Insomnia

Siamak Nabili, MD, MPH

What is insomnia?

Insomnia is defined as difficulty initiating or maintaining sleep, or both, despite adequate opportunity and time to sleep, leading to impaired daytime functioning. Insomnia may be due to poor quality or quantity of sleep.

Insomnia is very common and occurs in 30% to 50% of the general population. Approximately 10% of the population may suffer from chronic(long-standing) insomnia.

Insomnia affects people of all ages including children, although it is more common in adults and its frequency increases with age. In general, women are affected more frequently than men.

Insomnia may be divided into three classes based on the duration of symptoms.

• Insomnia lasting one week or less may be termed transient insomnia;
  
• short-term insomnia lasts more than one week but resolves in less than three weeks; and
  
• long-term or chronic insomnialasts more than three weeks.

Insomnia can also be classified based on the underlying reasons for insomnia such as sleep hygiene, medical conditions, sleep disorders, stressfactors, and so on.

It is important to make a distinction between insomnia and other similar terminology; short duration sleep and sleep deprivation.

• Short duration sleep may be normal in some individuals who may require less time for sleep without feeling daytime impairment, the central symptom in the definition of insomnia.
  
• In insomnia, adequate time and opportunity for sleep is available, whereas insleep deprivation, lack of sleep is due to lack of opportunity or time to sleep because of voluntary or intentional avoidance of sleep.

Dehidrasi

Deskripsi
Dalam kondisi normal, 75% tubuh terdiri atas air. Dehidrasi terjadi ketika tubuh tidak memiliki cukup suplai cairan atau air. Dehidrasi dapat disebabkan mengeluarkan banyak cairan, tidak cukup minum, atau keduanya. Muntah dan diare juga bisa menyebabkan dehidrasi. Selain itu, keringat yang berlebihan pun bisa mengakibatkan dehidrasi.

Gejala dan Tanda
Gejala dari dehidrasi antara lain mulut kering, mata berhenti menghasilkan air mata, kejang otot, mual dan muntah.

Perawatan
Minum secukup mungkin. Jika dehidrasi karena diare, maka diare harus disembuhkan. 


dikutip dari detikHealtSumber: medlineplus dan medicinet.

Antibiotik

ANTIBIOTIKA

Antibiotika adalah segolongan senyawa, baik alami maupun sintetik, yang mempunyai efek menekan atau menghentikan suatu proses biokimia di dalam organisme, khususnya dalam proses infeksi oleh bakteri.

Berdasarkan mekanisme kerjanya antibiotik dapat digolongkan menjadi:

              I.      Antibakteri yang menghambat sintesis asam nukleat

§         Sulfonamid

§         Trimetoprim

§         Quinolon

§         Nitroimidazol

           II.      Antibakteri yang menghambat sintesis dinding sel

§         Penisillin

§         Cefalosporin

§         Vancomysin

         III.      Antibakteri yang menghambat sintesis protein

§         Aminoglikosida

§         Tetrasiklin

§         Makrolida

§         Kloramfenikol

SULFONAMIDA

Merupakan antibakteri yang efektif untuk infeksi sistemik yang pertama kali ditemukan. Namun, penggunaannya sekarang sudah jauh berkurang karena ditemukannya obat-obat baru yang lebih efektif dan kurang toksik. Sulfanolamida menghambat dihidropteroat sintetase secara kompetitif sehingga akan menghambat produksi folat yang dibutuhkan untuk sintesis DNA bakteri.

Test-and-Treat Strategy for HIV in Resource-Limited Settings

Shahin Lockman, MD, MS

Authors and Disclosures

Test and Treat

The notion that potent antiretroviral therapy (ART) of all persons living with HIV-1, regardless of CD4 count or clinical status, might have a significant mitigating impact on the HIV epidemic by interrupting sexual transmission of HIV, has received significant attention since the publication of a paper presenting a mathematical model of this strategy.^[1] Accumulating observational evidence supports the underlying assumption that ART can drastically reduce at least heterosexual transmission of HIV from infected individuals.^[2,3]However, a lively debate has ensued about the "test-and-treat" strategy, encompassing these issues^[4,5]:

• Feasibility and acceptability of repeated HIV testing, and of treatment in patients with high CD4 counts;
• Cost -- treatment rationing is already a concern;
• Efficacy -- for example, if the epidemic is driven primarily during the first months after acute infection, or if risk compensation or poor ART adherence occur;
• Sustainability -- given already-strained health systems;
• Potential toxicity to the individual of longer exposure to antiretrovirals; and
• The spread of drug-resistant virus.

The importance of considering local HIV epidemiologic characteristics in weighing the risk-benefit ratio of this strategy has also been highlighted.^[6]