eMedinewS Editorial

Health Care 55 Comments

Exposure to HIV, Hepatitis B and or Hepatitis C infected blood

Although more than 200 different diseases can be transmitted from exposure to blood, the most serious infections are hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV. Co infection with HIV and hepatitis C infection or HIV with hepatitis B infection is also common since all three infections share similar routes of transmission. Approximately 30 percent of patients who are HIV infected are also co infected with HCV and 10% with chronic hepatitis B infection. The prevalence also depends on the route of transmission. Hepatitis C virus seroprevalence in HIV infected patients is seen in up to 73 % in intravenous drug users and 4 % in patients considered to be at low risk.

Injection drug users usually 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 C virus is transmitted efficiently via percutaneous routes, so seroprevalence rates are highest in intravenous drug users. Injection drug use is currently the leading route of HCV transmission.

Transmission

In order to be exposed to a blood-borne pathogen, one must have contact with virus containing blood, a visibly bloody fluid (sputum or urine containing blood), or another bodily fluid (semen or vaginal secretions). The blood or fluid must come in direct contact with some part of the body. A virus can enter the body through the bloodstream, open skin, or mucous membranes (eye, mouth, or genitals). Contact with intact skin (without new cuts, scrapes, or rashes) poses no risk of infection. Thus, exposure to a blood–borne pathogen is possible after a skin injury such as a needle stick or cut with a sharp object or contact with a mucous membrane (including exposure through sexual intercourse, especially if an ulcer is present or vaginal tissues are injured) or non intact skin.

Hepatitis B virus (HBV) is the most infectious virus that can be transmitted through the blood or bodily fluids. A healthcare worker who is stuck with a needle containing blood infected with hepatitis B virus has between 6 to 30% chance of developing hepatitis B. The risk of hepatitis C virus and HIV in the same situation is 1.8 and 0.3%, respectively. Hepatitis B virus gets transmitted by percutaneous and mucosal exposures and human bites. It has also been transmitted by fomites such as finger stick blood sugar check, multi dose medication vials, jet gun injectors, and endoscopes. HBV can survive on counter tops for seven days and remain capable of causing infection. 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 4 or 7 days.

Dr KK Aggarwal
Editor in Chief

eMedinewS Editorial

Health Care 305 Comments

For type 2 diabetes, prescribe both aerobics and resistance training

People with type 2 diabetes who did aerobic exercise some days and resistance training on others had lower blood sugar levels after nine months than people who did either type of exercise alone. The combination exercise program really works better said Dr. Timothy Church, director of preventive medicine research at the Pennington Biomedical Research Center at Louisiana State University System in Baton Rouge. The combination group was the only group that had significant improvement. They reduced their HbA1c levels, while also reducing the amount of diabetes medications.

‘The findings from the NIH funded study are published in the Nov. 24 issue of the Journal of the American Medical Association. The people in the resistance–training group exercised three days per week. Each session consisted of two sets of four upper–body exercises, three sets of three leg exercises, and two sets of abdominal crunches and back extensions. Most of these exercises were done with weight machines. The aerobic group did about 150 minutes a week of moderately paced walking on a treadmill. The combination group had two resistance–training sessions a week that consisted of one set each of the exercises listed above. They also walked slightly less than the aerobic–only group. The time each participant exercised each week was roughly the same, no matter which group they were in. The researcher supervised all of the exercise sessions.

Dr KK Aggarwal
Editor in Chief

eMedinewS Editorial

Health Care 51 Comments

All Foreign National/NRI to take prior permission
from MCI for attending any CME

As per MCI circular 202( l)(Gen.)/Regn.-2010/39212 dated 13/11/2010 issued to all the Principal/Deans Medical Colleges/Institutions in India; Secretary All Medical Associations and all the Hospitals in India on the subject: Prior permission/registration of Foreign National/NRI desires to participate in CME programmes/Workshop/Post Graduate course holding in India the MCI has directed all to ensure that all the Foreign National/NRI faculty will have to take prior permission from the Medical Council of India for attending any CME programmes/workshop/ Postgraduate courses conducted by Medical Colleges/Hospitals/Medical Associations and other medical organizations in India. As per MCI it is mandatory and suo-moto action would be initiated by MCI against the erring medical college/institutions.

This is in clarification to section 14(1) of the Indian Medical Council Act, 1956 which reads as under: -

  1. The Central Government after consultation with the Council, may, by notification in the Official Gazette, direct that medical qualifications granted by medical institutions in any country outside India in respect of which a scheme of reciprocity for the recognition of medical qualifications is not in force, shall be recognized medical qualification for the purposes of this Act or shall be so only when granted after a specified date: Provided that medical practice by persons possessing such qualifications: -
    a. shall be permitted only if such persons are enrolled as medical practitioners in accordance with   the law regulating the registration of medical practitioners for the time being in force in that country,
    b. shall be limited to the institution to which they are attached for the time being for the purposes of teaching,  research or charitable work ; and
    c.  shall   be   limited  to   the  period  specified   in   this behalf by  the  Central Government by general or special order.

Dr KK Aggarwal
Editor in Chief

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