Factors Associated with Marburg Hemorrhagic Fever:

Background. Reliable on-site polymerase chain reaction (PCR) testing for Marburg hemorrhagic fever (MHF) is not always available. Therefore, clinicians triage patients on the basis of presenting symptoms and contact history. Using patient data collected in Uige, Angola, in 2005, we assessed the sensitivity and specificity of these factors to evaluate the validity of World Health Organization (WHO)–recommended case definitions for MHF. Methods. Multivariable logistic regression was used to identify independent predictors of PCR confirmation of MHF. A data-derived algorithm was developed to obtain new MHF case definitions with improved sensitivity and specificity. Results. A MHF case definition comprising (1) an epidemiological link or (2) the combination of myalgia or arthralgia and any hemorrhage could potentially serve as an alternative to current case definitions. Our dataderived case definitions maintained the sensitivity and improved the specificity of current WHO-recommended case definitions. Conclusions. Continued efforts to improve clinical documentation during filovirus outbreaks would aid in the refinement of case definitions and facilitate outbreak control

The role of Coenzyme Q10 in statin-associated myopathy

Statins, or 3-hydroxyl-3-methylglutaryl coenzyme HMG-CoA reductase inhibitors,\ud are cholesterol-lowering drugs which are frequently used in the primary and secondary\ud prevention of coronary artery disease. Current research and recommendations support\ud and encourage more extensive use of these drugs.\ud However, statin usage is limited by many factors, including a high incidence of\ud statin-associated myalgia and myopathy. This review focuses on the use of Coenzyme Q\ud in statin-associated myopathy

HUBUNGAN FAKTOR YANG MEMPENGARUHI KEPATUHAN PENGGUNAAN OBAT ANALGESIK TERHADAP TINGKAT KEPATUHAN PASIEN MYALGIA DI PUSKESMAS TENGGILIS UBAYA

Abstrak - Myalgia yang dikenal dengan istilah nyeri otot merupakan gejala yang cukup sering menjadi keluhan dalam berbagai penyakit dan dianggap sebagian masyarakat sebagai gejala ringan akibat aktivitas fisik yang berlebihan, sehingga sering diatasi dengan pengobatan swamedikasi tanpa mengetahui penyebab nyeri otot yang dialami. Terapi yang sering digunakan adalah analgesik. Dalam penggunaan obat analgesik untuk gejala myalgia terkadang penderita mengkonsumsi obat tanpa melakukan konsultasi kepada tenaga kesehatan. Hal tersebut mengakibatkan penggunaan obat yang tidak rasional dan berdampak pada ketidakpatuhan penggunaan obat pasien penderita myalgia. Adapun faktor-faktor yang mempengaruhi kepatuhan penderita myalgia mencakup faktor terkait pasien, faktor medikasi, faktor sosial & ekonomi, faktor dari tenaga kesehatan dan faktor sistem layanan kesehatan. Tujuan dari penelitian ini adalah untuk mengidentifikasi faktor yang mempengaruhi kepatuhan penggunaan obat analgesik terhadap kepatuhan penderita myalgia di Puskesmas Kecamatan Tenggilis Kota Surabaya Provinsi Jawa Timur. Jenis penelitian ini adalah penelitian kuantitatif dengan studi potong lintang. Instrumen dalam penelitian ini adalah kuesioner. Sampel penelitian ini sebesar 93 penderita myalgia yang berkunjung di Puskesmas Kecamatan Tenggilis Kota Surabaya. Teknik analisis yang digunakan adalah analisis inferensial dengan metode regresi linier berganda. Hasil penelitian menunjukkan bahwa faktor medikasi signifikan mempengaruhi kepatuhan penggunaan obat analgesik terhadap kepatuhan penderita myalgia. Kata kunci: Myalgia, Kepatuhan, Penggunaan obat analgesik, Faktor-faktor yang mempengaruhi kepatuhan. Abstract - Myalgia known as muscle pain is a symptom that’s quite often considered part of the community as mild symptoms due to excessive physical activity, so it is often treated with self-medication without knowing the cause of muscle pain experienced. Therapy is often used analgesic drugs. In the use of it for myalgia, the patients taking the drug without consulting with the health professionals. It lead to irrational drug use and impact on non-compliance with medication use in myalgia patients. The factors that influence patient compliance myalgia include patient-related factors, medications factors, social and economic factors, factors of health professional and health care system factors. The purpose of this study to identify factors that influence adherence to the use of analgesic medication adherence in patients with myalgia at Health Clinic in Tenggilis District Surabaya City. This research is a quantitative study with cross-sectional. Instruments in this research is questionnaire. The research sample of 93 myalgia patients who visit the health center in Tenggilis District of Surabaya city. The analysis technique used is inferential analysis with multiple linear regression method. The results showed that the significant factors influencing adherence level to the use of analgesic drugs for myalgia patient’s compliance is factor medication. Keywords: Myalgia, Compliance/Adherence, Consuming Analgesic Drugs, factors which may affect to adherence

HUBUNGAN FAKTOR YANG MEMPENGARUHI KEPATUHAN PENGGUNAAN OBAT ANALGESIK TERHADAP TINGKAT KEPATUHAN PASIEN MYALGIA DI PUSKESMAS TENGGILIS UBAYA

Abstrak - Myalgia yang dikenal dengan istilah nyeri otot merupakan gejala yang cukup sering menjadi keluhan dalam berbagai penyakit dan dianggap sebagian masyarakat sebagai gejala ringan akibat aktivitas fisik yang berlebihan, sehingga sering diatasi dengan pengobatan swamedikasi tanpa mengetahui penyebab nyeri otot yang dialami. Terapi yang sering digunakan adalah analgesik. Dalam penggunaan obat analgesik untuk gejala myalgia terkadang penderita mengkonsumsi obat tanpa melakukan konsultasi kepada tenaga kesehatan. Hal tersebut mengakibatkan penggunaan obat yang tidak rasional dan berdampak pada ketidakpatuhan penggunaan obat pasien penderita myalgia. Adapun faktor-faktor yang mempengaruhi kepatuhan penderita myalgia mencakup faktor terkait pasien, faktor medikasi, faktor sosial & ekonomi, faktor dari tenaga kesehatan dan faktor sistem layanan kesehatan. Tujuan dari penelitian ini adalah untuk mengidentifikasi faktor yang mempengaruhi kepatuhan penggunaan obat analgesik terhadap kepatuhan penderita myalgia di Puskesmas Kecamatan Tenggilis Kota Surabaya Provinsi Jawa Timur. Jenis penelitian ini adalah penelitian kuantitatif dengan studi potong lintang. Instrumen dalam penelitian ini adalah kuesioner. Sampel penelitian ini sebesar 93 penderita myalgia yang berkunjung di Puskesmas Kecamatan Tenggilis Kota Surabaya. Teknik analisis yang digunakan adalah analisis inferensial dengan metode regresi linier berganda. Hasil penelitian menunjukkan bahwa faktor medikasi signifikan mempengaruhi kepatuhan penggunaan obat analgesik terhadap kepatuhan penderita myalgia. Kata kunci: Myalgia, Kepatuhan, Penggunaan obat analgesik, Faktor-faktor yang mempengaruhi kepatuhan. Abstract - Myalgia known as muscle pain is a symptom that’s quite often considered part of the community as mild symptoms due to excessive physical activity, so it is often treated with self-medication without knowing the cause of muscle pain experienced. Therapy is often used analgesic drugs. In the use of it for myalgia, the patients taking the drug without consulting with the health professionals. It lead to irrational drug use and impact on non-compliance with medication use in myalgia patients. The factors that influence patient compliance myalgia include patient-related factors, medications factors, social and economic factors, factors of health professional and health care system factors. The purpose of this study to identify factors that influence adherence to the use of analgesic medication adherence in patients with myalgia at Health Clinic in Tenggilis District Surabaya City. This research is a quantitative study with cross-sectional. Instruments in this research is questionnaire. The research sample of 93 myalgia patients who visit the health center in Tenggilis District of Surabaya city. The analysis technique used is inferential analysis with multiple linear regression method. The results showed that the significant factors influencing adherence level to the use of analgesic drugs for myalgia patient’s compliance is factor medication. Keywords: Myalgia, Compliance/Adherence, Consuming Analgesic Drugs, factors which may affect to adherence

HUBUNGAN FAKTOR YANG MEMPENGARUHI KEPATUHAN PENGGUNAAN OBAT ANALGESIK TERHADAP TINGKAT KEPATUHAN PASIEN MYALGIA DI PUSKESMAS TENGGILIS UBAYA

Abstrak - Myalgia yang dikenal dengan istilah nyeri otot merupakan gejala yang cukup sering menjadi keluhan dalam berbagai penyakit dan dianggap sebagian masyarakat sebagai gejala ringan akibat aktivitas fisik yang berlebihan, sehingga sering diatasi dengan pengobatan swamedikasi tanpa mengetahui penyebab nyeri otot yang dialami. Terapi yang sering digunakan adalah analgesik. Dalam penggunaan obat analgesik untuk gejala myalgia terkadang penderita mengkonsumsi obat tanpa melakukan konsultasi kepada tenaga kesehatan. Hal tersebut mengakibatkan penggunaan obat yang tidak rasional dan berdampak pada ketidakpatuhan penggunaan obat pasien penderita myalgia. Adapun faktor-faktor yang mempengaruhi kepatuhan penderita myalgia mencakup faktor terkait pasien, faktor medikasi, faktor sosial & ekonomi, faktor dari tenaga kesehatan dan faktor sistem layanan kesehatan. Tujuan dari penelitian ini adalah untuk mengidentifikasi faktor yang mempengaruhi kepatuhan penggunaan obat analgesik terhadap kepatuhan penderita myalgia di Puskesmas Kecamatan Tenggilis Kota Surabaya Provinsi Jawa Timur. Jenis penelitian ini adalah penelitian kuantitatif dengan studi potong lintang. Instrumen dalam penelitian ini adalah kuesioner. Sampel penelitian ini sebesar 93 penderita myalgia yang berkunjung di Puskesmas Kecamatan Tenggilis Kota Surabaya. Teknik analisis yang digunakan adalah analisis inferensial dengan metode regresi linier berganda. Hasil penelitian menunjukkan bahwa faktor medikasi signifikan mempengaruhi kepatuhan penggunaan obat analgesik terhadap kepatuhan penderita myalgia. Kata kunci: Myalgia, Kepatuhan, Penggunaan obat analgesik, Faktor-faktor yang mempengaruhi kepatuhan. Abstract - Myalgia known as muscle pain is a symptom that’s quite often considered part of the community as mild symptoms due to excessive physical activity, so it is often treated with self-medication without knowing the cause of muscle pain experienced. Therapy is often used analgesic drugs. In the use of it for myalgia, the patients taking the drug without consulting with the health professionals. It lead to irrational drug use and impact on non-compliance with medication use in myalgia patients. The factors that influence patient compliance myalgia include patient-related factors, medications factors, social and economic factors, factors of health professional and health care system factors. The purpose of this study to identify factors that influence adherence to the use of analgesic medication adherence in patients with myalgia at Health Clinic in Tenggilis District Surabaya City. This research is a quantitative study with cross-sectional. Instruments in this research is questionnaire. The research sample of 93 myalgia patients who visit the health center in Tenggilis District of Surabaya city. The analysis technique used is inferential analysis with multiple linear regression method. The results showed that the significant factors influencing adherence level to the use of analgesic drugs for myalgia patient’s compliance is factor medication. Keywords: Myalgia, Compliance/Adherence, Consuming Analgesic Drugs, factors which may affect to adherence

Foci of segmentally contracted sarcomeres in trapezius muscle biopsy specimens in myalgic and nonmyalgic human subjects : preliminary results

Objective The myofascial trigger point hypothesis postulates that there are small foci of contracted sarcomeres in resting skeletal muscle. Only one example, in canine muscle, has been published previously. This study evaluated human muscle biopsies for foci of contracted sarcomeres. Setting The Departments of Rehabilitation Sciences and Physiotherapy at Ghent University, Ghent, Belgium. Subjects Biopsies from 28 women with or without trapezius myalgia were evaluated, 14 in each group. Methods Muscle biopsies were obtained from regions of taut bands in the trapezius muscle and processed for light and electron microscopy and for histochemical analysis. Examination of the biopsies was blinded as to group. Results A small number of foci of segmentally contracted sarcomeres were identified. One fusiform segmental locus involved the entire muscle fiber in tissue from a myalgic subject. Several transition zones from normal to contracted sarcomeres were found in both myalgic and nonmyalgic subjects. The distance between Z-lines in contracted sarcomeres was about 25–45% of the same distance in normal sarcomeres. Z-lines were disrupted and smeared in the contracted sarcomeres. Conclusions A small number of foci of segmentally contracted sarcomeres were found in relaxed trapezius muscle in human subjects, a confirmation of the only other example of spontaneous segmental contraction of sarcomeres (in a canine muscle specimen), consistent with the hypothesis of trigger point formation and with the presence of trigger point end plate noise

HUBUNGAN FAKTOR YANG MEMPENGARUHI KEPATUHAN PENGGUNAAN OBAT ANALGESIK TERHADAP TINGKAT KEPATUHAN PASIEN MYALGIA DI PUSKESMAS TENGGILIS UBAYA

Abstrak - Myalgia yang dikenal dengan istilah nyeri otot merupakan gejala yang cukup sering menjadi keluhan dalam berbagai penyakit dan dianggap sebagian masyarakat sebagai gejala ringan akibat aktivitas fisik yang berlebihan, sehingga sering diatasi dengan pengobatan swamedikasi tanpa mengetahui penyebab nyeri otot yang dialami. Terapi yang sering digunakan adalah analgesik. Dalam penggunaan obat analgesik untuk gejala myalgia terkadang penderita mengkonsumsi obat tanpa melakukan konsultasi kepada tenaga kesehatan. Hal tersebut mengakibatkan penggunaan obat yang tidak rasional dan berdampak pada ketidakpatuhan penggunaan obat pasien penderita myalgia. Adapun faktor-faktor yang mempengaruhi kepatuhan penderita myalgia mencakup faktor terkait pasien, faktor medikasi, faktor sosial & ekonomi, faktor dari tenaga kesehatan dan faktor sistem layanan kesehatan. Tujuan dari penelitian ini adalah untuk mengidentifikasi faktor yang mempengaruhi kepatuhan penggunaan obat analgesik terhadap kepatuhan penderita myalgia di Puskesmas Kecamatan Tenggilis Kota Surabaya Provinsi Jawa Timur. Jenis penelitian ini adalah penelitian kuantitatif dengan studi potong lintang. Instrumen dalam penelitian ini adalah kuesioner. Sampel penelitian ini sebesar 93 penderita myalgia yang berkunjung di Puskesmas Kecamatan Tenggilis Kota Surabaya. Teknik analisis yang digunakan adalah analisis inferensial dengan metode regresi linier berganda. Hasil penelitian menunjukkan bahwa faktor medikasi signifikan mempengaruhi kepatuhan penggunaan obat analgesik terhadap kepatuhan penderita myalgia. Kata kunci: Myalgia, Kepatuhan, Penggunaan obat analgesik, Faktor-faktor yang mempengaruhi kepatuhan. Abstract - Myalgia known as muscle pain is a symptom that’s quite often considered part of the community as mild symptoms due to excessive physical activity, so it is often treated with self-medication without knowing the cause of muscle pain experienced. Therapy is often used analgesic drugs. In the use of it for myalgia, the patients taking the drug without consulting with the health professionals. It lead to irrational drug use and impact on non-compliance with medication use in myalgia patients. The factors that influence patient compliance myalgia include patient-related factors, medications factors, social and economic factors, factors of health professional and health care system factors. The purpose of this study to identify factors that influence adherence to the use of analgesic medication adherence in patients with myalgia at Health Clinic in Tenggilis District Surabaya City. This research is a quantitative study with cross-sectional. Instruments in this research is questionnaire. The research sample of 93 myalgia patients who visit the health center in Tenggilis District of Surabaya city. The analysis technique used is inferential analysis with multiple linear regression method. The results showed that the significant factors influencing adherence level to the use of analgesic drugs for myalgia patient’s compliance is factor medication. Keywords: Myalgia, Compliance/Adherence, Consuming Analgesic Drugs, factors which may affect to adherence

An unusual presentation of a case of human psittacosis

Background: Chlamydia psittaci is a gram-negative, obligate intracellular organism. Birds are the main reservoir, but also non-avian domestic animals and humans can be infected. In humans it mostly causes respiratory infections due to occupational exposure with varying severity. Sensitive and specific diagnostic tests are needed to define psittacosis in humans as these tests also allow rapid tracing of the animal source. However, diagnosis in humans is often based on time-consuming culture techniques and antibody detection assays as in many countries, the existing molecular diagnostic tests for psittacosis are not reimbursed by the public health insurance. Case presentation: An 82-year old female was referred to the hospital with a non-productive cough since four weeks and since one week fever up to 39 degrees C, myalgia, generalized skin rash, acral edema and generalized weakness under treatment with moxifloxacin. Blood analysis showed signs of inflammation with mild eosinophilia. Chest CT showed multiple peripheral ground glass opacities with consolidation in both lungs. Pulmonary function testing only showed a mild decrease in diffusion capacity. Viral and bacterial serology were negative. As the patient kept a pet parakeet for over ten years, a nested PCR for C. psittaci was performed on a nasopharyngeal swab of the patient and on feces of the parakeet. Both returned positive for the same genotype. Genotyping was performed by a genotype-specific real-time PCR. The patient fully recovered after a ten-day course of azithromycin. Conclusion: Due to non-specific signs during psittacosis, early detection of the infection and differentiation from hypersensitivity pneumonitis can be challenging. Culture and antibody titers for C. psittaci have a lower sensitivity than PCR-testing due to several factors. We present a case of human psittacosis (presenting as pneumonia) with diagnosis based on clinical findings confirmed by means of nested PCR. This case suggests the added value of PCR in suspect cases despite negative serology. Our current paper underlines the need for a broader implementation of PCR for early diagnosis of human psittacosis and thus early initiation of correct antibiotic treatment with reduction of morbidity and mortality

Trichinellosis in Vietnam

Trichinellosis is a zoonotic parasitic disease with a worldwide distribution. The aim of this work was to describe the epidemiological and clinical data of five outbreaks of trichinellosis, which affected ethnic minorities living in remote mountainous areas of northwestern Vietnam from 1970 to 2012. Trichinellosis was diagnosed in 126 patients, of which 11 (8.7%) were hospitalized and 8 (6.3%) died. All infected people had consumed raw pork from backyard and roaming pigs or wild boar at wedding, funeral, or New Year parties. The short incubation period (average of 9.5 days), the severity of the symptoms, which were characterized by diarrhea, abdominal pain, fever, myalgia, edema, weight loss, itch, and lisping, and the high mortality, suggest that patients had ingested a high number of larvae. The larval burden in pigs examined in one of the outbreaks ranged from 70 to 879 larvae/g. These larvae and those collected from a muscle biopsy taken from a patient from the 2012 outbreak were identified as Trichinella spiralis. Data presented in this work show that the northern regions of Vietnam are endemic areas for Trichinella infections in domestic pigs and humans