Benefits for baby babbling

"You've heard the babble-babble baby ... ... ..."Do you feel troubled by it?

... Hopefully not, because the chatter is the need and benefit to the baby.Did you know that your baby is a powerful communications expert, and we also understand that the babies are great not just be pointed at but can also do other things.

Since the first month of life, we've often heard the cries, murmurs and laughter. Sometimes, just feels a surprise when I discovered the crying peak occurs around the age of two months and will decline thereafter. Often in their first months, we heard a series of vowels in his throat, for example, "i.. I.. I. '," a.. A.. A "," u ... u ... u "and so on. It would be awesome if we respond to this, all issued by the body, as if they were part of a "conversation".

We even have convinced ourselves, though contrary to fact, that they had a meaningful contribution and each different sound indicating the condition of the baby's body is different (like, hungry or wet).

Around the age of seven months, infant subsequent success, that they began to babble. The first consonant (eg, ma ga ... ..., ta ..., pa ...) occurs when the baby's lips and decided to make a sound at the same time. Parents realize that it sounds like a conversation. Often the babies utter conversation understood only by their own (example: ".. ta ta ta .. pa .. pa .. pa .. ma ...?").

And at the end of the first year of our children often seem to ramble. Although babble that means nothing, but this is an important step for a baby in an attempt to master the larynx (larynx) and the volume of each person. That is why babies often shouted or whispered, in doing so they actually began to know the workings of their organs.

Babies have some clever way to show what is really desired. Although he did not have words to objects around it, to get what he wants, he can do from a sound continuously, pointing, shaking his head, jump, mencodongkan body and so forth.


It was clear he would not get anything if you do not have a parent or caregiver who appreciate the effort to communicate. This is where we should play a role with respect "message" of our children as if what it expresses clear and easy to understand when in reality is the opposite.Do you remember, how your baby's first babbling?

Sometimes all the wonderful things done before the baby's first words are often ignored or not getting a response. Do you know how much effort in analyzing the language of our children before said her first word? And do you know when you hear the chatter-chatter they can make you stay young?

From now on very important to start listening and responding to your baby babble.

Smile to your baby's babbling and join with them ... ..

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Playing since the Early Stimulation for Children's Intelligence

Was it stimulating play early on? According to Dr. Soedjatmiko, SpA (K), MSI, consultant pediatrician growth and development, early stimulation is the stimulation of play since the newborn. Stimulation or stimulation should be performed since the age of 6 month fetus in the womb. Why? 

Stimulation is believed to affect the growth of synapses (sinaptogenesis process), which requires a lot of sialic acid to form gangliosida, which is essential to speed the process of learning and memory.
Stimulation should be done with joy, affection, and every day to stimulate all the sensory system. Furthermore, it should also stimulate the movement of coarse and fine legs, hands and fingers, invite communication, and stimulate a good feeling from the minds of infants and toddlers. 

Stimulation is done with the atmosphere of play and compassion, from birth, continuous, and varied, will stimulate the establishment of branches of brain cells, doubling the number of relationships between cells of the brain to form a more complex brain circuitry, sophisticated, and powerful. Thus, the higher the intelligence of children and varied (multiple intelligence).
Then, how to stimulate the fetus is still in the womb? The mother or father can do this by speaking near the belly of the mother, singing songs, reading the prayers, religious songs, stroking the abdomen of the mother. Can also play songs with earphones stuck in the mother or the mother's abdomen also listen to the song. 

 There is some literature that says that listening to classical music good for brain development of children. If you really want to play classical music on children, it is also important for the mother loved the songs. Therefore, the mother's mood can also affect the baby. Stimulation should be done every day, every time the mother can interact with the fetus, eg, while bathing, cooking, washing clothes, gardening, and so on.
As for babies and toddlers, stimulation can be done in various ways according to developmental age, for example:
Age 0-3 months, give comfort, safe, and fun, hugging, holding, looking into the eyes baby, bring a smile, ringing sound or music, brightly colored moving objects, object sounds, overthrow the baby to the right / left, prone-supine, and stimulated to grab and hold toys.
3-6 months of age, can play "peekaboo", see the baby's face in the mirror, is stimulated to his stomach, back and forth on your back, sit down.
Age 6-9 months, calling his name, shaking hands, clapping, read fairy tales, excitatory sitting, standing holding practice.
Age 9-12 months, repeated calls mama-papa, brother, put toys into containers, drinking from a glass, roll the ball, practice standing, holding onto the street.

Age 12-18 months, training with doodles colored pencils, stacking cubes, blocks, pieces of simple images (puzzle), insert and remove small objects from the container, playing with dolls, spoons, plates, glasses, pots, broom, lap, and others.
Train to run without a handle, the way backward, climb stairs, kick a ball, loose pants, understand and perform simple commands (where the ball, hold it, enter it, grab it), name or showing objects.

Age 18-24 months, ask, say, point to body parts (eyes, nose, ears, mouth, etc.), ask the image or name the animals and objects around the house, talk about daily activities ( eating, drinking, bathing), exercise a line drawing, wash hands, wear-pants, throw balls, jump, and others.
Age 2-3 years, coupled with knowing and mention the color, use an adjective (big-small, hot-cold, high-low, many-few, and others), specify the name of a friend, count objects, wear clothes, toothbrush, playing cards, dolls, cook, cooking, drawing lines, circles, people, practice standing on one leg, urination / in the toilet.
After 3 years, in addition to developing abilities earlier age, stimulation is also geared for school readiness, among others, hold a pencil properly, write, recognize letters and numbers, simple arithmetic, understand simple commands (urinating / in the toilet) , and independence (left at school), share with friends, and so forth. Stimulation can be done at home (by caregivers and families), but can also be in play groups, kindergartens, or the like.

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10 Cholesterol-Lowering Foods

Many ways to lower cholesterol levels. Chemical-based drugs effectively lower cholesterol count. But of course there are side effects. You can try to lower cholesterol the natural way. There are a number of foods that can reduce levels of Low-Density Lipoproptein (LDL), aka bad cholesterol that causes plaque in blood vessels, and increase High-Density Lipoprotein (HDL) aka good cholesterol that can be utilized the body to process vitamins are soluble in fat. To reduce levels of LDL, you should reduce your intake of saturated fat. Saturated fats are usually found in animal products such as meat, milk, cream, butter, and cheese. There is also a saturated fat comes from vegetable oils such as coconut milk, coconut oil, and vegetable fat. But many foods that contain unsaturated fats that are very effective in lowering cholesterol levels. 

1. Soybeans Soybeans and derivatives, aliases such as soybeans that have been processed into tofu, tempeh, soy milk, and soy flour contains isoflavones, which are substances that can reduce LDL. But remember, though delicious tofu and tempeh can not effectively lower cholesterol when treated carelessly. For example, fried in cooking oil or mixed with coconut milk. Because, coconut milk and cooking oil are sources of saturated fat. Agency for the United States Food and Drug Administration (FDA) recommends to consume at least 25 grams of soy protein per day to lower cholesterol levels. 

2. Nuts Nuts are a source of soluble fiber are very high. Consuming soluble fiber can reduce cholesterol. Eating beans such as chickpeas, kidney beans, long beans regularly for six weeks can reduce cholesterol levels by 10%. 

3. Salmon Salmon is very good because they contain Omega-3 acids can lower LDL and raise HDL and trigiserilda. Salmon contains EPA and DHA are good for heart health. The American Heart Association recommends at least two servings per week to get the maximum benefit. Besides salmon, tuna, trout, sardines, mackerel, and herring are also good. 

4. Avocado Avocados are a source of unsaturated fats that can increase HDL levels. Unfortunately, high-calorie avocados, so it must be combined with vegetables that can reduce calories. One medium avocado contains 300 calories and 30 grams of unsaturated fats, while normal human body needs is 1,800 calories and 30 grams of unsaturated fat per day. 

5. Garlic Since thousands of years ago, garlic was believed to contain many substances that are good for human health. Ancient Egyptians wore garlic to increase stamina. In modern times, garlic is used to lower cholesterol, prevent blood clotting, lowers blood pressure, and protects the body from infection. The most recent findings, garlic can prevent cholesterol particles stuck to the walls of blood vessels. 

6. Spinach Spinach contains a lot of lutein. Lutein is an important substance that can maintain the health and sharpness of eye function. Lutein also was able to maintain heart health because it can prevent grease build up in blood vessels. It is advisable, to eat spinach every day about half a bowl for maximum results. 

7. Margarine Several types of margarines can lower cholesterol levels. Eg margarine canola flower from seed oil 

8. Cashew, Almonds, and Walnuts Monounsaturated fat, in the cashews, almonds, and walnuts are low-fat foods are good for heart health. Nuts also contain vitamin E, magnesium, and phytochemicals yangterkait closely to heart health. Unfortunately, like avocados, nuts are very high in protein. So, do not be greedy eating beans for maximum benefit really. 

9. Tea Tea, would be drunk cold or hot, the same benefits. Tea contains antioxidants that can make blood vessels relax so avoid blood clotting. Antioxidants in tea are flavonoids can prevent LDL oxidation that lead accumulates in blood vessels. Enjoying a glass of tea every day could meet the needs of antioxidants.

10. Chocolate Chocolate was healthy. Of course, mixed with too much chocolate milk contains too much fat. So, choose a dark or bitter chocolate. Healthy chocolate because it contains many antioxidants and flavonoids. White chocolate, it does not contain substances that are consumed less healthy. The content of flavonoids in chocolate varies depending on where the chocolate is growing and the processing process.

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Turning off lights when Sleep Tonight

Turning off the lights when the dark night's sleep quietly collaborating
with the body. Only in a state that really dark body
produces melatonin, a hormone in the immune system = 20
able to combat and prevent various diseases including cancer = 20
breast and prostate cancer.

Conversely, sleep with the lights on at night - no matter how small = 20
light causes the production of melatonin hormone stops.
Biologist Joan Roberts discovered the secret after the experiment = 20
in animals.

When the animals were given artificial light at night, melantoninnya = 20
decreased and the immune system is weakened.
Apparently, the lights - as well as TV - causes hormones to be = 20
very tired.

Therefore, in addition to saving energy by turning off lights when sleeping
is a natural way to improve health

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Stroke? chew the seeds of tomatoes

Maybe all this while cooking, discard the tomato seeds you like, because
Your lack of love or because you feel disgusted, especially by liquids
slippery accompanying tomato seeds. But, if you know the usefulness, in times of
future could be in the recipes, you always accompanies tomato seeds.


A study conducted Rowett Research Institute in Aberdeen,
Scotland discover the health benefits of tomato seeds. As quoted
health magazine Prevention, Asim K Dutta-Roy, PhD, the researcher
found, slippery liquid or contained a yellow jelly around the seeds
tomatoes, contain a compound or compounds that are effective against
stroke and heart disease.

The study also found that if you drink tomato juice without
discard seeds, then about 72 percent you have reduced the risk
occurrence of blood clots that can cause heart attacks.
Oops, small seeds that mucus was really great usefulness, huh?

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Heart Disease and Drinking Warm Water

This article is very good. Not only about the warm water after eat, but also about the heart attack. This makes sense ... Chinese and Japanese drink hot tea with their meals .. not cold water .. maybe it is time we adopt the habit of drinking warm water as their loss .. No.. even profit .. 

For those who like to drink cold water, this article is suitable for you. It is nice to have a cup of cold drink after a meal. However, water cold will solidify the oily stuff that you've just eaten. And slow down the digestion of food. When the precipitate is reacted with gastric acid, the sediment will be divided and absorbed by the intestine faster than solid foods. It will line the intestine. Very soon, this will turn into fats and lead to cancer. 

Best to drink / eat hot soup or warm water after a meal. Serious note about heart attacks: Not all symptoms searngan heart is a pain in the left arm. Beware if there is pain that continues constantly on the jaw.
Maybe we will not experience chest pain when the first heart attack. Nausea and excessive sweating also is a symptom are common. 60% of those having a heart attack when sleep does not wake up.
Pain in the jaw can wake you from sleeping soundly. Be careful and berwaspada. The more we know, the better chance we for survivors. 

A cardiologist says if they are getting this email send it to 10 people, we could save at least 1 lives.
An early indication of cancer & tumor usually begins with a full bag gall stones. Everyone tends to gall stones contain, but in certain circumstances would be a disease, the bottom of this article has given my way out, where four doctors to make sure I have an operation. Because a few weeks ago, I was exposed to hepatitis A and ultrasound results were bile I was full of stones. Gall stones full with ill will we know within normal circumstances, I only found out after doctors perform liver ultrasound and bile. According to Doctor: gall bladder operation with lift bags bile with major surgery or laparaskopi. Costs which we will remove u / surgery tsbt ranged between 40-60 million. (For operations only) 

Please read the original article at the bottom of Dr Lai Chiu-Nan, how removing gallstones without surgery and the cost is very cheap and not damaging our bodies. Subhanallah I have followed his advice and thank God I came out of all gallstones without surgery. (This is not a detox, but like cleaning the stomach). The results of my ultrasound has been full of bile stone, after doing this treatment I requested an ultrasound come back as evidence. It was true ... my gall bladder is empty ... 

Somehow I would like to thank to Dr Lai Chiu-Nan, but I just wanted to share the experience according to the intention of Dr Lai Chiu-Nan share our experience to saudara2 free. Suggestion: For those who well ... try, because when we are sick of acute or chronic ... not taste very good. This is one way of avoiding cancer and tumor and liver function bile: Neutralizes toxins in the body, neutralize fats we Bile asup to dlam body. Both are intertwined ... ... means that the net kedua2nya we have to nourish our bodies normal function of both. 

Healthy belongs to us all .. How nice if we occasionally gall bladder cleanse us.

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WATERMELON

Watermelon is believed to come from the Kalahari desert, Africa. According to the researchers, the fruit was first harvested 5,000 years ago in Egypt and according to ancestral beliefs at that time, the fruit is used for burial of kings so that they get nutrition spirits in the afterlife. And from That's where the watermelon was sent around to the countries in the world. Today, we know that that has been buried obviously can no longer enjoy watermelon nutrition. We are entitled to enjoy the delicious and how bergizinya one piece of fruit each function with a glass of water. But remember, when eating watermelon, green part near the skin is the important that you eat must come in addition to the red / yellow only. 

What are the functions of a watermelon?  
1. If you're on a diet, then the watermelon is your friend. The fruit is fat-free and have unlimited combination of sugar and water content abundant. Moreover, the fruit of this one is quickly filling in in the stomach. 
2. Watermelon is good for people with hypertension. Water content and High potassium can neutralize blood pressure. 3. Watermelon is also intensify the work of the heart. 4. Antioxidants including beta-carotene and vitamin C helps cells the body remains healthy. 5. Watermelon also serve to stimulate more rapid discharge of urine so it is good for those with impaired bowel small. 6. Watermelon can be used to reduce fever. 7. Watermelon can prevent ulcers with potent. 

Is it true that watermelon is a fruit of anti-cancer?  
All started from lycopene. Lycopene is a carotenoid components such as as beta-carotene. But diibandingkan other antioxidants, like vitamin C and E, lycopene forces in the fight against free radicals far more powerful. Free radicals are going out of control, either because of the chaotic eating patterns, pollution or negative thoughts, decreased immune. Consequently yes various diseases and skin tubuhpun becomes dry, dull and sagging. With the lycopene found in watermelon, free radicals can directly lame! 

Lycopene is able to crush the seeds of cancer. Many eating watermelon, even every day was no problem, it can shrink the cancer risk cervical and pancreatic cancer in women. Against gastrointestinal cancers, lycopene watermelon unable to stop until the risk is reduced half, such as oral cavity cancer, esophagus cancer, cancer stomach cancer, colon cancer, rectal cancer. Similarly with prostate cancer. Wow! 

In addition, lycopene is useful to create a glowing face, looked fresh and younger. For the elderly, the melon not only helps restore the health problems more quickly, but also helps improve memory and mental acuity. 

POWERFUL FRUITS Watermelon called for men, is it true?  
Lycopene in watermelon kasiat also donated specifically for men married. This fruit can increase fertility and help male sexual arousal. For those who missed had offspring, the fruit can also be very helpful. Believe it or not, studies show that compounds sitrulin in watermelon, have a great effect with the same afrosidiak viagra, but with absolutely no side effects. Want to try? 

Local watermelon seed, seedless watermelon, yellow watermelon, watermelon red, watermelon imports, round watermelon, watermelon oval, or varieties wherever it is, watermelon remains excellent and nutritious fruit high! Make fruit you love this as a gift for the family. Enjoyed no matter how safe you Like any fresh and incomparable.

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PREGNANT WOMEN CAN X ray?

Except in urgent situations, and urged, should be avoided for the fetus do not have disabilities. What about ultrasound? In certain conditions, pregnant women often have had to undergo radiological examination although not directly in the stomach, such as X-rays in the feet and hands. Be tense and anxious mother, lest be a negative impact on the fetus. According to dr. Riris Himawati Sp.Rad. Bintaro International Hospital in Tangerang, Banten, the impact of radiation exposure that must be wary not only focused on X-rays from x-rays, but also from the CT scan, MRI (Magnetic Resonance Imaging), or check with nuclear. Riris mentioned, the CT scan is a diagnostic test which is the development of x-rays which combines the use of X-rays and computer technology. How to capture members of this body using X-rays are very "thin", between 0.5 mm to 10 mm. The pictures that appear on the computer screen is obtained by using X-ray radiation that surround the patient's body. "X-rays that penetrate the body and be absorbed by bone, skin or body fluids in a variety of different amounts according to terrain. The difference is that then causes the 'bounce' the light that comes out of the body parts have different intensities." Intensity levels is captured by the detector which then change the X-rays into electrical signals, then transfer to a computer for further processing into digital information. Furthermore, processed by a computer program to display 2 or 3 dimensional drawings and prints. While the examination which is the development of radiological technology is the use of nuclear technology. These technologies utilize radio-isotopes are injected into the body to detect abnormalities of the body. Such damage / disease of the kidney, bone, lung, thyroid and others. If there is any abnormality in these parts, which included the nuclear isotope will detect the dark by projecting a color image on the display. Technology is believed to be the smallest radiation dangers, or even none at all is the MRI. Because of this high-tech diagnostic imaging uses magnetic fields, radio frequency, and a set of computers to generate images of the pieces of the cross-section of the human body. This image obtained from the interaction between the molecules of body cells and the signals emitted by radio frequency. The data was processed image computer and then printed in the form of photographs. 

SOUND WAVES THROUGH Initially, continued Riris, people unaware of the adverse effects of X-ray radiation up to continuous use for years. Later became known only to birth defects, among others, thanks to X-ray radiation or other wave in radiology. "Since then, radiological examinations of pregnant women began to be avoided. Especially during pregnancy under 12 weeks. Therefore, when the formation of the organs of the fetus is not perfect." When the initial cell division is disturbed by radiation, it is feared will bring up the defects in the body such as hands, feet and head. Or abnormalities in the heart, lungs, kidneys, or cancer. Defects or abnormalities are usually discovered when the baby is born or when it is many years old. Through 12 weeks of gestation, the formation of the organs of the fetus is perfect, so some experts believe the fetus will not be affected whatsoever. But according Riris, if not very forced, doctors generally recommend that pregnant women still do not undergo X-ray images using "Even if compelled, must wait for safe time. Such examination was delayed until the last trimester or just after 6 months of pregnancy. It is also still done by giving priority to safety. For example, protecting the body with a blanket layer of lead for radiation effects can be minimized. Another case with ultrasound. Although also the development of radiology, the impact is in no way harm the fetus. Work ultrasound, clear Riris, using sound waves. This is confirmed dr. Rudianti, SpOG, on separate occasions. Ultrasound, obstetricians clearly who is familiarly called Anti this is one diagnostic method to detect fetal development. "Instead of ultrasound with all the advantages, to overcome the limitations of roentgen diagnosis that is rich in radiation exposure." According to Anti, an ultrasound examination uses high frequency sound waves will not cause adverse effects, both for pregnant women, fetuses, and physicians who perform ultrasound. "Unfortunately, there are still a handful of doctors who do not understand well how the ultrasound. It may be because the result is an image, they think Ultrasound uses X-rays and contain radiation, so its use should be avoided." Although ultrasound is done each month, said Anti, until recently did not show significant difference in body weight and birth length. Also no effect on child development, learning ability, or create visual impairment, hearing, and nerves. What is clear, he added, pregnant women are entitled to an explanation of the purpose / objective ultrasound examination. Including the advantages and possible disadvantages. Only When Forced In general, pregnant or not, is not radiological examination will have a negative impact on the body. With notes, Riris demolished, "Inspection not done repeatedly, such as 5-10 times a year. Because, among others, could potentially cause infertility, cancer, skin disorders or other." The impact did not snap. Time consuming and can not be certain when emergence. Therefore, the message Riris, perform radiological examination only if recommended by a doctor for medical indications. Meanwhile, according to Anti, ideally before pregnancy, a woman must consult with the doctor concerned to seek the possibility of the disease. Like the lungs, abdominal cavity, abnormalities in the brain, or bone fractures that eventually expected to require radiological investigation. When the safe or the disease can be treated, pregnancy can be immediately scheduled. Unfortunately, radiological examination is often performed due to sudden demand. For example, the mother had an accident and need immediate radiological examination. Usually the doctor will look at the condition of the patient. When you can wait until the end of pregnancy, the examination will be deferred radiology. But if very urgent / emergency, such as detecting blockage of blood vessels in the brain, CT-scan is usually the choice is permitted. "This may be due to save the life of the mother." Meanwhile, to minimize its effect on the fetus, the mother's body will be protected by a blanket layer of lead.

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Dropped Coitus Interruptus Method

Many couples who want family planning or preventing pregnancy, but are reluctant to use contraceptives. But they are also reluctant to implement family planning calendar. The options are eventually dropped coitus interruptus method (pull out the penis before ejaculation). The consideration, the husband and wife can have intercourse at any time (after all, one can not determine when to or when baseball related mood right?), But not potentially cause pregnancy. 

However, this method was never advised by doctors. For men, this method requires awareness of the coming orgasm, and the ability to withdraw the penis right time. The problem, praejakulasi fluid, or pre-cum, it already contains a small amount of sperm that is able to swim to the uterus. 

Therefore CI technique is not considered a contraceptive method by practitioners. However, applying this technique is still better than not using contraceptives at all. For the women, coitus interruptus will become the last refuge when forget taking birth control pills, or condoms are not available during intercourse. Many are women who make the technique of "pull" it as a back-up from other methods. It is estimated that, at least one third (of the active population of women who had sexual intercourse) using this technique for family planning. 

The researchers themselves difficult to estimate how many couples who apply this method, because if not asked directly, she will not report it. This will cause the difficulty of assessing its effectiveness. Nevertheless, researchers should begin to consider this technique as a method of family planning beyond. Why? Basically, this technique is quite effective. When compared with the use of condoms, both are very effective when applied properly (about 4% compared to 2%), although less comfortable practiced (about 18% vs 17%). Now, your stay must make a choice. Do not forget, condom not only protects you from pregnancy but also sexually transmitted diseases.

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TUBERCULOSIS

Background Mycobacterium tuberculosis (TB) has infected a third of the world's population, according to the WHO about 8 million people worldwide were attacked TB with 3 million deaths per year (WHO, 1993). In developing countries these deaths account for 25% of deaths that could have held disease prevention. An estimated 95% of TB sufferers are in developing countries With the advent of HIV / AIDS epidemic in the world will increase the number of TB patients. Female mortality due to TB are more than the deaths due to pregnancy, childbirth and childbirth (WHO). WHO declared a global emergency for TB disease in 1993 due to a third of the world's population is estimated to have been infected with TB germs. 

In Indonesia, tuberculosis re-emerged as a leading cause of death after heart disease and respiratory tract. Pulmonary TB disease, remains a public health problem. Household health survey results (SKRT) in 1995 showed that tuberculosis is the number 3 cause of death after cardiovascular disease and respiratory disease in all age groups and number of class I of the infection. Between 1979? 1982 prevalence survey has been conducted in 15 provinces with the results of 200-400 patients per 100,000 population. It is estimated that every year 450,000 new cases of TB in which approximately 1 / 3 patients there were around health centers, 1 / 3 is found in service hospitals / clinics pemerintahd the private sector, private practice and the rest have not terjangku health care units. While deaths due to TB is estimated to 175,000 per year. TB disease attacks the most productive working age group, most TB patients from lower socioeconomic groups. From 1995-1998, the range of pulmonary TB patients with DOTS strategy (Directly Observed Treatment Shortcourse Chemotherapy)-or swallowing the direct supervision of short-term drug / every day-just reached 36% with 87% cure rate. Before the DOTS strategy (1969-1994) of coverage by 56% with cure rates can be achieved only 40-60%. Because the treatment of irregular and inadequate drug combinations in the past may have TB germs arise immunity against TB (anti tuberculosis drugs) in a widespread or multi-drug resistance (MDR). 

Definition:  
Tuberculosis: is directly infectious disease caused by the TB germ (Mycobacterium Tuberculosis), most of the TB germs attack the lungs, but can also on other organs. Tuberculosis Germs: Rod-shaped bacteria, have special properties of the acid in the staining Taha, therefore referred to as a Resistant Acid Bacillus (AFB), the TB germs die quickly in direct sunlight, but can survive a few hours a dark and humid place. In this germ tissue can Dormant, slept for a few years old. 

Mode of transmission:  
Source penularana are smear positive TB patients. At the time of coughing or sneezing, people spread germs keudara in the form of droplets. Droplets containing the bacteria can survive in the air at room temperature for several hours. People can become infected if the droplets are inhaled into the respiratory tract. During the TB germs enter the body through breathing, these TB germs can spread from the lungs other body gets, through the circulatory system, the system linfe tract, respiratory tract, or the spread of direct-nagian goto the other body. Power transmission from a patient is determined by the number of bacteria released from the lungs. The higher the degree of positive results of sputum examination, the patient is contagious. When the results of sputum examination is negative (no visible germ), then the patient is considered not contagious. The possibility of someone infected with TB is determined by the concentration of droplets in the air and the length of breathing air. 

Risk of Transmission:  
The risk of transmission of each year (Annual Risk of Tuberculosis Infection = ARTI) in Indonesia is considered quite high and berfariasi between 1? 2%. In regions with ARTI of 1%, means that every year between 1000 population, 10 (ten) people will be infected. Most of the people who will not become infected TB patients, only 10% of which will become infected TB patients. From the above description, it can be expected that regions with ARTI of 1%, then among the 100,000 people on average 100 (hundred) people with tuberculosis every year, of which 50% of patients are smear positive. Factors affecting the likelihood of someone to be patient endurance of TB is low, such as malnutrition or HIV / AIDS. 

History of Tuberculosis
Primary Infection:  
Primary infection occurs when a person was first exposed to TB germs. Are inhaled very small droplet size, so it can pass defense system mukosillier bronchus, and kept walking so until the alveolus and remained there. Infection begins when the TB germs to breed successfully by splitting themselves in the lungs, causing inflammation in the lung, the channel will bring crocus TB linfe to linfe glands around the lung hilum, and is called primary complex. The time between the occurrence of infection to primary complex formation is 4? 6 weeks. The presence of infection can be proved by the tuberculin reaction changes from negative to positive. Continuation after primary infection depends on the amount of germs that enter and immune responses (cellular immunity). In general, immune reactions can stop the progression of TB germs. Nevertheless, there are some germs will stay as germ persister or dormant (sleeping). Sometimes the immune system is unable mengehentikan germ development, resulting in a few months, the concerned will be patient Tuberculosis. The incubation period, the time needed from infected to become ill, it is estimated about 6 months. 

Post-Primary Tuberculosis (TB Post Primary):  
Post-primary tuberculosis usually occurs after several months or years after primary infection, such as decreased immune system due to HIV infection or poor nutritional status. Characteristic of the post-primary tuberculosis is extensive lung damage with the cavity or pleural effusion. 

Complications in Patients with Tuberculosis:  
The following complications often occur in patients with advanced stage:
Severe hemoptysis (bleeding from the lower respiratory tract), which can result in death due to hypovolemic shock or blockage of the airway. Collapse of the lobe due to bronchial retraction. Bronkiectasis and Fibrosis in the lung. Spontaneous pneumothorax: a spontaneous collapse because of damage to lung tissue. The spread of infection to other organs such as brain, bones, joints, kidneys and so forth. Cardio pulmonary insufficiency (Cardio Pulmonary insufficiency). Patients who experience severe complications should be hospitalized in the hospital. Pulmonary tuberculosis patients with extensive tissue damage that has been cured (smear negative) can still be experienced coughing up blood. This situation is often confused with cases of relapse. In such cases, treatment with OAT is not required, but adequate given symptomatic treatment. If heavy bleeding, patients should be referred to specialist units. 

Natural Journey TB Not Treated:  
Without treatment, after five years, 50% of TB patients will die, 25% will heal itself with high endurance, and 25% as? Cases of chronic? which remain infectious (WHO 1996). 

Effect of HIV Infection:  
HIV infection resulted in extensive damage to the immune system of mobile (Cellular Immunity), so if there is an opportunistic infection, like tuberculosis, it is concerned will become seriously ill and even cause death. When the number of people infected with HIV increases, the number of TB patients will increase, thus the transmission of TB in the community will increase as well. 

Symptoms of Tuberculosis  
General Symptoms:  
Persistent cough and phlegm for 3 (three) weeks or more. Other symptoms of Frequently Found: Sputum mixed with blood. Coughing up blood. Shortness of breath and chest pain. Body weakness, decreased appetite, weight loss, body discomfort (malaise), night sweats, although no activity, fever, fever more than a month. 

Discovery  Tuberculosis (TB) Patient
The discovery of Tuberculosis in Adult Patients.  
The discovery of the TB patients conducted in Passive, meaning crawl suspects held in those patients who come to visit the health care units. The discovery of these passively supported by extension actively, both by health workers and the community, to increase coverage suspected invention. This method is commonly known as the Passive Case Finding Promotive In addition, all contacts of smear positive pulmonary tuberculosis patients with similar symptoms, should be examined sputum. A health worker is expected to find a suspected case as early as possible, considering that tuberculosis is a contagious disease that can lead to kematian.Semua suspect patient should be examined three sputum specimens within 2 days in a row, both when? morning? while (SPS). The discovery of Tuberculosis Patients in Children. The discovery of tuberculosis in children is difficult. Most of the child's diagnosis of tuberculosis was based on clinical, radiological images and tuberculin test. 

Diagnosis of Tuberculosis (TB)  
Diagnosis of Tuberculosis in Adults.  
The diagnosis of pulmonary tuberculosis in adults can be enforced with the finding by sputum smear on microscopic examination. Examination results declared positive when at least two of the three SPS smear results are positive. If only 1 positive specimens need to hold further examination of chest x-rays or SPS specimen examination was repeated. If the results of x-rays support the TB, then the patient diidagnosis as smear positive TB patients. If the results of X-rays did not support the TB, then other tests, such as culture. If facilities allow, then it can be done other tests, such as culture. When the three negative sputum specimens, are given broad-spectrum antibiotics (eg co-trimoxazole or Amoxicillin) for 1? 2 weeks. If nothing changes, but remains suspicious clinical symptoms of TB, repeat sputum examination SPS: If positive results of the SPS, were diagnosed as smear positive TB patients. If results remain negative SPS, do pemriksaan chest x-rays, to support the diagnosis of TB. - When the results of x-rays support the TB, TB patients diagnosed as X-rays negative smear positive. - If the results do not support ropntgen TB, the patient is not TB.
UPK who do not have X-ray facility, patients can be referred for chest X-ray photographed. 

THREADS DIAGNOSIS OF TUBERCULOSIS IN ADULT LUNG 
In Indonesia, at present, tuberculin test has no meaning in determining a diagnosis of TB in adults, because most people already infected with Mycobacterium Tuberculosis Due to the high prevalence of TB. A positive tuberculin test indicates that the person concerned only been exposed to Mycobacterium tuberculosis. On the other hand, the results of tuberculin test can be negative even if the person is suffering from tuberculosis. For example, in people with HIV / AIDS, severe malnutrition, TB and morbili out military. 

Reflections on World TB Day  
Every March 24 is celebrated as a day of Tuberculosis (TB) worldwide. This year the commemoration day of TB worldwide theme of "Every Breath Counts-Stop TB Now!". This theme emphasizes the word "breath" which means not only breathing, but also the center of all human activity. Thus, damage to "breath" of tuberculosis will lead to the destruction of all human activity. This theme is once again remind us of the dangers of TB and the urgency of the eradication. In order to celebrate the TBC is also done "2nd Stop TB Partners', the forum and the Stop TB campaign for 2004-2005 which was held in New Delhi. 

Mass murderer
It is no exaggeration to say that the bacterium mycobacterium tuberculosis that causes TB is bekteri mass murderer. WHO estimates that this bacteria kills about 2 million people each year. Between the years 2002-2020 is estimated around 1 billion people will become infected. In other words the number of infections for more than 56 million each year. Typically 5-10 percent of the infection developing into disease, and 40 percent of which develop into the disease ended in death. If counted, the number of TB patients will be increased by about 2.8 to 5.6 million every year, and 1.1 to 2.2 million people die each year from TB. WHO estimates, namely, 2 million people die each year, is based on this calculation. This number is a number that large, because 2-4 people are infected every second, and nearly 4 people die of TB every minute of this. The speed of the spread of tuberculosis could increase again in accordance with the increasing spread of HIV / AIDS and the emergence of TB bacteria that are resistant to the drug. In addition, human migration also accelerate the spread of TB. In the United States, nearly 40 percent of TB patients are people born overseas. Their immigration to America and become a source of spread of TB. So also with the increasing number of refugees from the war with an unhealthy environment to facilitate the spread of TB. An estimated 50 percent of refugees in the world likely infected with TB. In Southeast Asia, WHO data (http:www.whosea.org) indicated that tuberculosis kills about 2,000 people every day. And about 40 percent of the world's TB cases are in Southeast Asia. Two of the three countries with the largest number of TB sufferers in the world, namely India and Indonesia, is in the region. Indonesia is under India, with the number of people in the world, followed by China in second place. Compared with other infectious diseases, tuberculosis is also the number one killer in this region, where the amount is 2-3 times the number of deaths caused by HIV / AIDS which is ranked second. Meanwhile, tropical diseases such as dengue hemorrhagic fever (DHF), not until the tenth. We can imagine how serious a problem this TB. Therefore, we need to realize again that TB is a disease that desperately need attention to be addressed. Because the bacterium Mycobacterium very easily transmitted through airborne droplets when coughing or sneezing TB patients, even while spitting and talking. One person can spread TB bacteria to 10-15 people in one year. Based on data from Hospital "Prof Dr Sulianti Saroso" (http:www.infeksi.com), in Indonesia every year there are 583 thousand cases and 140 thousand of them died. If counted, every day 425 people died from tuberculosis in Indonesia. If 1 patient could infect 10 people, in the following year the number of infected is 5.8 million people. Thus it is clear that tuberculosis is a mass murderer who should be eradicated. 

TB Therapy  
 Because the source of the spread of TB is TB patients themselves, effectively control TB is to reduce TB patients. There are two ways of being made to reduce the TB patients at this time, the therapy and immunization. For therapy, the WHO recommended TB treatment strategy with short-term direct supervision or known as DOTS (Directly Observed Treatment Shortcourse Chemotherapy). In this strategy there are three important stages, namely detection of patients, conduct treatment, and perform direct supervision. Detection or diagnosis of patients is very important because patients who escape from detection will be the next source of spread of TB. A person who is coughing for more than 3 weeks can be suspected tuberculosis. This person must then be diagnosed and confirmed infected with TB germs or not. Until now, accurate diagnosis is to use a microscope. X-ray diagnosis by less specific, while the molecular diagnostics such as Polymerase Chain Reaction (PCR) can not be applied. If the patient has been identified have TB, your doctor will give medicine to the composition and the dosage according to the condition of the patient. As for TB drugs are normally used are isoniazid, rifampicin, pyrazinamide, streptomycin, and Ethambutol. To avoid the emergence of resistant tuberculosis bacteria, are usually given drugs that consist of a combination of 3-4 this drug. Your doctor or health worker and then oversee the process of drugs and drinking patient's progress. This is very important because there is a tendency of patients stop taking the medication because their symptoms have disappeared. After taking TB drugs TB symptoms usually disappear within 2-4 weeks. However, to fully recover from tuberculosis are required to take the drug for at least 6 months. The negative effects that arise if we stop taking the drugs is the emergence of TB germs are resistant to the drug. If this happens, and germs are spread, TB control will be increasingly difficult. DOTS is the most effective strategy for dealing with current TB patients, with cure rates even to 95 percent. DOTS was introduced since 1991 and about 10 million patients have received DOTS treatment of this. In Indonesia, DOTS was introduced in 1995 with a cure rate of 87 percent in 2000 (http:www.who.int). This figure exceeds the WHO target, namely 85 percent, but it is very unfortunate that the level of detection of new cases in Indonesia is still low. Based on WHO data, for 2001, only 21 percent detection rate, far below the WHO target, 70 per cent. Therefore, efforts to medeteksi new cases should be improved. 


Immunization  
Control of TB is the second immunization. Immunization will provide active immunity against TB penyaki. TB vaccine, known as BCG is made from the bacterium M. tuberculosis strains of Bacillus Calmette-Guerin (BCG). This bacterium causes tuberculosis in cattle, but not in humans. This vaccine was developed in 1950 from the bacteria that live M. tuberculosis (live vaccine), and therefore can reproduce in the body and is expected to mengindus antibodies lifetime. In addition, the provision of two or three times had no effect. Therefore, BCG vaccination is required only once in a lifetime. In Indonesia, given before the age of two months. TB immunization is not entirely protect us from attack tuberculosis. Rate the effectiveness of these vaccines ranged between 70-80 percent. Therefore, despite having received the vaccine, we still must be vigilant against attack this TB. Because the effectiveness of this vaccine is not perfect, globally there are two opinions about this TB immunization. The first opinion is not necessary immunizations. United States is one of them. United States did not perform BCG vaccination, but they keep tight against persons or groups who are at high risk and to diagnose them. Patients who are detected will be immediately treated. Detection and diagnosis system that tidy is the key pengontorlan TB in the U.S.. A second opinion is a need for immunization. Because 70-80 percent effectiveness rate, most people can be protected from infection with TB germs. European countries and Japan is a country that considers the need for immunization. Even Japan has decided to perform BCG vaccination of all babies born without Tuberculin test, tests conducted to detect the presence or absence of antibodies that dihasikan by infection with TB germs. If the positive test results, deemed to have been infected with TB and will not be given the vaccine. Because rare cases of tuberculosis in Japan, considered all children not infected with TB germs, so it was decided that the Tuberculin test no longer need to be implemented. What about Indonesia? Because Indonesia is a big country with a population of many, apparently still need to implement this BCG vaccination. By implementing this vaccination, the number of cases of suspected (suspected cases) is much reduced, making it easier for us to detect TB patients, to further DOTS therapy for patients who are detected. Both approaches, ie vaccination and therapy needs to be done to eradicate tuberculosis from Indonesia. : Andi Utama (Research Center for Biotechnology-LIPI and Observer Health Issues)

Fight TB:  

10 THINGS ABOUT tuberculosis and for their handling.  
10 IMPORTANT FACTS ABOUT TB SITUATION IN INDONESIA
Each year there were 583,000 cases of TB in Indonesia Nationally, the TB? Kill? approximately 140,000 people each year Every day 425 people died from tuberculosis in Indonesia. Indonesia is? Contributor? TB cases to-3 in the World, after China and India. The level of risk for developing TB in Indonesia ranges from 1.7% - 4.4% (according to data from 1972 to 1987). Approximately ¾ of tuberculosis patients in Indonesia is categorized in the productive age. In 1995, the Indonesian government began to adopt starategi DOTS (Directly Observed Short-Course Tratment) to tackle tuberculosis. In 1996, TB drugs in health centers is given in the form Kombipak. In 1999 an important era in the response to tuberculosis in Indonesia, since the establishment of GERDUNAS-tuberculosis (TB Prevention National Integrated Movement) which is a real wujut partnership with various sectors involved in TB control in Indonesia. Health economics research in Indonesia found that if treatment can be applied early, every U.S. $ ¬ ¬ 1 that for TB control programs, it will be able to save U.S. $ ¬ ¬ 55 in 20 years.


10 IMPORTANT FACTS ABOUT TB  
Each year there is always an increasing number of TB patients are higher than the previous year. TB kills more youth and women than any other infectious disease. There are about 2 to 3 million people die from tuberculosis every year. Surely every death due to TB can be avoided. Every second, there is 1 person who died as a result of contracting TB. Every 4 seconds, someone is sick due to contracting tuberculosis. Every year. 1% of the population worldwide infected by the disease TB. One third of the world's population is already infected by TB germs (although) not infected by the disease. People with TB are not treated can transmit pentakit to about 10? 15 people in a period of 1 year. Like the flu, TB germs spread through the air when a person suffering from tuberculosis coughing and sneezing, spitting or speaking. TB germs usually attack the lungs. 

10 IMPORTANT FACTS ABOUT TB & TRANSFER OF POPULATION
About 50% of the number of refugees around the world may have been infected with TB, each year, more than 17,000 displaced people suffering from illness due to tuberculosis. Refugee populations face increasing problems due to tuberculosis, the number of IDPs and refugees worldwide has doubled 9 times during the last 20 years. Patients with untreated TB disease can spread rapidly, especially in the camps and the refugee camp environment, It is very difficult to provide TB treatment for people moving. WHO recommends that TB should be a priority, as soon as possible after the emergency phase for the refugees pass. Tourism, travel and migration between countries to support the spread of TB germs. In many industrialized countries, at least half of the number of cases of tuberculosis, was found in people who were born in another country. In the United States, one third of the total cases of tuberculosis, was found in people who are not in the U.S. birthplace The number of TB cases in the U.S. among people yanglahirnya not in the U.S., continues to increase every year. The homeless people in developed countries is the group that his risk of contracting tuberculosis is increasing. In 1995, it was reported that nearly 30% of the population of homeless people in San Francisco (USA) and approximately 25% of the population of homeless people in London (UK) have been infected by TB germs? much higher than the national average in both countries. 

10 IMPORTANT FACTS ABOUT TB & WOMEN  
Tuberculosis is a contagious disease that attacks the most violent and killing women. More than 900 million women around the world infected with TB germs. 1 million of them will die and 2.5 million will soon suffer from the disease this year, Women who suffer from TB are aged between 15? 44 years. Tuberculosis is the most deadly killer disease for young women age. TBC has a share of around 9% of deaths aged 15-44 years, compared to other causes of death (due to the war: 4%, HIV: 3%, and heart disease: 3%). Women in reproductive age are more susceptible to TB and more likely to be infected by TB disease than men of the same age group. Women in the reproductive age group are also at greater risk of HIV penuaran. In some African countries, the number of women who contracted tuberculosis is greater than the number of male sufferers. Tuberculosis causes a greater number of deaths for women than deaths from childbirth. In some parts of the world, stigma or embarrassment due to tuberculosis caused the isolation, ostracism and divorce for women. In some parts of the world, women's movement is pushing the effort to better control TB disease. 

WHAT IS DOTS?  
DOTS stands for Directly Observed or Treatment, Short-course TB treatment is short-term strategy with direct supervision. By using the DOTS strategy, then the healing process can be quick TB. Emphasized the importance of supervision of DOTS TB patients to swallow the medicine on a regular basis as required until declared cured. DOTS strategy provides a high cure rate, can be up to 95%. DOTS strategy recommended by WHO globally to tackle tuberculosis. 

DOTS strategy consists of five components, namely:  
o The political commitment of governments to genuinely tackle tuberculosis.
o The diagnosis of TB disease through microscopic examination of sputum  
o Treatment of tuberculosis with anti-tuberculosis drug combination of short-term, supervised directly by the PMO (observer treatment).  
o Availability of anti-tuberculosis drug combination of short-term consistently. o Recording and reporting of TB patients according to the standard. 

World Bank declared the DOTS strategy is a strategy that most health? Cost effective?. Bangladesh: With the strategy of DOTS, cure rate can reach about 80%. Maldives: cure rate reached about 85% thanks to the DOTS strategy. Nepal: After using DOTS, cure rates reach 85% - previously only reached 50%. PRC: achieve 90% cure rate with DOTS.

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