Nursing Job in Saudi Arabia

There are some reason for single nurses to work in Middle East Country such as Saudi Arabia. Free tax and full housing facilities are two of them. Thus, they can put more their money in saving.
High turnover of nursing staff from this country to US State, UK, Australia, Ireland or other western countries, is opening oportunities for those who want to extend their carrier step for the first time. It is because compare to modern countries, the entrance standard for nurses in Saudi Arabia is much more easier. There is no particular requirement for any international certification such as specific IELTS band or NCLEX passer.

Presently, Saudi Arabia offer monthly wage ranging from US $800-1200 for Diploma III in Nursing, and it will be more for BSN certificate holder. Indonesia is one of nursing personel suplier to this country. Through Yayayan Amri in Jakarta, they are recruiting around 800-900 nurses. First bacth was closed on August 30 2007 and it will be follow by the next group.

New Scheme of Nursing Education in Indonesia

Over more than 50 years, Indonesian nursing education system have modified it's self in order to answer the need of nursing personel in Indonesia. An obvoius changes, started during 1980,s when the first nursing study program was aounced to operate at University of Indonesia Jakarta. Lately, it turned to became a nursing faculty, as a further recognition of nursing profesionalism in Indonesia.

A very brave step has been taken by Binawan Institutes of Health Sciences, in 2004 by creating collaboration for it's nursing program with toplisted university in Australia UTS. Under such limitation as a new nursing program especially in staffing and student's financial capability however, the patnership came to real.

Presently, nearly of 200 students are following bridging program to deserve BSN and RN fron UTS. Despite they have graded as S.Kep and Ners - award for Bachelourate degree in indonesia- before the bridging program enrolment.

By then, it will diversify nursing personel in Indonesia. It also in other point of view, has strengthen Indonesian human recources power as one of the bigest problem faced by Inonesian government.
For further detailed program and course, visit the link bellow.

Binawan Institutes of Health Sciences

Hope for Tuberculosis Blood Test

Existing TB tests do not always detect bacteria

Scientists have devised a blood test for tuberculosis which they hope will help patients in the developing world.
The team from St George's Hospital and the Medical Research Council National Institute for Medical Research says its serum test is 94% accurate.

It looks for biomarkers - indicators of infection - and could out-perform alternatives, a Lancet study said.
But a TB expert said many teams had tried to devise such a test but ultimately found they were ineffective. We are putting forward a fresh approach to an ancient problem

Professor Sanjeev Krishna, St George's Hospital, There are 7,000 new cases of TB reported in the UK each year. The current method for diagnosing TB involves examining sputum from the lungs under a microscope. But outside clinics, in rural areas in developing countries, the test is only 40% to 60% accurate.

The researchers found a molecular "signature" for TB.

It was detected using a mass spectrometer and statistical methods to uncover complex patterns known as biomarkers within samples from people infected with TB. They then used this signature to work out a simpler way to diagnose TB infection.

'Research graveyard'

Dr Delmiro Fernandez-Reyes, of Medical Research Council National Institute for Medical Research, said: "Current developments in mass spectrometry together with new statistical methods for pattern discovery are allowing us to identify biomarkers of infection.

"Our work opens the door to further research into translating these findings to fast and reliable methods of detecting active TB infection that could have a major impact in global health.

"We are currently apply similar approaches to malaria diagnosis."

Professor Sanjeev Krishna of the Centre for Infection at St George's Hospital, who also worked on the study, said: "We are putting forward a fresh approach to an ancient problem.

"I think it is going to be very exciting to make this work in clinics where a test for TB is desperately needed.

"The next stage will be to use the biomarkers we have identified to develop a cheap, accurate and rapid diagnostic test that can be used easily and quickly out in the field."

But Professor Peter Davis, of the organisation TB Alert, said while developing a blood rather than a bacteria test for TB was a widespread aim, it had been a "graveyard" for many researchers.

"The current test isn't very sensitive, and we treat about a third of cases of pulmonary [lung] TB without confirmation of diagnosis from a bacterial test.

"So we do need a new test". "But not one of the blood tests devised in the past has ever had any value."

Source: BBC.co.uk/Health

A Case Study: Allergic Reaction to Henna Ink

For the first time, severe allergic cellulitis resulted from henna ink (ink for colouring skin and hair in arabic comunity) was reported to be admitted in Pediatric ward Mubarak Alkabir Hospital-Kuwait.

The patient was a 5 year old girl, known having allergic to henna previously in a limited area of her skin. However it was resolved with topical application.

The allergic reaction started immediatly after application of skin collouring agent on the lateral region of right lower arm. First symtomps were developing itchiness, redness which were getting worse to swelling and edema. About 12-14 hours afterward, the area was becaming much more worse with an emerging of blisters, painfull sensation and limitation of movement due to severe edema. The surface was likely to be kind of burn reaction, as more blisters filled up with serous discharges variety in sizes developed mssively. The further reactions was leakage of serossangouinish dischages/fluid from the edematous tissues.

The most prominent complain upon the admission were pain and alteration in skin integrity. It was clearly understand due to inflamation and tisues injury reaction. Therefore patient was treated with hydrocortisone and acetamenophen as antyinflamatory agent and analgesic respectivelly. Some blood works (CBC, SUE and Immunogobullin study)have been taken revealed a slight ellevation of white blood cell, whereas others shown to be normal. The ellevation was found more remarkable in the day 2 of care (day 3 of the allergic reaction).

In day 1 of care, She also was treated with combination of cefotaxime and cloccacillin as profilaxys. Despite, wound care was done to clean the severe fluid leakage and debriss since some blisters became opened due to movement during her sleeping. Sofratule and light gauze was applied as dry dressing after being cleaned with normal saline and betadine.

The inflamation procces at the day 2 put the patient in more terrible situation with more fluid leaking, and more pain complain. However, cold dressing and analgesic administration have helped her to be more comfortable.
Dramaticall changes was noted at the first time at the day 4. Although some blisters were remained, but it became smaler in sizes and flatter. Edema was generally reduced as well as fluid leakage became minimal. The skin laceration from the opened blisters was dry with minimal crust. No singns of secondary infection during healing procces noted.

She started to have social activity in palying roon at the day 6, while antibiotics, and antyinflamatory agent were continued. Pain sensation most likelly to be reduced and well tollerated since the day 4. At the day 7 of care, patient was discharged home with wound care techcique skill and pantenol and fusibact as topical agents.

New Hope for Nerve Damage Patients

For long periode of health science development, discovering that there is hope to help patients with permanent nerve damage to recover was a new step in neurosurgery unit. He was Profesor John Prietsley, a neurologyst expert and researcher from Queen Mary Faculty of Medicine and Dental in London, have proven that cells in nervous system could grow at specific fiber which are having similar characteristic with silk fiber produced by spider.

Artificial fiber named Spidex formed from spinned silk have been modified to help neurons tied and connected one another and it was said that the fiber has characteristic of layer where nuerons grow.

Researchers studied the respond of Spidex in both a media consist of nerve tissue and in an animal as an objeck of experiment. A satisfactory finding resulted from both experiments. New tissues produced soround the spidex was showing red color, as a neuron and blue color as Scahwann cells, an important tissue for neurons to regenarate.

"And in animal, we have succesfully done in spinal cord and synapses" said Priestly. He also reported that Spidex could be create as a kind of complex tube designed as a media for neurons to grow.

For this new discovery, the tim have awarded "Wellcome Trust Biomedical Image Awards 2006". The success was a part of best 26 biomedical innovation which their experimental process could be observed and supervised directly.

Researcher put a big hope in Spidex to help patients with damages in synapses regulating muscles contraction and transmitting stimulus from peripheral receptors. Another spectacular finding expected in the near future is how Spidex become a more complex media for neurons at spinal cord to regenerate.

Source : Kompas, BBC,

Get Rid off From Fatigue Syndrome

If you easily get exhausted without any strenous activity, it is the time you should aware for any possibility that you might be having Chronic Fatigue Syndrome (CFS)

Definition of CFS
A great deal of debate has surrounded the issue of how best to define CFS. In an effort to resolve these issues, an international panel of CFS research experts convened in 1994 to draft a definition of CFS that would be useful both to researchers studying the illness and to clinicians diagnosing it. In essence, in order to receive a diagnosis of chronic fatigue syndrome, a patient must satisfy two criteria:

Have severe chronic fatigue of six months or longer duration with other known medical conditions excluded by clinical diagnosis; and Concurrently have four or more of the following symptoms: substantial impairment in short-term memory or concentration; sore throat; tender lymph nodes; muscle pain; multi-joint pain without swelling or redness; headaches of a new type, pattern or severity; unrefreshing sleep; and post-exertional malaise lasting more than 24 hours.
The symptoms must have persisted or recurred during six or more consecutive months of illness and must not have predated the fatigue.

For more detailed information regarding the definition of CFS, Some information bellow will bring you to some understanding about CFS

Other Conditions That May Cause Similar Symptoms
In addition, there are a large number of clinically defined, frequently treatable illnesses that can result in fatigue. Diagnosis of any of these conditions would exclude a definition of CFS unless the condition has been treated sufficiently and no longer explains the fatigue and other symptoms. These include hypothyroidism, sleep apnea and narcolepsy, major depressive disorders, chronic mononucleosis, bipolar affective disorders, schizophrenia, eating disorders, cancer, autoimmune disease, hormonal disorders*, subacute infections, obesity, alcohol or substance abuse, and reactions to prescribed medications

Risk Factors for CFS
People of every age, gender, ethnicity and socioeconomic group can have CFS.
CFS affects women at four times the rate of men. Research indicates that CFS is most common in people in their 40s and 50s. Although CFS is much less common in children than in adults, children can develop the illness, particularly during the teen years.

Defining CFS Symptoms
CFS is marked by extreme fatigue that has lasted at least six months; is not the result of ongoing effort; is not substantially relieved by rest; and causes a substantial reduction in daily activities.
In addition to fatigue, CFS includes eight characteristic symptoms:
- postexertional malaise (relapse of symptoms after physical or mental exertion);
- unrefreshing sleep;
- substantial impairment in memory/concentration;
- muscle pain;
- pain in multiple joints;
- headaches of a new type, pattern or severity;
- sore throat; and
- tender neck or armpit lymph nodes.

Symptoms and their consequences can be severe. CFS can be as disabling as multiple sclerosis, lupus, rheumatoid arthritis, congestive heart failure and similar chronic conditions. Symptom severity varies from patient to patient and may vary over time for an individual patient.
Symptomatic Treatment

People with CFS present with different patterns of primary symptoms. Symptom severity can also vary considerably. Clinicians should query patients about which symptoms are most disruptive or disabling and tailor the management plan accordingly. Treatment can be directed toward the most problematic symptoms as prioritized by the patient, but only after underlying conditions applicable to those symptoms have been investigated and excluded.

Primary symptoms may include sleep problems, muscle and joint pain, cognitive dysfunction, fatigue, headaches and sore throat. Gastrointestinal complaints, orthostatic instability, depression and allergies are also seen in many patients. Aggressive symptom management for these and other disruptive symptoms is indicated.

Pharmacologic Therapy
Pharmacologic therapy is directed toward the relief of specific symptoms experienced by the individual patient. There are many over-the-counter and prescription drug therapies that can be used to treat sleep difficulties, cognitive problems, pain and other symptoms of CFS.

Many CFS patients are sensitive to medications, particularly sedating medications. Therapeutic benefits can often be achieved at lower than normal dosages, so try prescribing a fraction of the usual recommended dose to start and gradually increase as necessary and as tolerated. All medications can cause side effects, which may lead to new symptoms or exacerbate existing symptoms, so it is important to routinely monitor all prescription drugs, OTC therapies and supplements the patient is taking.

Some drugs act on multiple body systems and symptoms. For instance, tricyclic antidepressants may not only improve mood, but may help with sleep and pain. Prescribing such drugs allows the use of fewer medications to address multiple symptoms with minimal side effects.

Nutritional and Herbal Supplements
Nutritional supplements and vitamins are frequently used by people with CFS for symptom relief. While there have been few clinical trials and many CFS patients report symptom relief with supplements, these products are unregulated, and information on potency and side effects is frequently unknown. The health care professional needs to question patients about supplement use and OTC products to determine safety, efficacy and possible negative interactions with prescribed medications and therapies
Patients should be advised to avoid herbal remedies like comfrey, ephedra, kava, germander, chaparral, bitter orange, licorice root, yohimbe and any other supplements that are potentially dangerous.

Nutritional supplements can't take the place of good diet and nutrition and, as such, a well-balanced diet should be encouraged. Some people with CFS report sensitivities to various foods or chemicals, including refined sugar, caffeine, alcohol and tobacco, all of which should be minimized to promote optimum health.

Alternative Therapies
Alternative therapies are often explored by CFS patients to relieve symptoms. Encourage patients to discuss such options with a health care professional to make sure they are safe and effective. Acupuncture, aquatic therapy, gentle massage, meditation, deep breathing, biofeedback, yoga, tai chi and massage therapy have been found to help some patients and are often prescribed for CFS symptom management.

Sleep Disturbances
The majority of CFS patients experience some form of sleep dysfunction. Common sleep complaints include difficulty falling asleep, hypersomnia, frequent awakening, intense and vivid dreaming, restless legs and nocturnal myoclonus. Most CFS patients experience nonrestorative sleep as compared to their pre-illness experience.
Health professionals can help people with CFS adopt good sleep habits. Patients should be advised to practice standard sleep hygiene techniques: establish a regular bedtime routine; avoid napping during the day, incorporate an extended wind-down period; use the bed only for sleep and sex; schedule regular sleep and wake times; control noise, light and temperature; and avoid caffeine, alcohol and tobacco. Light exercise and stretching earlier in the day, at least four hours before bedtime, may also improve sleep.

When sleep hygiene isn't successful, the use of pharmaceuticals may be indicated. Initial medications to consider are simple antihistamines or over-the-counter sleep products. If this isn't beneficial, then start with a prescription sleep medicine in the smallest possible dose and briefest period possible.
Unrefreshing sleep can be present even though medications may help patients achieve requisite hours of sleep. A sleep specialist should evaluate patients whose sleep remains non-restorative following standard interventions.

Primary sleep disorders such as sleep apnea and narcolepsy exclude the diagnosis of CFS, and most people with such disorders respond to therapy. It is imperative to obtain a careful sleep history. The Pittsburgh Sleep Questionnaire, a validated 19-question tool, or a brief sleep survey adapted from the CDC Symptom Inventory can be useful in assessing sleep problems and tracking effectiveness of sleep management interventions.

Pain
CFS pain occurs both in muscles (sometimes described as "deep pain") and joints (arthralgias). Patients may also complain of headaches (typically pressure-like) and allodynia, which is generalized hyperalgesia or soreness of the skin to touch.
Most pain therapy begins with simple analgesics like acetaminophen, aspirin or NSAIDS..Additional therapy can be managed by a pain specialist. Counseling for pain management techniques is advisable for patients with this kind of unremitting pain.

Pain management should include nonpharmacological modalities and alternative therapies. Stretching and movement therapies, gentle massage, heat, toning exercises, hydrotherapy and relaxation techniques can be helpful for CFS care. Acupuncture, when administered by a qualified practitioner who is knowledgeable about CFS, may be effective for pain management in some patients.

Orthostatic Instability
Some patients with CFS may also exhibit symptoms of orthostatic instability, in particular frequent dizziness and light-headedness. Depending on severity and clinical judgment, these patients should be referred for evaluation by a cardiologist or neurologist. Specific treatment for orthostatic instability should only be initiated following confirmed diagnosis and by clinicians experienced in evaluating therapeutic results and managing possible complications.

Treatments for orthostatic problems include volume expansion for CFS patients who don't have heart or blood vessel disease. If symptoms don't improve with increased fluid and salt intake, prescription medications and support hose can be prescribed.
During office visits, provide a place for CFS patients to recline if they have difficulty staying upright for more than a few minutes at a time.

Depression
Research shows that CFS is not a form of psychiatric illness or depression. However, many people with chronic illnesses, including those with CFS, may suffer from secondary depression as the patient makes the multiple adjustments to having a debilitating, chronic illness.
As many as half of CFS patients develop depression sometime during the course of the illness. When it's present, it needs to be treated. Although treating depression can reduce anxiety and stress, it's not a cure for CFS.

Professionals are advised to use caution in prescribing antidepressants. Antidepressant drugs of various classes have other effects that may act on other CFS symptoms and/or cause side effects.
There are brief psychiatric screening tools available that can be administered and scored in the primary care setting, such as the Beck Depression Inventory and the PHQ9. Results of these screening tools that point to a possible underlying depression or other psychological disorder necessitate a referral to a mental health professional.

Cognitive Dysfunction
Memory and concentration complaints are two of the more distressing symptoms reported by people with CFS. Relaxation and meditation training and memory aids, such as organizers, schedulers and written resource manuals, can be helpful in addressing cognitive problems. Stimulating the mind with puzzles, word games, card games and other activities may also be beneficial for some patients.

Clinicians may want to refer some CFS patients to behavioral health professionals to help them problem-solve and develop specific techniques for conducting activities of daily living that have become difficult. Referral to a neuropsychologist, neurologist or psychiatrist for evaluation and testing may be necessary in severe cases to determine whether other underlying conditions may be involved. It should be noted that training to improve cognition is a highly specialized therapy and requires input of trained behavioral health clinicians.
Use caution in prescribing stimulants for cognitive problems. Mild stimulants may be helpful for some patients, but stronger stimulants can precipitate the push-crash cycle and cause relapse.

Managing Patients with CFS
While symptom management is critical to the care of patients with chronic fatigue syndrome, it is also important for clinicians to address the emotional and psychosocial consequences of CFS. Like other debilitating chronic illnesses, CFS can have a profound impact on daily life, requiring patients to make therapeutic lifestyle changes including adaptation to prevent life-altering limitations.

The overall treatment plan should acknowledge the limitations of this illness, and the patient’s emotional reactions to them. While patients are justified in their emotional response to such a devastating illness, educating them about the link between stress and symptom exacerbation is an important adjunct to validating their feelings and subsequent clinical improvement.

The Basics of Supportive Care
Health care professionals who are seeking information about helping CFS patients develop effective coping strategies can find guidance on developing an effective supportive care plan tailored for CFS patients in the CFS Toolkit for Health Care Professionals, a new resource.

"Taken From Center for Disease Control and Prevention 2006".

Herbal Medicine: Is It Safe?

Herb Medicine is a term used in medical science, explain about the usage of natural herb (plants/vegetations) instead of drug to cure or prevent diseases. However this method has already popular for very long time and are likely a germ of medicine developing nowadays. More ever herb medicine are believed having less effect compared with modern one.

Since there is motto "back to nature", presently people has tendency to turn from the modern medicine to natural or herb one. However, thinking that using herb medicine are totally secure, is not pretty true. There are some principal and side effects should be put into awareness. Even more complications such as allergic reactions and kidney failure and death have been reported due to toxic impurity and incorrectly mixed herbs and interaction with prescribed drugs respectively.

The following herbs are commonly used. Please read carefully to be aware of possible undesired effects:

Ginko.
Ginko is commonly used to improve memory, increase blood circulation either peripheral and into the brain. It is used in treating bronchial asthma, and some pulmonary conditions.
There are undesired effects commonly reported are increase risk of bleeding, affecting hemodynamic systems, gastrointestinal distress and interferes anti seizure drugs.

Ginseng
It is known as physical and mental stamina booster, enhance general health, stimulate central nervous system, decrease the advances of alzheimer disease, and reduce chronic tinitus.
Undesired effects such as, falsely increase digoxin level, for female users prone to have postmenopausal bleeding, combine with cafeine possible to produce hypertension, palpitation and interfere pregnancy and lactation.

Garlic
Decreases cholesterol and triglyceride level, decreases blood pressure, antioxidant, fibrynolytic and antimicrobial properties (destroying fungi, bacteria and paracites).
Some possible clinical side effects are enhancing the diabetic drugs effect producing risk for hypoglicemia, headache, myalgia and fatigue. For anticlotting medicine users potential for having bruises.

THERE IS ONLY ONE HERB MEDICINE SAFE!!

Feverfew.
Prevent migraine headache, decrease severity of headache, arthritis and rheumatic disease.
To be aware of potential allergic reaction with allergic to ragweed, asters, chrysanthemums or daisies. Risk for abdominal pain, glositis, stomatities, and allergic dermatitis. Increasing risk for bleeding if interacts with aspirin, anticoagulant and thrombolytics. If combine with Imitrex or other migraine drugs potential for resulting critical level of heart rate and blood pressure. In acute withdrawal, some symptoms like rebound headaches, insomnia, fatigue and nervousness often be reported. It is strongly forbidden for pregnant and lactating mother.

Kava Kava
Acts as muscle relaxant to release nervousness, anxiety, or restlessness. It is also used as antispasmodic, anticonvulsant-psychotropic and treatment for cystitis. But Some side effects reported are prolong and enhance effect of certain antiseizure and anesthetic drugs. Enhance of alcohol effect resulting alcohol toxicity. Risk for rashes, Gastric upset, change on ocular movement and toxic to liver. In people with endogenous depression, increase risk for suicide. Contraindicated for lactating and pregnant women.

Ginger
Commonly used to treat motion sickness, nausea, vomiting and vertigo. Also for stomatitis, to enhance digestion, and as a mild stimulant to promote circulation.

It is contraindicated for treating morning sickness in pregnant women, risk for hemorage in client already taking antycoagulant. Overdose leads to CNS depression or dysritmias.

Saw Palmetto
Used in treating prostate enlargement and unrinary inflamation. Likewise as mild diuretic.
Watch for undesireable effects such as GI upset, nausea, abdominal pain, hypertension, headache, urinary retension and back pain. Affecting others adrenergic hormone drugs, and may interfere contraseptive drugs lead to contraseptive failure. It is also reduce iron absorption. Not recommended for lactating and pregnant women since affecting hormonal function.

Vallerian
Mild sleep aid, muscle relaxant, releiving stomach upset, to relief stress or as sedtive. Sleep inducer without producing sleep hangover.
Some adverse reaction reported GI complain, headache. Potential to increase the effect or certain antiseizure drugs, and prolongs the effect of certain anesthetisia agent. Risk to have hepatomegaly shen combined with other herbs such as skullcap and mistletoe. Not recommended for infant and lactating mother.

THERE IS ONLY ONE HERB MEDICINE SAFE!!
In the islamic view, HONEY has so many benefit and used to treat so many kind of diseases. It is mention in The Holly Qur'an An Nahl (Bee) 16:68-69 mentioned: And your Lord inspired to bee, "Take for yourself among the mountains, houses(ie hives), and among the trees and (in) that which they construct. Then eat all the fruits (delicious subsatnces found by the bee) and follow the way of your Lord laid down (for you)". There emerges from their bellies a drink, varying in colors, in which there is healing for poeple. Indeed in that is a sign for people who give thought.

NCLEX EXAM TIPS
The way for nurse to succes

How ready you are to make it?
This question always asked by colleagues even you to others and yourself. And the most probable answer is : "I don't know"
Even, those who have passed the exam, they are very offten to not knowing how ready they were.

However it not very important to determine your readiness. The most important is how much you been preparing yourself.

Some tips bellow may helps you to be succesed:

1. All NCLEX book & material are the same. Don't be fanatic to one of it. The more you know them, the richer you are
2. Review material and questions on daily basis, not a huge our once a time.
3. Start to answer comprehensif test in a specified time to assess your strength and weakness. Check your answer once you have completed the test.
4. Reveiw the topic from the weakest aspect.
5. Try to get some keywords and the basic concept of each topic.
6. Get into another NCLEX book with the same topic, and try to answer questions inside.

So.. Get ready..........................