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Health care workers & HIV Prevention
Related to country: Pakistan

Translations available in: English (original) | French | Spanish | Italian | German | Portuguese | Swedish | Russian | Dutch | Arabic

Occupational exposure to HIV
In many countries for many years health care workers have become infected with HIV as a result of their work. The main cause of infection in occupational settings is exposure to HIV-infected blood via a percutaneous injury (i.e. from needles, instruments, bites which break the skin, etc.). The average risk for HIV transmission after such exposure to infected blood is low - about 3 per 1,000 injuries. Nevertheless, this is still understandably an area of considerable concern for many health care workers.

Certain specific factors may mean a percutaneous injury carries a higher risk, for example:

A deep injury
Terminal HIV-related illness in the source patient
Visible blood on the device which caused the injury
Injury with a needle which had been placed in a source patient's artery or vein
If percutaneous exposure occurs then the site of exposure should be washed liberally with soap and water but without scrubbing. Bleeding should be encouraged by pressing gently around the site of the injury (but taking care not to press immediately on the injury site). It is best to do this under a running water tap.

There are a small number of instances when HIV has been acquired through contact with non-intact skin or mucous membranes. Research suggests that the risk of HIV infection after mucous membrane exposure e.g. splashes of infected blood in the eye, is less than 1 in 1000. If mucocutaneous exposure occurs then the affected area should be washed thoroughly with soap and water. If the eye is affected, it should be irrigated thoroughly.

If intact skin is exposed to HIV infected blood then there is no risk of HIV transmission.

Post Exposure Prophylaxis
Research evidence seems to suggest that the use of anti-HIV drugs in combination with other anti-HIV drugs if given soon after an injury can reduce the rate of transmission. Such treatment is referred to as Post Exposure Prophylaxis (PEP). PEP is recommended for health care workers if they have had a significant occupational exposure to blood or another high risk body fluid which is likely to be infected with HIV. It is recommended that PEP should be commenced as soon as possible after exposure and ideally within the hour.

Although exposure through needle stick injuries can usually be avoided by following good working practices, health care workers should consider the implications of taking PEP. This will help them to make a swift decision in the event of an accident where an injury occurs.

What are Universal Precautions
Employing universal precautions means taking precautions with everybody. If precautions are taken with everyone, health care workers do not have to make assumptions about people's lifestyles and risk of infection. Health care workers should have the right to be able to protect them against infection, whether it is HIV, Hepatitis or anything else.

The following universal infection control precautions are advised by the World Health Organization3 to help protect health care workers from blood-borne infections including HIV:

Wash hands with soap and water before and after procedures.
Use protective barriers such as gloves, gowns aprons, masks, goggles for direct contact with blood and other body fluids.
Disinfect instruments and other contaminated equipment.
Handle properly soiled linen. (Soiled linen should be handled as little as possible. Gloves and leak proof bags should be used if necessary. Cleaning should occur outside patient areas, using detergent and hot water.)
Use of new, single-use disposable injection equipment for all injections is highly recommended. Sterilizable injection should only be considered if single use equipment is not available and if the sterility can be documented with Time, Steam and Temperature indicators.
Discard contaminated sharps immediately and without recapping in puncture and liquid proof containers that are closed, sealed and destroyed before completely full.
Document the quality of the sterilization for all medical equipment used for percutaneous procedures.

January 28, 2008 | 12:15 AM Comments  1 comments

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Stress
Related to country: Pakistan

Translations available in: English (original) | French | Spanish | Italian | German | Portuguese | Swedish | Russian | Dutch | Arabic

Stress is the “wear and tear" our bodies experience as we adjust to our continually changing environment; it has physical and emotional effects on us and can create positive or negative feelings. As a positive influence, stress can help compel us to action; it can result in a new awareness and an exciting new perspective. As a negative influence, it can result in feelings of distrust, rejection, anger, and depression, which in turn can lead to health problems such as headaches, upset stomach, rashes, insomnia, ulcers, high blood pressure, heart disease, and stroke. With the death of a loved one, the birth of a child, a job promotion, or a new relationship, we experience stress as we re-adjust our lives. In so adjusting to different circumstances, stress will help or hinder us depending on how we react to it. How Can I Eliminate Stress from My Life? As we have seen, positive stress adds anticipation and excitement to life, and we all thrive under a certain amount of stress. Deadlines, competitions, confrontations, and even our frustrations and sorrows add depth and enrichment to our lives. Our goal is not to eliminate stress but to learn how to manage it and how to use it to help us.



Insufficient stress acts as a depressant and may leave us feeling bored or dejected; on the other hand, excessive stress may leave us feeling “tied up in knots." What we need to do is find the optimal level of stress, which will individually motivate but not overwhelm each of us. How Can I Tell What is Optimal Stress for Me There is no single level of stress that is optimal for all people. We are all individual creatures with unique requirements. As such, what is distressing to one may be a joy to another. And even when we agree that a particular event is distressing, we are likely to differ in our physiological and psychological responses to it. The person who loves to arbitrate disputes and moves from job site to job site would be stressed in a job, which was stable and routine, whereas the person who thrives under stable conditions would very likely be stressed on a job where duties were highly varied. Also, our personal stress requirements and the amount which we can tolerate before we become distressed changes with our ages. It has been found that most illness is related to unrelieved stress. If you are experiencing stress symptoms, you have gone beyond your optimal stress level; you need to reduce the stress in your life and/or improve your ability to manage it.

How Can I Manage Stress Better Identifying unrelieved stress and being aware of its effect on our lives is not sufficient for reducing its harmful effects. Just as there are many sources of stress, there are many possibilities for its management. However, all require effort toward change: changing the source of stress and/or changing your reaction to it. How do you proceed?



1. Become aware of your stressors and your emotional and Notice your distress. Don't ignore it. Don't gloss over physical reactions. Determine what events distress you. What are you telling your problems. Determine how your body responds to yourself about meaning of these events The stress. Do you become nervous or physically upset? If so, in what specific Can you change your stressors byways



2. Recognize what you can change. Can you reduce their intensity avoiding or eliminating them completely Can(manage them over a period of time instead of on a daily or weekly basis) you shorten your exposure to stress (take a break, leave the physical premises) Can you devote the time and energy necessary to making a change (goal setting, time management techniques, and delayed gratification strategies may be helpful The here)



3. Reduce the intensity of your emotional reactions to stress. Stress reaction is triggered by your perception of danger...physical danger and/or emotional danger. Are you viewing your stressors in exaggerated terms Are you and/or taking a difficult situation and making it a disaster? Are you overreacting and viewing things as expecting to please everyone? Do you feel you must always prevail in every absolutely critical and urgent? Work at adopting more moderate views; try to see the stress as situation? Try to something you can cope with rather than something that overpowers you. Temper your excess emotions. Put the situation in perspective. Do not labour on the negative aspects and the “what if's.

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4. Learn to moderate your physical Slow, deep breathing will bring your heart rate and reactions to stress. Relaxation techniques can reduce muscle tension. respiration back to normal. Electronic biofeedback can help you gain voluntary control over such things as Medications, when prescribed muscle tension, heart rate, and blood pressure. by a physician, can help in the short term in moderating your physical reactions. However, they alone are not the answer. Learning to moderate these reactions on your own is a preferable long-term solution

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5. Build your physical Exercise for cardiovascular fitness three to four times a week reserves. (Moderate, prolonged rhythmic exercise is best, such as walking, swimming, Maintain your• Eat well-balanced, nutritious meals. •cycling, or jogging). Mix• Avoid nicotine, excessive caffeine, and other stimulants. •ideal weight. Get enough sleep. Be leisure with work. Take breaks and get away when you can. as consistent with your sleep schedule as possible.

6. Maintain your emotional • Develop some mutually supportive friendships/ relationships. •Reserves. Pursue realistic goals, which are meaningful to you, rather than goals others expect some frustrations, failures, and have for you that you do not share. Always be kind and gentle with yourself--be a friend to yourself sorrows.