Woman gets superbug with breast implant

June 16, 2012

Breast_Superbug

Mumbai, June 16: When a new mother from south Mumbai sought medical help for the significant distortion of her right breast, the term super-bug never crossed her mind. She may, however, be the most telling example of poor infection-control in Indian hospitals and the ensuing threat to patients undergoing surgeries.

The 30-year-old, who had undergone a breast implant surgery in 2009, was found to be suffering from an MRSA infection. MRSA (Methicillin-resistant Staphylococcus aureus) is one of the most potent superbugs or bacteria resistant to antibiotics. A few years back, the medical journal Lancet carried a series of controversial articles stating that newer superbugs such as NDM-1 (New Delhi Metallo-Beta-Lactamase 1) had emerged from India.

The young mother's right breast was not only more than double the size of the left, it was also lumpy and painful. An evaluation revealed that she first experienced firmness in her breast six months after the surgery, but she thought it was a result of her pregnancy. But the firmness worsened after she delivered her baby and started breast-feeding.

It was only when the doctors did an MRI scan did they realize that there was an infection in the lining (capsule) of the implant. "The MRI scan showed she was suffering from capsular contracture," said Dr Mohan Thomas, consultant cosmetic surgeon at Breach Candy Hospital. "She had undergone the cosmetic surgery in another hospital. By the time she came to us, the capsule (implant lining) of her right breast was about 12mm in size," he said, adding a normal lining does not go beyond 2mm in thickness.

The body reacts to any implant by forming a protective lining around it. This is referred to as the "capsule" or "tissue capsule" and is formed by one's own tissue. In some women, however, the capsule shrinks, squeezing the implant, referred to as capsular contracture. The tighter the capsule becomes, the firmer the breast feels.

It was only after her surgery that the reason for the capsular contracture was found. "While doing the surgery, a large amount of pus and fluid kept oozing out of her breast. We had to remove layers and layers of the capsule. After the surgery, we sent the fluid for examination and it turned out to be MRSA," said Dr Thomas. What surprised doctors was that clinical tests showed no signs of the infection, but only the fluid filled in the capsules showed the presence of the pathogens.

"If this pathogen had spread across the body, it could have killed the person. But in this woman's case, her capsule had taken the whole burden of this pathogen," said Dr Thomas. Worse, he said, she could have passed on the infection to her child since she was breast-feeding. After both her implants were removed, the doctors kept her in hospital until they were satisfied that she was free of infection.

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News Network
March 3,2020

Tehran, Mar 3: Iranian Foreign Minister Javad Zarif on Monday urged Indian authorities to ensure the well-being of all Indians and not let "senseless" violence prevail.

Ministry of External Affairs Spokesperson Raveesh Kumar said on Thursday that law enforcement agencies were working on the ground to prevent violence and ensure restoration of confidence and normalcy.

Mr Kumar has urged international bodies not to make irresponsible statements at this sensitive time. "Iran condemns the wave of organised violence against Indian Muslims. For centuries, Iran has been a friend of India. We urge Indian authorities to ensure the wellbeing of ALL Indians & not let senseless thuggery prevail. Path forward lies in peaceful dialogue and rule of law," Zarif tweeted.

The communal violence over the amended citizenship law in Delhi has claimed at least 42 lives. Frenzied mobs have torched houses, shops, vehicles, a petrol pump and pelted stones at police personnel.

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Agencies
June 6,2020

United Nations, Jun 6: The coronavirus disease has not "exploded" in India, but the risk of that happening remains as the country moves towards unlocking its nationwide lockdown that was imposed in March to contain the Covid-19, according to a top WHO expert.

WHO Health Emergencies Programme Executive Director Michael Ryan on Friday said the doubling time of the coronavirus cases in India is about three weeks at this stage.

“So the direction of travel of the epidemic is not exponential but it is still growing,” he said, adding that the impact of the pandemic is different in different parts of India and varies between urban and rural settings.

“In South Asia, not just in India but in Bangladesh and...in Pakistan, other countries in South Asia, with large dense populations, the disease has not exploded. But there is always the risk of that happening,” Ryan said in Geneva.

He stressed that as the disease generates and creates a foothold in communities, it can accelerate at any time as has been seen in a number of settings.

Ryan noted that measures taken in India such as the nationwide lockdown have had an impact in slowing transmission but the risk of an increase in cases looms as the country opens up.

“The measures taken in India certainly had an impact in dampening transmission and as India, as in other large countries, open up and as people begin to move again, there's always a risk of the disease bouncing back up,” he said.

He added that there are specific issues in India regarding the large amount of migration, the dense populations in the urban environment and the fact that many workers have no choice but to go to work every day.

India went past Italy to become the sixth worst-hit nation by the COVID-19 pandemic.

India saw a record single-day jump of 9,887 coronavirus cases and 294 deaths on Saturday, pushing the nationwide infection tally to 2,36,657 and the death toll to 6,642, according to the health ministry.

The lockdown in India, was first clamped on March 25 and spanned for 21 days, while the second phase of the curbs began on April 15 and stretched for 19 days till May 3. The third phase of the lockdown was in effect for 14 days and ended on May 17. The fourth phase ended on May 31.

The country had registered 512 coronavirus infection cases till March 24.

The nation-wide lockdown in containment zones will continue till June 30 in India but extensive relaxations in a phased manner from June 8 are listed in the Union home ministry's fresh guidelines on tackling the Covid-19 pandemic issued last week.

WHO Chief Scientist Soumya Swaminathan said the over 200,000 current coronavirus cases in India, a country of over 1.3 billion people, "look big but for a country of this size, it's still modest.”

She stressed that it is important for India to keep track of the growth rate, the doubling time of the virus and to make sure that that number doesn't get worse.

She said that India is a “heterogeneous and huge country” with very densely populated cities and much lower density in some rural areas and varying health systems in different states and these offer challenges to the control of Covid-19.

Swaminathan added that as the lockdown and restrictions are lifted, it must be ensured that all precautions are taken by people.

“We've been making this point repeatedly that really if you want behaviour change at a large level, people need to understand the rationale for asking them to do certain things (such as) wearing masks,” she said.

In many urban areas in India, it's impossible to maintain physical distancing, she said adding that it then becomes very important for people to wear appropriate face coverings when they are out, in office settings, in public transport and educational institutions.

“As some states are thinking about opening, every institution, organisation, industry and sector needs to think about what are the measures that need to be put in place before you can allow a functioning and it may never be back to normal.”

She said that in many professions working from home can be encouraged but in several jobs, people have to go to work and in such cases measures must be put in place that allow people to protect themselves and others.

“I think communication and behaviour change is a very large part of this whole exercise,” she added.

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Agencies
April 23,2020

New Delhi, Apr 23: With an increase of 1,229 new COVID-19 cases in the last 24 hours, the total number of cases reached 21,700, said the Union Ministry of Health and Family Welfare on Thursday.

The tally is inclusive of 16,689 active cases, 4,325 patients have been cured/discharged and migrated, while 686 patients who have died due to the deadly virus.

According to the ministry's data, Maharashtra is on the top of the list with most COVID-19 cases, 5,652 cases of which 789 patients have recovered and 269 patients succumbing to coronavirus.

Gujarat and Delhi are second and third on the list respectively with Gujarat having 2407 cases of which 179 patients have recovered and 103 deaths. Meanwhile, in Delhi, the tally stands at 2248 cases of which 724 patients have recovered and 49 patients have died from COVID-19.

Rajasthan's tally stands at 1,890 cases with 230 patients cured while 27 deaths have been reported as of Thursday.

Madhya Pradesh has 1695 cases of which 148 patients have recovered and 81 deaths reported. Tamil Nadu, on the other hand, stands with 1629 cases of which 662 patients have recovered and 18 have died due to the deadly virus.

Goa has seven cases reported of which all seven patients have recovered from the coronavirus.

Prime Minister Narendra Modi announced on April 14, that the nationwide lockdown would be extended to May 3.

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