Saturday, August 27, 2011

Life Insurance is Necessary ?


"Life is full of uncertainty, but death is one thing that will happen in our lives without a doubt ... .. '

According to the study of human sebuh today could expect to live until age 120 years, even every year around the world may be about 3000 people celebrated the 100th birthday, but not everyone can live that long. Most of us may die earlier in a workplace accident, road accident or because they hurt. The problem is the risk of death is not only the psychological impact of losing a loved one, furthermore the risk of death also could result in financial loss if it happens to the breadwinner. For most families in general the death of the breadwinner, then the inevitable will next run into financial difficulties in line with the cessation of family income.

For those of you who want to avoid unpleasant financial situation, then the answer is to anticipate the risk of financial loss by buying life insurance, which will pay some cash compensation when the insured person dies. Anticipate financial loss by buying life insurance is important for every person who has dependents, especially for those who are married especially if the spouse has no income, plus they already had children. For a life insurance as part of your family financial planning means ensuring that people whose lives depend on you financially will not suffer financial hardship if you die.

However, buying life insurance is also not as easy as it should.Lots of life insurance products currently offered on the market, unfortunately some of them do not provide the maximum benefit in accordance with the money we spend.

Who needs life insurance ?

Anyone who has dependents, or if there is someone else to provide for his life depends on your income. Consequently, if you die and automatic income was also suspended, then that person will find it hard to make ends meet. Most of the income protection needs arising from the risk of death when someone is married and has children. This is when the death of a parent or main breadwinner can cause a very serious financial losses. It is appropriate that measures risk aversion at any time made available on the risk of death occurred and also be able to replace lost income due to death of the breadwinner. The more dependent you are, then the greater the amount of coverage required

In addition to the reasons was the life insurance should also be taken by you who have mortgage debt obligations, especially large debts with a long term payment such as credit home mortgage or car loan repayments. Life insurance is taken specifically is designed to cover debt repayment guarantee of remaining debt, if you as the debtor dies. Thus if there is risk of death to you, should not leave your family or your spouse and your children are in debt payment obligations.

What is the magnitude of the sum insured ?

Ideally the sum insured provided the insurer should be able to replace the previous income families so that expenditure can be covered. However, to achieve the ideal condition is certainly needed some insurance money which can be very large, consequently the more expensive the premium payment. Like it or not we should be realistic in determining the amount of sum assured.

For example, for a young family it is an important protection as early as possible and not have to force myself to take the insurance with a large sum assured. But what value should be based on the minimum for his family in order to survive. For example, someone recently married man who predicted that with a capital of Rp 20 million, she could support herself by starting a business that until his death. Therefore the man can buy insurance with a sum of Rp 20 million. So no need to jor-rod to set aside money for insurance. Do not forget, there are still many other household needs that must be financed, not to mention having to save for future needs.

For insurance can also be purchased incrementally, so do not need all at once. Example: back on top, before having a child was quite young families take out insurance with a sum of Rp 20 million. Next after the children, then re-evaluated what his family needs in the long term after the child, for example, 18 years into the future or until the child has finished his school years. Thus man had enough to buy insurance for the needs in that period.Then the next time the child is born, again calculated how much the family needs now after the birth of the child to the two, at least had enough insurance money to help couples or wife left behind to support his family. Make a young family, the death of one of them means their partners should try to maintain family living standards so, at least until the youngest child can be financially independent. So a realistic amount of insurance money that should exist, although not able to meet all household needs for ever.

The amount of insurance money depends on several factors such as age, number of dependents, regular income, and how much debt they have. A young family may need a larger sum, than couples aged 40 or 50 years where the possibility of his sons were independent. When children can have their own income, the necessity of parents to have a certain amount of life insurance sum assured decreases. This is when the amount of the sum insured may be reduced

Friday, August 26, 2011

Hypertension Pulmonary




Pulmonary hypertension is a disease that is rarely found but because of progressive increase in pulmonary vascular resistance leading to decreased right ventricular function because of increased right ventricular afterload.Primary pulmonary hypertension is a rare disease of unknown etiology, whereas secondary pulmonary hypertension is a complication of many pulmonary diseases, cardiac and extrathoracic conditions. Chronic obstructive pulmonary disease, left ventricular dysfunction and disorders associated with hypoxemia frequently result in pulmonary hypertension

Diagnosis of pulmonary hypertension

To diagnose pulmonary hypertension, the doctor may perform one or more tests to evaluate the work of the heart and lung patients. This includes X-ray in the chest area to show an enlarged and abnormal vessels of the lungs, echocardiograms showing the visualization of the heart, a large measure of heart size, function and blood flow, and holding an indirect measurement of pressure in the vessels of the lungs.

With Radiology



Typical lung parenchyma in pulmonary hypertension net. Photos of the piston can help diagnose or help find other underlying disease pulmonary hypertensionTypical chest X-ray picture of pulmonary hypertension was found in hilar shadow, shadow the pulmonary artery and the lateral chest X-ray right ventricular enlargement.

Treatment of pulmonary hypertension

Treatment of pulmonary hypertension aims to optimize the left heart function by using drugs such as diuretics, beta-blockers and ACE inhibitors or by repairing the mitral heart valve or the aortic valve (the main blood vessel). In the treatment of pulmonary hypertension with lifestyle changes, diuretics, anticoagulants, and oxygen therapy is a therapy commonly done, but based on the study of the therapy has not been declared beneficial in overcoming the disease tersebut.Some possible treatment for pulmonary hypertension are listed in Table.Treatment of primary pulmonary hypertension is a complex, controversial and potentially dangerous.Patients benefit from referral to centers specializing in the management of common problems ini.Calcium channel blockers can reduce pulmonary vasoconstriction and prolong life in about 20 percent of patients with primary pulmonary hypertension. Unfortunately, there is no way to predict which patients will respond to vasodilators administered orally, and these drugs usually have a significant effect. Consequently, it is helpful to evaluate pulmonary vasoreactivity during catheterization, before long-term therapy is chosen. The most suitable drugs for testing acute response to a strong, short-acting and titratable. In patients who show evidence of acute hemodynamic response, long-term treatment with calcium channel blockers, administered orally in high doses, can produce a sustained hemodynamic response and improve survival. Epoprostenol (Flolan), or prostacyclin, is one of the most important advances in the treatment of primary pulmonary hypertensionThis Powerful short-acting vasodilator and inhibitor of platelet aggregation produced by the endothelium vaskularDalam one study, continuous intravenous infusion of epoprostenol exercise capacity, quality of life, hemodynamics and long-term survival in patients with class III or IV function.Although continuous infusion delivery system is complex, most patients can learn how to prepare and inject. Anticoagulation with warfarin (Coumadin) is recommended to prevent thrombosis and has been shown to prolong life in patients with pulmonary hypertension primaryPatients with this condition are susceptible to pulmonary thromboembolism because of sluggish blood flow, dilated right heart chambers, veins, and the relative lack of physical activity. Maintaining the International Normalized Ratio 1.5 to 2.0 is recommended. Other anticoagulants are also being studied. Inotropic agents such as digoxin (Lanoxin) is currently being investigated. In one study, digoxin produce acute beneficial hemodynamic effects in patients with right ventricular failure and primary pulmonary hypertension, but the long-term consequences of these treatments is unknown. Parenteral drug may also be useful

Surgical therapy

Surgery bulk head between the foyer of the heart (atrial septostomy) that connects between the right atrium and left the porch can reduce the pressure on right heart but the disadvantage of this therapy can reduce blood oxygen levels (hypoxia). Lung transplantation can cure pulmonary hypertension, but this is pretty much the complications of therapy and life expectancy figures for about 5 years.


Lung transplant

Primary pulmonary hypertension is usually progressive and eventually fatal. Lung transplantation is an option in some patients younger than 65 years who have pulmonary hypertension who did not respond to medical managementAccording to the 1997 U.S. transplant registry report, 24 lung transplant recipients with primary pulmonary hypertension had survival rates of 73 % in one year, 55 % in three years and 45 % in five years. Directreduction of pulmonary artery pressure was associated with improvement inright ventricular function. And Recurrence primary pulmonary hypertension after lung transplantation has not been reported

Conclusion

  • Pulmonary hypertension is a disease that is rarely found but because of progressive increase in pulmonary vascular resistance leading to decreasedright ventricular function because of increased right ventricular afterload.
  • Pulmonary hypertension is a complex problem that is marked with signs and symptoms are not specific and has many potential causes. It can be defined asa systolic pulmonary artery greater than 30 mm Hg or pulmonary artery pressure is greater than 20 mm Hg.
  • Diagnostic classification of pulmonary hypertension in according to (WHO) World Health Organization
    1. Hipertensi pulmonary artery
    2. Hipertensi pulmonary venous
    3. Pulmonary hypertension accompanied with respiratory system disorders and /  o hypoxemia
    4. Hipertensi pulmonale due to chronic thrombotic and / or disease
    5. Hiperetensi pulmonary embolism due to disorders directly affecting the pulmonary vascularization