HIV: QUICK FACTSIntroductionThe human immunodeficiency virus (HIV) is a subgroup of retrovirus (lentivirus) that causes HIV infection. After a period of time, this infection leads to what is called acquired immunodeficiency syndrome (AIDS).

Epidemiology

According to the Centers for Disease Control and Prevention (CDC), from 2010-2015, the estimated rate of HIV infection in all 50 US states decreased from 14.2 per 100,000 population in 2010 to 12.3 per 100,000 population in 2015. In 2015, 39,513 individuals were diagnosed with HIV infection. From 2010 to 2014, the annual number of new HIV infections decreased by 9%.

Virology HIV-1 and HIV-2 are retroviruses in the Retroviridae family, Lentivirus genus. They are enveloped, diploid, single-stranded RNA viruses with a DNA intermediate.Upon entry into the target cell, the viral RNA genome is converted into double-stranded DNA by an enzyme, reverse transcriptase that is transported along with the viral genome in the virus particle. The resulting viral DNA is then imported into the cell nucleus and integrated into the cellular DNA by a virally encoded enzyme, integrase. HIV contains three retroviral genes, namely gag, pol, and env.

Gag gene: Encodes group-specific antigen; the inner structural proteins
Pol gene: Encodes polymerase; it also contains integrase and protease
Env gene: Encodes the viral envelope, the outer structural proteins responsible for cell-type specificity. Glycoprotein 120, the viral envelope protein, binds to the host CD4+molecule
Pathophysiology

HIV infects vital cells in the human immune system, such as helper T cells (specifically CD4+ T cells), macrophages, and dendritic cells and leads to cellular immune deficiency. This results in the development of opportunistic infections and neoplastic processes.

Mode of Transmission
Sexual intercourse: Unprotected sexual intercourse; especially receptive anal intercourse and different sexual partnersContact with or transfer of blood, pre-ejaculate, semen, and vaginal fluids infected with the virus.Spread from an infected mother to her infant through breast milk. An HIV-positive mother can transmit HIV to her baby both during pregnancy and childbirth due to exposure to her blood or vaginal fluid.

Signs and Symptoms There are 3 categories of infection 

Category A: Asymptomatic HIV infection without a history of symptoms or AIDS-defining conditions
Category B: HIV infection with symptoms that are directly attributable to HIV infection
Category C: HIV infection with AIDS-defining opportunistic infections
Investigation

A high-sensitivity enzyme-linked immunosorbent assay (ELISA) should be used for screening.

Management

Start with antiretroviral therapy (ART) in all HIV-infected adults ready to start therapy. 
CD4 count is no longer a criterion for starting the therapy.
Use of nucleoside reverse transcriptase inhibitors and protease inhibitors.
For refractory cases, during the failing treatment regimen and before switching therapy, use rapid confirmation, perform resistance testing and reevaluate.

HIV - Quick Facts Need To Know!

Vertigo is marked by a feeling of dizziness and disorientation. This feeling could be so bad that even standing up makes a person feel lightheaded. Vertigo can even make a person feel nauseous. 

The five most common causes of vertigo are:

Meniere s disease: Meniere s disease is a condition that affects the inner ear. It is marked by a buildup of fluid in the inner ear as a result of a viral infection, allergies or an injury to the ear. Along with dizziness, it can also cause a ringing noise in the ears, the feeling of having plugged ears and hearing loss. Vertigo caused by Meniere s disease can last for months.
Benign Paroxysmal Positional Vertigo (BPPV): This is one of the most common triggers of vertigo. This condition is caused by small crystals that break free and float in the inner ear canals. These canals are known as semicircular canals. Vertigo caused by BPPV is usually short-lived and relieves itself is a few minutes. Moving the head in a certain way or jerky movements can trigger vertigo in such cases. The exact cause of this condition is not clear but it has been often associated with severe head trauma.
Labyrinthitis: This condition is also known as vestibular neuritis. It is marked by swelling and irritation of the two vestibular nerves in the inner ear canal. Labyrinthitis may be caused by a viral infection or an inner ear infection. In such cases, vertigo may be accompanied by hearing loss. Older adults are at the highest risk of this condition.
Vitamin B12 Deficiency: A simple vitamin deficiency can also cause vertigo and dizziness. Vitamin B12 helps prevent anaemia and keeps nerves and blood cells healthy. Low levels of this vitamin can cause neurological problems that in turn cause vertigo. This is because vitamin deficiencies reduce blood pressure and blood flow to the brain. A simple blood test can help check Vitamin B1 levels and identify a deficiency. Some of the best sources of vitamin B12 are dairy products, meats and fortified cereals.
Dehydration: 60% of the human body mass is water. Water plays a number of roles in the human body. One of the most important functions of water is the circulation of nutrients in the body and blood flow. Thus, even mild dehydration can make a person feel dizzy and nauseous. This type of vertigo may be relieved by drinking copious amounts of fluids. 

Vertigo - 5 Most Common Problems That Can Lead To It!

Celiac disease is a serious genetic autoimmune disease with over 300 symptoms, and most people manifest with a combination of them. It is caused by intolerance to gluten, which is a protein found in wheat, rye, barley, and other cereals. Gluten is usually present in the small intestine, and in patients with celiac disease, the lining of the small intestine gets attacked. Consequently, a number of organs and/or body systems are affected, making it extremely difficult to pointedly say that a person has celiac disease.

These symptoms cover almost all systems of the body including reproductive to digestive, cardiovascular to endocrine, respiratory to neuromuscular, and even affect the bones, and the teeth. Another major variation also is the age at which celiac disease becomes symptomatic. While some show symptoms quite early in their childhood, some others show symptoms later in their life, and some may not manifest with any symptoms all through their life.

Talking of the oral/dental symptoms, there are two main causes for concern one involving the soft tissues and the other involving the teeth. Let us look at the two in a little more detail.

Similar to the canker sores or the usual mouth ulcers, celiac disease also cause whitish sores. Unlike the canker sores which appear on the lips, the celiac mouth sores are common on the insides of the cheek, gums, lips, palate, and sometimes even the tongue. The appearance is very similar to that of aphthous ulcers, which have a whitish or grayish margin. They appear at random with no specific reason. The soft tissue lining of the digestive system is present from the stomach or intestine all the way to the mouth, and therefore these ulcers are seen. These can be quite discomforting and interfere with nutrition. Topical creams and/or gels can be applied to treat them. If celiac disease is diagnosed by then, abstaining from a gluten-free diet will help relieve the symptoms. Else, they may continue to recur and symptomatic treatment would be required.

The second oral symptom of celiac disease is the presence of visible defects of discoloration in the enamel. There are usually white, brown or yellow spots, usually discolored on the incisors and molars (front and back teeth). The bad news with the tooth issue is that these do not go away once a gluten-free diet is adopted. Depending on the severity, these may require tooth whitening treatments ranging from bleaching to veneers to full crowns.

The next time you have a group of symptoms, with the above two oral symptoms, contact your doctor and have a detailed discussion. It does not take much effort to diagnose and treat celiac disease.

Celiac Disease: How to Recognize and Manage Them

Cerebral ischaemia or brain ischemia is a medical condition that restricts the flow of blood to the brain, resulting in an unmet metabolic demand. This leads to limited oxygen supply in the brain, which could result in the death of brain tissues, cerebral infarction or an ischemic stroke. Thus, a cardiorespiratory arrest, a stroke, and irreversible brain damage are few possible consequences of cerebral ischaemia.

People with compressed blood vessels, low blood pressure, congenital heart defects or sickle cell anaemia have a high risk of developing cerebral ischaemia since compressed blood vessels or very low pressure can lead to restricted blood flow. Also, sickle-shaped cells have a greater tendency to clot, causing obstructed blood flow.

Patients with cerebral ischaemia experience a host of symptoms, such as weakness in the body, problems with coordination and movement, vision and speech impairment and unconsciousness.

Cerebral congestion, on the other hand, refers to the excessive quantity of blood in the brain vessels, causing pressure on the cerebral substance. Cerebral congestion is of two types. It is termed as active when there is too much arterial blood flow and passive when there is undue quantity of venous blood in the veins of the brain. Both conditions cause symptoms, such as a severe headache, insomnia, irritability and unconsciousness. The patient gets little sleep and is disturbed often followed by dreams. When awake, the patient s mental activity in the brain is very high.

Homeopathy is now a well-established school of medicine backed with years of research and practice. Gone are the days when homeopathy was considered no more than an extension of herbal home remedies.

Homeopathic laboratories around the world produce a large number of medicines covering almost all ailments. The benefits of homeopathic treatment are now well established due to its holistic approach and minimal side effects. Homeopathy is undoubtedly a ray of hope for patients with cerebral ischaemia and cerebral congestion, as it delivers a comprehensive treatment plan designed to target the signs and symptoms of the disease and address its non-occurrence.

The medications deal with mild to severe symptoms, including inflammation of the brain, headache, vomiting, insomnia, stroke/convulsions and seizures. The stramonium drug, for example, deals with seizures. Belladonna is an effective remedy for sharp shooting headaches, a common symptom of cerebral congestion. Ferrum is believed to be a valuable remedy for brain ischaemia. Few drugs deal with the symptoms of both ischaemia and congestion nux is a suitable drug for the treatment of ischaemia as well as for passive cerebral congestion. Similarly, phosphorus can be used to treat brain ischaemia and congestion. Zincum metallicum is a highly recommended drug for chronic cases of ischaemia.

The treatment is comprehensive and long term and shows substantive results. Regular follow-ups and consultation with a homeopath specialist is the key to an effective treatment.

Homeopathy Treatment Of Cerebral Ischaemia & Cerebral Congestion

ADHD is one of the commonest behavioral disorders that are found in mostly school going kids. In fact, this kind of trouble might affect kid's ability quite adversely. There are a few signs with the help of which ADHD in kids can be easily detected and some of the commonest ones are emotional turmoil, unfinished tasks, squirm and fidget, low focus careless mistakes and other related ones. 

Both interpersonal relationship and schooling success can be hampered to a great extent with this kind of mental disorder. This is why the kids facing the mentioned signs need to be thoroughly diagnosed medically so that the doctors can recommend best treatments that can provide fastest recovery and that too safely and easily. 

Best tips for tackling ADHD in kids
1. Setting behavior limits: If you make your kids learn how to lead a disciplined life, then appropriate behavioral limits are established. Arrogant child is mostly exposed towards ADHD. 

2. Staying calm: Child anger should be efficiently controlled otherwise. ADHD cannot be cured. If the kids remain calm and quiet, then only their concentration level will increase, and they can show productive outcomes. 

3. Setting pressure free structure: sensible routines and scheduled charts are to be prepared so that unwanted risks can be easily avoided. If the kids are under tremendous pressure, then they might face different kinds of behavioral troubles. 

4. Allow kids to make wise choices: If you let your kids free, then only they will be able to take right decisions. Kids with a cool mind can take wise decisions that are very much appropriate for upgrading their performances. 

5. Advocating child: Child advocating is highly needed for maintaining a good and healthy balance. But too much strictness should be avoided so that your kids' behavior can be controlled with ease.  This should be done either by parents or tutors so that they can choose the best direction in life. 

6. Avoid muting any headstrong child: Communicate with your child so that a proper interaction can be maintained. If your child remains silent for too long, then they might face different behavioral troubles. 

7. Acquiring knowledge about ADHD: Both parents and kids should have equal knowledge about ADHD and then only the probable signs can be easily avoided, and the necessary treatments can be known. 

8. Being persistent: Persistent behavior is to be maintained, and if you find any deviation in your kids, then you should take them to a doctor.

Parenting in Attention Deficit Hyperactivity Disorder

Rhinoplasty is a surgery which is performed to work on and reshape the structure and size of your nose. It is done for various reasons: correction and reconstruction of the nose, restoring functionality and aesthetic enhancement. With the help of this surgery, the size of the nose can be altered, the angle of the nose in relation to the lips can be changed, tip of the nose can be altered and bumps, indentations or other abnormalities can be corrected.

Rhinoplasty is of two types:
Open rhinoplasty: The surgeon makes the incision on the columella.
Closed rhinoplasty: The surgeon makes an incision inside the nose without touching the septum.

The Surgery

The procedure takes 1-2 hours; however, hospital stay may be mandatory, if the procedure is complex. Either general or local anesthesia is used to perform rhinoplasty.
The surgeon will either make an incision outside the nose or inside. The incisions are done to get access to the cartilage and bones supporting the nose. Depending on what the patient requires, cartilage and bone may be added or removed, or tissue could be added.
After the rearrangement and reshaping is done, and the incision is sutured, a splint is put over the nose to support it as it heals. The splint and the nose are carefully bandaged.
The surgeries are either conducted by plastic surgeons or otolaryngologists and maxillofacial surgeons.
Aftercare

You can go home the day the surgery is performed.
Your face and nose will swell up and hurt after the surgery and headaches will be common.
The nasal splint will be removed after 3-5 days. You should feel more comfortable after this.
However, full recovery takes a longer time. The healing process is gradual and slow and there might be some numbness and swelling in your nose for months to come.

Scarless Nose Job - Things You Must Consider!

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