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Traditional Devadasi system based sex work (dhandha) is practiced inIndia. The communities that
practice this system are affected severely by AIDS epidemic. Through this paper
we present the views of gharwalis (brothel
madams) regarding the impact of AIDS
on the traditional system (Devadasi system) of initiating girls as sex workers (Devadasis) and on the practice of sex work (dhandha) associated with that
in-depth interviews were conducted with twelve gharwalis as a follow-up of a cohort study, which investigated the patterns and
determinants of sex worker migration from northern Karnataka to southern
Maharashtra, in India. According to gharwalis,
the disease (AIDS) consequences; death, fear and stigma affected dhandha operations, changed the attitude
of the Devadasi community against the
practice of dhandha and the Devadasi system, besides, influenced the
community to take actions to stop the practice of dhandha and the Devadasi system.
The findings suggest that the interplay between the disease consequences and
the community’s response to those consequences contribute to transition dhandha and the Devadasi system. We
discuss our findings, describe the transition and the consequent risk enhancing
conditions. Finally, highlight
the need to address these conditions to reduce Devadasis risk and vulnerability to HIV infection.
Transfusions of blood products are common in medical practice and can be
lifesaving in certain situations. Potentially life threatening reactions could
occur and physicians should be alerted. Here we describe a case of
thrombocytopenia that was induced by transfusion of fresh frozen plasma (FFP).
A 52 years old male presented to the emergency department after two episodes of hematochezia that resolved spontaneously.
Since he was anticoagulated for atrial fibrillation he was given a unit
of FFP to reverse a slightly elevated INR. Within 6 hours from the administration
of the FFP he developed an acute decrease only in his platelet count. He was
managed conservatively and his thrombocytopenia started resolving gradually. After excluding other causes the
potential diagnosis was fresh frozen plasma induced thrombocytopenia. The pathophysiologic
mechanism is postulated to be immune mediated by passive transfer of antibodyies
from the donor to the recipient. The antibodies that are described in the
literature are anti-HPA-1a and anti-CD-36. We reported the event to the
American Red Cross. Interestingly a male was the donor of the plasma while in
all cases in the literature the donors are females with a prior history of
pregnancy. Therefore this is the first reported case of a male blood donor
whose blood product caused immune mediated thrombocytopenia post transfusion.