Carotenoid like astaxanthin can give us protection toward cardiovascular disease included hypertension. This condition related with blood vessel function disorder, contractible and rhythm change of blood vessel be mediated by relaxant substance (nitrate oxide NO; prostacycline) and constrictor factor (tromboxant; endothelin) in blood. More then, blood flow characteristic has importance function on pathologic complication that be viewed on atherosclerosis and coroner heart disease. Research that be presented here explain that astaxanthin can useful as part of an antioxidant therapy to reduce hypertension.

The result of research before that participate a carotenoid composition has been used to handle hypertension or high blood pressure. But Hussein et al., (2005a) publish the first research that participate astaxanthin with mouse spontaneous hypertension and stroke trend. This research investigates astaxanthin effect on blood pressure of aorta vessel which related with endothelium and nitrate oxide (NO) to explain mechanisms and response. Arterial blood pressure on mouse hypertension decrease approximately 10% when they are given astaxanthin 50 mg/kg/day for two weeks along. Giving for long period on mouse trend stroke show that by 5 mg/kg/day dose so has the same effect with 50 mg/kg/day. On Same time , on control group blood pressure increase until 8% at the five weeks. More next, astaxanthin hasn’t effect on normal blood pressure on mouse that healthy. The things that more interesting, author reported decrease 50% stroke incidence on trend stroke mouse which be given astaxanthin 50 mg/kg/day be compared with control group after 14 days.

Anti-hypertension mechanism by a part method can be explained from change of vascular reactivity and haemorheology. Micro-channel Array Flow Analysis (MC-FAN) measure a raising blood flow that significant amount 11% on a group that be given astaxanthin. Although plasma fluidity more be influenced by fibrinogen, on this researc, level of fibrinogen has not change and by that because, reparation of deformity and decreasing blood aggregation constitute the mechanism that probable. This matter be supported by Miyawaki et al., (2005) who so used MC-FAN to show reparation blood flow which significant in human who be given astaxanthin 6 mg for 10 days along. Sistematic investigation on relaxant response and constrictor show that astaxanthin can repair relaxation and sensitivity that depend on NO on constriction mechanisms. Astaxanthin reduce sensitivity toward angiotensin II (AngII) that be participated in blood vessel contraction, and bandaged ROS that usually prevent dilatation depending on Nitrate Oxide (NO) (Husein et al.,).

Therapy with Astaxanthin has so protect structural composition of wall structure of blood vessel. Hypertension usually causes process of thickening blood vessel wall that change rigidity and volume inside of blood vessel. So, reduce volume blood flow and increase pressure. Mouse which be given astaxanthin be protected from that structure changed and repair blood vessel wall until with ratio thickness lumen.

Although, that discovery from mouse spontaneous hypertension background, that matter constitute strong handling to make hypothesis longer on human clinical test.

Risk factors of Hypertension:
Advanced age more than 45 years; Women who had menopause; Family had hypertension history; Peoples who were not enforced healthy lifestyles.

Symptoms of Hypertension:
Hypertension has the same symptoms with other diseases and each people indicate very variously symptoms. Those symptoms like as: headache, heart palpitate, easily tired, blur of vision, more often urinate, tinnitus, vertigo or earth is felt around, bloody nose.

Diagnosis of Hypertension:
It is said hypertension if on measuring by sphygmomanometer indicate the result more than normal value of blood pressure (normal value by systole between 100-130 mmHg and diastole less than or same with 85 mmHg).

Classifications of Hypertension:
Hypertension disease can be classified as below to make easy in management of cases:

1. Hypertension degree 1 (mild hypertension) if on measuring gets systole between 140-159 mmHg and diastole between 90-99 mmHg.
2. Hypertension degree 2 (moderate hypertension) if on measuring gets systole between 160-179 mmHg and diastole between 100-109 mmHg.
3. Hypertension degree 3 (severe hypertension) if on measuring gets systole more than 179 mmHg and diastole more than 109 mmHg.

Prevention of Hypertension:

1. Regular’s examination of blood pressures.
2. Lessen the food which content high salt concentration.
3. Enforce physical activity 30 minutes minimal everyday.
4. Enforce aerobic sports (jogging, healthy walk, swim, bike, gymnastic) during 20-60 minutes minimal 3-5 times a week. Not smoking.
5. Keep normal body weight.
6. Restrain the stresses.
7. Rest enough.

Medical therapy of Hypertension:
There are two methods therapy of hypertension:

1. Non Pharmacology therapy, for hypertension degree 1 (mild hypertension) like as: low salt diet but rich potassium, no smoking, no hard drinks, reduces body weight for people who’s fatty, sport regularly, be avoided activity that cause stresses.
2. Pharmacology therapy, for hypertension degree 2 and 3 (moderate and severe hypertension) by some drugs like as: Prazosin (Alpha blocker), Captopril (Angiotensin Converting Enzyme / ACE inhibitor), and Nifedipine (Calcium antagonist). Prazosin (Minipress ®) has vasodilator effect by work on Alpha 1 receptor, very all right if be given for hypertension sufferers who had Diabetes Mellitus or Hypercholesterolemia. Prazosin usually is given by combination with diuretic drug. Initial Dose administration of Prazosin is twice of 0.5 mg daily and then be increased slowly until average dose twice of 1-2 mg daily. Captopril (Capoten ®) as ACE inhibitor inhibit the change of Angiotensin I to Angiotensin II wich cause not release Renin, until vasoconstriction is not occurred. Contraindication of Captopril administration is pregnancy. Initial dose administration of Captopril is twice to three times of 12.5 mg daily and then be increased slowly until average dose twice of 25-50 mg daily. Nifedipin is given to hypertension sufferers whose have heart disease suffering. Initial dose administration of Nifedipin is three times of 10 mg daily and then be increased slowly until average dose twice to three times of 30 mg daily.

If these problems go on severe and long standing will cause all kind health disorders like as cardiovascular disease, early aging process, cancer, and other kinds.

The kinds of free radicals as below:

Reactive oxygen species (ROS):

1. Superoxid radical
2. Hydrogen peroxide
3. Hydroxyl radical
4. Hydroperoxil radical

Reactive nitrogen species (RNS):

1. NO radicals
2. Nitrosomium cation (NO+)
3. Nitroxil anion (NO-)
4. Peroxynitritte (ONOO-)

One of all methods to against of free radicals is giving the oral antioxidant, but now many kinds of antioxidant be known, precisely be able to product new free radical (pro oxidant) if be used in multitude and long times.

Chemically definition of Antioxidant is the compounds as electron giver (electron donor), and biologically definition of Antioxidant is compound which can neutralize negative impact of oxidant for bodies, this compound prevent occur of stress oxidative.

Be found two big groups of antioxidant: Natural and Synthetic,

Natural antioxidants:

1. Enzyme (SOD/superoxid dysmutase, catalase, gluthation peroxides)
2. Transferrin
3. Lactofferin
4. Seruloplasmin
5. Albumin
6. Vitamin (vitamin C, vitamin E, tocoferol, beta carotene)
7. Ubiquinol 10
8. Flavonoid
9. Estrogen

Synthetic antioxidants:

1. SOD, catalase
2. Desperoxamin
3. Probucol
4. Salicylic, NSAID
5. Lasaroid
6. Captopril, beta-blocker, CCB, cinnarizine, amiodarone, methyl prednisolone
7. Xanthine oxides

Astaxanthin is natural carotene with unusually intensive antioxidant force. Astaxanthin can be found on micro alga all of world, begin from tropical lake to snow field of Antarctic. Astaxanthin is some substances which giving young red and red color on fresh meat salmon; prawn and lobster.

Astaxanthin is one of all antioxidants that strongest ever be found. Researcher found that astaxanthin has power:

1. Five hundred fifty multiplies stronger than vitamin E and 40 multiply stronger than beta carotene to take bundle the singlet oxygen.
2. One thousand multiplies stronger than vitamin E to peroxide the lipid.

Astaxanthin is one of all samples of evolution. Normally, micro algae that free swimming in the water reservoir is green color, but whiles the water reservoir dried and those algae are contacted by sunray; they begin to product astaxanthin with bright red colors in big amounts. Why? Because Astaxanthin as strong antioxidant which protecting algae from ultraviolet ray makes them life endurance - moreover although in most difficult conditions. Of because the function of astaxanthin is protecting cell nucleus toward free radicals that be caused by radiation ultraviolet ray this can damage DNA and peroxides energy sources.

During by the thousands years, Astaxanthin became part of human food. During the last twenty years, many kind of research and clinical test on human proofed antioxidant force and importance effect of Astaxanthin for health.

Toxoplasmosis or usually be named “toxo” is the disease that be caused by parasite : Toxoplasma gondii. This parasite the first time be found in spleen and liver Ctenodoctyles gondii, a type of rodent animal from Sahara, North Africa at year 1908. And in human be found in Cekoslowakia at year 1923.

Cat constitute the definitive host (excellent life place) of Toxoplasma parasite. On the fact this parasite so can be found on several type of animal, however only in cat intestine the parasite can develop accordance with sexual or asexual by self cracked. Infection will occur if infective shape of this parasite has been swallowed by appropriate host, i.e. : mammalian, avian, non except of human. In the body of this parasite host the parasite only can develop by asexual. Cat can suffer Toxoplasma after swallow minimally one of three shapes of infective parasite i.e. : cystic, oocystic, or takizoit. Intraintestinal cycles will occur if cystic in the body of avian or rat ( as intermediate host ) be swallowed by cat which constitute it predator. Parasite next will multiply itself on intestine wall and result out of oocystic which be excreted pass through feces of cat at time 2 - 3 weeks. On 5 days periods, oocystic has changed become infectious shape toward human and many type of other animal.

This infectious shape has enough high endurance toward environment condition, along with it can hold out on moist earth and sand in several month periods. During intra intestinal cycle is continuing, amount of Toxoplasma parasite make penetration on intestinal wall and self multiply become takizoit shape. Not long next this shape will exit from intestine and spread to other part of body to begin extra intestinal (outside of intestinal) . In finally immune system of cat will barricade the development of this infectious shape, and can cause accumulation of bradizoit shape that has dormant (sleep) characteristic in brain tissue and muscle tissue. Most cystic shape will permanent in body host during it’s life in dormant (sleep) condition. By slowly this shape will change become cystic shape and cause chronic infection in intermediate host. This extra intestinal cycle (outside of intestine) doesn’t only occur in cat body, but so can occur in the body of intermediate host, be included of human.

Although the incident of Toxoplasmosis has not experience change that enough significant yet at last several years, caution and attention toward this disease have drastic increasing. Be estimated around 30 - 50% of world population have been infected by Toxoplasma and more than 3000 Toxoplasma infection occur on pregnancy in USA, a big part without symptom. The research that be enforced by Gandhahusada year 1995 showed that prevalence rate of Toxoplasmosis in human revolve between 2 - 63%, in cat between 35 - 73%, in dog 75%, in goat between 11 - 61%, in pig between 11 - 36%, and less than 10% in cow/water buffalo.

Most of infection in adult human occur without symptom, or only show mild symptom like are increasing body temperature and enlargement of spleen gland. By base of impact that can be appeared this infection, congenital infection constitute the matter that need be concerned. Around about 45% spreading of Toxoplasma occur pass through congenital infection. From this amount, 60% of its constitute sub clinical infection, 9% with consequence of fetal death and 30% make appearing the enough severe impact (hydrocephalus, retinochoroiditis, and mental retardation).

Impact of infection very seldom be shown if mother suffer infection at last three semester her pregnancy, but more bad risk occur on infection at the first of three semester pregnancy infection, i.e. fetal death and baby malformation. More clear of symptom be shown after bearing, so can appear at some weeks, some months, moreover some years after bearing ( some clinical symptom so can show at puberty period as consequence of congenital infection ). Abnormality of nerve system ( mental retardation ) and vision ( blindness ), hydrocephalus, hearing disorder, fever, jaundice, with many kind of its complication, constitute as clinical manifestation that usually be suffered by patient of Toxoplasmosis. Symptom and other signs that maybe occur are macro cephalic or micro cephalic, skin eruption, bruised, and under skin bleeding, anemia, along with liver and spleen enlargement.

The symptom that appear of this infection i.e. :

• On many peoples appear without symptom of this disease.
• Fever, sore throat, exhausted, enlargement of lymphatic gland on neck and armpit area.
• On some cases can cause eyesight become blurred or loss of eyesight.
• Woman who in pregnancy time, or human who suffer a disease with low immunity system, like AIDS or cancer has high risk be attacked by this infection.

Toxoplasmosis disease can be treated with pirimetamin and sulfadiazin combination. Both of these medicine can pass through blood brain barrier. Toxoplasma parasite need vitamin B for life. Pirimetamin hamper the getting of vitamin B by Toxoplasma and Sulfadiazin hamper the using of vitamin B by Toxoplasma. Normal dose of these medicines are 50-75 mg pirimetamin and 2-5 g sulfadiazin per day. Both of these medicines disturb supplying of vitamin B and can cause anemia. Of that because be suggested that during the using of these medicines you should do laboratory examination periodically. People who with Toxoplasmosis usually use Calcium Folinat ( a kind of vitamin B ) to prevent anemia. The combination of these medicines very effective toward Toxoplasma. More than 80% peoples show improvement in 2-3 weeks.

Toxoplasmosis usually relapse after the first incident. people who have recovered from toxoplasmosis should use anti toxoplasmosis medicines with lower maintenance doses. Thus, the people with Toxoplasmosis better begin antiretroviral therapy early, and if CD4 up to 200 more than six weeks, therapy toxoplasmosis has finished and there are not sign of toxoplasmosis again, maintenance therapy of toxoplasmosis can be finished.

Many tips of prevention of toxoplasmosis, generally and during pregnancy :

• Better if planning the pregnancy, you should consult to doctor to enforce toxoplasmosis test examination before pregnancy. The aim of this action is if you have positive toxoplasmosis infection, then can be enforced optimal therapy before begin in your pregnancy.
• Avoid eat the food that uncooked or half baked.
• Clean and wash better fruits or vegetables before be eaten.
• Clean and wash hand, kitchen tools which be used to manage uncooked meat. This to prevent contamination with other foods.
• Don’t drink unpasteurized milk of animal.
• If clean trash or trash spot, don’t forget use hand sheath, and wash the hand, or give please this task to other family member while you in pregnancy condition.
• Use hand sheath if you want to work in the garden or home yard to avoid direct contact from infected feces of animal.
• If you have a planning that you will make pregnancy or if you in pregnant condition, better don’t take care of cat during pregnancy.

Usually the cat which be taken care at home that is not given uncooked meat, and it is not catching bird or rat, it is not infected.

Suggestion :

If you suspicious that you are suffering like the symptom of Toxoplasmosis, be suggested to you in order to consult with your trust physician.

The accurate methods to combat Dengue Hemorrhagic Fever scourge are avoiding mosquito bite and fight against the mosquito nest. Because the mosquito spreader of Dengue Hemorrhagic Fever (DHF) be present our around, then the active mosquito nest fighting must be enforced by community by watching the cleaning house and environment continuously. DHF be spread pass through of mosquito bite of Aedes Aegypti and or Aedes Albopictus. These mosquitoes bite at daylight by increasing bite activity two hours after sunrise and some hours before sunset. DHF is not spread directly from person to person.

After a people is bitten by Aedes Aegypti or Aedes Albopictus mosquito approximately 3-14 days later (generally 4-7 days) a people will indicate the symptoms or signs of DHF like as: Fever with body temperature more than 38 degree Celsius, Weakness, Appear red spot on the body, Nervous, feeling cool on end of hand and foot, Stomach-ache and vomiting, Its can be followed by bleeding like nose bleeding and bowel bleeding, and Thrombocytopenia.

To help a person who already indicate the symptom of Dengue Hemorrhagic Fever disease can be did the action like: please give drinks cooked waters (tea or fruit) more and more, cooling compress on the body of sufferer, and please give medicine to decease hot of body and if a sufferer has convulsion history give anti convulsion medicine too.

Until at this time, there is not medicine or vaccine to prevent DHF yet. The potent methods to prevent this disease are avoiding mosquito bite and mosquito nest fighting. Mosquito nest fighting can be enforced to break reproduction chain of Aedes mosquito by some actions: Cleaning the water reservoir and place where the waters is filled minimal once a week like bath container, large water jar, flower vase, bird beverage place, and others. For big container by sow with abate powders; Dense cover all places where can intercept and retain falling rain water; graving ex-things like as: ex-ban, bottle ex-beverage, plastic that can intercept and retain falling rain water; plus other methods like substitution the water of flower vase once a week, repairing the water flow and gutter those have damaged, covering holes on a cut of bamboo / wood by earth.

Important to be remembered:

Better preventive than curative of Dengue Hemorrhagic Fever, by control of mosquito spreader.

Other Pictures of Dengue Hemorrhagic Fever scourge combating Action :

Important to be remembered too that mosquito spreader of DHF maybe abide on our around.

]]> http://www.primaquality.com/2008/03/30/combating-of-dengue-hemorrhagic-fever-scourge/feed/ http://www.primaquality.com/2008/02/21/diabetes-mellitus-and-its-prevention/ http://www.primaquality.com/2008/02/21/diabetes-mellitus-and-its-prevention/#comments Thu, 21 Feb 2008 11:05:01 +0000 admin http://www.primaquality.com/2008/02/21/diabetes-mellitus-and-its-prevention/ Diabetes Mellitus is a chronic disease with high concentration of blood sugars. Be named as high blood sugars concentration if the result of chemical laboratory examination the blood sugar concentration in fast condition are more than 126 mg/dl and or two hours after meal are more than 200 mg/dl or at the time that blood sugar more than 200 mg/dl.

A high risk of Diabetes Mellitus like as:

• A people has brother or sister, parent, grandfather or grandmother with Diabetes Mellitus
• Obesity or over body weight
• Age more than 45 years
• Hypertension or high blood cholesterol
• A person who has a baby with born body weight more than 4 kg.

Classifications of Diabetes Mellitus:

Diabetes Mellitus type 1 or Insulin dependent Diabetes Mellitus:
The sufferers of Diabetes type 1 are children and adolescent, not obesity, always need insulin therapy, pancreas organ can make very a little of insulin or can not make insulin absolutely.

Diabetes Mellitus type 2 or Not insulin dependent Diabetes Mellitus:
The sufferers of Diabetes type 2 are a people had adult or old and fatty approximately.

The etiology of Diabetes Mellitus:

Genetic or hereditary factor is a principal etiology of Diabetes type 2, but the environments factor like as obesity and less of physical activities are a principal predisposition factor of this disease. Early a man with Diabetes has experience a condition that be named “Insulin Resistance” before he was obesity. Increasingly the age, foods consume habit not healthy, obesity and not enforce physical activity accordance with together can stimulate incident of Diabetes.

The symptomatic of Diabetes Mellitus:

The symptomatic of Diabetes Mellitus consist of:

• Often to urinate especially at night (nocturnal urinate)
• Quickly thirsty and hungry
• Body weight decrease without explicit etiology
• Quickly weak and sleepy
• Had wound that difficult to heal
• Itchiness on sex organ area
• Numb feeling on arm or leg
• Impotent
• Sightless or decrease of vision
• Baby delivery more than 4 kg

Chemical laboratory investigation:

Blood sugar concentration in fast condition at morning more than 126 mg/dl and or blood sugar concentration 2 hours after meal more than 200 mg/dl, or blood sugar concentration at time more than 200 mg/dl.

Complications of Diabetes Mellitus:

High blood sugar concentrations at long time period can cause seriously complications like as: Impotent, Heart attack, Stroke, Gangrene diabetic, blindness and renal failure.

Prevention of Diabetes Mellitus:

• Prevention of Diabetes Mellitus can be enforced by healthy lifestyles like as consume the food with balance nutrients, high fibrous and low fat, with enforce physical activity during 30 minutes everyday, until be created ideal body weight.
• Enforce regular checkup blood sugar concentrations at fast and two hours after meal; in order blood sugar concentrations always be controlled in normal condition.

Medical Therapy of Diabetes Mellitus:

If by dietary and regular physical activity can not manage high blood sugar concentrations may be needed medical therapy by Insulin injection or Anti Diabetic Oral tablets. Insulin injection only, specifically for Sufferers of Diabetes Mellitus type 1. Anti Diabetic Oral tablet or combinations of Insulin and Anti Diabetic Oral tablet for sufferers of Diabetes Mellitus type 2. Anti Diabetic Oral tablets that can be given for sufferers of Diabetes Mellitus type 2 like as ones of: Metfomin-HCl, Glibenklamida, Glipizida, Klorpromide, Glikazida, Acarbose. Doses of Anti Diabetic Oral tablets are appropriated with necessity and condition at times.

Approximately one per three of cases that be reported be found on child. Virus Hepatitis A is very easy to spread particularly with fecal - oral, direct or indirect. Spreading of acute viral Hepatitis A is related to inhabitant fully, bad personal hygiene, less sanitation, food and drink contamination, tight contact with patient, traveling to develop states and using intra vena forbidden drug. Acute Viral Hepatitis has been spread in whole world.

Parenteral transmission very seldom be occurred and this occur only on short viremia phase on incubation period of Acute Viral Hepatitis A.

Specific characteristic of Virus Hepatitis A (VHA) i.e.:

• VHA be found on feces of patient with acute infection, and be transmitted by fecal-oral route.
• Natural reservoir infection unknown yet
• It is not found viremia with persistent infection
• VHA is stable virus, exist persistent although on environment which is not benefit for virus itself.

By existence of environment sanitation and personal hygiene improvement will be happened change incident rate of Acute Viral Hepatitis A from younger ages to adult or elder ages. Of that because as prevention of Acute Viral Hepatitis A so anyone of younger ages must be given vaccination.

Etiology and Pathogenesis

As causer of acute viral Hepatitis A is viral hepatitis A. VHA shapes spherical, no envelope, by sizes 27 - 32 nm, its genome is RNA and be included family of picorna virus. VHA is stable extremely toward hot, cold box and acid conditions, by that cause virus resistant relatively to disinfectants.
Virus which be swallowed will create replication in small intestine and then migration through portal vena and in to liver. In liver cells be occurred replication again where then be excreted in to gallbladder and its finish will exit through feces. This condition goes continuous until appear clinical sign of hepatitis.

VHA doesn’t cause cytophatic effect in liver cells. When non specific immune system can not eliminate viral, specific immune system be stimulated to do it. Cytotoxic T lymphocytes (CTL) will play importance actor in virus elimination on liver cells which be infected, kill it’s by perforin mechanism ways, Fas legend and TNF-α (tumor necrosis factor).

Considering amount of liver cells 1000 times multiply or more than specific CTL in liver of patient, so viral cytolysis by CTL on liver cells which is infected only constitutes early step of liver cells damages. Macrophage, neutrophyl, and some type of cytokine so are participated in liver damaged next. Expansion of liver damages is established by host factor and viral. While immune respond work accordance with its character, so viral can be eliminated after acute attack of hepatitis.

But when immune respond work too strong can cause it’s occur fulminate hepatitis.
While viral infection start appear, non specific NK (Natural Killer) cell will recognize cell which be infected and then smash its. On time cells be infected by virus, will be stimulated production of interferon (IFN) α and β which will suppress viral replication. If infection can not be restrained at early stadium a while ago, so step by step will be stimulated production of neutralizing antibody and CTL which will as actor in viral elimination.
Neutralizing antibody will bundle specific viral particles in body fluids and will eliminate its, a moment CTL will recognize viral antigen which be expressed to cell infected surfaces and then attack cell and eliminated that viral.

Antibody production and activation along with CTL proliferation stay under control of T helper cells. T helper cells be activated at time they recognized existent of viral antigen which be presented by antigen presenting cells like as dendrite cell macrophage. While its be activated T helper cells type 1 (th1 cells) product interleukin (IL)-2 and IFN γ to accelerate activation and proliferation of CTL and NK cells. T helper cells type 2 (th2 cells) product IL-4, IL-5, IL-6 and IL-10 that promote β cells into antibody forming plasma cells and its cause proliferation of those cells.

Antigen presenting cells product IL-12 which be stimulated by activated T cells and this cytokine back to act on th1 cells, CTL and NK cells cause viral elimination and suppression viral replication. IL-10 which be produced by th2 cells to act on antigen presenting cells by decrease IL-12 production that suppress th1 cells activation, then will finish cellular immune respond toward virus.

The clinical picture of viral hepatitis A is extremely variable, ranging from asymptomatic infection without jaundice to fulminating disease. The clinical characteristics of the viral hepatitis A i.e. : infectious, faeca-oral transmission, incubation period 2 to 6 weeks, severity of acute illness mild to moderate, serology IgM-exposure, and immune prophylaxis normal Ig vaccine.

Diagnosis

The key features for diagnosis are :

• Prodrome of anorexia, nausea, vomiting, malaise, symptoms of upper respiratory infection of flu-like syndrome, aversion to smoking.
• Fever, enlarged and tender liver, jaundice.
• Abnormal liver tests, especially markedly elevated aminotransferases early in the course.
• Liver biopsy will show characteristic hepatocellular necrosis and mononuclear infiltrate. This rarely indicated.

Differential Diagnosis

The overseas traveller presenting with jaundice may have :

• Infection by any one of the viruses-hepatitis B, C, D or E. All are prevalent in deveploping countries, especially in south-eastern and eastern asia, some Pasific islands and Africa.
• Other causes to consider are malaria, ascending cholangitis and drug induced hepatic damage due to, for example, the antimalarials, including mefloquine (larium) and Fansidar.

Treatments

• Bed rest. Advisible during the acute initial phase of the disease, when symptoms are most severe. Return to normal activity during the convalescent period should be gradual.
• Fluids. If nausea and vomiting are pronounced or if oral intake is substantially decreased, intravenous administration of 10% glucose solution is indicated.
• Diet. Dietary management consists of giving palatable meals as tolerated, without overfeeding. Patients should avoid alcohol, and hepatotoxic agents.
• Corticosteroids. In control studies, corticosteroids have demonstrated no benefit in patients with viral hepatitis, including those with fulminant hepatitis. Treatment of patients with acute hepatitis C with alpha interveron appears to decrease the risk of chronic hepatitis.
• Encephalophalopathy or serve coagulopathy. Suspect fulminant hepatic failure and hospitalization is mandatory.

Coronary heart disease is certainly a heart disorder that is occurred by presence of coronary vessel anomaly. Coronary vessel anomaly is the constriction of blood vessel as consequence of blood vessel wall does not flexible by over fat accumulation.
The prime etiology of Coronary heart disease is over fat accumulation on wall in of artery coronary until be occurred vasoconstriction and can obstruct blood vessel circulations.

Predisposition factors of Coronary heart disease like as:

Less consume vegetables and fruits
Smoking habit
Less physical activity or sports
Hypertension
Blood cholesterol more than normal
Obesity
Stress emotion
Diabetes Mellitus
Genetics

Clinical signs of Coronary heart disease:

Suppressed sense at chest like as struck down by heavy load, chest pain, heartburn sense.
These senses can spread to all chests, left shoulder, left arm, back, distal neck and lower jaw.
Feeling like be throttled or chest crowd.
Duration of above signs about thirty minutes.
Cold sweat, weakness, palpitation.
Some time until coma.
Heart attacks often occurred at morning day.

Community’s actions to help patient with Acute Heart attack:

Lie down the patient
Released the clothes and belt
Calling a doctor or reference to hospital

Medical treatment:

Isosorbide dinitrate (Isodril®) 5 mg sublingually every 5 minutes (to maximum of 3) or
Glyceryl trinitrate sublingually spray: 1 to 2 sprays (to maximum of 3 in 15 minutes) or
Nifedipine 5 mg capsule (suck or chew) if intolerant of nitrates (warn about possible hypotension and unpleasant taste).

Prevention of Coronary Heart Disease:

Make balance nutrients by consume more vegetables and fruits, poor fat with limited salt and sugar consumptions.
Don’t smoking. All of cigarettes can cause coronary heart disease.
Avoid the stress by always positive thinking, quiet and be controlled.
Keep blood pressure normally by control regularly.
Please enforce sport or physical activity regularly.

The Fuji FinePix Z20fd digital camera features a 10-MegaPixel, a Fujinon 3x optical zoom lens, 2.5-inch LCD screen and packs 45MB of internal memory to give you some extra room when your memory card is full. The style-savvy FinePix Z20fd also introduces Fujifilm’s handy new Dual Blog Mode that automatically resizes any still image or movie you’ve captured, letting you post pictures and videos to blogs, video-sharing websites like YouTube, or e-mail to friends with ease.  The Fujifilm FinePix Z20fd also  and comes in four luminous colors - Jet Black, Wasabi Green, Hot Pink and Ice Blue - an ultra-portable design

Fujifilm FinePix Z20fd Key Features

• 10 Megapixels
• 2.5-inch LCD screen
• 3x Fujinon zoom lens
• Stylish ultra compact design
• Face Detection Technology with intelligent automatic red-eye removal
• Dual shutter releases: One button for still capture, one for movie record
• Intelligent Flash: i-Flash detects subtle lighting differences within a scene, and then varies the flash intensity accordingly. It also uses the high sensitivity of the FinePixZ20fd to enable the camera to use less flash, preventing that “blasted with light” effect
• Dual Shot Mode: In this mode, the Fuji FinePix Z20fd quickly shoots two images in succession - one with and one without the flash - saving both. In order to decide later on whether the Fujifilm Z20fd produced the best shot with or without flash
• Special scene modes: The Z20fd has 14 scene positions including Fireworks, Beach and Snow
• xD/SD/SDHC slot: Single media slot accepting xD Picture and SD/SDHC media cards
• Stamp It: “Stamp” a variety of fun designs to up to three detected faces in your shots!
• Battery Life: Long-life rechargeable Li-ion battery

The Nikon D60 digital SLR camera key features

• Extraordinary 10.2-Megapixel DX-format Nikon Picture Quality
• Outfit Includes AF-S DX-NIKKOR 18-55mm f/3.5-5.6G VR Image Stabilization Lens
• Fast Startup and Split-Second Shutter Response
• Shoots Continuously at up to 3 Frames per Second
• Active Dust Reduction with Airflow Control
• Easy Operation with Intuitive Controls
• Up to 500* Pictures per Battery Charge
• Bright, 2.5-Inch Color LCD Monitor with 170-Degree Wide-Angle Viewing
• Nikon’s Smallest Digital SLR Ever!
• Automatic Exposure With 8 Digital
• Vari-Program Scene Modes

The Nikon D60 dSLR camera will be packaged with the 3x zoom AF-S DX NIKKOR 18-55mm f/3.5-5.6G VR lens and will be available throughout the United States beginning in February 2008.

Example photos taken with Nikon D60 dSLR camera: