Tape worm infection taenea saginata

Taeniasis is an infection due to an adult tapeworm in the intestine. Humans acquire taeniasis from ingestion of undercooked pork / cow meat containing cysticerci. Cysticercosis is the development of extraintestinal encysted larva forms of Taenea in various organs. The Central Nervus System is involved in 60-90% of cases.

Humans are the definitive host. Adult tapeworms live in the human intestine. Humans pass gravid eggs in feces; mature eggs contaminate pastures and barnyards, where cattle and pigs ingest them. Upon reaching the alimentary canal of infected animals, the embryos are released, penetrate the gut, enter the circulation.

The embryos filter from the circulation and encyst in muscular tissue. Larvae (ie, cysticerci) become infectious within 2-3 months. Humans develop a tapeworm infection by eating raw or undercooked beef or pork containing cysticerci. The cysticercus becomes activated, attaches to the wall of the small intestine , and becomes a mature tapeworm. This maturation process takes 12 weeks . A single tapeworm produces an average of 50,000 eggs per day and may live up to 25 years.

Symptoms

Most patient without symptoma or have mild-to-moderate complaints.

The most common complaint is passage (active or passive) of proglottids (part body of worm).

• Nausea
• Weakness
• Loss of appetite
• Increased appetite
• Headache
• Constipation
• Diarrhea

Stomach pain and nausea are reportedly common in the morning and are characteristically relieved by eating small amounts of food.

The most common complication of adult tapeworm infection is appendicitis. Other reported complications include obstruction of bile ducts, pancreatic duct and tapeworm growth in ectopic locations

If adult tapeworms are detected in the stools, anthelmintic therapy is reccomended

Prevention

Prevention and control of T. solium infection as recommended by WHO .
• Mass drug administration for taeniasis
• Identification and treatment of taeniasis cases
• Health education, including hygiene and food safety
• Improved sanitation
• Improved cultivation and production of pig 
• Anthelmintic treatment of pigs
• Vaccination of pigs
• Improved meat inspection and processing of meat products

Influenza Vaccine

Influenza, the most common infectious diseases, highly contagious airborne disease that occurs in seasonal epidemics, manifests as an acute febrile illness with variable degrees of systemic symptoms, from mild fatigue to respiratory failure and death. Influenza causes significant loss of workdays, human suffering, and mortality.

Transmission of influenza from poultry or pigs to humans predominantly as a result of direct contact with infected animals. The risk high during preparation for consumption; eating properly cooked meat poses no risk. Avian influenza can also be spread through exposure to water and surfaces contaminated by bird droppings

Influenza viruses spread from human to human via aerosols created when an infected individual coughs or sneezes.

Signs and symptoms :

• Fever
• Sore throat
• Myalgias
• Frontal or retro-orbital headache
• Nasal discharge
• Weakness and severe fatigue
• Cough and other respiratory symptoms
• Tachycardia
• Red, watery eyes

The incubation period of influenza is 2 days long on average

Influenza diagnosed on the basis of clinical criteria, further laboratorium tests is viral culture of nasopharyngeal samples or throat samplesP

Prevention

Prevention of influenza is the most effective management strategy. Influenza vaccine is administered each year before flu season. The CDC analyzes the vaccine subtypes each year and makes any necessary changes on the basis of worldwide trends.

The vaccine is trivalent (ie, designed to provide protection against 3 viral subtypes, generally an A-H1, an A-H3, and a B). The first quadrivalent vaccines, which also provide coverage against a second influenza B subtype, were approved in 2012 and were made available for the 2013-2014 flu season.

What is Epidermoid / Sebaceus Cyst ?

also known as a sebaceous cyst, is a benign cyst most commonly located on the face,neck, and trunk. epidermoid cysts can be found anywhere including the scrotum,genitalia, fingers, and cases within the buccal mucosa. Cysts may progressslowly and remain present for years. these cysts are recognized as benignlesions, rare malignancy can arise.

Epidermoid cysts are the most common skin cysts

Epidermoid cysts are the result of plugging of the skin folliculer pore. they can also occur from traumatic and penetrate injuring leading to the implantation of the epithelium. the cysts are asymptomatic until they rupture. When the cysts rupture, an inflammatory reaction occurs from the displacement of soft and yellow keratin into the dermis and surrounding tissue.

Physical examination

Generally  0.5 cm to several centimeters compressible mass with central, dark comedone opening (punctum). Epidermoid cysts are usually asymptomatic; if ruptured it may develop a furuncle with tenderness to palpation, erythema, and swelling. A yellowish cheese-like material discharged from the skin may be described.

Treatment

Recommended to having complete surgical excision of the cyst with the cyst wall intact . A local anesthetic with epinephrine is preferred to minimize bleeding. For optimal cosmetic results, maintaining the incision in the minimal skin tension lines is important. Removing of the entire cystic lining is important in decreasing recurrence.

Complications

Complication of rupture cyst include erythema, swelling, and pain. Complications of surgical removal include bleeding, infection, and scaring.

Asthma Bronchiale

 

is a common chronic disease worldwide. It is the most common chronic disease in childhood, affecting an estimated 7 million children. The pathophysiology of asthma involves airway inflammation, intermittent airflow obstruction, and bronchial hyperresponsiveness.

Signs and symptoms of asthma

• Wheezing
• Coughing
• Shortness of breath
• Chest tightness/pain

Airway hyperresponsiveness or bronchial hyperreactivity in asthma is an exaggerated response to numerous exogenous and endogenous stimuli.

Pulse oximetry measurement is desirable in all patients with acute asthma to exclude hypoxemia.

Most patients with asthma, chest radiography findings are normal or may indicate hyperinflation.

Factors that can contribute to asthma :

• Environmental allergens (eg, house dust mites; animal allergens, especially cat and dog; cockroach allergens; and fungi)
• Viral respiratory tract infections

• Exercise, hyperventilation
• Gastroesophageal reflux disease
• Chronic sinusitis or rhinitis
• Aspirin or nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity,
• Use of beta-adrenergic receptor blockers (including ophthalmic preparations)

• Obesity
• Environmental pollutants, tobacco smoke
• Occupational exposure
• Irritants (eg, household sprays, paint fumes)
• Various high- and low-molecular-weight compounds (eg, insects, plants, latex, gums, wood dust ; associated with occupational asthma)

• Emotional factors or stress
• Perinatal factors

Laboratory assessments and studies are not routinely indicated for the diagnosis of asthma, but they may be used to exclude other diagnoses. Eosinophilia and elevated serum IgE levels may help guide therapy in some cases. Pulse oximetry are valuable for assessing severity of exacerbations and following response to treatment.

Treatment

Environmental exposures and irritants can play a strong role in symptom exacerbations. Therefore, in patients who have persistent asthma, the use of skin testing or in vitro testing to assess sensitivity to perennial indoor allergens is important. Once the offending allergens are identified, counsel patients on avoidance from these exposures. In addition, education to avoid tobacco smoke (both first-hand and second-hand exposure) is important for patients with asthma.

Planning treatment

Asthma medications are generally divided into two categories:

• Quick relief
• Long-term control
   

 

Skin Wart / Verucca

 

Verucca is the common wart,  is a benign growth caused by localized infection with one of the many types of human papillomavirus. Warts are especially common among children and adolescents and may occur on any mucocutaneous surface.

Verucca vulgaris cause by human papilloma virus subtipe 1,2,4,7,27,29,57,63 infected epidermis layer of your skin

Human papilloma virus contagious from direct contact (skin with the wart) or indirect contact (toilet, swimming pool etc) . virus transmission most happen on skin with micro abrasion / minimal laceration injury.

The typical wart is a rough surfaced nodule that may be either lighter or darker than the surrounding skin, definite borderline, soliter or multiple . Hand, knee, foot, finger , elbow are the most common location . Some patient complain about cosmetically aspect.

Treatment

• Cryotherapy (freezing treatment )
• Electrokauterization (heat treatment )
• Medication Topical drugs, such as mild salicylic acid may be pre-scribed to destroy warts. Tretinoin (retinoic acid) or benzoyl peroxide may be prescribed to help in treating warts.

Corn / Clavus

A Corn (also termed clavus) is a thickening of the skin due to intermittent pressure and frictional forces. The extensive thickening of the skin in a corn may result in chronic pain, particularly in the forefoot ; this thickening may result in ulcer formation.

Corns are often seen in athletes and in patient populations exposed to uneven friction from footwear or gait abnormalities, including elderly persons, diabetic patients. Abnormal foot mechanics, foot deformities, high activity level also contribute to the formation of corns

Irregular distribution of pressure and repetitive motion injury (especially in athletes) are believed to be the main inciting causes. Inappropriately shaped or constrictive footwear in the presence of bony prominences may exacerbate corn formation.

Complication

Complication include secondary bacterial or fungal infection in patients with diabetes or in patients with immunosuppression.

Corns are often in close proximity to joints and bones, increasing the chances for septic arthritis or osteomyelitis to occur if left untreated.

Patients with diabetes, may have ulcerations from chronic pressure can lead to infection and cellulitis.

Laboratorium test

Blood glucose testing is required when diabetes mellitus is suspected. Rheumatoid factor testing for deformities consistent with rheumatoid arthritis may be indicated.

Imaging studies are required in clavus patients only to detect underlying bony abnormalities.

Treatment

Treating clavus, the primary objective is to debulk or pare the lesion. Treatment should be aimed at reducing symptoms such as pain and discomfort with walking. Paring of the lesions immediately reduces pain gradually remove sequential layers of keratin

The final treatment goals are to remove the central keratin core with local anesteshia

Reduced friction may be accomplished with the use pads. Insoles may be made of silicone or soft plastics.

Shoes with extra length are required for toe deformity, and shoes with extra width are required for lateral toe clavus. Shoes should be soft inside without seams that rub or press.

Overall, removing or adjusting the mechanical stress that causing the corn—finding footwear that matches the length and width of a foot—is the first step towards treatment of this condition.  Patient awareness of their footwear is critical to the prevention of future corns

Lipoma / Fat Benign Tumor

Lipoma on Back

Lipomas are the most common soft-tissue tumor. These slow-growing benign fatty tumors form soft, lobulated masses enclosed by a thin, fibrous capsule.

While the exact etiology of lipomas remains uncertain

Lipomas occur in 1% of the population. Most of these are small subcutaneous tumors that are removed for cosmetic reasons.

Lipomas most often asymptomatic. they arise from fatty tissue between the skin and deep fascia,  soft, fluctuant feel, lobulation, and free mobility of overlying skin.

Treatment

Lipomas are removed with minor surgery under local anestesia for the following reasons:

• Cosmetic reasons
• To evaluate their histology
• When they cause symptoms
• When they grow and become larger than 5 cm

Obtain biopsies patology examination of large lipomas or of those tethered to fascia to rule out a liposarcoma (malignancy)

Nail Fungus Infection

Fungal infection of the toenails or fingernails could involve any component of the nail unit, including the matrix, bed, or plate. Can cause pain, discomfort, and disfigure of nail. May produce serious physical and occupational limitations

Usually without symptomatic , patients usually first present for cosmetic reasons without any physical complaints.

As the disease progresses may interfere with standing, walking, and exercising.

Patient nail plate shows colour changes which is usually yellow-white-green,  becomes roughened and crumbles , sometimes with inflammation around nail.

Patient may report nubness , pain, discomfort on toe / nail. They also may report loss of self-esteem.

Skin injury adjacent to the nail allow organisms to colonize, increasing the risk of infectious complications. Reports of complications include cellulitis, abcess,  osteomyelitis and tissue necrosis.

Laboratorium Test

with 20% potassium hydroxide (KOH) preparation and Cultur test will help to diagnose and specify the fungal species that cause the nail problems

Treatment

A combination of systemic and topical treatment increases the cure rate. Because the rate of recurrence remains high, the decision to treat should be made with a clear understanding of the cost and risks involved, as well as the risk of recurrence.

Some fungal nail infection need long oral tablet medication , that have side effects interfere liver function

To decrease the adverse effects and duration of oral therapy, topical treatments and nail avulsion may be combined with oral antifungal management. 

Removal of the nail plate should be considered an adjunctive treatment in patients undergoing oral therapy. A combination of oral, topical, and surgical therapy can increase efficacy and reduce cost.

About

Establised since 2010 in Kuta Bali , our practice offer a medical services to individual and families that stay in Bali

We Delivers primary healthcare in North Kuta Area (Kerobokan, Seminyak, Canggu) that have various illness case

The different of climate , quality of highway infrastructure and pattern of infectious disease are factors that can affecting health condition

To support the reliable diagnose and treatment, our clinic have cooperation with national private laboratory and private hospitals

Medical Services  :

• House Visite Doctor
• Minor Surgery
• Wound Dressing
• General Medical Check up
• Vaccination
• Laboratory analysis

 

 

Minor Surgery in Bali

Minor Surgery Tool Set

 

Minor surgery is  surgery procedure that involving little risk to the life of the patient,  specifically : an operation on the superficial structures of the body or a manipulative procedure that does not involve a serious risk

There are a fair number of benign tumors that can develop in parts of the body.

Different types of benign tumors that need minor surgery are included :

• Lipomas grow from fat cells are the most common type of benign tumor, often found on the back, arms, or neck. They are usually soft and round, and can be moved slightly under the skin.
• Nevi also known as moles. These are noncancerous growths on the skin and they are very common.
• Abcess is a tender mass generally surrounded by a colored area from pink to deep red. The middle of an abscess is full of pus and debris. the most common sites are in your armpits , around anus, genitalia, around tooth , and in your groin. inflamation around haor follicle can also lead to the formation of an abscess called folikulitis
• Common warts (verruca vulgaris) is hyperkeratotic papules with a rough, irregular surface. They range smaller than 1 mm to larger than 1 cm. They can occur on any part of the body but are seen commonly on the hands and knees
• Sebaceous cysts (atheroma cyst) form out of your sebaceous gland. The sebaceous gland produces the oil that coats your hair and skin. Cysts develop if the gland or its duct (the passage from which the oil is able to leave) becomes damaged or blocked. This usually occurs due to a trauma at the area.
• Clavus (corn) is a thickening of the skin due to intermittent pressure and frictional forces. The extensive thickening of the skin in a corn may result in chronic pain, particularly in the soles

Diagnosa

Your doctor may performing a physical examination and collecting your medical history. They also ask you about the symptoms.

Benign tumors often have a visual border of a protective sac that helps doctors diagnose them as benign.

In some cases, doctors will take a biopsy of the tumor and consult with pathology doctor to determine whether it’s benign or malignant.

Treatment

Not all benign tumors need treatment. If your tumor is small and isn’t causing any symptoms, your doctor may recommend wait and see approach.

If your doctor decides to pursue minor surgery treatment, the specific treatment will depend on the location of the tumor. It may be removed for cosmetic reasons