A preliminary study to detect human worm carriers of Taenia solium in Papua (Irian Jaya), Indonesia was carried out using stool examinations for the detection of copro-antigens and adult proglottids after chemotherapy, and confirmation by mitochondrial DNA analysis using expelled proglottids and metacestodes developed in NOD/Shi-scid mice from eggs of expelled proglottids. Approximately 8.6% of the local population in Kama (5/58), 1 km from the local capital city centre, Wamena, were confirmed to harbour adult T. solium using these techniques.
Dilaporkan kasus seorang perempuan Bali, berumur 33 tahun, agama Hindu dengan nodul multipel sistiserkosis di bawah kulit dan otak. Ditemukan gejala kejang sejak remaja yang kemudian tidak diobati. Sejak tiga tahun sebelum dirawat di rumah sakit, penderita menemukan nodul multipel di dalam kulit, mulai pada dahi dan sejak setahun yang lalu juga di bagian lain dari kepala dan tubuh, seperti pada bahu, dada dan punggung. Ternyata sampel serum yang diperiksa dengan cara immunoblot positif terhadap antigen Taenia solium. Hasil tes kopro-antigen yang juga positif memberi petunjuk adanya cacing dewasa T. solium di usus. Penderita diterapi dengan prazikuantel terhadap infeksi dengan cacing dewasa dan kemudian dengan albendazol terhadap stadium larva, yang berupa kista. Tidak berhasil ditemukan cacing dewasa di dalam tinja 24 jam. Setelah tiga minggu jumlah kista yang teraba di dalam kulit sangat berkurang, demikian juga di dalam otak. Setelah setahun tes imunoblot masih positif.
Chronic pain is a complex problem that eludes precise definition and can be clinically difficult to diagnose and challenging to treat. In the Asia-Pacific region, prevalence estimates that chronic pain ranges from 12% to 45% of the population, with musculoskeletal, rheumatic or osteoarthritis pain making up the majority of the disease burden. Implementation of current management guidelines into routine clinical practice has been challenging and as a result, patients with musculoskeletal pain are often poorly managed. For these reasons, a multidisciplinary Chronic Pain Advisory Board of leading physicians from various Asian countries was convened to explore ways to improve treatment and compliance, especially among patients with osteoarthritis and rheumatoid arthritis. We have identified a number of unmet therapeutic needs and prioritized initiatives with the potential to contribute toward a more integrated approach to chronic pain management. Key priorities included using evidence-based interventions as recommended by current guidelines, particularly those aspects pertinent to addressing treatment priorities in Asia (e.g., patient compliance), and the incorporation of cyclooxygenase-2 inhibitors and non-steroid anti-inflammation drugs into the management algorithms for osteoarthritis and rheumatoid arthritis. Treatment must be individualized for each patient based on efficacy, side-effect profile and drug accessibility. Further studies are required to examine head-to-head comparisons among analgesics, combinations of analgesics and long-term efficacy outcomes. Our increasing understanding of the problem combined with the promise of new therapy options offers hope for improved management of musculoskeletal pain in Asian countries.
AbstrakGedung-gedung perkantoran umumnya dilengkapi dengan sislim sirkulasi udara atau pendingin secara buatan untuk menciptakan kondisi lingkungan kerja yang nyaman. Namun, masih terdapat gejala-gejala sindrom gedung sakit (SGS). Salah satu gejala SGS adalah nyeri kepala SGS (NK SGS)
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