Tattooing and HIV: Study in AP

By U Sudhakar Reddy
Tattooing in men has been identified as one of the risky behaviours associated with the spread of HIV.
A study conducted in the state by the Nizam’s Institute of Medical Sciences in association with the George Institute of International Health Studies (GIIHS) found that tattooing and male non-circumcision are risky behaviours among HIV infected males, apart from homosexuality, multiple sex partners and blood transfusion.
Commenting on the findings, the AP State Aids Control Society director, Mr R.V. Chandravadan, said, “using the same needles (for tattooing) is risky. We are not sure if HIV is spread by tattooing and we cannot rule out the possibility of infection. Sterilised needles have to be used for tattooing.” Regarding non-circumcision, he said, studies showed that circumcision can reduce the spread of HIV infection. “However the attendant conse quences associated with circumcision have to be studied,” he said. “It has a socio-religious implication.” The study, titled ’Risk factors associated with HIV in a population-based study in Andhra Pradesh’ was headed by Lalit and Rakhi Dandona of George Institute of International Health. The study found that among men, there was significant association between HIV and history of sex with other men, sex workers or multiple women partners, consuming alcohol before sex, recreational drug use, male non-circumcision and tattooing.
“The highest impact of reducing the HIV number per unit population was for male circumcision in Guntur,” said the study.
Among women, the study said, “the only identified behavioural factor associated with HIV was multiple male sex partners.” The researchers interviewed a population-based sample of 12,617 persons aged 15 to 49 years from 66 rural and urban clusters in Guntur district.
(Photo courtesy: howstuff works)

Polio(P3 strain) again in Andhra Pradesh

By U Sudhakar Reddy

Migrant labour from UP and Bihar travelling to the state are seen as potential carriers of the polio virus, that struck in the state on Friday.
Also, locals from Mahbubnagar and Ranga Reddy migrating to Mumbai and Pune could be bringing back the virus.
Thanks to these groups, the wild polio virus of P3 strain though termed as weak has resurfaced in the state, particularly in urban areas. The P3 strain was first reported in Bihar in 2003 and has since spread to southern states. Bihar has reported over 1,300 cases of polio this year.
The family welfare commissioner, Mr Anil Punetha, said, that migrants do not vaccinate their newborns. “Due to lack of awareness they don’t approach health workers,” he said Health officials of the health department have decided to go for a subnational immunisation programme.
Mr Punetha agreed that in isolated cases, immunised children are also affected by the virus, as happened in Kakinada on Friday. “We will analyse the P3 strain,” he said.

City cancer Institute gets radiation bunker

By U Sudhakar Reddy
Hyderabad, May 2: The MNJ Cancer Hospital is constructing a specially-designed concrete bunker to house its high energy radiation equipment so that accidental leakage don’t affect surrounding localities. The MNJ Institute of Oncology and Research Centre is located in a highly-populated area of Red Hills.
On the instructions of the Bhaba Atomic Research Centre and the Atomic Energy Regulatory Board, the hospital has created a bunker which has two gigantic floors and walls more than two-and-a-half metres thick. It is meant to safekeep four high energy linear accelerators used for radiotherapy of cancer patients.
“The linear accelerator is high radiation-emitting unit and has to be kept in a specially designed place,” said MNJ director, Dr T. Mandapal. “It has been named Rajiv Gandhi Linear Accelerator block and the work is in progress.” The hospital is hoping to complete the work on the bunker in two-and-a-half months.
“It is being constructed by Andhra Pradesh Health, Medical Housing and Infrastructure Development Corporation on 1,000 square yards at an estimated cost of Rs 4.8 crore,” said Dr Mandapal. Each floor of the bunker is almost ‘two stories’ high since the roof has to be high above the machines.
A linear accelerator with high dual energy mode system costs around Rs 6 crore. There are radiation safety officers in the hospital to take care of the systems. It was in 2000 that BARC permitted MNJ to resume radiation treatment for cancer patients which was suspended after it lost a hazardous radioisotope needle. Hospital authorities had said that it had only minimum radiation.

Fraudsters make money off childbirth

By U. SUDHAKAR REDDY

Hyderabad

The Janani Suraksha Yojana scheme to encourage institutional deliveries among poor women is being rampantly misused.
Under the scheme, a woman who undergoes delivery in hospital will be given Rs 600. Two women were caught red-handed the other day for trying to claim this incentive at Niloufer Hospital by producing fake discharge cards.
Hajera Begum, 18, wife of Mohammed Ali of Mangalhat and Sajeeda Begum, wife of Shaik Abdul Raheem, were warned and let off by the hospital.
Hajera took the discharge card of one Asma Begum and changed the name. Then she approached the family planning department at Niloufer to claim the incentive. Sajeeda Begum tried to claim the money by forging the discharge card of one Zaheda Begum.
The Niloufer resident medical officer, Ms K. Usha Rani, said. "Officials became doubtful as one of them claimed to have had a second delivery in six months."
It is learnt that such incidents are common in several government hospitals in the city.
"These are isolated cases," said the district medical and health officer, Ms Ch Jaya Kumari.
"In most instances, it is deserving people who get the benefits. We are checking all claims. I will also inquire into the latest incident," Ms Kumari told this correspondent.
The Janani Suraksha Yojana scheme to encourage insti- tutional deliveries among poor women is being ram- pantly misused. Under the scheme, a woman who undergoes delivery in hospital will be given Rs 600. Two women were caught red-handed the other day for trying to claim this incentive at Niloufer Hospital by producing fake discharge cards. Hajera Begum, 18, wife of Mohammed Ali of Mangal- hat and Sajeeda Begum, wife of Shaik Abdul Raheem, were warned and let off by the hospital. Hajera took the discharge card of one Asma Begum and changed the name. Then she approached the family planning department at Niloufer to claim the incentive. Sajeeda Begum tried to claim the money by forging the discharge card of one Zaheda Begum. The Niloufer resident medical officer, Ms K. Usha Rani, said. "Officials became doubtful as one of them claimed to have had a second delivery in six months." It is learnt that such inci- dents are common in sever- al government hospitals in the city. "These are isolated cases," said the district medical and health officer, Ms Ch Jaya Kumari. "In most instances, it is deserving people who get the benefits. We are check- ing all claims. I will also inquire into the latest inci- dent," Ms Kumari told this correspondent.

(Published in Deccan Chronicle on Feb 6 2008)

Mock surgery on conjoined twins model

By U Sudhakar Reddy

Hyderabad, Feb. 2: A team of neurosurgeons of Breach Candy Hospital in Mumbai aided by doctors from the city-based Niloufer Hospital will prepare a model of the conjoined heads of the Siamese twins Veena and Vani for mock surgery.
Doctors will decide on the actual surgery to separate the twins after reviewing their performance on the model.
The model will have blood vessels and other systems resembling the craniophagus twins. Doctors are planning to use 3D imaging software to perform simulation surgery on computers.
The twins share the same blood vessel to the brain which makes the surgery risky. Veena and Vani were shifted to Breach Candy on January 16 for clinical investigations.
Niloufer Hospital's resident medical officer, Dr K Usha Rani, told this correspondent, "They will try to analyse complications that may arise during the surgery and get expertise in handling the case."
Dr A. Narendra Kumar, head of the department of paediatric surgery wing of Niloufer, was part of the team of Breach Candy Hospital neuro surgeons lead by Dr Ashish Mehta.
Niloufer Hospital superintendent Dr S Narasimha Rao said, "Clinical investigations are still going on. They may take a few more days." He said the twins will be shifted to Niloufer after the conclusion of investigations

IMA snaps at Naidu for backing quacks

By U Sudhakar Reddy

Hyderabad. Jan. 30: The Telugu Desam president, Mr N. Chandrababu Naidu, faced the ire of Indian Medical Association and the doctors' community for his decision to support quacks, popularly known as RMPs and PMPs.
The Andhra Pradesh Medical Council and the AP Private Nursing Homes Association joined the IMA to condemn Mr Naidu's support to the quacks. On Tuesday Mr Naidu had demanded that the government should utilise the services of quacks in villages.
There are around 1.5 lakh unqualified practitioners in the state who can influence rural vote banks.
According to the AP Medical Council, there are around 58,000 qualified doctors. After excluding those who left the country and those who are dead, the number would be about 40,000.
The APMC member, Dr K. Ramesh Reddy, said, "Quacks are totally unqualified and do not have basic training in medical sciences whether it is allopathic or Indian system of medicine."
"Most of these people worked as compounders or ward boys with qualified doctors. At any cost they can not claim to be doctors and can't be trained," Dr Kumar said.
"They may be used as paramedical staff. They should not run any clinic and if they do it is illegal and punishable under law," he said.
"There is nothing like a condensed training course. If these quacks are allowed to practise medicine it will risk the lives of patients."
He asked the government to provide infrastructure to the doctors to run clinics in rural areas.
The Indian Medical Association's city secretary, Dr P. Pulla Rao, said, "A court case is pending regarding the qualification of quacks. The government also told the Andhra Pradesh Legislative Council that there are no plans to recognise quacks."
"For political mileage the parties are raking up these issues and giving assurances. Instead of punishing the quacks they are trying to regularise them, which is not acceptable," Dr Pulla Rao said.
The Andhra Pradesh Private Nursing Homes Association president, Dr Y. Ravindar Rao, said, "Nowhere in the world are unqualified persons given permission to practice. Taking a small test and issuing a certificate is not correct."
"If the government or the Opposition does this for political mileage it is incorrect," he said.
The RMPs and PMPs may be used as health workers to distribute tablets and perform first aid.
"They should not be allowed to practice, diagnose and prescribe," he added

Study finds retinal degeneration is widespread

By U. Sudhakar Reddy
Age related macular degeneration (AMD), an irreversible condition, has suddenly risen to become the third biggest eye disease in India, next only to cataract and diabetic retinopathy and corneal scars.
AMD is recognised as the biggest cause of irreversible vision and retinal blindness in the US and Europe.
The sudden rise of AMD in India was revealed in a study conducted in Andhra Pradesh by L.V. Prasad Eye Institute. Earlier the estimated prevalence of retinal diseases was 10.3 per cent of which AMD constituted 2.7 per cent. That has now doubled, the study showed.
AMD generally strikes at about age 50. A person whose vision blurs in the centre may have AMD. It is a complex disorder and unlike other eye diseases treatment is limited and expensive and there is no reliable cure.
Change in food habits, smoking, hypertension, increase in cholesterol are cited as reasons for the increase in AMD incidence.
The eye institute also found a genetic basis for AMD. The Brien Holden Eye Research Centre of the institute stated in a report published in Investigative Ophthalmology and Visual Sciences that variation of a gene Complement Factor-H increased the risk of AMD by five to ten times.
Dr R. Narayanan, a retinal diseases consultant of the institute, said that the disease affects the macula, a part of the retina. Macula is the part on which light rays are focused.
Intake of anti-oxidants like Vitamin E, Vitamin C and Zinc can slow the onset of AMD if not prevent it. "There is no awareness of the disease in the public," the doctor said. "We see at least two to three patients a day at our institute alone. When we compare the figure with those three years ago, it is almost double."
Treatment can be lengthy and expensive. In photo dynamic therapy, a cold laser shrinks abnormal blood vessels and decreases swelling. It costs around Rs 60,000 per sitting and is spread over three sittings.
Macugen, a medicinal drug, is injected into the eye. Each injection costs Rs 40,000 and Between 10 to 20 per cent of patients show improvement.
Between 20 to 30 per cent of patients show improvement with Avastin, a drug used for intestinal cancer treatment. It costs Rs 1,000 injection.
Lucentis was launched in the US in July this year but it costs $2,000 a shot. Repeats indicate that 30 to 40 per cent of patients are benefited.

(Published in Deccan Chronicle and Asian Age on October 26 2006)