Last week two births made me very happy.
I had blogged about one of the mother before. She was a type 1 Diabetic dependent on Insulin for more than 12 years now. I had blogged about my interview with her to-be-husband in 'Strange Interview' . Also I had posted about the first time she became pregnant in 'Happy News' and about her abortion in 'Sad News'. Now she has delivered a healthy baby. She recently came to me with her husband and the new born and we were all smiling.
Many type 1 Diabetics deliver normal healthy babies but still it is a difficult task. Perinatal mortality and still birth rates are 4 to 5 times of normal pregnancies. That is why we were smiling.
The other birth was the planned conception and delivery of a baby for an HIV positive couple.The couple were my patients for last 5 years.They had asked me the possibility of parenting a child before .Initially I did not encourage them because I did not knew how compliant they will be with the treatment.schedule. They were regular in their follow up and very compliant in taking medicines in time. When they asked me again after 3 years of Anti retro viral therapy I was more positive.I directed them to a suitable center for guidance. After a lot of counseling they were ready to accept the risks involved. They did everything as told and the mother delivered by cesarian section a healthy baby recently.
This proved that nothing is impossible for a 'positive' couple.
Read more about HIV and Pregnancy here
Thursday, July 29, 2010
Saturday, March 27, 2010
Is alcohol good or bad for the Heart?
Is alcohol good or bad for the heart?
I am asked this question many a time in my practice. I usually answer without committing myself. I will reply that in very small amounts it may not be harmful.
I am aware that many studies from the West have shown that mild to moderate intake of alcohol,especially Red wines are somewhat protective to the heart. At the same time I know that many who ask this question are alcoholics who just want a positive response from the doctor to continue to indulge in spirits.
A recent study in Indian males disapproves the theory that alcohol in mild to moderate doses has a protective effect on Heart. In a large retrospective survey based study [being the first of it kind in India looking at this question] conducted in 10 centers showed that alcohol consumption even in low amounts increased coronary artery disease risk. Heart attacks were more seen in those who are regular drinkers, occassional drinkers and even ex-drinkers when compared to life long abstainers.
Why Indian male drinkers are more prone to heart disease than Western drinking population?
The reasons are not clear and even lack of protective effect has to be proved with large prospective randomised controlled studies. But some theories are postulated.
1. Indians are more prone to binge drinking than Caucasian population.Binge drinking can cause Heart attack. In the above study around 55% were binge drinkers.
2. Indians tend to drink more stronger spirits that Caucasians. We drink more whiskey and Rum than wine and beer.
3. There may be genetic/racial difference in effect of alcohol on human body. African American drinkers also do not have that much protective effect on Heart as Caucasians.
So in conclusion let me state that the so called protective effect of alcohol on Heart is under a big question mark especially for Indians.
So please do not drink to live.
I am asked this question many a time in my practice. I usually answer without committing myself. I will reply that in very small amounts it may not be harmful.
I am aware that many studies from the West have shown that mild to moderate intake of alcohol,especially Red wines are somewhat protective to the heart. At the same time I know that many who ask this question are alcoholics who just want a positive response from the doctor to continue to indulge in spirits.
A recent study in Indian males disapproves the theory that alcohol in mild to moderate doses has a protective effect on Heart. In a large retrospective survey based study [being the first of it kind in India looking at this question] conducted in 10 centers showed that alcohol consumption even in low amounts increased coronary artery disease risk. Heart attacks were more seen in those who are regular drinkers, occassional drinkers and even ex-drinkers when compared to life long abstainers.
Why Indian male drinkers are more prone to heart disease than Western drinking population?
The reasons are not clear and even lack of protective effect has to be proved with large prospective randomised controlled studies. But some theories are postulated.
1. Indians are more prone to binge drinking than Caucasian population.Binge drinking can cause Heart attack. In the above study around 55% were binge drinkers.
2. Indians tend to drink more stronger spirits that Caucasians. We drink more whiskey and Rum than wine and beer.
3. There may be genetic/racial difference in effect of alcohol on human body. African American drinkers also do not have that much protective effect on Heart as Caucasians.
So in conclusion let me state that the so called protective effect of alcohol on Heart is under a big question mark especially for Indians.
So please do not drink to live.
Monday, February 8, 2010
Pregnant but HIV positive
The other day I received a call from a Gynaecologist of a nearby Hospital.
'I have an ante-natal [pregnancy] patient who is HIV positive. Should I send her to you now or after delivery?'
The doctor was asking me.
I was happy that she called to inform me, but was disappointed with her question. I had spend some effort as an HIV/AIDS trainer to make doctors aware that pregnant women need anti-HIV treatment to prevent the birth of a 'positive' child. I am not sure whether the above-mentioned doctor attended the training, but I expected her to know the importance of ART [anti HIV treatment] in pregnancy.
'You should send her to me immediately. She needs treatment to prevent the birth of a 'positive' child.' I replied.
The next day the patient came with her husband. I explained the situation to them in detail and asked them to attend the Govt ART center as early as possible. I telephoned the ART Medical Officer about this patient and fixed a suitable time for the patient to reach the center.
That lady will get the treatment, which will greatly reduce the chance of the birth of a 'positive' child from about 40% to less than 5%.
All pregnant females should be tested for HIV and if found positive should immediately receive treatment so that we can eliminate the chance of birth an HIV positive child
'I have an ante-natal [pregnancy] patient who is HIV positive. Should I send her to you now or after delivery?'
The doctor was asking me.
I was happy that she called to inform me, but was disappointed with her question. I had spend some effort as an HIV/AIDS trainer to make doctors aware that pregnant women need anti-HIV treatment to prevent the birth of a 'positive' child. I am not sure whether the above-mentioned doctor attended the training, but I expected her to know the importance of ART [anti HIV treatment] in pregnancy.
'You should send her to me immediately. She needs treatment to prevent the birth of a 'positive' child.' I replied.
The next day the patient came with her husband. I explained the situation to them in detail and asked them to attend the Govt ART center as early as possible. I telephoned the ART Medical Officer about this patient and fixed a suitable time for the patient to reach the center.
That lady will get the treatment, which will greatly reduce the chance of the birth of a 'positive' child from about 40% to less than 5%.
All pregnant females should be tested for HIV and if found positive should immediately receive treatment so that we can eliminate the chance of birth an HIV positive child
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