Medinews e-Newsletter - July 2009 - A service from the IJCP Group of Publications
EditorialDebate: Blood Donation from Men who Have Sex with Men 
In This Issue...
Dr K K Aggarwal
Dear Colleagues
Most European countries, the United States, and Canada have a lifetime ban on blood donations from men who have sex with men, whereas Spain, Australia, and New Zealand accept blood from these donors after one year has elapsed since the last sexual contact. Regarding organ donation as per CDC guidelines, male having sex with male cannot donate organ for  five years after last sexual encounter.

A report posted online in February, 2009 in the British Medical Journal debates the pros and cons of whether men who have sex with men should be allowed to give blood.

The UK independent Committee on the Safety of Blood, Tissues, and Organs states that one must give the highest priority to ensuring that blood provided to patients who need a transfusion is safe but they also have a duty not to discriminate unnecessarily against donors as discrimination and stigma have physiological consequences, including impaired immune function.

The right of recipients to receive safe blood should override the asserted rights of donors to give blood. The primary, if not exclusive, responsibility of blood collection centers and transfusion services should be to provide adequate amounts of safe blood to recipients.
The policy further states that men who have sex with men should be excluded from donating blood to protect the blood supply from transfusion-transmissible infections.

According to the National Blood Service of England and North Wales, accepting blood donations from people in groups that are at high risk of carrying HIV and other blood-borne diseases would lead to an unacceptable rise in risk for transmission of these diseases. Health Protection Agency data indicate that men who have ever had oral or anal sex with men are disproportionately affected by HIV.

Although the UK services screen all donations for antibodies to HIV and hepatitis B virus and surface antigen for hepatitis B, there is a long "window" between infection and antibodies being detectable, which can be months for HIV. Tests for HIV RNA or for the p24 antigen, which are used in New Zealand and Spain, have shorter windows but are not required for blood screening in the United Kingdom or in India. Other problems include false-negative results and the accidental release of blood that tests positive. Australia's policy is a 1-year deferral for all high-risk categories. The American Association of Blood Banks since 1997 and American Red Cross since 2006 support 1-year deferral for all high-risk categories.

Removing the exclusion might increase the risk of HIV-infected blood entering the blood supply by 5-fold and that changing deferral to 1 year from the last homosexual contact would increase the risk by 60%.Those who support lifelong ban on blood donation from men who have had sex with men argue because the risk for transmissible infection is too great.  Prevalence of HIV among men who have had sex with men is 60-fold greater than in the general population, 800-fold greater than in first-time blood donors, and 8000 times greater than in repeat blood donors.  Also one cannot rely on blood screening, even though improved, because of the often large window between infection and detection of antibodies.

However apart from MSM, other high-risk groups are not similarly excluded from blood donation. Drug users and female sex workers, are permitted to donate blood after one year has elapsed from the last high-risk behavior.Also changing the criterion to 12 months from the last male-male sexual contact with a new partner would result in only 1 more unit of HIV-positive blood out of 1.5 crore units processed.
The current view is that one can consider one year behavior fee interval for the donor.

All donors should be informed of various high risk behaviors e.g. heterosexual or homosexual promiscuity, intravenous drug abuse, etc. The donors should be asked to self-exclude themselves from donation if they are practicing a high risk behavior. In addition, they must be educated about window period during which they may be the carriers of HIV infection but may not have developed the antibodies.

It is very important to exclude donations from those at risk of infection with HIV or other blood borne diseases. However, if a donor with a high risk behavior is under pressure to donate, he can confidentially indicate to the physician after the donation to discard his collected blood unit and not use it for any patient. This approach is known as confidential unit exclusion (CUE).
One should remember that donors may fight for their rights to donate blood more important are the rights of the recipients. They also have the right to know the extent of safety of the blood they are receiving and the right to know the high risk behaviors of the donor.

 BSNL Dil ka Darbar on 6th September
The unique BSNL dil ka darbar is all set to be held on 6th September at MAMC auditorium, Being organized on the lines of Mughal Darbar the event will give opportunity to heart patients to get their all queries answered and get very highly subsidize treatment. Imagine all branded drugs at 50% all path labs at 50% pacemakers and stents at 50% of the cost.
 
 MTNL Perfect Health Mela

16th MTNL Perfect Health Mela, an annual event, by Heart Care Foundation of India in association with various departments of Delhi Government is being organised from 3rd to 12th October 2009 at NDMC Grounds Laxmibai Nagar, New Delhi. The Mela will create awareness about all aspects of health for people from all sections of the society and all walks of life incorporating all pathies under one roof using cost effective infotainment modules. The focus of the Mela this year is 'Rising Lifestyle Disorders'.

The major activities of the Mela will be Harmony (inter school festival), Heritage (inter dancing school festival), Divya Jyoti (inter nursing school festival), Medico Masti (inter medical college and college festival), Anmol (festival for children with special needs), Omegatone heart check up camp, Swasthya Pavilion (general and specialty checkups), Health Durbar (public audience with medical experts), Medline (live video conferencing between Delhi & Mumbai doctors interacting with patients), Jaago India (media festival), Swagat (inaugural function), Bid adieu (valedictory function), Eco- festival (involving various eco school clubs), Kaviyon Ki Kushti with Ashok Chakradhar (Kavi Sammelan), etc.  The Mela will provide free education, exhibition, general and specialty checkups, ECG, Color Doppler Echocardiography, competition opportunities, etc. Highly subsidized executive blood test will be available to the general public at a nominal registration fee of Rs. 110/- (market cost 1500/-)

 

 DMC election process starts

Delhi Medical Council election process has started. The registrar has already issued the first process of updating the valid voters list. The last date to check your name is 23rd August. Election will be held for the eight elected DMC members.

 

 Dr Anil Kohli reelected as DCI president

Congratulations... Dr Anil Kohli has been reelected as the president Dental Council Of India for a second five-year term.

 

 Common Entrance Test for All Medical Colleges

It is planned that The Medical Council of India (MCI) would henceforth hold a common entrance test for all the medical colleges in the country. The MCI, which is tasked with the maintenance of uniform standards of medical education in the country recommended to the Central Govt. a common entrance examination for all the roughly 300 medical colleges in India, in both private and government sectors, starting from next year. This was on a suggestion by the Supreme Court. The MCI had set up an expert committee of three retired heads of medical colleges, which recommended that an all-India common entrance test would be binding on all private and government medical colleges. The test also applies to Homoeopathy, Ayurveda and Sidha colleges which are registered with the MCI. But, the nursing degree (B.Sc. Nursing) would be out of its purview. Therefore it asked the Central government to set up an authority to conduct the entrance test.

The all-India test would make admissions to medical courses transparent and would eliminate room for corruption and capitation fee. It would also open up the opportunities for students to study in reputed institutions in other parts of the country. One great advantage for the students would be that they would have to take only one test instead of the several now. In the current system, students take an all-India medical entrance examination for admission to Central government-run institutions, State entrance examinations in different States and the tests conducted by some private medical colleges.

Source: www.hindu.com/2009/07/11/.../2009071154710100.htm

 

 H1N1 update

According to the WHO, since the H1N1 flu outbreak began four months ago, it has caused more than 700 deaths across the world. This figure denotes a jump of at least two-thirds from the last published official death toll figure of 429 on July 6. Most infections are mild and the large majority of patients usually recover within a week. But, the WHO has stated that the pandemic is increasing at such a high speed that it is now futile to undertake to document every case. Margaret Chan, WHO Director-General, has cautioned that swine flu could become the biggest flu pandemic ever seen. In past pandemics, flu viruses required a time period of more than six months to spread as far and wide as the new H1N1 virus has done in less than six weeks.

 

Food bad for teeth, harmful for body too

Dental diseases may be a warning that the high-glycemic diet that leads to dental problems in the short term may, in the long term, cause harm to the body. Dr. Philippe P. Hujoel, professor of dental public health sciences at the University of Washington School Of Dentistry in Seattle evaluated two contradictory viewpoints on the role of dietary carbohydrates in health and disease. The debate circled around fermentable carbohydrates i.e. foods that turn into simple sugars in the mouth. Fermentable carbohydrates are not just sweets like cookies, doughnuts, cake and candy. They also include bananas and several tropical fruits, sticky fruits like raisins and other dried fruits, and starchy foods like potatoes, refined wheat flour, yams, rice, pasta, pretzels, bread, and corn.

One viewpoint suggested that certain fermentable carbohydrates were beneficial to general health and that the harmful dental consequences of such a diet should be managed by the tools found in the oral hygiene section of drugstores. A contrasting viewpoint highlighted that fermentable carbohydrates were bad for both dental and general health, and that both dental and general health needed to be maintained by restricting fermentable carbohydrates.

Hujoel explains that eating sugar or fermentable carbohydrates drops the acidity levels of dental plaque and is considered an initiating cause of dental decay. According to Dr. Hujoel, there is fascinating evidence that suggests that the higher the glycemic level of a food, the more it will drop the acidity of dental plaque, and the higher it will raise blood sugar. So, possibly, dental decay may really be a marker for the chronic high-glycemic diets that lead to both dental decay and chronic systemic diseases. This puts a whole new light on studies that have linked dental diseases to such diverse illnesses as Alzheimer's disease and pancreatic cancer.

Source: www.newkerala.com/nkfullnews-1-71303.html

 

Bed side test: prolonged PTT or CT

Insulin-resistant men improve in erectile function when metformin is added to sildenafil. Sildenafil alone fails to improve erectile function, and men who received a placebo in addition to the phosphodiesterase-5 inhibitor continued to have erectile problems, as per Dr Pablo Knoblovits, of Hospital Italiano de Buenos Aires in Argentina. Metformin potentiates the activity of sildenafil by improving insulin resistance and nitric oxide activity in the vascular endothelium of the penis.

If the mixing test indicates an inhibitor, diagnosis of a lupus anticoagulant is then confirmed with other tests.

 

Omegatone fish oil capsules: How it works

If you aren't able to eat fish 2 to 3 times a week, Healtheries Omegatone Blended Fish Oil 1000mg natural Omega-3 can help.  It's a blend of mackerel, sardines, tuna, anchovy & salmon oils sourced from pacific & atlantic oceans, and is a rich source of essential fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid).  They are shown to benefit heart, brain, vision, memory & learning functions and maintain health of cells in your body. They are also shown to reduce intima media thickness, platelet aggregation, fibrinogen, triglycerides, bad smaller LDL cholesterol & BP; provides protection from cardiac sudden death; reduces risk of paralysis & non fatal heart attacks and raises good HDL cholesterol.

Source: Heart Care Foundation of India

 

Killer parasites' genes decoded

The smaller female parasite lives inside the thicker male. Schistosoma mansoni and S. japonicum both cause the debilitating disease schistomiasis. The researchers have already uncovered possible targets for new treatments to combat the disease, which causes symptoms such as fever and fatigue. People become infected with Schistosoma when they wade or bathe in water inhabited by tiny snails that host the parasites. The parasites are released into the water, and use fork tails to burrow into the skin and travel to blood vessels that supply urinary and intestinal organs, including the liver, where they mature. Female worms, which live inside the thicker males, release many thousands of eggs each day. Eggs shed in urine and feces may make their way into snail-inhabited water, where they hatch to release parasites that seek out snails to begin the cycle again.

Researchers working on the genetic blueprint of S. mansoni, the most widespread of the schistomiasis parasites, found that it was made up of 11,809 genes - about 10 times the size of the malaria parasite genome. In particular, they identified a large number of genes which produce enzymes that break down proteins, giving the parasite its ability to bore through tissue. The analysis also found that S. mansoni lacks a key enzyme needed to make essential fats, and must rely on its host to provide these - revealing a potential Achilles' heel that could be exploited for drug development. It provides a foundation for understanding aspects of the parasite's complex biology as well as a vehicle to immediately identify new targets for drug treatment.

Source:news.bbc.co.uk/2/hi/health/8151199.stm

 

Babies of older mums have higher cancer risk

A new study demonstrates that babies born to older mother may have a slightly higher risk for many of the cancers that occur during childhood. Currently, about one in 435 children under 15 years in the US gets cancer. They include leukemia, lymphoma, central nervous system tumor, neuroblastoma, Wilms' tumor, bone cancer and soft tissue sarcoma.

For this population-based case-control study, Spector and colleagues used information from birth registry records in New York, Washington, Minnesota, Texas, and California. The study included the records of 17,672 children in those states diagnosed with cancer at ages 0-14 years between 1980 and 2004 and 57,966 children not diagnosed with cancer.

"We saw that the risk of seven of the 10 most common childhood cancers increased slightly, about seven to 10 percent, with every five-year increase in maternal age," Spector said. However the father's age did not seem to matter once the mother's age was taken into account. Some of the possible explanations of this phenomenon could be age-related changes in hormonal levels during pregnancy and alterations in DNA markings in eggs that can be transmitted to the offspring.

Source: www.livescience.com/health/.../090708-fountain-youth-pill.html

 

Water... your best weapon against aging

According to a new study, water may be the best remedy against wrinkles due to aging. Scientists have recently identified 1,500 genes that decide how long people can keep their youthful looks, and discovered that skin ages by eight ways, each of which is controlled by different sets of genes. Amongst these, the most important is how well the skin collects and retains water. There are about 700 genes that help keep the skin hydrated, which become less active with advancing age and hence, cells are less capable to retain water as they age causing wrinkles. Collagen levels are also important. Collagen is a molecule that gives structure and strength to the skin. There are 40 genes which become overactive in older age and accelerate collagen breakdown, which also leads to wrinkles.

Source: news.oneindia.in/.../newkit-to-help-parents-check-kids-drug-abuse-by-testingju.html

 

Your cell phone can now be a microscope

A new add-on device, the CellScope, has been developed by scientists that can be attached to a mobile phone. The device acts as a fluorescence microscope and can take detailed images and analyze them to diagnose diseases such as TB. The research is published in the journal PLoS One.Typical fluorescence microscopes are bulky, expensive devices and are only available in hospitals and laboratories. According to David Breslauer, a University of California Berkeley researcher and lead author of the study, their technique is innovative as they have incorporated a portable fluorescent microscope with a cell phone. A standard Nokia handset with a 3.2 megapixel camera was used in the study, developing a "snap-on" addition that includes the microscope optics and a holder for blood samples on glass slides. The CellScope makes use of economical commercial light-emitting diodes as the light source instead of the high-power, gas-filled lamps used in laboratory versions of the device, and inexpensive optical filters to isolate the light coming from the fluorescent tags. The resolution is just over one millionth of a meter, and the team was able to identify tuberculosis bacteria in a sample. Several other tagging molecules are in development to address the diagnosis of other diseases.The study authors demonstrated its clinicaly utility by imaging P. falciparum-infected and sickle red blood cells in brightfield and M. tuberculosis-infected sputum samples in fluorescence with excitation.

 

 Dr Good and Dr Bad & Make Sure.... 
 Dr Bad Dr Good
 
Make Sure.. 


 
Debate: Blood Donation from Men who Have Sex with Men

BSNL Di ka Darbar on 6th September
MTNL Perfect Health Mela
DMC election process starts
Dr Anil Kohli reelected as DCI president
Common Entrance Test for All Medical Colleges
H1N1 update
Food bad for teeth, harmful for body too
Bed side test: prolonged PTT or CT
Omegatone fish oil capsules: How it works
Killer parasites' genes decoded
Babies of older mums have higher cancer risk
Water... your best weapon against ageing
Your cell phone can be now be a microscope

IJCP
 
IJCP
 
 
IJCP
IJCP

IJCP

IJCP

IJCP

IJCP


IJCP

IJCP

IJCP

IJCP

IJCP

IJCP

IJCP

IJCP

IJCP
 
Head Office
Daryacha, 39
Hauz Khas Village
New Delhi-110016
e-mail: drkk@ijcp.com
editorial@ijcp.com