The Role of Breastfeeding in Mother-to-Child Transmission of HIV/AIDS: A Comparative Case Study of Three Countries

The HIV pandemic has affected millions of people around the world both medically and socially, since there is a stigma associated with this disease. Common methods of transmission include sexual intercourse and sharing needles, but there are other lesser known methods through which people can contract this disease. One such way is mother-to-child transmission (MTCT), in which a mother could transmit the virus to her child either during pregnancy, childbirth, or through breastfeeding. This paper focuses on the role of breastfeeding in the transmission of HIV from mother to child. Many studies have investigated how breastfeeding results in the transmission of the virus, and effective common treatment methods have been established. However, the issue of MTCT of HIV still exists even though it can easily be eradicated with the proper techniques. This suggests that there are still factors that contribute to HIV transmission from mother to child that have yet to be eliminated. Thus, this paper reviews the breastfeeding rates and breastfeeding practices of three different countries: South Africa, India, and the United Kingdom. This paper analyzes epidemiological data, studies from medical journals, and studies from anthropology journals to determine what social influences surround breastfeeding practices in each of these countries to see how these may contribute to MTCT of HIV via breastfeeding. While there were no apparent trends between child HIV prevalence rates and breastfeeding rates in these countries, there were some social and cultural factors that were similar across all three nations. This information may be useful in creating more effective treatment plans that are conducive to the social environments in these countries

Clinical impact of intraoperative hyperlactatemia during craniotomy.

OBJECT:Patients often develop markedly elevated serum lactate levels during craniotomy although the reason for this is not entirely understood. Elevated lactate levels have been associated with poor outcomes in critically ill septic shock patients, as well as patients undergoing abdominal and cardiac surgeries. We investigated whether elevated lactate in craniotomy patients is associated with neurologic complications (new neurological deficits) as well as systemic complications. METHODS:We performed a cohort study of elective craniotomy patients. Demographic and intraoperative data were collected, as well as three timed intraoperative arterial lactate values. Additional lactate, creatinine and troponin values were collected immediately postoperatively as well as 12 and 24 hours postoperatively. Assessment for neurologic deficit was performed at 6 hours and 2 weeks postoperatively. Hospital length-of-stay and 30-day mortality were collected. RESULTS:Interim analysis of 81 patients showed that no patient had postoperative myocardial infarction, renal failure, or mortality within 30 days of surgery. There was no difference in the incidence of new neurologic deficit in patients with or without elevated lactate (10/26, 38.5% vs. 15/55 27.3%, p = 0.31). Median length of stay was significantly longer in patients with elevated lactate (6.5 vs. 3 days, p = 0.003). Study enrollment was terminated early due to futility (futility index 0.16). CONCLUSION:Elevated intraoperative serum lactate was not associated with new postoperative neurologic deficits, other end organ events, or 30 day mortality. Serum lactate was related to longer hospital stay