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FIRST NATIONAL eMEDICAL NEWSPAPER OF INDIA

eMedinewS is now available online on www.emedinews.in or www.emedinews.org

Special issue – HIV/AIDS

  From the desk of editor in chief
Dr KK Aggarwal

Padma Shri and Dr B C Roy National Awardee
Dr KK Aggarwal
President, Heart Care Foundation of India; Sr Consultant Physician, Cardiologist and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR

 
  Editorial ...

1st December, 2010, Wednesday

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

Today is World AIDS Day

Now a preventive pill for HIV (counseling, condom and a pill for the prevention for high risk sexual act and patients)

Emtricitabine and tenofovir disoproxil fumarate antiretroviral chemoprophylaxis can also prevent the HIV virus spread.

A study shows that giving the drug to high-risk men along with counseling and condom use reduced their risk of getting HIV by an average of 44%. In the study, published in the New England Journal of Medicine, researchers found that the men taking combination of emtricitabine and tenofovir disoproxil fumarate were 44% less likely to get infected with the HIV virus as compared to an equal number taking a placebo. Results are even better than this summer’s revelation that a vaginal microbicide protected 39% of all the women testing it and 54% of those who used it faithfully.

The drug is to be taken before the act and continued for seven days as against 28 days in post exposure prophylaxis said Dr Nalin Nag, an HIV expert at Apollo Hospitals. ???? Tenofovir cream is also available for local vaginal use.

Today is World AIDS Day

December 1 has been earmarked as the World AIDS Day every year. The idea of having a special day was first conceived by James W. Bunn and Thomas Netter, two public information officers for the Global Programme on AIDS at the World Health Organization in Geneva, Switzerland in August 1987. The first world AIDS Day was observed on December 1, 1988 when the disease had just begun to make its presence felt. With activities spread throughout the year, the day is dedicated to spreading awareness about the AIDS pandemic due to the HIV infection.

The theme for the year 2010 is Universal Access & Human Rights

Dr KK Aggarwal
Editor in Chief
drkkaggarwal Dr K K Aggarwal on Twitter
Krishan Kumar Aggarwal Dr k k Aggarwal on Facebook
 
  HIV/AIDS Update

Dr KK Aggarwal, Dr S C Sharma & Dr Nalin Nag

  1. Over 200 diseases can be transmitted from exposure to blood; the most serious infections are hepatitis B virus, hepatitis C virus and HIV. HIV, Hepatitis B and hepatitis C can all be transmitted through blood and blood products and or by sexual route. Though the prevalence of HIV is only 0.3% in the general population the same of hepatitis C virus is up to 5%.
  2. New weapons of war are HIV kanya, HIV blood transfusions after kidnapping, HIV positive syringes for extraction of money and infected hepatitis C, hepatitis B and HIV combined blood (most deadly weapon ever possible).
  3. The average risk of seroconversion after a needle stick injury is about 3 per 1000 with no prophylaxis. This risk is reduced at least 80 % when post exposure prophylaxis (started within 3 hours) is administered in a timely fashion.
  4. Infection is high with hollow needle, high bore needle and if the needle is inserted in the artery or the vein.
  5. Prior to the widespread use of hepatitis B vaccine among health care workers, the prevalence of hepatitis B virus markers was higher among health care workers than the general public. In 1991, the guidelines came that all health care workers be offered hepatitis B vaccine. This strategy has been highly successful in reducing hepatitis B virus infection among health care workers with a 95% decline in the incidence of hepatitis B infection among them.
  6. 30% of HIV positive patients are also co infected with HCV and 10% with chronic hepatitis B infection.
  7. IV drug users acquire hepatitis C virus before HIV infection while men who have sex with men typically are infected with HIV before they acquire hepatitis C virus infection.
  8. Hepatitis B virus is the most infectious of the three blood borne viruses. It is transmitted by percutaneous and mucosal exposures and human bites. Hepatitis B can be transmitted by fomites such as finger stick blood sugar check, multi dose medication vials, jet gun injectors, and endoscopes.
  9. Hepatitis B virus can survive on counter tops for 7 days and remain capable of causing infection.
  10. The prevalence of HCV infection among health care worker is similar to that of the general population. Testing of health care workers for hepatitis C virus should be performed after needle sticks, sharp injuries, mucosal, or non intact exposure to hepatitis C virus positive blood.
  11. The average incidence of seroconversion to hepatitis C virus after unintentional needle sticks or sharps exposures from a hepatitis C virus positive source is 1.8 % (range, 0–7 %).
  12. Transmission of hepatitis C virus can occur from infected fluid splashes to the conjunctiva.
  13. Hepatitis C virus can survive on environmental surfaces for up to 16 hours.
  14. The first step after being exposed to blood or bodily fluids is to wash the area well with soap and water. Expressing fluid by squeezing the wound will not reduce the risk of blood–borne infection.
  15. Give Hepatitis B Vaccine to all unvaccinated persons after exposure to blood. If the exposed blood is positive for HBV and the exposed person is unvaccinated treatment with hepatitis B immune globulin is recommended.
  16. As per CDC do not use preventive post exposure HIV drugs when exposure occurred more than 72 hours prior or when intact skin was exposed or when the bodily fluid is urine, nasal secretions, saliva, sweat, or tears, and is not visibly contaminated with blood.
  17. Give 2 to 3 drugs for 4 weeks
  18. Precautions are important during the first three months after exposure, when most people who are infected with HIV become antibody positive.
  19. Precautions include abstaining from sexual intercourse or using condoms every time.
  20. Condoms reduce, but do not completely eliminate, the chances of transmitting hepatitis B, hepatitis C, or HIV infection to others.
  21. Women exposed to blood or body fluids from a person known to be infected should avoid becoming pregnant during this time.
  22. Individuals exposed to HIV infected fluids should not donate blood, plasma, organs, tissue, or semen during the follow up period.
  23. Breast feeding women should stop breastfeeding due to the risk of passing the infection to their child.
  24. On Saturday, April 4, 2009, 52–year–old Johnson Aziga was found guilty of murder by a Montreal jury for not sharing his HIV status with sexual partners, two of whom later died from AIDS–related illnesses. According to prosecutors, this marks the first case in Canada, and possibly the world, where an HIV positive individual has been convicted of murder for failing to inform partners of his status. Aziga, a former government research analyst from Uganda, was found guilty. He infected seven women; four other partners did not contract the virus. The Crown argued that Aziga infected the women with slow acting poison that destroyed immune system: leading to their cancers and to their deaths. The sex was not considered consensual because the women were not aware he was HIV positive.

FAQs on HIV/AIDS

1. What are AIDS–related illnesses?

Ans. AIDS–related illnesses are defined by presence of opportunistic infections. Tuberculosis: Normally, in healthy persons, 70% people have lung TB and 30% people have extra pulmonary TB. In HIV–positive patients with good immune status, the percentage is the same. But when the immunity is low, one comes across more extra pulmonary TB.

2. What is TB HIV link?

Ans. The dictum is, when you see TB, get HIV done and when you come across a patient with HIV, look for TB.

3. What is the link between Candida and HIV?

Ans. Candida is normally present in diabetic patients, children and in patients on chemotherapy. Always rule out HIV illness, if oral candida is seen in adults.

4. What is the link between herpes zoster and HIV?

Ans. If there is bilateral herpes, recurrent attacks or herpes lesion present in multiple dermatomes, rule out HIV infection.

5. What is the link between Herpes simplex and HIV?

Ans. Ulcerative lesions, big lesions, non healing herpes, rule out HIV.

HIV–The Rule of 3

HIV has 3 words
1. Human
2. Immuno deficiency
3. Virus

STI has 3 words
1. Sexually
2. Transmitted
3. Illnesses

ARV has 3 words
1. Anti
2. Retro
3. Viral

HBV has 3 words
1. Hepatitis
2. B
3. Virus

HCV has three words
1. Hepatitis
2. C
3. Virus

3 areas of HIV
1. Highly prevalent areas
2. Highly vulnerable areas
3. Vulnerable areas

3 zones of HIV prevalence
1. Red
2. Yellow
3. Green

3 changes in HIV scenario in the country
1. Spread of disease from high risk population to low risk population
2. Disease moving from urban to rural population
3. Disease moving from male to female population

3 things to know about HIV
1. Must know
2. Good to know
3. Nice to know

3 important things in HIV control program
1. Anxieties of the healthcare workers
2. Difficulties
3. Thoughts

 
  Quote of the Day

(By Dr. GM Singh)

"The key to success is not information, its people."…………………………………………Lee Iacocca

 
    Photo Feature (from the HCFI Photo Gallery)

 The first Pyramid Meditation Centre to open in Delhi

The opening of the first ever meditation centre under a pyramid at C–599, Defence Colony was announced at a press conference. The inauguration function will be on December 2, 2010.
Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President HCFI and Acharya Dr. Sadhvi Sadhna Ji Maharaj, a spiritual scholar in a joint statement said that any meditation done inside pyramid or underneath a pyramid is called Pyramid Meditation.

 
Dr K K Aggarwal
 
    National News

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

Most AIDS cases from AP; country sees 50–pc drop in fresh ones in 8 yrs

While the number of people infected with HIV/AIDS in India has gone down tremendously — 23.9 lakh people are infected with the virus now — Andhra Pradesh continues to report the maximum number of cases, followed by Maharashtra and Karnataka. According to recent estimates by the National AIDS Control organisation (NACO), the number of new cases in India annually has shown a 50 per cent fall when compared with figures eight years ago. In 2009, 1.2 lakh people were infected, which is half of the 2.4 lakh who got the virus in 2001. Andhra Pradesh continues to be a problem state, reporting the maximum number of cases (5,19,827), with an estimated HIV prevalence in males at 1.07 per cent, more than the overall prevalence of 0.31 per cent. Manipur has reported the maximum of all states–prevalence of 1.89 among the male population. The overall adult HIV prevalence among men is 0.36 per cent, while among women it is 0.25 per cent. (Source: Indian Express, Nov 29, 2010)

Stamp in honour of Green Revolution architect

Commemorating the memory of the architect of the Green Revolution in India, C. Subramaniam, a stamp was released by the Indian postal service –– India Post – on Sunday in the presence of Union Home Minister P. Chidambaram and Minister of State for Communications and IT Sachin Pilot. (Source: The Hindu, Nov 29, 2010)

 
    International News

(Dr Monica and Brahm Vasudev)

Today is World AIDS Day

December 1 has been earmarked as the World AIDS Day every year. The idea of having a special day was first conceived by James W. Bunn and Thomas Netter, two public information officers for the Global Programme on AIDS at the World Health Organization in Geneva, Switzerland in August 1987. The first world AIDS Day was observed on December 1, 1988 when the disease had just begun to make its presence felt. With activities spread throughout the year, the day is dedicated to spreading awareness about the AIDS pandemic due to the HIV infection.

The theme for the year 2010 is Universal Access & Human Rights.

New HIV Infections and AIDS–related deaths show decline

The annual report of the UNAIDS released on Tuesday says that the number of new HIV infections has declined by about one-fifth over the past decade but millions of people are still missing out on major progress in prevention and treatment. About 2.6 million people contracted the HIV virus in 2009, which was 19% less than the 3.1 million individuals who acquired the infection in 1999. AIDS–related deaths also declined nearly 20 % over the past five years. In 2009, an estimated 1.8 million people worldwide died from AIDS–related illnesses compared to the 2.1 million deaths in 2004. A 30% increase in the number of people taking anti–HIV drugs was also noted. (UNAIDS report)

First Drug for Lipodystrophy gets FDA nod

Tesamorelin (Egrifta), the first drug for treatment of HIV patients with lipodystrophy associated with antiretroviral therapy has been approved by the US FDA. It is a growth hormone releasing factor drug, to be administered by injection once daily.

Obesity delays immune recovery in HIV infection

According to a study presented at the annual meeting of the Infectious Diseases Society of America (IDSA), obesity is an additional risk factor to people infected with the HIV. The response to antiretroviral therapy is not in the same league as that seen in HIV patients of normal weight. Nancy Crum–Cianflone, MD, of the Uniformed Services University of the Health Sciences said that obese HIV patients regain fewer CD4–positive T cells after they start therapy as compared to people with normal weight.

 
    Infertility Update

Dr. Kaberi Banerjee, Infertility and IVF Specialist Max Hospital; Director Precious Baby Foundation

Q. Do we need to get admitted in the IVF process?

A. A patient undergoing IVF does not require admission. However, one should visit the center 3–5 times during monitoring cycle. On the day of egg collection, the patient would need to fast for 6 hours & come to clinic (the procedure takes about half an hour). Patients can go home after the effect of anesthesia wears off which takes about 2–3 hours. The next scheduled visit is after 2–3 days for the embryo transfer, which again takes about half an hour and patients are free to go home after resting for one hour.

For queries contact: banerjee.kaberi@gmail.com

 
    Medicine Update

Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity

How can tooth decay be prevented in children?

  • Never put your child to bed with a bottle or food. Not only does this expose your child’s teeth to sugars, it can also put your child at risk for ear infections and choking.
  • Give your child a bottle only during meals. Do not use a bottle or sippy cup as a pacifier or let your child walk around with or drink from them for long periods.
  • Teach your child to drink from a cup as soon as possible. Drinking from a cup is less likely to cause the liquid to collect around the teeth. Also, the cup cannot be taken to bed.
  • If your child must have a bottle or sippy cup for long periods, fill it only with water.
 
    Medicolegal Update

Dr Sudhir Gupta, Associate Professor, Forensic Medicine & Toxicology, AIIMS

What is narcoanalysis?

Narcoanalysis is a controlled administration of intravenous hypnotic medications called truth drugs (barbiturates or other drugs like suxametanium/thiopentone/sodimamytal/scopolamine called truth drugs/serum), which induce a sleeplike state in the person. Under the influence of the drug, the accused has garbled speech and tends to talk about fantasies, and labors under delusions. For example, a person may talk about a crime he/she fantasized about committing, even if they actually have not done it. Their state resembles that of a person in delirium, so these tests cannot be treated accurate.

Narcoanalysis is used by investigating agencies in criminal cases, as an interrogation technique. The scientific validity of the test has been questioned by medical professionals, ethics forum and the legal validity has also been debated in several international and national cases.

  • The truth serum or sodium pentothal is the same substance that in larger dosages is used to induce a deep coma like state for executions by lethal injection in USA. A large dose of the drug is lethal; a test could result in coma or even death. It can be difficult to determine the correct dose of the drug.
  • In the United States of America, the New Jersey Supreme Court banned the use of narcoanalysis in Pitts. V. State for lack of scientific reliability. In India as well, the use of narcoanalysis has been questioned in courts.
  • The main argument against Narcoanalysis is that it is infringement of the fundamental right under Article 20(3) of the Constitution, which provides for a privilege against self-incrimination. It can also be construed as violating human rights of privacy, and the right to health. At the same time, narcoanalysis is an invaluable tool for investigators. Since the results of the test cannot solely be used to prove the guilt of the accused, advocates of narcoanalysis point out that it is not violative of the right against self–incrimination. Statements made under the test have to be corroborated by further evidence.
 
    Renal Update: Question of the Day

(Contributed by Dr GM Singh)

What are the advantages of transplantation over dialysis?

  • There is no dependence on the machine thrice a week for the rest of life.
  • There are hardly any restrictions in the diet and fluid intake after a successful transplant.
  • The physical sense of well–being is so much better that one can go back to work in a style similar to that before the illness.
  • Usually the anemia (and feeling of tiredness) seen in patients with renal failure is reversed after a successful transplant, since the kidney is functioning to maintain normal red cell production. For patients on dialysis, correction of anemia requires life–long use of erythropoietin injections which are extremely expensive.
  • A woman may be able to conceive a child after having a successful transplant. (Women on dialysis usually do not ovulate and therefore are unable to become pregnant.)
  • Men who may be having sexual problems such as inability to maintain an erection may find this problem eliminated once they receive a successful transplant.
 
    ENT Update

Dr. Aru Handa MS, DNB (Department Co–coordinator and Senior Consultant Deptt. Of ENT Moolchand Medcity)

What is Meniere’s syndrome?

Meniere’s syndrome is characterized by recurrent, spontaneous attacks of objective rotatory vertigo, each lasting more than 20 min duration but less than 24 hours, along with tinnitus (ringing in the ear) and ear blockage. This vertigo is often associated with nausea, vomiting and sweating.

 
    DMC order

Order DMC/DC/F.14/Comp.642/2010/ 7th June, 2010: The Delhi Medical Council

Council examined a complaint of Shri KCP forwarded by Directorate of Health Services, alleging medical negligence on the part of doctors of MH in the treatment administered to complainant’s son DPP (referred hereinafter as the patient). The Council taking note of various grievances raised in the complaint observes that Augmentin and Augapen contains the same salt and once a drug is licensed after approval, it can’t be labeled as of inferior quality unless proved by drug authorities. The patient was given only 110 mg of Amikacin 3 times daily (only 330 mg daily) which is not a high dose as alleged. The patient developed pleurisy later on which is not uncommon in cases of pneumonia. Most of these cases develop sub–pneumonic effusion referred as pleurisy. However, the patient was adequately treated for the same and recovered, hence, prima facie, no case of medical negligence is made out against the doctors of Moolchand Hospital. Most of the other issues raised in the complaint are administrative in nature and hence be referred to DHS for appropriate action.

 
    Lab Update

(Dr Naveen Dang and Dr Arpan Gandhi)

Potassium (K+)

  • Increase in serum potassium is seen in states characterized by excess destruction of cells, with redistribution of K+ from the intra– to the extracellular compartment, as in massive hemolysis, crush injuries, hyperkinetic activity, and malignant hyperpyrexia.
  • Hyperkalemia due to pure excess of K+ intake is usually iatrogenic
  • Decreased renal K+ excretion is seen in acute renal failure, some cases of chronic renal failure, Addison’s disease, and other sodium–depleted states.
 
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    Medi Finance Update

Personal Accident Individual

Exclusion

Treatment arising from or traceabletopregnancy, childbirth, miscarriage, abortion or complications of any of this, including cesarean section.

 
    Drug Update

List of Drugs Prohibited for Manufacture and Sale through Gazette Notifications under Section 26a of Drugs & Cosmetics Act 1940 by the Ministry of Health and Family Welfare

List of drugs prohibited for import

Mepacrine Hydrochloride (Quinacrine and its Salts) in any dosage form for use for female sterilization or contraception

 
    IMSA Update

International Medical Science Academy (IMSA) Update

Chronic hepatitis C in children

In a multicenter trial, combination therapy with pegylated interferon and ribavirin to treat chronic hepatitis C in children yielded 93 % sustained viral response in patients with genotype 2 or 3, and 53 % in those with genotype 1.

(Ref: Wirth S, et al. High sustained virologic response rates in children with chronic hepatitis C receiving peginterferon alfa–2b plus ribavirin. J Hepatol 2010;52:501).

 
    IJCP Special

Dr Good Dr Bad

Situation: A smoker wanted to know his risk of lung cancer.
Dr Bad: It’s not that high.
Dr Good: You are at a very high risk.
Lesson: The primary risk factor for lung cancer is cigarette smoking and accounts for 90% of all lung cancers. The risk of lung cancer for a current smoker of one pack per day for 40 years is 20 times that of someone who has never smoked. Factors include the extent of smoking and exposure to asbestos.

Make Sure

Situation: A patient’s blood pressure was not responding on Arkamin.
Reaction: Oh My God! Why was the patient given Artamin?
Lesson: Make sure that prescription is clearly written.

 
    Lighter Side of Reading

An Inspirational Story

There is no success without hardship

The world is so constructed that if you wish to enjoy its pleasures, you must also endure its pains.
Like it or not, you cannot have one without the other. Success is not measured by what you accomplish.
It’s measured by the opposition you encounter, and the courage with which you maintain your struggle against the odds.
You’ II find all things are difficult before they are easy. The greater your obstacles, the more glory in overcoming them.
So, make up your mind before you start that sacrifice is part of the package.
No pain, no gain; No thorns, no throne; you’ve got to go through the negative before you get to the positive…

………………………………

Mind Teaser

Read this…………………

little LARGE
little LARGE
little little
little LARGE  

Yesterday’s Mind Teaser: "thought an"
Answer for yesterday’s Mind Teaser: "An afterthought"

Correct answers received from: "Dr KV Sarma, Dr Sudipto Samaddar, Dr G Padmanabhan, Dr Anurag Jain, Dr Neelam Nath"

Answer for 29th November eQuiz: "B."
Correct answers received from: Dr Prachi 

Send your answer to ijcp12@gmail.com

………………………………

Laugh a While
(Contributed by Dr G M Singh)

"Recently, while I was on a shopping trip in a department store, I heard a little five–year–old talking to his mother on the down escalator. He said, ‘Mommy, what do they do when the basement gets full of steps?’"

 
    Readers Responses
  1. Dear Sir, eMedinews is a very good initiative taken by you. Congratulations. Regards: Dr Anupam
 
    Public Forum

(Press Release for use by the newspapers)

Avoid unnecessary injections: World AIDS DAY

HIV, Hepatitis B and Hepatitis C can all be transmitted through blood and blood products and or by sexual route.

Keeping in mind World AIDS Day, Padma Shri & Dr BC Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India cautioned that getting injections from unqualified health care workers can spread HIV/AIDS.

The spread of HIV in India is primarily restricted to the southern and north eastern regions of the country. In India, the main factors which have contributed to its large HIV infected population are extensive labor migration, low literacy level in certain rural areas resulting in lack of awareness and gender disparity.

Transmission

In order to pass HIV from one person to another, HIV–infected internal fluid from one person needs to get into the bloodstream of another person. HIV is usually transmitted through: Sharing needles, unprotected anal, vaginal, and sometimes oral sex, and from mother to infant before or during delivery and while breast–feeding.

HIV can spread through unprotected sexual contact with multiple partners, blood products, mother to baby (before or during, or through breast milk) and sexual intercourse (vaginal and anal). In the genitals and the rectum, HIV may infect the mucous membranes directly or enter through cuts and sores caused during intercourse (many of which would be unnoticed). Vaginal and anal intercourse is a high–risk practice.

The mouth is an inhospitable environment for HIV (in semen, vaginal fluid or blood), meaning the risk of HIV transmission through the throat, gums, and oral membranes is lower than through vaginal or anal membranes. There are however, documented cases where HIV was transmitted orally, so it cannot be stated that getting HIV–infected semen, vaginal fluid or blood in the mouth is without risk. However, oral sex is considered a low risk practice.

An injection needle can pass blood directly from one person’s bloodstream to another. It is a very efficient way to transmit a blood–borne virus. Sharing needles is considered a high–risk practice.

It is possible for an HIV–infected mother to pass the virus directly before or during birth, or through breast milk. Breast milk contains HIV, and while small amounts of breast milk do not pose significant threat of infection to adults, it is a viable means of transmission to infants.

Effective strategy to prevent HIV

Becoming educated about HIV and understanding the facts about transmission are the first, and perhaps most important way to prevent the spread of HIV.

Abstaining from sex particularly with multiple sexual partners and needle sharing is the most effective way for people to protect themselves from HIV and other sexually transmitted diseases. However, when abstinence is not an option for people, using barrier protection such as latex condoms (male or female) is the next best thing.

Three stages of prevention

  • Firstly, everyone should take steps to avoid contracting the infection,
  • Secondly, an infected person who does not know that he is infected should be made aware of his condition through symptoms or thorough examination and
  • Finally, the already infected persons should be made aware of the need for prevention of other diseases and be aware that he can infect others.

The most effective ways to prevent HIV Infection

  • Not having sex – whether vaginal, anal, or oral
  • Sex only between two mutually monogamous, uninfected partners who do not share needles or syringes with anyone.
  • Practicing safe sex
  • Not injecting non prescribed drugs
  • Not sharing needles or syringes for any reason (when injected illegal drugs, medications, vitamins, or steroid; tattooing; or body piercing)
  • Not engaging in activities that involve exchange of blood, semen, vaginal fluids, or breast milk.

Ways to reduce the risk of HIV Infection

  • Using a latex condom the right way every time during vaginal, anal, or oral sex.
  • Not using drugs or alcohol, which can impair judgment.
  • Cleaning needles and syringes with chlorine bleach and water if more effective prevention is not available.
  • Using barrier protection (e.g. latex gloves) when coming into contact with blood.

A new weapon of war, HIV kanya, HIV blood transfusions after kidnapping, HIV positive syringes for extraction of money

On Saturday, April 4 09, 52 year old Johnson Aziga was found guilty of murder by a Montreal jury for not sharing his HIV status with sexual partners, two of whom later died from AIDS–related illnesses. According to prosecutors, this marks the first case in Canada, and possibly the world, where an HIV–positive individual has been convicted of murder for failing to inform partners of his status. Aziga, a former government research analyst from Uganda, was found guilty. He infected seven women; four other partners did not contract the virus. The Crown argued that Aziga infected the women with "slow–acting poison’ that destroyed their immune systems… leading to their cancers and to their deaths." The sex was not considered consensual because the women were not aware he was HIV positive.

Needle stick injury

  1. The average risk of seroconversion after a needle stick injury is about 3 per 1000 with no prophylaxis. It is estimated that this risk is reduced at least 80 percent when post exposure prophylaxis (started within 3 hours) is administered in a timely fashion. Infection is high with hollow needle, high bore needle and if the needle is inserted in the artery or the vein.
  2. Prior to the widespread use of hepatitis B vaccine among health care workers, the prevalence of hepatitis B virus markers was higher among health care workers than the general public. In 1991 the guidelines came that all health care workers be offered hepatitis B vaccine. Recent studies suggest that this strategy has been highly successful in reducing hepatitis B virus infection among health care workers with a 95 percent decline in the incidence of hepatitis B infection among them.
  3. Hepatitis B virus is the most infectious of the three blood borne viruses. It gets transmitted by percutaneous and mucosal exposures and human bites. It has also been transmitted by fomites such as finger stick devices used to obtain blood for glucose measurements, multi dose medication vials, jet gun injectors, and endoscopes. The virus can survive on counter tops for seven days and remain capable of causing infection.
  4. The prevalence of HCV infection among health care worker is similar to that of the general population. Testing of health care workers for hepatitis C virus HCV should be performed after needle sticks, sharp injuries, mucosal, or non intact exposure to hepatitis C virus positive blood. The average incidence of sero conversion to hepatitis C virus after unintentional needle sticks or sharps exposures from a hepatitis C virus positive source is 1.8 percent (range, 0–7 percent). Transmission of hepatitis C virus from blood splashes to the conjunctiva has been described. Hepatitis C virus has been demonstrated to survive on environmental surfaces for at least 16 hours but not four or seven days.
  5. Infected blood with hepatitis C, hepatitis B and HIV together is the most deadly weapon ever possible.
 
    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

eMedinewS Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on January 08–09, 2011.

January 08, 2011, Saturday, 6 PM – 9 PM – Opening Ceremony, Cultural Hungama and eMedinewS Doctor of the Year Awards. For registration contact – emedinews@gmail.com

January 09, 2011, Sunday, 8 AM – 6 PM – 2nd eMedinewS revisiting 2010, A Medical Update

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