Tuberculosis is an opportunistic infection caused by the bacteria Mycobacterium tuberculosis. The infections occurring in people with weak immunity as compared to the people with a healthy immune system are called as opportunistic infections. As, HIV enters the human body, it replicates and weakens the immune system which in turn increases the risk of contracting Tuberculosis in people already suffering from HIV infection.

An HIV and Tuberculosis co-infection occurs when an individual has both, the HIV infection and an either latent or active TB disease simultaneously.  Each disease acts in speeding up the progress of the other, when HIV and TB infection is present together in the body. HIV infection speeds up the progression from latent to active Tuberculosis, Mycobacterium tuberculosis also accelerates the progression of replication and spread of the HIV infection.

HIV infection and Tuberculosis are totally different type of infectious diseases. HIV is a viral infection and TB is a bacterial one. An HIV infected person will not contract TB unless a contact happens with a TB infected person. TB spreads via droplet infection and is communicable. If a person lives in a country with a high prevalence rate of TB, an HIV patient is highly susceptible to contracting the infection. In the similar manner, a person suffering from TB gets infected with the HIV infection only through the blood and bodily fluids borne route, with unprotected sexual intercourse with an HIV infected individual being the most important cause.

Amongst all the other opportunistic infections, TB occurs at an earlier stage in the course of an HIV infection than most other opportunistic infections. Mortality rate in the co-infected patients is more than twice that of HIV infected individuals without a TB infection. Even if a patient is undergoing anti-retroviral therapy, the death rates remain high in co-infected individuals.The natural history and course of TB gets altered in people with an infected immune system. The damage to immunity due to HIV infection causes a drastic reduction in the pathogen killing capacity of the body. In such patients if there is no anti-retroviral treatment prescribed, then the latency period between the infection and progression of disease gets eliminated. 

An active phase of TB is observed in such individuals progressing within a short span of time, ranging from weeks to months, rather than years as it normally should be spanning. Risk of progression from a latent stage to an active stage of TB is around 10-15 times greater in an HIV infected individual as compared to the non-infected person. Such individuals also communicate the disease more rapidly to others.Pulmonary tuberculosis in an HIV infected person can present similar symptoms like that of a classic TB disease. However, a co-infection can sometimes show less presenting TB symptoms, where even the chest X-ray scans can be observed to be normal. A  subclinical  phase of Tb in co-infected patients can cause delay in the diagnosis of the symptoms and subsequently affect the prognosis due to lack of timely treatment.

Social stigma and discrimination has caused an obstacle in provision of adequate treatment for people with HIV. Proper counseling  and initiatives taken to provide indiscriminate care can aid in identification of co-infection and earlier stages. Anti-retroviral treatment teamed up with anti-tubercular drug regimen is prescribed and a successful treatment for drug sensitive cases of TB can be provided with medications for 6-8 months.

How HIV & TB  Are Related?

5 natural ways to treat corn

Corns are formed when our hands or feet try to defend themselves from some injury, forming a callused shield instead. The outermost skin comes together in a pile and forms a strong cover made of dead cells, if an area is rubbed too often. This usually happens if one is wearing ill-fitted shoes. Some home remedies to take care of these corns or calluses are:

1. Rub with pumice stone - this can be done after a shower or bath, as the skin is wet and soft now. Rub the area with a pumice stone to remove the dead cells. Don't rub harshly in a single attempt. Instead, rub mildly every day until the all the dead cell comes out. If the corn is very thick, this process might take a few weeks.
2. Apply castor oil - castor oil acts as a softener. One can either soak the area with castor oil dipped in cotton to use the oil with a cord pad.
3. Wear comfortable shoes and socks - wear socks with shoes that are comfortable and have thick cushioned soles. Ensure that your shoe fits you well and that it is wide enough for your toes to be placed comfortable inside.
4. Use bread mask - rub the corn slightly with the pumice stone so that the loose dead skin falls off. Soak a piece of bread in half a cup of apple cider vinegar. When well soaked, put the piece of bread on the corn, wrap it with gauze and secure it with an adhesive tape. The bread can also be mashed into a paste.
5. Lemon and olive - miss a couple of tablespoons of lemon juice with two teaspoons of olive oil. Add to this, some baking soda to form a thick paste. Apply this paste on the corn and cover it with gauze.

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Cranial nerve palsy is one of the common culprits of causing double vision. This is all the more true for people above the age of 60. A person is more prone to cranial nerve palsy if he is suffering from high blood pressure and diabetes. This is the reason why this disease is more commonly known as diabetes palsy. Eventually, though they get better and the problem of double vision disappears.

Symptoms:

One weak cranial nerve leads to the weakness of other cranial nerves as well. In case the eyes fail to move together, chances are that the patient will have double or blurred vision. In case the sixth nerve gets affected, side to side double vision is encountered. For the 3rd and 4th nerve disturbance, there could be a vertical double vision. The lack of blood flow causes pain to the eye.

Possible Causes of Cranial Nerve Palsy?

Cranial nerve palsy can result from traumatic or congenital factors. They can also result from vascular diseases such as strokes, hypertension, diabetes, and aneurysms. It can also arise out of infections, increased intracranial pressure, migraines, and tumours. A patient's age and clinical findings help a doctor decide the right course of treatment.

Treatment:

There are no particular treatments which can speed up the recovery of cranial nerve palsy. In a case of pupil pain, doctors may prescribe anti-inflammatory drugs such as Motrin and Advil. They key to natural recovery is to ensure that the blood sugar and the blood pressure is diligently controlled. By patching the eyes, the problem of double vision can be resolved. They are typically worn over both the eyes. They are however known to slow down the process of recovery and strain the eye. There is no known exercise to fix this condition. Botulinum injections are sometimes used by doctors to straighten the eyes but the result of such a treatment greatly varies from person to person. Doctors mostly rely on watchful waiting until the phase passes within 6-8 weeks. Pain medications are recommended on a case to case basis.

Lifestyle Changes:

Managing cranial nerve palsy can be difficult for a working person. It involves many lifestyle changes till the condition fully cares. Some of the suggestions given by an ophthalmologist include resting the eye as long as one can. Reading or working on a computer should be eschewed since it puts great pressure on the eyes. The eye should not be contacted with forehands in case there is too much pain. Other basic hygiene issues include taking the medicine time to time, cleaning the eye with fresh water two to three times a day, putting the eye drops on time as prescribed by the doctor.

How To Treat And Manage Cranial Nerve Palsy?

Sadly, there is no known cure for hiv. However, it can be controlled through medication. Hiv or the human immunodeficiency virus attacks the body's immune system and over time leaves it vulnerable to a number of other diseases. In its most advanced stages, it can lead to aids. Hence, it is essential to control this virus in its early stages.

Hiv treatment is known as antiretroviral therapy or art. This involves taking a series of hiv medicines on a daily basis. Art can help hiv patients live a longer, healthier life and can also reduce the risk of hiv transmission.

The first step towards getting treated for hiv is to get tested. This can be easily done at your nearest health center and the results will be kept confidential. With hiv prevention is better than cure and hence, if you have more than one sexual partner, you must insist on them getting tested as well.

As soon as you test positive for the virus, start the treatment. Do not wait till you start feeling sick. Art can be taken by anyone at any stage of the condition. If you are pregnant, breast feeding or have been diagnosed with early hiv infection, this is all the more important.

Hiv medication works by preventing the hiv cells from multiplying and thus reduces the amount of hiv cells in the body. A low level of hiv cells gives the immune system a chance to recover and strengthen itself. A lowered hiv count also reduces chances of transferring the virus to another person.

Art involves following a regimen of a number of medicines. There are 25 hiv medicines that can be grouped under six drug classes depending on how they affect hiv cells. These include:

1. Nucleoside reverse transcriptase inhibitors
2. Non-nucleoside reverse transcriptase inhibitors
3. Protease inhibitors
4. Fusion and entry inhibitors
5. Pharmacokinetic enhancers and
6. Integrase strand transfer inhibitors

Usually, a person is prescribed 3-4 hiv medicines from a minimum of 2 drug classes. A number of factors go into deciding what form of hiv treatment is most suitable to a patient. This includes the person's individual needs, symptoms presented, potential drug interactions and possible side effects. Convenience of following the regimen and costs are also taken into account while prescribing a form of treatment to a hiv patient.

Once treatment is started, art can be proven to be effective within 3-6 months by lowering the number of hiv cells in the body.

HIV/AIDS - How Can It Be Treated?

Tuberculosis or TB as it is commonly known in medical circles is a bacterial infection commonly affecting the lungs. While there are some countries in the world, where TB is more common, anybody can develop TB if they are not very healthy. The TB bacteria spreads through the air. While some people's immune system would be able to fight the disease back; some people who have risk factors, the disease may continue to develop and present with symptoms. 

So, a person can develop TB in two circumstances:

Exposure to TB
Visited a country where TB is very common
Spent time with a person who is infected with TB
Exposure to crowded places like a market or a healthcare facility where TB virus is present
Weakened immune system
Be HIV infected
Weak immune system due to long-term use of steroids
Chronic diseases like diabetes, malnutrition, end-stage kidney or liver disease, cancer, etc.
Extremes of age (children whose immune system is not fully developed, elderly whose immunity is weakened)
Chronic smoker, IV drug abuse, and/or alcohol user
Repeatedly exposed to TB bacteria in the last two years
Had TB bacteria, but not identified or treated
Drug therapy like chemotherapy, long-term use of steroids, auto-immune disease treatments, etc.
Signs and symptoms of TB: 

If you are at risk, it is also suggested that you know the early warning signs and symptoms of TB. TB most commonly affects the lungs and is known as pulmonary tuberculosis. Watching out for these helps in early diagnosis which can both help arrest the condition in the early stages and improve prognosis.

A persistent cough which lasts for more than 3 weeks
Pain in the chest worsened with coughing
Presence of blood in the sputum
Generalized and extreme weakness or fatigue
Unexplained weight loss
Loss of appetite
Fever and chills
Profuse sweating at night
If a person has TB bacteria in the system but does not feel sick and does not have the above systems, then it means that the person is not actively infected. This person also cannot spread the disease to another person. However, when immunity is weak, this can develop into an infection. In a country like India where tuberculosis is quite prevalent, it is best to get yourself screened for active tuberculosis infection if you display any such symptoms.

Tuberculosis (TB) - When A Person Can Develop It?

Headaches and migraines can vary drastically depending on their duration, specific symptoms and the person they are affecting. The more you know about your specific type of headache or migraine, the better prepared you will be to treat them and possibly even prevent them. The two types of migraine are- 

Migraine without aura: The majority of migraine sufferers have Migraine without Aura. 
Migraine with aura: Migraine with Aura refers to a range of neurological disturbances that occur before the headache begins, usually lasting about 20-60 minutes.
Symptoms of migraine vary and also depend on the type of migraine. A migraine has four stages: prodrome, aura, headache and postdrome. But it is not necessary that all the migraine sufferers experience all the four stages.

Prodrome: The signs of this begin to appear a day or two days before the headache starts. The signs include depression, constipation, food cravings, irritability, uncontrollable yawning, neck stiffness and hyperactivity.
Migraine Aura: Auras are a range of symptoms of the central nervous system. These might occur much before or during the migraine, but most people get a migraine without an aura. Auras usually begin gradually and increase in intensity. They last for an hour or even longer and are 

Visual: Seeing bright spots, various shapes, experiencing vision loss, and flashes of light
Sensory: Present in the form of touch sensations like feeling of pins and needles in the arms and legs
Motor: Usually related with the movement problems like the limb weakness
Verbal: It is related with the speech problems
Headache: In case of a migraine attack one might experience:

Pain on both sides or one side of the head
Pain is throbbing in nature
Vomiting and nausea
Sensitivity to smells, sound and light
Vision is blurred
Fainting and lightheadedness
Postdrome: This is the final phase of the migraine. During this phase one might feel fatigued, though some people feel euphoric.

Red flags that the patient may be having underlying serious disorder not migraine

Onset of headaches >50 years 
Thunderclap headache - subarachnoid haemorrhage 
Neurological symptoms or signs 
Meningism 
Immunosuppression or malignancy 
Red eye and haloes around lights - acute angle closure glaucoma 
Worsening symptoms 
Symptoms of temporal arteritis
These patients require CT scan / MRI or CSF examination. Most Migraine patients do not need these tests. 

Diagnosis of Migraine: Usually migraines go undiagnosed and thus are untreated. In case you experience the symptoms regularly then talk to the doctor, who evaluates the symptoms and can start a treatment. You can also be referred to a neurologist who is trained to treat the migraines and other conditions. During the appointment the neurologist usually asks about the family history of headaches and migraines along with your symptoms and medical history.

The doctor might advise for some tests like:

Blood Tests: These reveal problems with the blood vessel like an infection in the spinal cord and brain.
CT scan: Used to diagnose the infections, tumors, brain damage, and bleeding that cause the migraines.
MRI: This helps to diagnose the tumors bleeding infections, neurological conditions, and strokes.
Lumbar Puncture: For analyzing infections and neurological damages. In lumbar puncture a thin needle is inserted between the two vertebrae to remove a sample of the cerebrospinal fluid for analysis.
Treatments

Migraine treatments can help stop symptoms and prevent future attacks.

Many medications have been designed to treat migraines. Some drugs often used to treat other conditions also may help relieve or prevent migraines. Medications used to combat migraines fall into two broad categories:

Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms.
Preventive medications. These types of drugs are taken regularly, often on a daily basis, to reduce the severity or frequency of migraines.
Your treatment strategy depends on the frequency and severity of your headaches, the degree of disability your headaches cause, and your other medical conditions.

Some medications aren't recommended if you're pregnant or breast-feeding. Some medications aren't given to children. Your doctor can help find the right medication for you.

Migraine - Identifying the Early Signs!

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