Dengue viral infection is a global disease with a spectrum of clinical manifestations mild fever to severe disease both dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). DHF is severe form of dengue fever (DF), which can be life-threatening. Climate changes is not the only factor that affects dengue transmission, but also globalization changes includes travel and trade. The pathogenesis of dengue infection is complex. The mechanism involved antibody-dependent enhancement, NS1 and its antibodies, T cells, and DENV genomics. There are several novel methods to detect the presence of dengue virus in the body of infected patients. These include ELISA-specific IgM and IgG detection, detection of monoclonal antibodies and mosquito cell strains, and PCR reverse transcriptase detection. Several trials found novel methods to predict the severity of dengue hemorrhagic fever earlier. These include platelet count, Aspartate aminotransferase / platelet count index (APRI) Index, serum chymase level, serum cytokine/chemokine profile, Tropomyosin-alpha 1 (TPM 1), Reticulocyte Production Index (RPI), and Immature Platelet Fraction (IPF). Several pharmacological therapies are known to have potential antidengue effect. Some of these are corticosteroids, antimalarial drugs, doxycycline and tetracycline, anticholesterol drugs, IVIG, celgosivir, balapiravir, pentoxifylline and calcium supplementation. Some natural products are known to have activity against Aedes aegypti through antiviral mechanisms, larvacidal activity, mosquitocidal, and mosquito repellants. It can be developed as the latest therapy of dengue hemorrhagic fever on the future. The objective of this paper is to provide new insight about the development of dengue hemorrhagic fever related to the history of its distribution, pathogenesis, and the latest developments related to detection methods, severity prediction methods, and the management of dengue hemorrhagic fever on the future. Keywords: globalization changes, novel detection methods, severity prediction methods, latest development in DHF therapy
Diabetes melitus merupakan penyakit yang banyak ditemui sehari-hari, akan tetapi memiliki manifestasi klinis yang tidak lazim. Salah satu manifestasinya adalah sindroma hemichorea-hemiballismus, spektrum gerakan involunter yang berlangsung terus-menerus tanpa pola dan melibatkan satu sisi tubuh akibat hiperglikemia non-ketotik pada diabetes yang tidak terkontrol. Dilaporkan dua kasus pasien diabetes dengan hiperglikemia non-ketotik yang mengalami sindrom hemichorea-hemiballismus. Kasus pertama-wanita 57 tahun mengalami gerakan involunter, repetitif, dan tidak berirama di lengan dan tungkai kanan, disertai kedutan di wajah kanan selama dua minggu. Pasien tersebut memiliki riwayat diabetes melitus tidak terkontrol. Kasus kedua-laki-laki 60 tahun dengan kejang umum tonik-klonik. Pasien mengalami gerakan involunter pada lengan kanan selama empat hari dan riwayat diabetes sebelumnya tidak diketahui. Terapi diazepam intravena tidak memberikan respons terhadap kejang. Gambaran CT scan kepala pada kedua pasien menunjukkan lesi hiperdens pada ganglia basalis yang diduga disebabkan oleh hiperglikemia non-ketotik, akan tetapi lesi hiperdens pada pasien kedua tampak lebih luas. Gerakan involunter membaik setelah target glukosa darah tercapai dengan rehidrasi dan insulin intravena kontinyu. Respons klinis pada kasus hemichorea-hemiballismus di atas bersifat reversibel meskipun gambaran lesi hiperdens dapat bertahan selama berbulan-bulan.
Occupational asthma is defined as an adult onset of asthma triggered by specific exposures or combinations from the workplace. Occupational asthma is classified into a sensitizer-induced occupational asthma or allergic occupational asthma caused by exposure or sensitization by a causative agents induced by immunological reactions; and irritant-induced occupational asthma or non-allergic occupational asthma caused by agents that are irritative to the airway. Occupational asthma can occur in health workers at hospitals. In the hospital there are various exposure of agents, medicines, and health equipments which can induce the asthma symptoms for health workers. The diagnosis of occupational asthma established by history taking, physical examination, supporting examination (spirometry, bronchial hyper-responsiveness test, exhaled nitric oxide, and immunological tests), and biomarker test. Management of occupational asthma includes principle management by avoiding exposure, pharmacological therapy, and immunotherapy. Precautions taken by primary, secondary (medical surveilance) and tertiary prevention (prevention of disability through worker’s compensation system).
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