emedinews
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FIRST NATIONAL DAILY eMEDICAL NEWSPAPER OF INDIA
eMedinewS is now available online on www.emedinews.in or www.emedinews.org

  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 (07–08c); 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

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos…
Nobility of medical profession Video 1 to 9 Health and Religion Video 1–7
DD Take Care Holistically Video 1–7 Chat with Dr KK On life Style Disorders
Health Update Video 1–15 Science and Spirituality
Obesity–Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

12th September 2012, Wednesday

PURE: 40% of adult population worldwide has hypertension

  • Hypertension is truly a global epidemic, being highly prevalent in all communities worldwide, according to new data from the Prospective Urban Rural Epidemiology (PURE) study.
  • Awareness is very low and that once patients are aware, most are treated, but control is very poor.
  • The prevalence of hypertension was lowest in lowest–income countries (around 30%) and highest in upper–middle–income economies (around 50%), with high–income and low–middle–income economies having an intermediate level (around 40%).
  • Only 30% of the population had optimal blood pressure, with another 30% found to be in the prehypertension range. Of the 40% with hypertension, 46% of these individuals were aware of their condition, 40% were treated, but only 13% were controlled.
  • In low–income countries, there were higher rates of hypertension in urban areas than in rural areas, but this was reversed in upper–income countries, where hypertension was more prevalent in rural communities.
  • Men were more likely to be hypertensive than women in high– and middle–income countries, but women were more likely to be hypertensive than men in low–income countries.
  • Low levels of education were association with increased prevalence of hypertension in high– and middle–income economies, but the reverse was true in low–income countries, where hypertension was actually more common in better–educated people.
  • Awareness, treatment, and control was higher in urban than in rural communities across all incomes, and women had higher rates of awareness, treatment, and control than men again across the board.
  • The use of multiple antihypertensive drugs was very low, at just 14%, and "practically nonexistent" in low–income countries.
  • Better screening methods are required and increased use of combination medications is needed.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

What is the approach to evaluation of a patient with constipation?

A comprehensive physical examination should be performed that includes a rectal exam to palpate for hard stool, assess for masses, anal fissures, hemorrhoids, sphincter tone, push effort during attempted defecation, prostatic hypertrophy in males, and posterior vaginal masses in females.

For comments and archives

 
Dr K K Aggarwal
    eMedinewS Audio PostCard

Stay Tuned with Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal on

Daily asprin to prevent heart disease may increase risk of GI or cerebral bleeding

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Seminar on Diet, Health & Religion

An Inter Religion Seminar on Diet, Health & Religion was organized at Bharatiya Vidya Bhavan in association with Heart Care Foundation of India

 
Dr K K Aggarwal
    National News

Public Private Partnerships necessary to boost health sector, says Azad

BANGALORE: Public Private Partnerships in healthcare sector is the need of the hour to provide affordable healthcare for rural patients, said Ghulam Nabi Azad, Union minister of health and family welfare, on Saturday. "Cancer and chronic heart diseases are the biggest threat in our country. And their treatments are costly and unaffordable. We need more hospitals and doctors to treat cancer and heart patients. I have realized that we can control the outbreak of non–communicable diseases only by increasing our resources. In the next decade, India will have a large number of doctors treating cancer and heart diseases, but till then we will need collaborations in public and private sector at national and state level," he said after inaugurating Dedicated Surgical Oncology Complex of HealthCare Global Hospital. Stating that private hospitals have the expertise in treating cancer patients in rural areas under PPP collaboration, he said: "A large number of people would benefit if private doctors work under PPP model.

Pilot project in 100 districts. The health ministry has initiated a pilot project in 100 districts in the country to screen diabetes and hypertension patients under PPP model. "But, the problem is that we are not getting enough specialists to screen cancer and heart patients," said Azad. "There is no dearth of funds. But we have a deficiency of doctors in rural areas. The government has floated various initiatives to attract doctors to serve in rural areas, which didn’t work out. Doctors have a mindblock against working in rural areas. About 99% of the doctors who come to the city for education does not wish to go back and serve in their home town," said Azad. (Source: Sep 9, 2012)

For comments and archives

4th Dil Ka Darbar

September 23, 2012, 9:00 AM–6:00 PM , Tal Katora Indoor Stadium, Connaught Place, New Delhi

A non stop question answer–session between all top cardiologists of the NCR region and the public.

My Profession My Concern

2. Quality standards for any clinical establishments

Golden hour in clinical practice

One should not ignore warning signals as "time is life" in medical science. The three cardinal warning signals are: anything which is unusual, anything which cannot be explained and any symptom appearing for the first time in life. Time is life is an old saying. In the case of a heart attack, time is muscle and for brain, time is brain.

Most acute emergencies will require emergent evaluation and treatment. Delay in treatment even of minutes can take away life. In an emergency, one should not waste time to think, rush to a bigger hospital with full facilities and make sure that the person is attended to in time. Many hospitals may have ill–equipped emergency departments or may have inadequately trained staff. In nursing homes, the ER doctor may be from other systems of medicine.

In emergency medicine, the golden hour refers to the first hour following traumatic injury being sustained by a casualty, during which there is the highest likelihood that prompt medical treatment will prevent death. If bleeding can be stopped and person can be infused enough fluids within first hour most trauma death can be avoided.

  • Platinum 10 minutes refers to first ten minutes after trauma and refers to the importance of starting first aid within ten minutes to reduce the chances of death.
  • Door to ECG time is an important terminology in the treatment of heart attack. One should get an ECG within 10 minutes of chest pain. A prolonged door–to–ECG time is associated with an increased risk of clinical outcomes in patients with ST elevation heart attack.
  • Door–to–Doctor time in Stroke is another term. In emergency department arrival to initial physician evaluation should be less than 10 minutes in stroke or the mortality will be high.
  • Door to neurologist time is for the specialist. In emergency department, arrival to Paralysis Stroke Team Notification time should be less than 15 minutes.
  • Door to CT scan time is the time before which the CT should be done in suspected paralysis. In the emergency department, arrival to CT scan initiation in stroke should be less than 25 minutes. Door–to–CT Interpretation in stroke should be < 45 minutes.
  • Door to tPA time is the treatment window in paralysis: 80% of eligible paralysis patients presenting to the emergency department should be treated with tPA clot dissolving drug within 60 minutes.
  • Door to antibiotic time in community-acquired pneumonia refers to the time to start antibiotics. Practice guidelines suggest that all patients hospitalized with community–acquired pneumonia should receive antibiotics within 4 hours of admission.
  • Door to antibiotic time in meningitis of more than 6 hour is linked to high mortality (8.64 times).
  • Door to needle time in acute heart attack is the time before which the clot dissolving drug should be given. In ST elevation heart attack, it is recommended that the door–to–needle time should be less than 30 minutes.
  • Door to balloon time is for angioplasty. Primary percutaneous coronary intervention (PCI) is now preferred for most patients if it can be performed by an experienced operator with less than a 90 minute delay from presentation to the emergency department.

For comments and archives

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

    Valvular Heart Disease Update

Errors in diagnosing MR severity

  • Severe chronic MR does not exist without left atrial or left ventricular enlargement
  • If LVEDD (Left ventricular end–diastolic diameter) is < 60 (35 mm/m2), then revise the diagnosis of severe chronic MR
  • Left atrial enlargement defines the severity and duration of chronic MR

(Experts: Dr Bhabha Nanda Das and Dr Ganesh K Mani, Dr. Yugal Mishra, Dr Deepak Khurana, Dr K S Dagar, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

For comments and archives

    International News

(Contributed by Dr Monica and Brahm Vasudev)

USPSTF says no to routine tests for ovarian Ca

Women with an average risk of ovarian cancer should not undergo routine screening for the disease, according to a recommendation from the U.S. Preventive Services Task Force (USPSTF). (Source: Medpage Today)

For comments and archives

Acupuncture does help for chronic pain

Acupuncture provides more relief from various types of chronic pain than does usual care and should be considered a valid therapeutic option, the authors of a meta–analysis concluded. (Source: Medpage Today)

For comments and archives

Team effort cuts in–hospital blood infections

A combination of best practices, improved safety culture, and a bigger focus on teamwork cut central–line–associated bloodstream infections (CLABSIs) in hospitals by 40%, the Agency for Healthcare Research and Quality (AHRQ) reported. (Source: Medpage Today)

For comments and archives

    Twitter of the Day

@DrKKAggarwal: Walnuts Good for Semen The daily addition of 75 g of whole–shelled walnuts to a typical Western–style diet…http://fb.me/sQLFxHwL

@DeepakChopra: Love is the only reality, and it is not a mere sentiment. It is the ultimate truth that lies at the heart of creation

    Spiritual Update

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinews)

What Are The Dietary Restriction In Jainism?

The core principle of Jainism is Nonviolence. Food is the main source of energy to survive. Bhagwan Mahavir talked about two types of diet – Hitkari (Beneficial) and Mitkari (Moderate). Jains are lacto vegetarian and even many are vegans. Many avoid root vegetables in their diet. Among the seven prohibited addictions, alcohol is one.

For comments and archives

    4th Asia Pacific Vascular Intervention Course (APVIC)

4th Asia Pacific Vascular Intervention Course–Excerpts from a Panel discussion Read More

The 4th Asia Pacific Vascular Interventional Course begins Read More

Excerpts of a talk and interview with Dr. Jacques Busquet by Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Editor–in–Chief Cardiology eMedinewS Read More

4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty Read More

Press Conference on 4th Asia Pacific Vascular Intervention Course – Dr KK Aggarwal with Faculty
Read More

4th Asia pacific vascular intervention course Read More

4th Asia pacific vascular intervention course paper clippings Read More

    Infertility Update (Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the success rates of IUI?

The success rates with donor insemination depend on many factors. These include the female age and the presence of other female fertility factors such as endometriosis, tubal disease, or ovulatory dysfunction. In general, the monthly chance of pregnancy ranges from 8–15%. The risk of birth defects as a result of conceiving with donor insemination is no different than from conceiving naturally, and is in the range of 2–4%.

For comments and archives

    Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

What is Hemoglobin?

Hemoglobin is a protein present in the red cells. It helps to carry oxygen and carbon dioxide. On an average, in a healthy male it should be between 14 – 16 gm/dL and in a female it should be about 12 – 14 gm/dL. Hb is synthesized daily and new Hb is replacing the old store.

For comments and archives

    An Inspirational Story (Ms Ritu Sinha)

Love in action

One night a man came to our house and told me, "There is a family with eight children. They have not eaten for days," I took some food and I went. When I finally came to the family, I saw the faces of those little children disfigured by hunger. There was no sorrow or sadness in their faces, just the deep pain of hunger. I gave the rice to the mother. She divided it in two, and went out, carrying half the rice with her. When she came back, I asked her, "Where did you go?" She gave me this simple answer, "To my neighbors–they are also hungry."

I was not surprised that she gave–because poor people are generous. But I was surprised that she knew they were hungry. As a rule, when we are suffering, we are so focused on ourselves we have no time for others.

For comments and archives

    Cardiology eMedinewS

Steroids, renal disease hike CV risk in lupus Read More

SPECT scan possible in very obese Read More

    Pediatric eMedinewS

Tight glucose control no help for CICU babies Read More

Fish oil does not prevent early allergies in infants Read More

    IJCP Special

Dr Good Dr Bad

Situation: A patient with Mediclaim for the last seven years came for executive checkup.
Dr. Bad: You will have to pay from your pocket.
Dr. Good: You can claim it from Mediclaim.
Lesson: In addition to cumulative bonus, the insured shall be entitled for a reimbursement of the cost of medical checkup once at the end of block of every four underwriting years provided there are no claims reported during the block. The cost so reimbursable shall not exceed the amount of 1% of the total amount of the average sum insured during the block of four claim free underwriting years.

For comments and archives

Make Sure

Situation: An asthmatic patient became worse after receiving a painkiller.
Reaction: Oh my God! Why was he not put on a leukotriene receptor antagonist?
Lesson: Make sure that a patient with asthma is not given aspirin or he is put on a leukotriene receptor antagonist.

For comments and archives

    Legal Question of the Day (Dr MC Gupta)

Q. I am a psychiatrist having my own private clinic where I have arrangements for giving ECT. What precautions should I take to avoid legal complications?

Ans. You should take care of the following.

  • You must maintain proper records.
  • You must remember that ECT is a procedure involving unconsciousness and electric current and can lead to brain damage, fractures and death. If such complications occur, consent will have little value, especially if it is substitute consent. You must have by your side oxygen, emergency tray and facilities for intubation.
  • You must remember that though the use of ECT is common, it remains controversial and some studies have even reported that it is no better than placebo. The following is from Wikipedia–7nd "Contrary review articles have concluded that ECT is no more effective than placebo.(6)(27) Surveys of public opinion, the testimony of former patients, legal restrictions on its use and disputes as to the efficacy, ethics and adverse effects of ECT within the psychiatric and wider medical community indicate that the use of ECT remains controversial.(28)(29)(30)(31)(32)(33) This is reflected in the recent decision by the FDA’s Neurological Devices Advisory Panel to maintain ECT devices in the Class III device category for high risk devices except for patients suffering from catatonia. This will result in the manufacturers of such devices having to do controlled trials on their safety and efficacy for the first time.(34) In justifying their position, panelists referred to the memory loss associated with ECT and the lack of long–term data.(35)"
    http://en.wikipedia.org/wiki/Electroconvulsive_
    therapy#Degree_of_effectiveness_and_risks
  • You must take proper written consent. Proper consent means proper informed consent.
  • Proper informed consent must be taken in writing from the patient himself as long as he is capable of giving consent (Age above 18 years; Sound mind).
  • Being a psychiatric patient does not mean that the person is of unsound mind. Unsoundness of mind must be recorded in writing along with reasons/proof of the same under signatures of two or preferably three persons. The other persons may be doctors/paramedical persons as far as possible.
  • If the patient is not capable of giving consent, substitute written informed consent may be obtained from legal guardian or spouse.
  • If it is a substitute consent (consent obtained from others when the patient is not capable of giving consent), the following points must be stated in the information on the basis of which the consent is obtained:
    • That there is no alternative treatment except ECT.
    • The ECT has to be given as a life saving measure;
    • That the ECT treatment recommended/consented is valid for a specified number of ECT sessions".
  • If the above precautions are not taken, the patient, himself or through his legal guardian or through a social spirited NGO, can sue you for violating his legal rights. Examples of others suing on behalf of the patient are—
    • Aruna Shanbaug case: Aruna Ramchandra Shanbaug versus Union of India and others, decided on 7 March 2011 by Markandey Katju, J. and Gyan Sudha Misra, J.
      http://ibnlive.in.com/news/
      full–text–supreme–courts–judgment–on–
      aruna–ramachandra–euthanasia–petition/
      145201–53.html
    • Suchita Srivastava case: "Suchita Srivastava & Anr. vs Chandigarh Administration, SC, decided on 28 August, 2009 (Bench: K.G. Balakrishnan, P. Sathasivam, B.S. Chauhan)".
      This judgment can be viewed at
      http://indiankanoon.org/doc/1500783/

For comments and archives

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Photos and Videos of 3rd eMedinewS – RevisitinG 2011 on 22nd January 2012

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  Quote of the Day (Dr GM Singh)

When you are at a loss of what to do, do nothing. Doing nothing can be very wise. When you pause doing things, you become more aware of God’s presence, and often an unexpected solution to your question will arise.

  Stem Cell Update (Dr S K Verma, Consultant Ophthalmologist, New Delhi)

Researches from Thailand have shown in their study that human embryos cryopreserved and stored for 18 years can yield viable embryonic stem cells after thawing and these cells could prove a valuable resource for drug screening and research.

  Lab Update (Dr Navin Dang and Dr Arpan Gandhi)

Globulin, A/G ratio

  • Globulin is increased disproportionately to albumin (decreasing the albumin/globulin ratio) in states characterized by chronic inflammation and in B–lymphocyte neoplasms, like myeloma and Waldenström’s macroglobulinemia. More relevant information concerning increased globulin may be obtained by serum protein electrophoresis.
  • Decreased globulin may be seen in congenital or acquired hypogammaglobulinemic states. Serum and urine protein electrophoresis may help to better define the clinical problem.
    Mind Teaser

Read this…………………

Which nursing measure would avoid constriction on the affected arm immediately after mastectomy?

A. Avoid BP measurement and constricting clothing on the affected arm
B. Active range of motion exercises of the arms once a day.
C. Discourage feeding, washing or combing with the affected arm
D. Place the affected arm in a dependent position, below the level of the heart

Yesterday’s Mind Teaser: Which is an incorrect statement pertaining to the following procedures for cancer diagnostics?

A. Biopsy is the removal of suspicious tissue and the only definitive method to diagnose cancer
B. Ultrasonography detects tissue density changes difficult to observe by X–ray via sound waves.
C. CT scanning uses magnetic fields and radio frequencies to provide cross-sectional view of tumor
D. Endoscopy provides direct view of a body cavity to detect abnormality.

Answer for yesterday’s Mind Teaser: C. CT scanning uses magnetic fields and radio frequencies to provide cross-sectional view of tumor

Correct answers received from: YJ Vasavada, Dr PC Das, Dr Pankaj Agarwal, Dr (Maj. Gen.) Anil Bairaria, Dr. B. B. Aggarwal, Dr.K.V.Sarma, Jayesh Sonvani, Dr.K.Raju, Dr Chandresh Jardosh, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai, Dr. Thakor Hitendrsinh G, Dr Avtar Krishan, Dr Parimal Shah.

Answer for 10th September Mind Teaser:B. Rapid cell catabolism

Correct answers received from: Dr V K Badhwar, Dr Shamsher Singh, Dr.Mohit Sharma, Drjella, y. j. vasavada.

Send your answer to ijcp12@gmail.com

    Fitness Update (Rajat Bhatnagar, MonaVie, www.mymonavie.com/sonraj)

Healthy habits can extend life for older adults

According to new research published in the British Medical Journal, remaining physically active and maintaining a social network can add 5.4 years of life for people over 75 years of age, and 4 years for people over 85. For the study, researchers used data from over 1,800 Swedish adults aged 75 and older and looked at 18 years worth of information.

Researchers found that people who maintained a healthy weight and did not smoke lived on average one year longer than people who were underweight and/or smokers, and adults who remained active lived 2 years longer than their inactive peers. While the participants in this research were already 75 years old at the start (meaning there is room for bias since participants had previously been in good enough health to reach the age of 75), this study provides evidence that remaining physically and socially active can potentially extend life in older adults.

    Laugh a While (Dr GM Singh)

The teacher, during an English lesson, asked her students: "Now tell me, what do you call a person who keeps on talking when people are no longer interested?"

Little Johnny, in the back row, raised his hand. "Yes, Johnny," said the teacher.

"A teacher!"

    Medicolegal Update

(Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

World Medical Association Declaration – Principle V – Clinical Education

The clinical component of medical education must be centered on the supervised study of patients and must involve direct experiences in the diagnosis and treatment of disease. The clinical component should include personal diagnostic and therapeutic experience with gradual access to responsibilities. An adequate relation of the numbers of students admitted for training and teaching at the bedside of the individual patient must be observed.

  • Before beginning independent practice, every physician should complete a formal program of clinical education. This program, usually of at least one year’s duration, should be characterized by a supervised increase of responsibility for the management of clinical problems.
  • The faculty is responsible for determining that students who receive the first professional degree, have acquired a basic understanding of clinical medicine the basic skills needed to be evaluated.
  • Addressing clinical problems and to take appropriate action independently, and have the attitude and character to be an ethical physician.

For comments and archives

    Public Forum

(Press Release for use by the newspapers)

Avoid unnecessary injections, finger prick blood tests

Over 200 diseases can be transmitted from exposure to blood; of these, the most serious infections are hepatitis B virus, hepatitis C virus and HIV, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

  • HIV, hepatitis B and hepatitis C can be transmitted through blood and blood products and/or by sexual route. The prevalence of HIV is only 0.3% in the general population and that of hepatitis C is up to 5%.
  • 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 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.
  • 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 percent decline in the incidence of hepatitis B infection among them.
  • Thirty percent of HIV–positive patients are also co infected with HCV and 10% with chronic hepatitis B infection.
  • 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.
  • Hepatitis B virus is the most infectious of the three blood-borne viruses. It gets 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.
  • Hepatitis B virus can survive on counter tops for 7 days and remains capable of causing infection.
  • 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.
  • 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 percent (0–7 percent).
  • Transmission of hepatitis C virus can occur from infected fluid splashes to the conjunctiva.
  • Hepatitis C virus can survive on environmental surfaces for up to 16 hours.
  • 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.
  • 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.
  • The CDC does not recommend 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. Give 2 to 3 drugs for 4 weeks.
  • Precautions are important during the first three months after exposure, when most people who are infected with HIV become antibody positive.
  • Precautions include abstaining from sexual intercourse or using condoms every time.
  • Condoms reduce, but do not completely eliminate, the chances of transmitting hepatitis B, hepatitis C, or HIV infection to others.
  • Women exposed to blood or body fluids from a person known to be infected should avoid becoming pregnant during this time.
  • Individuals exposed to HIV infected fluids should not donate blood, plasma, organs, tissue, or semen during the follow up period.
  • Breastfeeding women should stop breastfeeding due to the risk of passing the infection to their child.

On 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.

    Readers Responses
  1. Dear Sir, in a Telugu movie, the hero tries to adjust the light in the operation theatre with gloved hand and then proceeds to do the surgery. Many such mistakes do happen due to lack of medical knowledge and observation. Dr Valluri Ramarao.
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