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INTRODUCTION: Health Care Workers (HCWs) are at risk of occupational transmission of HIV, Hepatitis B and Hepatitis C, which can be minimized by following guidelines for standard precautions as well as taking Post Exposure Prophylaxis (PEP) measures. There are limited studies from India documenting details of PEP for HIV and Hepatitis B. AIM: We aimed to study the efficacy, tolerance, details of PEP regimens used among HCWs exposed to HIV and Hepatitis B as well as vaccination status and (Anti-Hepatitis B Surface Antigen) anti-HBS Antibody Titre Level Among HCWs exposed Hepatitis B. STUDY DESIGN: This retrospective observational study was done at a rural based tertiary care teaching centre of Western India. MATERIALS AND METHODS: Hospital Infection Control Committee of our institute was maintaining a record of all reported incidences of HIV and Hepatitis B positive exposures since 2003. We analysed reported incidences of exposures to HIV and Hepatitis B positive source occurred during the period of January 2003 to December 2015. RESULTS: Of the total 96 exposures, 48 were to HIV and 48 were to Hepatitis B. Of the 48 exposures to HIV, PEP was warranted in 39. Of 39 exposures, only 14 (35.9%) received PEP within two hours. Basic regimen was used in 22 and expanded in 17 exposures. Only 12 (31.6%) reported side effects to PEP. Zidovudine based regimen was less well tolerated. All side effects were reported by female HCWs only. Of the 48 exposed to Hepatitis B, 33 (68.6%) were completely vaccinated. Out of 33, titre result was not available for eight. Three (12.0%) of remaining 25 were having low titre (<10mIU/ml) of anti-HBS antibody. Five of six with incomplete vaccination status demonstrated anti HBS antibody titre > 100mIU/ml. Of the 48, in 17 (35.4%) incidences no action was required; 23 (47.9%) were managed with booster dose of Hepatitis B vaccine and eight (16.7%) with Hepatitis B immunoglobulin. No cases of sero-conversion was reported either for HIV or Hepatitis B from available data. CONCLUSION: Inspite of high incidences of exposures to HIV or Hepatitis B positive source, good efficacy of PEP was observed with no sero-conversion. PEP for HIV was well tolerated; female HCWs were less tolerant. Study emphasized the need for creating awareness about timely reporting of incidence, achieving maximum vaccination against Hepatitis B for all HCWs and need for anti-HBS antibody titre.
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INTRODUCTION: Prevalence of Vitamin B12 deficiency has increased in community in recent time. Possibility is raised for new and yet unidentified factors being associated with this increased prevalence. One of these factors frequently questioned is use of Reverse Osmosis (RO) processed water for drinking. AIM: We aimed to study association of use of RO processed water for drinking with Vitamin B12 deficiency. MATERIALS AND METHODS: This cross-sectional study was done at tertiary care centre of Western India. Total 250 participants were recruited after excluding those participants with known factors responsible for Vitamin B12 deficiency. Information about gender, type of diet, milk intake and duration, dairy product intake, use of RO water and Vitamin B12 level was collected. RESULTS: Total 70 (28%) participants out of 250 were having Vitamin B12 deficiency. Forty (50.6%) of 79 participants using RO water were Vitamin B12 deficient against 30 (17.5%) of 171 using other sources. Logistic regression analysis showed independent association between use of RO water and Vitamin B12 deficiency. Although association of male gender, milk quantity of less than 100 ml per day and duration of RO water intake with occurrence of Vitamin B12 deficiency was found statistically significant in univariate analysis, logistic regression analysis did not show significant association. CONCLUSION: Use of RO processed drinking water was associated with Vitamin B12 deficiency. This being cross- sectional study, further longitudinal studies with large sample size and taking confounding factors into consideration, are required to establish this association.