MEDICALL 2007 - August 3,4,& 5 2007 at RAJAH MUTHIAH HALL

MEDICALL 2006, The unique hospital needs expo organised at Chennai, India on August 4,5,&6 2006 was a grand success.
We are planning the next year show on August 3,4,& 5 2007 at RAJAH MUTHIAH HALL .

Dr.S. Manivannan MD.,DNB.,
CEO
MEDEXPERT
ISHA Homes
No.74, 1 st Avenue ,
Indira Nagar
Adayar, Chennai- 20
Ph: 91 – 44 – 32516661
Mo: 91 – 0 – 9385511033

Dip NB Medicine, Surgery, Anaesthesia in Trichy, Tamil Nadu

Kavery Medical centre And Hospital, Tennur,Trichy,Tamilnadu, India has been recognised for DNB.

Click here for further details

Tirunelveli Medical College Alumni Association - Nellaimedicos: Doctors' Day

Tirunelveli Medical College Alumni Association - Nellaimedicos: Doctors' Day

Prostitution Defines AIDS Pandemic More Than Other Factors

By Public Library of Science, [RxPG] In new academic research published today in the online, open-access, peer-reviewed scientific journal PLoS ONE, male circumcision is found to be much less important as a deterrent to the global AIDS pandemic than previously thought. The author, John R. Talbott, has conducted statistical empirical research across 77 countries of the world and has uncovered some surprising results.

The new study finds that the number of infected prostitutes in a country is the key to explaining the degree to which AIDS has infected the general population. Prostitute communities are typically very highly infected with the virus themselves, and because of the large number of sex partners they have each year, can act as an engine driving infection rates to unusually high levels in the general population. The study has a number of important findings that should impact policy decisions in the future. First, male circumcision, which in previous studies had been found to be important in controlling AIDS, becomes statistically irrelevant once the study controls for the number of prostitutes in a country. The study finds that the more Muslim countries of North Africa do indeed suffer much less AIDS than southern and western Africa, but this lower prevalence is not due to higher numbers of circumscribed males in these Muslim communities, but rather results from the fact that there are significantly fewer prostitutes in northern Africa on a per capita basis. It appears that religious families in the north, specifically concerned fathers and brothers, do a much better job protecting their daughters from predatory males than do those in the south. A history of polygamy in these Muslim communities does not appear to contribute to hi gher AIDS prevalence as previously speculated. In a frequently cited academic paper, Daniel Halperin, an H.I.V. specialist at the Harvard Center for Population and Development and one of the world’s leading advocates for male circumcision, weighted results from individual countries by their population. When this artificial weighting was removed Talbott found that circumcision was no longer statistically significant in explaining the variance in AIDS infection rates across the countries of the World.

Second, to date, there has not been an adequate explanation as to why Africa as a continent is experiencing an AIDS epidemic far in excess of any other region of the world with some African countries’ prevalence rates exceeding 25% of the adult population and tens of millions dying from the disease on the continent. Talbott’s new study suggests that the reason is that Africa as a whole has four times as many prostitutes as the rest of the word and they are more than four times as infected. Some southern Africa countries have as many as 7% of their adult females infected and working as prostitutes while in the developed world typically this percentage of infected prostitutes is less than .1%. If these 7% of infected prostitutes in Africa sleep with five men in a week that means they are subjecting 35% of the country’s male population to the virus weekly. The virus is not easy to transmit heterosexually, b ut over time with multiple exposures, infection is inevitable. These men then act as a conduit to bring the virus home to their villages, their other casual sex partners and to their wives.

The study has important policy implications. Several international AIDS organizations have begun to provide funding for male circumcisions as a deterrent to AIDS. While male circumcision may indeed reduce the risk of transmission by some 50% to 60% in each sexual encounter, reducing single encounter transmission rates alone cannot control the epidemic. The reason is that individuals in highly infected countries have multiple contacts with the infected so reducing transmission rates only defers the inevitable.

The real question is what can be done with the prostitute community. Outlawing the world’s oldest profession would most likely prove to be ineffective. If the profession can be legalized and treatment and care provided to the practitioners, there would be much more reason to be hopeful. But, and this is the key, programs of action can not just be voluntary. Too many innocent people are dying and there is too much disregard for human life among infected prostitutes to leave treatment decisions solely up to them. A program of testing and treatment for prostitutes must be mandatory and those that refuse treatment must be held liable.

Many international aid organizations are against such mandatory treatment programs for prostitutes as they find them to be discriminatory, violate the individual’s human rights and are perceived as an attack on female prostitutes who are viewed as victims of gender and income inequality. Such organizations do not properly weigh the loss of human rights and life itself that this virus, unleashed on a community, is causing. This virus, itself, is a violation of human rights and we must do everything in our power to stop it. To argue we should do nothing about infected prostitutes during an AIDS epidemic because of a fear of creating a stigma against the infected would be like an animal rights activist claiming that a rabid dog must be allowed to run free in a neighborhood regardless of how many men women and children he infected and killed.

It is not surprising that computer models rarely show the virus reaching epidemic proportions; it is very hard to transmit this illness heterosexually. Only when model building researchers introduce a highly sexually active infected subset of “prostitutes” to their mathematical models does the infection spread exponentially to the general population.

Original research article: http://www.plosone.org/article/fetchObjectAttachment.action?representation=PDF&uri=info%3Adoi%2F10.1371%2Fjournal.pone.0000543
DOI of the scientific paper: http://plosone.org/doi/pone.0000543
Publication: Talbott JR (2007) Size Matters: The Number of Prostitutes and the Global HIV/AIDS Pandemic. PLoS ONE 2(6): e543. doi:10.1371/journal.pone.0000543
On the web: www.plos.org

Epidemiology As of January 2006, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) estimate that AIDS has killed more than 25 million people since it was first recognized on June 5, 1981, making it one of the most destructive epidemics in recorded history.

Key Points of this article

The number of infected prostitutes in a country is the key to explaining the degree to which AIDS has infected the general population

Male circumcision, which in previous studies had been found to be important in controlling AIDS, becomes statistically irrelevant once the study controls for the number of prostitutes in a country

More Muslim countries of North Africa do indeed suffer much less AIDS than southern and western Africa, but this lower prevalence is not due to higher numbers of circumscribed males in these Muslim communities, but rather results from the fact that there are significantly fewer prostitutes in northern Africa on a per capita basis

A history of polygamy in communities does not appear to contribute to hi gher AIDS prevalence as previously speculated

STAMP system can help medical professionals to predict violence

By Blackwell Publishing Ltd.,
A researcher who spent nearly 300 hours observing patients in an accident and emergency department has developed a method for identifying possible flashpoints, according to the latest Journal of Advanced Nursing.

STAMP
STAMP - which stands for Staring and eye contact, Tone and volume of voice, Anxiety, Mumbling and Pacing could be used by any professionals in potentially violent situations, such as law enforcement and social services.

Lauretta Luck, who carried out her research at the University of Western Sydney, Australia, points out that the STAMP violence assessment framework could have much wider applications than just hospitals.

The five-month research project was carried out in a 33-bedded emergency department in a public hospital serving a large rural, remote and metropolitan community in Australia.

It serves a multi-cultural community, which includes a high number of tourists and seasonal workers as well as a large metropolitan population.

Luck carried out 290 hours of observation and interviewed 20 Registered Nurses who agreed to take part in the study.

"During my time in the department there were 16 violent episodes aimed at staff taking part in the study," says Luck. "Because I was on the spot I was able to obtain feedback from them while the event was still fresh in their minds. They were able to tell me how they perceived the event and how they tried to handle it.

"Many more episodes were observed during the study period and I was keen to note how staff managed to defuse potentially violent episodes".

“Violence towards healthcare staff and other professionals such as police officers and social security staff are an increasing part of daily life” says Luck.

“We feel that the STAMP system provides an easy to remember checklist that can be used in a wide range of potentially stressful situations to provide an initial indication of possible violence.

“Recognising the early signs that can lead to a violent episode can give staff the time they need to defuse the situation before it escalates.

“STAMP also provides a basic framework that can be developed by healthcare organisations and other agencies – using research, observation and experience

Level of Evidence
2c - Ecological Study
Key Points of this article
Staring was an important early indicator of potential violence. It was frequently noted in observational data and featured in nine of the 16 observed violent episodes. Nurses felt that staring was used to intimidate them into prompter action – when they responded to this cue violence tended to be avoided
Lack of eye contact was also an issue and was associated with anger and passive resistance. However, it was noted that there can be cultural reasons for avoiding eye contact and it was important to differentiate these from other cases
Tone and volume of voice was associated with 13 of the 16 violent episodes. Most of the cases involved raised voices and yelling but two involved sarcastic and caustic replies
Many of the people who attended the emergency department were anxious and nurses were acutely aware of how stressful a visit to casualty could be. They normally intervened before anxiety reached dangerous levels, but one patient’s anxiety did escalate into violence
Main results
Eleven of the 16 patients who became violent were observed mumbling, using slurred or incoherent speech or repeatedly asking the same question or making the same statements. Mumbling was perceived to be a sign of mounting frustration and a cue for violence. Pacing was seen as an indication of mounting agitation and was observed in nine of the 16 episodes analysed in detail. Other physical indicators included staggering, waving arms around or pulling away from healthcare staff trying to treat them.

Extended Shifts for Medical Interns Negatively Impact Patient Safety

By American Academy of Sleep Medicine,

Working an extended duration shift can pose a risk to not only the safety and well-being of medical interns, but also to that of their patients.

The study, authored by Laura Barger, PhD, of Brigham and Women's Hospital in Boston, was based on 2,737 physicians in their first post-graduate year, who participated in a nationwide Web-based survey, completing a total of 17,003 monthly reports. A regression analysis was performed to determine the relationship between the number of extended duration work shifts (greater than or equal to 24 hours in length), reported medical errors and a self-reported measure of stress.

It was discovered that the reporting of medical errors and the number of extended duration shifts worked in a month were both significant predictors of stress. Compared to months in which no extended duration shifts were worked, interns working five or more extended duration shifts had seven times greater odds of reporting at least one fatigue-related significant medical error that resulted in an adverse patient event and reported 300 percent more fatigue-related preventable adverse events resulting in the death of the patient. Moreover, interns who reported a medical error that resulted in an adverse patient outcome were more than three times as likely to report high stress in that month.

These results suggest that extended duration shifts negatively impact patient safety and the well-being of medical interns. They have important public policy implications for post-graduate medical education and suggest the need for counseling or other care for interns who make medical errors, said Barger.

The amount of sleep a person gets affects his or her physical health, emotional well-being, mental abilities, productivity and performance. Recent studies associate lack of sleep with serious health problems such as an increased risk of depression, obesity, cardiovascular disease and diabetes.

Experts recommend that adults get between seven and eight hours of sleep each night to maintain good health and optimum performance.