This study aimed to determine the prevalence of hepatitis C virus (HCV) in females in Islamabad, Pakistan and identify associated risk factors. The researchers surveyed 252 females and found that 24.6% tested positive for HCV antibodies. Logistic regression identified receiving a blood transfusion, undergoing dental procedures, and dilation and curettage as significantly associated with HCV positivity. The high prevalence of HCV in this population highlights the need for improved healthcare practices and public education on prevention and control.
The relationship between the molecular epidemiology of hepatitis c and the be...Alexander Decker
This study examined the molecular epidemiology and prevalence of hepatitis C virus (HCV) infection in Jordan. Researchers tested 1929 patients for HCV antibodies between 2010-2011. A total of 149 patients (9%) tested positive, with the infection being twice as common in males compared to females. The most common causes of infection were blood transfusion (68%), kidney dialysis (17%), addiction treatment centers (6%), and unknown causes (9%). HCV RNA detection and genotyping was performed on positive samples. The results suggest blood transfusion is a major route of HCV transmission in Jordan and screening of blood donors has helped reduce prevalence over time.
Evolution and Revolution: Current Issues in HIV and HCV Co-infection
Chapter 1 – HIV-Hepatitis C Virus Co-infection: An evolving epidemic
Chapter 2 - Management of HIV infection in HIV/HCV co-infected patients
Chapter 3 - Management of HCV in co-infected patients
Chapter 4 - HCV Therapy: Direct acting antiviral agents in co-infected individuals
Chapter 5 - Drug interactions with directly acting antivirals for HCV: Overview & challenges in HIV/HCV Co-infection
Chapter 6 - Complicated cases
Chapter 7 - Future trials of Hepatitis C therapy in the HIV co-infected
Chapter 8 - HCV infection in marginalized populations
Chapter 9 - HIV/HCV Co-infection: Through the eyes of a co-infected hemophiliac
This study investigated the seroprevalence of hepatitis B virus (HBV) infection in outpatients at a district hospital in Mardan, Pakistan. The study found that 34.8% of the 270 patients tested positive for HBV DNA using real-time PCR. Males had a slightly higher prevalence of HBV (34.5%) than females (35.1%). The highest prevalence was found in patients aged 21-40 years old (38.9%). When analyzing viral load levels, 50% of positive patients had a low viral load, 33% had an intermediate load, and 17% had a high viral load. Females were more likely to have a high viral load compared to males. The study provides
This study examined risk factors for HCV infection and severity of liver disease in 86 Mexican women reactive for anti-HCV antibodies. Surgery (80%) and blood transfusions before 1993 (58%) were main risk factors, with 52% having both. The most common reasons for surgery and transfusion were obstetric/gynecologic (74% and 68%). 64% were HCV RNA positive. Age and history of transfusion before 1993 predicted cirrhosis. Anti-HCV levels correlated with time since transfusion but not age. HBV co-infection rate was low (5%) and did not influence severity.
Management of Fournier’s Gangrene in a Low Resource Settingasclepiuspdfs
external genitalia and perineum. Although the condition is rare in absolute terms, over 1726 cases have been reported in English literature, with a male/female ratio of 10:1. There have been 502 cases from Africa, which ranks second to the USA/Canada. At present, there is only one published literature on the management of FG in Liberia. Objective: This study highlig hts the late presentation and the challenges in the management of FG at the John F. Kennedy Medical Center. Methodology: This is a retrospective study of 30 patients with FG who were admitted and managed by our division of urology, from January 2018 to May 2019. The patient’s records were retrieved and reviewed for age, sex, onset of disease, sites of the disease, management, duration of stay, and outcome. The frequency and percentage of various parameters were displayed in tables.
Risk factors of chronic liver disease amongst patients receiving care in a Ga...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This study examines risk factors for multiple treatments and recurrence of anal condyloma in HIV-negative men who have sex with men. The study retrospectively analyzed 231 patients treated at a private surgical practice between 2008-2012. Most patients (79.2%) were treated with electrocautery ablation and achieved primary clearance after one treatment. However, having moderate disease severity, intra-anal and perianal lesions, and receiving imiquimod adjuvant therapy were associated with requiring multiple treatments. No single factor predicted recurrence, but those with moderate disease experienced recurrences sooner. The study aims to better understand effective treatment of anal condyloma in this high-risk population.
This systematic review analyzed 22 studies involving over 825,000 people in Mexico to determine the prevalence of hepatitis C virus (HCV) infection. The studies tested asymptomatic low-risk populations, mainly blood donors, for anti-HCV antibodies between 1993-2005. The weighted mean prevalence of anti-HCV was 0.37%, and most studies reported a prevalence below 1%. Blood transfusion was the main risk factor reported. Genotype 1 was the most prevalent among those with confirmed HCV infection, with subtype 1b being the most common. The review concludes that HCV prevalence in Mexico may be lower than previous estimates of 1%, and calls for a nationwide study to better determine the epidemiology of HCV in the country.
The relationship between the molecular epidemiology of hepatitis c and the be...Alexander Decker
This study examined the molecular epidemiology and prevalence of hepatitis C virus (HCV) infection in Jordan. Researchers tested 1929 patients for HCV antibodies between 2010-2011. A total of 149 patients (9%) tested positive, with the infection being twice as common in males compared to females. The most common causes of infection were blood transfusion (68%), kidney dialysis (17%), addiction treatment centers (6%), and unknown causes (9%). HCV RNA detection and genotyping was performed on positive samples. The results suggest blood transfusion is a major route of HCV transmission in Jordan and screening of blood donors has helped reduce prevalence over time.
Evolution and Revolution: Current Issues in HIV and HCV Co-infection
Chapter 1 – HIV-Hepatitis C Virus Co-infection: An evolving epidemic
Chapter 2 - Management of HIV infection in HIV/HCV co-infected patients
Chapter 3 - Management of HCV in co-infected patients
Chapter 4 - HCV Therapy: Direct acting antiviral agents in co-infected individuals
Chapter 5 - Drug interactions with directly acting antivirals for HCV: Overview & challenges in HIV/HCV Co-infection
Chapter 6 - Complicated cases
Chapter 7 - Future trials of Hepatitis C therapy in the HIV co-infected
Chapter 8 - HCV infection in marginalized populations
Chapter 9 - HIV/HCV Co-infection: Through the eyes of a co-infected hemophiliac
This study investigated the seroprevalence of hepatitis B virus (HBV) infection in outpatients at a district hospital in Mardan, Pakistan. The study found that 34.8% of the 270 patients tested positive for HBV DNA using real-time PCR. Males had a slightly higher prevalence of HBV (34.5%) than females (35.1%). The highest prevalence was found in patients aged 21-40 years old (38.9%). When analyzing viral load levels, 50% of positive patients had a low viral load, 33% had an intermediate load, and 17% had a high viral load. Females were more likely to have a high viral load compared to males. The study provides
This study examined risk factors for HCV infection and severity of liver disease in 86 Mexican women reactive for anti-HCV antibodies. Surgery (80%) and blood transfusions before 1993 (58%) were main risk factors, with 52% having both. The most common reasons for surgery and transfusion were obstetric/gynecologic (74% and 68%). 64% were HCV RNA positive. Age and history of transfusion before 1993 predicted cirrhosis. Anti-HCV levels correlated with time since transfusion but not age. HBV co-infection rate was low (5%) and did not influence severity.
Management of Fournier’s Gangrene in a Low Resource Settingasclepiuspdfs
external genitalia and perineum. Although the condition is rare in absolute terms, over 1726 cases have been reported in English literature, with a male/female ratio of 10:1. There have been 502 cases from Africa, which ranks second to the USA/Canada. At present, there is only one published literature on the management of FG in Liberia. Objective: This study highlig hts the late presentation and the challenges in the management of FG at the John F. Kennedy Medical Center. Methodology: This is a retrospective study of 30 patients with FG who were admitted and managed by our division of urology, from January 2018 to May 2019. The patient’s records were retrieved and reviewed for age, sex, onset of disease, sites of the disease, management, duration of stay, and outcome. The frequency and percentage of various parameters were displayed in tables.
Risk factors of chronic liver disease amongst patients receiving care in a Ga...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This study examines risk factors for multiple treatments and recurrence of anal condyloma in HIV-negative men who have sex with men. The study retrospectively analyzed 231 patients treated at a private surgical practice between 2008-2012. Most patients (79.2%) were treated with electrocautery ablation and achieved primary clearance after one treatment. However, having moderate disease severity, intra-anal and perianal lesions, and receiving imiquimod adjuvant therapy were associated with requiring multiple treatments. No single factor predicted recurrence, but those with moderate disease experienced recurrences sooner. The study aims to better understand effective treatment of anal condyloma in this high-risk population.
This systematic review analyzed 22 studies involving over 825,000 people in Mexico to determine the prevalence of hepatitis C virus (HCV) infection. The studies tested asymptomatic low-risk populations, mainly blood donors, for anti-HCV antibodies between 1993-2005. The weighted mean prevalence of anti-HCV was 0.37%, and most studies reported a prevalence below 1%. Blood transfusion was the main risk factor reported. Genotype 1 was the most prevalent among those with confirmed HCV infection, with subtype 1b being the most common. The review concludes that HCV prevalence in Mexico may be lower than previous estimates of 1%, and calls for a nationwide study to better determine the epidemiology of HCV in the country.
Seroepidemiology of Toxoplasma gondii infection in drivers involved in road t...Erwin Chiquete, MD, PhD
Background: The prevalence of toxoplasmosis in the general population of Guadalajara, Mexico, is around 32%.
Toxoplasmosis can cause ocular lesions and slowing of reaction reflexes. Latent toxoplasmosis has been related
with traffic accidents. We aimed to assess the prevalence of anti-Toxoplasma gondii antibodies and visual
impairments related with traffic accidents in drivers from the metropolitan Guadalajara.
Methods: We prospectively evaluated the prevalence of IgG and IgM anti-T. gondii antibodies in 159 individuals
involved in traffic accidents, and in 164 control drivers never involved in accidents. Cases of toxoplasmosis
reactivation or acute infection were detected by PCR in a subset of 71 drivers studied for the presence of T. gondii
DNA in blood samples. Ophthalmologic examinations were performed in drivers with IgG anti-T. gondii antibodies
in search of ocular toxoplasmosis.
Results: Fifty-four (34%) traffic accident drivers and 59 (36%) controls were positive to IgG anti-T. gondii antibodies
(p = 0.70). Among the 113 seropositive participants, mean anti-T. gondii IgG antibodies titers were higher in traffic
accident drivers than in controls (237.9 ± 308.5 IU/ml vs. 122.9 ± 112.7 IU/ml, respectively; p = 0.01 by Student’s t
test, p = 0.037 by Mann–Whitney U test). In multivariate analyses, anti-T. gondii IgG antibody titers were consistently
associated with an increased risk of traffic accidents, whereas age showed an inverse association. The presence of
IgM-anti-T. gondii antibodies was found in three (1.9%) subjects among traffic accident drives, and in two (1.2%)
controls. Three (4.2%) samples were positive for the presence of T. gondii DNA, all among seropositive individuals.
No signs of ocular toxoplasmosis were found in the entire cohort. Moreover, no other ocular conditions were found
to be associated with the risk of traffic accidents in a multivariate analysis.
Conclusions: Anti-T. gondii antibody titers are associated with the risk of traffic accidents. We could not determine
any association of ocular toxoplasmosis with traffic accidents. Our results warrant further analyses in order to clarify
the link between toxoplasmosis and traffic accidents.
This document provides guidelines from the WHO on chronic hepatitis C infection from April 2016. It discusses the global burden of HCV, noting over 700,000 deaths per year. New direct-acting antiviral medications have transformed HCV treatment, enabling shorter, oral regimens with over 90% cure rates and fewer side effects. The guidelines recommend screening high-risk populations and using RNA testing to confirm chronic infection before treatment. They provide guidance on clinical assessment, noting the importance of staging liver fibrosis/cirrhosis and assessing severity. Successful treatment results in reduced liver inflammation and fibrosis regression, lowering risks of liver cancer and transplant.
This study analyzed serious non-AIDS events (SNAs) among HIV-infected adults in Latin America. The researchers identified 130 patients with SNA events out of 6007 patients in the cohort, representing an incidence rate of 0.86 events per 100 person-years. Risk factors like hepatitis B/C coinfection, diabetes, and alcohol abuse were associated with SNA events. Lower CD4 cell counts prior to and at the index date were significantly associated with SNA events occurring, even in patients receiving antiretroviral treatment. The study found HIV-associated immune deficiency increased the risk of SNA events.
Christian B. Ramers, M.D., M.P.H., of Family Health Centers of San Diego, presents "The HCV Treatment Revolution: A View from the Community Health Center" for AIDS Clinical Rounds at UC San Diego
1. This document provides guidelines for the diagnosis, management, and treatment of hepatitis C virus (HCV) infection based on a formal review of recent literature and expert consensus.
2. It recommends screening high-risk groups for HCV infection, including current and former injection drug users, those with HIV, and prior blood transfusion recipients.
3. It also provides guidance on counseling HCV-infected individuals, including advising them to avoid behaviors that may spread the virus and informing them that properly performed tattooing and piercing pose a very low risk of transmission.
This document provides guidelines from the American Association for the Study of Liver Diseases (AASLD) for the management of chronic hepatitis B infection. It summarizes recommendations for screening high-risk populations to identify those infected with hepatitis B virus (HBV), including people born in areas with high HBV prevalence and those with risk factors like injection drug use or multiple sexual partners. The guidelines are based on a review of medical literature on HBV and aim to provide a data-supported approach to treating chronic HBV patients.
HIV and Tuberculosis of Urinary Tract: What is The Role of Urologists? Vincent Khor
The document discusses various urological manifestations and complications associated with HIV/AIDS that urologists may encounter. It covers topics like HIV-associated infections of the genitourinary tract, urolithiasis due to protease inhibitors, HIV-associated cancers, prostate cancer in HIV patients, circumcision for HIV prevention, andrological complications like erectile dysfunction and infertility in HIV patients, and renal dysfunction in HIV patients. The role of urologists is increasing as HIV patients live longer lives and present with the same urological issues as the general population. Management of urological diseases in HIV requires consideration of HIV-related factors.
Prevalence and risk factors of hepatitis b virus among pregnant women in jaza...Alexander Decker
This study aimed to determine the prevalence and risk factors of Hepatitis B Virus (HBV) infection among pregnant women in Jazan Region, Saudi Arabia. The researchers tested 537 pregnant women for HBV and found an overall prevalence of 4.1%. The prevalence increased with age, with the highest rate of 13.8% in women over 40 years old. Hospitalization and a history of jaundice were significant risk factors associated with HBV infection. The study suggests expanding Hepatitis B vaccination programs to reduce HBV risk among pregnant women in the region.
This document provides an updated practice guideline from the American Association for the Study of Liver Diseases (AASLD) for the treatment of genotype 1 chronic hepatitis C virus infection. The guideline is based on a formal review of recent literature and considers new direct-acting antiviral agents and genetic markers associated with treatment response. Major advances since the previous guideline include the development of direct-acting antiviral protease inhibitors and identification of single-nucleotide polymorphisms related to hepatitis C virus clearance. The guideline provides recommendations for treating genotype 1 infection with current standard of care therapies as well as newer protease inhibitor regimens, noting that additional data is still needed as treatments continue to evolve.
This study aims to discover potential white blood cell surface biomarkers that could predict which patients presenting to the emergency department with suspected sepsis will develop severe sepsis. The study will prospectively collect data from three patient populations - 300 patients with suspected sepsis in the emergency department, 100 critically ill patients with established sepsis in the ICU, and 100 non-septic control patients in the emergency department. White blood cell surface markers will be analyzed using flow cytometry. Candidate biomarkers will be selected by comparing markers between cohorts, and their predictive value for clinical outcomes will be explored within the suspected sepsis emergency department cohort. The goal is to identify biomarkers that could help predict deterioration early to guide triage, treatment and monitoring.
Dexamethasone is a corticosteroid that has shown promise in improving outcomes for patients with bacterial meningitis. However, previous studies have found conflicting results on whether it benefits all patients or only certain subgroups. This study conducted a meta-analysis of individual patient data from 5 randomized controlled trials involving 2029 patients to identify which patients are most likely to benefit from dexamethasone treatment. The analysis found that dexamethasone did not significantly reduce death rates or neurological disability overall. It also did not provide significant benefits within any prespecified subgroups based on factors like causative organism, pre-treatment with antibiotics, HIV status, or age. The only benefit seen was a reduction in hearing loss among survivors.
New Treatment for hepatitis C: Impact on morbidity and mortality - Dr Helen H...ReShape
Treating hepatitis C patients with direct-acting antiviral drugs (DAAs) could significantly reduce disease burden in the UK. Strategies focusing only on advanced disease may reduce liver disease cases but will have little impact on transmission. Models show treating mild and moderate cases, including people who inject drugs (PWID), could reduce prevalence and incidence of hepatitis C among PWID by over 50% by 2030, curbing new infections. Achieving WHO elimination targets by 2030 will be challenging and require improved testing, treatment, and harm reduction for PWID. Monitoring outcomes like new infections and liver disease cases can assess progress toward elimination goals.
This document provides updated guidelines for primary care providers on the management of patients infected with HIV. Key changes from the 2004 guidelines include:
1) The guidelines have a new format to more clearly identify recommendations.
2) Tables have been added on immunizations and routine health care maintenance.
3) Guidelines on many HIV-related topics have been updated, including new antiretroviral drugs, diagnostic HIV tests, and screening and management recommendations.
4) The guidelines address the long-term care of HIV patients, including non-AIDS related health issues, as improved treatment has increased patient lifespan.
People Living with Human Immunodeficiency Virus in Hadhramout: Clinical Prese...asclepiuspdfs
The objective of the study was to determine the clinical features and outcome of patients living with human immunodeficiency virus (HIV) in Hadhramout and nearby governorates. Materials and Methods: This descriptive study was conducted in the antiretroviral therapy (ART) site at Ibn-Sina General Hospital, Mukalla, Hadhramout governorate. All 145 patients were enrolled in HIV treatment and care program from December 2008 to the end of December 2016 with confirmed HIV test. Data included all personal data, clinical staging, drugs taken, and outcomes. Patients were grouped according to the decades to five groups, ≤15 years, 16–30 years, 31–50 years, 51–70 years, and >70 years. Cases classify according to the antiretroviral drugs to ART group and Pre-ART group. The relevant data parameters were analyzed using SPSS statistical software version 21 and Excel 10. Results: A total of 145 cases, most adults (97.9%), males and females were104 (71.7%) and 41 (28.3%), respectively. Mean age was 36.46 years and 30–50 years the most affected age group (55.2%). Clinical Stages 3 and 4 were the common presentation in 73.8%, and most cases were from Mukalla city. Of the total cases, 74.5% were on ART 53.1 of them improved, pulmonary tuberculosis was found in 4 cases, and death cases were (18.5%), mostly due to late presentation and non-adherence, and mostly occurred in early 6 months of starting the ART. 37 patients were in a pre-treatment group (21.6%), where the mortality rate is 35.1%, mainly due to loss of follow-up. Conclusions: Most cases were adult males, young age and have had late presentation, where mortality is higher in the pre-treatment group due to loss of follow-up and in early 6 months of treatment.
Upsurge of Cases of Lichen Planus in Iraqi Population in Baghdad City with Fr...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV) which is most commonly spread through blood-to-blood contact, especially among injection drug users by sharing needles. While many initial HCV infections are asymptomatic, the virus persists in the liver in about 85% of cases and may eventually lead to liver damage, cirrhosis, or liver cancer over decades. There is currently no vaccine for HCV.
This study aimed to better understand the current epidemiology of malaria in western Thailand using more sensitive molecular detection methods. The study analyzed blood samples from 219 residents of a village and 61 patients at a malaria clinic. Quantitative PCR (qPCR) detected Plasmodium DNA in 25 village samples (11.4% prevalence), mostly asymptomatic and submicroscopic infections. qPCR also found 27 positive samples (44.3% prevalence) from the clinic, including submicroscopic infections. All samples showed antibody responses to malaria antigens, suggesting widespread exposure despite low detected parasite levels by microscopy. These findings suggest parasite prevalence is higher than estimated by local authorities and that asymptomatic and submicroscopic infections still contribute to transmission as malaria declines in Thailand.
This document discusses cancers that are more common among people living with HIV/AIDS compared to the general population. It notes that HIV weakens the immune system, making people more susceptible to infections that can lead to cancer. It highlights that HIV-positive individuals are at higher risk for cancers caused by viruses like Kaposi Sarcoma herpesvirus, Epstein-Barr virus, human papillomavirus, and hepatitis B and C. The introduction of antiretroviral therapy has reduced rates of Kaposi sarcoma and non-Hodgkin's lymphoma but not cervical cancer. Regular cancer screening is important for HIV-positive people according to guidelines.
This study aimed to determine the prevalence of high-risk HPV infections in healthy Saudi women attending gynecology clinics in western Saudi Arabia. The study found that 27 out of 485 women (5.6%) tested positive for high-risk HPV. The highest prevalence was among women aged 60 years and older. This prevalence of HPV in Saudi women is similar to other Arab countries but lower than Western countries. The results provide useful baseline data for establishing HPV testing in a cervical cancer screening program in Saudi Arabia.
Hepatitis C is a major public health problem in the Arab world and North Africa with an estimated 25 million people affected. [1] Genotype 4 is most common in this region. [2] Major risk factors for transmission include blood transfusions, hemodialysis, healthcare procedures, and injection drug use. [3] Transmission within healthcare settings poses a risk, with one study in Egypt finding a 12.3% incidence of transient viremia in exposed healthcare workers. [4] Strategies are needed to improve infection control and screening measures to reduce the high prevalence of Hepatitis C in this part of the world.
The Prevalence of Hcv Infection among Renal Failure Patients Before Starting ...CrimsonpublishersMedical
HCV infection is common and associated with significant morbidity and mortality among heamodialysis (HD) patients [1]. Heamodialysis is a trusted intermediate procedure for management of chronic kidney disease (CKD) patients. As such CKD is an immunedeficient state, hence blood borne viral infection particularly HCV pose great risk to patients treated by heamodialysis [2]. A high prevalence of HCV infection in heamodialysis patients has been reported in heamodialysis units since the introduction of heamodialysis therapy. Risk factors such as the number of blood transfusions or duration on heamodialysis. The prevalence of HCV infection in patients undergoing dialysis is greater than that in the general population, suggesting that patients on dialysis may be at higher risk of acquiring HCV infection.
Seroepidemiology of Toxoplasma gondii infection in drivers involved in road t...Erwin Chiquete, MD, PhD
Background: The prevalence of toxoplasmosis in the general population of Guadalajara, Mexico, is around 32%.
Toxoplasmosis can cause ocular lesions and slowing of reaction reflexes. Latent toxoplasmosis has been related
with traffic accidents. We aimed to assess the prevalence of anti-Toxoplasma gondii antibodies and visual
impairments related with traffic accidents in drivers from the metropolitan Guadalajara.
Methods: We prospectively evaluated the prevalence of IgG and IgM anti-T. gondii antibodies in 159 individuals
involved in traffic accidents, and in 164 control drivers never involved in accidents. Cases of toxoplasmosis
reactivation or acute infection were detected by PCR in a subset of 71 drivers studied for the presence of T. gondii
DNA in blood samples. Ophthalmologic examinations were performed in drivers with IgG anti-T. gondii antibodies
in search of ocular toxoplasmosis.
Results: Fifty-four (34%) traffic accident drivers and 59 (36%) controls were positive to IgG anti-T. gondii antibodies
(p = 0.70). Among the 113 seropositive participants, mean anti-T. gondii IgG antibodies titers were higher in traffic
accident drivers than in controls (237.9 ± 308.5 IU/ml vs. 122.9 ± 112.7 IU/ml, respectively; p = 0.01 by Student’s t
test, p = 0.037 by Mann–Whitney U test). In multivariate analyses, anti-T. gondii IgG antibody titers were consistently
associated with an increased risk of traffic accidents, whereas age showed an inverse association. The presence of
IgM-anti-T. gondii antibodies was found in three (1.9%) subjects among traffic accident drives, and in two (1.2%)
controls. Three (4.2%) samples were positive for the presence of T. gondii DNA, all among seropositive individuals.
No signs of ocular toxoplasmosis were found in the entire cohort. Moreover, no other ocular conditions were found
to be associated with the risk of traffic accidents in a multivariate analysis.
Conclusions: Anti-T. gondii antibody titers are associated with the risk of traffic accidents. We could not determine
any association of ocular toxoplasmosis with traffic accidents. Our results warrant further analyses in order to clarify
the link between toxoplasmosis and traffic accidents.
This document provides guidelines from the WHO on chronic hepatitis C infection from April 2016. It discusses the global burden of HCV, noting over 700,000 deaths per year. New direct-acting antiviral medications have transformed HCV treatment, enabling shorter, oral regimens with over 90% cure rates and fewer side effects. The guidelines recommend screening high-risk populations and using RNA testing to confirm chronic infection before treatment. They provide guidance on clinical assessment, noting the importance of staging liver fibrosis/cirrhosis and assessing severity. Successful treatment results in reduced liver inflammation and fibrosis regression, lowering risks of liver cancer and transplant.
This study analyzed serious non-AIDS events (SNAs) among HIV-infected adults in Latin America. The researchers identified 130 patients with SNA events out of 6007 patients in the cohort, representing an incidence rate of 0.86 events per 100 person-years. Risk factors like hepatitis B/C coinfection, diabetes, and alcohol abuse were associated with SNA events. Lower CD4 cell counts prior to and at the index date were significantly associated with SNA events occurring, even in patients receiving antiretroviral treatment. The study found HIV-associated immune deficiency increased the risk of SNA events.
Christian B. Ramers, M.D., M.P.H., of Family Health Centers of San Diego, presents "The HCV Treatment Revolution: A View from the Community Health Center" for AIDS Clinical Rounds at UC San Diego
1. This document provides guidelines for the diagnosis, management, and treatment of hepatitis C virus (HCV) infection based on a formal review of recent literature and expert consensus.
2. It recommends screening high-risk groups for HCV infection, including current and former injection drug users, those with HIV, and prior blood transfusion recipients.
3. It also provides guidance on counseling HCV-infected individuals, including advising them to avoid behaviors that may spread the virus and informing them that properly performed tattooing and piercing pose a very low risk of transmission.
This document provides guidelines from the American Association for the Study of Liver Diseases (AASLD) for the management of chronic hepatitis B infection. It summarizes recommendations for screening high-risk populations to identify those infected with hepatitis B virus (HBV), including people born in areas with high HBV prevalence and those with risk factors like injection drug use or multiple sexual partners. The guidelines are based on a review of medical literature on HBV and aim to provide a data-supported approach to treating chronic HBV patients.
HIV and Tuberculosis of Urinary Tract: What is The Role of Urologists? Vincent Khor
The document discusses various urological manifestations and complications associated with HIV/AIDS that urologists may encounter. It covers topics like HIV-associated infections of the genitourinary tract, urolithiasis due to protease inhibitors, HIV-associated cancers, prostate cancer in HIV patients, circumcision for HIV prevention, andrological complications like erectile dysfunction and infertility in HIV patients, and renal dysfunction in HIV patients. The role of urologists is increasing as HIV patients live longer lives and present with the same urological issues as the general population. Management of urological diseases in HIV requires consideration of HIV-related factors.
Prevalence and risk factors of hepatitis b virus among pregnant women in jaza...Alexander Decker
This study aimed to determine the prevalence and risk factors of Hepatitis B Virus (HBV) infection among pregnant women in Jazan Region, Saudi Arabia. The researchers tested 537 pregnant women for HBV and found an overall prevalence of 4.1%. The prevalence increased with age, with the highest rate of 13.8% in women over 40 years old. Hospitalization and a history of jaundice were significant risk factors associated with HBV infection. The study suggests expanding Hepatitis B vaccination programs to reduce HBV risk among pregnant women in the region.
This document provides an updated practice guideline from the American Association for the Study of Liver Diseases (AASLD) for the treatment of genotype 1 chronic hepatitis C virus infection. The guideline is based on a formal review of recent literature and considers new direct-acting antiviral agents and genetic markers associated with treatment response. Major advances since the previous guideline include the development of direct-acting antiviral protease inhibitors and identification of single-nucleotide polymorphisms related to hepatitis C virus clearance. The guideline provides recommendations for treating genotype 1 infection with current standard of care therapies as well as newer protease inhibitor regimens, noting that additional data is still needed as treatments continue to evolve.
This study aims to discover potential white blood cell surface biomarkers that could predict which patients presenting to the emergency department with suspected sepsis will develop severe sepsis. The study will prospectively collect data from three patient populations - 300 patients with suspected sepsis in the emergency department, 100 critically ill patients with established sepsis in the ICU, and 100 non-septic control patients in the emergency department. White blood cell surface markers will be analyzed using flow cytometry. Candidate biomarkers will be selected by comparing markers between cohorts, and their predictive value for clinical outcomes will be explored within the suspected sepsis emergency department cohort. The goal is to identify biomarkers that could help predict deterioration early to guide triage, treatment and monitoring.
Dexamethasone is a corticosteroid that has shown promise in improving outcomes for patients with bacterial meningitis. However, previous studies have found conflicting results on whether it benefits all patients or only certain subgroups. This study conducted a meta-analysis of individual patient data from 5 randomized controlled trials involving 2029 patients to identify which patients are most likely to benefit from dexamethasone treatment. The analysis found that dexamethasone did not significantly reduce death rates or neurological disability overall. It also did not provide significant benefits within any prespecified subgroups based on factors like causative organism, pre-treatment with antibiotics, HIV status, or age. The only benefit seen was a reduction in hearing loss among survivors.
New Treatment for hepatitis C: Impact on morbidity and mortality - Dr Helen H...ReShape
Treating hepatitis C patients with direct-acting antiviral drugs (DAAs) could significantly reduce disease burden in the UK. Strategies focusing only on advanced disease may reduce liver disease cases but will have little impact on transmission. Models show treating mild and moderate cases, including people who inject drugs (PWID), could reduce prevalence and incidence of hepatitis C among PWID by over 50% by 2030, curbing new infections. Achieving WHO elimination targets by 2030 will be challenging and require improved testing, treatment, and harm reduction for PWID. Monitoring outcomes like new infections and liver disease cases can assess progress toward elimination goals.
This document provides updated guidelines for primary care providers on the management of patients infected with HIV. Key changes from the 2004 guidelines include:
1) The guidelines have a new format to more clearly identify recommendations.
2) Tables have been added on immunizations and routine health care maintenance.
3) Guidelines on many HIV-related topics have been updated, including new antiretroviral drugs, diagnostic HIV tests, and screening and management recommendations.
4) The guidelines address the long-term care of HIV patients, including non-AIDS related health issues, as improved treatment has increased patient lifespan.
People Living with Human Immunodeficiency Virus in Hadhramout: Clinical Prese...asclepiuspdfs
The objective of the study was to determine the clinical features and outcome of patients living with human immunodeficiency virus (HIV) in Hadhramout and nearby governorates. Materials and Methods: This descriptive study was conducted in the antiretroviral therapy (ART) site at Ibn-Sina General Hospital, Mukalla, Hadhramout governorate. All 145 patients were enrolled in HIV treatment and care program from December 2008 to the end of December 2016 with confirmed HIV test. Data included all personal data, clinical staging, drugs taken, and outcomes. Patients were grouped according to the decades to five groups, ≤15 years, 16–30 years, 31–50 years, 51–70 years, and >70 years. Cases classify according to the antiretroviral drugs to ART group and Pre-ART group. The relevant data parameters were analyzed using SPSS statistical software version 21 and Excel 10. Results: A total of 145 cases, most adults (97.9%), males and females were104 (71.7%) and 41 (28.3%), respectively. Mean age was 36.46 years and 30–50 years the most affected age group (55.2%). Clinical Stages 3 and 4 were the common presentation in 73.8%, and most cases were from Mukalla city. Of the total cases, 74.5% were on ART 53.1 of them improved, pulmonary tuberculosis was found in 4 cases, and death cases were (18.5%), mostly due to late presentation and non-adherence, and mostly occurred in early 6 months of starting the ART. 37 patients were in a pre-treatment group (21.6%), where the mortality rate is 35.1%, mainly due to loss of follow-up. Conclusions: Most cases were adult males, young age and have had late presentation, where mortality is higher in the pre-treatment group due to loss of follow-up and in early 6 months of treatment.
Upsurge of Cases of Lichen Planus in Iraqi Population in Baghdad City with Fr...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV) which is most commonly spread through blood-to-blood contact, especially among injection drug users by sharing needles. While many initial HCV infections are asymptomatic, the virus persists in the liver in about 85% of cases and may eventually lead to liver damage, cirrhosis, or liver cancer over decades. There is currently no vaccine for HCV.
This study aimed to better understand the current epidemiology of malaria in western Thailand using more sensitive molecular detection methods. The study analyzed blood samples from 219 residents of a village and 61 patients at a malaria clinic. Quantitative PCR (qPCR) detected Plasmodium DNA in 25 village samples (11.4% prevalence), mostly asymptomatic and submicroscopic infections. qPCR also found 27 positive samples (44.3% prevalence) from the clinic, including submicroscopic infections. All samples showed antibody responses to malaria antigens, suggesting widespread exposure despite low detected parasite levels by microscopy. These findings suggest parasite prevalence is higher than estimated by local authorities and that asymptomatic and submicroscopic infections still contribute to transmission as malaria declines in Thailand.
This document discusses cancers that are more common among people living with HIV/AIDS compared to the general population. It notes that HIV weakens the immune system, making people more susceptible to infections that can lead to cancer. It highlights that HIV-positive individuals are at higher risk for cancers caused by viruses like Kaposi Sarcoma herpesvirus, Epstein-Barr virus, human papillomavirus, and hepatitis B and C. The introduction of antiretroviral therapy has reduced rates of Kaposi sarcoma and non-Hodgkin's lymphoma but not cervical cancer. Regular cancer screening is important for HIV-positive people according to guidelines.
This study aimed to determine the prevalence of high-risk HPV infections in healthy Saudi women attending gynecology clinics in western Saudi Arabia. The study found that 27 out of 485 women (5.6%) tested positive for high-risk HPV. The highest prevalence was among women aged 60 years and older. This prevalence of HPV in Saudi women is similar to other Arab countries but lower than Western countries. The results provide useful baseline data for establishing HPV testing in a cervical cancer screening program in Saudi Arabia.
Hepatitis C is a major public health problem in the Arab world and North Africa with an estimated 25 million people affected. [1] Genotype 4 is most common in this region. [2] Major risk factors for transmission include blood transfusions, hemodialysis, healthcare procedures, and injection drug use. [3] Transmission within healthcare settings poses a risk, with one study in Egypt finding a 12.3% incidence of transient viremia in exposed healthcare workers. [4] Strategies are needed to improve infection control and screening measures to reduce the high prevalence of Hepatitis C in this part of the world.
The Prevalence of Hcv Infection among Renal Failure Patients Before Starting ...CrimsonpublishersMedical
HCV infection is common and associated with significant morbidity and mortality among heamodialysis (HD) patients [1]. Heamodialysis is a trusted intermediate procedure for management of chronic kidney disease (CKD) patients. As such CKD is an immunedeficient state, hence blood borne viral infection particularly HCV pose great risk to patients treated by heamodialysis [2]. A high prevalence of HCV infection in heamodialysis patients has been reported in heamodialysis units since the introduction of heamodialysis therapy. Risk factors such as the number of blood transfusions or duration on heamodialysis. The prevalence of HCV infection in patients undergoing dialysis is greater than that in the general population, suggesting that patients on dialysis may be at higher risk of acquiring HCV infection.
Hepatitis C is a global health problem affecting over 170 million people worldwide. It is transmitted through blood and body fluids. In Pakistan, studies have found hepatitis C in 18-60% of patients with liver disease. Major risk factors for hepatitis C in Pakistan include unsafe injections, which have been found to transmit hepatitis C due to widespread reusing of needles and syringes. Tattooing and body piercing have also been associated with hepatitis C transmission in Pakistan. Diagnosis involves testing for hepatitis C antibodies and RNA. Treatment involves pegylated interferon and ribavirin combination therapy. Prevention strategies in Pakistan should focus on needle exchange programs, education on safe injection practices, and ensuring access to sterile syringes.
A 45-year-old woman presents with fatigue, weakness, loss of appetite, and abnormal liver function tests. Laboratory results show elevated AST, ALT, bilirubin levels and positive tests for HCV antibody and RNA. A liver biopsy revealed severe inflammation and bridging fibrosis. The patient is diagnosed with chronic hepatitis C virus infection based on her history of blood transfusion, symptoms, laboratory abnormalities and biopsy findings. The best course of action is to treat her HCV infection with antiviral therapy to reduce liver damage and prevent progression to cirrhosis.
This document describes a study that aimed to generate a clinical prediction rule to predict hepatitis C viremia using both clinical and serologic data from 114 hepatitis C virus-seropositive patients. The researchers identified independent predictors of hepatitis C viremia using logistic regression. They found that a ratio of the immunoassay signal strength of the sample to the cutoff value (S/CO) greater than 15 had the best performance at detecting cases with viremia. A rule combining a history of blood transfusion before 1993 and S/CO greater than 15 had the highest accuracy, positive predictive value, and positive likelihood ratio for predicting viremia in all patients. This clinical rule performed even better for predicting viremia in asymptomatic patients
The Evolution of the Hepatitis C Genotypes and Probable Risk Factors for Infe...CrimsonpublishersMedical
Hepatitis C is rapidly emerging as a major health problem in developing countries including Pakistan that leads to death and morbidities. HCV has a high genetic variation and is classified into six major genotypes and 67 subtypes. (Direct-Acting-Antivirals) anti-HCV drugs therapy response, resistance and recovery rates depend on HCV genotype. The epidemiological study of HCV genotypes in 2014-2016 and their main routs of infection in the Punjab Pakistan. Observational study of the patients from 27 centers. A total of 4823 serum samples were tested by type-specific genotyping assay. RNA was extracted using FoverGen Mini Kit. For HCV genotyping AmpliSens® HCV-genotype-FRT PCR kit variant FRT-g1-6. Detail history of each patient was taken on a predesigned questioner which was approved by Institutional Ethical Committee.
Total 7800 individuals were analyzed by anti HCV ELISA out of which 5451 patient were found reactive. The positive samples were further conformed by PCR for HCV and their genotypes, out of which 4823 (88.47%) were found detected for HCV RNA. In the division of genotypes in Punjab varies from a maximum of 57.6% the genotype 3a, followed by 3b 14.76% on the other hand least common genotype was type-5 (0.14%). The major route of infection was surgery/dental procedures (52.02%), use of unsafe syringes (18.45%), blood transfusion (16.26%), razors or circumcision (5.90%), less than 3% due to needle stick, while 6.35% was unclear. HCV The most spread genotype in Pakistan was 3a with rate of 58% followed by genotype 3b and 1a, respectively. Dental surgery was the main source of infection.
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HPV infection, cervical abnormalities, and cancer in HIV-infected women in Mu...Dr.Samsuddin Khan
Background: HIV-infected women are at a higher risk of cervical intraepithelial neoplasia (CIN) and cancer than women in the general population, partly due to a high prevalence of persistent human papillomavirus (HPV) infection. The aim of the study was to assess the burden of HPV infection, cervical abnormalities, and cervical cancer among a cohort of HIV-infected women as part of a routine screening in an urban overpopulated slum setting in Mumbai, India.
Methods: From May 2010 to October 2010, Médecins Sans Frontières and Tata Memorial Hospital Mumbai offered routine annual Pap smears and HPV DNA testing of women attending an antiretroviral therapy (ART) clinic and a 12-month follow-up. Women with abnormal test results were offered cervical biopsy and treatment, including treatment for sexually transmitted infections (STIs).
Results: Ninety-five women were screened. Median age was 38 years (IQR: 33–41); median nadir CD4-count 143 cells/µL (IQR: 79–270); and median time on ART 23 months (IQR:10–41). HPV DNA was detected in 30/94 women (32%), and 18/94 (19%) showed either low-grade or high-grade squamous intraepithelial lesions (LSIL/HSIL) on Pap smear. Overall, >50% had cervical inflammatory reactions including STIs. Of the 43 women with a cervical biopsy, eight (8.4%) had CIN-1, five (5.3%) CIN-2, and two (2.1%) carcinoma in situ. All but one had HPV DNA detected (risk ratio: 11, 95% confidence interval: 3.3–34). By October 2011, 56 women had completed the 12-month follow-up and had been rescreened. No new cases of HPV infection/LSIL/HSIL were detected.
Conclusion: The high prevalence of HPV infection, STIs, and cervical lesions among women attending an ART clinic demonstrates a need for routine screening. Simple, one-stop screening strategies are needed. The optimal screening interval, especially when resources are limited, needs to be determined.
PWP Recommendations: Treatment As PreventionCDC NPIN
This document discusses recommendations for using antiretroviral therapy (ART) as prevention of HIV transmission. [1] It reviews data showing ART reduces HIV transmission risk and existing US treatment guidelines. [2] The recommendations are that HIV-infected persons with ongoing risk behavior should be offered ART regardless of CD4 count to reduce transmission risk, and that ART should be initiated for those willing and able to commit to long-term therapy, guided by optimal treatment of the individual. [3] The benefits of ART for prevention must be balanced with continuing other prevention measures and prioritizing treatment of infected individuals.
The document discusses evaluating the efficacy of the OraQuick rapid HIV test kit using oral fluid for HIV antibody detection in patients attending dental hospitals in India. The study found the OraQuick test to have a sensitivity and specificity of 100% compared to standard blood tests. It was found to be an effective and accurate screening tool for HIV detection using oral fluid. However, it could not distinguish between HIV-1 and HIV-2 antibodies. Further larger studies were recommended to introduce it as a routine screening procedure.
The UC San Diego AntiViral Research Center sponsors weekly presentations on infectious diseases research and clinical practices. A presentation on whether widespread HIV treatment can end transmission discussed recent trends showing HIV declining among adolescents and young adults in the US. The presentation reviewed research showing that early HIV treatment dramatically reduces heterosexual transmission but some transmission may still occur through anal sex among men who have sex with men on antiretroviral therapy. Future interventions could focus on optimizing HIV treatment, comparing antiretroviral regimens, and suppressing coinfections like CMV to further reduce HIV transmission.
This document evaluates a low-cost viral load assay called the Cavidi reverse transcriptase (RT) assay for monitoring the virologic response to antiretroviral therapy in 100 HIV-infected adults in Kenya over 48 weeks. The RT assay was compared to gold standard assays, Roche RNA PCR and Bayer bDNA. While the mean differences in viral loads between assays were small, the limits of agreement exceeded 0.5 log copies/ml, meaning the RT assay cannot be used interchangeably with the gold standards to monitor individual patients. However, the RT assay had 100% sensitivity and 95% specificity in detecting viral loads above 400 copies/ml compared to the gold standards, and 96% of patients had undetect
This document summarizes the position statement of the American College of Preventive Medicine (ACPM) regarding routine HIV screening. The ACPM supports routine HIV screening for all adolescents and adults ages 13-64, as well as pregnant women, based on evidence that risk-based screening is inadequate and leads to low testing rates, lack of HIV status awareness, and late diagnoses. The ACPM endorses opt-out consent procedures, use of rapid HIV tests, streamlined counseling separate from screening, and linking patients to treatment. The organization also recommends annual repeat testing for high-risk groups and repeat testing every 5 years for the general population.
This document discusses laboratory diagnosis and transmission of HIV infection. It begins with an introduction to HIV and AIDS, then covers the virus's morphology, epidemiology, modes of transmission, pathogenesis, signs and symptoms, and laboratory diagnosis. Laboratory diagnosis can be qualitative via rapid tests to detect antibodies or quantitative via viral load testing. Diagnosis is important for management and prevention/control efforts like safe sex practices, treatment as prevention, voluntary counseling and testing, and public health education.
This document provides an overview of the epidemiology of HIV/AIDS. It discusses the history and microbiology of HIV, global and national statistics on prevalence, risk groups in India, modes of transmission, clinical manifestations, diagnosis and treatment. Key points include: globally 38 million people are living with HIV, generalized epidemics exist where prevalence is over 1% in pregnant women, and high-risk groups in India include sex workers, injecting drug users, and men who have sex with men. Diagnosis involves antibody detection tests like ELISA and confirmation with Western blot. Progression is monitored using CD4 counts and viral load levels, with opportunistic infections occurring at different CD4 thresholds.
IOSRPHR(www.iosrphr.org) IOSR Journal of Pharmacyiosrphr_editor
This document summarizes a study that examined the oral microbial pathogens isolated in newly diagnosed HIV positive patients in Dakar, Senegal. 57 newly diagnosed HIV patients were included in the study. The patients' CD4 counts, viral loads, and oral examinations were analyzed. Common oral lesions found were pseudomembranous candidiasis, xerostomia, and gingivitis. Microbial pathogens isolated included Pseudomonas, Klebsiella, Proteus, Staphylococcus aureus, and Escherichia coli. There was an inverse correlation between CD4 count and viral load. The frequency of oral lesions and microbial isolates increased with higher viral loads. Most patients had CD4 counts below
IOSRPHR(www.iosrphr.org) IOSR Journal of Pharmacyiosrphr_editor
This document summarizes a study that examined the oral microbial pathogens isolated in newly diagnosed HIV positive patients in Dakar, Senegal. 57 newly diagnosed HIV patients were included in the study. Their CD4 counts, viral loads, and oral examinations were performed. Samples found the most common microbial pathogens were Pseudomonas, Klebsiella, and Proteus. An inverse correlation was found between CD4 count and viral load. The frequency of oral lesions and microbial isolates increased with higher viral loads. 70% of patients had CD4 counts below 500. The study concludes maintaining a low oral microbial load is important for preventing opportunistic infections in HIV patients.
This document discusses infectious diseases and healthcare-associated infections. It begins with an overview of hospital epidemiology and the roles of epidemiologists in identifying risks of infection and developing strategies to minimize those risks. Common sites of healthcare-associated infections are the urinary tract, respiratory tract, bloodstream, surgical wounds, and gastrointestinal tract. Factors that can promote healthcare-associated infections include prolonged use of medical devices, extremes of age, surgery and other procedures, immune status, understaffing, and poor infection control practices. The document then discusses measures for quantifying disease frequency like prevalence, incidence and case definitions.
Similar to Prevalence & factors associated with hepatitis c virus seropositivity in females (20)
Environmental cleaning depends on Infection Control risk Assessment as High, Moderate & Low Risk Areas. This document includes Procedures & Practices in Hospital for Environmental Cleaning & Disinfection based on cheapest hospital grade disinfectant i.e Clorox / Household Bleach available for especially third world countries.
This document discusses infection control practices in neonatology units. It begins with a brief history of pioneers in infection control such as Ignaz Semmelweis and Joseph Lister. It then defines types of infections including healthcare-associated infections. The chain of infection and aims of infection control are described. Basic infection control measures like standard and transmission-based precautions are outlined. Hand hygiene is emphasized as the most important infection control practice. The 5 moments for hand hygiene are defined. Aseptic techniques including clean, aseptic and sterile techniques used in neonatology units are summarized.
Equipment management in home health care by Dr Anjum HashmiAnjum Hashmi MPH
This document provides guidance on equipment management for home health care. It discusses the role of home care workers (HCW) in ensuring patient safety with medical devices used at home. HCWs should maintain an inventory of equipment and its locations, perform maintenance checks, and have backups for life-sustaining devices. All HCWs should be trained on various equipment. The document outlines safety precautions for oxygen equipment and describes types of potential medical device problems that should be reported, such as defects, failures, or interactions with other devices. It stresses the importance of HCWs reporting any adverse events or issues with devices so that problems can be addressed.
Enviromental safety in Home Healthcare by Dr Anjum HashmiAnjum Hashmi MPH
This document discusses various environmental safety hazards faced by home healthcare workers and recommendations to address them. It identifies physical hazards like slips, trips, falls and musculoskeletal disorders from patient handling. Biological hazards include infectious diseases and needlestick injuries. Psychological hazards include workplace violence and stress. Recommendations provided include assessing patient homes for hazards, using assistive devices for safe patient handling, following standard precautions like gloves and proper disposal of sharps.
This document provides guidelines from the Ministry of Health (MOH) on managing hospital waste. It defines healthcare waste and outlines how different types of waste should be disposed of, such as infectious waste in yellow bags, sharp waste in yellow sharp containers, and pathological waste in red bags. The guidelines apply to all medical, nursing, housekeeping, and other non-medical staff. Proper waste disposal and training of healthcare workers is important to prevent the spread of infections.
H1 N1 Influenza A virus, its Transmission Indoor Air & Role of HVACAnjum Hashmi MPH
1) The document discusses the transmission of H1N1 influenza A virus indoors and the role of HVAC systems. It describes how low indoor humidity in winter increases the level of infectious airborne droplet nuclei which can spread via HVAC systems.
2) Various methods for capturing and deactivating airborne viruses are discussed, including MERV filters, UV lights, photocatalytic oxidation, and bi-polar ionization, and their effectiveness when used individually or in combination.
3) Preventive measures for healthcare workers are outlined, such as patient isolation, protective equipment, hand hygiene, and environmental cleaning.
Middle East Respiratory Syndrome Coronavirus (MERS Co V)Anjum Hashmi MPH
This document discusses Middle East Respiratory Syndrome Coronavirus (MERS-CoV), a novel coronavirus first identified in 2012. It provides details on the virus, including that it is different from coronaviruses that cause common colds and SARS. The document summarizes transmission between humans and animals, symptoms, surveillance and testing procedures, protective equipment, and control measures. It notes that a vaccine candidate has been developed but more research is still needed to understand and control the virus.
This document discusses needlestick injuries and prevention strategies. It defines needlestick injuries as accidental skin punctures from medical sharps. Needlesticks can expose healthcare workers to bloodborne pathogens like HIV, Hepatitis B, and Hepatitis C. The document provides epidemiological data on needlestick injuries, discusses who is at risk, outlines steps to take if injured, and recommends multiple prevention strategies like safety devices, sharps disposal procedures, training, and vaccination.
This document discusses key concepts of infection control, including definitions of infection and colonization. It notes that healthcare-associated infections are a major problem, with higher rates in developing countries. Factors influencing infection risk include microbial agents, patient susceptibility, and environmental factors. The document outlines standard and transmission-based precautions to prevent infection spread. It emphasizes hand hygiene, personal protective equipment, and cleaning and disinfection as core infection control measures.
This document discusses the use of ultraviolet (UV) technology for disinfecting surfaces in healthcare settings. It provides background on healthcare-associated infections and the role of contaminated surfaces in transmission. It then summarizes studies that found UV light effectively reduces bacteria and viruses on surfaces. The document reviews different types of UV light technologies, including portable UV devices and stationary whole-room disinfection systems. It discusses the mechanisms of how UV light deactivates microbes and lists advantages and disadvantages of UV disinfection. Overall, the document concludes that UV light is a promising method for reducing healthcare-associated infections by disinfecting surfaces, though it has some limitations compared to traditional cleaning methods.
This document discusses antimicrobial textiles and introduces Vestex, a cotton-based fabric treated with silver, cationic antimicrobials, or organosilane compounds to kill bacteria. Vestex fabrics repel fluids, resist stains, and contain antimicrobial properties to reduce bacterial transmission. The antimicrobial in Vestex punctures cell membranes and uses an electrical charge to kill microorganisms without allowing resistance. Vestex is durable, machine washable, helps keep users dry and cool, and aims to reduce healthcare-associated infections through antimicrobial uniforms and linens.
The document discusses various antimicrobial papers and products that can help reduce healthcare-associated infections. It summarizes different antibacterial papers including those coated with silver nanoparticles or zinc oxide nanoparticles. Nanotechnology allows for magnetic, waterproof and fluorescent antibacterial papers. Proper hand hygiene including effective hand drying remains important, and antimicrobial paper towels can further reduce bacterial contamination compared to warm air dryers.
This study assessed diabetic foot care practices among 100 diabetic patients in Pakistan. The results found that only 6% of patients practiced proper foot care according to guidelines. Few patients inspected their feet daily, washed their feet daily, dried their feet after washing, applied emollients, checked shoes before wearing, or wore correct shoes. Proper foot care was associated with receiving foot care education and higher literacy levels. The study concluded that greater efforts are needed to educate diabetic patients and the community about proper foot care practices to reduce complications.
Knowledge attitude and practice about acute respiratory infectionAnjum Hashmi MPH
This document summarizes a research article about a study assessing mothers' knowledge, attitudes and practices regarding acute respiratory infections in children under five in Tharparkar Desert, Pakistan. The study found that 72% of mothers could recognize symptoms of ARI but only 56% saw it as serious. 76% said breastfeeding should continue during illness. 36% used home remedies initially while 64% sought medical care. Most followed doctors' advice but knowledge of causes was low. Urban mothers had better breastfeeding practices during illness than rural mothers. The study highlights the need for health education interventions to improve maternal knowledge and care of ARI in children.
Prevalence of obesity & factors leading to obesity among high school stud...Anjum Hashmi MPH
This document summarizes a research study on childhood obesity among high school students in Hyderabad, Pakistan. The study aimed to determine the prevalence of obesity and factors leading to obesity. Some key findings:
1) The prevalence of overweight was 23% in boys and 16% in girls, while obesity prevalence was 15% in boys and 8% in girls.
2) Multivariate analysis showed that girls were 67% less likely to be obese than boys. Older age groups were also less likely to be obese.
3) Students from middle socioeconomic status families were over 3 times more likely to be obese than lower socioeconomic status students.
4) Eating fruit more than 4 times a
Contraceptive methods & factors associated with modern contraceptives useAnjum Hashmi MPH
The study examined contraceptive use among 288 females in Karachi, Pakistan. Modern contraceptive methods, such as injections, implants, and IUDs, were used by 75% of participants. Factors associated with higher odds of modern contraceptive use included: being younger than 30 years old, receiving information from a family planning worker, and having a child younger than 1 year old. Television and billboard advertisements were associated with lower odds of modern contraceptive use. The study provides insight into prevalent contraceptive methods and influencing factors in the region.
Incorrect inhaler technique compromising quality of life of astematic patientsAnjum Hashmi MPH
This study examined incorrect inhaler technique in 215 asthmatic patients in Pakistan. The researchers found that 83.7% of patients used their inhalers incorrectly. Education level was significantly associated with incorrect use, with higher education levels associated with better technique. Doctors provided education on inhaler use was more effective than education from nurses. There were no significant associations between incorrect use and age, gender, asthma duration, inhaler duration, or frequency of inhaler use. The study concluded that a large percentage of asthmatic patients' quality of life is compromised by incorrect inhaler use, and education level impacts proper technique.
Role baby friendly hospital initiative on KAP of nursing mothersAnjum Hashmi MPH
The document summarizes a study on the role of the Baby Friendly Hospital Initiative (BFHI) on the knowledge and practices of nursing mothers regarding infant feeding. The study compared mothers who delivered at a Baby Friendly Hospital (BFH) versus a non-BFH. It found that some feeding practices were better in the BFH group, such as a lower rate of pre-lacteal feeding and longer duration of exclusive breastfeeding. However, the non-BFH group had a higher rate of initiating breastfeeding within the first hour. The BFHI was found to have a beneficial impact on certain infant feeding practices and the duration of exclusive breastfeeding.
Prevalence of NSI among healthcare workers of Najran Saudi ArabiaAnjum Hashmi MPH
This document summarizes a research article on needle-stick and sharp injuries among healthcare workers in Najran, Saudi Arabia. The study found that 32 such injuries occurred over a 6-month period, with nurses accounting for nearly half of the injured workers. Most injuries took place in operating/recovery rooms and involved contaminated needles during use of medical devices. The majority of injuries occurred while wearing only one pair of gloves. The study concludes that healthcare worker safety can be improved through measures like safety devices, training, and adherence to universal precautions.
The document provides information about HIV/AIDS, including its causes, symptoms, transmission, treatment and prevention. Some key points:
- HIV is a virus that weakens the immune system and causes AIDS. It can be transmitted through bodily fluids including blood, semen and breastmilk.
- Symptoms vary depending on the stage of infection, from flu-like symptoms during acute infection to opportunistic infections and cancers with late-stage AIDS.
- Treatment involves antiretroviral drugs to suppress the virus and prevent transmission. Combination drug therapy can control the virus and prolong healthy life.
- Prevention methods include safe sex practices, needle exchange for drug users, treatment of infected mothers and newborns,
Prevalence & factors associated with hepatitis c virus seropositivity in females
1. IJPM
Prevalence and Factors Associated with Hepatitis C Virus Seropositivity
in Female Individuals in Islamabad, Pakistan
Anjum Hashmi1, Khalid Saleem2, Jamil Ahmed Soomro3
ABSTRACT
1 Community Health Officer Depart- Objectives: An estimated 150-200 million people worldwide are
ment of Community Health Prf Medical infected with hepatitis C. Only limited information about the
Center Karachi Pakistan. epidemiology of Hepatitis C virus (HCV) infection is available.
2 Medical Superintendent PINS Com-
The aim of this study was to determine the prevalence of anti-
plex Hospital Nalore Islamabad.
3 NMCH Officer WHO Pakistan.
HCV antibodies and the possible factors for transmission in the
female population of a largely urban city, Islamabad, Pakistan.
Methods: A cross-sectional study was conducted from May to
August 2006 in Islamabad. The city is divided into forty union
Correspondence to:
Dr Anjum Hashmi, Community Health
councils. Five union councils were selected randomly and then,
Officer, Department of Community we randomly selected 252 female households (n = 252) of age
Health, PRF Medical center, Karachi, ranges between 15-50 years who were able to read and write the
Pakistan. self-administered questionnaires. Those with severe debilitating
Email: anjumhashmi61@hotmail.com disease, physical or mental handicapped or those who did not give
consent and known cases of HCV were excluded. The primary
Original Article
outcome variables were HCV seropositivity and factors as history
of major surgical procedure, blood transfusion and intravenous
drug use.
Results: The mean age of participants was 33.21 (9.95) years and
HCV seropositivity prevalence was 62 (24.6%). Final forward
stepwise multiple logistic regression showed blood transfusion
[OR, 10.09; 95% CI: 1.95-52.25], dental procedure [OR, 5.38; 95%
CI: 2.31-12.50] and dilation and curettage [OR, 3.86; 95% CI: 1.86-
8.01] were significantly associated with HCV seropositivity.
Conclusions: The study highlights the poor quality of care pro-
vided and a massive need to educate general population including
patients as well as health professionals and allied health workers
for controlling, combating and preventing the wild epidemic of
Date of Submission: 31 Jun 2010 HCV.
Date of Acceptance: 29 Sep 2010 Keywords: Hepatitis C, Risk factors, Prevalence, Pakistan.
Int J Prev Med 2010; 1(4): 252-256
INTRODUCTION tory of sexually transmitted disease (STD) (p <
Hepatitis C is a blood-borne infectious dis- 0.001), and lack of travels outside of Europe (p
ease caused by the hepatitis C virus (HCV), af- < 0.05).2
fecting the liver. An estimated 150-200 million Only limited information about the epidemi-
people worldwide are infected with hepatitis C. ology of HCV infection especially in females is
Prevalence is higher in some countries in Asia available in high prevalence areas like Pakistan.
and Africa. Egypt has the highest seroprevalence Previous study has suggested a prevalence of 9%
for HCV up to 20% in some areas.1 Hepatitis C HCV seropositivity among a sample of patients
infects nearly 200 million people worldwide and in Mardan, Pakistan.3 Although HCV infection
4 million in the United States. The factors asso- has been identified as one of the major causes of
ciated with HCV are intravenous drug use (p < chronic hepatitis CLD and hepatocellular carci-
0.001), blood transfusion (p < 0.01), tattoos (p < noma its prevalence in the female population
0.001), previous hospitalization (p < 0.05), his- and associated factors like minor surgical proce-
252 International Journal of Preventive Medicine, Vol 1, No 4, Fall 2010
2. Hepatitis C in Pakistan
dures, biopsy, endoscopy, and dilation and cu- working as a health worker (included doctors,
rettage (D & C) are largely unknown. nurses, and all laboratory and paramedical staffs
The aim of this study was to determine the etc).
prevalence of anti-HCV antibodies and the pos- Five ml of blood was collected from each
sible risk factors for transmission in the female case and was sent to the designed laboratory.
population of a largely urban based city, Islama- Sera were separated by centrifugation and were
bad. tested for anti HCV antibodies within one hour.
The anti HCV antibodies were tested by the Dot
METHODS immunochromatographic method. The immu-
The study was conducted in Islamabad, capi- nochromatographic test is for HCV core antigen
tal of Pakistan having a population of around detection. It is easily to performed, ripid, highly
0.9 million (1997) with population growth rate sensitive and specific test, based on the immu-
of 2.6% (1997). Female to male ratio is 94 per nochromatographic strip. Positive reactions can
100, meaning our study population was 0.85 be detected weakly at a 1:15 dilution of the se-
million (1997). Currently the approximate popu- rum and more strongly in 1:10, 1:5, 1:2 and 1:1
lation is well above 1.5 million. dilutions, by the immunochromatographic strip.
The study was carried out from May 2006 to In addition, the test was capable of detecting
August 2006 in Islamabad, Pakistan. All female 0.25–12.0 µg of the recombinant protein. This
inhabitants of age range between15-50 years immunochromatographic technique opens new
living in the study site were eligible to partici- perspectives for the diagnosis of hepatitis C dur-
pate in the study. A cross-sectional study design ing the early seroconversion phase and for rapid
was used to achieve the primary objective. To core antigen detection.
determine the prevalence of HCV seropositivity Results were analyzed for finding the preva-
and evaluate potential risk factors by comparing lence of Hepatitis C in the target population.
HCV seropositive and seronegative female indi- The data was analyzed using the Statistical
viduals. A multi stage sampling was used. The Package for Social Sciences (SPSS Inc., Chi-
city was divided into 40 union councils. We cago, IL) version 13. Descriptive statistics of
randomly selected five union councils and then socio-demographic and other variables of the
female households were randomly selected sampled population were computed. Means and
among five selected union councils. Our sample standard deviations (SD) were calculated for
size of the study was 252. quantitative variables and proportions for cate-
Two co-researchers also medical reactionar- gorical variables. Logistic regression analysis
ies registered with Pakistan Medical and Dental was performed to measure the association be-
Council (PMDC) went to the selected houses tween dependent and independent variables.
and approached the female head in the family. Odds ratios (OR) and 95% confidence intervals
They explained the purpose and objectives of the (CI) were calculated from β coefficients and
study and asked for written informed consent their standard errors. Associations between in-
from participants before administering the ques- dependent variables were assessed using chi
tionnaire and collecting a blood sample. The self square and only those with significant associa-
administered questionnaires were available in tion were entered to perform multivariate analy-
both Urdu and English versions. The questions sis. A multivariate logistic regression model was
gathered demographic characteristics including employed with HCV antibody status as the de-
age, socio-economic status based on monthly pendent variable. P values < 0.05 were consid-
incomes (classified into high class, upper middle ered to be statistically significant.
class, lower middle class, and poor), marital
status and also number of years in education RESULTS
(classified into primary educated, secondary The descriptive analysis showed that the mean
educated, and graduate), history of surgical pro- age of the sample was 33.21 (± 9.95) years with
cedure, blood or blood products transfusion, minimum and maximum values of 15 and 50
history or current use of Intravenous drug use years respectively. HCV seropositivity was 62
(IVDU), history of tattooing or scarification, (24.6%). About 148 (58.73%) were poor, 80
history of dental treatment, ear piercing, minor (31.7%) middle class and 24 (9.52%) were upper
surgical procedures like biopsy and D & C, ce- class; married were 225 (89.2%) and unmarried 27
sarean section (C-section), abroad visits and (10.7%); 141 (55.9%) were illiterate, 51 (20.2%)
International Journal of Preventive Medicine, Vol 1, No 4, Fall 2010 253
3. Hepatitis C in Pakistan
passed primary and 40 (15.8%) secondary schools, The univariate analysis showed that blood
and 20 (10.7%) were graduated; 70 (27.7%) chew transfusion, sexual contact, surgery, health
tobacco, smokers were 190 (75.3%) and 8 ( 3.1%) worker, dental procedure, endoscopy, biopsy,
have history of traveling abroad (Table 1). The dilation and curettage, and cesarean section
frequency of factors associated with HCV sero- were significantly associated with HCV sero-
positivity were as: blood transfusion 12 (4.8%), positivity (Table 2). Final Forward Stepwise
sexual 2 (0.8%), surgery 88 (34.9%), IVDU (Intra- (Wald) multiple logistic regression showed
venous drug user) 15 (5.9%), health worker 4 blood transfusion [OR, 10.09; 95% CI: 1.95-
(1.6%), tattooing 6 (2.4%), dental procedures 154 52.25], dental procedure [OR, 5.38; 95% CI:
(61.1%), endoscopy 14 (5.6%), biopsy 4 (1.6%), 2.31-12.50], and dilation and curettage [OR,
dilation and curettage 134 (53.2%) and cesarean 3.86; 95% CI: 1.86-8.01] were significantly asso-
section 36 (14.3%). ciated with HCV seropositivity in females
Table 1. Demographic characteristics of participants (Table 3).
Demographic characters n (%)
Age groups
DISCUSSION
(years) 15-20 18 (7.1) We observed a significantly high prevalence
21-25 40 (15.9) 24.6% of HCV in Islamabad. Egypt has a high
26-30 58 (23) prevalence up to 20% in some areas. A survey
31-35 42 (16.7) conducted in California showed prevalence of
36-40 36 (14.3) up to 34% among prison inmates.4 A case con-
41-45 24 (9.5) trol study by Irfan et al. in Mardan, Pakistan in
46-50 34 (13.5) 2004, showed much lower prevalence of 4.34%.5
Socio economic 148 (58.73) A study conducted in 2002 in Sindh, Pakistan
Poor also showed low HCV prevalence of 9%.6 Even
Middle Class 80 (31.7) in a hospital based study conducted in commu-
Upper Class 24 (9.52) nity clinic of Islamabad in 2004, only 5.31%
Marital status 225 (89.2) individuals were positive for anti-HCV.7
Married Studies by Khan et al.3 and Muhammad et
Unmarried 27 (10.7) al.8 conducted in Pakistan has showed the his-
Level of education 141 (55.9) tory of reused syringes, blood transfusion, dental
Illiterate procedure, surgical operation and tattooing as
Primary 51 (20.2) significant risks. Similarly, Batash et al. also
Secondary 40 (19.8) showed intramuscular injections (odds ratio 9.1;
Gradate 20 (7.9) 95% CI: 2.0-42.4) and blood transfusions (odds
Addiction 70 (27.7) ratio 3.2; 95% CI: 1.2-9.0) were significantly
Tobacco chewing associated with HCV seropositivity.9 Our results
Smoking 50 (19.8) again reiterate their findings as blood transfusion
IVDU 15 (5.9) [OR, 10.09; 95% CI: 1.95-52.25] and dental pro-
Traveling abroad 8 (3.1) cedure [OR, 5.38; 95% CI: 2.31-12.50] to be
IVDU: intravenous drug use significantly associated with HCV.
Table 2. Factors associated with seropositivity of Hepatitis C
Anti Hepatitis Positive C Antibody Negative
Risk Factors P value
n (%) n (%)
Blood transfusion 12(4.8) 240(95.2) < 0.001
Sexual 2(0.8) 250(99.2) 0.013
Surgery 88(34.9) 164(65.1) < 0.001
Dental procedures 154(61.1) 98(38.9) < 0.001
Health worker 4(1.6) 248(98.4) < 0.001
Endoscopy 14(5.6) 238(94.4) < 0.001
Biopsy 4(1.6) 248(98.4) < 0.001
Dilation and curettage 134(53.2) 118(46.8) < 0.001
C- section 36(14.3) 216(85.7) 0.003
254 International Journal of Preventive Medicine, Vol 1, No 4, Fall 2010
4. Hepatitis C in Pakistan
Table 3. Factors associated with seropositivity of Hepatitis C identified in multiple logistic regression
Risk Factors OR 95% CI P value
Blood transfusion 10.094 1.95-52.25 0.006
Dental procedure 5.381 2.31-12.50 < 0.001
Dilation and curettage 3.869 1.86-8.01 < 0.001
Consistent with studies by Cacoub et al.,10 tion,13,14 HCV antibody testing provides a rea-
transfusion of blood products (21.7 vs. 5.5%; p < sonable estimate of the amount of HCV infec-
0.0001), and dental treatment (55% vs8.3%; p < tion in a population. Finally, the selection of
0.0001) and Nafeh et al. previous blood transfu- cross sectional study was unable to determine
sion (10.5; 4.7-23.2) and sexual contact with an the biologic plausibility between HCV and iden-
intravenous drug user (6.9; 3.1-15.2). Delage et tified factors.
al.12 also showed intravenous drug use (IVDU) We observed a significantly high prevalence
(p < 0.001) and blood transfusion (p < 0.01), to of HCV in Islamabad 24.6%; even five folds
be statistically significant like our study. more than in 2004.
It is noteworthy that in our study many fac- This is an alarming sign for an urban area
tors like history of used syringes, intra venous like Islamabad. More so because of the factors
drug used, major surgery, sexual contact, tattoo- identified. The association of these factors,
ing, cesarean section and travel abroad, were not blood transfusion, dental procedure and dilation
significant in final multiple logistic regression. and curettage, with HCV has proved an inade-
While factors like travel abroad and tattooing quate unsafe health practices and quality of care
were even not significant at univariate analysis. in developing countries. Moreover, previous
The possible justification would be female sam- studies have not shown dilation and curettage to
ple population selection; as tattooing and travel- be a significant factor associated with HCV.
ing to abroad are not common in females of our Massive health education and promotion
society. should be done in order to control and combat
It was also interesting to find significant asso- HCV epidemic.
ciation of female health worker, biopsy and en-
doscopy with HCV seropositivity. This high- ACKNOWLEDGEMENTS
lights still poor quality of care provided to the Our heartiest acknowledgements to Islama-
patients with use of unsterilized instruments in bad city administration and union council em-
tertiary care government facilities. Even our ployees in providing every possible administra-
female health workers, main health care provid- tive help.
ers are not using safe practices. The most impor-
tant finding of our study was to find dilation and Conflict of interest statement: All authors de-
curettage to be statistically significant, even in clare that they have no conflict of interest.
multiple regression models, along with blood
transfusion and dental procedures; of course Sources of funding: None
again it was due to our female sample popula-
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