Fungsi Tubuh Error Akibat Tremor

Bayangkan jika tangan yang vital bagi aktivitas kita sehari-hari tiba-tiba gemetaran tak karuan. Jangankan menulis, untuk memegang pena saja rasanya sulit. Itu bisa terjadi bila kita terkena tremor. Kalau tidak diatasi, penyakit yang menyerang saraf ini akan mengacaukan fungsi tubuh.

Seperti yang dialami Johan. Pegawai swasta berusia 27 tahun ini merasa kaget karena ketika akan menulis, tiba-tiba tangan kanannya bergetar halus. Sebelumnya dia tidak pernah merasakan gejala aneh pada tangan kanannya itu. Dia juga tidak sedang dalam kondisi emosi yang berlebihan.

Bukannya mereda, keadaan itu malah berlanjut hingga berbulan-bulan. Merasa terganggu, ia pun berkonsultasi ke dokter. Hasil pemeriksaan, ia dinyatakan mengalami tremor esensial. Ia lalu diberi obat penenang untuk meredakan getaran pada tangannya.

Proses penuaan

Tremor merupakan gerakan gemetar akibat kontraksi otot yang tidak terkontrol. Frekuensi getaran berkisar antara 4 hingga 12 kali per detik.

Tremor dapat terjadi di hampir seluruh bagian tubuh, misalnya di ujung lengan atau tungkai, pinggang, bagian wajah, bahkan pita suara. Meski demikian, paling sering terjadi pada tangan. Gejala yang paling gampang dilihat, orang tangannya gemetaran scat memegang apa saja, contohnya mangkuk bakso atau gelas minum.

Biasanya tremor terjadi karena proses penuaan. Namun, tidak menutup kemungkinan kondisi ini juga dialami oleh kalangan usia produktif, seperti pada Johan. Meski tidak berakibat fatal, jika dibiarkan tremor bisa bertambah parah dan menyebabkan hilangnya fungsi bagian tubuh yang terkena.

Uji motorik

Untuk mendiagnosis tremor, dokter biasanya meminta pasien melakukan serangkaian tes seperti menggambar lingkaran. Tujuannya, untuk menguji kemampuan sensorik dan motorik pasien.

Pemeriksaan urin dan darah juga dapat membantu untuk menegakkan diagnosis, apakah ada faktor lain yang memengaruhi, misalnya pengaruh obat-obatan atau penyakit tertentu. Pemeriksaan menggunakan teknologi Magnetic Resonance Imaging (MRI) ataupun elektromiogram juga dapat dilakukan sebagai penunjang.

Tremor yang sudah parah dapat menurunkan kualitas hidup dan menyebabkan penderitanya tergantung terhadap orang lain. Bisa dibayangkan jika profesi seperti dokter bedah mengalami tremor, bisa-bisa terjadi salah potong. Dokter pun terpaksa puasa bekerja hingga tremornya hilang.

Merkuri kosmetik

Menilik penyebabnya, tremor bisa timbul karena berbagai hal. "Perasaan emosi yang berlebih dapat menimbulkan tremor. Orang yang sedang ketakutan atau gugup juga dapat gemetar. Ini termasuk jenis tremor fisiologis yang normal dialami manusia. Tremor ini akan hilang dengan sendirinya jika emosi sudah tenang," ucap Dr. Jofizal Jannis, Sp.S, spesialis saraf dari RSCM Jakarta.

Ada tremor yang terjadi karena penyakit tertentu, seperti tremor pada pasien parkinson. Tremor yang diakibatkan oleh penyakit tak bisa hilang jika penyebabnya tidak ditangani lebih dahulu. Tremor ini termasuk rest tremor, yaitu getaran terjadi hanya pada saat pasien tidak melakukan apa pun. Sebaliknya, jika pasien tengah beraktivitas, getaran tidak muncul.

Jenis tremor yang lain adalah tremor iatrogenik. Tremor ini terjadi karena efek samping obat-obatan. Contohnya, keracunan merkuri yang berasal dari kosmetika. Meskipun hanya dioleskan di wajah, merkuri dapat masuk ke dalam aliran darah dan menyebabkan gejala tremor.

Paling banyak

Yang belum diketahui penyebab pastinya, yaitu tremor esensial. Padahal, penderita tremor jenis ini paling banyak jumlahnya. Tremor ini termasuk action tremor, artinya getaran akan muncul jika pasien melakukan kegiatan dan menghilang jika pasien dalam keadaan istirahat atau tidak melakukan aktivitas.

Banyak yang mengatakan bahwa tremor esensial terjadi karena faktor genetik atau keturunan. Ada juga mitos, postur tubuh tinggi besar berpengaruh terhadap timbulnya tremor.

"Hal tersebut tidak benar. Tinggi badan tidak ada kaitannya dengan tremor," ujar Dr. Jofizal.

Hingga kini para ahli medis masih mencari penyebab pasti tremor jenis ini.

Hindari kafein

Banyak penderita tremor esensial tidak memerlukan pengobatan selama keluhannya tak mengganggu kehidupan atau mengarah ke penyakit yang lebih berat. Perubahan pola hidup, misalnya menambah waktu istirahat dan menghilangkan beban pikiran, dapat membantu mengurangi gejala tremor.

Ada yang berpendapat bahwa alkohol dapat mengurangi tremor. "Meski banyak yang mencoba, hal ini belum bisa dibuktikan secara medis. Alkohol belum tentu dapat mengurangi tremor karena justru ada orang yang terpicu tremornya karena alkohol," papar Dr. Jofizal.

Tindakan lain mengurangi gejala adalah menghindari kafein. Alasannya, kafein dapat meningkatkan kadar adrenalin yang menyebabkan tremor bertambah parah.

Aktivitas fisik yang dianjurkan, yaitu menguatkan tangan dan pergelangan tangan menggunakan beban seberat 0,5 hingga 1 kg yang digerakkan seperti mengangkat barbel.

Tremor esensial juga dapat menyebabkan masalah sosial yang cukup serius karena penderita merasa dirinya tidak berguna dan tersingkirkan dari kehidupan sosial. Untuk mengatasi masalah percaya diri pada pasien, disarankan untuk selalu mendukung pasien.

Awas kecanduan

Jika perubahan pola hidup tidak membantu mengurangi gejala tremor, dapat dilakukan terapi medikamentosa (obat-obatan) . Biasanya para terapis menyarankan penggunaan obat betablocker seperti propranolol. Yang harus diingat, obat ini tidak cocok bagi manula dan pengidap asma, diabetes, serta pasien gangguan organ jantung.

Jika betablocker tidak mempan, bisa digunakan obat yang mengandung primidone atau valium. "Pastinya penggunaan obat-obatan ini harus di bawah pengawasan dokter karena dapat menimbulkan efek samping berbeda pada tiap orang. Terutama jenis obat yang mengandung valium, yang dapat menyebabkan kecanduan, " kata pria yang juga staf pengajar neurologi di FKUI ini.

Jalan terakhir yang dapat ditempuh adalah tindakan bedah. Dijelaskan oleh Dr. Jofizal, tindakan bedah yang dikenal dengan nama talamotomi dilakukan dengan memutuskan lingkaran saraf di otak.

Efek samping talamotomi yang dapat terjadi adalah kesulitan bicara dan terganggunya keseimbangan. Namun, dengan semakin majunya teknologi kedokteran saat ini, efek samping itu sudah bisa diminimalkan. "Bahkan sudah bisa dibilang mencapai nol persen," tuturnya.


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Algebra Capital and Elaf Bank Launch 'The Sukuk Fund'

Dubai, UAE - 7th of September 2008. Algebra CapitalAlgebra CapitalAlgebra Capital Limited
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and Elaf Bank have announced the launch of The Sukuk Fund today (the "Fund"). Targeting an initial size of USD 100 million and returns above 8%, the open ended fund seeded by Elaf Bank and managed by Algebra CapitalAlgebra CapitalAlgebra Capital Limited
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will provide exposure to Shari'a compliant securities issued in the MENASIA region. Elaf Bank will also serve in an advisory capacity on the Fund's Investment Committee.


"We are very happy to be launching and managing The Sukuk Fund, and on working with Elaf Bank. This will be the second fund managed by Algebra CapitalAlgebra CapitalAlgebra Capital Limited
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in its fixed income line of business," commented Ziad Makkawi, Founder & CEO of Algebra CapitalAlgebra CapitalAlgebra Capital Limited
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. "The Sukuk Fund reflects both our constructive view of the region's fixed income markets; as well as the importance of the Shari'a compliant space to us."


Dr. Jamil Jaroudi, CEO of Elaf Bank, added that "The Sukuk Fund is an attractive vehicle to gain exposure to and benefit from the rapidly evolving and attractive Sukuk asset class capitalizing on Elaf Bank's access to and expertise in Islamic finance and benefiting from Algebra CapitalAlgebra CapitalAlgebra Capital Limited
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's investment process and extensive MENA research capability".


"The global Sukuk market now exceeds USD $100bn and the MENA region's contribution to it is expected to continue," commented Mohieddine Kronfol, Managing Director, Algebra CapitalAlgebra CapitalAlgebra Capital Limited
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and the Portfolio Manager for the fund. "MENA Sukuk now represents 33% of the global Sukuk market and a little more than 33% of MENA corporate fixed income issues. Strong economic fundamentals, large infrastructure projects and increasing capital market activity support and advance prospects for the Sukuk market in our region".


"By launching The Sukuk Fund, we hope that it will be considered by investors as a unique financial product providing diversification for their portfolios through the addition of Shari'a compliant income generating issues such as Sukuk." said Ahmad Tayara, General Manager for Investment Banking at Elaf Bank.


-Ends-


About Algebra CapitalAlgebra CapitalAlgebra Capital Limited
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:
Algebra CapitalAlgebra CapitalAlgebra Capital Limited
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operates out of the DIFC and is regulated as a financial services provider by the DFSA. A leading emerging markets asset management firm specializing in the Middle East/North Africa (MENA) region, Algebra CapitalAlgebra CapitalAlgebra Capital Limited
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manages assets in private and public markets across all asset classes. Services are packaged as fund solutions, discretionary mandates or structured products. Clients are a mix of institutional investors and high net worth individuals. Particular attention and resources will be dedicated to attracting international capital flows to our target markets, the MENA and emerging Asia regions (MENASIA). Algebra CapitalAlgebra CapitalAlgebra Capital Limited
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claims the longest combined track record in the Middle East.


About Elaf Bank:
Elaf Bank is a Bahrain-based, Islamic Bank regulated by the Central Bank of Bahrain and operating with an investment banking license ("Elaf" or the "Bank"). Elaf was established in June 2007 with a paid-in capital of USD 200 and an authorized capital of USD 500 million.


Elaf offers a range of investment banking services to corporate clients, institutional investors, and high net worth individuals encompassing advisory services focused on the debt & equity capital markets, as well as asset management services. The Bank's primary focus is to originate, structure, and offer financial products that will strengthen the current state of the primary and secondary market for Sukuk. Furthermore, Elaf intends to carve itself a niche by actively participating in the equity and Islamic financing capital market as a market maker for Sukuk in the primary and secondary capital markets.

Emirates Islamic Bank expands its network with aswaaq

Dubai, September 6th , 2008: aswaaqaswaaq, a public joint stock company under formation, has recently signed a contract to lease to the Emirates Islamic Bank (EIB)Emirates Islamic Bank (EIB)Emirates Islamic Bank
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an area of its second community centre in Al-Mizhar, scheduled to be opened in the last quarter of this year.


AswaaqAswaaq CEO, Abdul Baset Al-Janahi, signed the contract for his side, while EIBEIB's Retail Banking General Manager, Mr. Faisal Aqil, also signed for his outfit in a short ceremony attended by officials from both sides.


In a statement after the signing of the contract agreement, Al Janahi said: "The leasing of this area to a leading player such as Emirates Islamic Bank is a good achievement for AswaaqAswaaq which aims at providing the best services to its customers and shoppers by ensuring the availability of all their day to day needs in AswaaqAswaaq community centers."


He added that AswaaqAswaaq had started leasing its community centers since last February and had received a large volume of applications from various interested companies.


He noted that diversification and precision are the basic features of his outfit's policy in deciding which company should be leased space in AswaaqAswaaq centers although advantage is given to members of the Mohammed bin Rashid Establishment for Young Business Leaders and UAE nationals living in the areas where the center is located.


EIBEIB Retail Banking General Manager, Faisal Aqil, expressed happiness for his outfit's success in signing a leasing contract with AswaaqAswaaq. "With this step, Emirates Islamic Bank has added a new branch to its numerous branches in all emirates of the UAE to meet the demands of the bank's customers," he added.


He pointed out that the new bank in AswaaqAswaaq community center in Al-Miz'har basically aims at serving the residents of the area and shoppers in the centre. "By opening this branch we ensure being closer to our customers," he said, adding that the new branch, which will provide various banking services, will have ATM for cash deposit and withdrawal to allow shoppers at the centre to enjoy easy day to day banking services at all time.

Banking

Islamic banking has the same purpose as conventional banking except that it operates in accordance with the rules of Shariah, known as Fiqh al-Muamalat (Islamic rules on transactions). The basic principle of Islamic banking is the sharing of profit and loss and the prohibition of riba (usury). Amongst the common Islamic concepts used in Islamic banking are profit sharing (Mudharabah), safekeeping (Wadiah), joint venture (Musharakah), cost plus (Murabahah), and leasing (Ijarah).

In an Islamic mortgage transaction, instead of loaning the buyer money to purchase the item, a bank might buy the item itself from the seller, and re-sell it to the buyer at a profit, while allowing the buyer to pay the bank in installments. However, the fact that it is profit cannot be made explicit and therefore there are no additional penalties for late payment. In order to protect itself against default, the bank asks for strict collateral. The goods or land is registered to the name of the buyer from the start of the transaction. This arrangement is called Murabaha. Another approach is EIjara wa EIqtina, which is similar to real-estate leasing. Islamic banks handle loans for vehicles in a similar way (selling the vehicle at a higher-than-market price to the debtor and then retaining ownership of the vehicle until the loan is paid):There are several other approaches used in business deals. Islamic banks lend their money to companies by issuing floating rate interest loans. The floating rate of interest is pegged to the company's individual rate of return. Thus the bank's profit on the loan is equal to a certain percentage of the company's profits. Once the principal amount of the loan is repaid, the profit-sharing arrangement is concluded. This practice is called Musharaka. Further, Mudaraba is venture capital funding of an entrepreneur who provides labor while financing is provided by the bank so that both profit and risk are shared. Such participatory arrangements between capital and labor reflect the Islamic view that the borrower must not bear all the risk/cost of a failure, resulting in a balanced distribution of income and not allowing lender to monopolize the economy.

And finally, Islamic banking is restricted to Islamically acceptable deals, which exclude those involving alcohol, pork, gambling, etc. Thus ethical investing is the only acceptable form of investment, and moral purchasing is encouraged. Islamic banking is an example of full-reserve banking, with banks achieving a 100% reserve ratio. However, in practice, this is not always the case.

Islamic banks have grown recently in the Muslim world but are a very small share of the global banking system. Micro-lending institutions founded by Muslims, notably Grameen Bank, use conventional lending practices and are popular in some Muslim nations, especially Bangladesh, but some do not consider them true Islamic banking. However, Muhammad Yunus, the founder of Grameen Bank and microfinance banking, and other supporters of microfinance, argue that the lack of collateral or excessive interest in micro-lending is consistent with the Islamic prohibition of usury (riba):

The World Economy

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