ABSTRACT
There is a potential risk of bacterial and viral infection being transmitted through anaesthesia circuits. Several studies have shown contamination of parts of anaesthetic equipment with bacteria that colonise the mouth and upper airway. A definite relationship between such contaminated anaesthetic equipment and subsequent lung infection remains to be established. Various factors contribute to the transmission and pathogenesis. Among the recommendations for preventing transmission of infection through anaesthetic circuits are using a bacterial/viral filter for every patient or using disposable circuits. Owing to financial constraints, all these recommendations may not be practical in India. Possible guidelines for India may include discarding endotracheal tubes after single use and rigorous cleaning and disinfection of masks and laryngoscopes. Corrugated tubings used in the expiratory limb of the circuit may be washed with soap and water after each patient and dried before use. It is advisable to disinfect all such tubings in 2% glutaraldehyde, and then to wash in water and to dry before use at least once a day or when they are visibly contaminated.
Subject(s)
Anesthesia/adverse effects , Cross Infection/epidemiology , Disease Transmission, Infectious/prevention & control , Equipment Contamination/prevention & control , Female , Humans , Incidence , India/epidemiology , Male , Primary Prevention/methods , Risk Assessment , Risk Factors , Sterilization/methodsABSTRACT
BACKGROUND: Wilson's disease usually presents in childhood. Early recognition and treatment is crucial to retard the progression of this disease, which can be debilitating, if not fatal. We analysed the clinical manifestations and survival pattern of patients admitted at our centre from 1993 to 1996. METHODS: Hospital records of patients were reviewed to obtain the clinical manifestations. The survival status of patients was determined by a prospective follow up. The Kaplan-Meier survival curve and univariate Cox proportional hazards model were used to determine the survival pattern and risk for death in Wilson's disease. RESULTS: A total of 60 patients were studied. The median age at onset of symptoms was 12 years (range 5-52 years). The log rank test showed a significant difference in the mean (SD) survival between patients who presented with hepatic [87.36 (15.26) months] and neurological symptoms [114.33 (9.14) months]. Cox proportional hazards analysis showed a hazard ratio of 4.9 for patients with a hepatic presentation compared to those with neurological presentation. CONCLUSION: The presentation of Wilson's disease is not limited to the paediatric age group. Patients with a hepatic presentation had a five-fold higher risk of mortality when compared to those with a neurological presentation.
Subject(s)
Adolescent , Adult , Age of Onset , Analysis of Variance , Child , Child, Preschool , Female , Hepatolenticular Degeneration/drug therapy , Humans , India/epidemiology , Male , Middle Aged , Proportional Hazards Models , Retrospective Studies , Survival RateABSTRACT
Health care workers are exposed to blood-borne pathogens, mainly the human immunodeficiency virus, hepatitis B virus and hepatitis C virus. Infection by these viruses leads to chronic or fatal illnesses which are expensive and difficult to treat. Individuals who harbour these viruses may be asymptomatic and hence all patients should be assumed to harbour a blood-borne pathogen. All health care workers should take adequate precautions (a set of guidelines termed 'universal precautions'). Methods of preventing transmission of blood-borne pathogens include vaccination against hepatitis B virus, following universal precautions and taking adequate post-exposure prophylaxis.