Rabu, 07 September 2011

MORBUS HANSEN (1)

Gerhard Armauer Hansen



Born 29 July 1841(1841-07-29)
Bergen, Norway
Died 12 February 1912(1912-02-12) (aged 70)
Florø, Norway
Fields Epidemiology
Alma mater University of Oslo
Notable awards Royal Norwegian Order of St. Olav

Gerhard Henrik Armauer Hansen (29 July 1841 – 12 February 1912) was a Norwegian physician, remembered for his identification of the bacterium Mycobacterium leprae in 1873 as the causative agent of leprosy.

Hansen was born in Bergen and studied medicine at the Royal Frederik's University (now the University of Oslo), gaining his degree in 1866. He served a brief internship at the National Hospital in Christiania (Oslo) and as a doctor in Lofoten. In 1868 Hansen returned to Bergen to study leprosy while working with Daniel Cornelius Danielssen, a noted expert.

Leprosy was regarded as largely hereditary or otherwise miasmic in origin. Hansen concluded on the basis of epidemiological studies that leprosy was a specific disease with a specific cause. In 1870-71 Hansen travelled to Bonn and Vienna to gain the training necessary for him to prove his hypothesis. In 1873, he announced the discovery of Mycobacterium leprae in the tissues of all sufferers, although he did not identify them as bacteria, and received little support.

In 1879 he gave tissue samples to Albert Neisser who successfully stained the bacteria and announced his findings in 1880, claiming to have discovered the disease-causing organism. There was some conflict between Neisser and Hansen, Hansen as discoverer of the bacillus and Neisser as identifier of it as the etiological agent. Neisser put in some effort to downplay the assistance of Hansen. Hansen's claim was injured by his failure to produce a pure microbiological culture in an artificial medium or to prove that the rod-shaped organisms were infectious. Further Hansen had attempted to infect at least one female patient without consent and although no damage was caused, that case ended in court and Hansen lost his post at the hospital.

Hansen remained medical officer for leprosy in Norway and it was through his efforts that the leprosy acts of 1877 and 1885 were passed, leading to a steady decline of the disease in Norway from 1,800 known cases in 1875 to just 575 cases in 1901. His distinguished work was recognized at the International Leprosy Congress held at Bergen in 1909.

Hansen had suffered from syphilis since the 1860s but died of heart disease.

In Bergen, a medical museum has been designated Hansen, which is often referred to as the Leprosy Museum. The University of Bergen has also dedicated a research facility to him - Armauer Hansen Building - located at Haukeland University Hospital in Bergen. The Leprosy Archives in Bergen has been nominated by UNESCO to the list:Memory of the World.

Selasa, 06 September 2011

Simple Question

Hari ini dr.BS datang ke morning report. Satu pertanyaan sederhana dan menggelitik ditujukan ke kami. Begini pertanyaannya : "Sebagai dokter Rehab medik, apa sih yang kalian terapi/obati?" Sederhana, menghenyak dan menggelitik kami. Kalau dokter umum kita mengobati penyakit, tapi sebagai dokter Rehab apakah cukup? Hmmm...
Berdasarkan definisi IKFR (sudah saya posting sebelumnya), Rehab medik mengelola secara komprehensif kecacatan/keterbatasan fisik akibat penyakit/cedera yang mengenai sistem neuromuskuloskeletal dan kardiorespirasi beserta gangguan psiko-sosio-vokasional yang menyertainya.
Sebenarnya apa sih kecacatan/keterbatasan fisik itu?
Ada 3 hasil terapi yaitu Sembuh, mati dan cacat. Sedangkan cacat itu sendiri juga ada 3 yaitu Impairment, Disability dan Handicap.
Impairment adalah suatu kelainan menyangkut struktur anatomi, fungsi organ, psikis yang dapat disebabkan oleh penyakit, cedera atau kelainan kongenital.
Disability adalah keterbatasan kemampuan seseorang dalam melakukan kegiatan yang dianggap normal bagi orang dengan usia tertentu, akibat impairment.
Handicap adalah kemunduran seseorang dalam interaksi dengan orang lain, lingkungan atau kehidupan sosial akibat impairment atau disability.
Jadi secara singkat impairment pada organ level, disability pada human level, dan handicap pada environment level.
Sebagai seorang dokter Rehab ketiga kecacatan itulah yang di terapi.
Contoh pada pasien dengan Trigger finger digiti III dextra dan de Quervains tenosynovitis, maka Impairmentnya adalah Trigger finger 3rd digiti manus D dan Tenosynovitis tendon AbductorPollicis Longus and Extensor Pollicis Brevis D. Sedangkan disabilitynya adalah Wrist pain to carrying her grandchild, doing her daily activity like washing, lifting water and wudlu. Handicapnya adalah unpleasant family relationship.
Semoga bermanfaat.
Terima kasih untuk dr.BS buat pertanyaannya. Simple Question, but the answer has content great responsibility.


Senin, 05 September 2011

My first Short Case : OA GENU


Short case ini sudah dipresentasikan pada tanggal 9/8/2011
Summary
It has been reported female, 59 years old, referred from Oscar laboratory with OA Genu D. Chief complaint was “lutut kanan terasa cekot-cekot”.
She felt dull pain at her right knee since 3 weeks ago. The pain was increase when she was changes position from sitting to standing, walking far distance, climbing the stairs. The pain was decrease when she take a rest. She felt stiffness at her right knee in the morning and it lasted about 15 minutes and it was relieved when she walked several steps. She did not heard the ‘kretek-kretek’ sound on her right knee when she moved. The pain disturbed her daily activity, but she hasn`t difficult to toiletting because her closet is sitting type. No numbness and tingling sensation of her right knee. She worried about her disease.
From physical examination was found tender point at lateral right patella with VAS:6, crepitation right knee, patellar grinding test was positive right side. Conclusion X-Ray examination was OA Genu Dextra. Planning diagnosis are consult to nutriton departement. Planning therapy are SWD kontraplanar at genu dextra, TENS at tender point tibial plateau area, strengthening knee joint. Planning monitoring are clinical sign, symptoms, VAS, body weight, BMI. Planning Education are explain about her disease, knee joint conservation, warm compress genu dextra, isotonic quadriceps strengthening dextra and dietary.

Mulailah dengan kekaguman


Hari ini aku mendapatkan pelajaran berharga. Jika mau belajar sesuatu mulailah dari kekaguman kita terhadap sesuatu tersebut. Dari kekaguman itu akan timbul passion untuk lebih mngenal dan mendalaminya....
wuih...great advice...
Terima kasih dr.RR untuk semuanya...
Aku juga mau belajar Rehab dengan kekaguman, kekaguman terhadap Sang Khalik yang menciptakan manusia sedemikian unik dan luar biasa..

Minggu, 04 September 2011

Petuah

Beberapa petuah dari dosen IKFR dr. Sutomo, yang aku catat dalam hatiku :
dr.BS : Gurumu yang utama adalah pasien, maka hormatilah dan sayangilah
dr.RDS : Mau jadi Sp.KFR yang bagaimana di masa mendatang, ditentukan apa yang kamu lakukan semasa PPDS, maka teruslah belajar dan laparlah akan ilmu.
dr.RR (kutipan dari dr.RDS) : Jangan berharap ada black forest di IKFR, karena yang ada ada adalah bahan-bahannya, dan kita harus menjadi kokinya...
Terima kasih dokter....akan kuingat dan kulakukan dalam hidupku semua nasihat dan petuahmu..

I have a dream


Semuanya berawal dari mimpi. Mimpi ini yang memotivasiku, dan ini adalah motivasiku mengapa IKFR menjadi pilihan (atas kehendak dan pilihan Tuhan tentunya) hidupku :
It began when I was child. I have neighbours, people called him : Ndithil. That means from javanese : ndi kok siji thil (in English : where is the other, it's just one). He is still has complete arm and leg, but the other side his arm until elbow joint and his leg until ankle joint. From that I have passion to be some one who can help people like Ndithil.
After I am being doctor, I meet people with deformity like Ndithil, who need help. I also meet people with other deformity, which should be prevent.
By becoming physiatrist, I hope I can help people to prevent deformity and adding quality to their lives.
It's like philosophy of Rehabilitation medic :
Rehabilitation is brigde to spanning gap between : uselessnes and usefulnes, hopelesnes and hopefulnes, despite and happinnes. Rehabilitation not only add years to life, but also add life to years.
I have a dream to be some one like that....

IKFR

IKFR adalah singkatan dari Ilmu Kedokteran Fisik dan Rehabilitasi, yang dulu (sekarang pun kadang masih digunakan) bernama Rehabilitasi Medik.
Definisinya adalah cabang ilmu kedokteran yang mengelola secara komprehensif kecacatan/keterbatasan fisik akibat penyakit/cedera yang mengenai sistem neuromuskuloskeletal dan kardiorespirasi beserta gangguan psiko-sosio-vokasional yang menyertainya.
Sungguh ilmu kedokteran yang sangat mulia. Aku secara pribadi sangat bersyukur pada Tuhan yang memberi jalan bagiku untuk mendalami ilmu ini. Thanks Lord...

this is Your way

Yes, Lord this is Your way for me...
thank you for Your gift ... big gift for me and thanks for everything