Biohazards in Medical Practice

Last Updated on Wednesday, 7 April 2010 11:53 Written by Natural Health Team Wednesday, 7 April 2010 11:53

BIO-HAZARDS IN MEDICAL PRACTICE

Dr T.V. RAO MD.

INTRODUCTION

Bio-hazards remain a great challenge to the health care workers who come in contact with the patients. In a health care setting the problem of bio-hazards rarely spread from health care workers to patients. In each of these pathways transmission risk depends on the prevalence of infected individuals in the population. While blood is the important source of HBV, HIV and other blood borne pathogens in the health care setting, transmission can also occur through accidental exposure to contaminated tissues, semen, vaginal secretions, cerebrospinal fluid, pleural fluid, peritoneal fluid, pericardial fluid and amniotic fluid.

Important Blood Borne Infections.

The important diseases which are of great concern in Health care setting.

1) Hepatitis B infection: there being more than 400 million carriers in the world, there is a high risk of infection with contamination of the hands, mucus membrane of the eyes, nose and mouth by infectious blood and other body fluids. The risk of HBV infection following exposure to virus is 45-120 times.

2) The risk of HIV infection is low in health setting. The risk of HIV infection following percutaneous needle-stick exposure to HIV contaminated blood is estimated to be between 0.13% and 0.5%.There is no evidence that HIV or HBV is transmitted by the air borne route, In spite level of occupational risk is low, the consequences of infections with HIV are dire and should not be under rated by Medical personnel

To counter the bio-hazards the bio safety guidelines are to be followed for the protection of health care workers handling patients, samples arising out of Human Immunodeficiency Virus, Hepatitis B virus and other viral infections. It is to be impressed on the health workers to consider all patients are potentially infected with HIV/HBV or other blood borne pathogens, and follow infection control precautions.

The following guidelines as recommended by the Centre for disease control (Universal Precautions) should be appreciated and practiced to protect ourselves and our patients from the bio-hazards.

In Day To Day Medical Practice

1) Hand washing :

Regardless of frequency, the hand must always be washed thoroughly, with meticulous attention to all areas including the nails and interdigital space, with vigorous rubbing.

Indications for Hand washing.

a) In prolonged and intense contact with the patient

b) Before taking care of particularly susceptible patients (immuno compromised patients or new born children)

c) Before and after doing invasive procedures.

d) Before and after touching wounds.

e) In situations when Microbial contamination of hands is likely to occur (e.g. Contact with mucous membrane blood, body fluids secretions and excretions.)

2) Hand Washing Policies and procedures:

The use of nonmedicated soaps and detergents in solid or liquid form is efficacious in removing most transient contaminations from hands. In special circumstances the following chemical agents can be used.

a) Ethyl or isopropyl alcohol approximately diluted with sufficient water for maximum bactericidal action.

b) Detergent formulations containing chlorhexidine, povidone-iodine or hexachlorophene may be used for disinfection of the hands

3) Gloves should be worn for touching blood and body fluids, mucous membranes non intact skin, and handling of items or surfaces soiled with body fluids.

4) Guidelines for collection of blood and other body fluids.

a) Inspect your hands. If broken or any ulcer is present wear gloves.

b) Wash your hands with ordinary soap and water immediately after any blood contamination and after the work is completed.

c) If you wear gloves wash your hands with soap and water after removing it.

d) Place used needles and syringes in a puncture resistant container.

Do not recap needles.

Do not remove needles from syringes.

e) In the event of needle stick or other skin puncture or wound, wash the injured area thoroughly with soap and water. Never forget to encourage bleeding.

f) In the event of any injury while working in the hospital with HIV/HBV infected patients, inform the head of the unit for necessary safety measures, you may need antiviral prophylaxis.

g) Gowns or aprons should be worn during procedures that are likely to generate splashes of blood and other body fluids.

5) Prevention of Bio-hazards by the First-Aid workers.

a) Mouth to mouth resuscitation.

1) Mouth to mouth resuscitation is a life saving procedure which should not be with held through fear of contracting HIV or other infections.

2) If there is a bleeding from the mouth wipe out the blood with clean cloth or handkerchief from the patients mouth before resuscitation.

b) Bleeding patients

Health worker should not hesitate to handle the bleeding patients effectively.

6) Pregnant health care workers

Pregnant health care workers are not known to be at greater risk of contracting infectious diseases. however if health care worker develops HIV/HBV infection during pregnancy the infant is at risk of infection resulting from perinatal transmission.

7) Precautions during invasive procedure

All the health care workers who participate in invasive procedures must routinely use appropriate barrier precautions to prevent skin and mucous membrane contact with blood and other body fluids of all patients. All the health care workers who perform or assist in vaginal or cesarean deliveries should wear gloves and gowns when handling the placenta or the infant until blood and amniotic fluid have been removed from the infant’s skin and should wear gloves during post delivery care of the umbilical cord.

Precautions in dentistry

Blood, saliva, gingival fluid from all dental patients should be considered infective, dental workers should wear surgical mask and protective eye wear.

House keeping and laundry:

1) Environmental surfaces such as walls, floors and other surfaces are not associated with transmission of infections to patients or health care workers. Therefore extraordinary attempts to disinfect or sterilize these environmental surfaces are not necessary.

2) Although soiled linen has been identified as a source of large number of certain pathogenic microorganisms, the risk of actual disease transmission is negligible. All soiled linen should be bagged at the location where it was used; it should not be sorted or rinsed in patient care areas. Linen soiled with blood or body fluids should be placed and transported in bags that prevent leakage. If hot water is used, linen should be washed with detergent in water at 71°c for 30 minutes.

3) Any item which has contact with blood, exudates, or secretion may be potentially infective, it is not usually considered practical or necessary to treat all such waste as infective. Infective waste in general should either be incinerated or should be autoclaved before disposal, in a sanitary landfill. Bulk blood, suctioned fluids, excretions and secretions may be carefully poured down a drain connected to a sanitary sewer.

When none of the modern facilities are available the infectious waste should be deposited in trenches, covered with earth and compacted daily. The controlled fill must be fenced off, and scavenging is strictly prohibited.

Vaccination for Prevention of Hepatitis B Infection.

HBV vaccine should be available to all health care workers who are at risk due to professional responsibilities.

E mail; tvraodoctor2000@yahoo.co.in

Semen Leakage

Why Does an Enlarged Prostate Cause Urinary Discomfort?

Last Updated on Tuesday, 6 April 2010 11:53 Written by Natural Health Team Tuesday, 6 April 2010 11:53

The prostate plays an important role in the reproductive cycle of a man. It is actually a very tiny gland, smaller than a quarter, which is found in the groin area. It is found right underneath the bladder, and above the rectum, close to the urethra. The prostate gland is an important gland in the production of semen. The urethra is a tubular organ that allows the urine to pass out of the body. As the prostate grows, more pressure is placed on the bladder, making the urethra much thinner and more difficult to release urine.

One of the major causes of an enlarged prostate is age. Most men will encounter some form of an enlarged prostate after they are over the age of 40. The only difference is that other men experience a worse condition than others. Diet and lifestyle also plays an important role in the risk of getting an enlarged prostate. Alcohol has been said to increase the cell count in the prostate which means a larger amount of tissue in the gland.

It is usually difficult for a man to determine if they have an enlarged prostate. The gland will grow over a period of time, and might not show any sign of symptoms for some time. However, this is one of the main reasons that an annual check-up is important, so that the severe cases of an enlarged prostate can be avoided. One of the first signs of a problem is difficulty urinating. As mentioned earlier, as the prostate grows, the bladder has a large amount of pressure placed on it. This causes it to work harder in order to send urine through the urethra.

The man will first notice urine leakage, either when he has not been to the restroom or right afterwards. Eventually, the man will have the frequent urge to urinate. As the bladder becomes more stressed, the muscles relax and have trouble contracting in order to help the man urinate. This is the last stage of the condition and usually the most severe. When this happens, the man will not be able to urinate at all. In this case, an immediate surgical procedure will be recommended in order to prevent any further damage on the bladder.

If you have the symptoms of an enlarged prostate, it is important that you not panic or worry. In most cases, it can be repaired and the pain can be taken away with medication. You should not wait about visiting the doctor at the first sign of a symptom. He or she can prevent the problem from becoming worse and give you comfort from the pain. Often, if the condition is in the early stages, it can be taken care of with medication without the use of a surgical procedure.

It is important that you visit the doctor on an annual basis to ensure that you do not have the beginning signs of an enlarged prostate. This is especially important if you are over the age of 40. Your doctor can perform certain tests to determine if you need an ultrasound or x-ray to find out if your prostate is enlarged.

Semen Leakage

Having Trouble Getting Pregnant ? 3 Natural Tips on How to Get Pregnant

Last Updated on Monday, 5 April 2010 11:53 Written by Natural Health Team Monday, 5 April 2010 11:53

If a woman is fertile, then she will easily get pregnant. However, it is not easy to be fertile, and in fact, it’s quite complicated, and there are various factors which determine fertility of a woman. If you are having trouble getting pregnant, then it means that you are struggling with your fertility.

Know all causes and natural ways to cure them in perfect pregnancy guide on www.getpregnantfastguide.info

Common Causes of Female Infertility
Polycystic Ovarian Syndrome or PCOS, Problems with Ovulation, Endometriosis, Poor Egg Quality, and Blocked or Damaged Fallopian Tubes are some of the most common reasons that cause infertility in women.

3 Natural Tips to Get Pregnant Fast There are some foods that can improve your ability to conceive by correcting hormonal imbalances in your body. You are advised to follow a diet that contains these foods.
It is also important to note that there are certain foods such as alcohol, and Xenoestrogens that can lower infertility. You need minimize the intake of such foods in order to get pregnant naturally. If you are having problem conceiving, you can try and experiment different conception positions during sexual intercourse. You can easily get pregnant if your partner deposits his sperm close to your cervix. There are certain positions that can make this easy for you. The best conception position can be achieved by placing a pillow under your hips while intercourse as this will allow deeper penetration.
You are advised to avoid sex while sitting, standing, or with you on the top of your partner as it can cause leakage of semen from your body. Acupuncture, aromatherapy, homeopathy, and naturopathy are several other natural fertility techniques that can be successfully used to cure infertility.

Know more natural tips on Lisa olson’s Pregnancy guide on www.getpregnantfastguide.info That will help you to solve pregnancy troubles with all natural ways. And allow your body to conceive fast maximum in 8 weeks.

Semen Leakage

Cannine Reproduction

Last Updated on Sunday, 4 April 2010 11:53 Written by Natural Health Team Sunday, 4 April 2010 11:53

Nomenculature  of cannines

The female  dog is called a bitch and male as the dog,a  breeding dog is called  as stud The domestication of the dog is  as old and man (WANI 2002)The cannines mature sexually at an age varing between breeds and even indiduals.Normally  puberty age  ranges  between  6 to 12 months, although this can be delayed until up to two years of age for some large breeds. Pregnancy is possible as soon as the first estrus cycle, but breeding is not recommended prior to the third cycle. It is known that both wolves and domestic dogs have the same number of chromosomes; 39 pairs

Male

Secondary sex characteristics include increased muscle mass, enlargement, of sexual organs,  anal hypertrophy, and development of a gland at the base of the tail. Testosterone levels are also responsible for the sex drive, which is not cyclical. Males are receptive to mating at any time, and are willing to mate even if the bitch is not receptive.

 Female

The anatomy of female dogs is similar to that of many other mammals. They have two ovaries located caudal to the kidneys in the abdominal cavity. They have a bicornuate uterus or two-horned uterus which ends as the cervix, a short canal which connects to the vagina. The cervix is muscular with fibrous tissue support, and its opening closes in a stellate pattern. The vagina opens into an enlarged space called the vestibule which also receives the opening of the urethra. The vestibule makes a steep downward turn exits within the vulva. Females have a clitoris just inside the vulva. Bitches often have a vaginal stricture, which is a remnant of where the vagina and vestibule fused together during embryonic development. This stricture is often asymptomatic and is broken down during mating.The bitches are polyoestrus and show breeding cycle towice in a year,

Conversely, undomesticated canine species experience estrus once a year, typically in late winter.

Most female dogs come into season for the first time between 6 and 12 months, although some larger breeds delay until as late as 2 years. Like most mammals, the age that a female first comes into season is mostly a function of her current body weight as a proportion of her body weight when fully mature. They then experience estrus about every seven months until old age. Female dogs do not experience menopause, although their cycles will become irregular and fertility becomes unpredictable as they become older. Dogs over around 7 or 8 years are usually considered no longer appropriate for breeding, but can still remain fertile.

The reproductive cycle Female cycle

The average length of the reproductive cycle for females is 7 months. Bitches reach sexual maturity (puberty) between 4 and 18 months of age. There is a tremendous variability in the maturation age between breeds, and even within a breed of dog. The first stage of the reproductive cycle is proestrus, in which eggs in the ovaries begin to mature and estrogen levels begin to rise. During this stage males are attracted to non-receptive females. Initially, the vulvar lips will swell up and become pliable, there are small amounts of bloody vaginal discharge, and signs of frequent urination and restlessness. Proestrus generally lasts 9 days. Estrus is the next stage, in which estrogen levels are high, mature eggs are released from the ovaries, and the females mentally and physically become receptive to copulation. It is only during estrus that copulation will result in pregnancy. During proestrus and estrus, females may have a clear to bloody discharge. This stage is also known as “heat.” The length of these cycles varies greatly between individuals. Proestrus and estrus can last anywhere from 5 days to 21 days. Diestrus is the period following mating. Diestrus lasts approximately 56 to 58 days in the pregnant females, and 60 to 100 days in the non-pregnant females. During both of these periods, progesterone levels are high. Because the hormonal profile of a pregnant female and a female in diestrus are the same, sometimes a non-pregnant female will go through a period of pseudo-pregnancy. At that time she may gain weight, have mammary gland development, produce milk, and exhibit nesting behaviours. Anestrus is the period of reproductive quiescence. The female has no attraction to or from the male. Anestrus generally lasts four to five months.

Copulation adopted from mekmanal for editing and corrections

When copulating, a male canine initially mounts the female from behind, as with most tetrapods, a position known informally as doggy style. The female will hold her tail to the side (called “flagging”) and allow this if receptive. If unreceptive she may sit or lie down, snap, move away,

When the male achieves penetration, he will often hold tighter and thrust faster, and it is at this point when he is mating that the male’s penis expands. Canine reproduction is different from human sexual intercourse, because human males become erect first, and then enter the female; canine males enter first, then swell and become erect. This is because in humans the testicles produce sperm constantly and it is moved to the epididymous (the channels at the back of the testis.) They allow a human to release all the stored sperm at the end of intercourse defined by ejaculation. Dogs do not have the epididymal storage space. They are required to “pump” their sperm directly from their testicles. This process requires at least 20 minutes of cellular transfer directly from their testicles, through their urethra, and eventually into the female. It is not convenient for the male if the female wants to bolt away 2 minutes after the male orgasm initiates, and is able to run off.

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Once the male sexual organ  is locked into the vagina by the bulbus glandis (when the stud is “tied”), the male will usually lift a leg and swing it over the female’s back while turning around. The two stand with their hind ends touching and the penis locked inside the vagina while ejaculation occurs, decreasing leakage of semen from the vagina. After some time, typically 5 – 20 minutes (but sometimes longer), the bulbus glandis disengorges, allowing the mates to separate. Virgin dogs can become quite distressed at finding themselves unable to separate during their first copulation, and may try to pull away or run. Dog breeders often suggest it is appropriate for those involved to help calm and settle the mating dogs once this stage is reached, if they show anxiety, through until eventual separation.

Note that similar canine mounting behavior (sometimes with pelvic thrusting) is also used by dominant canines of both sexes. Dominance mounting, with or without thrusting, should not be confused with copulatory mounting, in which the thrusting is short term until a “tie” is achieved.

In dominance mounting, the dominant dog is merely trying to get its head above the subordinate dog. If a male dog does this, one may notice that the genitals are aimed over the subordinates tail rather than under it. Unsheathing of the male genitals are a sign that the dominant dog has “won the fight” of dominance.

Semen Leakage

Enlarged Prostate Tests

Last Updated on Saturday, 3 April 2010 11:53 Written by Natural Health Team Saturday, 3 April 2010 11:53

Prostate enlargement, or benign prostatic hyperplasia, is a common diagnosis that affect many men over the age of forty years or older. While it is not a common cause of prostate cancer, it can cause the bladder to shut down if it is not treated, as well as urinary tract infections, and a great deal of discomfort.

Understanding what the prostate is will help you understand your condition as well. The prostate is very small, almost the size of a nickel. It is located near the base of your bladder. It is the gland that produces the white secretion that later makes the semen. The secretions from the prostate help to nourish the sperm when it is ejaculated from your body.

Before seeking the help of a doctor, you need to determine if your symptoms might be the cause of an enlarged prostate. The first sign is urine leakage. This soon turns into frequent urination, and then eventually you will not be able to urinate at all. If you are having any of these ate gland, or benign prostatic hyperplasia, is a condition that a man faces who is over the age of forty. It is also thought to be the most common diagnosis for men over the age of sixty. While having an enlarged prostate does not necessarily mean that prostate cancer is ahead, it is still a very uncomfortable problem to deal with.

The cause of an enlarged prostate is almost as mysterious as the common cold. A normal prostate gland is smaller than a quarter, but larger than a peanut. As the prostate grows, it begins to squeeze the urethra causing a large amount of pain. After this occurs, the bladder feels the constant urge to push urine down the narrowed urethra in a forceful manner. The bladder will eventually feel the urge to not completely release itself and it is then that the patient starts to have urinary retention.

In order to prevent the worst from happening, it is important that you spot the signs and symptoms of an enlarged prostate before the condition becomes worse. The first sign is the leakage of urine. If you let the problem continue, eventually you will not be able to completely empty the bladder. This will cause you to have frequent trips to and from the bathroom, especially in the middle of the night. Of course, the last symptom is the inability to urinate. You should not take any of the symptoms lightly and seek medical attention at the sign of the first symptom.

In the worst circumstances, patients who have let the problem persist without getting help for their symptoms have experienced fever, chills, nausea, extreme lower back pain, and blood in the urine. This could cause the patient to be hospitalized until their condition has been rendered stable. This is also one of the main reasons that men are recommended to visit the doctor each year for a prostate check. If the doctor finds that an enlarged prostate is present, there are two certain medications that can be used: Finasteride and Alpha-blockers.

Alpha-blockers can be used to relieve the symptoms of the enlarged prostate by relaxing the muscles in the gland. Doctors will then follow up with Finasteride in order to start shrinking the prostate gland. Mixed with the Alpha-blockers, the condition can be treated appropriately and you will not be in an extreme amount of pain as you were prior to the diagnosis occurring.

If medicine does not cure the problem, there is a surgical procedure that can be done, known as the transurethral resection of the prostate. The procedure consists of scraping tissue from the core of the prostate with the aid of a telescope. The transurethral incision of the prostate has also been considered as an option as well. Unlike the resection, the incision procedure involves a few cuts in the prostate in order relieve the pressure from the urethra. There is no scraping involved which is why it is preferred over the first procedure. If you sense that you might have an enlarged prostate, do not wait about seeking medical attention. The condition will only worsen if you wait.

Semen Leakage