Dengue Hemorrhagic Fever (DHF) 5

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Tip's How to Cope Dengue Hemorrhagic Fever

Early diagnosis
* Home-like other diseases, it is necessary to alert
* Please support tools (laboratory)
* Note the sign of the gravity
* Need to monitor regularly: symptoms and laboratory

* Early disease: fever problem, resulting in anti-fever drugs
* Expect plenty of fluids
* Replacement of fluid (drinking & IV)
* Other drugs depending on complications arising

Special Attention
* Fever 3 days or more without cause
* Drugs down the heat: paracetamol, not asetosal
* Drink a lot, kind of taste
* Do not check blood without doctor's approval
* Blood tests should be at fever day 3 or more
* No need to panic if the child still wants to drink a lot
* If there are cases of DHF in the same house, each child with fever was treated immediately

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Dengue Hemorrhagic Fever (DHF)4

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Need to be reminded, at the time led the patient to be treated; shortly after arriving at the hospital immediately inform the nurse that the child is likely suffering from dengue fever. This notification should be submitted to the nurse or doctor who received the first time to get help faster. Patients in a state of crisis, need immediate help and be helped sooner more likely to recover.
When one family member suffering from dengue fever, would be easily transmitted through mosquito bites (remember the nature of mosquitoes that can bite a few people respectively. So, if there are other family members with fever soon to determine whether treatment of contracting dengue fever or not .

DISEASE PREVENTION Dengue Hemorrhagic Fever
Prevention of dengue fever include

· Against mosquitoes intermediaries ie
o mosquito Aedes aegypti eradication of carriers and their eggs

Against ourselves ·
o strengthen the immune system
o protect from bites yamuk

· Against environment with the aim of changing the behavior of healthy living, especially environmental health

Guidance For Communities
As described above that until now there has been no drug that can kill dengue virus or dengue fever vaccines, the efforts to prevent dengue fever is aimed at the eradication of mosquitoes and their place perindukannya. Therefore, primary prevention of dengue fever is to give health education to the community memberantasan how adult mosquitoes and mosquito-breeding marshes known as the eradication of mosquitoes nest or PSN. For the successful prevention of dengue fever, PSN should be done jointly by all layers of society, both at home, in schools, hospitals, and public places such as places of worship, cemeteries, and others. Thus people should be able to change the behavior of healthy life, especially improving environmental hygiene.

How to Eradicate larvae

How to eradicate larvae is done by 3 M of drains, closed, and bury, that is:
* Kuras bath once a week (exhaust),
* Close the water storage meetings (closed),
* Bury cans, old tires, etc.. (buried).
Habits such as changing and cleaning the birds drink every day or replace and clean the vase, is often forgotten. Hygiene outside the home such as cleaning plants from bin berpelepah regular rain or growing fish in ponds that are difficult drained, can reduce mosquito-breeding marshes.
At the pool or a reservoir which can be difficult diraburkan drained abate powder that can be sown abate powder that can kill the larvae. This abate powder can be purchased at pharmacies.
Guidelines for Use of Powder Abate (Abatisasi)
* Peres one tablespoon (10 grams) to 100 liters of water
* Walls do not brushed after abate powder dusted
* Powder will stick on the wall of the tub / jar / Pool
* Abate powder remains effective up to 3 months

How to Combat Adult Mosquitoes
To eradicate adult mosquitoes, try cleaning the places favored by mosquitoes to rest.
Reduce Resting Place For Mosquitoes
* Do not hang clothes second-hand (mosquitoes love the smell of humans)
* Put mosquito netting on the vents and windows
* Protect your baby while sleeping in the morning and afternoon with a mosquito net
* Spray the house mosquito morning & afternoon (8:00 and 18:00 hours)
* Note the cleanliness of the school, when class was dark and damp, spray with insect repellent before classes begin
* Smoking (called fogging) is only done when the treated patients met or menginggal. Fumigation is required for the report from the treating hospital.

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Dengue Hemorrhagic Fever (DHF)3

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Further symptoms occurred on 3rd hospital day-5, is a moment of danger in the disease dengue hemorrhagic fever. Body temperature will fall, so as if the child was not recovered because of a fever again. That need to be considered today, is the child's behavior. When the fever disappears, the child looked fresh and willing to play and want to eat / drink usually includes mild dengue fever, but if the fever disappears, but as children grow weak, like sleep, and do not want to eat / drink anything especially with abdominal pain, this is an early sign of shock. A state of shock is a very dangerous situation because of all the organs of the body will be starved of oxygen and this can cause death within a short time.

Signs of shock should be properly identified if we take care of children suspected of suffering from dengue fever, or children who have a high fever for 3 days or more. Children looked nervous shock or when the child becomes unconscious, breathing rapidly as if shortness of breath. The whole body felt cold and damp, cold feeling of the most easily recognized when we touched the feet and hands of patients. Lips and nails looked bluish blood vessels described in the end of contract as compensation to pump more blood to the heart. Children will feel thirsty, and urinating less or no urine at all. Shock will easily occur if the child prior to the shock, less or not drink.

If the shock has been described previously not treated properly it will follow next symptom is bleeding from the GI tract. Gastrointestinal bleeding may be mild or severe depending on how long the shock occur until treated appropriately. Decreased levels of oxygen in the blood will trigger the occurrence of bleeding, shock occurs gradually lower the oxygen levels in the blood of the more powerful bleeding occurred. At first gastrointestinal bleeding is not visible from the outside, because going on in the stomach. Which will appear only belly growing bulge and pain when touched. Next will be vomiting blood and blood defecate / poop black. In the event of bleeding the patient will be very painful, but when the shock has long been suffering in general are not aware anymore. Other bleeding that can occur is bleeding in the lungs. Children will be more crowded again, maikn nervous, and very pale. Further accelerated by the death of bleeding in the brain.

On the sixth day of illness and so on, is a time of healing. Current fever had disappeared and the temperature became normal again, no longer met the new bleeding, and appetite comes back. In general, after someone recovered from an illness the child is still looking weak, face slightly swollen belly with a little tense, but a few days later the body condition of the child will recover to normal without any symptoms remaining. As a sign of healing sometimes occur red spots overall in both feet and hands with white spots in between, the child complained of itching in these spots. So, if the rash has come a very broad at the foot and the boy's hand sign the child has recovered and no longer need to be treated.

First Aid on Dengue Hemorrhagic Fever Patients

A person who is suffering from dengue fever in the beginning will suffer a high fever. In this feverish state of the body more dehydrated due to evaporation occurs more than usual. More body fluid decreases when children are vomiting constantly or do not want to drink. So the most important first aid is to drink as much as possible.

Give kirakira drinking 2 liters (8 cups) in a day or 3 tablespoons every 15 minutes. Beverages provided such child according to the taste of white water, sweet tea, syrup, fruit juice, milk, oralit, softdrink, can also be given a lot of diet nutricious currently available. By providing drinking lots of fluids in the body is expected to remain stable. To monitor that the fluid is not less, note the amount of urine of children. If the child urinate a lot, at least 6 times in one day means the amount of fluid the child drinks enough.

High fever that will also reduce the body fluids and can cause seizures in children who have a history of seizures when high fever, therefore, must be given febrifuge. To reduce fever, give febrifuge. For type-lowering drugs should be selected this summer from drug groups or asetaminophen paracetamol, do not be kind of aspirin asetosal or because it may stimulate the stomach so that it will aggravate if there is bleeding of the stomach. Compresses can help when a child has a fever is too high should be given a warm compress and not a cold compress, since cold compresses can cause the child to shiver. In addition to children who have a history of febrile seizures in addition to fever-lowering drugs can be given anti-seizure medication.

At the beginning of the fever hospital 1-3 days, the symptoms often resemble other illnesses such as strep throat, measles, or typhoid fever (typhus), therefore, necessary control over the doctor if the fever remained high 3 days continuously especially as children grow weak and listless. To distinguish from other diseases as mentioned above, the current required blood tests can be done. Blood tests required to determine whether the blood tends to be thick or more. If things are still good kids, it means there is no sign of the gravity and blood laboratory results were normal, then the child can be treated roads. Gravity can still occur during the child was still feverish, so that the blood tests often need to be repeated again.

When do patients have to be taken to the hospital?

A person who is suspected of having dengue fever will experience a shock hazard if and heavy bleeding. To prevent these things, it is recommended that patients being treated in hospital. Someone must be treated if the suffering is recommended hospitalization. Someone must be treated if suffering from symptoms below:
1. Fever too high (more than 390C or more)
2. Continuous vomiting
3. Can not or do not want to drink the recommended
4. Seizures
5. Heavy bleeding, vomiting or dysentery
6. Great abdominal pain
7. Symptoms of shock, anxiety or unconscious, breathing quickly, the whole body palpable and moist, bluish lips and nails, the child feels thirsty, urinating less or not at all
8. Laboratory results showed increased blood viscosity and or decrease in the number of platelets.
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Dengue Hemorrhagic Fever (DHF)2

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a. Fever

Fever in dengue fever are sudden and ranged between 38.50 C-400C, In children there is a sudden increase in temperature. In the morning the children are still able to school and play, the sudden end of the day complaining of fever is very high. Fever will continue both in the morning and night and only dropped a little after being given febrifuge. In older children or adults at the time of initial symptoms are often ignored by less because of fever came suddenly. They keep doing the usual activities and had felt the pain when the following symptoms of lethargic, not eating well and so forth.

b. Listless

Besides the sudden high fever and dengue hemorrhagic fever sufferers will complain or appear lethargic and weak. The whole body is weak as there is no power, on small children can not complain, but children who are active this time will not play anymore and prefer to sit or lie quietly. Agencies will increasingly weakened by the appetite completely disappeared either drinking or eating, nausea and discomfort in the stomach and solar plexus area causing all the food and drink eaten out again. Nausea, vomiting and pain in the gut would further increase if the patient drinks febrifuge which could stimulate the stomach (see Section 3 of treatment). In small children can be accompanied by diarrhea 3-5 times a day, liquid, without mucus. Thus, if a child suffering from diarrhea accompanied by high fever we must be vigilant especially dengue fever occur in infants or small children under the age of 2 years. Dengue hemorrhagic fever as a viral disease often causes the face and body reddish children as "shrimp boil" (flushing) and when held very hot body.

c. Stomach pain

Abdominal pain is an important symptom of dengue hemorrhagic fever. These symptoms apparent in the large child or adult because they have been able to feel. Abdominal pain can be felt in the solar plexus and the area under the curve to the right ribs. Abdominal pain below the right rib arch over lead to the disease dengue hemorrhagic fever abdominal pain compared to solar plexus. The cause of abdominal pain under the right arch ribs are enlarged liver (liver) resulting in membrane stretch wrapped heart. In further signs of bleeding may be followed by small blood vessels in the membrane. While abdominal pain in the gut region that resembles the symptoms of stomach pain (stomach ulcers) can also be caused by stimulation febrifuge especially aspirin or drugs asetosal group. To ensure there is abdominal pain can be stress (feeling with emphasis) on the solar plexus region and under the right rib arch, especially in children who can not complain. It should be noted that abdominal pain can mimic the symptoms of appendicitis. Location of the appendix in the lower right abdomen near the right groin. So if there is inflammation of the appendix is going to hurt when pressed on the lower right abdomen, but the feelings children abdominal pain may spread and be felt at the navel area that is sometimes difficult to distinguish from abdominal pain in dengue hemorrhagic fever. Moreover, the symptoms of appendicitis is also accompanied by fever, vomiting, and abdominal pain. In our experience about 2 / 3 people with dengue hemorrhagic fever in children and adults complaining of abdominal pain, therefore if there is abdominal pain, high fever should be wary.

d. Bleeding signs

At the beginning of the disease dengue hemorrhagic fever, signs of bleeding that happens is a relatively mild bleeding. Bleeding skin is the most bleeding was found. Reddish spots for pins end spots like mosquito bites. Thus, to distinguish the rash caused by bleeding in dengue fever with spots for mosquito bites, look also in a protected area clothing (eg chest and back) that will almost certainly be protected from mosquito bites. Then try to press the red dot is: if it means missing a mosquito bite, and vice versa if the settlement is bleeding skin, also the touch of a mosquito bite will be felt protruding dengue fever while in the flat spots in the skin surface. This is due to mosquito bite rash caused by the dilation of blood vessels as a result of the reaction to the "poison" contained in the mosquito salivary glands and not because of skin bleeding. Red spots on dengue fever are not clustered like the measles rash, but a separate one-one.

Another bleeding is often found nosebleeds. Especially in children need to be considered whether the children often suffer from a nosebleed before. Nosebleeds, most caused by the rupture of blood vessels in the nasal mucous membranes caused by stimulation either from within or from outside the body such as high fever, the air is too cold, the air is too hot, too tired, so less rest or eat less regularly, and so on . If the child had suffered a nosebleed before, it may not dangerous nosebleeds, but to a child who has never nosebleeds and a high fever and bleeding it is necessary to watch out. Other bleeding symptoms that can be encountered is the excessive menstrual girls or bruises on the skin of the former taking blood, and bleeding gums.

e. Other symptoms

A child who has a history of seizures if fever, high fever during seizures can occur. Although there have also difikirkan other infectious diseases such as inflammation of the brain or the lining of the brain, especially if the child after the seizure did not regain consciousness. Other symptoms often complained of by a large child or adult accompany the disease dengue hemorrhagic fever are headache, pain behind the eyes, feeling sore in the muscles and joints. These complaints in adults is very disturbing so quick to seek treatment, while the children usually do not complain or a complaint is not felt disturbing.

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Dengue Hemorrhagic Fever (DHF)

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What Is Dengue Hemorrhagic Fever?

Of dengue fever are infectious diseases caused by viruses. Known for various types of the virus that causes dengue fever, but in Indonesia there are only 2 types of viruses that cause dengue fever and dengue virus Chikungunya virus. Among the two types of viruses that are in our country, dengue virus is the most important cause of hemorrhagic fever. Therefore, dengue fever, as we know the exact name of dengue hemorrhagic fever, according to the name of the virus that causes.

Dengue virus as the cause of the disease dengue hemorrhagic fever, is a very small microorganisms that can only be seen by electron microscopy. The virus can only live in a living cell, then for the sake of survival, viruses must compete with human cells are occupied primarily for protein needs. If a person immune to the virus infection is low, as a result tissue cells will become damaged if the virus has evolved a lot of the organ function is good, it will recover and emerge immunity against dengue virus had entered the body.

Dengue dengue fever through the bite of a mosquito Aedes aegypti. Mosquitoes that transmit the disease is an adult female mosquitoes. Female mosquito takes blood from humans or animals to live and breed. If in the vicinity of the nest of mosquitoes found someone who was ill dengue fever dengue fever dengue mild or severe. When good body resistance and the virus is not malignant, the degree of illness is not severe. Conversely, if low body resistance like in children, the disease is dengue infection can be severe and even be deadly.

Like other viruses (eg influenza, measles) patients most children recover on their own, whether treated or not treated because the disease is self-limiting viral disease. Thus, infectious diseases caused by viruses have a uniqueness that is sudden, the disease will continue despite treatment, and eventually will heal by itself depends on the resilience of people affected by the body. So, what's the point treated? Actually that is treated as symptoms arising 'caused by' the virus that ended symptoms of fever, shock, or bleeding, because until now there has been no drug that can kill dengue virus, the other hope is made of dengue vaccine, which until now still in the research stage and not yet released.

Affected Anyone Dengue Hemorrhagic Fever?

Dengue hemorrhagic fever is a disease that is always there throughout the year in our country, so called endemic disease. This disease shows an increasing number of people infected every 4-5 years. Age groups are often affected are children aged 4-10 years, although it can also about babies under 1 year of age. Lately, many of the young adults aged 18-25 years. Men and women are equally affected without exception.

How to live mosquitoes especially the female mosquitoes that bite in the morning and afternoon, presumably is why young children are prone to dengue fever. Aedes mosquito that likes the shade, protected against the sun, and the smell of humans, therefore, a toddler who still need to sleep in the morning and afternoon is often the target of a mosquito bite. Mosquito nests than in the house, also encountered in school, especially when it was dark and damp classes. The next target is school children in the morning and afternoon at school. Besides the mosquito Aedes aegypti is happy living in the house, there are also Aedes albopictus mosquitoes that can transmit the disease dengue hemorrhagic fever. Aedes albopictus mosquitoes living outside the home, in the shady garden, so that school age children may also have been bitten by mosquitoes the gardens during the day when being played. Durability factor of immature kids like adults, probably also a factor why the children were exposed to dengue hemorrhagic fever disease than adults.

In urban areas, the mosquito is very easy to fly from one house to another house from the house to the office, or public places such as places of worship, and others. Therefore, even adults become the next target after the children. Especially young adults (18-25 years) in accordance with the activities of this group during the day outside the home. However, in general, dengue hemorrhagic fever disease is lighter than adult children.

Initial symptoms

Clinical symptoms of dengue hemorrhagic fever at the beginning of the disease (fever days 1-3) can mimic other illnesses such as strep throat, measles, and typhoid. Symptoms that distinguish one another with the accompanying symptoms of dengue fever symptoms as listed above.

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