
- hiv testing in pregnancy should be done early so as standard care can be taken for the pregnant women.


- this hiv testing must be repeated in the third trimester, usually before 36 weeks of gestation. This should be done in women with hiv-seronegative and also in pregnant women who are at a high risk of developing hiv infection.


- expedited hiv tests should be performed at the time of delivery and labor and this is a must in women who have not been documented for hiv. The results of the test should be available in one hour of the test and the testing should be available 24 hours. In case the results are positive then, infant postnatal antiretroviral and intrapartum drug prophylaxis should be started immediately.


- women who have not been able to be tested for hiv at the time of labor and delivery are suggested expedited screening for hiv. Their screening can be done immediately postpartum or their babies should undergo screening. In case the infant and mother, both are positive, then infant antiretroviral drug prophylaxis should be started immediately. These mothers should avoid breastfeeding their babies, until the supplemental hiv tests are negative. In infants with positive hiv, prophylaxis should be discontinued and antiretroviral drug therapy should be started.


- in case of acute hiv infection during pregnancy, that is in the intrapartum period, or during breast feeding, initial testing can be performed with an antigen/antibody combination immunoassay. If the supplemental test is negative, then an additional test which is the virologic test (dna, rna) are necessary for the diagnosis of the hiv infection.
- if the mother is hiv positive then this information must be documented in the infant's medical record and also communicated to the infants care provider.
The knowledge of an antenatal maternal hiv infection allows the:
- women with hiv infection to get the correct antiretroviral therapy along with prophylaxis for the infections which might occur due to the immunocompromised state of the body. This also prevents and decreases the risk of transmission to their partners.
- when there is provision for antiretroviral therapy for the mother during pregnancy and labor along with antiretroviral drug prophylaxis for the baby there is less risk of perinatal transmission of the hiv.
- the hiv infected women should be counseled for a cesarean delivery. The option of an elective cesarean reduces the perinatal transmission of the hiv.
- the hiv women should be counseled about the risk of breastfeeding.

Identification and Management of Perinatal HIV Treatment

Addison s disease is considered to be a life threatening and serious illness. When one suffers from this disease, the amount of hormones like Aldosterone and Cortisol reduces rapidly due to the poor functioning of the Adrenal glands. The hormones that the Adrenal glands produce are necessary for the body to function normally. To better understand what Addison s disease is all about, below are some basic facts.

Fact 1: Addison s disease is often confused or linked with adrenal insufficiency. However, Addison s disease is more of an autoimmune disorder that later leads to adrenal insufficiency, which is a hormone-related imbalance.
Fact 2: Addison s disease can happen to anyone regardless of their gender or age. However, genetics may also have a role to play here, as those who have someone affected with Addison s in the family, face greater risks.
Fact 3: While for someone it may take years for totally disrupting the hormone production, for some it may grow worse very quickly. Though it is rare, it is possible.
Fact 4: The symptoms of Addison s disease often get unnoticed or misinterpreted, as the disease is very uncommon. This is a rare disease that occurs in one in a million.
Fact 5: When suspected of having Addison s disease, the screening process doesn t take much time. Generally, a normal blood test showing the amounts of ACTH and cortisol hormone will confirm the diagnosis.
Fact 6: Some very common symptoms of this disease are mild to severe pain in the bones and in the abdomen, weight loss, nausea, forgetfulness, low blood pressure and lack of energy. It is these common symptoms that can point to numerous other conditions that make its diagnosis a tricky one.
Fact-7: Sometimes, Addison's disease may cause the skin tone to become darker due to the hormonal changes. It is probably the only disease that can cause such darkening or skin discolorations of the otherwise normal skin.
Fact 8: People who have Addison s disease generally become dependent on the daily intake of cortisol medications or steroids. Without Cortisol, the stress hormone, the body may go into serious adrenal crisis.
Fact 9: When overlooked for a long time or not provided with the treatment and medication when needed, Addison's disease may lead to sudden organ failure. Therefore, understanding the symptoms and opting for a blood test is essential if this disease is suspected.
Fact 10: Lastly, Addison's disease can be easily cured and treated by introducing a few serious lifestyle changes and hormonal therapies. Sometimes when oral hormone supplements fail to get properly absorbed, injecting the supplements becomes necessary.
Studies have shown that around 140 people approximately suffers from Addison's disease out of every million. Therefore, knowing the above-mentioned facts becomes necessary for have a clear understanding of the disease which may help in dealing with it in the best way possible.

Addison's Disease - 10 Interesting Facts You Must Know!

Nerve pain or peripheral neuropathy, as it is medically known, is characterized by pain, numbness and weakness that arise out of nerve damage. This pain is usually restricted to the feet and the hands.

What are the common causes?

Diabetes is the most common cause for this condition. However, other causes, such as injuries, infections and prolonged exposure to certain toxins can also trigger nerve pain.

How can you control nerve pain?

Nerve pain can be managed and taken care of at home taking into consideration the points that have been mentioned below:

Topical Painkillers: Certain over the counter ointments and creams can help relieve nerve pain. These medications act as local anesthetics; that is they numb the area of the pain. Capsaicin, a derivative of chili peppers, is one of the major ingredients used in these medicines. Others use botanical oils as the major ingredients.

Painkillers: There are painkillers available OTC which can curb nerve pain. However, painkillers such as ibuprofen, aspirin and acetaminophen do not really work well for severe pain of the nerves.

Supplements: The lack of Vitamin B12 is considered to be a very important cause, and at times, a catalyst for nerve pain. In a case such as this, Vitamin B12 supplements or injections might be administered. Although more research needs to go into this, but certain supplements, especially gamma-linolenic and alpha-lipoic acid can help soothe nerve pain caused by diabetes.

Acupuncture: This time-honored Chinese approach is a proven alleviator of nerve pain. Acupuncture releases chemicals which numb the pain, or prevent the pain signals from travelling to the brain.

Physical Therapy and Massages: Physical Therapy can especially heal and strengthen weak muscles that can stem from acute nerve damage and pain. Though more evidence is needed, according to a few sufferers of this condition, massages can be helpful with the tremendously painful muscle spasms that can so often result from nerve pain.

Relaxation Techniques: In combination with the abovementioned approaches, relaxation techniques can go a long way in relieving debilitating neural pain. Besides being helpful with dealing and reducing a few stress phases of life which can cause nerve pain, these techniques might actually root out the actual pain itself.

Lifestyle Modifications: This one s always a winner! Eating a well-balanced diet that guarantees all nutrients in uniform amounts can never go wrong. Regular exercises for about 30-45 minutes can remedy different types of pain; nerve pain being one of them. Try and limit alcohol intake (a peg once a week won t harm one, but binge drinking can play the ultimate spoilsport and make all health plans go topsy-turvy!). Abstain from smoking or chewing tobacco as this is usually the primary contributor towards any medical condition or disorder.

How To Control Nerve Pain?

Alcohol addiction commonly known as alcoholism is a fairly common problem that has shown to affect people from every walk of life. Scientists have tried to pinpoint the absolute cause behind alcoholism, but to no success. Certain factors like sex, genetic, and socioeconomic factors have shown to have some effect on alcoholism. The cause of alcoholism is never singular. Alcohol addiction is indeed a disease, where a person may not have full control over his actions and is seen to change the neurochemistry of the brain.

The symptoms of alcohol addiction can be seen in many ways and the severity of the situation varies from person to person. Other factors such as the frequency of consumption may also be specific. While some people are heavy drinkers and drink throughout the day; others may drink occasionally and remain sober for a few days.

A person who is dependent on alcohol will prioritise drinking over other essential activities and will eventually cause disruption in his social life, work or other areas of his life. It can also create a negative effect in the victim s life along with their families and their near and dear ones.

What are the signs of alcohol addiction and alcohol abuse?
The signs and symptoms of alcoholism or addiction are rather conspicuous. Since drinking alcohol is common in social events in most cultures around the world, it becomes difficult to recognise when someone is addicted to alcohol, unlike drugs like cocaine and heroin.

The physical signs of alcohol abuse include:

Loss of control over the quantity of alcohol consumed.
Lack of adequate sleep, followed by overcompensation for sleep.
Expression of anger and other negative behaviours my increase in inappropriate places and situations.
Lack of proper attention towards the priorities in life.
How does alcohol affect the body?
Chronic abuse of alcohol can have negative effects on almost every part of your body and plays havoc in your system. Alcohol is liable to cause irreversible damage to several organs of the body which is vital for sustenance:

Nervous system
Stomach or Intestines
Liver
Heart
Brain
Alcoholism in itself can lead to several diseases like:

High blood pressure
Cancer
Increased incidences of osteoporosis, especially in women
Sexual issues

Alcohol - How Over Consumption Affects Your Body?

Diabetes is a metabolic disorder characterized by Hyperglycemia (elevated blood glucose level) due to either reduced production of insulin or the inability of the body to utilize the insulin produced. Today management of diabetes has become a prime concern. Over the winter months, diabetic patients are likely to suffer from higher blood glucose levels than during the warmer months. As the temperature drops and the sugar levels up, thus, diabetic patients should be extra careful about the temperature fluctuations or seasonal changes.The cold weather makes diabetics experience many health problems, besides creating a major change in their sugar levels.

Following are the most harmful effects that diabetic patients may suffer from during the cold weather

Change in hemoglobin level: There is a great change in their glycated hemoglobin levels. Whatever the type of diabetes an individual has, the freezing temperature can increase the level of HbA1c or glycated hemoglobin. This is most likely because of decreased physical activity. Cold weather makes it difficult for some people to go out. A little activity each day can help with insulin sensitivity (in all types of diabetes) which can help the body to regulate sugar level in a better way.
Prone to diseases: Since the immune system is also not at its best strength in winters, there are increased incidences of microbial infections like cold and flu or in some cases pneumonia. As a result, the body produces counterregulatory hormones (Cortisol, Adrenaline, and Glucagon) to counteract the situation. These hormones affect the utilization of insulin by the body thereby elevating the blood glucose level. Also, conditions like flu and cold tend to make them feel lethargic and stress and can prevent them from taking the diet, which is required, which eventually can lead to an increase in the blood sugar level.
Winter blues: It is often seen that people feel low during winters, as they tend to go out less and prefer to stay indoors. Less outdoor activity during winters can sometimes trigger mood swings or in some cases depression, which in turn can shoot up the level of blood sugar in their body. Thus it is advisable that one should spend more time with friends and family, in order to keep these blues at bay. 
Other problems: Most diabetic people are unaware of their nerve functions, and are unable to feel the difference between the cold and hot water, which can lead to burn injury. Also, during the winter season, most diabetic patients tend to lose feeling in their toes and feet due to vascular changes. Therefore, it is advisable that people should check their feet frequently, so as to ensure that there is no open wound or pressure area in their feet. One must take very good care of their feet, keep them moisturized, inner fingers clean and dry, prevent any type of fungal growth in toes, etc. By taking required preventive measures before the onset of winters diabetic patients can control their blood sugar level, which enables them to stay away from associated problems. 
In case the blood sugar level goes beyond 130, one should not take the medicine on their own but should get in touch with their endocrinologist (diabetologist).

Cold Weather - How It Can Affect Diabetic Patients?

Stress fractures are small cracks that may appear in a bone. It occurs due to repetitive application of force in the same area. It is very common among various sports such as running, tennis and football. It may also occur due to osteoporosis as this disorder weakens the bones and allows stress fractures to occur easily.


The majority of stress fractures occur due to overuse of a specific muscle. The bones and the muscles used in a specific movement do not get time to recover, thus leading to stress fracture.


Causes
The major cause of stress fracture is change in physical activity, such as a sudden increase in exercise. The other factors that may lead to stress fracture are -


1. Poor conditioning: if you are starting an exercise regimen without proper preparation, then it may cause stress on the muscles. It is important that you condition your body before doing any intense activity to prevent injuries.


2. Bone insufficiency: various disorders such as osteoporosis reduces bone strength and increases the likelihood of a stress fracture. If you have low bone density then you are at a higher risk of having stress fractures.


3. Change in surface: change in surface like shifting from running on grass to road tends to cause more stress on the legs, thus increasing the likelihood of a fracture.


4. Improper form: performing any exercise with improper form may lead to a number of injuries. It is recommended to learn the correct technique before exercising, so you may use a spotter or a trainer to guide you.


Symptoms
The symptoms of a stress fracture are: 


1. Pain: you may experience dull to severe pain if you have stress fractures. The severity of pain will depend on the severity of the fracture.


2. Swelling: pain may be accompanied by swelling on the sides and the top of the foot.


3. Tenderness: stress fractures may cause tenderness in the muscles around the affected area.

Causes and Symptoms of Stress Fracture

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