degree of burns

7/29/2019 Degree of Burns

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Degree of Burns

First Degree Burns: First degree burns affect

only the skin surface, also known as the

epidermis. The burn site often is red, painful

and dry. Sunburn is a good example of a first

degree burn


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Second Degree Burns: Second Degree Burns

penetrate the skin surface and involve the

next lawyer of skin tissue known as the

dermis. The urn site is often red, blistered,

swollen and painful. These burns are

frequently caused by scalding injuries from

hot fluids, flames and brief skin contact with ahot object.


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Third Degree Burns: Third Degree Burns are deepburns that destroy the outer and inner skinprotections. In these burns the epidermis anddermis tissue is destroyed. Often times in a third

degree burn in addition to skin damage, bones,tendons and muscles are also injured. The skinappears to be white or charred. In a third degreeburn nerve tissue is also damaged causing varying

amounts of pain. Like second degree burns, thirddegree burns are frequently caused by a scaldingliquid, skin that comes into contact with a hotobject, flames and electrical or chemical contact.


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Siklus toxoplasma gondii

Siklus hidup toxoplasma ada dua fase, yaitu

fase intestinal dan ekstraintestinal. Fase

intestinal hanya terjadi dalam intestinum

kucing. Enzim pencernaan dihasilkan

toxoplasma untuk menembus dinding

intestinum.


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Reproduksi parasit menghasilkan berjuta-juta

oocyst yang tidak infeksius, yang akan

diekskresikan bersama feses. Di luar tubuh

kucing, oocyst mengalami sporulasi

(sporogony) yang terjadi paling lama 21 hari,

dan menghasilkan oocyst infeksius.


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Pada daerah dengan suhu panas dankelembaban tinggi, oocyst dapat tahan hidupsampai satu tahun. Fase ekstraintestinal dapat

terjadi pada semua hewan atau manusia yangterinfeksi. Pada fase ini, bentuk tachyzoite(trophozoite) dapat menyebar ke berbagaiorgan melalui sirkulasi. Dalam jaringan akan

berubah menjadi zoithocyste (bradyzoite)yang dapat menjadi persisten selama hidup,menjadi bentuk infeksi khornik atau laten.


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DIABETES MELLITUS

Insulin Dependent Diabetes(Tipe I)

Kurangnya insulin dalam jumlah besarkarena hancurnya sel beta.

Perkembangannya cepat.

Biasanya terjadi pada usia 35 tahun&kebanyakan terjadi antara usia 10-16tahun.(oleh karena juvenile diabetes).

Catatan laporan diabetik sekitar 10%.

Non Insulin DependentDiabetes(Tipe II)

Sela beta tidak menghasilkan

cukup insulin / insulin yangdihasilkan menjadi kurangefektif.

Perkembangan secaraberangsur-angsur.

Biasanya terjadi pada usia > 40tahun (oleh karena faktor usia)

Catatan laporan diabetik sekitar90%.

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ANTI DIABETIK ORAL

GOLONGAN ANTI DIABETIK ORAL

1. SULFONILUREA Golongan obat ini bekerja dengan cara menstimulasi

sel-sel beta di pulau langerhans pankreas untukmeningkatkan sekresi insulin.

Contoh : klorpropamid, tolbutamid, tolazamid, glimepirid,glibenklamid, glipizid, gliklazid.

2. BIGUANID

Mekanisme kerja obat ini belum diketahui dengan pasti,kemungkinan adalah dengan penghambatan glukoneogenesis

di hati & peningkatan penyerapan glukosa di jaringan perifer.

Contoh : metformin, fenformin dan buformin.

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3. ANALOG MEGLITINID

Bekerja dengan cara mengikat reseptor sulfonilurea &

menutup ATP-sensitive potassium chanal

Contoh : Repaglinid

4. ALFA GLUKOSIDASE INHIBITOR

obat ini bekerja dengan cara inhibisi enzim alfa glukosidase

di mukosa duodenum sehingga penguraian di/polisakaridamenjadi monosakarida dihambat.

contoh : akarbose, miglitol

5. THIAZOLIDINDION

obat ini bekerja dengan cara meningkatkan sensitivitasjaringan perifer terhadap insulin, sehingga mendorongpankreas untuk meningkatkan pelepasan insulin.

contoh : rosiglitazon, pioglitazon

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Significant implications of the UKPDS

findings include the following:

Glycemic control has minimal effect on

macrovascular disease risk; excess

macrovascular risk appears to be related to

conventional risk factors such as dyslipidemiaand hypertension

Sulfonylureas and insulin therapy do not

increase macrovascular disease risk


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Metformin reduces macrovascular risk in

patients who are obese[

Vigorous blood pressure control reduces

microvascular and macrovascular events; beta

blockers and angiotensin-converting enzyme

(ACE) inhibitors appear to be equally effective

in this regard


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Conventional oral hypoglycemic agents, such assulfonylurea (SU), are not suitable due to the riskof prolonged hypoglycemia; furthermore,

metformin is contraindicated for moderate toadvanced CKD

The National Kidney Foundation Kidney DiseaseOutcomes Quality Initiative guidelines

recommended that alpha-glucosidase inhibitorsshould be avoided in patients with advancedstage CKD and on dialysis


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Cardioversion

The most common indications for

synchronized cardioversion are unstable atrial

fibrillation, atrial flutter, atrial tachycardia, and

supraventricular tachycardias.

degree of burns

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