1. Choose teleconsultation services
   As long as your sick complaint is not urgent, teleconsultation is an effective solution to meeting your health needs during a pandemic. This is because you only need a video call with your chosen doctor more easily and practically anywhere without having to visit in person.
2. Make an appointment first with the dentist if you have to make a visit or direct treatment
   Specifically if you experience an urgent medical condition related to your dental health, as follows:
   – Uncontrolled bleeding
   – Pain in the teeth accompanied by swelling of the gums to the outer cheek area
   – Dislocation of the jaw joint
   – Control after surgery, such as removal of sutures
   – Jawbone broken
   – Making dentures for cancer treatment or certain radiation therapy patients
   – Measures to adjust the braces that hurt your cheeks or gums
   – Biopsy of abnormal tissue
   Also, do not forget to contact your dentist specifically if you feel the symptoms of COVID-19 when you will visit the dental examination.
3. Keep wearing a mask when seeing a dentist
   Comply with the health protocol in force at the entrance of the health facility visited.

Pandemic may still continue for the next few months, so it is important to maintain oral health from now on. Start by applying clean and healthy living behaviors such as diligent brushing your teeth every morning and before going to bed, limit consumption of sweet and sour foods, and drink enough water. Come on, take care of your teeth and mouth for happy smiling days!

Download article ‘Is it Safe to See a Dentist During a Pandemic?’

Most cases of Parkinson’s attack people over the age of 60 so that making this disease is often called a disease of old age. But, that does not mean Parkinson can not occur at a younger age. Therefore, everyone needs to adopt a healthy lifestyle to prevent Parkinson’s.

Here’s a simple way to reduce your risk of developing Parkinson’s:

1. Expand art activities
   Know your favorite art activities, be it painting, making crafts, writing stories, and the like. This is because art activities require better coordination between the brain and muscles, and cause psychological effects in the form of feelings of happiness.
   This combination will train you in carrying out complex planning or brain planning before doing something. This is difficult to do when exposed to Parkinson’s, so when you continually sharpen it, chances are you can get Parkinson’s preventable.
2. Regular exercise
   Exercise is also useful for preventing Parkinson’s, especially aerobic types. Routine aerobic exercise can even overcome the symptoms of Parkinson’s such as muscle stiffness, disturbed balance, and slowness of movement. Keep moving actively is the key to preventing Parkinson’s early.

3. Consumption of balanced nutritious food
   Increase consumption of vegetables and fruits that contain antioxidants, vitamin E and vitamin C, including green vegetables and fruits such as berries and kiwi. Consuming green tea is also good for the body, because the content of polyphenols can reduce toxic compounds that can interfere with the function of nerve cells in the brain.

Apply the above methods as a first step towards a healthy lifestyle without Parkinson’s. Let’s build a better quality of old life!

Download article ‘5 Healthy Ways to Prevent Parkinson’s’

According to research, coronary heart disease is one type of heart disease that has the highest mortality rate in the world because both children and adults are at risk of developing this disease. In Indonesia alone, there are around 35% of deaths caused by this disease and 5-9% aged over 20 years.

Blockage of blood vessels can also occur due to various factors, such as high cholesterol, smoking, obesity, hypertension to diabetes.

Symptoms of coronary heart disease

Everyone can experience coronary heart disease, so knowing the symptoms of this disease is very important to be detected as early as possible. Here are the symptoms that you should be aware of:

1. Chest or chest pain as suppressed
   Chest pain is one of the most common symptoms of heart disease. This condition is usually caused by a lack of oxygen-rich blood intake to the heart muscle so that the chest feels heavy or oppressed. Chest pain usually occurs and is felt when you are doing activities, for example when you exercise and when you are experiencing emotional stress.

2. Hard to breathe
   A heart that is not functioning properly, that is pumping blood to the lungs that makes it difficult for you to breathe. Not only that, the amount of fluid contained in the lungs will make this condition worse, especially if it occurs together with chest pain.

3. Feeling tired easily
   Easy fatigue is an effect caused by abnormal heart function. Usually fatigue is easily accompanied by dizziness caused by disrupted blood circulation.

4. Cold sweat, nausea, and vomiting
   When blood vessels constrict, the muscles in the heart will indirectly lack oxygen, causing ischemia. Ischemia itself is a condition that triggers excessive sweating and nausea and vomiting.

Examination of coronary heart disease:

1. Treadmill
   Physical activity makes the heart pump harder and faster. Therefore, a treadmill examination is done to find out how the heart works when you do physical activity, so a treadmill check is very helpful to reveal any blood flow problems in the heart.
2. CT Coronary Angiography
   This type of X-ray examination is done specifically for coronary heart disease to see arteries. By doing this type of examination, the doctor will be easier to diagnose disorders and damage to blood vessels.
3. Heart Record (ECG)
   Cardiac record or EKG (echocardiogram) is one of the examination of coronary heart disease using sound waves. With this tool, usually doctors at Siloam Hospitals can also detect other heart diseases.
4. Cardiac catheterization
   Cardiac catheterization to see for sure the blockage in coronary arteries.

To minimize the occurrence of coronary heart disease, you are advised to do a regular heart check. You can contact the call center 1-500-181 to get more information about Siloam Hospitals outpatient registration.

Download article ‘Recognize the Symptoms of Coronary Heart Disease and its Treatment’

What’s more, the fact of the World Health Organization (WHO) notes that approximately 92% of the world’s population breathes poor quality air, which causes each year there are 7 million deaths (2 million in Southeast Asia) due to outdoor and indoor air pollution. What are the diseases caused by air pollution and how to prevent it?

Diseases caused by air pollution

1. Acute Respiratory Infection (ARI) – Acute respiratory infections are not only caused by bacterial or viral infections in the body, but also due to air pollution. Toxic substances such as carbon monoxide, particulates, nitrogen dioxide and sulfur dioxide are examples of air pollution compositions that can easily disturb your respiratory organs.
2. Asthma – Air pollution is one of the triggers for an outbreak of asthma. This is dangerous because asthma is a chronic respiratory disease followed by symptoms of difficulty breathing, coughing, and chest pain due to the narrowing of the chest muscles.
3. Bronchitis – This respiratory disorder occurs due to inflammation of the lining of the bronchial tubes. This disease appears with symptoms of cough with phlegm or no phlegm at all. If it has phlegm, generally the phlegm is clear, greenish, and yellowish. Usually bronchitis is caused by a viral infection and air pollution can make it worse.
4. Chronic Obstructive Pulmonary Disease (COPD) – is a type of respiratory disease caused by damage to the lungs. Exposure to outdoor and indoor pollution can disrupt lung performance and increase the risk of COPD. The symptoms themselves are almost the same as bronchitis, but can be prolonged.
5. Lung cancer – Air pollution contains 6 substances that are harmful to health, one of which is carbon monoxide. In carbon monoxide there are carcinogens that are prone to trigger lung cancer, especially for the elderly over the age of 40 years. This disease is also risky for people who are often exposed to substances from industry, and often are in the street or room.
6. Heart disease and stroke – Smooth blood flow and flexible conditions are a sign that blood vessels are healthy. However, the impact of air pollution can cause blood vessels to become stiff and narrow. This condition triggers stroke and heart disease because blood flow to the brain or other organs becomes blocked, especially if followed by an unhealthy lifestyle.

How to prevent diseases caused by air pollution

Even though it looks clean, the air that you breathe every day can actually increase your risk of various respiratory illnesses. Therefore, you should not underestimate this condition. Try practicing healthy tips against air pollution, as follows:

1. Use a mask to reduce the entry of pollution into the respiratory tract and lungs
2. Avoid activities in areas with unhealthy air quality
3. Apply clean and healthy lifestyle, such as consumption of nutritious food, adequate rest, hand washing, and not smoking
4. When driving by car, you should close all windows and turn on the air conditioner in re-circulate mode
5. Do not light the fire source in the room
6. Place plants or air purifier equipment (air purifiers) to maintain indoor air quality
7. If you experience respiratory complaints due to frequent outdoor activities and frequent exposure to pollution, you should immediately consult a doctor.

For those of you who are still healthy, it is also advisable to have regular lung health checks to reduce the risk of lung disease that can attack by registering yourself at https://mcu.siloamhospitals.com. Don’t forget to continue to practice healthy tips against pollution, prevent before it’s too late.

Download article ‘Staying Healthy Under Air Pollution, How to Do it?’

Conditions like this often attack over the age of 60 years, but the age above 40 years and especially menopause should be vigilant. This fact is reinforced by a number of studies which state that as many as 23% of women in Indonesia with an age range of 50-80 years experience osteoporosis.

Age is indeed a risk factor for triggering osteoporosis. However, this condition is actually also influenced by a number of other factors, as follows:

1. Gender

Women are four times more likely to suffer osteoporosis than men, especially women from Caucasian or Asian races. This is because the bone mass that women have is lower than that of men and Asian women’s body postures are relatively smaller so that they have lower bone mass compared to other races.

2. Hormone

In women, low estrogen levels that usually occur due to menopause, ovarian removal surgery, and chemotherapy can make it harder for bones to form new tissues and structures
In men, low testosterone levels are a risk factor for bone loss.

3. Family History

If there is a family member who has a history of osteoporosis, then someone will be at greater risk for experiencing the condition.

4. Body Size

Women and men with small and thin body shapes are at higher risk for bone loss than women and men who have large body shapes.

5. Lack of vitamin D

Vitamin D works to help the body absorb enough calcium for bone health and strength. People who are deficient in vitamin D are prone to osteoporosis. Not the maximum body in absorbing calcium can also be caused by disruption of intestinal performance due to celiac disease and primary biliary cirrhosis.

If you have one or more of the above risk factors, immediately consult a doctor. Usually you are encouraged to do a physical examination, blood tests, and urine tests to determine the condition of the bones. Continue to exercise regularly and consume foods rich in vitamin D to maintain your bone density from an early age.

Download the article ‘Not Only Age, These 5 Other Osteoporosis Risk Factors’

Pneumonia is an acute infection or inflammation in the lung tissue caused by various microorganisms, such as bacteria, viruses, parasites, fungi, exposure to chemicals or physical damage to the lungs. Pneumonia can affect anyone, such as children, adolescents, young adults and the elderly, but more in toddlers and elderly.

The incidence of pneumonia is more common in developing countries and attacks around 450 million people each year. On December 31, 2019, in the Chinese city of Wuhan, there were reported cases of severe pneumonia whose cause was unknown. The results of the study considered the possible causes of these cases related to Severe Acute Respiratory Infection (SARS) caused by the Corona virus and had caused a pandemic in the world in 2003. Corona virus has been reported to continue to spread to other countries such as Japan, South Korea and Thailand.

Symptoms that arise in pneumonia include fever, weakness, dry cough, and shortness of breath or difficulty. In people who are elderly or have other comorbidities will have a higher risk to aggravate the condition.

The method of transmission and the incubation period is unknown. Based on investigations from several institutions in Wuhan, some cases occur in people who work in the fish market, but there is no evidence that shows transmission from human to human. But most likely the transmission of this virus can be through sneezing or coughing from an infected person to someone close to him.

Some vaccines currently available to prevent Pneumonia have not been used to prevent pneumonia that is currently outbreak because outbreak cases are caused by a new type of Corona virus (2019-nCoV), while some vaccines are available for investigators against Corona Virus Lurking at LippoInsurancet Pneumonia is as follows:

• The PCV13 Pneumococcal vaccine provides immunity against 13 strains of the Streptococcus Pneumoniae bacterium. The protection period is around 3 years. The PCV13 vaccine is primarily aimed at infants and children under 2 years of age.
• The PPSV23 Pneumococcal vaccine provides protection against 23 strains of pneumococcal bacteria. PPSV23 vaccine is aimed at older age groups (65 years and over) or aged 2 to 64 years with special conditions.
• Hib vaccine provides protection against Haemophilus influenzae type B (Hib) which is a cause of pneumonia and inflammation of the brain (meningitis).

In response to this, PDPI (Indonesian Lung Doctors Association) suggested a number of things, including:

1. So that people do not panic.
2. The community remains vigilant especially when experiencing symptoms of fever, coughing with difficulty breathing, immediately seek help to the nearest hospital.
3. Health advice

• Perform routine hand hygiene, especially before handling the mouth, nose and eyes.
• Wash your hands with soap and water and rinse for at least 20 seconds then dry with a towel or disposable paper. If there is no hand washing facility, can use 70-80% alcohol
• Cover your mouth and nose with a tissue when sneezing or coughing.
• When you have respiratory symptoms, wear a mask and seek treatment at a health care facility.

4. Travel advice

• Avoid touching or direct contact with animals such as pigs, dogs, cats, rats, rabbits, cows, birds and chickens.
• Avoid visiting wet markets, farms or live animal markets.
• Avoid close contact with patients who have symptoms of respiratory tract infections.
• Comply with food safety instructions and hygiene rules.
• If you feel that your health is uncomfortable when in an outbreak area, especially fever or cough, wear a mask and seek health services.
• After returning from the outbreak area, consult a doctor if there are symptoms of fever or other symptoms.

References:

1. Pengurus Pusat Perhimpunan Dokter Paru Indonesia., (2020), Press Release “Perhimpunan Dokter Paru Indonesia (PDPI) Outbreak Pneumonia Di Tiongkok, Perhimpunan Dokter Paru Indonesia : Jakarta.
2. Kementerian Kesehatan Republik Indonesia Direktorat Jenderal Pencegahan Dan Pengendalian Penyakit., (2020), Kesiapsiagaan dan antisipasi penyebaran penyakit Pneumonia berat yang belum diketahui etiologinya : Jakarta.
3. BBC News Indonesia, (2020),“Virus Corona: Orang keempat meninggal dunia akibat penularan antarmanusia menjelang libur Imlek”, from https://www.bbc.com/indonesia/dunia-51168932, 21 Januari.
4. Reni Utari, (2020),”Virus Korona, Penyebab Sakit Misterius di Tiongkok Bisa Menular Antarmanusia”, from https://www.sehatq.com/artikel/virus-korona-penyebab-sakit-misterius-di-tiongkok-bisa-menular-antarmanusia, 21 Januari.
5. Andi Utama, (2003),”Virus baru : Coronavirus dan Penyakit SARS”, from http://lipi.go.id/berita/virus-baru-:-coronavirus-dan-penyakit-sars/176, 23 April.

Download article ‘Alert! Corona Virus lurks!’

The following types of strokes have the most potential to cause severe disability and even death:

Brain stem stroke

The brain stem is a vital part of the brain because it controls almost all important functions, such as breathing, blood pressure, heart rate, and is the center of brain awareness that allows us to remain aware of the world around us. All nerve impulses from the brain to get to the whole body must go through the brain stem. Therefore, a stroke that occurs in the area of the brain stem both ischemic and hemorrhagic strokes can cause severe disability to permanent unconsciousness and even sudden death. This depends on how widespread the stroke is.

Hemorrhagic stroke

Hemorrhagic stroke is caused by bleeding in the brain. There are 2 types of hemorrhagic stroke, namely intracerebral hemorrhage where bleeding occurs in the brain tissue and subarachnoid hemorrhage where bleeding occurs in the subarachnoid space (the narrow space between the surface of the brain and the layer of tissue that covers the brain).

There are many risk factors for someone to have a hemorrhagic stroke, but some of the most frequent of them are uncontrolled hypertension, brain blood vessel abnormalities such as arteriovenous malformations, ruptured aneurysms. Hemorrhagic stroke can cause complications such as hydrocephalus, increased intracranial pressure, and seizures. If not treated aggressively, this condition can cause severe brain damage, brain herniation, and even death.

Large thrombotic stroke

Thrombotic strokes are caused by large blood clots, which form in blood vessels, or migrate to one of the brain’s main blood vessels. This large blood clot is very dangerous because it can stop the flow of blood to the largest and most important blood vessels in the brain.

Malignant middle cerebral artery (MCA) syndrome is an example of this type of stroke. In this stroke the media cerebral arteries are blocked by large blood clots which cause large infarcts from almost all sides of the brain. As a result there will be extensive swelling in the brain, subsequently causing an increase in high pressure in the brain. This causes a decrease in consciousness, global brain disorders, herniation, and finally death. This large thrombotic stroke is most often caused by a condition of abnormal heart rhythm (atrial fibrillation)

Symptoms of stroke are often found to be non-typical such as weakness of limbs, slurred speech and / or mouth opening, language difficulties, but can be in the form of spinning dizziness, headache, double vision, impaired balance and impaired memory. Signs and symptoms of stroke can appear and occur in different parts of the body. Not everyone can recognize the signs and symptoms of this stroke easily. However, most of the signs and symptoms of stroke are quite troublesome and unsettling so it is difficult to simply ignore.

There’s an easy way to find out signs of a sudden stroke and remind you to act quickly if it happens:

There is a speech disturbance, do your words sound unclear and have difficulty speaking and being understood? Try saying simple sentences over and over like “blue sky.” Are the sentences repeated correctly and smoothly?

Asymmetrical Face, does one side of the face feel heavy or numb? Try to smile and ask others to see your face, is the smile uneven?

Members of Body Movement Feel Weak, does one of your arms feel weak or numb? Try lifting your arms. Is one arm not raised?

Immediately to the hospital! If you or someone shows these symptoms, and even if the symptoms have disappeared, call an ambulance and leave immediately or take the person to the hospital. Check the time so that you know when symptoms first appear because this information is important for the doctor to influence treatment decisions.

• Kepala pusing
• Lumpuh separuh badan dan tidak ada refleks gerakan
• Bisa terjadi buta mendadak dan pandangan kabur karena suplai darah dan oksigen ke mata berkurang secara drastic
• Mulut mencong ke satu sisi karena terganggunya otot dan persarafan sekitar mulut

Faktor Risiko Stroke
Banyak faktor yang menjadi penyebab stroke antara lain riwayat keturunan, penyakit hipertensi (tekanan darah tinggi), hiperkolesterolemia (peningkatan kolesterol berlebihan), atherosclerosis (penumpukan lemak di pembuluh darah hingga menimbulkan plak, penyakit diabetes melitus (kencing manis), penyakit jantung, gaya hidup tidak sehat seperti konsumsi junk food berlebihan, konsumsi alkohol, kurangnya olah raga dan obesitas.

FAST
Segera lakukan tindakan F.A.S.T bila curiga seseorang terserang stroke!
Face (Wajah)
Perintahkan orang tersebut tersenyum. Apakah wajahnya simetris sisi kiri dan kanan?
Arms (Lengan)
Perintahkan orang tersebut mengangkat kedua lengannya. Apakah salah satu lengannya tidak bisa terangkat/lumpuh?
Speech (Bicara)
Perintahkan orang tersebut untuk mengulang kalimat sederhana. Apakah kalimat tersebut dapat diulang dengan benar?
Time (Waktu)
Jika terdapat kelainan pada tiga poin diatas, yang paling penting adalah waktu. Jangan terlambat untuk segera konsultasikan penderita ke RS terdekat karena telah terjadi kerusakan pada sel- sel otak dan harus segera ditangani.
GOLDEN TIME PERIODE
Untuk kasus stroke adalah empat jam, artinya dalam empat jam pertama, bila terdeteksi seseorang mengalami gejala stroke, segera bawalah penderita tersebut ke RS terdekat untuk segera mendapat penanganan medis. Dengan pertolongan sesegera mungkin akan mengurangi derajat kerusakan sel otak yang terjadi. Apabila terlambat, tidak menutup kemungkinan akan terjadi cacat/kelumpuhan yang bersifat sementara hingga permanen dan yang dikhawatirkan menimbulkan kompikasi yang berat berujung pada kematian.
Bagaimana mencegahnya?

• Keep Slim

Jaga berat badan ideal dengan teratur olahraga dan pola makan sehat dan seimbang

• Manage Stress

Hindari stress dengan aktivitas yang rileks dan menyenangkan seperti yoga dan mendengarkan musik

• Good Sleep

Istirahat cukup untuk memulihkan kondisi fisik

• Low Salt and Low Fat Diet

Lakukan diet rendah garam dan rendah lemak

• Stop Alkohol and Drugs Abuse

Hindari alkohol dan konsumsi narkoba

• Low Sugar Diet

Kurangi konsumsi gula
FACTS
Deteksi sedini mungkin dan mengenali gejala awal stroke adalah kunci utama untuk terhindar dari komplikasi stroke yang mematikan.
Daftar Pustaka

1. Seri Gaya Hidup Sehat: Cara Bijak Hadapi Stroke, Jantung & Pembuluh Darah, Agustus 2007, PT Gramedia
2. http://www.thesecretalert.wordpress.com
3. http://www.penangananstroke.com