feces ( red feces ). If the cause is Giardia lamblia, you’ll find pear-shaped parasit with flagella under microscope ( bring your feces to Parasitology Lab ).

If your temperature is 36,5 – 37,5 C, you maybe not infected by pathogen. However, you need to reassure that there is no pathogen in your body. The temperature is normal and diarrhea only happens in the certain situation ( e.g., when you are not ready to face final exam in your school ). The cause is problably from your psychological state. You need to go to the psychiatrist.

Your temperature is normal and your psychological state is fine, but you have diarrhea only after you eat certain food ( e.g., spicy food, acidic food, milk, etc. ).  You may have alergic condition or food poisoning because of the food.

Please go to your doctor to treat your diarrhea condition ! 

Iron-deficiency Anemia and Your Cognitive Function

Anemia is the most common blood disorder worldwide. Iron deficiency is the most common nutritional disorder and accounts for approximately one-half of anemia cases¹.

Iron deficiency affects more than 2 billion people worldwide. However, the prevalence of iron deficiency anemia has recently decreased , but iron deficiency is still common cause of anemia. Iron deficiency anemia is dangerous for young children and premenopausal women². Pregnant women should be screened during pregnancy. Children must check for it at one years old. But if you are men or postmenoupausal women, you won’t need this screening anymore but you’ll need gastrointestinal endoscopy when you are diagnosed¹.

It is chronic and frequently asymptomatic so this disease go undiagnosed if you don’t check your hemoglobin level and iron stores. Weakness, fatigue, difficulty in concentrating, and poor work productivity are nonspecific symptoms. This symptoms happen because of low delivery of oxygen to human tissues and decreased activity of iron-containing enzymes. There are nonhematological effects that may not respond to iron therapy. What is that ? Yes, these are the signs of iron deficiency in the tissues. For example, decreased cognitive performance and delayed mental and motor development in children³.

Reference

¹Short, M. Iron deficiency anemia: evaluation and management,  Am Fam Physician 2013; 87: 98-104.

²McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993-2005. Public Health Nutr 2009;12: 444-54.

³Camaschella, C. Iron-Deficiency Anemia, N Engl J Med 2015;372: 1832-1843.

The New Medication for Management Your Weight

Why it is so important ?

The loss of 5 to 10% of body weight can have many beneficial effects on your cardiovascular system and metabolism. In my opinion, if you have normal weight, you'll look more beautiful / handsome. So you get more confident. Look at the picture below !

Medication

LIRAGLUTIDE ( a glucagonlike peptide-1 analogue )

Once-daily dose of 3.0 mg of liraglutide subcutaneously, as an adjunct to reduced-calorie diet and increased physical activity, was associated with increased weight loss in overweight and obese adults who did not have diabetes (Pi-Sunyer, et al., 2015)

LOCASERIN (selective serotonin 2C receptor agonist )

Locarserin 10 mg twice daily with  nutritional and physical exercise program was associated with increased weight loss in overweight and obese adults. Moreover, Lorcaserin was also associated with improved values for biomarkers that may be predictors of future cardiovascular events, including lipid levels, insulin resistance, levels of inflammatory markers, and blood pressure (Smith, et al., 2010).

Conslusion

The key of weight loss program is diet and exercise program. You can read that Locaserin and Liraglutide can work alonely. In my opinion, if you want to lose your weight, you won’t need any medication, but you need strong motivaton from your heart J So be natural my friend.

Note : please don’t use it without consulting with your doctor !

Reference

Pi-Sunyer, X., Astrup, A., Fujioka, K. & Greenway, F., 2015. A Randomized, Controlled Trial of 3.0 mg of Liraglutide. N Engl J Med, 373(1), pp. 11-22.

Smith, S. R. et al., 2010. Multicenter, Placebo-Controlled Trial. N Engl J Med, 363(3), pp. 245-255.

You can read the journal at

http://www.nejm.org/doi/full/10.1056/Nejmoa0909809

http://www.nejm.org/doi/full/10.1056/NEJMoa1411892

What is Difference Between HIV and AIDS ?

HIV ( Human Immunodeficiency Virus ) is a name of a virus. Human immune system can kill the most viruses, but they can't overcome HIV. Why ? Because HIV infects human immune system ( CD4 cell ). CD4 cell is a type of lymphocyte and lymphocyte is a type of leukocyte / white blood cell. So what happen if CD4 cell its attacked by HIV ? Your immunity will be very weak so immune system can't combat the infection. So, the opportunistic pathogens emerge. The opportunistic pathogens are organism/virus that normally can't make any disease in human body, but in someone with " deficiency of immunity " it can be a very dangerous organism.

AIDS ( Acquired Immunodeficiency Syndrome ) is a final stage of HIV infection. Why ? Because syndrome is collection of wide range of symptoms and complications. For example, extrapulmonary tuberculosis, chronic diarrhea, oral hairy leukoplakia, esophageal candidiasis, and many more.

HIV is very horrible virus. If you are infected by this virus, it means you will always be with you forever. Until today, there is no definitive treatment for HIV infection. So, the best treatment for HIV is prevention and only that.


What can we do?

1. Don't do drugs
2. Be faithful to your partner ( safe sex )
3. Be careful if you need blood from other people ( check the blood )
4. Don't breastfeed your baby if you are HIV positive ( except some conditions )

Reference :
AIDS.gov
Buku Panduan Praktik Klinis bagi Dokter di Fasilitas Pelayanan Kesehatan Primer
Robbins Cotran Basic Pathology of disease 8th edition

Stretch Marks ( Striae or Streaks )

Stretch mark or striae are often pink, red or purple indented streaks that often appear on the abdomen, breasts, upper arms, buttocks and thighs and eventually fade to white. However, if striae become shiny white streak ( SWS ), you don't just ignore this streak. SWS maybe a sign of malignancy especially melanoma. So go to your doctor !

Causes of the streaks 

1. Infection / scratch injury ( red streaks )
2. Pregnancy ( bluish or darkening vertical line on the central abdomen ) -> stria gravidarum : stria is line and gravidarum is pregnancy
3. Scabies ( short fine grey lines )
4. Excess of adrenocortical ( purple-pink lines ) -> a classic sign
5. Weight gain / weight loss rapidly -> cacexia in cancer ( sudden weigh loss )

Reference

Mayoclinic.org

Medicinenet.com

Rightdiagnosis.com

Shitara. D et al. 2014,'Shiny white streaks: a sign of malignancy at dermoscopy of pigmented skin lesions', Acta Derm Venereol., Vol. 94, No. 2, pp.7-132

WebMD.com

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