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Sabtu, 26 Mei 2012

COMING AGAIN!!


The return of Jesus is mentioned more than three hundred times in the 260 chapters of the New Testament, an average of one verse in every twenty-five, according to Dr. M. E. Dodd, in his book, Jesus Is Coming to Earth Again. In the Bible, there are eight times as many references to the second coming of Jesus as to the first. Patriarchs, in the Old Testament, looked forward to it (Jude 14; Job 19:25-27); and it has also been the blessed hope of the church in the New Testament (Titus 2: 13; Acts 3:19-21).
This great truth has been embraced by prominent Christian leaders throughout recent centuries, and many have given voice to their belief in the second advent.
Martin Luther wrote, "I ardently hope that, amidst these internal dissensions on the earth, Jesus Christ will hasten the day of His coming."
John Calvin said, "We must hunger after Christ till the dawning of that great day."
John Knox wrote, "We know that He shall return, and that with expedition."
John Wesley, commenting on the closing verses of Revelation, said, "The spirit of adoption in the bride, in the heart of every true believer, says . . 'Come and accomplish all the words of this prophecy.'
John Milton sublimely wrote, "Come forth out of thy royal chambers, 0 Prince of all the kings of the earth. . take up that unlimited scepter. . For now the voice of Thy bride calls thee, and all creatures sigh to be renewed.
Moody said, "The church has had very little to say about it [the second advent]. Now, I can see a reason for this; the devil does not want us to see this truth, for nothing would wake up the church so much."
A deep and abiding faith in the second coming of Christ has a tremendous purifying and uplifting power.

1: WILL CHRIST COME AGAIN?

John 14:2-3 "In my Father's house are many mansions: if it were not so, I would have told you. I go to prepare a place for you. And if I go and prepare a place for you, I will come again, and receive you unto Myself; that where I am, there ye may be also."
We can rely upon the word of Christ. Our eternal future is secure when it rests upon the promises of His Word. Jesus said, "I will come again," and He surely will. Nothing in heaven or earth can be more certain than His Word and, therefore, His coming.
For centuries the people of God awaited the fulfillment of the promises concerning Christ's first coming as the Messiah. Then came the wonderful day when heavenly messengers made the announcement:
 "Unto you is born this day in the city of David a Saviour, which is Christ the Lord" (Luke 2:11).
Just as surely as the promises of God were fulfilled in the first advent of Jesus to this world, just so surely will be those that pertain to His second advent. The day of His return will be the most wonderful day in all history.
When Jesus was put under oath by the high priest at His trial, as He stood a prisoner flanked by guards at the foot of Caiaphas' throne, He said, "Hereafter shall ye see the Son of man sitting on the right hand of power, and coming in the clouds of heaven" (Matthew 26:64). This promise, made under the oath, and can be depended upon - He will come again.

2: HOW WILL HE COME?

1. So we can see Him.
Revelation 1:7 "Behold, He cometh with clouds; and every eye shall see Him, and they also which pierced Him."
Matthew 24:30 "Then shall all the tribes of the earth mourn, and they shall see the Son of man coming in the clouds of heaven with power and great glory" (Acts 1 :9-11; Matthew 24:23-27).
2. So we can hear Him.
Matthew 24:31 "He shall send His angels with a great sound of a trumpet, and they shall gather together His elect from the four winds, from one end of heaven to the other."
1 Thessalonians 4:16 "The Lord Himself shall descend from heaven with a shout, with the voice of the archangel, and with the trump of God."
3. He will come in glory.
Matthew 25:31 "When the Son of man shall come in His glory, and all the holy angels with Him, then shall He sit upon the throne of His glory."
The effect of this glory upon the inhabitants of earth we can only faintly imagine. If, at the time of Christ's resurrection, the appearance of one angel prostrated the Roman guards as dead men (Matthew 28:2-4), it is no wonder that many will try to hide from the glory of Christ, praying for the rocks and mountains to fall on them (Revelation 6:14-17) when He appears in the glory of all the holy angels.
4. He will come unexpectedly.
Matthew 24:44 "Therefore be ye also ready: for in such an hour as ye think not the Son of man cometh."
Matthew 24:36 "Of that day and hour knoweth no man, no, not the angels of heaven, but My Father only."
In the clearest language, Jesus Christ taught that His coming would be open, announced, personal, literal, visible, and that good and bad alike would see Him come. He was to come as a "thief in the night" only in the sense that none would know the "day and hour," and multitudes would be unprepared.
Sometimes we find, in certain commentaries or in Bible footnotes, references to a secret coming of our Lord. These are only expressions of man: and, although well-meaning, they are not the inspired Word of God. If we are led into delusions about secret comings of Christ, we shall be open to other deceptions. Eve was "deceived," but God held her responsible. Before she could believe the deceiver she had to disbelieve God. Jesus warned, "Take heed that no man deceive you" (Matthew 24:4).
A woman came up to a preacher and asked, "Are you the man who talks over the radio?"
"Yes," he said, "I am one such man."
"Do you believe Christ is coming literally?" she queried.
"Yes," answered the man.
Said she, "I wish you would come over to my town. My minister has a private séance. I will get you in for nothing. A mighty power comes. A glorious being appears. This is Jesus Christ."
"Well," said the preacher, "I will not be there." Said he, "I have an old Book that explains all that."
He took out his Bible and read Matthew 24:26-27: "Wherefore if they shall say unto you, Behold, he is in the desert; go not forth: behold, he is in the secret chambers; believe it not. For as the lightning cometh out of the east, and shineth even unto the west; so shall also the coming of the Son of man be."
Then he said, "Madam, I don't deny that somebody comes there to that private séance, but it is not my Saviour, and it is not my Lord, and I will not be there to meet the one who comes there."
Friend, if some glorious being, or any other kind of being, should appear to you and even perform some miracles of healing or work a thousand wonders, it is not Jesus Christ. He is not coming that way. Fantastic delusive teachings are sweeping millions into a river of deception.
When Christ comes back, He will be "this same Jesus" who went away (Acts 1:9-11). "This same Jesus" who rose from the dead had flesh and bones (Luke 24:39-43). He ascended to heaven as the Son of man to be our Mediator (1 Timothy 2:5). He is coming back literally and physically as the Son of man (Matthew 26:64). There will be nothing secretive or ghostly about it.

3: WHY WILL HE COME?

1. To raise the righteous dead.
1 Thessalonians 4:16 "The Lord Himself shall descend from heaven with a shout. with the voice of the archangel. and with the trump of God: and the dead in Christ shall rise first."
2. To catch up the righteous living with the resurrected dead.
1 Thessalonians 4:17 "Then we which are alive and remain shall be caught up together with them in the clouds. to meet the Lord in the air: and so shall we ever be with the Lord:"
3. To change their vile bodies.
Philippians 3:20-21 "Our conversation is in heaven; from whence also we look for the Saviour, the Lord Jesus Christ: who shall change our vile body, that it may be fashioned like unto His glorious body, according to the working whereby He is able even to subdue all things unto Himself."
4. To take the righteous to heaven.
John 14:2-3 "I go to prepare a place for you. And if 1 go and prepare a place for you, 1 will come again, and receive you unto Myself; that where 1 am, there ye may be also."
He comes for His people. With intense longing has He desired that "they also, whom Thou hast given Me, be with Me where I am" (John 17:24)."
The One who was rejected, crucified, exalted, and glorified is "coming again in like manner as He ascended; to raise the dead, to judge the world, to save His people, to be glorified in His saints, to crush the usurper, to destroy His foes, and to reign forever as the Lord of all" (H. L. Hastings).
5. To destroy the living wicked.
2 Thessalonians 1:7-9 "The Lord Jesus shall be revealed from Heaven with His mighty angels. in flaming fire taking vengeance on them that know not God, and that obey not the gospel of our Lord Jesus Christ" (2 Thessalonians 2:8, about those whom He will "destroy with the brightness of His coming").

4: HOW MAY WE BE READY?

1. We can come to Him.
John 6:37 "All that the Father giveth Me shall come to Me; and Him that cometh to Me 1 will in no wise cast out."
If we are to be accepted by Christ when He comes, He must be accepted by us now. One great reason He has not already come is that there are still honest souls to be saved.
2. We can live for Him as did Paul.
2 Timothy 4:7-8 "I have fought a good fight. I finished my course, I have kept the faith: henceforth there is laid up for me a crown of righteousness, which the Lord, the righteous judge, shall give me at that day: and not to me only, but unto all them also that love His appearing."
Mere profession of Christianity or church membership will not avail. "For me to live is Christ," said Paul (Philippians 1:21).
3. We can seek to be like Him.
1 John 3:2-3 "We know that, when He shall appear, we shall be like Him; for we shall see Him as He is. And every man that hath this hope in Him purifieth himself, even as He is pure:"
A man visited an art gallery to see a famous painting. Rules limited all visits to five minutes. The man came day after day and gazed upon the picture, then hastened away to sketch what he could remember. After a long time he invited friends to see his completed work. They marveled at his exquisite workmanship. "We did not know you were such an artist!" Then he told them the secret, that this was only a copy of a great masterpiece. Then they all exclaimed, "If that is only a copy, we must see the original."
Shall we not gaze upon Christ until we ourselves are so like Him that others will want to see Him and prepare to meet Him?
4. We can look for Him.
Hebrews 9:28 "Christ was once offered to bear the sins of many; and unto them that look for Him shall He appear the second time without sin unto salvation:'
If we look for Him, it will affect our preparation for His coming. In the parable given by Christ, one servant said, " 'My lord delayeth His coming,' " and he began "to smite his fellow servants and to eat and drink with the drunken. The lord of that servant shall come in a day when he looketh not for Him, and in an hour that he is not aware of. And shall cut him asunder and appoint him his portion with the hypocrites" (Matthew 24:48-51).
5. We can love His appearing.
2 Timothy 4:8 "Henceforth there is laid up for me a crown of righteousness. which the Lord, the righteous judge, shall give me at that day: and not to me only, but unto all them also that love His appearing."
Yes, those who love His appearing will be ready.
A minister preached on the second coming. After the service a woman came up to him and said, "Young man, I am just as good a Christian as you are." He said, "I don't doubt that at all." She said, "I love the Lord as much as you do, and I'm old enough to be your mother."
"I can't deny it," said he.
"I know the Bible as well as you do," she continued.
"I do not doubt that either," he replied.
"Well," she said, "I love the Lord, but I don't want Him to come in my day."
"Now, Mother," said the preacher, "suppose a young man and a young woman should fall in love and marry, and he should say, 'Dear, I must go off to Europe. I am to have a great job over there. When I have started to work and built a home, I am going to come back for you.' He promises to write her letters, and the letters begin to come. She reads them, and takes them to her friends, and reads them over and over. She says, 'Oh, isn't it wonderful? Isn't he a wonderful husband? Isn't it wonderful? I love him; he is the grandest man in all the world, but I hope he doesn't come back in my day.' Don't you think there would be something wrong with a person like that?"
The woman saw the point. She said, "I'm wrong."
"If Jesus should come at this moment
"To catch up with Him in the air
"All those who love His appearing,
"Forever to be with Him there,
"How would He find you? I wonder
"Watching, waiting, faithful, true?
"Dearly beloved, consider
"How will it be with you?"
To be among those for whom Jesus comes - this is the supreme hope of the human heart. God grant that when Jesus comes He will come for you.
This time He is not coming to die on a cross, but to end sin and death. He is mindful of your sufferings; and, in the great day of His appearing, He will take them all away. He knows what to do for every trouble and how to make all things right. He will establish His kingdom of righteousness and banish all cares, which weigh down the heart with sorrow. War, tyranny over the weak, oppression of the poor, and weapons of destruction with their constant threat of death will all be removed.
How much it means to be ready when Jesus comes! What a thrill to see Him face to face and to feel His arm around you thrown! How will it be to meet Him in peace and hear Jesus speak your name? What joy awaits you, living with Him through the endless ages of eternity! When Jesus comes for you - That is the most satisfying experience that can ever come to any human being. May that experience be yours.

CHRIST'S SECOND COMING: SUPPLEMENT 

"One of the most solemn and yet most glorious truths revealed in the Bible is that of Christ's second coming to complete the great work of redemption. To God's pilgrim people, so long left to sojourn in 'the region and shadow of death,' a precious, joy-inspiring hope is given in the promise of His appearing, who is 'the resurrection and the life,' to 'bring home again His banished.'
"The doctrine of the second advent is the very keynote of the Sacred Scriptures. From the day when the first pair turned their sorrowing steps from Eden, the children of faith have waited the coming of the Promised One to break the destroyer's power and bring them again to the lost Paradise. Holy men of old looked forward to the advent of the Messiah in glory, as the consummation of their hope. Enoch, only the seventh in descent from them that dwelt in Eden, he who for three centuries on earth walked with his God, was permitted to behold from afar the coming of the Deliverer. 'Behold,' he declared, 'the Lord cometh with ten thousands of His saints, to execute judgment upon all' (Jude 14,15).
"The coming of Christ to usher in the reign of righteousness has inspired the most sublime and impassioned utterances of the sacred writers. The poets and prophets of the Bible have dwelt upon it in words glowing with celestial fire. The psalmist sang of the power and majesty of Israel's King: 'Out of Zion, the perfection of beauty, God hath shined. Our God shall come, and shall not keep silence. . . . He shall call to the heavens from above, and to the earth, that He may judge His people.' (Psalm 50:2-4). 'Let the heavens rejoice, and let the earth be glad. . . before the Lord: for He cometh, for He cometh to judge the earth: He shall judge the world with righteousness, and the people with His truth.' (Psalm 96:11-13). .
"When the Saviour was about to be separated from His disciples, He comforted them in their sorrow with the assurance that He would come again: 'Let not your heart be troubled. . In My Father's house are many mansions. . I go to prepare a place for you. And if I go and prepare a place for you, I will come again, and receive you unto Myself' (John 14: 13). 'The Son of man shall come in His glory, and all the holy angels with Him.' 'Then shall He sit upon the throne of His glory: and before Him shall be gathered all nations' (Matthew 25:31, 32).
"The angels who lingered upon Olivet after Christ's ascension repeated to the disciples the promise of His return: 'This same Jesus, which is taken up from you into heaven, shall so come in like manner as ye have seen Him go into heaven' (Acts 1: 11). And the apostle Paul, speaking by the Spirit of Inspiration, testified: 'The Lord Himself shall descend from heaven with a shout, with the voice of the Archangel, and with the trump of God' (1 Thessalonians 4: 16). Says the prophet of Patmos: 'Behold, He cometh with clouds; and every eye shall see Him' (Revelation 1:7)." Great Controversy, 299-301

Rabu, 23 Mei 2012

Terapi DM




Tujuan utama dari pengobatan diabetes adalah untuk mempertahankan kadar gula darah dalam kisaran yang normal. Namun, kadar gula darah yang benar-benar normal sulit untuk dipertahankan.

Meskipun demikian, semakin mendekati kisaran yang normal, maka kemungkinan terjadinya komplikasi sementara maupun jangka panjang menjadi semakin berkurang. Untuk itu diperlukan pemantauan kadar gula darah secara teratur baik dilakukan secara mandiri dengan alat tes kadar gula darah sendiri di rumah atau dilakukan di laboratorium terdekat.

Pengobatan diabetes meliputi pengendalian berat badan, olah raga dan diet. Seseorang yang obesitas dan menderita diabetes tipe 2 tidak akan memerlukan pengobatan jika mereka menurunkan berat badannya dan berolah raga secara teratur.

Namun, sebagian besar penderita merasa kesulitan menurunkan berat badan dan melakukan olah raga yang teratur. Karena itu biasanya diberikan terapi sulih insulin atau obat hipoglikemik (penurun kadar gula darah) per-oral.

Diabetes tipe 1 hanya bisa diobati dengan insulin tetapi tipe 2 dapat diobati dengan obat oral. Jika pengendalian berat badan dan berolahraga tidak berhasil maka dokter kemudian memberikan obat yang dapat diminum (oral = mulut) atau menggunakan insulin.

Berikut ini pembagian terapi farmakologi untuk diabetes, yaitu:
  1. Obat Hipoglikemik Oral (OHO)
    Golongan sulfonilurea seringkali dapat menurunkan kadar gula darah secara adekuat pada penderita diabetes tipe II, tetapi tidak efektif pada diabetes tipe I. Contohnya adalah glipizid, gliburid, tolbutamid dan klorpropamid. Obat ini menurunkan kadar gula darah dengan cara merangsang pelepasan insulin oleh pankreas dan meningkatkan efektivitasnya.

    Obat lainnya, yaitu metformin, tidak mempengaruhi pelepasan insulin tetapi meningkatkan respon tubuh terhadap insulinnya sendiri. Akarbos bekerja dengan cara menunda penyerapan glukosa di dalam usus.

    Obat hipoglikemik per-oral biasanya diberikan pada penderita diabetes tipe II jika diet dan oleh raga gagal menurunkan kadar gula darah dengan cukup.

    Obat ini kadang bisa diberikan hanya satu kali (pagi hari), meskipun beberapa penderita memerlukan 2-3 kali pemberian.

    Jika obat hipoglikemik per-oral tidak dapat mengontrol kadar gula darah dengan baik, mungkin perlu diberikan suntikan insulin.
  2. Terapi Sulih Insulin Pada diabetes tipe 1, pankreas tidak dapat menghasilkan insulin sehingga harus diberikan insulin pengganti. Pemberian insulin hanya dapat dilakukan melalui suntikan, insulin dihancurkan di dalam lambung sehingga tidak dapat diberikan per-oral (ditelan).

    Bentuk insulin yang baru (semprot hidung) sedang dalam penelitian. Pada saat ini, bentuk insulin yang baru ini belum dapat bekerja dengan baik karena laju penyerapannya yang berbeda menimbulkan masalah dalam penentuan dosisnya.

    Insulin disuntikkan dibawah kulit ke dalam lapisan lemak, biasanya di lengan, paha atau dinding perut. Digunakan jarum yang sangat kecil agar tidak terasa terlalu nyeri.

    Insulin terdapat dalam 3 bentuk dasar, masing-masing memiliki kecepatan dan lama kerja yang berbeda:
  3. Insulin kerja cepat.
    Contohnya adalah insulin reguler, yang bekerja paling cepat dan paling sebentar.
    Insulin ini seringkali mulai menurunkan kadar gula dalam waktu 20 menit, mencapai puncaknya dalam waktu 2-4 jam dan bekerja selama 6-8 jam.
    Insulin kerja cepat seringkali digunakan oleh penderita yang menjalani beberapa kali suntikan setiap harinya dan disutikkan 15-20 menit sebelum makan.
  4. Insulin kerja sedang.
    Contohnya adalah insulin suspensi seng atau suspensi insulin isofan.
    Mulai bekerja dalam waktu 1-3 jam, mencapai puncak maksimun dalam waktu 6-10 jam dan bekerja selama 18-26 jam.
    Insulin ini bisa disuntikkan pada pagi hari untuk memenuhi kebutuhan selama sehari dan dapat disuntikkan pada malam hari untuk memenuhi kebutuhan sepanjang malam.
  5. Insulin kerja lambat.
    Contohnya adalah insulin suspensi seng yang telah dikembangkan.
    Efeknya baru timbul setelah 6 jam dan bekerja selama 28-36 jam.

Sediaan insulin stabil dalam suhu ruangan selama berbulan-bulan sehingga bisa dibawa kemana-mana.

Pemilihan insulin yang akan digunakan tergantung kepada:
  • Keinginan penderita untuk mengontrol diabetesnya
  • Keinginan penderita untuk memantau kadar gula darah dan menyesuaikan dosisnya
  • Aktivitas harian penderita
  • Kecekatan penderita dalam mempelajari dan memahami penyakitnya
  • Kestabilan kadar gula darah sepanjang hari dan dari hari ke hari

Sediaan yang paling mudah digunakan adalah suntikan sehari sekali dari insulin kerja sedang. Tetapi sediaan ini memberikan kontrol gula darah yang paling minimal.

Kontrol yang lebih ketat bisa diperoleh dengan menggabungkan 2 jenis insulin, yaitu insulin kerja cepat dan insulin kerja sedang. Suntikan kedua diberikan pada saat makan malam atau ketika hendak tidur malam.

Kontrol yang paling ketat diperoleh dengan menyuntikkan insulin kerja cepat dan insulin kerja sedang pada pagi dan malam hari disertai suntikan insulin kerja cepat tambahan pada siang hari.

Beberapa penderita usia lanjut memerlukan sejumlah insulin yang sama setiap harinya; penderita lainnya perlu menyesuaikan dosis insulinnya tergantung kepada makanan, olah raga dan pola kadar gula darahnya. Kebutuhan akan insulin bervariasi sesuai dengan perubahan dalam makanan dan olah raga.

Beberapa penderita mengalami resistensi terhadap insulin. Insulin tidak sepenuhnya sama dengan insulin yang dihasilkan oleh tubuh, karena itu tubuh bisa membentuk antibodi terhadap insulin pengganti. Antibodi ini mempengaruhi aktivitas insulin sehingga penderita dengan resistansi terhadap insulin harus meningkatkan dosisnya.

Penyuntikan insulin dapat mempengaruhi kulit dan jaringan dibawahnya pada tempat suntikan. Kadang terjadi reaksi alergi yang menyebabkan nyeri dan rasa terbakar, diikuti kemerahan, gatal dan pembengkakan di sekitar tempat penyuntikan selama beberapa jam.

Suntikan sering menyebabkan terbentuknya endapan lemak (sehingga kulit tampak berbenjol-benjol) atau merusak lemak (sehingga kulit berlekuk-lekuk). Komplikasi tersebut bisa dicegah dengan cara mengganti tempat penyuntikan dan mengganti jenis insulin. Pada pemakaian insulin manusia sintetis jarang terjadi resistensi dan alergi.

Pengaturan diet sangat penting. Biasanya penderita tidak boleh terlalu banyak makan makanan manis dan harus makan dalam jadwal yang teratur. Penderita diabetes cenderung memiliki kadar kolesterol yang tinggi, karena itu dianjurkan untuk membatasi jumlah lemak jenuh dalam makanannya. Tetapi cara terbaik untuk menurunkan kadar kolesterol adalah mengontrol kadar gula darah dan berat badan.

Semua penderita hendaknya memahami bagaimana menjalani diet dan olah raga untuk mengontrol penyakitnya. Mereka harus memahami bagaimana cara menghindari terjadinya komplikasi.

Penderita juga harus memberikan perhatian khusus terhadap infeksi kaki sehingga kukunya harus dipotong secara teratur. Penting untuk memeriksakan matanya supaya bisa diketahui perubahan yang terjadi pada pembuluh darah di mata.