HIV or the human immunodeficiency virus is a retroviral agent that causes the immune system of the body to weaken and lead to cause the acquired immune deficiency syndrome (AIDS). It is now treatable. Research is being conducted all over the world to formulate a targeted drug therapy for combating this life-threatening disease. No vaccine is available, which renders the world population highly susceptible to contract the infection.

HIV infection spreads from an infected person through contact with certain bodily fluids like blood and semen. Spread from one human being to another is called as transmission of HIV. Mother to child transmission, i.e. perinatal transmission is also common. Healthcare and hospital staff are at a great risk of occupational transmission. Other causes of transmission include sharing intravenous drug equipment, needle prick injury, organ transplantation and artificial insemination. Since vaccination and targeted drug therapy for remission are not available, prevention strategies play an important role in curbing the spread of infection.

A three-level prevention strategy is implemented for HIV infection.

Primary prevention- Activities that focus on prevention of uninfected people being infected.
Secondary prevention- Aimed at the provision of proper health care and behavioral facilities for HIV infected people like lifestyle changes, welfare rights advice, anti-discrimination measures.
Tertiary prevention- Aimed at minimizing the symptoms of an infected person; includes the provision of prophylactic drugs and complementary therapies.
The risk avoidance approach for transmission of HIV infection includes certain measures like practicing mutual monogamy & delayed sexual activity in the young population. Safe and appropriate use of syringes and needles is advised. Unnecessary blood transfusions should be completely avoided. Routine screening of HIV antibody should be done.

Risk reduction approach propagates the mandatory use of condoms during sexual intercourse. Sexually transmitted diseases should be treated to avoid the risk of transmitting infection. Sterile syringes should be used. If blood transfusion is necessary, then blood transfused should be evaluated well to meet the quality standards.

If HIV infection is suspected, anti-retroviral drug therapy should be started.
The only universally approved method of HIV transmission during sexual activity is the use of condoms.
Pharmaceutical methods for prevention and treatment include antibiotic drug therapy for sexually transmitted diseases, anti-retroviral drugs for infected individuals, pre and post-exposure prophylaxis and use of low space dead syringes.
Pre-exposure prophylaxis is advised for people who are at a higher than average risk of contracting the infection.
Drug therapy consisting of a combination of Tenofovir and Emtricitabine is prescribed, one per day.
Visit the physician at regular intervals and routine screening is done. Post-exposure prophylaxis is considered to be effective if the treatment is started within an hour of exposure, to effectively reduce the risk of seroconversion. A drug combination of Emtricitabine, Tenofovir and Raltegravir is given.
Social initiatives are undertaken to spread awareness and educate people regarding AIDS. Behavioral change and acceptance of social message is necessary to benefit from the social initiatives. Sex education, LGBT sex education and awareness, safe injection use programs, needle exchange programs, safe sex practice education are some social strategies implemented.
Prevention of transmission of HIV from mothers to children involves anti-retroviral drug therapy during pregnancy and post birth in the newborn child. Breastfeeding is avoided and bottle feeding is advised.

HIV Transmission - How Can It Be Prevented?

One of the most common problems faced by ageing men is benign prostatic hypertrophy. Prostate is the gland at the base of the urethra near the bladder and when it enlarges it can lead to symptoms, mostly related to urination.

1. Frequent urge to pass urine
2. Prolonged urination
3. Frequent nocturnal visits to the toilet
4. Intermittent urination
5. Difficulty to start urinating
6. Inability to completely empty the bladder
7. Urinary tract infections

There are medications available to manage this, but offer only temporary relief. Many men therefore prefer to have the surgery undergone to manage these bothersome symptoms. However, like any surgery, the risks and benefits need to be considered along with other conditions like age, overall health status, other comorbid conditions, etc.

Surgical removal of the enlarged prostate gland is a more definitive approach to manage these symptoms. In addition to providing a quick cure, it also is used in the following cases:

1. Patients who do not respond to medications
2. Presence of blood in the urine
3. Associated bladder stones
4. Frequent infections of the urinary tract
5. Associated damage to the kidneys

Procedure of Surgery
During the procedure, a tube is passed through the tip of the penis into the urethra towards the bladder neck. Once it is in the desired position, laser is passed through it to deliver energy that acts on the prostate to either completely or partially destroy it. There are two methods by which laser acts on the enlarged prostate and making way for free flow of the urine.

1. Ablation: Excess prostate tissue is melted away by the laser by using photosensitive vaporization of the prostate. This is also known as Greenlight laser therapy or KTP laser vaporization. Alternately, Holmium can be used as the source of laser energy to ablate the prostate tissue.

2. Enucleation: Excess prostate tissue is cut and teased out through the urethra. Holmium laser is used to resect the prostate into smaller pieces, which are then removed out through a resectoscope. Another technique uses a tissue morcellator which grinds the enlarged prostate into smaller pieces to enable easy retrieval.

More men now opt for laser prostate removal as it has the following advantages:

1. Reduced risk of bleeding: This becomes essentially important in patients who are on blood thinners.
2. No hospitalization: This can be done either as an outpatient or with minimal one day stay at the hospital
3. Immediate symptom relief: As compared to medications, the relief is felt almost immediately after the surgery
4. No catheter: With laser surgery, a catheter may be required for less than 24 hours unlike in open surgical cases.

As noted above, as with any surgery, once enlarged prostate symptoms set in, have a detailed discussion with your doctor to identify if you are a suitable candidate for laser surgery.

Know About Laser Prostate Surgery

Vaginitis is a vaginal disorder, which is characterized by pain, itching and inflammation. It is usually caused due to an imbalance of the bacteria in the vagina. It may also occur because of low estrogen levels after menopause.

Vaginitis is classified into four types:

Yeast Infections: These infections are caused by a fungus known as candida albicans.
Bacterial Vaginosis: This disease results from an imbalance of bacteria in the vagina.
Vaginal Atrophy: Vaginal atrophy (vaginal inflammation resulting from tissue shrinking and thinning) occurs due to low estrogen levels in the body.
Trichomoniasis: This disease is caused by a parasite and is usually transmitted through sexual intercourse.
The symptoms of this disorder are:

Itching in the vagina
Abnormal bleeding from the vagina
Intense pain while having sexual intercourse
Vaginal discharge that changes in color and amount
Intense pain while urinating
Note: The cause of the disorder depends on the type of vaginitis you have; bacterial vaginitis results from an imbalance of the bacteria in the vagina. Yeast infections result from an overgrowth of fungi in the vagina. Trichomoniasis is caused by a single celled parasite 'Trichomonas vaginalis'.

Vaginitis - 4 Common Types

The prostate gland in a man begins to grow in size on reaching 25 years of age quite naturally, and this is known as benign prostatic hyperplasia abbreviated as BPH. Now the problem arises when the enlargement of the prostate is more than normal.

In men, the urine flows through the urethra from the bladder. An abnormally enlarged prostate blocks the flow of urine through the urethra. The cells of the prostate slowly multiply to cause it to enlarge. This puts pressure on the urethra thereby giving rise to a number of problems, most of which manifest as symptoms.

Common Symptoms of an Enlarged Prostate Gland
The condition of enlarged prostate gives rise to some noticeable symptoms which provide the signs that you need to visit a doctor to get it treated. A weak or slow urinary system is one of the most common symptoms of being affected with an enlarged prostate. This includes urinating more often, an increase in the urgency to urinate, difficulty in starting urination and a feeling of incomplete bladder emptying immediately after urinating. At times, it is seen that passing urine becomes very strenuous. All these above symptoms indicate that there is an enlargement of the prostate gland and medical help should be sought immediately to prevent the condition from worsening.

Steps to Manage an Enlarged Prostrate

Effective medication is usually the first step in the management of an enlarged prostate gland. Alpha blockers are the drugs that are most commonly used in this situation. These drugs do not reduce the size of the prostate, but they are great in relieving the symptoms to allow free and painless passage of urine. Another group of drugs known as 5-alpha reductase inhibitors can help in shrinking an enlarged prostate. The drugs work by the reducing the levels of the male hormone called dihydrotestosterone.
In some advanced stages of prostate enlargement, minimally invasive treatments are used for the effective management of the condition. Transurethral Microwave Thermotherapy or TUMT is used to treat mild blockages that reduce the frequency of urination, the urgency, and straining. However, it is not able to correct the bladder emptying issues. Transurethral Radio Frequency Needle Ablation or TUNA helps in the destruction of the prostate tissues resulting in an improvement in the flow of urine.
Prostatic stents are also sometimes used for the management of the condition of an enlarged prostate. In this treatment procedure, a small metal coil is inserted into the urethra for widening it and keeping it open. In most severe case of prostate enlargement, only surgical methods remain as the opted method of treatment. Laser surgeries are performed to destroy the tissues of the prostate for easing of the condition. Ultimately, an open prostate surgery is performed when the transurethral procedure cannot be used. In this surgery, the tissues of the prostate are removed by the surgeon in case of great enlargement.
The condition of an enlarged prostate gland requires medical attention and treatment for the most effective management, and it is best that a medical professional is consulted as soon as any of the symptoms surface.
Enlargement starts usually after 50 years. Surgery 'Transurethral resection of prostate (TURP)' either by monopolar or bipolar electrocautery. Enucleation of prostate by laser is also an option.

Enlarged Prostate - How Can It Be Managed?

Most of us are affected by diseases, which spread through physical contact, but most of us do not consider it important to get them checked, due to which they turn into major ailments. Sexually transmitted diseases (stds) are infections, which are transmitted through any kind of sexual contact. The organism that causes the disease is transmitted from one person to the other during sex intercourse. Sometimes stds can be asymptomatic (no symptoms or signs)

Here are some stds that you should be informed about:

1. Gonorrhoea: genital infection caused by bacteria is called gonorrhoea, its symptoms include 

 Bloody vaginal discharge
 Painful urination
 Heavy period bleeding
 Anal itching

2. Chlamydia: bacterial infection in the genital tract is called chlamydia. Chlamydia is usually difficult to diagnose, its symptoms include

 Pain during urination
 Pain in lower abdomen
 Vaginal discharge
 Painful intercourse
 Bleeding between menstrual cycles

3. Syphilis: the bacterium treponema pallidum causes syphilis, its symptoms include

 Rashes
 Sores in the mouth, anus or vagina
 In later stages, it causes nerve and organ damage

4. Genital herpes: the herpes simplex virus (hsv) causes herpes. Signs and symptoms include-

 Small red bumps or ulcers in the anal, genital and other areas
 Itching or pain around the genital area, thighs and buttocks

5. Human papillomavirus (hpv) and genital warts: genital warts are caused by hpv. It infects the genital tract. Hpv has been linked to cervical cancer, its symptoms include

 Small swellings in the genital area
 Itching
 Bleeding during sex

6. Chancroid: chancroid is a bacterial infection. The bacterium haemophilus ducreyi causes chancroid, its symptoms include

 Development of red bumps on the skin folds covering the genitals
 Pain during urination
 Burning sensation during bowel movement

7. Ectoparasitic infections: ectoparasitic infections are caused by small parasitic bugs like mites or lice. The parasites usually affect the hair or skin. Scabies and crabs are common parasites that cause such infections. They both cause intense itching and visible rashes.

8. Human immunodeficiency virus (hiv) and acquired immunodeficiency syndrome (aids): the virus that causes aids is called hiv. It can spread through blood, vaginal fluids, semen and breast milk. Unprotected sex or sharing needles with an infected person is how the disease spreads. It includes symptoms, such as

 Slight fever
 Fatigue
 Muscle aches
 Weight loss.

Most Common STDs in Women

STDs or STIs are usually transmitted from one person to another through body fluids while being in a physical relationship. Herpes, Chlamydia, HIV and gonorrhea are some of the common STDs you may be susceptible to. These diseases are extremely unpleasant and usually cause long term health issues. Sometimes they might even be fatal. Here are a few ways you could use to prevent yourself from getting affected with STDs:

    Abstinence: The best and most certain way of preventing STDs is practicing abstinence. Although abstinence from any type of sexual activities including oral, vaginal or anal sex is a surefire method of prevention, it is not a very realistic method to do so. If you don't want to practice abstinence, make sure you educate yourself about other prevention methods.
    Single partner: Practicing monogamy in terms of sex is the safest kind of sexual activity. Make sure both you and your partner get tested for any STD. If you and your partner are not suffering from any STD and you both agree to practice monogamy with each other, then you automatically cut down on the risk of suffering from STDs.
    Talk: Talk to your sexual partner about his/her sexual health. Inform him/her about yours as well. Avoid having sex with someone who does not inform you with his or her sexual health information.
    Avoid taking drugs or alcohol: Try not to get drunk or take drugs before having sex. They reduce inhibitions which actually tend to make you reckless. You tend to become more adventurous and do not keep the sexual hygiene in mind at that time. Using a condom in the influence of alcohol and drugs can also result in a condom failure. Be sober enough before you have sex.
    Do not indulge with a person with symptoms: If someone shows symptoms of suffering from any kind of STD, do not indulge in any sexual activity with him or her. Refrain from having sex with him or her until he or she is treated by a doctor.
    Take precaution: Use different forms of protection while having sex to prevent pregnancy as well as STDs. But you have to realize the fact that these forms of protection are not full proof and always have a slight percentage of risk embedded in them.

Be extremely careful before you indulge in any type of sexual activity with anyone. After all, your health is in your hands.

How To Best Prevent Yourself from STDs or STIs

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