Dear Dr.Rewari Sir,
Thanks for taking notice of the things.when i cited a case of reduction of d4T dosages ,I cited only after confirming the weight.The reduction was done just because of shoratge anyways.
To add salt to the injury I was informed of death of another patient APS s/o KD.This patient used to come to me from Pasla a village near Jalandhar(80KMS from Amritsar) ever since 2003.His mRNA in March 2003 was 141550,cD4 13,cD8 447 and had CMV retinitis. By October his cD4 went upto 318 and viral load was 1118 with ARV's( d4T+3TC+EFV),february 2004 cd4 was 285 and till mid 2006 he maintained cd4 above 250 and was doing well. then because of distance and economy he went to ART ,center,Jalandhar in later quarter of 2006 when the center came into being.. The people manning that center failed to recognise the clinical and immunological failure in time and the result APS breathed his last on two days before.
I agree you train people well. But sir ,my point of view is that is 12 days training sufficient,are the people employed tested for their competance and aptitude before the patients are exposed to them.
My querry is what is the harm in instructing them to avail services of locally available resources.
With best regards
Dr.Rakesh Bharti
MD,American Academy HIV specialist,
27-D,Sant Avenue,The Mall,
Amritsar
143001
telephone-911832277822;9814044213
email-rakesh.bharti1@gmail.com
1 comment:
Anti-viral drugs commonly used to treat CMV retinitis are ganciclovir (Cytovene), foscarnet (Foscavir) and cidofovir (Vistide). These medications can slow down the progression of CMV, but they can't cure it. These potent anti-viral drugs can also cause unpleasant or serious side effects.
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