Samuel Gultom | samuelgultom
Hello November,,,,hello flood..

Sammy Page
  • Samuel Gultom Activities 2015
    This all my activities during 2015, all with photos documentations.

     with OPUNG and cousins

    at  ragunan zoo

  • Merry Christmast And Happy New Year 2014
    Almost one year we tread life. Until now there is the spirit of fatigue and how to survive the crush of life. During this time, a lot of changes that occur within one year. By now I was sitting in the second grade of elementary school. Atmosphere played that a few years ago I lead now filled with school subjects that feels endless.

    Samuel Gultom & Stephan Gultom

    Samuel Gultom & Stephan Gultom At School

    Samuel At Taekwondo Uniform

    Samuel Practice Taekwondo

    There is some activities that I used to do whole this year.

    Now, I am Wishing You a Merry Christmast, 25 December 2013 and Happy New Year, 1 January 2014.


    Samuel Gultom

  • Honey's Natural Benefits

    Medicinal Use Of Honey

    What researchers are learning about honey's possible health benefits.

    Honey has a long medicinal history. The ancient Egyptians not only made offerings of honey to their gods, they also used it as an embalming fluid and a dressing for wounds. On that last point, at least, they were on to something.

    Today, many people swarm to honey for its antibacterial and anti-inflammatory properties. Holistic practitioners consider it one of nature's best all-around remedies.

    But outside of the laboratory, claims for honey's healthfulness are unproven -- except in the area of wound care and, to a lesser extent, cough suppression.

    Here's the truth behind the claims about honey's health benefits -- and an important warning.

    Never Give Honey to an Infant

    Honey is natural and considered harmless for adults. But pediatricians strongly caution against feeding honey to children under 1 year old.

    "Do not let babies eat honey," states, a web site of the U.S. Department of Health and Human Services.

    That's because of the risk of botulism. The spores of the botulism bacteria are found in dust and soil that may make their way into honey. Infants do not have a developed immune system to defend against infection, says Jatinder Bhatia, MD, a Georgia neonatologist who heads the American Academy of Pediatrics' Committee on Nutrition.

    "It's been shown very clearly that honey can give infants botulism," a paralytic disorder in which the infant must be given anti-toxins and often be placed on a respirator in an intensive care unit, he says. Bhatia has never seen a case of infant botulism.

    But parents may feed their infants cereals that contain honey, he says. "It's cooked, so it's OK," Bhatia says. He explains that when it comes to botulism risk, "we're talking about honey out of the bottle.''

    The National Honey Board, which the USDA oversees, also agrees that infants should not be given honey. "The concern for babies stems from the fact that infants lack the fully developed gastrointestinal tract of older humans," the Board's web site states.

    Antibacterial Honey?

    In the laboratory, honey has been shown to hamper the growth of food-borne pathogens such as E. coli and salmonella, and to fight certain bacteria, including Staphylococcus aureus and Pseudomonas aeruginosa, both of which are common in hospitals and doctors' offices. But whether it does the same in people hasn't been proven.

    Shop for honey and you'll see that some are lighter, others are darker. In general, the darker the honey, the better its antibacterial and antioxidant power.

    Honey comes in many varieties, depending on the floral source of pollen or nectar gathered and regurgitated by the honey bee upon arrival in the hive.

    Honey producers may apply to the U.S. Department of Agriculture (USDA) for a grade on their product, but the score does not account for color. Rather, the honey is judged for clarity, aroma, and flavor, and the absence of sediments, such as honeycomb particles.

    Honey and Wound Care

    Manuka honey is sometimes used to treat chronic leg ulcers and pressure sores.
    Manuka honey is made in New Zealand from the nectar of Leptospermum scoparium. It's the basis of Medihoney, which the FDA approved in 2007 for use in treating wounds and skin ulcers. It works very well to stimulate healing, says wound care specialist Frank Bongiorno, MD, of Ann Arbor, Mich.

    "Medihoney has been our standard for healing wounds in the past year, since it started coming on the market," Bongiorno says. A healing wound, whether chronic or acute, is a clean, granulating wound that is absent of bacteria and swelling. Bongiorno doesn't use Medihoney for burns because it can cause pain.

    Bongiorno has visited Haiti, where people use ordinary honey for wounds, and although it isn't harmful, it doesn't have the impact of Medihoney, which is purified with ultraviolet light rather than heat. Its antibacterial action is better preserved, he says.

    That, of course, is useful in treating wounds, but it is Manuka honey's pH content, which leans toward acidic, that helps the healing process, says Bongiorno, who has no ties to Medihoney's maker. "It is soothing and feels good to the wound.''

    Honey and Allergies

    Some laboratory studies suggest honey has the potential to clear up stuffy noses and ease allergies triggered by pollen. But it's a bit of a stretch to apply that to patients, says New Jersey allergist Corinna Bowser, MD.

    Bowser says she doesn't consider the studies on honey and congestion to be adequate, for a few reasons: most allergy sufferers are sensitive to wind-carried pollens like grass and ragweed -- the kind not carried by bees and transformed into honey.

    "If you want to treat someone for common allergies, it's not commonly found in bee honey," Bowser says.

    "Even if there are allergens in the honey, it wouldn't make a difference, because it gets broken down by stomach acids and doesn't trigger an immunological response," Bowser says. In contrast, "The pills we take for allergies are coated so they don't get broken down," she says.

    Honey and the Common Cold

    Maryland family doctor Ariane Cometa, MD, who describes herself as a holistic practitioner, likes to use a buckwheat honey-based syrup to ease early symptoms of a cold. She says it calms inflamed membranes and eases a cough -- the latter claim supported by a few studies.

    In a study that involved 139 children, honey beat out dextromethorphan (a cough suppressant) and diphenhydramine (an antihistamine) in easing nighttime cough in children and improving their sleep.

    Another study involving 105 children found that buckwheat honey trumped dextromethorphan in suppressing nighttime coughs.

    "If you're suffering from a cold or something going on in the throat or upper airways, getting on board with honey syrup will help fight infection and soothe membranes," says Cometa, who also recommends a buckwheat honey-based allergy medicine.

    Honey and Diabetes

    Even if honey is natural, it is no better than ordinary white or brown sugar for dieters or people with diabetes, says dietitian Toby Smithson, RD, CDE, a spokesperson for the American Dietetic Association and founder of the web site, Diabetes Everyday.

    A tablespoon of honey, in fact, has more carbohydrates and calories than granulated white or brown sugar.

    "One of my favorite quotes is that 'a sugar is a sugar' when it comes to diabetes," Smithson says. "I think it's a widespread myth that honey is better for diabetes. Some patients don't classify honey as a sugar.''

    Smithson, who has type 1 diabetes, says she prefers getting carbs from a cup of fresh berries or a carton of yogurt because they have about the same number of carbs as a tablespoon of honey -- but less sugar.

    "There are some minerals and vitamins and antioxidant properties in honey -- the darker the honey, the higher the level of antioxidants -- but with yogurt, you can also get those benefits. When you have diabetes, you have to be picky and choosy about carbs and calories.''

    WebMD Feature

    Honey as Nature’s Skin Care

    Manufacturers have used honey in everything from hand lotions and moisturizers to bar soaps and bubble baths. One reason they use honey is for its wholesome, all-natural image; more and more consumers are demanding cosmetics and personal care products made from natural ingredients. In the case of honey, however, image is just the beginning.

    First, honey is a humectant, which means it attracts and retains moisture. This makes honey a natural fit in a variety of moisturizing products including cleansers, creams, shampoos and conditioners.

    Look for honey in store-bought beauty products or simply add a squeeze of honey to your moisturizer, shampoo or soap at home.  For some extra pampering, try whipping up a simple beauty recipe yourself.

    Using honey, a natural humectant with antimicrobial properties, we have created a series of recipes that will help hydrate skin while relaxing the soul.

    We also recommend the following tips for keeping skin at its pure and natural best.
    Protect Skin from the Sun: Use sunblock every day - not just when it’s sunny. Apply sunscreen 30 to 40 minutes before exposure to allow active ingredients to begin working.

    Cleanse Twice Daily: Cleansing in the morning removes waste excreted during the skin’s nocturnal self-cleansing process. In the evening, it ensures removal dirt, oil and makeup.

    Get Adequate Sleep: Your skin will tell you if you’re sleep deprived. Without adequate sleep, your body can’t restore and repair itself. Not only will you live longer, your skin will look better, too!

    Reduce Stress: Stress ages body tissue - especially skin tissue. Exercise, massage therapy, yoga, aromatherapy and meditation are highly effective against stress.

  • Lose Weight Easy Ways
    It’s only natural to want quick weight loss results once you make the commitment to shed a few pounds or more. But this is one area in which slow and steady is the way to go. “Permanent weight loss can only be achieved when one makes a lifestyle change,” says Peter Vash, MD, MPH, executive director of Lindora Medical Clinics in Costa Mesa, Calif. and assistant clinical professor of medicine at UCLA’s Center for Health Sciences in Los Angeles. Eating a healthful diet and sweating it out regularly are the best ways to reach your weight-loss goal. But here’s how to make those two pound-shedding tools work to your advantage.

    One key to achieving healthy weight loss is to use your scale. “Weighing yourself is an important part of any weight loss program as it helps to hold you accountable and keep you on track,” says Dr. Vash. How often you do so is up to you — within reason. Vash recommends weigh-ins at least once a week — around the same time of day — and not more often than once or twice a day. Keep in mind small variances in the number on the scale can occur because of water retention or dehydration.

    While we’d all like to snap our fingers and be instantly slim, it takes time and effort to see results — especially when it comes to exercise. At a minimum, adults should get 150 minutes a week of moderate intensity aerobic activity or 75 minutes of vigorous intensity, coupled with two or more days of strength training all muscle groups to boost your weight-loss efforts. Exercise is crucial for both healthy weight loss in the short-term and maintaining a slimmer silhouette in the future.

    Emotional support from family and friends can go a long way toward encouraging you to reach your weight-loss goal. If you’re in charge of the grocery store runs, rather than loading up on chips and cookies at the supermarket, buy fruits, vegetables, and whole grains — and convert the whole family to eating a healthy diet. Support groups are another great option to help you stay on track. Ask your doctor for a local recommendation or look online for Web-based support groups where you’ll be able to share weight-loss tips.

    Changing your bad eating patterns is essential. “Giving in to food cravings promotes excess eating,” says Vash. “It is important to remove foods you crave (cookies, sodas, candy, chips, ice cream) from your home and office.” Giving in is a surefire way to slow down the weight loss process. Instead, opt for healthy foods, such as fruits, vegetables, protein, and whole grains, and use strategies to help stop a craving in its tracks. When your sweet tooth strikes, try to thwart it by drinking water, tea, or coffee with non-fat milk and artificial sugar.

    While it may seem counterintuitive for quick weight loss, eating three meals a day is important when trying to shed pounds. Skipping breakfast can lead to excessive hunger, which can sabotage a healthy diet and cause you to overeat later in the day. Consider starting the day off with filling oatmeal or another whole grain cereal to keep you feeling satisfied longer. And don’t try to substitute a snack for a meal — your body will know the difference.

    Binge eating — consuming large amounts of food in a short period of time — will get in the way of reaching a healthy weight. The disorder can be triggered by emotional issues or stress from being on a diet. Try to fight the temptation to overindulge with extra calories, which will only set you back. Instead, try taking a walk, going to the gym, or calling a close friend to get your mind off the desire to eat.

    Almost everything is more fun with a friend, and that includes shedding pounds. Try to find a buddy to team up with on your quest for healthy weight loss. You can motivate each other by sharing recipes and weight-loss tips and by hitting the gym together. Both of you should keep a food journal as well, which helps encourage you to eat healthy foods. Consider recording a second log of your exercise routines, too.

    It’s easy to fall for fad diets when looking for quick ways to lose weight. Any diet that promises immediate results with little to no effort should raise a red flag. Also, any eating plan that fixates on a specific type of food, restricts certain foods, or doesn’t consider counting calories should not be a part of a healthy diet.

    One way to assist in healthy weight loss is to set some rules for yourself. “It is very important not to eat after dinner because that accounts for a large portion of excess weight gain,” says Vash. Avoid grazing and refrigerator-raiding at all costs as well as mindlessly eating while watching your favorite television shows. Also, never eat in the car. Not only will your vehicle be cleaner, but it’ll be that much easier to bypass your favorite fast food drive-thru and stick to your healthy diet.

    Pay attention to what you drink as well as what you eat when looking for boost your weight-loss success. Alcohol, sodas, and even lemonade and juices are full of calories that can undermine a healthy diet. Instead of these sugary beverages, try drinking water (plain or flavored, regular or carbonated), tea, or coffee. Another weight-loss tip: If you do choose to indulge in a glass of juice, try watering it down to reduce calories.

    source: Everyday Health
  • Pneumococcal Vaccine for Infants And Toddlers

    FDA today approved the first vaccine to prevent invasive pneumococcal diseases in infants and toddlers -- diseases which can cause brain damage and, in rare cases, death. The vaccine prevents invasive diseases caused by the organism Streptococcus pneumonia (also known as Pneumococcus) including bacteria (an infection of the bloodstream) and meningitis, an infection of the lining of the brain or spinal cord.

    The vaccine -- Pneumococcal 7-valent Conjugate Vaccine (Diphtheria CRM197Protein)-- will be marketed as Prevnar by a unit of Wyeth-Ayerst Laboratories, a Division of American Home Products Corporation in Philadelphia, Pennsylvania.

    Infants can receive the vaccine as a series of four inoculations administered at 2,4,6, and 12-15 months of age. For children who cannot receive the vaccine starting at age two months, it is recommended that parents see their health care provider for alternative schedules.

    Prevnar is the first multivalent conjugate pneumococcal vaccine for children under the age of two. It targets the most common seven strains of pneumococcus that account for approximately 80 percent of invasive disease in infants. It is manufactured by attaching the polysaccharides (purified surface components of the different strains) to a genetically modified nontoxic form of the diphtheria toxin protein called CRM197.

    "This new vaccine is great news for parents and their children because now, for the first time, we have a highly effective way to prevent a major cause of meningitis and serious blood infections in the most susceptible children -- those under two years of age." said Dr. Jane Henney, Commissioner of Food and Drugs. "When we prevent these infections, we are also preventing brain damage and mortality from pneumococcal diseases."

    It is estimated that each year in the U.S. there are about 16,000 cases of pneumococcal bacteremia and 1400 cases of pneumococcal meningitis among children under age five. Children under the age of two are at highest risk for infection. In up to half the cases of meningitis, brain damage and hearing loss occurs and about 10 percent die.

    Clinical trials included a large multicenter safety and efficacy study conducted at Northern California Kaiser Permanente in Oakland, Calif. The controlled, double- blind trial enrolled approximately 38,000 children, about half of whom received Prevnar. The vaccine was given at 2,4, 6 and 12-15 months of age along with routinely recommended vaccines. In this trial, the vaccine was 100 percent effective in preventing invasive pneumococcal disease caused by the seven strains of pneumococcus in the vaccine. The vaccine was approximately 90 percent effective in preventing invasive disease for illnesses caused by all pneumococcal subtypes.

    This vaccine is not indicated for use in adults or as a substitute for other approved pneumococcal polysaccharide vaccines approved for high risk children over the age of two.

    Side-effects in the trials were generally mild and included local injection site reactions, irritability, drowsiness and decreased appetite. Approximately 21 percent of the children had fevers over 100.3 compared to about 14 percent in the control group not receiving Prevnar.

    The vaccine's effectiveness in preventing ear infections, another infection caused by pneumococcus, has not been evaluated by FDA.

    Meningitis is usually caused by a viral or bacterial infection. There are different types of bacterial meningitis. Before the approval of the first Haemophilus influenza type b (HIB) conjugate vaccine in 1990 for infants, Hib was the leading cause of bacterial meningitis, but today Streptococcus pneumonia is one of the leading causes of bacterial meningitis.

    This is not a vaccine against ear infections as many think. It does decrease ear infections somewhat but it is for preventing meningitis, bacteremia (blood infection --- it killed Jim Hensen of the Muppets) and decrease pneumonia and ear infections caused by this germ.

    Dose for ages:
    0-6m -------- 3 doses and a booster at 15 months
    6-12m ------ 2 doses and a booster at 15 months
    12-24m ----- 2 doses
    2-4y -------- 1 dose only is susceptible to infections.
    >4y --------- not given usually

    Some insurance companies are paying for it and some are not yet. We will give it as soon as we can.

    Here is the AAP handout for this vaccine:

    Pneumococcal Infection and Vaccine

    Pneumococcus is a type of bacteria that can attack different parts of the body and cause many serious infections including
    • Meningitis (brain)
    • Bacteremia (blood stream)
    • Pneumonia (lungs)
    • Sinusitis (sinus membranes)
    • Otitis media (ears)

    These infections can be dangerous to very young children, the elderly, and people with certain high-risk health conditions.

    Pneumococcal infection
    What is pneumococcal infection?

    Pneumococcal bacteria live naturally in humans in the back of the nose. Many people carry the bacteria and never Set sick. In fact, being a carrier helps boost one's natural immunity to the disease. Others are not immune and can get very sick from the infections caused by the bacteria.

    Pneumococcal infections occur most often during the winter months. They spread from person to person the same way a cold or the flu spreads - by droplets passed through the air from coughing or sneezing, and through direct contact such as touching unwashed hands or kissing. The disease may spread quickly, especially in places where there are a lot of children, like child care centers and preschools.

    Very young children do not have fully developed immune systems. This makes them more at risk from bacteria] infections like pneumococcus. In addition, pneumococcal infections can be life threatening for people with certain health problems such as
    • HIV infection or other immune system disorders
    • Sickle-cell disease
    • White cell cancers like leukemia or lymphoma
    • Chronic lung, heart, or kidney disease
    • A removed spleen or one that doesn't work properly
    • Bone marrow or organ transplants

    Common pneumococcal infections and their symptoms
    Bacteremia and meningitis
    Pneumococcal bacteremia and pneumococcal meningitis occur when pneumococcal bacteria get into the bloodstream and/or the central nervous system. Bacteremia is the presence of bacteria in the blood. Meningitis is an infection of the thin lining and blood vessels that cover the brain and spinal cord. Symptoms of meningitis include High fever Stiff neck
    • Headache
    • Vomiting
    • Extreme tiredness and/or irritability
    • Loss of appetite

    Pneumococcal pneumonia is a chest infection in which the lungs become filled with fluid. Symptoms of pneumonia include
    • Cough that may bring up thick yellow-green or bloody mucus
    • High fever
    • Shortness of breath or chest pain
    • Extreme tiredness
    • Hard and rapid breathing

    Sinusitis occurs when the membranes lining the airfilled pockets in the bone of the face (sinuses) swell. The sinus cavities may fill with fluid. Symptoms of sinusitis include
    • Pressure behind the eyes
    • Pain in the face
    • Trouble breathing through the nose
    • Postnasal drip or prolonged runny nose
    • Fever
    • Toothache

    Otitis media
    Otitis media is an infection of the middle ear. Young children commonly develop middle ear infections when they have colds, the flu, or other viral respiratory infections. Symptoms of an ear infection include
    • Ear pain (very young children may pull at their ears because of the pain)
    • Fever
    • Restlessness or irritability
    • Crying
    • Runny nose

    Diagnosis and treatment of pneumococcal infections
    Your pediatrician will be able to tell if your child has a pneumococcal infection by your child's symptoms, a physical examination, and looking at your child's medical history. X-rays, blood tests, and sometimes a spinal tap also may be done to confirm pneumococcal infection in your child.

    Prompt treatment with antibiotics is usually effective. In addition, your child may need bed rest and a lot of fluids. In some cases, your child may need to be hospitalized.

    Unfortunately, some strains of the pneumococcal bacteria are developing resistance to the antibiotics usually used to kill them. This means that other antibiotics must be used. Your pediatrician will let you know which antibiotic is best for your child.

    Prevention of pneumococcal infections

    •Teach your children to wash their hands regularly with soap and water. This helps prevent the spread of infection.
    •Avoid dust, tobacco smoke, and other substances that may interfere with breathing and make children more likely to set sick.

    Pneumococcal vaccine

    A vaccine now offers infants and young children protection against pneumococcal infections. It is most effective against the major pneumococcal diseases - bacteremia, meningitis, and pneumonia. The vaccine is minimally effective in preventing otitis media and sinusitis. Pneumococcal vaccine is safe and can be given as a separate injection at the same time as other immunizations.

    Who should receive the vaccine?

    The American Academy of Pediatrics recommends that all children younger than 2 years of age receive the Heptavalent Pneumococcal Conjugate Vaccine (PCV7 or Prevnar). A series of doses may be given at 2, 4, 6, and 12 to 15 months of age. A "catch-up" immunization schedule is available for children who get a late start.

    Some children between the ages of 2 and 5 years who have certain health problems also need pneumococcal vaccine because they are at higher risk of getting serious infections. Two types of vaccines may be given to children in that group. Your pediatrician can explain which vaccine is best for your child.

    Pneumococcal vaccines may be given to some children 5 years of age and older, although the risk associated with pneumococcal infections is much lower in older children.

    Are there side effects to pneumococcal vaccines?

    Most children have no side effects with pneumococcal vaccines. Those side effects that do occur are mild and temporary. The possible side effects include

    • Soreness, swelling, and redness where the shot was given
    • A mild-to-moderate fever
    • Fussiness

    These symptoms may begin within 24 hours after the shot and usually go away within 48 to 72 hours.

    Talk to your pediatrician to see if your child should be vaccinated for pneumococcal infection and about the possible reactions to these immunizations.

    The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

    'Me American Academy of Pediatrics is an organization of 55,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of infants, children, adolescents, and young adults.

    Now available from the American Academy of Pediatrics ... Guide to Your Child's Symptoms. More than 100 common symptoms are listed alphabetically and designed to enable a parent to quickly identify a symptom, learn its possible cause, and determine how best to proceed. To order this 266-page deluxe hardcover edition, send a check or money order for $19,95, plus $5.50 shipping and handling, to: AAP Publications - Symptoms, PO Box 747, Elk Grove Village, IL 60009-0747. Or visit the AAP Web site at to order online.

    Other parenting guides from the Academy include Caring for Your Baby and Young Child. Birth to Age 5, Caring for Your School-age Child. Ages 5 to 12, and Caring for Your Adolescent, Ages 12 to 21. These books (except Caring for Your Adolescent) are available in softcover each for only $15.95, plus $5.50 shipping and handling, and all three books are available in hardcover each for $19.95, plus $5.50 shipping and handling.

    American Academy of Pediatrics
    Division of Publications
    PO Box 747
    Elk Grove Village, IL 60009-0747
    Web site -
    All rights reserved.

    Copyright NCM Publishers, Inc

    The pneumococcus is the most common cause of invasive pneumococcal disease (IPD) and acute otitis media in children. Although a 23-valent pneumococcal vaccine composed of purified capsular polysaccharide antigens of 23 pneumococcal serotypes (23PS) has long been available, like other polysaccharide antigens, many of the pneumococcal serotypes in the vaccine have limited immunogenicity in children younger than 2 to 3 years of age. With the recent licensure of a heptavalent pneumococcal conjugate vaccine (Prevnar"', PCV7), which contains serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F conjugated to CRM,197, a mutant diphtheria toxin, an important new tool is available to prevent serious pneumococcal infections in children.

    The American Academy of Pediatrics (AAP) recently issued recommendations for the prevention of pneumococcal infections, including the use of pneumococcal conjugate vaccine, pneumococcal polysaccharide vaccine, and antibiotic prophylaxis (Pediatrics. 2000;106:367-376). These guidelines should be useful as physicians incorporate pneumococcal conjugate vaccine into the routine childhood immunization schedule.

    According to Larry K. Pickering, MD, special consultant to the director, National Immunization Program, Centers for Disease Control and Prevention, in Atlanta, Georgia, the guidelines for use of pneumococcal conjugate vaccine from the Advisory Committee on Immunization Practices will be available in late summer or early fall and will be very similar to those issued by the AAP and the American Academy of Family Physicians.

    "The pneumococcal conjugate vaccine is an important vaccine, said Jon Abramson, MD, chairperson of the AAP's Committee on Infectious Diseases and Weston M. Kelsey Professor and Chair, Department of Pediatrics, Wake Forest University School of Medicine, in Winston Salem, North Carolina. "Since Haemophilus influenzae type b conjugate vaccine has proven so effective in preventing invasive disease in children caused by that organism, the pneumococcal conjugate vaccine is the next vaccine to deal with the causes of important systemic bacterial infections in children," Dr Abramson told VACCINE BULLETIN.

    At its June 2000 meeting, the ACIP added the pneumococcal conjugate vaccine to the Vaccines for Children program. According to Dr Abramson, reimbursement issues related to the pneumococcal conjugate vaccine are of concern and must be determined state by state. "Even the universal purchase states differ with respect to vaccine reimbursement," he added. The AAP is trying to deal with reimbursement issues to smooth the process by which a new vaccine is rolled out once a recommendation is made.

    Who should receive the pneumococcal conjugate vaccine? According to the AAP, administration of PCV7 is of the highest priority for infants and toddlers 23 months of age and younger and for children at high risk for pneumococcal disease because of underlying illnesses. Currently, data are insufficient to support a recommendation for universal immunization of any children older than 24 months of age, other than those who are at high risk, according to the AAP.

    Children 23 Months of Age and Younger

    The PCV7 vaccine is recommended for routine administration to all children 23 months and younger, at 2,4,6, and 12 to 15 months of age (Table 1). Each 0.5-mL dose of the vaccine should be administered intramuscularly. The initial 2month dose should be given no earlier than 6 weeks of age; very-low-birth-weight infants (<1500 g) should be immunized at the time they attain a chronological age of 6 to 8 weeks, regardless of their calculated gestational age.

    All children 23 months of age and younger who have not received doses of PCV7 prior to 6 months of age should be given catch-up doses according to the schedules given in Table 1:

    - Children 7 to 11 months of age who have not previously received vaccine should receive two doses at least 6 to 8 weeks apart, followed by a third dose at 12 to 15 months of age or at least 6 to 8 weeks after the second dose.

    - Children 12 to 23 months of age who have not been immunized previously should receive two doses at least 6 to 8 weeks apart.

    According to the AAP, infants should receive the PCV7 immunization series in conjunction with other required childhood vaccines at the time of the first regularly scheduled well-child visit after at least 6 weeks of age. For children 23 months of age or younger who begin a catch-up immunization series at 7 months of age or older, the PCV7 immunization series should start at the time of their next clinic visit, including those visits that are not related to well-child care unless contraindicated.

    Children 24 to 59 Months of Age at High Risk for I PD

    The AAP recommends PCV7 vaccine for all children 24 to 59 months old who are at high risk for IPD, i.e., rates of infection of at least 150 / 100,000 (Table 2). Among the conditions that render a child at high risk for IPD are sickle-cell disease, other types of functional or anatomic asplenia, HIV infection, and primary immune deficiency. Children who are receiving immunosuppressive drugs also are in the high risk category for IPD.

    Recommended schedules of pneumococcal immunization for high-risk children who are 24 to 59 months of age and who may or may not have received prior doses of 23PS or PCV7 vaccine are given in Table 3. These schedules advocate the use of both 23PS and PCV7 vaccines in older children.

    The AAP policy statement points out that few data exist regarding the safety and immunogenicity of combined regimens of PCV7 and 23PS vaccines, and no data are available that address the efficacy of such regimens for the prevention of pneumococcal disease. But immunogenicity data suggest that PCV7 induces a primary immune response that will provide immune memory for the boosting of antibody to some serotypes contained in 23PS vaccine. Because 23PS vaccine provides a potential expansion of serotype coverage, it is recommended for use in high risk children. However, because of concern that repeated doses of 23PS vaccine may result in an increased incidence of local reactions, recommendations for the number of doses and dose intervals for pneumococcal vaccines (Table 3) should be carefully followed.



    Age at First Dose (months) Primary Series Booster Doses'

    2-6 3 doses, 6-8 weeks apart 1 dose at 12 -15 months of age

    7-11 2 doses, 6-8 weeks apart 1 dose at 12-15 months of age

    12-23 2 doses, 6-8 weeks apart

    >24 1 dose

    *Recommendations for high-risk groups are given in Table 3.
    Booster doses to be given at least 6 to 8 weeks after the final dose of the primary series.



    High Risk (IPD attack rate >150 cases/100,000/y)
    1. Sickle-cell disease, congenital or acquired asplenia, or splenic dysfunction
    2. Infection with HIV

    Presumed High Risk (I PD attack rate not calculated)
    1. Congenital immune deficiency: some B- (humoral) or T-lymphocyte deficiencies, complement deficiencies (particularly C1, C2, C3, and C4 deficiencies), or phagocytic disorders (excluding chronic granulomatous disease.
    2. Chronic cardiac disease (particularly cyanotic congenital heart disease and cardiac failure)
    3. Chronic pulmonary disease (including asthma treated with high-dose oral corticosteroid therapy)
    4. Cerebrospinal fluid leaks
    5. Chronic renal insufficiency, including nephrotic syndrome
    6. Diseases associated with immunosuppressive therapy or radiation therapy (including malignant neoplasms, leukemias, lymphomas, and Hodgkin's disease) and solid organ transplantation*
    7. Diabetes mellitus

    Moderate Risk (I PD attack rate >20 cases/1 00,000/y)
    1. All children 24-35 months of age
    2. Children 36-59 months of age attending out-of-home care
    3. Children 36-59 months of age who are of Native American (American Indian and Alaska Native) or African-American descent

    *Guidelines for the use of pneumococcal vaccines for children who have received bone marrow transplants are currently undergoing revision.


    Children 24 to 59 Months of Age at Moderate Risk for IPD

    Data are inadequate to recommend routine universal administration of PCV7 or 23PS vaccine to children greater than 24 months of age who are at moderate risk for IPD (attack rates of at least 20/100,000 but less than those deemed high-risk). Children who are considered to be at moderate risk for IPD include

    - All children 24 to 35 months of age

    - Children 36 to 59 months of age who attend out-of-home care (>4 hours weekly in the company of at least two unrelated children)

    - Children 36 to 59 months of age who are of Native American (American Indian and Alaska Native) or African American descent

    Other factors that might be considered when establishing priorities for possible elective immunization of children 24 to 59 months of age with a pneumococcal vaccine include
    - Social or economic disadvantage
    - Residence in crowded or substandard housing/state of homelessness
    - Chronic exposure to tobacco smoke
    - History of severe or recurrent otitis media within the year prior to immunization or prior tympanostomy tube placement

    According to the AAP, PCV7 vaccine administered electively for children 24 to 59 months of age should be given according to the schedule in Table 1. An alternative is administration of a single dose of the 23PS vaccine for all children 2 years of age or older. If PCV7 is used , a single dose of 23PS vaccine after administration of PCV7 should be considered, particularly in children of American Indian descent, to provide broadened pneumococcal serotype coverage. The dose of 23PS vaccine should be given no earlier than 6 to 8 weeks after the last dose of PCV7.

    Healthy Children 5 Years of Age and Older

    Health care professionals also may elect immunization with PCV7 or 23PS vaccine for certain children 60 months of age or older, although the risks for IPD are much lower in these older children, according to the AAP. Although data are limited, studies of small numbers of children with sickle-cell disease and HIV suggest that PCV7 is safe and immunogenic when administered to children up to 13 years of age. Therefore, administration of a single dose of PCV7 to children of any age, particularly children at high risk for IPD, is not contraindicated. However, 23PS also may be effective and immunogenic in older children at increased risk of invasive or severe respiratory tract infections caused by pneumococci. Therefore, immunization with a single dose of PCV7 or 23PS vaccine is acceptable. If both vaccines are used, they should be given 6 to 8 weeks apart.

    Use of Pneumococcal Vaccine in Children With Severe or Recurrent Otitis Media

    Pneumococcal polysaccharide vaccines have not been successful in reducing the incidence of acute otitis media (AOM) in children of any age. Therefore, 23PS vaccine is not recommended for the prevention of AOM. However, PCV7 vaccine has effected a modest reduction (<10 ) in the incidence of AOM in children with a history of recurrent AOM (defined as three or more episodes in 6 months or four or more episodes in the year before vaccine administration). And PCV7 may be beneficial for children 24 to 59 months of age who have not previously received pneumococcal vaccines and who have a history of recurrent AOM or who have AOM complicated by placement of tympanostomy tubes.

    Control of Pneumococcal Disease Among Children Attending Out-of-Home Care

    Studies have found that rates of IPD among children attending out-of-home care are 2- to 3-fold higher than those among other healthy children of the same age group who are not enrolled in out-of-home care (defined as at least 4 hours per week in out-of-home care shared with at least two unrelated children). Immunization with 23PS vaccine does not reduce nasopharyngeal carriage of pneumococci, and available data are insufficient to determine efficacy of PCV7 in preventing or interrupting nasopharyngeal carriage or transmission of pneumococcal infection in out-of home-care settings where one or more invasive pneumococcal infections have occurred. Until additional data become available, routine immunization with PCV7 or 23PS vaccine is not recommended for children in out-of-home care, although the elective use of either vaccine is not contraindicated.

    Use of Pneumococcal Vaccines in Children With a History of Pneumococcal Disease

    Children who have had IPD should receive all recommended doses of pneumococcal vaccines (PCV7 or 23PS) appropriate for their age and underlying condition. The full series of scheduled doses should be completed even if the series is interrupted by an episode of IPD.

    Pneumococcal Vaccines: General Recommendations

    Either PCV7 or 23PS may be given concomitantly with other vaccines. A separate syringe should be used for the injection of either type of pneumococcal vaccine, which should be administered at a different site than other vaccines given during the same visit. The concurrent administration of pneumococcal vaccine with diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine, H influenzae type b conjugate vaccines, hepatitis B vaccine, inactivated poliovirus vaccine, measles-mumps-rubella vaccine, and varicella vaccine has not been shown to meaningfully impair the immune response to other vaccines.

    Rates of local reactions after administration of PCV7 are similar to those seen with H influenzae type b conjugate vaccines, although fever and local reactions occur more often with PCV7. The PCV7 vaccine does not contain thimerosal.

    In patients in whom elective splenectomy is performed for any reason, immunization with PCV7 or 23PS should be performed at least 2 weeks before splenectomy. Immunization should precede the initiation of immune-compromising therapy by at least 2 weeks, the AAP indicated. In general, pneumococcal vaccines should not be administered during pregnancy, because the effects on the developing fetus are unknown.

    Questions for the future

    According to Jerome 0. Klein, MD, professor of pediatrics, Boston University School of Medicine, in Boston, Massachusetts, questions that remain to be answered after recommendations for use of pneumococcal conjugate vaccine are implemented include
    - What pattern of pneumococcal disease will be seen in the first few years following widespread use of the vaccine in infants and children?
    - Will the incidence of pneumococcal bacteremia, meningitis, and pneumonia decline?
    - Will carriage of pneumococcal vaccine types be reduced, and will carriage of nonvaccine types increase?
    - Will the use of antibiotics for respiratory infections and suspected invasive disease decline?
    - Will the incidence of multidrug-resistant pneumococci decline? -


    The following Q&As were adapted from the "Doctors Frequently Asked Questions" section of the Web site, which is provided as an educational service of Wyeth Lederle Vaccines.

    Q: In addition to the fact that the pneumococcal conjugate vaccine can be given to children younger than 2 years, what are its benefits, compared with the currently licensed polysaccharide pneumococcal vaccine?

    Kathryn Edwards, MD, Vanderbilt University, Nashville, Tennessee: The pneumococcal conjugate vaccine includes seven most common serotypes in children, whereas the vaccine contains the 23 most common serotypes in adults and children. The conjugate vaccine generates memory to the seven serotypes included in the vaccine, while the 23-valent does not generate memory to the 23 serotypes in the vaccine. The conjugate vaccine generates an immune response in children as young as 2 months of age, while the 23-valent vaccine does not generate antibody until a child is 2 years of age. The conjugate vaccine has been shown to prevent invasive pneumococcal disease in infants, whereas the 23-valent vaccine has not.

    Q: If a patient received the 23-valent pneumococcal vaccine at 2 years of age, would he still need to receive the 7-valent pneumococcal conjugate vaccine between the ages of 3 and 5 years?

    Dr. Edwards: The use of pneumococcal conjugate vaccine booster doses in children who have been immunized with the 23-valent vaccine at the age of 2 years has been evaluated in a small number of studies to date. However, according to the available studies, it appears that the conjugate vaccine will result in a better antibody response than the 23-valent vaccine. The conjugate vaccine also primes for a memory response, so that subsequent boosters with the 23 valent vaccine would likely be very immunogenic. It has also been shown that children first receiving the 23-valent vaccine followed by the conjugate vaccine do not appear to have more frequent or severe local reactions.

    Q: What about infants beginning the pneumococcal conjugate vaccine series at the 6-month well-child visit? Do they need the full four doses, or can an adequate response be achieved with doses at the 6-, 9-, and I 2-month visits?

    George H. McCracken, Jr, MD, University of Texas South western Medical School, Dallas: Three doses of pneumococcal conjugate vaccine after 6 months will produce protective antibody titers, but the infant could be unprotected at 2 to 6 months, especially if the mother did not have adequate antibody titers to all seven serotypes at the time of birth. The 2-, 4-, and 6-month regimen was studied because it was the time of other childhood immunizations and also was the time H influenzae type b vaccine was given with such excellent results.

    Q: What are the recommendations for use of the pneumococcal conjugate vaccine in premature infants?

    Dr. McCracken: For most premature infants, routine immunizations are given when they reach 2 months of age, unless they remain hospitalized for medical problems. I am sure there are few data on the immunogenicity of the pneumococcal conjugate vaccine for most premature, low birth-weight babies, but studies will be done in the near future. I would administer pneumococcal conjugate vaccine to most premature infants when they have reached 2 months of age.

    source : Rougerknapp

  • Healthy Family

    Healthy Living Tips and Tricks

    It seems that everyone is concerned with healthy living these days. This is a good thing; it is important to be concerned with your health and to look for better strategies to improve your life. On the other hand, it also seems like everyone has a quick solution for healthy living, for a hefty fee of course. It seems at times that you can't turn on the television or open a magazine without seeing a celebrity or doctor trying to get you to buy their new book detailing the latest miracle diet that will change your life, whether it is fresh ground wheat grass or a daily tin of Brazil nuts. The reality is that these diets are unnecessary. Healthy living is available to everyone, and does not depend on buying the latest diet book or the most expensive vitamins. All that you need to do is to start making healthy decisions.

    How to eat healthy

    The most important facet of your life that you need to change as you move towards healthy living is to start eating nutritious foods. Do not try to follow a trendy diet, just eat a balanced diet of nutritious foods. When you eat well, you lower your risk of many health problems such as obesity, type 2 diabetes, heart disease, certain kinds of cancer and osteoporosis. You will also give yourself more energy, allowing you to enjoy life again.

    The most important group of foods, and the one that is most often the cause of poor diets, is fruit and vegetables. There is nothing particularly innovative about this advice; everyone knows that you need to eat your fruit and vegetables. The main problem is that so few people actually consume the seven to ten daily servings of fruits and vegetables they are supposed to have each day. And when they do eat fruit and vegetables, it is in forms that include added sugar, salt or fat.

    The food group that we all eat too much of is meat. Try to limit your meat intake, and emphasize meat alternatives for your protein needs. While you definitely need meat or an alternative for the protein, most people eat far too much from this food group. You will be surprised at how little is actually required to get you through the day.

    Get active

    Once you have started eating well, it is time to go out and get some physical activity! Now, this does not mean that you have to incorporate a rigorous physical workout into your daily routine. Just including small amounts of physical activity in your life will make a difference. So take the stairs instead of the escalator, or walk to the corner store instead of driving four blocks. Start slowly and incorporate more physical activity into your life, and you will be amazed at how quickly the results will add up.

    Have fun

    The final component of healthy living is to have a healthy mind. Build up a strong peer group who will give you the social support you need to be truly happy. This will reduce your stress, which will only lead to a healthier body.

    source : funny jokes (Go Article)

    10 Great Family Fitness Exercise Ideas

    Now that you've set the ground rules for sedentary activities, plan some family togetherness time. The idea is to get 60 minutes of moderate to vigorous exercise every day. So, how can you get your family moving in a way that's fun and doesn't feel like a punishment? Here are some easy ways to reach that goal together.
    1. Walk to school. Lace up your walking shoes and join the kids for a brisk walk to and from school each day.
    2. Check out physical participation video games. "I'm delighted with some of the newer action toys such as the [Nintendo] Wii games. People have the ability to play tennis, bowling, baseball, skateboarding, and snowboarding," Shannon says. "Kids love them. I'm generally trying to get kids away from the TV, but in this case, if they are swinging a bat or dancing, it's great."
    3. Build strong bones. Be sure to include bone-strengthening exercise as well, such as hopscotch, jumping rope, gymnastics, or volleyball — any "weight-bearing" activity, one that you do standing up.
    4. Take a tour of the park. Make going to the park a reward for a job well done, a good test grade, or anything that deserves a positive non-food reward. When you get there, play a fast game of Frisbee or pitch a ball.
    5. Turn birthdays into an active adventure. Make your presents for birthdays related to activities. Plan a family ski or snow-tubing day trip or visit a nearby zoo. A bike makes a great gift for every family member, as does a basketball hoop in the driveway and a badminton net in the back yard. Make sure that Mom and Dad are included in the bike rides and pick-up games, too.
    6. Get to the playground. Muscle-strengthening exercise doesn't mean just weight lifting. Take the kids to the playground to swing on the bars, climb a tree, or play tug-of-war.
    7. Go to the head of the class. To learn a new activity, take a class together, such as martial arts, dance, or yoga — a favorite among hard-to-please teen girls.
    8. Walk the dog. Treat your dog to daily walks that include the entire family.
    9. Plant a garden. Whether you choose fruit and vegetables or just some pretty flowers, get the kids involved in an organic gardening project. They'll get some brisk exercise digging, planting, and weeding. Then the whole family can enjoy the fruits of their labor with fresh produce and cut flowers.
    10. Follow your kids' lead. "This year I bought my granddaughter the Playskool Dance Cam because she loves to dance," Shannon says. "It takes a picture of a child dancing and puts it on TV dancing with cartoon characters. My basic words of advice are 'go with the flow.' If your child shows interest in some activity, such as dancing, encourage it and go with her to participate."
    Souce: Kid's Health Center
    Medically reviewed By Pat F. Bass III, MD, MPH

    Samuel Gultom


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  • Vacation To Samosir
    A Journey to our ancestor

    Recently, my parents and me have been travelling to Toba Lake, Samosir, North Sumatera, Indonesia. That was a great experience with a beautiful sight all over the lake. For information, Toba lake is the World famous is the crater Toba Lake in the Batak highlands; approximately five hours drive from Medan. Toba Lake is the largest lake in South East Asia and also one of the most spectacular, surrounded by tall mountains and with the large island of Samosir in the middle. If we descend from the mountain we see the lake glittering in all its beauty. The Dutch writer Rudy Kousbroek even called Toba Lake, 'the most beautiful place on earth'. Most visitors stay on the peninsula of Tuk Tuk on Samosir, named after the linguist Herman Neubronner van der Tuuk. In general people stay several days on Samosir to discover the island, to visit traditional Batak villages, to swim in the lake and go to the hot springs in Pangururan. (source : Toba Lake Tourism)

    We spent a week for that journey. Even I have to celebrate my fourth birthday in Pangururan, Samosir. I was very happy, swim, travel, and looking for a new experience. Actually, everything at Samosir was a new to me.... the traditional batak houses, animals, culture and the environment, totally new experience to me. We visited our families, our ancestor grave, and many activities.

    This vacation was mean to me.....

    Me and Nathan ride a Becak

    Me at originally batak houses

    Playing while waiting for sunset


    Samuel Gultom


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  • Infant Vaccinations
    Some parents are choosing to space out and delay recommended vaccines because they're worried that their infants are getting too many shots too soon, potentially contributing to later mental health issues.

    The issue has been especially persistent when it comes to autism, which some believe is tied to vaccines, although numerous studies have discounted such a link.

    However, a study published online May 24 in the journal Pediatrics finds no neurological benefit to delaying immunizations during the first year of life.

    Researchers at the University of Louisville analyzed the health records of more than 1,000 children. After comparing the kids' performance on 42 neuropsychological tests between the ages of 7 and 10 against the timeliness of vaccination during the first year of life, the researchers found no evidence that delaying vaccines gave children any advantage in terms of brain development.

    "Our study shows that there is only a downside to delaying vaccines, and that is an increased susceptibility to potentially deadly infectious diseases," said lead researcher Dr. Michael J. Smith, a pediatric infectious diseases specialist at the University of Louisville School of Medicine. "We hope these findings will encourage more parents to vaccinate according to the American Academy of Pediatrics schedule, and reassure them that they're making a safe choice when they do so."

    Smith said the study is the first to evaluate the long-term neuropsychological impacts of multiple vaccinations received in the first seven months of life. In the past few years, more and more parents are asking their pediatricians for an alternative vaccine schedule, "but we found that nobody had really looked at whether there are any advantages to delaying vaccines," he said.

    Using publicly available records collected for a previous study of exposure to the vaccine preservative thimerosal, Smith and co-author Dr. Charles Woods reviewed the immunization records of 1,047 children born between 1993 and 1997, as well as their performance on 42 in-depth neuropsychological tests taken between 2003 and 2004. Children were classified as up-to-date if they had received at least two hepatitis B, three diphtheria-tetanus-pertussis (DTP), three Haemophilus influenzae type B (Hib) and two polio vaccines on time during the first seven months of life. A vaccine was considered on time if it was given within 30 days of the recommended age.

    The developmental tests included assessments of speech and language, fine motor coordination, behavior regulation, general intellectual functioning and other abilities.

    Two separate analyses were performed. In the first, children with timely receipt of vaccination were compared to all other children in the study who had delays in receipt of one or more doses. In a second analysis, children who received the maximum number of vaccines in the first seven months of life were compared to those who received the fewest vaccines in the study group.

    In both analyses, the researchers found no evidence to suggest that multiple vaccines in the first year of life negatively impact a child's cognitive abilities later. In fact, the first analysis revealed that children who received all their vaccines on time performed slightly better on two of the 42 tests, after adjustment for familial and socioeconomic factors. Kids who missed or were late on one or more doses of vaccine didn't do better on any test.

    Vaccine expert Dr. Gary L. Freed, director of the Child Health Evaluation and Research Unit at the University of Michigan Health System, said he wasn't surprised by the findings, since "there's never been any evidence whatsoever that delaying vaccines does any good for any child." And the reason children receive so many vaccines at such young ages is because "the life-threatening diseases that they protect against are most likely to attack at these ages," he said.

    The researchers pointed out that newborns now receive two additional vaccines and one that has been reformulated, so more studies are needed to confirm this study's implications for new generations of babies. However, they also noted that infants' immune systems are actually exposed to fewer vaccine antigens now than they were during the period covered by this study, so the findings are likely to be similar.

    more source : CDC

    Articles: Jakarta Post

    RI to produce H1N1, H5N1 vaccines

    The government, together with state-owned pharmaceutical company PT Bio Farma, plans to start producing vaccines for the H1N1 and H5N1 strains of influenza by November 2010.

    The plan was revealed Monday during the inauguration ceremony of Airlangga University's avian influenza research center (AIRC) bio safety level-3 (BSL-3) in Surabaya by Vice President Boediono.

    "I hope the vaccines to be produced will be beneficial to the people of Indonesia," Boediono said.

    The center's team of researchers handed over the seed vaccines for both H1N1 and H5N1 to Boediono, who in turn gave them to Health Minister Endang Rahayu Setyaningsih as a symbolic gesture. The minister then passed them on to PT Bio Farma.

    Also attending the ceremony were National Education Minister Muhammad Nuh, East Java Governor Soekarwo, Deputy Governor Syaifullah Yusuf and Airlangga University's rector Fasichul Lisan.

    Speaking at the ceremony, Boediono expressed his pride that the team of researchers could successfully develop the seed vaccines.

    He also encouraged academics and industry to develop other vaccines as well as master the technology to do so for the benefit of the people.

    As Indonesia is plagued by tropical diseases, the challenge was to find and develop successful vaccines, he said.

    PT Bio Farma director Iskandar said the government had allocated Rp 1.3 trillion (US$139 million) to fund the research, development and production of the vaccines.

    He said his company had planned to begin clinical trials in March 2010 and would start producing the H1N1 vaccine by November 2010. "We will produce about 20 million doses in our first production run," he said.

    Health Minister Endang said researchers and paramedics would receive vaccines from the first production run, arguing that they were the ones who were critically exposed to the viruses in their work.

    Center researcher C.A. Nidom said his team had begun research on the vaccines in 2006 after the Health Ministry handed over five strains of the avian flu virus. In August 2009, it again gave them six strains of the influenza A virus.

    Following research, the 13-member team comprising researchers from Airlangga University and PT Bio Farma finally succeeded in creating and developing seed vaccines for both infectious diseases.

    Nidom also expressed optimism that the vaccines would be effective in preventing the spread of the diseases among human beings, especially after his team found the vaccines effective in trials on marmots, mice and monkeys.

    He claimed that Bio Farma would be successful in mass producing the vaccines as it was the only vaccine producer in Southeast Asia.

    Speaking previously in Bandung, Iskandar said the vaccine factory would be established simultaneously with the development of a chicken farm in Lembang, North Bandung.

    Around 48,000 poultry seeds will be developed at the facility to support the production of the vaccines by providing clean embryonated eggs as the media for developing the flu viruses using Japanese technology.

  • Vitamins and Minerals

    What You Eat is Just as Important as How Much You Eat

    Your body is growing a baby, and you need the right kind of fuel to do a good job. Vitamins and minerals help your body use the energy provided by foods. They also help repair and maintain cells and tissues. A prenatal supplement is a vitamin and mineral supplement you can take daily to make sure you're getting the right amount of certain important nutrients during pregnancy.

    In general, you'll want to look for one that contains more of certain nutrients (such as folic acid and iron) that you may not be able to get enough of from your diet. Just as important is to find one that includes no more than the recommended amounts of other nutrients (particularly vitamin A) that can be harmful to your baby if you take too much.

    This is one of the reasons that most prenatal supplements contain vitamin A at least partly in the form of beta-carotene, a nutrient that you get from fruits and vegetables that converts to vitamin A in the body. Unlike vitamin A from animal products, which has been known to cause birth defects when taken in high doses before conception or during pregnancy, beta-carotene is not considered to be toxic in high doses.

    You may also want to take an omega-3 supplement. In addition to the many wonderful things omega-3 fatty acids have been shown to do, including improving the health of your heart, preventing cancer, reducing hypertension, and easing symptoms of lupus and other autoimmune diseases, it can also do some wonderful things for your baby. Studies have shown that omega-3 fatty acids help improve brain and eye development in the fetus and baby. Plus, extra amounts of omega-3 can help you ward off depression.

    Variety is the Key to Health
    What are some good choices? Fruits, vegetables, whole-grain breads and pastas, milk products, and low-fat protein sources such as lean red meat, beans, tofu, poultry and some fish. (See Food to Avoid for a list of fish that are off-limits to pregnant women.)

    Folic Acid
    If you eat well and have no specific risk factors, the experts do not agree about whether you need to take a prenatal supplement. So talk with your practitioner about what's right for you. But everyone does agree that you need to take 400 micrograms (mcg) of folic acid a day in addition to the folic acid you get from food.

    Start taking folic acid at least a month before you start trying to get pregnant and during your first trimester. In fact, since half of all pregnancies are unplanned, the U.S. Public Health Service recommends that ALL women of childbearing age take 400 mcg of folic acid a day. That's because research has shown that doing this can reduce the risk of neural tube defects in your baby by up to 70 percent.

    If you do take a prenatal supplement, it's likely to contain between 600 and 1,000 mcg of folic acid. If you don't take one, make sure you still take a separate folic acid supplement. If you've previously had a baby with neural tube defects, you'll need to take 4,000 mcg, or 4 milligrams, of this vitamin each day starting at least a month before conception; see your practitioner about getting a prescription for pills that provide this larger dose.

    Women with Certain Health Issues
    Women with dietary restrictions or pregnancy complications need to take a prenatal supplement - and not just for the folic acid and iron. This includes vegetarians and vegans; women who are lactose-intolerant or have certain other food intolerances; smokers and women who abuse other substances; women who are having twins or higher multiples; and women with certain blood disorders and chronic diseases. If any of these situations apply to you, talk to your caregiver about what kind of supplement is best for you.

    Important Vitamins and Minerals:

    • Calcium (1,000mg) Where to get it: Dairy foods, dark leafy greens, calcium-fortified soy milk, calcium-fortified juices and cereals
    • Folate (folic acid is the synthetic form, available in supplements)(600mcg) Where to get it: Dried beans, peas, lentils, orange juice, oranges, dark leafy greens, soy nuts, avocados, broccoli, asparagus
    • Iron (27mg) Where to get it: Liver, meat, seafood, prune juice, dry beans, wheat germ, oatmeal, tofu, soy nuts, grains
    • Protein (70g) Where to get it: Meat, poultry, seafood, dairy foods, beans and legumes, nuts
    • Vitamin C (85mg) Where to get it: Citrus fruits and juices, strawberries, bell peppers, tomatoes, dark leafy greens, broccoli, Brussel sprouts
    • Omega-3 Fatty Acids (200-300mg)Where to get it: Salmon, walnuts, flaxseed, leafy-green vegetables

    What the Experts Say
    Your health care provider will most likely recommend you take prenatal multivitamins containing the recommended amounts of vitamins, including folic acid. Your prenatal vitamin is crucial throughout pregnancy to support the growth of the baby, so be sure you take it every day. In fact, your need for iron doubles during pregnancy, and you may not be able to get enough from your diet.

    Some pregnant women need to take a 30-milligram iron supplement during their second and third trimesters to help prevent anemia. Your health care provider will recommend one if you need it. Your provider also may recommend a calcium supplement if you are unable to consume dairy products. Never take a supplement that contains more than the Daily Value (DV) of vitamins and minerals without talking to your health care provider, because large doses of certain vitamins (such as vitamin A) may harm your baby.

    source : Pregnancy-Info

    7 More Vital Vitamins for Pregnant Woman

    When you are pregnant it is important that you fully appreciate the significance of vitamins and minerals. They are essential for the healthy development of your unborn baby. Therefore, you need to know what the various vitamins do and more importantly how you can make them a part of your diet. In this article there are seven of these important vitamins and minerals in greater detail

    1. Vitamin B6 (Pyridoxine):- This vitamin helps your baby's brain and nervous system develop. In some cases it has also been noted to reduce morning sickness. Pyridoxine can be sourced in; bananas, watermelon, chick peas and chicken breast.
    2. Calcium:- This mineral is essential for the development of your baby's bones and your need for this mineral will increase greatly during pregnancy. Calcium deficiency can lead to osteoprosis (porous bones) and reduce the strength of your baby's bones. Calcium is contained in lots of dairy products such as; milk, cheese, yogurt, spinach, tofu and broccoli.
    3. Vitamin E:- This vitamin helps a baby's muscles and red blood cells to develop. A lack of Vitamin E has been linked with low birthweight, whilst getting too much of this vitamin has been associated with stillbirth. It is therefore vital that you ask for your doctor's advice before considering Vitamin E supplementation. You can get Vitamin E in a number of foods including; vegetable oil, nuts, and fortified cereals.
    4. Iron:- This mineral plays a major role in the development of red blood cells which are required for the healthy development of your baby. Iron is also an important mineral in the growth of the placenta. Iron can be sourced from; red meats, vegetables, grains and fortified cereals.
    5. Protein:- Protein is one of the core building blocks in all your baby's body cells. The need for protein increases during the second and third trimester of your pregnancy. Many dietary products are rich in protein including; meat, fish, eggs, cheese and tofu. It can also be found in supplements such as bars and shakes.
    6. Vitamin B1 (Thiamin):- This vitamin is essential for the development of your baby's central nervous system. Not getting enough Thiamin can put your baby at risk of beriberi which can damage the baby's heart and lungs. Foods which contain Thiamin include; whole grain foods, wheat germ and eggs.
    7. Zinc:- This mineral is highly important for cell growth in your unborn baby. Zinc also promotes the production of enzymes such as insulin in pregnant women. Zinc can be found in; red meats, poultry, beans, grains and dairy products.

    Vitamins and minerals are a crucial part of any pregnant woman's diet. I hope this article gives you some guidance on which vitamins you need and where you can find them. However, for professional advice on the vitamins and minerals you will require during your pregnancy you should consult your doctor.

    source : Article Base

  • Morning Sickness : My Mom's Got Pregnant

    My Mom's always looks pale every morning, she looks not so health and always go to bathroom. One day I ask my mom to feed me while I was playing my computer, but she seems to be not so encourage with that. "May be you should ask your sister to feed you, my boy", mom said and ask my sister (nanny) to feed me.

    Well, after a couple days, I realize that my mom's got pregnant, and waiting for my little brother to delivery. I do hope that my Mom's give me little brother . Of course, I can play better with my him someday.

    Morning Sickness

    The following are safe, proven treatments for morning sickness. Still, few women gain complete relief from morning sickness treatment. Taking ginger or doxylamine is most likely to effectively curb nausea and vomiting.

    • Certain antihistamines like doxylamine or dimenhydrinate, taken as your doctor advises, may relieve morning sickness.2 If one of these antihistamines alone does not relieve your morning sickness, you can try taking it with vitamin B6.3
    • Ginger, taken regularly as a powder in a capsule, grated fresh into hot water for a tea, or in syrup or crystallized form, can significantly relieve morning sickness after a few days of treatment.3
    • Vitamin B6 and B12, taken regularly as your doctor advises, can reduce nausea and vomiting.
    • Acupressure, firmly placed on the P6 point (the inner side of your arm, in line with your middle finger and one-sixth of the way between your wrist and elbow), relieves nausea for some women.

    Follow these guidelines for minimizing nausea and vomiting during pregnancy.

    • Keep food in your stomach but not too much. An empty stomach can make nausea worse. Eat several small meals every day instead of three large meals.
    • For morning nausea, eat a small snack (like crackers) before you get out of bed. Allow a few minutes for the snack to digest, then get out of bed slowly.
    • Stay hydrated. Drink a lot of fluids. Try a sports hydration drink, as well as water, broth, or juice.
    • Eat more protein, and cut your fatty food intake.
    • Avoid smells and foods that make you feel nauseated. Citrus juice, milk, coffee, and caffeinated tea commonly make nausea worse.
    • Avoid iron supplements, which can make nausea worse. These aren't necessary during the first trimester.
    • Get lots of rest. Stress and fatigue can make morning sickness worse.

    Contact your doctor immediately if you vomit more than 3 times a day or are unable to take fluids, especially if you also have pain, fever, or both.

    First Trimester of Pregnancy

    No matter how well you prepare for your pregnancy, you may not be able to fully anticipate all of the different changes that are about to take place in your body. During the first trimester (the first three months after your last menstrual period), these changes will help your baby develop and prepare your body to nourish the baby.

    Knowing what to expect can help you get ready for the months ahead and learn to distinguish between symptoms that are just uncomfortable and signs that there might be a real problem with your pregnancy.

    What to Expect: Changes in Your Body

    Pregnancy is different for every woman. Some women glow with good health and vitality during those first three months; others feel absolutely miserable. Here are some of the changes you might experience, what they mean, what you can do to relieve any uncomfortable symptoms, and which signs warrant a call to your doctor.

    Bleeding. About 25% of pregnant women experience some bleeding during their first trimester. Early in the pregnancy, light spotting may be a sign that the fertilized embryo has implanted in the uterus. However, if you have significant bleeding, cramping, or sharp pain in your abdomen, call your doctor. These could be signs of a miscarriage or ectopic pregnancy (a pregnancy in which the embryo implants outside of the uterus).

    Breast tenderness. Sore breasts are one of the earliest signs of pregnancy. They're triggered by hormonal changes, which are preparing your milk ducts to feed your baby, and will probably last through the first trimester. Going up a bra size (or more) and wearing a support bra can make you feel more comfortable; you can go back to the lacy bras after your baby is finished nursing.

    Constipation. During pregnancy, the muscle contractions that normally move food through your intestines slow because of higher levels of the hormone progesterone. Add to that the extra iron you're getting from your prenatal vitamin, and the result is uncomfortable constipation and gas that can keep you feeling bloated throughout your pregnancy. Increase your fiber intake and drink extra fluids to keep things moving more smoothly. Physical activity can also help.

    If your constipation is really bothering you, talk to your doctor about what mild laxative or stool softeners are safe to use during pregnancy.

    Discharge. It's normal to see a thin, milky white discharge (called leukorrhea) early in your pregnancy. You can wear a panty liner if it makes you feel more comfortable, but don't use a tampon because it can introduce germs into the vagina. If the discharge is foul-smelling, green, or yellow, or if there's a lot of clear discharge, call your doctor.

    Fatigue. Your body is working hard to support a growing fetus, which can wear you out more easily than usual. Take naps or rest when you need to throughout the day. Also make sure you're getting enough iron (too little can lead to anemia, which can cause excess fatigue).

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