Over 720,000 cases of infectious disease were reported in the country last month, the commission said. Plague, cholera, hepatitis, syphilis, dysentery and gonorrhoea were the major diseases.

H Patil from Navi Mumbai was diagnosed with penile cancer around six months ago and after trying alternative treatment he opted for surgery. Owing to this delay the tumour had grown to a staggering 12 cm and weighed 4 kg! Penile cancer is usually dreaded for its aggression and high recurrence state.

Last week, docs at Vertex Hospital in Mulund operated upon him and removed the tumour in an eight-hour surgery. The tumour had originally developed on his left thigh but kept on moving upwards and finally grew to cover his entire groin. ‘Penile cancers are uncommon. In his case though, the tumour was big and involved some main blood vessels in his thigh. He had a very high possibility of losing a limb but we managed to avoid it,’ said consultant cancer surgeon Dr Amit Gandhi, adding that a team of experts from the cardiac and plastic surgery specialty were kept as a standby if the surgery took an untoward turn. ‘Patil suffered from the rare form of cancer, sarcomatoid carcinoma of penis, wherein the disease originates from blood vessels.’ In 95% penile cancer cases, the disease grows in skin cells.

Patil’s son-in-law, Shailesh Mhatre, said the symptoms started showing last year. ‘He would suffer excruciating pain in the groin and thigh, spending sleepless nights. He lived with it for around two months before seeing a doctor,’ he said, adding that the diagnosis came as a shock to them. ‘We have never heard of anyone suffering from cancer of the penis.’ Statistics suggest that it’s one of the rarest forms of cancer and is likely to affect 1-2 Indian men in 1 lakh. 

For his product, Manoj last week received Best Invention Awards for 2011 from the National Research Development Corporation, an undertaking of the science and technology ministry, and World Intellectual Property Organisation at a function in New Delhi. A World Health Organisation report says more than 20 million people are infected with HIV and hepatitis every year and 1.3 million of them die. The infection is spreading because around 600 crore used syringes come back in the market without being sterilised.

Read: Together we can end HIV/AIDS

Over a million blood infections occur annually in India leading to HIV and hepatitis, and around 300,000 of the infected people die. Manoj has developed a disposable syringe whose needle and barrel can be disabled quickly after injection. He did this by creating a groove around the hub of the syringe to which the needle is connected.

After use, a slight manual pressure on the groove breaks the needle and the barrel, which is its critical component.  The needle, which is a major disease-transferring component, is disabled as the broken piece of the barrel is tightly packed inside the needle’s plastic connector. ‘It is as simple as breaking a peanut shell and so I have called it Peanut Safe,’ he said. He said the name of the product was derived from a riddle. 

‘Break open a peanut shell, eat the nuts and nobody will use it again. This is true of Peanut Safe syringes too. Open the cover and you will get a syringe which nobody has ever used before. Use it and no one can use it ever again,’ Manoj said.
Manoj has patented the product and plans to start marketing it soon. 

Do you know the common symptoms of HIV/AIDS?

The liver is a highly under-appreciated organ. In the post, I’ll try and explain what the liver does, the diseases which can affect it and end with tips to maintain it in top shape.

Your liver is a one and a half kg organ that sits behind your right rib cage. If you did not have your liver, you would not be able to process nutrients like carbohydrates, proteins, fats, vitamins and minerals from your food. Your body would not get rid of all the toxins and microbes. Your blood would probably never clot! The liver plays a vital role in maintaining the body’s metabolic balance.

As the liver performs a variety of important functions it is extremely vulnerable to a variety of metabolic, toxic, microbial, circulatory and cancerous insults. Awareness of the liver’s functions and what all can cause liver disease can help you take the road to great health.

Let’s start with a few commonly known diseases that can affect the liver:

1. Fatty Liver: This disease was traditionally known to occur in association with excessive alcohol intake but now the non-alcoholic variant is reaching epidemic proportions in the developed countries. Known to occur in association with metabolic syndrome consisting of hypertension, diabetes, obesity and hyperlipidemia this disease occurs because of faulty fat metabolism in the liver. Prevention is the best treatment and if uncontrolled can even end up in liver failure.
2. Viral hepatitis is an infection of the liver that is caused by a group of viruses that have particular affinity for the liver. Out of these, hepatitis A and E are caused by eating food contaminated with the virus. Hepatitis B, C and D are acquired through blood, body fluids and by unprotected sexual contact.
3. Alcoholic hepatitis is inflammation (swelling) of the liver due to ingestion of alcohol.
4. Cirrhosis or scarring of the liver is caused mostly due to alcohol intake, viral infection due to hepatitis B  and C , bile duct disease or iron overload. It is among the top 10 causes of death in the world. The liver ceases to function normally due to irreversible damage. It progresses gradually and can lead to end stage liver disease.
5. Drug induced damage caused due to the various medicines we take and chemicals we are exposed to. As liver is the major detoxifying organ in the body, it is subject to an enormous variety of drugs and chemicals. Always be careful when consuming medicines. Even over the counter medications like paracetamol can cause fulminant liver failure. Never take medications beyond the recommended dosage. It is always better to consult a doctor before taking medications and follow up at the slightest evidence of ill health. Certain herbal medications could also cause damage to the liver and so can medications for tuberculosis.
6. Liver cancer can be caused by many factors including viral infections (hepatitis B and C), chronic alcoholism, certain food contaminants, genetic factors, cirrhosis of the liver.

What are the symptoms of liver disease?

 This depends on the onset and rapidity of progression of liver damage.

In case of acute liver damage (due to drugs, toxins, viral hepatitis A, B or E), there may be fever with yellowish discoloration of sclera (the white of the eye), skin and urine. In most cases this may be self-limiting. In a small percentage, this may progress to fulminant liver failure leading to coma, altered blood clotting, kidney failure, secondary infections and may even require liver transplantation.

In chronic liver damage (due to hepatitis B, C or alcohol), the symptoms would be more gradual in onset:

• Jaundice or yellowish discoloration of skin and the white of the eye.
• Swelling especially in the legs and feet due to low protein levels.
• Enlargement of breasts known as gynecomastia (in a male).
• Reddish spider like discolorations (spider nevi) beneath the skin especially over the chest.
• Accumulation of fluid (ascites) in the abdomen giving it a protruded appearance.
• Problems with clotting of blood
• Vomiting of blood or blood in stools
• Altered senses with change in behavior, confusion, forgetfulness and other symptoms related to the brain also known as hepatic encephalopathy.
• Gradual worsening of kidney function

The above symptoms are not comprehensive and it is best to consult a doctor at the earliest onset of any of the above.

 Tips for a healthy liver:

Diet and Alcohol: A balanced diet with low fat content would be well suited to prevent fatty liver. Alcohol is best avoided.

Exercise: Plays a role in controlling cholesterol and in the metabolism of fat thus indirectly protecting the liver.

Vaccination: Hepatitis B is preventable by vaccination. Three shots of the hepatitis B vaccine taken over three months can provide long term protection against the dreaded disease.

Hygienic food and drinking water: Hepatitis A and E are known to spread via the oral route. Think twice before having road side delicacies! Boil the water that you intend to drink. It is the best way to prevent communicable diseases.

Avoid self-medication: Various drugs can damage the liver if taken indiscriminately

Regular check-ups: Once diagnosed with liver disease, be regular in follow ups with the doctor. Reversible damage can become irreversible if neglected.

 This World Liver day, let’s strive not to abuse our liver, one of the most useful organs that we have. Let’s treat it with the love and respect it deserves. 

Marc Pellegrini, Greg Ebert and colleagues from the Walter and Eliza Hall Institute of Medical Research’s infection and immunity division, Australia, with collaborators from the University of Toronto, Canada, led the research, the journal Nature Immunology reported.

Infectious disease specialist Pellegrini said that Arih2 is found in dendritic cells, the sentinels of the immune system that play an essential role in raising the alarm about the presence of foreign invaders in the body, according to a Walter Eliza Institute statement.

‘Arih2 is responsible for the most fundamental and important decision that the immune system has to make – whether the immune response should be initiated and progressed or whether it should be switched off to avoid the development of chronic inflammation or autoimmunity,’ Pellegrini said. ‘If the wrong decision is made, the organism will either succumb to the infection, or succumb to auto-immunity,’ he added. 

‘During evolution, some organisms have evolved ways of exhausting our immune system to the point where the immune system just switches off, and this is what happens in HIV, Hepatitis B and tuberculosis,’ said Pellegrini.

‘These organisms counter the immune response – exhausting T cells which are stimulated over and over again by the infection and becoming exhausted or paralysed,’ he said. ‘With this current discovery, what we should be able to do is circumvent these mechanisms and reinvigorate the immune response temporarily to boost the immune system and help clear these infections,’ he added.

Ebert said the research team was now looking at the effect on the immune response of switching off Arih2 for short periods of time during chronic infections.

‘We are investigating how manipulating Arih2 and associated pathways promotes immunity in chronic overwhelming infections, where we know the immune response is inadequate,’ Ebert said.

According to Pellegrini, it would take many years to translate the discovery to a drug that could be used in humans. ‘We are very excited about this discovery,’ he concluded.

 Source: IANS

The district health officer, Bangalore Urban, has been directed by BK Eshwarappa, Assistant Director of health and family welfare, to conduct an inquiry and submit a report. Health minister Aravind Limbavali had directed the department to look into the complaint.

The complainant had been to the hospital in February to undergo dialysis for his renal problem. His blood samples taken before admitting him was negative for HCV RNA PCR.  The test was conducted at Reliance Life Sciences, Mumbai.

After a few months of dialysis at the hospital he was shocked to know that his blood tested on August 8 at Ananya Hospital had tested positive for Hepatitis C virus. ‘Later I got tested at Religare SRL Diagnostics and Anand Diagnostic Laboratory. Both the tests confirmed presence of Hepatitis C virus. The HCV Viral load was 5,43,000. After coming to know about my health condition, my mother died. I have lost my health and mother. I spent a few lakhs of rupees for the treatment and dialysis. Now I have no money even to pay for dialysis,’ the complainant told a leading daily broadsheet newspaper.

Researchers found that the human monoclonal antibody targeting the virus protected chimpanzees from HCV infection in a dose-dependent manner in a study conducted at Texas Biomed’s Southwest National Primate Research Center in San Antonio. Chimpanzees are the only species other than humans that can be infected by the hepatitis C virus and therefore the results from this study were critical in the development of the monoclonal antibody.

The therapy has been developed by MassBiologics of the University of Massachusetts Medical School (UMMS) and tested in an animal model at the Texas Biomedical Research Institute.

Researchers had previously demonstrated that the monoclonal antibody, called HCV1, blocks HCV from infecting liver cells in laboratory tissue culture. “This is an important proof-of-concept study demonstrating a high dose of neutralizing antibody can protect the liver from HCV infection using monoclonal antibodies in a study that was designed to mimic the transplantation setting,” said study co-author Robert E Lanford, of Texas Biomed.

“One can envision improving on these results with a cocktail of antibodies or by using this antibody with some of the newer antivirals currently in clinical trials. Infection of the new donor liver by residual virus in the patient is one of the major obstacles preventing a full recovery in these patients,” Lanford said.

MassBiologics has been pursuing the development of HCV1 as a therapy for patients with end-stage liver disease undergoing liver transplantation as a result of HCV infection. HCV1 is a monoclonal antibody that binds to the surface of the HCV virus and blocks the ability of the virus to enter liver cells. Scientists from MassBiologics; Texas Biomed; the National Institutes of Health (NIH) and Merck Research Laboratories, and funded by MassBiologics and NIH collaborated in the work.

The findings appeared in the recent issue of PLOS Pathogens.

• Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease.
• The virus is transmitted through contact with the blood or other body fluids of an infected person.
• Two billion people worldwide have been infected with the virus and about 600 000 people die every year due to the consequences of hepatitis B.
• The hepatitis B virus is 50 to 100 times more infectious than HIV.
• Hepatitis B is an important occupational hazard for health workers.
• Hepatitis B is preventable with the currently available safe and effective vaccine.

Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus. It is a major global health problem and the most serious type of viral hepatitis. It can cause chronic liver disease and puts people at high risk of death from cirrhosis of the liver and liver cancer.

Worldwide, an estimated two billion people have been infected with the hepatitis B virus and more than 240 million have chronic (long-term) liver infections. About 600 000 people die every year due to the acute or chronic consequences of hepatitis B.

A vaccine against hepatitis B has been available since 1982. Hepatitis B vaccine is 95% effective in preventing infection and its chronic consequences, and is the first vaccine against a major human cancer.

Geographical distribution

Hepatitis B virus can cause an acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain. People can Hepatitis B is endemic in China and other parts of Asia. Most people in this region become infected with the hepatitis B virus during childhood and 8–10% of the adult population is chronically infected. Liver cancer caused by hepatitis B is among the first three causes of death from cancer in men, and a major cause of cancer in women in this region.

High rates of chronic infections are also found in the Amazon and the southern parts of eastern and central Europe. In the Middle East and Indian subcontinent, an estimated 2–5% of the general population is chronically infected. Less than 1% of the population in western Europe and North America is chronically infected.

Transmission

Hepatitis B virus is transmitted between people by direct blood-to-blood contact or semen and vaginal fluid of an infected person. Modes of transmission are the same as those for the human immunodeficiency virus (HIV), but the hepatitis B virus is 50 to 100 times more infectious. Unlike HIV, the hepatitis B virus can survive outside the body for at least seven days. During this time, the virus can still cause infection if it enters the body of a person who is not protected by the vaccine.

In developing countries, common modes of transmission are:

• perinatal (from mother to baby at birth)
• early childhood infections (inapparent infection through close interpersonal contact with infected household contacts)
• unsafe injection practices
• unsafe blood transfusions
• unprotected sexual contact.

In many developed countries (e.g. those in western Europe and North America), patterns of transmission are different from those in developing countries. The majority of infections in developed countries are transmitted during young adulthood by sexual activity and injecting drug use. Hepatitis B is a major infectious occupational hazard of health workers.

The hepatitis B virus is not spread by contaminated food or water, and cannot be spread casually in the workplace.

The incubation period of the hepatitis B virus is 90 days on average, but can vary from 30 to 180 days. The virus may be detected 30 to 60 days after infection and persists for variable periods of time.

Symptoms

Most people do not experience any symptoms during the acute infection phase. However, some people have acute illness with symptoms that last several weeks, including yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

In some people, the hepatitis B virus can also cause a chronic liver infection that can later develop into cirrhosis of the liver or liver cancer.

Who is at risk for chronic disease?

The likelihood that infection with the hepatitis B virus becomes chronic depends upon the age at which a person becomes infected. Young children who become infected with the hepatitis B virus are the most likely to develop chronic infections:

• 90% of infants infected during the first year of life develop chronic infections;
• 30–50% of children infected between one to four years of age develop chronic infections.

In adults:

• 25% of adults who become chronically infected during childhood die from hepatitis B-related liver cancer or cirrhosis;
• 90% of healthy adults who are infected with the hepatitis B virus will recover and be completely rid of the virus within six months.

Diagnosis

A number of blood tests are available to diagnose and monitor people with hepatitis B. They can be used to distinguish acute and chronic infections.

Laboratory diagnosis of hepatitis B infection centres on the detection of the hepatitis B surface antigen HBsAg. A positive test for the hepatitis B surface antigen (HBsAg) indicates that the person has an active infection (either acute or chronic). WHO recommends that all blood donations are tested for this marker to avoid transmission to recipients.

Other commonly used tests include the following:

• testing for antibodies to the hepatitis B surface antigen – a positive test indicates that the person has either recovered from an acute infection and cleared the virus, or has received a hepatitis B vaccine. The person is immune to future hepatitis B infection and is no longer contagious.
• testing for antibodies to the hepatitis B core antigen – a positive test indicates that the person has had a recent infection or an infection in the past. Combined with a positive test for the hepatitis B surface antigen, a positive test usually indicates a chronic infection.

Treatment

There is no specific treatment for acute hepatitis B. Care is aimed at maintaining comfort and adequate nutritional balance, including replacement of fluids that are lost from vomiting and diarrhoea.

Some people with chronic hepatitis B can be treated with drugs, including interferon and antiviral agents. Treatment can cost thousands of dollars per year and is not available to most people in developing countries.

Liver cancer is almost always fatal and often develops in people at an age when they are most productive and have family responsibilities. In developing countries, most people with liver cancer die within months of diagnosis. In high-income countries, surgery and chemotherapy can prolong life for up to a few years.

People with cirrhosis are sometimes given liver transplants, with varying success.

Prevention

The hepatitis B vaccine is the mainstay of hepatitis B prevention. WHO recommends that all infants receive the hepatitis B vaccine.

The vaccine can be given as either three or four separate doses, as part of existing routine immunization schedules. In areas where mother-to-infant spread of the hepatitis B virus is common, the first dose of vaccine should be given as soon as possible after birth (i.e. within 24 hours).

The complete vaccine series induces protective antibody levels in more than 95% of infants, children and young adults. Protection lasts at least 20 years and is possibly lifelong.

All children and adolescents younger than 18 years old and not previously vaccinated should receive the vaccine. People in high risk groups should also be vaccinated, including:

• people with high-risk sexual behaviour
• partners and household contacts of infected people
• injecting drug users
• people who frequently require blood or blood products
• recipients of solid organ transplantation
• people at occupational risk of hepatitis B virus infection, including health-care workers
• travellers to countries with high rates of hepatitis B.

The vaccine has an outstanding record of safety and effectiveness. Since 1982, over one billion doses of hepatitis B vaccine have been used worldwide. In many countries, where 8–15% of children used to become chronically infected with the hepatitis B virus, vaccination has reduced the rate of chronic infection to less than 1% among immunized children.

As of July 2011, 179 countries vaccinate infants against hepatitis B as part of their vaccination schedules – a major increase compared with 31 countries in 1992, the year that the World Health Assembly passed a resolution to recommend global vaccination against hepatitis B.

WHO response

WHO is working in the following areas to prevent and control viral hepatitis:

• raising awareness, promoting partnerships and mobilizing resources;
• evidence-based policy and data for action;
• prevention of transmission; and
• screening, care and treatment.

Source: WHO

WHO has identified four key actions countries can take to prevent viral hepatitis B and C among people who inject drugs. Of the estimated 16 million people who inject drugs worldwide, it is estimated that 10 million are infected with hepatitis C. An additional 1.2 million are infected with hepatitis B.

Risk from shared syringes and needles

Many drug users are unable to obtain sterile syringes: in some countries it is illegal to distribute or possess syringes for non-medical purposes. The risk of contracting hepatitis and HIV infection occurs when people share syringes and needles. Used injection equipment retains traces of blood. If that blood contains HIV, hepatitis or another type of virus, the next person using the syringe could be infected.

Reducing the risk of HIV and hepatitis infections

A number of countries have established programmes to reduce HIV infections among people who inject drugs.

“Most of the interventions that prevent HIV transmission between people who inject drugs are virtually the same as those for preventing viral hepatitis B and C,” says Dr Gottfried Hirnschall, Director of the WHO Department for HIV/AIDS. “So it makes sense to reduce the risk of both infections by linking viral hepatitis prevention with HIV prevention, care and treatment.”

Hepatitis is an inflammation of the liver. Together, hepatitis B and C are the most common cause of cirrhosis and cancer of the liver. Viral hepatitis progresses faster among people living with HIV because their immune systems are weaker, and causes more severe liver-related health problems than it does among people without HIV infection.

WHO recommendations

WHO recommends:

• Implementing and scaling up HIV prevention programmes such as clean needle and syringe programmes and opioid substitution therapy (treatment of opioid dependence with methadone or buprenophine).
• Offering people who inject drugs the rapid hepatitis B vaccination regimen (completed in 3 weeks instead of 6 months), along with incentives to increase uptake and completion of the vaccine schedule. More than 175 countries now include a cheap, safe and effective vaccine against hepatitis B in their national infant immunization schedules. WHO has already recommended countries provide catch-up vaccination for people at increased risk of hepatitis infection, including injection drug users, but this does still not occur systematically at present. There is no vaccine against hepatitis C.
• Using “low dead space” syringes that retain less blood after use reduces the survival of HIV and hepatitis C in the blood that remains in the syringe. This potentially reduces the risk of transmission if injecting equipment is shared.
• Involving drug users in hepatitis prevention programmes to maximize their impact.

Public health approach

“Countries that have adopted a public health approach to injecting drug use and HIV have been the most successful in turning round their HIV epidemics. We need to do the same for hepatitis,” says Dr Ying-Ru Lo of the HIV Department at WHO.

The new evidence-based guidelines are designed for use by national public health officials, managers of HIV, drug dependence and harm reduction programmes, civil society and health workers in low- and middle-income countries. They are intended to be tailored and implemented according to local situations and needs.

Rajesh Khanna, India’s first superstar passed away recently. A close friend of his said that he died of liver infection. Kaka’s battle with alcohol is well documented. Though no one wants to say it out loud, it was his drinking habit that probably hastened his early demise. So why is alcohol dangerous to the liver? For that we need to understand how important an organ the liver is – click here to read more about the importance of the liver. 

What does the liver do?

The liver serves so many different functions that till now no single artificial organ or device that can perform all its functions. The liver processes nutrients from your food, gets rid of toxins and even helps your blood clot. The liver is also responsible for providing glucose so that all your bodily functions can take place properly.

What happens when you drink alcohol?

When you drink booze, the liver works overtime to convert ethanol into acetic acid which is then converted into a less toxic form like acetate which we eventually release as urine. However, this means that the liver is diverted from its primary functions like providing glucose. The effects of hangovers like nausea, vomiting, headaches and fatigue is due to this – the lack of glucose or hypoglycaemia. Glucose is also very important for our brain functions and this explains why we are lethargic and have slower cognitive function during hangovers. And these are only the short term effects.

Long term effects of alcohol consumption on liver

The long term effects are far worse. It takes a toll on all liver functions. Along with fatty foods excessive alcohol consumption is one of the primary causes of all liver diseases. The fat deposited due to absorption of alcohol leads to fatty liver disease. It also causes inflammation of the liver which leads to alcoholic hepatitis. Hepatitis is inflammation of the liver and alcoholic hepatitis is one of the first stages of alcohol liver disease and may progress to fibrosis (thickening of connecting tissues) or cirrhosis (a chronic liver disease marked by cell degeneration, inflammation and advanced fibrosis). Though the liver is a remarkably resilient organ (it can function normally even after losing 70% of its mass), cirrhosis of liver leads to its complete shutdown. It prevents the free flow of blood leading to accumulation of waste and toxins in the body. The symptoms of cirrhosis (jaundice, fluid build-up, itching, nosebleeds, red spots, lowered immunity) may occur either simultaneously or gradually. The symptoms of liver cirrhosis are only visible when it has progressed to an advanced stage. By that time very little can be done for the patient.

So think what the alcohol is going to do to your body before you have your next drink.