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Global Update

Indian Pediatrics 2005; 42:1064

News in Brief


Infected syringes

An outbreak of unusual fungal meningitis in Sri Lanka recently, has alerted health authorities worldwide. Patient profile was diverse from post-natal mothers, pediatric patients to adults on chemotherapy. It was soon clear that the common thread for all patients was a recent lumbar puncture. Authorities cracked down on syringes, which were found to be infected with aspergillus and candida spores. Some syringes were got through international tenders while others had been received as donation. Investigations are on to determine whether the contamination was during manufacture, transit or storage. Health authorities have asked doctors to "avoid or minimise" spinal anaesthesia, lumbar puncture, myelograms and intrathecal drug administration during the crisis period and are replacing 1.5 million syringes. Aspergillus fumigatus as a cause of nosocomial meningitis after spinal anesthesia was unheard of so far and 4 of the 14 patients affected so far have died. An ongoing system of checks and quality control in health systems is sorely needed (BMJ 10 September 2005; 331: 535).

Criminal prosecution of doctors

A recent ruling by the Supreme Court has provided some respite to beleaguered doctors. In its ruling last week the court said criminal prosecution of a doctor could take place only if "the accused did something or failed to do something which in the given circumstances no medical professional would have done or failed to do." It said a doctor could not be held liable for negligence merely because a better alternative or course of treatment was available. Doctors may be criminally prosecuted only for gross negligence or a high degree of negligence and that "a simple lack of care, an error of judgment, or an accident is not proof of negligence." This was in relation to the case against Dr Jacob Matthews of CMC Ludhiana who had inadvertently attached an empty oxygen cylinder to a 10 year old boy who subsequently died. While the court has said that Dr Matthews cannot be criminally prosecuted the hospital may or may not be liable for civil action (BMJ 20 August 2005; 331: 422).

One embryo, 3 donors

Permission has recently been granted in the UK to researchers to develop techniques to develop embryos using 3 donors. The need arises in cases of mitochondrial disorders. Mitochondrial diseases are transmitted from mother to offspring via the DNA in their mitochondria, which is present in the cytoplasm and not nucleus. To prevent the embryo from being affected, scientists want to transplant the nucleus from a fertilized egg into another woman's ovum. For the research scientists will be using fertilized ovum from consenting donors, which have some kind of chromosomal anamoly which prevents their implantation normally. The resultant embryo will not be allowed to progress into a fetus (BMJ 17 September 2005; 331: 591).

 

Gouri Rao Passi,
Consultant,
Department of Pediatrics,
Choithram Hospital & Research Center,
Indore -452001, Madhya Pradesh,
 India.
E-mail: [email protected] 

 

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