Apa yang akan anda lakukan jika anda menemukan seseorang yang mengalami kecelakaan atau seseorang yang
terbaring di suatu tempat tanpa bernapas spontan? apakah anda dapat menentukan orang tersebut sudah mati ?
Seseorang yang mengalami henti napas ataupun henti jantung belum tentu ia mengalami kematian, mereka masih dapat
ditolong. Dengan melakukan tindakan pertolongan pertama, seseorang yang henti napas dan henti jantung dapat
dipulihkan kembali. Tindakan pertolongan pertama yang dilakukan untuk memulihkan kembali seseorang yang
mengalami henti napas dan henti jantung disebut bantuan hidup dasar, atau dalam istilah Inggris disebut Basic Life
Support.
Salah satu bentuk tindakan nyata dari BLS ini adalah Resusitasi Jantung Paru (RJP) atau dalam istilah Inggris disebut Cardio-Pulmonary Resucitation (CPR). RJP merupakan tindakan pengembalian fungsi jantung dan paru agar kembali normal. Tindakan RJP ini dapat dilakukan dimana saja, tanpa mempergunakan alat oleh orang yang terlatih, mulai dari orang awam sampai dokter.
Resusitasi jantung paru tidak dilakukan pada semua penderita yang mengalami gagal jantung atau pada orang yang sudah mengalami kerusakan pernafasan atau sirkulasi yang tidak ada lagi kemungkinan untuk hidup, melainkan yang mungkin untuk hidup lama tanpa meninggalkan kelainan di otak. Keberhasilan resusitasi dimungkinkan oleh adanya waktu tertentu diantara mati klinis dan mati biologis. Mati klinis terjadi bila dua fungsi penting yaitu pernafasan dan sirkulasi mengalami kegagalan total. Jika keadaan ini tidak ditolong akan terjadi mati biologis yang irreversibel. Resusitasi jantung paru yang dilakukan setelah penderita mengalami henti nafas dan jantung selama 3 menit, presentasi kembali normal 75 %tanpa gejala sisa. Setelah 4 menit presentasi menjadi 50 % dan setelah lima menit menjadi 25 %. Maka jelaslah waktu yang sedikit itu harus dapat dimanfaatkan dengan sebaik mungkin.
Langkah-langkah bantuan hidup dasar terdiri dari tiga tahap:
a. Memeriksa Jalan Napas (Airway control)
Pada korban yang tidak sadar akan terjadi relaksasi dari otot-otot termasuk otot-otot di dalam mulut. Akibatnya lidah akan jatuh ke bagian belakang dari tenggorokan dan akan menutupi jalan napas. Akibatnya, korban tidak dapat bernapas. Penutupan jalan napas ini juga dapat disebabkan oleh gigi palsu, sisa-sisa muntahan, atau benda asing lainnya.
Di sini penolong memeriksa apakah korban masih bernapas atau tidak. Bila tidak bernapas akibat adanya sumbatan maka penolong harus membersihkan jalan napas ini agar menjadi terbuka.
Korban dibaringkan terlentang.
Penolong berlutut di samping korban sebelah kanan pada posisi sejajar dengan bahu.
Letakkan tangan kiri penolong di atas dahi korban dan tekan kearah bawah dan tangan kanan penolong mengangkat dagu korban ke atas. Tindakan ini akan membuat lidah tertarik ke depan dan jalan napas terbuka serta akan membentuk satu garis lurus sehingga oksigen mudah masuk.
Dekatkan wajah Anda ke wajah korban, dengar serta rasakan hembusan napas korban sambil melihat ke arah dada korban apakah ada gerakan dada atau tidak.
b. Bantuan Pernapasan (Breathing Support)
Setelah jalan nafas terbuka, penolong hendaknya segera menilai apakah pasien dapat bernafas spontan atau tidak. Ini dapat dilakukan dengan mendengarkan gerak nafas pada dada korban. Bila pernafasan spontan tidak timbul kembali diperlukan ventilasi buatan.Untuk melakukan ventilasi mulut ke mulut penolong hendaknya mempertahankan kepala dan leher korban dalam salah satu sikap yang telah disebutkan diatas dan memencet hidung korban dengan satu tangan atau dua kali ventilasi dalam.Bila denyut nadi karotis tidak teraba, dua kali ventilasi dalam harus diberikan sesudah tiap 15 kompresi dada pada resusitasi yang dilakukan oleh seorang penolong dan satu ventilasi dalam sesudah tiap 5 kompresi dada pada yang dilakukan oleh 2 penolong. Tanda ventilasi buatan yang adekuat adalah dada korban yang terlihat naik turun dengan amplitudo yang cukup ada udara keluar melalui hidung dan mulut korban selama respirasi sebagai tambahan selama pemberian ventilasi pada korban, penolong dapat merasakan tahanan dan pengembangan paru korban ketika diisi.Pada beberapa pasien ventilasi mulut ke hidung mungkin lebih efektif daripada fentilasi mulut ke mulut. Ventilasi mulut ke stoma hendaknya dilakukan pada pasien dengan trakeostomi. Bila ventilasi mulut ke mulut atau mulut ke hidung tidak berhasil baik walaupun jalan nafas telah dicoba dibuka, faring korban harus diperiksa untuk melihat apakah ada sekresi atau benda asing.
c. Bantuan Sirkulasi ( Circulation Support)
Bantuan ketiga dalam BHD adalah menilai dan membantu sirkulasi. Tanda- tanda henti jantung adalah :
Kesadaran hilang dalam waktu 15 detik setelah henti jantung.Tak teraba denyut nadi arteri besar (femoralis dan karotis pada orang dewasa atau brakhialis pada bayi).Henti nafas atau megap- megap.Terlihat seperti mati.Warna kulit pucat sampai kelabu.Pupil dilatasi (45 detik setelah henti jantung)Tidak ada nadi yang teraba pada arteri besar, pemeriksaan arteri karotis sesering mungkin merupakan tanda utama henti jantung. Korban hendaknya terlentang pada permukaan yang keras agar kompresi dada luar yang dilakukan efektif. Penolong berlutut di samping korban dan meletakkan sebelah tangannya diatas tengah pertengahan bawah sternum korban sepanjang sumbu panjangnya dengan jarak 2 jari dari persambungan episternum. Tangan penolong yang lain diletakkan diatas tangan pertama, jari- jari terkunci dengan lurus dan kedua bahu tepat diatas sternum korban, penolong memberikan tekanan ventrikel ke bawah yang cukup untuk menekan sternum 4 sampai 5 cm.
Setelah kompresi harus ada relaksasi, tetapi kedua tangan tidak bo;eh diangkat dari dada korban, dianjurkan lama kompresi sama dengan lama relaksasi. Bila ada satu penolong, 15 kompresi dada luar (laju 80 sampai 100 kali/ menit) harus diikuti dengan pemberian 2 kali ventilasi dalam (2 sampai 3 detik). Dalam satu menit harus ada 4 siklus kompresi dan ventilasi (yaitu minimal 60 kompresi dada dan 8 ventilasi). Jadi 15 kali kompresi dan 2 ventilasi harus selesai maksimal dalam 15 detik. Bila ada 2 penolong, kompresi dada diberikan oleh satu penolong dengan laju 80 sampai 100 kali/ menit dan pemberian satu kali ventilasi dalam 1 sampai 1,5 detik oleh penolong kedua sesudah tiap kompresi kelima. Dalam satu menit minimal harus ada 60 kompresi dada dan 12 ventilasi. Jadi lima kompresi dan satu ventilasi maksimal dalam 5 detik.
Sumber : http://www.promosikesehatan.com/artikel.php?nid=146
http://pdpersi.co.id/?show=detailnews&kode=397&tbl=cakrawala
http://href="http://www.honda-megapro.or.id/index2.php?option=com_content&do_pdf=1&id=86">www.honda-megapro.or.id/index2.php?option=com_content&do_pdf=1&id=86
http://medlinux.blogspot.com/2007/09/resusitasi-jantung-paru.html
Kamis, 06 Desember 2007
Jumat, 26 Oktober 2007
Genes, Age and Family Can Be Risk Factors To Get Breast Cancer
Nowdays, many people in the world are affraid about this cancer, especially for women. Simply living longer is one of the strongest contributors to breast cancer, since age brings greater exposure to cancer-causing agents. Not the least of these is the female hormone estrogen, which can prompt breast tissue to grow abnormally after waxing and waning over a lifetime of menstrual cycles. But exactly how breast cells react to the hormone is influenced by genes. Two known genetic mutations, BRCA1 and BRCA2, have been identified, but other, still unknown genes almost certainly contribute to risk for the disease. The often cited risk factors are familiar to most people, but some may be more fiction than fact.
THINGS TO THINK ABOUT
Age: The older a woman is, the greater her lifetime exposure to potential carcinogens and cancer-promoting estrogen.
Genetics:About 10% of breast-cancer cases in the U.S. are due to inherited genetic mutations in the BRCA1 or BRCA2 genes.
Family Ties: Having two or more first-degree relatives with breast cancer could hint at unidentified genetic contributors to the disease.
Delayed Childbirth: Putting off pregnancy increases exposure to estrogen by increasing the total number of menses over a lifetime.
Treatment
The goal of any cancer treatment is to clear away malignant cells while leaving the remaining cellular landscape as intact as possible. MammoSite, a five-day, seed-based therapy, does that by directing radiation at only cancer-rich regions of the breast. After surgically removing cancerous growth, doctors insert a balloon with a catheter into the cavity left behind by the tumor. They can then thread radioactive seeds into the balloon to zap away any residual cancer cells.
RESULTS
No More Tumors — After five years, women treated with MammoSite showed no recurrent growths in their breasts.
A Fresh Choice — Women who thought mastectomy was preferable to the traditional six weeks of radiation now have a new option.
sumber : http://www.time.com/time/specials/2007/article/0,28804,1666089_1666563_1668362,00.html
THINGS TO THINK ABOUT
Age: The older a woman is, the greater her lifetime exposure to potential carcinogens and cancer-promoting estrogen.
Genetics:About 10% of breast-cancer cases in the U.S. are due to inherited genetic mutations in the BRCA1 or BRCA2 genes.
Family Ties: Having two or more first-degree relatives with breast cancer could hint at unidentified genetic contributors to the disease.
Delayed Childbirth: Putting off pregnancy increases exposure to estrogen by increasing the total number of menses over a lifetime.
Treatment
The goal of any cancer treatment is to clear away malignant cells while leaving the remaining cellular landscape as intact as possible. MammoSite, a five-day, seed-based therapy, does that by directing radiation at only cancer-rich regions of the breast. After surgically removing cancerous growth, doctors insert a balloon with a catheter into the cavity left behind by the tumor. They can then thread radioactive seeds into the balloon to zap away any residual cancer cells.
RESULTS
No More Tumors — After five years, women treated with MammoSite showed no recurrent growths in their breasts.
A Fresh Choice — Women who thought mastectomy was preferable to the traditional six weeks of radiation now have a new option.
sumber : http://www.time.com/time/specials/2007/article/0,28804,1666089_1666563_1668362,00.html
Pesticide Contamination Ubiquitous In Pregnant Women
A study from the University of Granada in Spain that analyzed the presence of organochlorine pesticides in pregnant women found that all the participants showed placental traces of at least one pesticide. More alarmingly, on average, the women were contaminated with eight different pesticides.
Organochlorine pesticides fall into a group of chemical compounds known as persistent organic pollutants. They are present in the environment in food, biomass, soil and water. They cannot be assimilated and tend accumulate in the fatty parts of the body.
Exposure to organochlorine pesticides has been linked to various malformations in the genitals and urinary systems of offspring. The most common effects of exposure in the womb are cryptorchidism (undescended testicles) and hypospadias (a total fusion of the urethral folds) in male infants.
The study - in which 300 women participated - involved sampling the blood, umbilical cord and the placenta at birth. Other general data on the parents, their places of residence, profession, medical history, age, tobacco habits, lifestyle and diet were also considered.
The analysis of the placental tissues revealed the presence of multiple endocrine disruptive (interfering with the hormonal system) organochlorine pesticides. The most common were DDE (found in 93 percent of the women), lindane (75 percent), endosulfan diol (62 percent) and y endosulfan-I (54 percent). Endosulfan-diol recorded the highest concentration at 4.15 nanograms per gram of placenta. Incredibly, some of the subjects' placentas contained 15 of the 17 pesticides analyzed.
For pregnant women, the researchers suggest that organic foodstuffs, daily exercise and the avoidance of tobacco are important in minimizing the risk of male reproductive health disorders in offspring.
sumber: http://www.scienceagogo.com/news/20070414232527data_trunc_sys.shtml
Organochlorine pesticides fall into a group of chemical compounds known as persistent organic pollutants. They are present in the environment in food, biomass, soil and water. They cannot be assimilated and tend accumulate in the fatty parts of the body.
Exposure to organochlorine pesticides has been linked to various malformations in the genitals and urinary systems of offspring. The most common effects of exposure in the womb are cryptorchidism (undescended testicles) and hypospadias (a total fusion of the urethral folds) in male infants.
The study - in which 300 women participated - involved sampling the blood, umbilical cord and the placenta at birth. Other general data on the parents, their places of residence, profession, medical history, age, tobacco habits, lifestyle and diet were also considered.
The analysis of the placental tissues revealed the presence of multiple endocrine disruptive (interfering with the hormonal system) organochlorine pesticides. The most common were DDE (found in 93 percent of the women), lindane (75 percent), endosulfan diol (62 percent) and y endosulfan-I (54 percent). Endosulfan-diol recorded the highest concentration at 4.15 nanograms per gram of placenta. Incredibly, some of the subjects' placentas contained 15 of the 17 pesticides analyzed.
For pregnant women, the researchers suggest that organic foodstuffs, daily exercise and the avoidance of tobacco are important in minimizing the risk of male reproductive health disorders in offspring.
sumber: http://www.scienceagogo.com/news/20070414232527data_trunc_sys.shtml
Menstrual Migraines Hit Hard
Migraines can attack with a vengeance during menstruation, but taking medication before your period begins may help stave off these excruciating headaches.
One study sought to confirm the association between migraine and menstruation that many women already report to their doctors. The British researchers found that, indeed, such an association does exist: Women are 2.5 times more likely to have a migraine during the first three days of menstruation, and they're more than three times as likely to report the migraine as severe.
The other study looked for a way to relieve menstrual migraines. Researchers compared the preventative use of the migraine medication frovatriptan to a placebo. They found that by starting frovatriptan therapy two days before menstruation begins and continuing treatment for six days, the occurrence of menstrual migraines could be reduced by as much as 26 percent.
The researchers found that women were 2.1 times more likely to have a migraine in the two days before a period, and that number increased to 2.5 times more likely during the first three days of menstruation. Women were 3.4 times more likely to report that migraines that occurred during menstruation were severe.
In the treatment study, 443 women with migraines were recruited from 36 centers across the United States. They were randomly assigned to one of three groups during each of three menstrual cycles. One group took a placebo; one group took 2.5 milligrams of frovatriptan once daily; and the other took 2.5 milligrams of frovatriptan twice a day. All took the treatments for six days, beginning two days before the expected start of menstruation.
Sixty-seven percent of the women taking the placebo reported having migraines, while only 52 percent of those taking frovatriptan did. The group taking frovatriptan twice a day had the best results, with only 41 percent experiencing a migraine.
sumber : http://www.healtharticles.org/menstrual_migrains_081204.html
One study sought to confirm the association between migraine and menstruation that many women already report to their doctors. The British researchers found that, indeed, such an association does exist: Women are 2.5 times more likely to have a migraine during the first three days of menstruation, and they're more than three times as likely to report the migraine as severe.
The other study looked for a way to relieve menstrual migraines. Researchers compared the preventative use of the migraine medication frovatriptan to a placebo. They found that by starting frovatriptan therapy two days before menstruation begins and continuing treatment for six days, the occurrence of menstrual migraines could be reduced by as much as 26 percent.
The researchers found that women were 2.1 times more likely to have a migraine in the two days before a period, and that number increased to 2.5 times more likely during the first three days of menstruation. Women were 3.4 times more likely to report that migraines that occurred during menstruation were severe.
In the treatment study, 443 women with migraines were recruited from 36 centers across the United States. They were randomly assigned to one of three groups during each of three menstrual cycles. One group took a placebo; one group took 2.5 milligrams of frovatriptan once daily; and the other took 2.5 milligrams of frovatriptan twice a day. All took the treatments for six days, beginning two days before the expected start of menstruation.
Sixty-seven percent of the women taking the placebo reported having migraines, while only 52 percent of those taking frovatriptan did. The group taking frovatriptan twice a day had the best results, with only 41 percent experiencing a migraine.
sumber : http://www.healtharticles.org/menstrual_migrains_081204.html
Selasa, 23 Oktober 2007
The Biggest Hidden Dangers For Newborns
For most young women whose have a newborn baby usually become overprotective to their baby. They will make sure that their baby is always in good condition. It's easy to overlook potential falling-related dangers and a few general home safety issues. Falling-related dangers include your baby falling, the person carrying your baby falling, and objects falling on your baby. There are some tips to help keep your baby safe:
• Keep heavy or breakable objects out of reach: Move objects such as picture frames and ceramic figures away from the changing table and crib so your child can't topple them.
• Place furniture away from hazards: Keep cribs and changing tables away from windows, window cords, and hanging mobiles to prevent your child from getting tangled, suffocating, or falling out or through the window. * Secure unstable furniture: If you live in an earthquake-prone area, make sure tall or unstable pieces of furniture are securely braced to the wall.
Pay particular attention to things that could fall on your child — bookshelves, armouries, and entertainment centers — and to those that could fall and prevent your escape or access to your child.
• Check the changing table pad: Be sure the changing pad is secured to your changing table so your child is less likely to squirm off.
• Prevent falls: Parents, relatives, and sitters can fall while carrying a baby due to poor lighting, loose rugs, or loose or nonexistent stair railings. You're probably familiar with these hazards in your own home and will naturally compensate for some of them. But a relative or sitter may not be, and could take a tumble, potentially injuring both themselves and your baby. To help prevent that from happening, use nightlights liberally, put fresh carpet grips under your rugs, and fix or install stair railings.
• Make your home fire safe: Place functional smoke detectors in each bedroom, in the adjacent hallway, and on each level of your home. If your detectors are more than ten years old, replace them. You should have at least one fire extinguisher on each floor of your house and a carbon monoxide detector next to the sleeping areas.
http://www.healtharticles.org/newborn_hidden_dangers_081304.html
• Keep heavy or breakable objects out of reach: Move objects such as picture frames and ceramic figures away from the changing table and crib so your child can't topple them.
• Place furniture away from hazards: Keep cribs and changing tables away from windows, window cords, and hanging mobiles to prevent your child from getting tangled, suffocating, or falling out or through the window. * Secure unstable furniture: If you live in an earthquake-prone area, make sure tall or unstable pieces of furniture are securely braced to the wall.
Pay particular attention to things that could fall on your child — bookshelves, armouries, and entertainment centers — and to those that could fall and prevent your escape or access to your child.
• Check the changing table pad: Be sure the changing pad is secured to your changing table so your child is less likely to squirm off.
• Prevent falls: Parents, relatives, and sitters can fall while carrying a baby due to poor lighting, loose rugs, or loose or nonexistent stair railings. You're probably familiar with these hazards in your own home and will naturally compensate for some of them. But a relative or sitter may not be, and could take a tumble, potentially injuring both themselves and your baby. To help prevent that from happening, use nightlights liberally, put fresh carpet grips under your rugs, and fix or install stair railings.
• Make your home fire safe: Place functional smoke detectors in each bedroom, in the adjacent hallway, and on each level of your home. If your detectors are more than ten years old, replace them. You should have at least one fire extinguisher on each floor of your house and a carbon monoxide detector next to the sleeping areas.
http://www.healtharticles.org/newborn_hidden_dangers_081304.html
Low Back Pain (LBP)
Do you wake up in pain? When you are trying to get out of bed the pain in your back takes your breath away…you move slowly…you make it into the shower and let the hot water run on your back…and finally you’re “almost ok”. And it’s still early in the day! As the day goes on it seems to improve a bit, until you get into the car and drive home. By the time you try to get out of the car the pain is back with a vengeance. This time it doesn’t seem to get any better, and you eventually go to bed – to repeat the cycle tomorrow.
These conditions can all be the end result of muscle spasms! While it seems incredible that a simple thing like a spasm can cause so much trouble, it’s easy to understand when you take a close look at the body. There are 600 muscles in the body and 206 bones. The only reason that bones move is because muscles pull on them (unless you have a traumatic accident), and therein lies the problem. The muscle originates at a stationary point in the body; it then crosses over a joint and inserts onto another bone. When a muscle contracts it pulls the insertion point toward the origination point, and the joint bends.
That condition usually being called Low Back Pain (LBP). Pain in the low back is something that at least 70% of our chronic pain clients complain about, and it is also one of the most misunderstood conditions.There are two muscles that move the low back. One is called “Quadratus Lumborum” and it is right where you rub yourself when your low back is hurting. It originates on the five lumbar vertebra and inserts onto the top of your hipbone. As mentioned earlier, the other muscle, the one that causes the majority of low back pain, is called the psoas. This muscle also originates on the five lumbar vertebra, however it goes forward, through the curve of your hips, and inserts onto the front of your thighbone (the femur).
When the muscle contracts you fold at the hip. Every time you take a step, sit down, bend over, or do anything that brings your leg up or your trunk down, you are contracting the psoas muscle. This muscle is contracted the majority of the day, and for most people, it is also contracted all night because the sleep with their legs bent. Because of this, it is common for the muscle to become shortened. However the origination and insertion points are still the same distance apart, so two things happen. First, when you are lying down you are told you have a “short leg”. The bones of your leg haven’t shortened, however the muscles are pulling your leg up toward the hip so it appears shorter. As soon as you stand up on both of your feet your legs are equal length again.
The second, and more serious, condition occurs when you are standing. The muscle is still to short, so it pulls on the other attachment – the lumbar vertebra. You now feel pain in your low back. The lumbar vertebra are being pulled forward, the disks are being compressed, the nerves are being impinged, and again you are feeling the “hair pulling” effect on the bone. The pain intensifies when you go from sitting to standing, and you can relieve the pain somewhat when you bend over, or sit down. This is because as you bend at the hip you have just brought the two ends closer together, and the strain has been removed from the insertion points. When you stand up it will again return as the muscle again pulls on the lumbar vertebra. The answer is to stretch the muscle!
Stretching is vital to the free movement of joints, and is amazing to the healing process of repetitive strain injury. Get in touch with your body. Trust your intuition. And stretch!
http://www.healtharticles.org/low_back_pain_070804.html
These conditions can all be the end result of muscle spasms! While it seems incredible that a simple thing like a spasm can cause so much trouble, it’s easy to understand when you take a close look at the body. There are 600 muscles in the body and 206 bones. The only reason that bones move is because muscles pull on them (unless you have a traumatic accident), and therein lies the problem. The muscle originates at a stationary point in the body; it then crosses over a joint and inserts onto another bone. When a muscle contracts it pulls the insertion point toward the origination point, and the joint bends.
That condition usually being called Low Back Pain (LBP). Pain in the low back is something that at least 70% of our chronic pain clients complain about, and it is also one of the most misunderstood conditions.There are two muscles that move the low back. One is called “Quadratus Lumborum” and it is right where you rub yourself when your low back is hurting. It originates on the five lumbar vertebra and inserts onto the top of your hipbone. As mentioned earlier, the other muscle, the one that causes the majority of low back pain, is called the psoas. This muscle also originates on the five lumbar vertebra, however it goes forward, through the curve of your hips, and inserts onto the front of your thighbone (the femur).
When the muscle contracts you fold at the hip. Every time you take a step, sit down, bend over, or do anything that brings your leg up or your trunk down, you are contracting the psoas muscle. This muscle is contracted the majority of the day, and for most people, it is also contracted all night because the sleep with their legs bent. Because of this, it is common for the muscle to become shortened. However the origination and insertion points are still the same distance apart, so two things happen. First, when you are lying down you are told you have a “short leg”. The bones of your leg haven’t shortened, however the muscles are pulling your leg up toward the hip so it appears shorter. As soon as you stand up on both of your feet your legs are equal length again.
The second, and more serious, condition occurs when you are standing. The muscle is still to short, so it pulls on the other attachment – the lumbar vertebra. You now feel pain in your low back. The lumbar vertebra are being pulled forward, the disks are being compressed, the nerves are being impinged, and again you are feeling the “hair pulling” effect on the bone. The pain intensifies when you go from sitting to standing, and you can relieve the pain somewhat when you bend over, or sit down. This is because as you bend at the hip you have just brought the two ends closer together, and the strain has been removed from the insertion points. When you stand up it will again return as the muscle again pulls on the lumbar vertebra. The answer is to stretch the muscle!
Stretching is vital to the free movement of joints, and is amazing to the healing process of repetitive strain injury. Get in touch with your body. Trust your intuition. And stretch!
http://www.healtharticles.org/low_back_pain_070804.html
Jumat, 05 Oktober 2007
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