Penyakit Dan Kelainan Pada Tulang Otot Manusia

<div dir="ltr" style="text-align: left;" trbidi="on"> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6pt; text-align: right;"> <b style="line-height: 120%; text-align: left;"><span style="font-family: "arial" , "sans-serif"; font-size: 12.0pt; line-height: 120%; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";">Kelainan pada Otot</span></b></div> <div class="MsoListParagraph" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level1 lfo1; text-indent: -18.0pt;"> <!--[if !supportLists]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">    </span></span></b><!--[endif]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Tetanus<o:p></o:p></span></b></div> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh4M9Q8HE-XYbF7wTLl1K8xEegqI5INH6_X2qeAqTWXVtDevvAUAIXR5U7jbStsl_nEZuqPfg4IVJIqoJhG8fl-9kRXwrJ6GffihFaAnNhSMMPP9AzPnSPj1WC3-1CL2GU_xZli4wxjs7-B/s1600/tetanus1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="213" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh4M9Q8HE-XYbF7wTLl1K8xEegqI5INH6_X2qeAqTWXVtDevvAUAIXR5U7jbStsl_nEZuqPfg4IVJIqoJhG8fl-9kRXwrJ6GffihFaAnNhSMMPP9AzPnSPj1WC3-1CL2GU_xZli4wxjs7-B/s1600/tetanus1.jpg" width="320" /></a></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Definisi</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Tetanus adalah suatu penyakit toksemik akut dan fatal yang disebabkan oleh Clostridium tetani dengan tanda utama spasme tanpa gangguan kesadaran. Gejala klinis timbul sebagai dampak eksotoksin pada sinaps ganglion spinal dan neuromuscular junction serta saraf autonom. Tetanus neonatorum menyebabkan 50% kematian perinatal dan 20% kematian bayi. Angka kejadian 6-7/100 kelahiran hidup di perkotaan dan 11-23/100 kelahiran hidup di pedesaan. Disebut juga lockjaw karena terjadi kejang pada otot rahang. Tetanus banyak ditemukan di negara-negara berkembang.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Gejala dan tanda</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pada pasien anak, ketika melakukan anamnesis sebaiknya ditanyakan:<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l20 level1 lfo2; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Riwayat mendapat trauma, pemotongan dan perawatan tali pusat yang tidak steril, riwayat menderita otitis media supurativa kronik (OMSK), atau gangren gigi.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l20 level1 lfo2; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Riwayat tidak diimunisasi/tidak lengkap imunisasi tetanus.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pemeriksaan fisis</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l11 level1 lfo3; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Masa inkubasi 5-14 hari.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l11 level1 lfo3; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Gejala awal adalah trismus; pada neonatus tidak dapat/sulit menetek, mulut mencucu. Disertai dengan kaku kuduk, resus sardonikus, opistotonus, perut papan. Selanjutnya dapat diikuti kejang apabila dirangsang atau kejang spontan; pada kasus berat dijumpai status konvulsivus.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Derajat penyakit</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l33 level1 lfo4; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">a.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Derajat I (tetanus ringan)<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Trismus ringan sampai sedang<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kekakuan umum: kaku kuduk, opistotonus, perut papan<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Tidak dijumpai disfagia atau ringan<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Tidak dijumpai kejang<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Tidak dijumpai gangguan respirasi<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l33 level1 lfo4; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">b.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Derajat II (tetanus sedang)<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Trismus sedang<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kekakuan jelas<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Dijumpai kejang rangsang, tidak ada kejang spontan<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Takipneu<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Disfagia ringan<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l33 level1 lfo4; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">c.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Derajat III (tetanus berat)<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Trismus berat<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Otot spastis, kejang spontan<<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Takipne, takikardia<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Serangan apne (apneic spell)<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Disfagia berat<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Aktivitas sistem autonom meningkat<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l33 level1 lfo4; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">d.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Derajat IV (stadium terminal), derajat III ditambah dengan<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Gangguan autonom berat<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hipertensi berat dan takikardi, atau<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hipotensi dan bradikardi<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l9 level1 lfo5; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hipertensi berat atau hipotensi berat<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Penatalaksanaan</span></b><br /> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><br /></span></b> <div style="text-indent: 0px;"> <span style="line-height: 120%; text-indent: -18pt;"><span style="font-family: arial, sans-serif;">1.<b> </b></span></span><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Antibiotik (penisilin prokain, ampisilin, tetrasiklin, metronidazol, eritromisi Bila terdapat sepsis/ pneumonia dapat ditambahkan sefalosporin</span></div> <div style="text-indent: 0px;"> <span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">2. Netralisasi toksi</span></div> <div style="text-indent: 0px;"> </div> <ul> <li><span style="font-family: arial, sans-serif; line-height: 19.2px; text-indent: -18pt;">Anti tetanus serum (ATS), dilakukan uji kulit lebih </span></li> <li><span style="font-family: arial, sans-serif; line-height: 19.2px; text-indent: -18pt;">Bila tersedia, dapat diberikan human tetanus immunoglobulin (HTIG)</span></li> </ul> <br /> <div style="text-indent: 0px;"> <span style="font-family: arial, sans-serif; line-height: 19.2px; text-indent: -24px;">3. Anti konvulsan (diazepam)</span></div> <div style="text-indent: 0px;"> <span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">4. Perawatan luka atau port d’entree dilakukan setelah diberi antitoksin dan anti-konvulsan </span><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Terapi</span></div> <div style="text-indent: 0px;"> </div> <ul> <li><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Bebaskan jalan </span></li> <li><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Hindarkan aspirasi dengan mengisap lendir perlahan-lahan dan memindah-mindahkan posisi </span></li> <li><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Pemberian </span></li> <li><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Perawatan dengan stimulasi </span></li> <li><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Pemberian cairan dan nutrisi adekuat, bila trismus berat dapat dipasang sonde </span></li> <li><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Bantuan napas pada tetanus berat atau tetanus </span></li> <li><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Pemantauan/monitoring kejang dan tanda penyulit</span></li> </ul> <b style="line-height: 120%;"><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Tetanus ringan dan </span></b><br /> <div style="text-indent: 0px;"> </div> <ul> <li><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Diberikan pengobatan tetanus dasar.</span></li> </ul> <b style="line-height: 120%;"><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Tetanus </span></b></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <ul> <li><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Terapi dasar </span></li> <li><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Perhatian khusus pada keadaan jalan napas (akibat kejang dan </span></li> <li><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Pemberian cairan parenteral, bila perlu nutrisi secara </span></li> </ul> <b style="line-height: 120%;"><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Tetanus </span></b></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <ul> <li><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Terapi dasar seperti di </span></li> <li><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Perawatan dilakukan di ICU, diperlukan intubasi dan </span></li> <li><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Keseimbangan cairan dimonitor secara </span></li> <li><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Apabila spasme sangat hebat, berikan pankuronium bromida 0,02 mg/kg IV, diikuti 0,05 mg/kg/kali, diberikan tiap 2-3 </span></li> <li><span style="font-family: arial, sans-serif; line-height: 120%; text-indent: -18pt;">Apabila terjadi aktivitas simpatis yang berlebihan, berikan bblocker seperti propranolol/a dan b blocker labetalol.</span></li> </ul> </div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pencegahan</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l27 level1 lfo9; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Imunisasi aktif Imunisasi dasar DPT diberikan tiga kali sejak usia 2 bulan dengan interval 4-6 minggu, ulangan pada umur 18 bulan dan 5 tahun.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l27 level1 lfo9; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pencegahan pada luka<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l24 level1 lfo10; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">a.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Luka dibersihkan, jaringan nekrotik dan benda asing dibuang.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l24 level1 lfo10; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">b.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Luka ringan dan bersih<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l10 level1 lfo11; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Imunisasi lengkap: tidak perlu ATS atau tetanus imunoglobulin<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l10 level1 lfo11; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Imunisasi tidak lengkap: imunisasi aktif DPT/DT.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l27 level1 lfo9; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">3.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Luka sedang/berat dan kotor<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l25 level1 lfo12; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Imunisasi (-)/tidak jelas: ATS 3000-5000 U, IV, tetanus imunoglobulin 250-500 U. Toksoid tetanus pada sisi lain.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l25 level1 lfo12; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">munisasi (+), lamanya sudah >5 tahun: ulangan toksoid, ATS 3000-5000 U, IV, tetanus imunoglobulin 250-500 U.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoListParagraph" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level1 lfo1; text-indent: -18.0pt;"> <!--[if !supportLists]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">    </span></span></b><!--[endif]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Astrofi</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhOXwD9pILdrsDuVFeaBiEmS5IFWSRtcSShqbgkfQphsUc0bWWF8z3UrZcAdMHh-cP__cUg98skuG_WBGcRqGQg8a6STt0OwYmasfJm6cpZJkMPJLgXTMoZ_BDTgj8SfpMogUzwHlWsY3Pd/s1600/atrofi.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhOXwD9pILdrsDuVFeaBiEmS5IFWSRtcSShqbgkfQphsUc0bWWF8z3UrZcAdMHh-cP__cUg98skuG_WBGcRqGQg8a6STt0OwYmasfJm6cpZJkMPJLgXTMoZ_BDTgj8SfpMogUzwHlWsY3Pd/s1600/atrofi.jpeg" /></a></div> <div align="center" class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: center;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Atropi atau penyusutan disebut juga atrofi adalah fenomena yang bilangan dan zat sel masing-masing berkurangan dan mengecil, menyebabkan tisu dan organ yang terlibat mengerut. Atropi berkemungkinan berlaku akibat tindak balas adaptasi terhadap tekanan sehingga isi padu sel mengerut dan seterusnya keperluan tenaga diturunkan ke tahap yang minimum. penyebab lain yang mungkin ialah sel kurang digunakan seperti dalam otot rangka. selain penurunan keperluan sesuatu fungsi, kekurangan bekalan oksigen atau nutrisin, inflamasi kronik dan proses penuaan juga menyumbang kepada fenomena atropi. Begitu juga dengan gangguan isyarat dalam tindakan hormon berakibat fungsi sesuatu organ berkurangan.<br /> PENYEBAB<br /> Jika suatu otot tidak digunakan, kandungan aktin dan miosinnya akan berkurang, serat – seratnya menjadi lebih kecil, dan dengan demikian otot tersebut berkurang massanya (atrofi) dan menjadi tidak lemah. Atrofi otot dapat terjadi melalui dua cara. Disuse atrophy terjadi jika suatu otot tidak digunakan dalam jangka waktu lama. Atrofi denervasi terjadi setelah pasokkan saraf ke suatu otot terputus. Apabila otot dirangsang secara listrik sampai persarafan dapat dipulihkan, seperti pada regenerasi saraf perifer yang terputus, atrofi dapat dihilangkan tetapi tidak dapat dicegah seluruhnya. Aktfitas kontraktil itu sendiri jelas berperan penting dalam mencegah atrofi; namun, factor – factor yang belum sepenuhnya dipahami yang dikeluarkan dari ujung – ujung saraf aktif, yang mungkin terkemas bersama dengan vesikel Ach, tampaknya berperan dalam integritas dan pertumbuhan jaringan otot.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Apabila suatu otot mengalami kerusakkan, dapat terjadi perbaikkan secara terbatas, walaupun sel – sel otot tidak dapat membelah diri secara mitosis untuk menggantikan sel – sel yang hilang. Di dekat permukaan otot terdapat populasi kecil sel – sel yang tidak berdiferensiasi ( seperti yang dijumpai pada massa perkembangan mudigah ), yaitu mioblas. Sewaktu sebuah serat otot rusak, sekelompok mioblas melakukan fusi untuk mengganti otot tersebut dengan membentuk sebuah sel besar berinti banyak yang segera mulai mensintesis dan menyusun perangkat intrasel khas untuk otot. Pada cedera luas, mekanisme yang terbatas ini tidak cukup untuk mengganti semua serat yang hilang.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt;"> <br /></div> <div class="MsoListParagraph" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level1 lfo1; text-indent: -18.0pt;"> <!--[if !supportLists]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">3.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">    </span></span></b><!--[endif]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Distrofi</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"> <b>Otot</b><o:p></o:p></span></div> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfRJB72av8Mh7eDRnj_Wm58mFYwx9FO7o4I_hQ2esJUEQRp2oBHryqHZc-nN8Boha2_ATrudcJxGdQhLCmxIasXCM7Rg2BzCpCn_zdnZul0XgsxOQfWRb5-OjwdhSTuMaqpdKkcktYsU8u/s1600/distrofiototduchenne.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="289" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfRJB72av8Mh7eDRnj_Wm58mFYwx9FO7o4I_hQ2esJUEQRp2oBHryqHZc-nN8Boha2_ATrudcJxGdQhLCmxIasXCM7Rg2BzCpCn_zdnZul0XgsxOQfWRb5-OjwdhSTuMaqpdKkcktYsU8u/s1600/distrofiototduchenne.jpg" width="320" /></a></div> <div align="center" class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: center;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Distrofi otot atau Muscular dystrophy (MD) adalah penyakit otot turunan di mana serat-serat otot sangat rentan rusak. Otot, terutama otot-otot sukarela, menjadi semakin lemah. Pada tahap akhir distrofi otot, lemak dan jaringan ikat sering menggantikan serat otot. Beberapa jenis distrofi otot mempengaruhi otot-otot jantung, otot tak sadar dan organ lainnya.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Gejala</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><br /> Tanda dan gejala bervariasi sesuai dengan jenis distrofi otot. Secara umum, gejala distrofi otot antara lain: kelemahan otot, kelumpuhan, menghasilkan fiksasi (kontraktur) otot di sekitar sendi dan minimnya mobilitas.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Banyak tanda-tanda dan gejala spesifik yang bervariasi dari antara jenis-jenis MD. Setiap jenis MD berbeda di masa awal terjangkiti, gejala muncul pada daerah yang mengalami distrofi otot.<br /> <br /> <b>Perawatan</b><br /> Saat ini tidak ada obat untuk segala bentuk distrofi otot. Pengobatan saat ini dirancang untuk membantu mencegah atau mengurangi kelainan bentuk pada persendian dan tulang belakang dan untuk memungkinkan orang dengan MD untuk tetap bergerak selama mungkin. Perawatan dapat mencakup berbagai jenis terapi fisik, obat-obatan, alat bantu dan pembedahan.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Distrofi Otot Duchenne & Becker adalah penyakit yang menyebabkan kelemahan pada otot-otot yang dekat dengan batang tubuh. <o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Penyebab</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kelainan gen yang menyebabkan distrofi otot Duchenne berbeda dengan kelainan gen yang menyebabkan distrofi otot Becker, tetapi keduanya terjadi pada gen yang sama.<br /> Gen ini bersifat <i>resesif</i> dan dibawa oleh <i>kromosom X</i>. <o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Seorang wanita bisa membawa gen ini tetapi tidak menderita penyakitnya karena kromosom X yang normal dapat mengkompensasi kelainan gen dari kromosom X yang lainnya.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Setiap laki-laki yang menerima kromosom X yang cacat akan menderita penyakit ini.  Anak laki-laki yang menderita distrofi otot Duchenne mengalami kekurangan protein otot yang penting, yaitu <i>distrofin</i>, yang diduga berperan dalam mempertahankan struktur sel-sel otot. 20-30 di antara 100.000 bayi laki-laki yang lahir, menderita distrofi otot Duchenne. <o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Anak laki-laki yang menderita distrofi otot Becker menghasilkan distrofin tetapi ukurannya terlalu besar dan tidak berfungsi sebagaimana mestinya.<br /> Penyakit ini terjadi pada 3 dari setiap 100.000 anak laki-laki. <o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoListParagraph" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level1 lfo1; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">4.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">    </span></span></b><!--[endif]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hernia Abdominal/Hernis Abdominal<o:p></o:p></span></b></div> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEieKFgA2zAPhC0J9G4Py10b2_tz7RrmBRV_dHP8eBEgmTX_SwSPcB-P0l451mjVhpjHp0yxOpK6s800nrk5Yt5uWduNt7JIuXpOm-WfPHRhbARzurZGGyxbz-8ypeNxNbvqJornHQIx2dpm/s1600/hernia.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEieKFgA2zAPhC0J9G4Py10b2_tz7RrmBRV_dHP8eBEgmTX_SwSPcB-P0l451mjVhpjHp0yxOpK6s800nrk5Yt5uWduNt7JIuXpOm-WfPHRhbARzurZGGyxbz-8ypeNxNbvqJornHQIx2dpm/s1600/hernia.jpg" width="294" /></a></div> <div align="center" class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: center;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">DEFENISI</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hernia (burut) adalah penonjolan abnormal dari suatu viscus ke luar dari rongga yang normal. Viscus adalah berbagai organ interior besar yang terdapat dalam rongga tubuh yang besar khususnya di abdomen. Cincin hernia adalah cincin dari jaringan muskuler (terbuka) melalui dimana viscus menonjol. Pembukaan dari dinding rongga dimana viscus menonjol mungkin bervariasi ukurannya dan mungkin congenital atau didapat. Penonjolan dari viscus mungkin intermitten atau terus menerus, tergantung dari jenis dan beratnya hernia. Walaupun istilah ini mungkin dipakai pada berbagai bagian tubuh (misalnya hernia diskus intervertebral, hernia cerebral, umumnya mengarah pada penonjolan suatu viskus abdomen dari rongga abdomen.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">KLASIFIKASI</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hernia abdominal mungkin diklasifikasikan berdasarkan lokasi anatomi dan beratnya protrusi. Daerah yang paling sering muncul adalah hiatal (diafragma), insisional (ventral), umbilical, inguinal (langsung atau tidak langsung), atau femoral.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Tingkat beratnya penyakit mungkin digambarkan dengan satu dari empat istilah : reducible (dapat kembali), irreducible, inkarserata atau strangulata. Pada hernia reducible, penonjolan dari viskus akan menyusut ke dalam abdomen secara mekanik jika penderita supinasi, atau secara manual dapat dikembalikan dengan menekan massa kembali ke rongga. Hernia irreducible tidak dapat dikembalikan ke dalam rongga abdomen dengan cara apapun. Hernia inkarserata adalah keadaan dimana viskus yang menonjool bersifat irreducible dan obstruksi. Keadaan ini akan berakibat tersumbatnya aliran darah dari dan ke viskus, dan hernia menjadi strangulata. Kedua keadaan terakhir ini adalah serius dan perbedaan antara keduanya susah.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hernia inkarserata dan strangulasi dianggap sebagai emergensi bedah karena viskus akan menjadi tersumbat secara akut, dan jika suplai darah tidak terpenuhi, maka dengan cepat menjadi nekrosis dan gangreng. Usus atau kandung kencing pada hernia femoral, adalah organ yang mungkin terdapat dalam kantong hernia dan oleh karenanya mengalami proses ini. Hernia inguinal indirek, umbilikal dan femoral adalah yang lebih sering mengalami strangulasi dari yang lain karena kantongnya mempunyai leher yang lebih kecil dan cenderung dikelilingi oleh jaringan cincin yang kaku, kebalikannya dari hernia inguinal direk, yang cenderung mempunyai leher yang lebih luas. Juga, perlengketan mungkin timbul antara kantong dan isinya dan menyebabkan hernia irreducible atau inkarserata.<br /> <br /> <b>ETIOLOGI DAN PATOFISIOLOGI</b><o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hernia abdominalis disebabkan oleh kombinasi dari kelemahan atau defek dari dinding otot dan peningkatan tekanan intra abdominal, defek dari dinding otot ini mungkin timbul dari kelainan congenital termasuk gangguan dari jaringan kolagen dan integritas otot, atau dari intervensi bedah sebelumnya, kelemahan dinding otot yang didapat mungkin terjadi sebagai akibat dari trauma atau dengan proses ketuaan.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Tekanan intraabdominal dapat meningkat oleh sejumlah keadaan lingkungan dan keadaan patologis tertentu. Meliputi kehamilan, obesitas, kerja keras (Manuver Valsava) seperti konstipasi lama, penekanan yang dikaitkan dengan tekhnik yang salah ketika mengangkat beban atau barang yang berat, mendorong atau menarik, asites, batuk kronis, dan pembesaran tumor atau lesi, tekanan intraabdominal yang meningkat, mungkin tidak akan menyebabkan hernia jika tidak disertai dengan kelemahan dinding otot.<br /> <br /> <b>TYPE HERNIA</b><o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l18 level1 lfo13; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hiatal Hernia<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hiatal hernia adalah penonjolan dari bagian lambung melalui hiatus dari diafragma dan masuk ke dalam rongga thoraks, ada 2 jenis hiatal hernia:<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l12 level1 lfo14; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">a.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Sliding hernia, lambung dan persambungan antara usofagus dan lambung tergelincir masuk ke dada (yang paling umum).<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l12 level1 lfo14; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">b.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Paraesofagal hernia (rolling hernia) – bagian dari kurvatura mayor dari lambung masuk melalui defek diafragma.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Patofisiologi/etiologi<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l14 level1 lfo15; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">a.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kelemahan otot karena proses ketuaan atau keadaan lain, seperti karsinoma esophagus atau trauma, atau setelah prosedur bedah tertentu.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Manifestasi klinik<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l30 level1 lfo16; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">a.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Mungkin tidak bergejala.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l30 level1 lfo16; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">b.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Heartburn/perasaan panas dalam perut (dengan atau tanpa regurgitasi dari isi lambung ke mulut)<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l30 level1 lfo16; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">c.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Disfagia; nyeri dada.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Evaluasi diagnostic<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l2 level1 lfo17; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">a.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pemeriksaan barium dari hernia sepanjang esophagus.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l2 level1 lfo17; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">b.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pemeriksaan endoskopi melihat defek. Penanganan : Tinggikan bagian kepala tempat tidur (15-20 cm) / 6 – 8 inci untuk mengurangi refluks pada malam hari untuk menetralisir asam lambung. Therapi antasida <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l2 level1 lfo17; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">c.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Histamin-2 reseptor antagonis (cimetidin, rantidin) – jika pasien menjalani esofagitis.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l2 level1 lfo17; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">d.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Perbaikan bedah dari hernia jika gejala memberat.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l2 level1 lfo17; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">e.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Komplikasi, terbatasnya aliran darah. Inkarserata dari bagian lambung dalam rongga dada. Tindakan keperawatan /Pembelajaran pasien :<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l31 level1 lfo18; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Anjurkan pasien pencegahan dari refluks isi lambung ke dalam esophagus dengan :<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l23 level1 lfo19; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Makan sedikit-sedikit.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l23 level1 lfo19; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Menghindari rangsangan sekresi lambung dengan menghindari kafein dan alcohol.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l23 level1 lfo19; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">3)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Menghentikan merokok.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l23 level1 lfo19; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">4)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Menghindari makanan berlemak – meningkatkan refluks dan menghambat pengosongan lambung.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l23 level1 lfo19; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">5)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Menghindari berbaring terlentang paling tidak 1 jam setelah makan.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l23 level1 lfo19; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">6)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Menurunkan berat, jika obesitas.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l23 level1 lfo19; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">7)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Menghindari menekuk pinggang dan atau memakai pakaian yang ketat.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l31 level1 lfo18; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Nasehati pasien untuk melaporkan ke fasilitas kesehatan segera jika timbul nyeri dada akut – mungkin mengindikasikan inkarserasi dari hernia paraesofagal besar.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l18 level1 lfo13; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hernia Abdominalis</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Manifestasi klinik<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l13 level1 lfo20; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">a.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Penonjolan diatas daerah hernia jika pasien berdiri atau menarik, dan menghilang jika terlentang.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l13 level1 lfo20; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">b.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hernia cenderung bertambah ukurannya dan muncul kembali dengan tekanan intraabdominal.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l13 level1 lfo20; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">c.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hernia strangulasi timbul disertai nyeri, muntah, oedema dari kantong hernia, tanda-tanda iritasi peritoneum dari abdominal bawah, demam.<br /> Evaluasi diagnostic Didasarkan pada manifestasi klinik :<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l31 level1 lfo18; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Abdominal X rays – menampakkan keadaan abnormal dari tinggi gas dalam perut.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l31 level1 lfo18; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pemeriksaan laboratorium (darah lengkap, elektrolit) – mungkin menunjukkan heokonsentrasi (peningkatan hematokrit), dehidrasi (peningkatan atau penurunan sodium), dan peningkatan WBC (eritrosit).<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 108.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l35 level1 lfo21; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "wingdings"; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">  </span></span><!--[endif]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Penanganan</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 108.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Mekanik (hanya pada hernia reducible)<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 126.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l21 level1 lfo22; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pembebat dipasang dengan bantalan dan ikat pinggang yang dipasang dengan pas diatas hernia untuk mencegah isi abdomen masuk ke kantong hernia. Tidak mengobati hernia; digunakan hanya jika pasien tidak/bukan calon bedah.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 126.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l21 level1 lfo22; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hernia parastomal seringkali ditangani dengan ikat pinggang yang menyokong hernia dengan Velcro dan ditempatkan di sekitar system kantong ostomy (hampir sama dengan pembebat).<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l31 level1 lfo18; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "symbol"; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">         </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pembedahan – dilakukan untuk memperbaiki hernia sebelum timbul strangulasi, yang kemudian menjadi keadaan emergensi.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l1 level1 lfo23; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Herniorafi – pengangkatan dari kantong hernia, isinya dikembalikan ke dalam abdomen; lapisan otot dan fascia dijahit. Herniorafi laparoskopi mungkin, seringkali dilakukan pada pasien rawat jalan.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l1 level1 lfo23; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hernioplasti meliputi memperkuat jahitan (seringkali dengan mesh/alat untuk menautkan) untuk memperbaiki hernia yang luas.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l1 level1 lfo23; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">3)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hernia strangulasi memerlukan reseksi dari usus yang iskemia disamping memperbaiki hernia.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Komplikasi<o:p></o:p></span></b></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Obstruksi usus.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pengkajian keperawatan<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l15 level1 lfo24; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Menanyakan kepada pasien apakah hernia memebesar dan tidak menyenangkan.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l15 level1 lfo24; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">tentukan apakah pasien memperlihatkan tanda dan gejala strangulasi, seperti distensi, demam, mual dan muntah. <o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Diagnosa keperawatan<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo25; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Nyeri berhubungan dengan penonjolan hernia (mekanik).<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo25; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Nyeri berhubungan dengan prosedur pembedahan.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo25; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">3)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Resiko infeksi berhubungan dengan prosedur emergensi pada hernia strangulasi dan inkarserata.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 54.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l3 level1 lfo25; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">4)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Intervensi keperawatan :<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l26 level1 lfo26; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">a.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Memberi rasa nyaman.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo27; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pasang pembebat atau ikat pinggang pada pasien jika hernia bersifat reduce (dapat kembali) jika dianjurkan.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo27; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Posisi trendelenburg mungkin mengurangi tekanan pada hernia, jika memungkinkan.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo27; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">3)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Menekankan pada pasien untuk memakai pembebat di dalam pakaian dan memasang sebelum bangun dari tempat tidur jika hernia bersifat reduce (dapat kembali).<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo27; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">4)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Evaluasi tanda dan gejala hernia inkarserata atau strangulasi.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l6 level1 lfo27; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">5)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pasang NGT, jika diindikasikan, untuk menghilangkan penekanan pada kantong hernia.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l26 level1 lfo26; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">b.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Menghilangkan nyeri post operasi.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo28; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Anjurkan pasien membelat daerah insisi dengan tangan atau bantal jika batuk untuk mengurangi nyeri dan melindungi lokasi dari peningkatan tekanan intraabdominal.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo28; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Berikan analgetik sesuai anjuran.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo28; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">3)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Ajarkan tentang istirahat, pemberian es, dan elevasi skrotum sebagai tindakan yang dilakukan untuk mengurangi edema skrotum atau pembengkakan setelah perbaikan dari hernia inguinal.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo28; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">4)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Ajarkan ambulasi segera setelah diperbolehkan.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l4 level1 lfo28; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">5)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Nasehati pasien bahwa kesukaran dalam berkemih setelah pembedahan adalah hal yang umum terjadi; meningkatkan eliminasi untuk menghindari rasa tidak nyaman dan memasang catheter jika diperlukan.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l26 level1 lfo26; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">c.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pencegahan infeksi<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l22 level1 lfo29; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Periksa pembalut drain dan insisi adanya kemerahan dan pembengkakan.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l22 level1 lfo29; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Monitor tanda dan gejala infeksi lain; demam, dingin, malaise dan keringat berlebihan.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l22 level1 lfo29; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">3)<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Berikan antibiotik, jika diperlukan.<br /> Pembelajaran pasien/memelihara kesehatan<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 108.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l7 level1 lfo30; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Nasehati bahwa nyeri dan pembengkakan skrotum mungkin timbul 24 – 48 jam setelah pembedahan pada hernia inguinal.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 108.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l7 level1 lfo30; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Ajarkan untuk memonitor sendiri tanda-tanda infeksi : nyeri, perembesan dari insisi, peningkatan suhu, juga kesukaran yang terus menerus dalam buang air.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 108.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l7 level1 lfo30; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">3.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">menginformasikan bahwa mengangkat beban harus dihindari selama 4 – 6 minggu. Atletik dan penggunaan tenaga yang berlebihan dihindari selama 8 sampai dengan 12 minggu post operasi, setiap pemberian istruksi.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 90.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Evaluasi<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 108.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l19 level1 lfo31; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hernia yang dapat dihilangkan secara efektif dengan pembebat atau ikat pinggang; pasien merasa nyaman ; tidak ada gejala dan infeksi.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 108.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l19 level1 lfo31; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kebutuhan analgesik minimal; tidak timbul edema, ambulasi.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 108.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l19 level1 lfo31; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">3.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Tidak demam, luka bersih dan kering.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b style="line-height: 120%; text-align: left; text-indent: -18pt;"><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">5.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">    </span></span></b><b style="line-height: 120%; text-align: left; text-indent: -18pt;"><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kaku</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"> <b>Leher / Leher Kaku / Stiff</b></span></div> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiaxnPlprVzgJZwoxLNNg5ptScI-pJh4OTDXJoLKM29FKBkwjwDoMggCHPxP4mcwAbI5yMW4DlnBL-qmtkf50Q5aZ2jqv1CkQ4lZr10h-yP1jrHkQPIGAzDLMCwIhWppnKmLp18zb3UGli8/s1600/stiff.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiaxnPlprVzgJZwoxLNNg5ptScI-pJh4OTDXJoLKM29FKBkwjwDoMggCHPxP4mcwAbI5yMW4DlnBL-qmtkf50Q5aZ2jqv1CkQ4lZr10h-yP1jrHkQPIGAzDLMCwIhWppnKmLp18zb3UGli8/s1600/stiff.jpeg" /></a></div> <div align="center" class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: center;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kaku leher adalah suatu kelainan yang terjadi karena otot yang radang / peradangan otot trapesius leher karena salah gerakan atau adanya hentakan pada leher serta menyebabkan rasa nyeri dan kaku pada leher seseorang.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt;"> <b><span style="font-family: "arial" , "sans-serif"; font-size: 14.0pt; line-height: 120%; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: "Times New Roman";">Kelainan pada Tulang</span></b><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></b></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt;"> <br /></div> <div class="MsoListParagraph" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo32; text-indent: -18.0pt;"> <!--[if !supportLists]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">    </span></span></b><!--[endif]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Osteoporosis<o:p></o:p></span></b></div> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjij3WMQJi9RsSUwq8c0YrZbClupTVJTbeEYS8s78RdNqL4ewwghLF6aFc1lTceR6WPFVgzExl2FsVAWd23LBFbhlBFQck_h7X4MhBcyv_3Ty-H73kG-NgzkQTbobo2Yjb1VJsGZM1BN6zw/s1600/osteoporosis.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjij3WMQJi9RsSUwq8c0YrZbClupTVJTbeEYS8s78RdNqL4ewwghLF6aFc1lTceR6WPFVgzExl2FsVAWd23LBFbhlBFQck_h7X4MhBcyv_3Ty-H73kG-NgzkQTbobo2Yjb1VJsGZM1BN6zw/s1600/osteoporosis.jpeg" /></a></div> <div align="center" class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: center;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Osteoporosis adalah penurunan densitas tulang, kerusakan arsitektur tulang, dan meluasnya kerapuhan tulang sehingga menurunkan kekuatan tulang. Padahal tulang adalah jaringan keras yang melindungi bagian vital tubuh dan membuat manusia dapat tegak, berjalan, dan mengangkat beban berat. jadi bagaimana bisa beraktivitas jika tulang kita rapuh.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Osteoporosis atau keropos tulang umunya lebih rentan diderita pada kaum wanita dibanding Pria. Berdasarkan penelitian di Amerika serikat, lebih dari 1,5 juta penderita patah tulang karena osteoporosis tiap tahunnya diderita oleh kaum wanita. karena wanita akan mengalami Menopause yang dapat menurunkan massa tulang, sehingga selama Menopause massa tulang dapat turun drastis kurang lebih sekitar 10% dari yang normal sehingga dapat menyebabkan kerapuhan atau keropos tulang. Kondisi rendahnya massa tulang ini bisanya baru disadari setelah seseorang mengalami patah tulang, umumnya terjadi pada tulang pinggul, tulang belakang atau tulang pergelangan tangan.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kekuatan massa tulang seseorang tergantung dari ukuran dan kepadatan tulang itu sendiri. kepadatan tulang sanagt tergantung pada jumlah asupan calsium, Phospor, dan mineral lainnya yang dibutuhkan oleh tulang. ketika tulang mengalami kekurangan asupan mineral, maka kepadatan tulang akan berkurang, sehingga menyebabkan kerapuhan dan mengalami perubahan struktur.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Para Ilmuwan telah banyak belajar dan meneliti penyebab terjadinya kerapuhan pada tulang, ternyata berkaitan dengan proses pembentukan tulang dalam tubuh. Tulang secara berkesinambungan mengalami proses pergantian atau regenerasi. Secara alamiah regenerasi sel tulang terjadi sekitar 2 sampai 3 bulan, proses ini akan meningkatkan massa tulang yang berfungsi menguatkan tulang kita. Namun ketika umur menginjak 35-40 tahun proses regenerasi sel perlahan-lahan menurun dan dapat menurunkan massa kepadatan tulang, sehingga dapat meningkatkan resiko osteoporosis atau keropos tulang.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Selain itu kurangnya asupan vitamin D dan kalsium,Phospor dan mineral lainnya dalam makanan, kondisi tubuh yang terlalu stress, gangguan kelenjar endokrin, asupan obat-obatan yang mengandung cortikosteroid juga dapat meningkatkan resiko terkena Osteoporosis.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Beberapa Faktor yang dapat meningkatkan Osteoporosis atau keropos tulang, antara lain:<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l29 level1 lfo33; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">a.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">JENIS KELAMIN<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Resiko patah tulang yang disebabkan karena keropos tulang akan lebih tinggi diderita kaum wanita dibanding kaum pria. Hal ini disebabkan karena faktor hormonal dalam tubuh wanita yang mengalami menstruasi, melahirkan dan menjelang Menopause dapat menurunkan massa kepadatan tulang dan menurunkan proses regenerasi sel tulang. pada saat wanita mengalami Menopause, kadar estrogen yang menurun drastis dapat menyebabkan tulang rapuh karena penyerapan mineral yang dibutuhkan tulang akan berkurang. namun tidak menutup kemungkinan pria juga mengalami osteoporosis, hal ini dapat terjadi pada pria umur 65 tahun keatas, jika kadar hormon testosteron dalam tubuhnya menurun, juga dapat meningkatkan resiko terkena osteoporosis.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l29 level1 lfo33; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">b.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">USIA<br /> Faktor usia juga sangat menentukan kekuatan tulang anda. Semakin tinggi resiko kita mengidap osteoporosis dan tulang kita juga semakin lemah, karena regenerasi sel tulang pun berjalan secara perlahan.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l29 level1 lfo33; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">c.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">MAKANAN ATAU MINUMAN<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">makanan juga merupakan faktor penentu kekuatan tulang kita. jika makanan kurang vitamin dan mineral yang dibutuhkan oleh tulang seperti kalsium, phospor, vitamin-D. seperti suus, daging,keju, dan ikan, juga dapat menyebabkan osteoporosis. selain itu minuman yang mengandung soda, alkohol juga dapat menyebabkan osteoporosis, karena kadar soda dan alkohol dalam tubuh dapat menghambat penyerapan calsium dalam tulang dan dapat mengganggu metabolisme vitamin-D dalam hati. dan lainya.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l29 level1 lfo33; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">d.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">OBAT-OBATAN<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Mengkonsumsi obat-obatan dalam jangka waktu yang panjang juga dapat menyebabkan resiko keropos tulang. Beberapa obat-obatan yang menyebabkan keropos tulang, yaitu obat yang mengandung kortikosteroid, obat diuretic, obat antacid, obat antikanker dan lainnya. untuk pencegahannya dari dini kita harus meningkatkan asupan vitamin dan mineral dalam tubuh kita dengan mengkonsumsi makanan kesehatan yang baik untuk tubuh kita.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">GEJALA :</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Patah tulang belakang, rasa nyeri, mulai dari ringan, sedang dan berat sampai tidak bisa bangun. Patah tulang sendi pinggul selain nyeri hebat, juga tidak dapat berjalan selama lebih dari 6 bulan.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">PENCEGAHANNYA :</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l35 level1 lfo21; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "wingdings"; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">  </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Perbaiki gizi pada makanan dan minuman yang mencakupi gizi lima sempurna yang mengandung cukup kalsium untuk pembentukan kerangka tulang yang kuat.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l35 level1 lfo21; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "wingdings"; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">  </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Olah raga yang teratur menjamin tulang dan otot tetap kuat<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l35 level1 lfo21; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "wingdings"; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">  </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Usahakan untuk mendapatkan sinar matahari selama 30 menit dalam seminggu, untuk dapat membentuk struktur tulang yang kuat<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l35 level1 lfo21; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "wingdings"; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;">ü<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">  </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hindari makanan dan minuman yang dapat menyebabkan hilangnya kalsium dari tulang seperti: daging berlemak,kopi, minuman keras, garam, obat-obatan dan rokok.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoListParagraph" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo32; text-indent: -18.0pt;"> <!--[if !supportLists]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">    </span></span></b><!--[endif]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Polio<o:p></o:p></span></b></div> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj2hBcCUfUVcP4G8q4NK_1STmgkplrtsnr3SzFJfjBaR_bX5O4vVt2kbhRgZj-mMbvaUwfgE40BplAFlmzDbnroLdPB80geYX7N3yjpgHuc9PXvDJno_rBZFmG7eump9eNQe_EkQTrYY8Wq/s1600/Polio.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj2hBcCUfUVcP4G8q4NK_1STmgkplrtsnr3SzFJfjBaR_bX5O4vVt2kbhRgZj-mMbvaUwfgE40BplAFlmzDbnroLdPB80geYX7N3yjpgHuc9PXvDJno_rBZFmG7eump9eNQe_EkQTrYY8Wq/s1600/Polio.jpeg" /></a></div> <div align="center" class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: center;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Polio adalah penyakit menular yang dikategorikan sebagai penyakit peradaban. Polio menular melalui kontak antarmanusia. Polio dapat menyebar luas diam-diam karena sebagian besar penderita yang terinfeksi poliovirus tidak memiliki gejala sehingga tidak tahu kalau mereka sendiri sedang terjangkit. Virus masuk ke dalam tubuh melalui mulut ketika seseorang memakan makanan atau minuman yang terkontaminasi feses. Setelah seseorang terkena infeksi, virus akan keluar melalui feses selama beberapa minggu dan saat itulah dapat terjadi penularan virus.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Poliomyelitis atau Polio, adalah penyakit paralisis atau lumpuh yang disebabkan oleh virus. Agen pembawa penyakit ini, sebuah virus yang dinamakan poliovirus (PV), masuk ke tubuh melalui mulut, mengifeksi saluran usus. Virus ini dapat memasuki aliran darah dan mengalir ke sistem saraf pusat menyebabkan melemahnya otot dan kadang kelumpuhan. Kata Polio sendiri berasal dari bahasa Yunani yaitu πολιομυελίτις, atau bentuknya yang lebih mutakhir πολιομυελίτιδα, dari πολιός "abu-abu" dan μυελός "bercak". Virus Polio termasuk genus enteroviorus, famili Picornavirus. Bentuknya adalah ikosahedral tanpa sampul dengan genome RNA single stranded messenger molecule. Single RNA ini membentuk hampir 30 persen dari virion dan sisanya terdiri dari 4 protein besar (VP1-4) dan satu protein kecil (Vpg). Polio adalah penyakit menular yang dikategorikan sebagai penyakit peradaban. Polio menular melalui kontak antarmanusia. Virus masuk ke dalam tubuh melalui mulut ketika seseorang memakan makanan atau minuman yang terkontaminasi feses. Poliovirus adalah virus RNA kecil yang terdiri atas tiga strain berbeda dan amat menular. Virus akan menyerang sistem saraf dan kelumpuhan dapat terjadi dalam hitungan jam. Polio menyerang tanpa mengenal usia, lima puluh persen kasus terjadi pada anak berusia antara 3 hingga 5 tahun. Penyebab penyakit polio terdiri atas tiga strain yaitu strain 1 (brunhilde) strain 2 (lanzig), dan strain 3 (Leon). Strain 1 adalah yang paling paralitogenik atau yang paling ganas dan sering kali menyebabkan kejadian luar biasa atau wabah. Strain ini sering ditemukan di Sukabumi. Sedangkan Strain 2 adalah yang paling jinak<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">JENIS – JENIS POLIO<o:p></o:p></span></b></div> <div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l34 level1 lfo34; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Polio non-paralisis<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Polio non-paralisis menyebabkan demam, muntah, sakit perut, lesu, dan sensitif. Terjadi kram otot pada leher dan punggung, otot terasa lembek jika disentuh.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l34 level1 lfo34; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Polio paralisis spinal<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Strain poliovirus ini menyerang saraf tulang belakang, menghancurkan sel tanduk anterior yang mengontrol pergerakan pada batang tubuh dan otot tungkai. Meskipun strain ini dapat menyebabkan kelumpuhan permanen, kurang dari satu penderita dari 200 penderita akan mengalami kelumpuhan. Kelumpuhan paling sering ditemukan terjadi pada kaki. Setelah virus polio menyerang usus, virus ini akan diserap oleh pembulu darah kapiler pada dinding usus dan diangkut seluruh tubuh. Virus Polio menyerang saraf tulang belakang dan syaraf motorik — yang mengontrol gerakan fisik. Pada periode inilah muncul gejala seperti flu. Namun, pada penderita yang tidak memiliki kekebalan atau belum divaksinasi, virus ini biasanya akan menyerang seluruh bagian batang saraf tulang belakang dan batang otak. Infeksi ini akan mempengaruhi sistem saraf pusat — menyebar sepanjang serabut saraf. Seiring dengan berkembang biaknya virus dalam sistem saraf pusat, virus akan menghancurkan syaraf motorik. Syaraf motorik tidak memiliki kemampuan regenerasi dan otot yang berhubungan dengannya tidak akan bereaksi terhadap perintah dari sistem saraf pusat. Kelumpuhan pada kaki menyebabkan tungkai menjadi lemas — kondisi ini disebut acute flaccid paralysis (AFP). Infeksi parah pada sistem saraf pusat dapat menyebabkan kelumpuhan pada batang tubuh dan otot pada toraks (dada) dan abdomen (perut), disebut quadriplegia.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l34 level1 lfo34; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">3.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Polio bulbar<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Polio jenis ini disebabkan oleh tidak adanya kekebalan alami sehingga batang otak ikut terserang. Batang otak mengandung syaraf motorik yang mengatur pernapasan dan saraf kranial, yang mengirim sinyal ke berbagai syaraf yang mengontrol pergerakan bola mata; saraf trigeminal dan saraf muka yang berhubungan dengan pipi, kelenjar air mata, gusi, dan otot muka; saraf auditori yang mengatur pendengaran; saraf glossofaringeal yang membantu proses menelan dan berbagai fungsi di kerongkongan; pergerakan lidah dan rasa; dan saraf yang mengirim sinyal ke jantung, usus, paru-paru, dan saraf tambahan yang mengatur pergerakan leher. Tanpa alat bantu pernapasan, polio bulbar dapat menyebabkan kematian. Lima hingga sepuluh persen penderita yang menderita polio bulbar akan meninggal ketika otot pernapasan mereka tidak dapat bekerja. Kematian biasanya terjadi setelah terjadi kerusakan pada saraf kranial yang bertugas mengirim ‘perintah bernapas’ ke paru-paru. Penderita juga dapat meninggal karena kerusakan pada fungsi penelanan; korban dapat ‘tenggelam’ dalam sekresinya sendiri kecuali dilakukan penyedotan atau diberi perlakuan trakeostomi untuk menyedot cairan yang disekresikan sebelum masuk ke dalam paru-paru. Namun trakesotomi juga sulit dilakukan apabila penderita telah menggunakan ‘paru-paru besi’ (iron lung). Alat ini membantu paru-paru yang lemah dengan cara menambah dan mengurangi tekanan udara di dalam tabung. Kalau tekanan udara ditambah, paru-paru akan mengempis, kalau tekanan udara dikurangi, paru-paru akan mengembang. Dengan demikian udara terpompa keluar masuk paru-paru. Infeksi yang jauh lebih parah pada otak dapat menyebabkan koma dan kematian. Tingkat kematian karena polio bulbar berkisar 25-75% tergantung usia penderita. Hingga saat ini, mereka yang bertahan hidup dari polio jenis ini harus hidup dengan paru-paru besi atau alat bantu pernapasan. Polio bulbar dan spinal sering menyerang bersamaan dan merupakan sub kelas dari polio paralisis. Polio paralisis tidak bersifat permanen. Penderita yang sembuh dapat memiliki fungsi tubuh yang mendekati normal.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">TANDA DAN GEJALA<o:p></o:p></span></b></div> <div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Suhu tubuh meningkat<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Sakit kepala disertai mual dan muntah<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kram pada otot leher dan punggung<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Otot terasa lembek jika disentuh<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kelumpuhan terjadi dalam 1 minggu permulaan sakit<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Terjadi kelimpuhan yang permanen<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">kaku kuduk dan punggung <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">kelemahan otot asimetrik <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">onsetnya cepat <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">segera berkembang menjadi kelumpuhan <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">lokasinya tergantung kepada bagian korda spinalis yang terkena <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">perasaan ganjil/aneh di daerah yang terkena (seperti tertusuk jarum) <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">peka terhadap sentuhan (sentuhan ringan bisa menimbulkan nyeri) <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">sulit untuk memulai proses berkemih <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">sembelit <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">perut kembung <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">gangguan menelan <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">nyeri otot <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">kejang otot, terutama otot betis, leher atau punggung <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">ngiler <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">gangguan pernafasan <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">rewel atau tidak dapat mengendalikan emosi <o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">refleks Babinski positif. <o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">VIRUS POLIO</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Ada tiga tipe virus: tipe 1, 2, dan 3. Tipe 1 adalah yang terganas dan umum terjadi. Tipe 2 tak pernah terdeteksi di seluruh dunia sejak 1999.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">SIKLUS HIDUP VIRUS POLIO<o:p></o:p></span></b></div> <div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l16 level1 lfo36; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Satu virus polio mendekati sebuah sel saraf melalui aliran darah.<b><o:p></o:p></b></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l16 level1 lfo36; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Reseptor-reseptor sel saraf menempel pada virus.<b><o:p></o:p></b></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l16 level1 lfo36; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">3.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Capsid (kulit protein) dari virus pecah untuk melepaskan RNA (materi genetik) ke dalam sel.<b><o:p></o:p></b></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l16 level1 lfo36; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">4.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">RNA polio bergerak menuju sebuah ribosom-stasiun perangkai protein pada sel.<b><o:p></o:p></b></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l16 level1 lfo36; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">5.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">RNA polio menduduki ribosom dan memaksanya untuk membuat lebih banyak RNA dan capsid polio.<b><o:p></o:p></b></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l16 level1 lfo36; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">6.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Capsid dan RNA polio yang baru bergabung untuk membentuk virus polio baru.<b><o:p></o:p></b></span></div> <div class="MsoListParagraphCxSpLast" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l16 level1 lfo36; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">7.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Sel inang membengkak dan meledak, melepaskan ribuan virus polio baru kembali ke aliran darah.<b><o:p></o:p></b></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Terdapat 3 pola dasar pada infeksi polio :<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l28 level1 lfo37; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">1.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Infeksi subklinis ( tanpa gejala atau berlangsung kurang dari 72 jam )<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Demam ringan<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Sakit kepala<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Tidak enak badan<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Nyeri tenggoriokkan<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Tenggorokkan tampak memerah<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Muntah<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l28 level1 lfo37; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">2.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">    </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Non paralitik ( gejala berlangsung 1-2 minggu)<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Demam sedang<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kaku kuduk<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Muntah<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Diare<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kelelahan yang luar biasa<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Rewel<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Nyeri atau kaku punggung, lengan , tungkai dan perut<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Ruam kulit atau luka dikulit yang terasa nyeri<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kekakuan otot<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Paralitik<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Demam timbul 5-7 hari sebelum gejala lainnya <o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Sakit kepala<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kaku kuduk dan punggung<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kelemahan otot asimetrik<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Onsetnya cepa<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Segera berkembang<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Lokasinya tergantung pada bagian korda spinalis yang terkena<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Peka terhadap sentuhan<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Sulit untuk memulai proses berkemih<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Sembelit<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Perut kembung<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Gangguan menelan<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Nyeri dan kejang otot<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">UPAYA PENCEGAHAN<o:p></o:p></span></b></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Ada beberapa langkah upaya pencegahan penyebaran penyakit polio ini, di antaranya adalah:<o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Eradikasi Polio<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Dalam World Health Assembly tahun 1988 yang diikuti oleh sebagian besar negara di seluruh penjuru dunia dibuat kesepakatan untuk melakukan Eradikasi Polio (ERAPO) tahun 2000, artinya dunia bebas polio tahun 2000. Program ERAPO yang pertama dilakukan adalah dengan melakukan cakupan imunisasi yang menyeluruh.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">PIN (Pekan Imunisasi Nasional)<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Selanjutnya, pemerintah mengadakan PIN pada tahun 1995, 1996 dan 1997. Imunisasi polio yang harus diberikan sesuai dengan rekomendasi WHO yaitu diberikan sejak lahir sebanyak 4 kali dengan interval 6-8 minggu. Kemudian diulang pada saat usia 1,5 tahun; 5 tahun; dan usia 15 tahun.Upaya imunisasi yang berulang ini tentu takkan menimbulkan dampak negatif. Bahkan merupakan satu-satunya program yang efisien dan efektif dalam pencegahan penyakit polio.<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpLast" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l5 level1 lfo32; text-indent: -18.0pt;"> <!--[if !supportLists]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">3.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">    </span></span></b><!--[endif]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Lordosis<o:p></o:p></span></b></div> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMj5mYRn5arVqXcAZzAQaWpJzl3RMV3rZvEEqI8uzMGTkWwvAcHuLAnq6WQmAJ0mpCrDSBPQ3oqeu47yRpVxKPpy76G0bmw7Rlf5ASNSW5-TfSpTn17tYcfRrUdOwDbEK7BHcabE0kuTao/s1600/lordosis.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMj5mYRn5arVqXcAZzAQaWpJzl3RMV3rZvEEqI8uzMGTkWwvAcHuLAnq6WQmAJ0mpCrDSBPQ3oqeu47yRpVxKPpy76G0bmw7Rlf5ASNSW5-TfSpTn17tYcfRrUdOwDbEK7BHcabE0kuTao/s1600/lordosis.jpg" width="274" /></a></div> <div align="center" class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: center;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Lordosis adalah salah satu bentuk kelainan tulang belakang dimana tulang cervical dan thorax melengkung ke arah depan sehingga penderita tampak seperti sedang membusungkan dada. Lordosis ini sering juga disebut swayback, saddle back.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Penyebab Lordosis <o:p></o:p></span></b></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Lordosis terjadi karena perbedaan ketebalan antara bagian depan dan belakang tulang belakang. Kelainan ini dapat terjadi karena ketegangan otot tulang punggung.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Gejala dan tanda klinis :<o:p></o:p></span></b></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Lordosis ini paling sering terlewatkan diantara ketiga bentuk kelainan tulang punggung. Bahkan lordosis ringan cenderung memberikan penampilan gagah. Namun penderita lordosis ini akan sering mengalami sakit pinggang.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pemeriksaan</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Sama dengan bentuk kelainan tulang pungung lainnya. Diagnosis ditegakkan berdasarkan penampilan fisik, pengukuran, dan foto x ray tulang belakang.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Penatalaksanaan</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoListParagraph" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Penatalaksanaan bergantung pada tingkat keparahan Lordosis. Pada Lordosis ringan mungkin hanya diperlukan terapi Rehabilitasi Medik dan Fisioterapi. Sementara pada kasus yang berat akan membutuhkan ortese khusus (Brace) yang membantu memperbaiki kembali posisi tulang belakang. Tindakan bedah jarang diperlukan untuk lordosis ini.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pencegahan</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="background: white; line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pencegahan meliputi pencegahan primer dan pencegahan sekunder. Pencegahan primer agar tidak terkena Lordosis danan pencegahan sekunder bertujuan agar Lordosis ditemukan sedini mungkin. Pencegahan primer dan sekunder meliputi :<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level2 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "courier new"; mso-fareast-font-family: "Courier New";">o<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">   </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Duduk dengan posisi yang benar<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level2 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "courier new"; mso-fareast-font-family: "Courier New";">o<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">   </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Berolahraga teratur,<o:p></o:p></span></div> <div class="MsoListParagraphCxSpMiddle" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level2 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "courier new"; mso-fareast-font-family: "Courier New";">o<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">   </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Diet yang cukup kalsium dan Vit D<o:p></o:p></span></div> <div class="MsoListParagraphCxSpLast" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l17 level2 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "courier new"; mso-fareast-font-family: "Courier New";">o<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">   </span></span><!--[endif]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Periksa ke dokter bila anda mengalami sakit punggung yang sering berulang.<o:p></o:p></span></div> <div class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoListParagraph" style="background: white; line-height: 120%; margin-bottom: 6.0pt; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level1 lfo1; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">6.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">    </span></span></b><!--[endif]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Skoliosis<o:p></o:p></span></b></div> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj5IIHIMJWf7zfyqZsbI2UP4EN5sWyPcnukYof02iARg6udl_xgTR4N7WipSARKcuUahJef-LytY8Kq7sXbUY8ORPD3c-AgHyLgGykh3XOz_Pvz6YlXY5j57rtw4zasvOoXbgPK1t8XBJ8_/s1600/Skloliosis.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj5IIHIMJWf7zfyqZsbI2UP4EN5sWyPcnukYof02iARg6udl_xgTR4N7WipSARKcuUahJef-LytY8Kq7sXbUY8ORPD3c-AgHyLgGykh3XOz_Pvz6YlXY5j57rtw4zasvOoXbgPK1t8XBJ8_/s1600/Skloliosis.jpeg" /></a></div> <div align="center" class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: center;"> <br /></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Skoliosis kini bermakna sebagai lengkungan ke samping dalam tulang belakang. Hal ini untuk membedakan bentuk lengkungan tulang belakang yang memang ke arah depan dan belakang. Cara pengobatannya pun kini lebih bervariasi. Dalam tingkat yang masih ringan, skoliosis seringkali tidak menimbulkan masalah, namun bila lengkungan ke samping itu terlalu parah, akan menyebabkan cacat bentuk tulang belakang yang cukup berat dan bisa mengganggu fungsi tubuh lainnya seperti jantung dan paru-paru.</span><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pada skoliosis, pembengkakan terjadi karena berbagai sebab. Misalnya, karena sikap tubuh salah yang terus menerus pada saat bekerja. Atau bisa seseorang berjalan miring demi mencegah rasa sakit. Misalnya, sebagai akibat kelumpuhan atau luka karena kecelakaan.</span><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Gejala dan Perawatan</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Yang terpenting untuk diperhatikan mengenai skoliosis adalah bahwa keluhan tersebut akan semakin berat seiring dengan berjalannya pertumbuhan tulang. Makin besar tulang belakang melengkung menyebabkan gangguan pertumbuhan pada tulang rusuk maupun tulang belakang. Ketidaklurusan tulang belakang ini akhirnya akan menyebabkan nyeri persendian di daerah tulang belakang pada usia dewasa dan kelainan bentuk dada yang dapat mengganggu fungsi jantung dan paru-paru, sehingga mempercepat kematian.</span><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><br /> <span style="background: white;">Skoliosis dengan penyebab yang tidak diketahui timbul secara perlahan-lahan tanpa adanya rasa sakit. Jika terdapat rasa sakit pada remaja yang sedang mengalami perkembangan skoliosis, segeralah memeriksakannya ke dokter untuk mengidentifikasi penyebabnya. Pada tahap perkembangan dini, skoliosis terlihat berupa perubahan kecil pada penampakan jasmani. Misalnya, Anda bisa mengamati salah satu bahu yang tampak lebih tinggi atau tulang belikat yang satu tampak lebih menonjol dibandingkan dengan yang lain.</span><br /> <span style="background: white;">Umumnya, tanda-tanda skoliosis yang bisa diperhatikan yaitu tulang bahu yang berbeda, tulang belikat yang menonjol, lengkungan tulang belakang yang nyata, panggul yang miring, perbedaan ruang antara lengan dan tubuh. Pemeriksaan lain yang sangat membantu dalam menangani skoliosis ini adalah foto rontgen tulang belakang. Dari foto rontgen dapat diukur derajat banyaknya lengkungan yang tidak normal.</span><o:p></o:p></span></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Selama itu, salah satu cara terbaru untuk mengawasi perkembangan skoliosis adalah dengan topografi Moire, yaitu suatu pemotretan khusus yang memungkinkan pengamatan tentang perbedaan pada permukaan tubuh tanpa menimbulkan risiko.</span><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Cacat bentuk pada skoliosis bertambah sesuai dengan pertumbuhan badan. Karenanya, faktor terpenting dalam menilai kemungkinan hasil akhir skoliosis adalah jumlah pertumbuhan yang tersisa. Makin berat lengkungan, besar kemungkinan untuk bertambah parah. Hal ini berarti bahwa lengkungan ringan yang dijumpai pada seorang anak perempuan berusia 14 tahun mungkin tak akan banyak bertambah, sedangkan derajat kelengkungan sama yang dijumpai pada seorang anak perempuan berusia 10 tahun hampir pasti akan meningkat, terutama pada periode pertumbuhan.</span><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pengobatan lainnya yang dilakukan tanpa operasi antara lain latihan jasmani yang dirancang khusus untuk mencegah terjadinya kelainan yang lebih berat. Hasilnya akan lebih efektif jika dikombinasikan dengan pemakaian semacam alat penopang. Alat penopang memberi antara tarikan dan penekanan samping pada lengkungan tulang belakang. Walaupun cara ini tidak memperbaiki lengkungan yang ada, tapi pada banyak kasus dapat mencegah kerusakan lebih lanjut selama masa pertumbuhan anak.</span><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Perawatan dan penanganan skoliosis memerlukan pengawasan dan pengobatan dalam bentuk yang cukup lama, menemukan kelainan secara dini dan mengobatinya dengan segera akan mencegah berlanjutnya cacat bentuk akibat skoliosis.</span><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoListParagraph" style="line-height: 120%; margin-bottom: 6.0pt; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l8 level1 lfo1; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">7.<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; font-weight: normal; line-height: normal;">    </span></span></b><!--[endif]--><b><span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kifosis</span></b><b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></b></div> <div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiqzYXs5QpRqGdh64NHUwQYYbkJZa8lzs6vi2gLV2NJ0fjjPWK2GTUdfIFTQ1plTUY68tBHsWyXIMIdYIasngFn9WR7_a2_iqxYQzR9l0xgclh3XporJMZaEQ1W0jXdVj56P4silqGlRgTe/s1600/Kifosis.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiqzYXs5QpRqGdh64NHUwQYYbkJZa8lzs6vi2gLV2NJ0fjjPWK2GTUdfIFTQ1plTUY68tBHsWyXIMIdYIasngFn9WR7_a2_iqxYQzR9l0xgclh3XporJMZaEQ1W0jXdVj56P4silqGlRgTe/s1600/Kifosis.jpeg" /></a></div> <div align="center" class="MsoNormal" style="background: white; line-height: 120%; margin-bottom: 6.0pt; text-align: center;"> <br /></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify; text-indent: 36.0pt;"> <span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Kifosis adalah salah satu bentuk kelainan tulang punggung, di mana punggung yang seharusnya berberntuk kurva dan simetris antara kiri dan kanan ternyata melengkung ke depan melebihi batas normal. Kelainan ini di masyarakat awam sering disebut sebagai “Bungkuk”</span><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Penyebab Kifosis<o:p></o:p></span></b></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Penyebab Kifosis bermacam-macam. Kelainan otot, kelainan lahir bawaan, kekurangan vitamin D dan kalisum. Serta diperparah oleh posisi duduk yang salah</span><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Gejala dan Tand<o:p></o:p></span></b></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Sakit leher dan punggung adalah gejala yang paling sering terjadi. Pada Kifosis yang berat akan terjadi sesak napas karena paru-paru tidak dapat mengembang sempurna. Seringkali justru orang lain yang sudah lama tidak bertemu yang menyadari adanya kifosis (kebungkukan) ini.</span><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Penegakan diagnose<o:p></o:p></span></b></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Penegakan diagnose dilakukan dengan cara pemeriksaan fisik dan ditunjang oleh foto Spinal lateral dan AP (antero posterior).<b><o:p></o:p></b></span></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Penatalaksanaan</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoListParagraph" style="line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Penatalaksanaan bergantung pada tingkat keparahan Kifosis. Pada Kifosis ringan mungkin hanya diperlukan terapi Rehabilitasi Medik dan Fisioterapi. Sementara pada kasus yang berat akan membutuhkan ortese khusus (Brace) yang membantu meluruskan kembali posisi tulang belakang. Pada Kifosis ekstrim seringkali dibutuhkan tindakan bedah.<b><o:p></o:p></b></span></div> <div class="MsoNormal" style="line-height: 120%; margin-bottom: 6.0pt; text-align: justify;"> <b><span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pencegahan</span></b><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div> <div class="MsoListParagraphCxSpFirst" style="line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Pencegahan meliputi pencegahan primer dan pencegahan sekunder. Pencegahan primer agar tidak terkena Kifosis dan pencegahan sekunder bertujuan agar Kifosis ditemukan sedini mungkin. Pencegahan primer dan sekunder meliputi :<b><o:p></o:p></b></span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Duduk dengan posisi yang benar<b><o:p></o:p></b></span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Hilangkan kebiasaan bertopang dagu<b><o:p></o:p></b></span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Berolahraga teratur,<b><o:p></o:p></b></span></div> <br /> <div class="MsoListParagraphCxSpLast" style="line-height: 120%; margin-bottom: 6.0pt; mso-add-space: auto; mso-list: l17 level1 lfo35; text-align: justify; text-indent: -18.0pt;"> <!--[if !supportLists]--><span style="font-family: "arial" , "sans-serif"; mso-fareast-font-family: Arial;">-<span style="font-family: "times new roman"; font-size: 7pt; font-stretch: normal; line-height: normal;">       </span></span><!--[endif]--><span style="background: white; font-family: "arial" , "sans-serif"; mso-fareast-font-family: "Times New Roman";">Diet yang cukup kalsium dan Vit D<b><o:p></o:p></b></span></div> </div>

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