Ebm Flu Burung

Nama : NPM :

Dewa Ayu Bulan Nabila 1102012059

Ilustrasi kasus Saudara baru saja disumpah sebagai dokter dan siap mengikuti program Internsip Dokter Indonesia. Sahabat saudara bertanya melalui telepon. Dia mengatakan mungkin dia terkena flu. Banyak rekan sekantornya tidak masuk dengan penyakit yang sama. Dia akan periksa ke dokter perusahaan, tapi sebelumnya ingin nasehat dari sadudara perlukah dia minta resep Tamiflu, apalagi sekarang banyak kasus flu burung. Apakah obat itu akan menyembuhkan penyakitnya lebih cepat sehingga dia bisa segera bekerja kembali dan apakah manfaatnya seimbang dengan harganya. Saudara pernah membaca tentang hal ini di suatu harian ibukota, tetapi perlu melakukan telaah bukti-bukti yang ada sebelum menjawab pertanyaan sahabat saudara. Sehingga saudara mengatakan jawabannya akan diberikan nanti agar tidak salah. Background Questions : 1. Apa yang dimaksud dengan flu? 2. Apa yang dimaksud dengan flu burung? 3. Bagaimana seseorang bisa tahu bahwa di terkena flu burung? 4. Bagaimana seseorang bisa tahu bahwa di terkena flu? 5. Bagaimana flu dapat menjangkit seseorang? 6. Apakah pengaruh dari mengonsumsi Tamiflu? Key word(s) for searching 1. Flu 2. Avian influenza 3. Tamiflu

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PATIENT/PROBLEM INDICATOR COMPARISON OUTCOME Pekerja kantor Tamiflu Flu sembuh PICO : pada seorang pekerja kantor yang diduga menderita flu, dapatkah tamiflu menyembuhkannyasecara cepat? TYPE OF QUESTION : Therapy/Treatment TYPE OF STUDY/METHODOLOGY : Systematic review Search results : 1. Influenza (the flu) is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness, and at times can lead to death. Some people, such as older people, young children, and people with certain health conditions, are at high risk for serious flu complications. The best way to prevent the flu is by getting vaccinated each year. The upcoming season's flu vaccine will protect against the three influenza viruses that research indicates will be most common during the season. This includes an influenza A (H1N1) virus, an influenza A (H3N2) virus, and an influenza B virus. http://www.cdc.gov/flu/about/disease/index.htm

2. Avian influenza; H5N1 is flu infection in birds. The virus that causes the bird infectin can change (mutate) to infect humans. Such mutation could start a deadly worldwide epidemic. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004522/ 3. Symptoms of avian flu infection in humans depend on the strain of virus. Infection with the H5N1 virus in humans causes typical flu-like symptoms, which might include:  Cough (dry or productive)  Diarrhea  Difficulty breathing  Fever greater than 100.4°F (38°C)  Headache  Malaise  Muscle aches  Runny nose  Sore throat http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004522/ 4. The flu usually comes on suddenly. People who have the flu often feel some or all of these symptoms:  Fever* or feeling feverish/chills  Cough  Sore throat  Runny or stuffy nose  Muscle or body aches  Headaches  Fatigue (tiredness)  Some people may have vomiting and diarrhea, though this is more common in children than adults. http://www.cdc.gov/flu/about/disease/index.htm 5. Person to Person People with flu can spread it to others up to about 6 feet away. Most experts think that flu viruses are spread mainly by droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth or nose. (To avoid this, people should wash their hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub. Linens, eating utensils, and dishes belonging to those who are sick should not be shared without washing thoroughly first. Eating utensils can be washed either in a dishwasher or by hand with water and soap and do not need to be cleaned separately.) The Flu Is Contagious Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick. Children may pass the virus for longer than 7 days. Symptoms start 1 to 4 days after the virus enters the body. That

means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick. Some persons can be infected with the flu virus but have no symptoms. During this time, those persons may still spread the virus to others. http://www.cdc.gov/flu/about/disease/spread.htm 6. Tamiflu is a prescription antiviral medication that can be used to treat influenza infections (the flu) in children and adults, if their symptoms have started within the last day or two before starting to take Tamiflu. It can also be used to prevent the flu in children, teens and adults who have been exposed to the influenza virus. http://pediatrics.about.com/od/drugprofiles/p/05_tamiflu.htm Tamiflu (oseltamivir phosphate) is an oral anti-viral drug approved for the treatment of uncomplicated influenza in patients one year and older whose flu symptoms have not lasted more than two days. This product is approved to treat Type A and B influenza; however, the majority of patients included in the studies were infected with type A, the most common in the U.S. Efficacy of Tamiflu in the treatment of influenza in subjects with chronic cardiac disease and/or respiratory disease has not been established. Tamiflu is also approved for the prevention of influenza in adults and children aged one year and older. Efficacy of Tamiflu for the prevention of influenza has not been established in immunocompromised patients. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsa ndProviders/ucm107838.htm

Nama :

Dewa Ayu Bulan Nabila

NPM

1102012059

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TUGAS EBM SKENARIO: Saudara baru saja disumpah sebagai dokter dan siap mengikuti program Internsip Dokter Indonesia. Sahabat saudara bertanya melalui telepon. Dia mengatakan mungkin dia terkena flu. Banyak rekan sekantornya tidak masuk dengan penyakit yang sama. Dia akan periksa ke dokter perusahaan, tapi sebelumnya ingin nasehat dari sadudara perlukah dia minta resep Tamiflu, apalagi sekarang banyak kasus flu burung. Apakah obat itu akan menyembuhkan penyakitnya lebih cepat sehingga dia bisa segera bekerja kembali dan apakah manfaatnya seimbang dengan harganya. Saudara pernah membaca tentang hal ini di suatu harian ibukota, tetapi perlu melakukan telaah bukti-bukti yang ada sebelum menjawab pertanyaan sahabat saudara. Sehingga saudara mengatakan jawabannya akan diberikan nanti agar tidak salah. PERTANYAAN KLINIS: pada seorang pekerja kantor yang diduga menderita flu, dapatkah tamiflu menyembuhkannyasecara cepat? PICO: P

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Pekerja kantor

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Tamiflu

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Flu sembuh

KATA KUNCI

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flu AND tamiflu

PEMILIHAN SITUS

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http://www.ncbi.nlm.nih.gov/pubmed

LIMITASI

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last five years, free full article, review article type, and human as object

HASIL PENCARIAN

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ARTIKEL YANG DIPILIH :

38 Artikel Study of specific oligosaccharide structures related with swine flu (H1N1) and avianflu, and tamiflu as their remedy.

Dimuat dalam http://www.ncbi.nlm.nih.gov/pubmed/21617340