This phenomenon appears not only in Indonesia, but also in other parts of the world. Often, there is excessive and not appropriate intervention exact indication either in treatment or surgery in patients. This is not only done a doctor, but often occurs because of pressure patients.
Not realizing that the action or excessive medical intervention and not as an indication that may adversely impact patients ranging from mild to life-threatening risk. Excessive medical intervention and did not fit indikasiyang most often are antibiotics, tonsillectomy, inpatient hospital, an appendectomy and operation sectio Caesaria. Other excessive medical intervention is the administration of drugs and excessive vitamins, no surgery or surgery as indicated in condition very poor patient prognosis and indeed there is no hope for recovery.
Here are 5 medical intervention in health Indonesia excessive:
1. Antibiotics
According to research by the U.S. National Ambulatory Medical Care Survey in 1989, each year about 84 percent each year every child get antibiotics. Other results obtained 47.9 percent of prescriptions in children aged 0-4 years are antibiotics. This figure, according to calculations many experts actually quite worrying.
In the same year, also found that bacteria resistance is high due to the excessive use of antibiotics. In Indonesia, there is no official data on the use of antibiotics. So many people today do not worry and do not seem problematic. But based on the level of education or knowledge society and the fact that found everyday, it seems the use of antibiotics in Indonesia is much more and more worried. Indications proper and correct in giving antibiotics to children is when the cause of the infection is bacterial.
According to the CDC (Centers for Disease Control and Prevention) is an indication of antibiotics when coughs and colds sustained for over 10-14 hari.yang occur throughout the day (not just at night and early morning). Night and morning cough usually associated with allergies or is no longer in phase of infection and do not need antibiotics. Another indication if there are symptoms of severe acute sinusitis infection such as heat> 39 degrees Celsius with purulent nasal discharge, pain, swelling around the eyes and face.
Another indication is strep throat streptococcal bacteria infection. This disease generally attacks children aged 7 years or more. At the young age of 4 years, only 15 percent who had strep throat bacteria. Other diseases that should get antibiotics are urinary tract infections and typhoid. Most cases of illness in ambulatory children the cause is a virus. In other words, should the possibility of the use of antibiotics was not great or maybe only about 10-15 percent of people with children. Disease virus is a disease that includes "self-limiting disease" or a disease cured itself within 5-7 days.
Most infectious diseases diarrhea, coughs, colds and heat cause is a virus. Recommendations and outreach campaign to the parents and doctors who had conducted the joint CDC and AAP (American Academy of Pediatrics) giving a true understanding of the use of antibiotics. Colds, fever and cough are symptoms of upper respiratory infection caused by a virus. Change the color of phlegm and yellow snot turned into thick, slimy and green is a clinical course of acute respiratory tract infection due to a virus, antibiotics are not indicative. Antibiotics will not shorten the course of the disease and prevent bacterial infections ride
2. Inpatient hospital
Often a child is a child with a high fever or seizures but generally good condition advise me straight in the hospital inpatient. Possibly, an indication of hospital inpatient cases are correct. But instead, many cases that should not require inpatient hospitalization forced. Sometimes excessive action is not only done the doctor, but also the parents do. Due to excessive anxiety little boy had a high fever or vomiting several times is forcing doctors to do inpatient care.
Some institutions have issued recommendations indication when to hospitalizations for various cases of the disease. But the limits and criteria are generally still very wide and lead to various interpretations and debate. Impact of hospitalization is not appropriate indications other than wasting a huge cost also risk getting nosocomial infections or new infections contracted in hospitals. In general, even more virulent bacteria of nosocomial infection than infection outside of the hospital.
3. Tonsillectomy tonsillectomy
Tonsillectomy or tonsillectomy is the most common actions during asejarah operation. Tonsillectomy is the most widely reported controversy than any surgery. Tonsillectomy when appropriate indication is necessary and should be done. However, there are many cases tonsillectomy is not as indicated. Often parents are confused in the face of the child who advise me for tonsillectomy or tonsillectomy. Confused because often there is a difference of opinion between some doctors.
Mengadviskan particular doctor's opinion to suspend operations due to various medical reasons such as there is still no absolute indication. But instead, the opinion of a particular doctor for immediate tonsillectomy as soon as various other medical reasons.
Actually indkasi should be operating according to the American Academy of Otolaringology Headneck Surgery (AAO) is only 3, namely (1) Tonsils (tonsils) are great to cause respiratory problems, severe pain swallow, sleep disorders or complications have occurred cardiopulmonary diseases. (2) peritonsiler Abscess (Peritonsillar abscess) that does not improve with treatment. And enlarged tonsils causing growth disorders face or mouth, documented by oral surgery dentist.(3) Tonsillitis which resulted in seizures and fever.(4) the estimated Tonsil biopsy requires the network to determine the pathological picture of the network.
Indication of the relative mean surgery is better not diporasi no problem. The indications are (1) Tonsillitis 3 times or more in one year and did not respond as expected to treatment medikamentosa adequate. (2) Bad breath or bad breath odors that settled in chronic tonsillitis that does not improve with treatment. (3) chronic tonsillitis or recurrent tonsillitis suspected carrier streptococcus bacteria that do not show a positive repon to treatment with antibiotics. (4) Enlarged tonsil on one side (unilateral) associated with suspected malignancy (neoplastic).
Pretense used as an indication of such operations (1) If no intelligence operations declined. (2) If the surgery does not cause heart disease and lung disease. (3) When not in operation the child of oxygen to the brain is reduced so less concentration and less intelligent. (4) Or other indication of improper operation due to impaired weight growth, kesullitan eating, speech disorders, sleep disorders, bad breath, enuresis (bedwetting).
4. An appendectomy
Research at the University of Washington showed that 16 percent of appendectomy surgery performed on patients who really do not need. Appendicitis or appendicitis is dangerous that doctors generally do not want to take the risk and choose quickly cut the body does not clear functions.
Appendicitis can be identified by investigation in the form of ultrasound, or CT scan, and the number of white blood cells that exceed 10.000/mcL. Severe abdominal pain is often diagnosed appendicitis, abdominal pain but can also occur in many cases. Sometimes frequent overdiagnosis of appendicitis because the symptoms that occur about the same quality and location of pain with other disorders. Misdiagnosis of appendicitis is common in people with allergies or asthma who previously had a history of colic as a baby, often fussy when aged under the age of 3 months or recurrent abdominal pain. Abdominal pain will arise in these patients when exposed to a viral infection that attacks the body.
5. Operation sectio
Operations Sectio Caesaria no indications including the most common medical interventions. WHO global survey conducted in nine Asian countries in 2007 and 2008, covers Cambodia, China, Nepal, Philippines, Sri Lanka, Thailand, and Vietnam. China showed the highest number of Caesarea sectio 46.2 percent and had surgery without the greatest indication is 11.7 percent while Vietnam with the 1 percent.
Study conducted in Jakarta in 2009 showed that surgery without indications have been reported by 13.9 percent. Compared with spontaneous vaginal delivery, the delivery operative cause of maternal mortality was significantly higher. The results showed that there are maternal mortality and morbidity in women undergoing sectio Caesarea without indication.
Each operative measures improve maternal mortality and morbidity indices such as blood transfusion, hysterectomy (removal of the uterus), internal iliac artery iligasi, mortality, or ICU care much larger than spontaneous labor. The increase was primarily due to higher ICU and blood transfusion. No error if medical intervention with a clear indication, but if they consider that a Caesarean is a harmless act, then the public should be made aware of the evidence is.
Impact and preventionControversy about excessive intervention is reasonable medical treatment occurs in every doctor's decisions and actions. Often there is a difference of opinion as every case is different background conditions. In performing medical procedures, physicians should always wear a medical indication with reference evidance base medicine (or evidence-based scientific events based research), the patient's condition and the interests of patients.
Be unnatural if the medical treatment is not in the interest of the patient but for the sake of the individual, the interests of the hospital or other particular interests. In addition, excessive medical intervention can also be caused by patient demand, even without indication of a doctor anyway.
Often the patient's anxiety excessive force doctors to perform medical acts too much for him. When this happens, your doctor should have to educate the adverse effects of medical intervention is not indicated. Instead pass a patient's request after they were aware dampakburuk risks that can occur.
Adverse effects of medical interventions and not excessive as indicated This can result in the loss or wastage costs enormous. Other harm is resulting in morbidity or other health problems are very mengangggu new. In fact, other adverse effects may meningktkan risk of mortality or life threat. The best prevention is not going to be excessive medical intervention and appropriate indication is an indication of the proper conduct when making medical intervention. When the risk of excessive intervention and not as indicated, the patient should undertake a second opinion or a second opinion to another doctor.
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