India heading towards AIDS epidemic
Dr Nidhi Chaudhary
AT the time of detection of the first case of HIV in India in 1986, AIDS was presumed to be a foreign disease limited to the Sub-Saharan region. However, since the HIV positive cases have taken a giant leap forward, resulting in an estimated 3.82 million HIV infections in the adult population (15-49 years) in India during 2002. There are nearly 40 million people living with AIDS in the world at present. Out of these, five million have been infected this year, including 700,000 children.

• Social stigma attached to a disease

Knee arthritis: early detection can make life less painful
by Dr Ravinder Chadha
Osteoarthritis of the knee is a very common condition afflicting the elderly, but thinking of it as inevitable leads to a lot of suffering. If not managed early and properly, it leads to not only the curtailment of routine activities but also much agony, disability and depression. It also burdens society with a huge expenditure every year. Therefore, it is important to understand that this condition can be overcome if treated properly at the initial stage.

Joint growth gives hope to arthritis sufferers
LONDON: Scientists have turned bone marrow cells into a ball of bone and cartilage of the kind found in the joint of a human jaw, they report today. This latest step in stem cell technology could mean that hip and knee replacements of the future could be made with a patient's own tissue, rather than metal and polymers.

New cancer detection technique
WASHINGTON: A simple and very accurate technique that takes just 15 minutes may be all it takes to find tiny cancers, stones and other problems in the kidneys, bladders and urinary tracts of high-risk patients. This will potentially save the patients from many additional tests, and from delayed detection and treatment.

India heading towards AIDS epidemic
Dr Nidhi Chaudhary

AT the time of detection of the first case of HIV in India in 1986, AIDS was presumed to be a foreign disease limited to the Sub-Saharan region. However, since the HIV positive cases have taken a giant leap forward, resulting in an estimated 3.82 million HIV infections in the adult population (15-49 years) in India during 2002. There are nearly 40 million people living with AIDS in the world at present. Out of these, five million have been infected this year, including 700,000 children.

Nearly 85% of the cases in India have been caused by sexual transmission. The disease is hitting the young people the hardest, with 50% of the new cases being reported in the age group of 15-24 years. Contrary to the earlier belief that AIDS is afflicting mainly high-risk individuals like commercial sex workers, truck drivers and health professionals, more women are getting infected and consequently are transmitting the infection to their newborn. Also in our society, the infected women experience greater levels of discrimination than men, thereby decreasing their chance of accessing treatment opportunities.

In India, initially the disease was reported from metropolitan cities like Mumbai and Chennai, the hub of commercial sex workers. With the passage of time, it has taken roots in all states, cutting across all religions and communities. At the rate with which the infection is rising in India, it may lead to an epidemic. For long it has been thought that rural people guided by their moral values are at a lower risk for STDs/HIV. Perhaps, this false sense of assurance coupled with the religious and cultural sentiments and ignorance of the rural community may lead to a devastating situation in future if lessons are not learnt in time from African experience. HIV is rapidly spreading to rural areas through migrant workers and truck drivers. Various surveys show that 5 to 10 per cent of the truck drivers in India are infected with HIV.

Nearly 54% boys and 70% girls out of 700 adolescents interviewed in the rural areas of Panchkula district recently did not know about the modes of spread of HIV/AIDS. With delayed marriages and greater exposure to the media, the period of vulnerability for the adolescent increases, resulting in an earlier sexual debut. This along with inaccessibility or lack of knowledge about condom usage augments the risk of STD/HIV for the youth. It is now time to wake up and let not history repeat itself as has been the fate of Africa.

The writer is associated with the Society for Women and Children’s Health (SWACH), Panchkula.

Social stigma attached to a disease

NEW DELHI: There wasn't much to cheer in India on the occasion of World AIDS Day, which fells on December 1.

Despite prevention and treatment efforts to bring the spread of this debilitating disease under control, not much success has been achieved so far.

The prevention efforts notwithstanding, the other problem that is gaining ground is the social stigma and ostracisation attached to the disease.

Reports of such apathetic behaviour have been received from places like Andhra Pradesh, where an HIV/AIDS-afflicted woman was left to die on the streets.

Parents of two children in Kerala were asked to take them out of school, but they were readmitted later after several appeals were made to the higher authorities. — ANI

Knee arthritis: early detection can make life less painful
by Dr Ravinder Chadha

Osteoarthritis of the knee is a very common condition afflicting the elderly, but thinking of it as inevitable leads to a lot of suffering. If not managed early and properly, it leads to not only the curtailment of routine activities but also much agony, disability and depression. It also burdens society with a huge expenditure every year. Therefore, it is important to understand that this condition can be overcome if treated properly at the initial stage.

Diagnosis and evaluation

The insidious onset with gradual progression of pain is usually the initial symptom of osteoarthritis, although some may be asymptomatic. The pain may be localised to the knee or radiate widely. It is often aggravated by weight-bearing or increased use. Patients may also complain of anterior knee pain that worsens with prolonged sitting, climbing stairs, jumping, squatting or kneeling. Initially, pain reduces with rest, but as disease progress pain may occur both during rest and at night.

Other symptoms include stiffness and limitation of functions, with or without a sensation of crepitus. Patients also describe the "gel phenomenon" — stiffness — with rest and inactivity that resolves within a few minutes of activity.

Treatment

There is no cure for arthritis, but physical therapy can make living with arthritis easier and less painful. Activities such as deep squatting, kneeling, and stair climbing should be avoided.

• Treatment of early osteoarthritis of the knee may be very effective if conscientiously carried out. Weight loss should be strongly encouraged but not expected immediately.
• Modalities other than heat or cold have not been shown to be of help. If the patient starts with extremely weak muscles, electric stimulation may be used to begin the process.
• Hyaluronic acid injections into the knee are of limited value. They appear to work best before there is bone-on-bone crepitus. Similarly, intra-articular steroid injections have a very temporary and limited role.
• A cane in the opposite hand greatly decreases the stress on the arthritic joint, but for cosmetic considerations many "young" or female arthritics will not use the cane.

The writer is a former doctor/physiotherapist of the Indian cricket team.

Joint growth gives hope to arthritis sufferers

LONDON: Scientists have turned bone marrow cells into a ball of bone and cartilage of the kind found in the joint of a human jaw, they report today. This latest step in stem cell technology could mean that hip and knee replacements of the future could be made with a patient's own tissue, rather than metal and polymers.

The experiment, published in next month's Journal of Dental Research, is based on two medical advances: stem cell therapy and tissue engineering. Stem cells are the natural sources of new blood, fresh skin, repaired bone, and so on. Tissue engineers try to grow replacement heart, liver, skin or other cells in laboratory dishes. But stem cells could be a kind of "magic tablecloth" for tomorrow's tissue engineers.

In the latest advance, Jeremy Mao and a colleague at the University of Illinois in Chicago took adult stem cells from the marrow of rats. The type of stem cells they took can, under certain conditions, become a number of things: tendon, skeletal muscle, teeth, ligament, cartilage and bone. The team used chemical triggers and natural growth factors to persuade their sample cells to develop into sources of cartilage and bone. They formed the growing cells into two layers, and shaped them in a mould taken from the jaw joint of a human corpse.

Several weeks later they had what looked like a living jaw joint, with a layer of cartilage wrapped around bone tissue. Tests confirmed that each layer of tissue mimicked the stuff grown naturally in a healthy mammal. — The Guardian

New cancer detection technique

WASHINGTON: A simple and very accurate technique that takes just 15 minutes may be all it takes to find tiny cancers, stones and other problems in the kidneys, bladders and urinary tracts of high-risk patients. This will potentially save the patients from many additional tests, and from delayed detection and treatment.

The detailed imaging scan can be done using modern CT (computed tomography) machines now found in many large hospitals.

University of Michigan Health System radiologists will present these findings on multi-detector CT urography or MDCTU at the annual meeting of the Radiological Society of North America.

As one of the most experienced MDCTU teams, they hope to show colleagues that the technique is extremely sensitive, very accurate and relatively easy to adopt. — ANI