Spread of HIV infection from a woman who has transmits HIV to her child during pregnancy, childbirth (labor and delivery), or breastfeeding (breast milk) is called as  Mother to child  transmission (MTCT) of HIV. It is also termed as the perinatal transmission of the HIV infection or  vertical  transmission. In the absence of medical intervention, perinatal transmission rates are very high, between 20-45% in different parts of the world. In various regions of the African subcontinent a large number of HIV infected children are present. It is a major cause of deaths in teens and adolescents in that region. 

Almost 90% of all HIV infected children live in the sub-Saharan Africa. In some districts of AP, Karnataka, Maharashtra and TN that were highly HIV-prone, we have several HIV infected children and adolescents. The virus replicates in the body and affects the immune system. Due to decreased immunity, various opportunistic infections enter the body and cause AIDS related symptoms. Prevention of HIV infection in infants and young children is now a high priority and has been the rallying point for enhanced prevention efforts. MTCT HIV infection can be prevented with adequate measures by way of Anti-retroviral treatment (ART). All expecting mothers who are HIV infected should have access to the preventive medical services throughout the gestation period, during labor and also during breastfeeding. 



Proper provision of resources with skilled staff and awareness programs can help in avoiding new infection cases. Breastfeeding is the primary source of transmission of infection from mother to child. Basically, once ART is started in an HIV infected pregnant woman that should continue forever. With proper ART course, chances of MTCT are near Zero. At the Unison Medicare & Research Centre; which is India s first fully comprehensive clinic for HIV Care and infectious Diseases, during last decade, not a single MTCT has occurred after treating more than 160 such HIV infected mothers. Even prior to that MTCT rate was lower than 1%. Our motto has been making the mothers virally suppressed commensurate with the global principle of  Undetectable = Untransmittable ! In fact now more and more HIV infected couples have been coming forward for an elective pregnancy. Even HIV un-infected children orphaned by AIDS or living with sick caregivers are at the great risk of emotional and physical abuse, which in turn increases the child s vulnerability to HIV infection. 

Reduction of risks to these vulnerable children is of great importance and various programs are being implemented for the welfare of orphans and vulnerable children. Various risk factors that are implicated in the transmission of HIV infection from mother to child are as follows: 

Increased viral load 
Genital tract viral load 
Reduced CD4 cell count 
Unprotected sexual intercourse with infected partner 
Smoking, Substance and drug abuse 
Deficiency of Vitamin A and other essential nutrients 
Presence of other Sexually transmitted diseases (STDs) 
Pre-term delivery 
Placental disruption 
Invasive monitoring of the fetus 
Breast feeding In most cases, HIV will not cross through the placenta from mother to baby. 
In an otherwise healthy mother, risk of child getting infected is low. Prenatal visits shouldn t be increased until a complication arises. The physician should observe symptoms of AIDS and pregnancy-related complications on a regular basis. HIV may be the direct cause or a marker of a complex interaction of related medical and social conditions that affect pregnancy. Most HIV positive women are usually asymptomatic and have no major obstetrical problems during their gestation period. They should receive similar obstetric antenatal care as the HIV-negative women, unless indicated by the need to provide specific treatment for HIV related conditions. There is no evidence of a need to increase the number of antenatal visits, provided there are no complications of the HIV infection, although additional counseling sessions may be required to reassure the mother and family. 

Care of the HIV positive woman during pregnancy should include ongoing counseling and support as an integral part of the management. Invasive diagnostic procedures, such as chorionic villus sampling, amniocentesis or cordo-centesis should be avoided wherever possible, due to a possible risk of infection of the fetus. In case you have a concern or query you can always consult an expert & get answers to your questions!

How Can We Achieve HIV-Free Generation?

A Guide to Dealing with Fibromyalgia

Fibromyalgia is a chronic condition marked by constant flu-like symptoms such as fatigue, headaches, insomnia and joint pains. However, the disease has no visible symptoms. There are also no known causes for the disease. While some believe stress to be a trigger for fibromyalgia, other theories suggest that physical and emotional factors such as a prior illness lead to the onset of this disease. This leads to fibromyalgia patients being often misunderstood and misdiagnosed. Almost 80% of fibromyalgia patients are women. While the disease is not lethal, it can make daily life difficult.

The criteria for fibromyalgia were established only in the late 1900s. In addition, the symptoms of this disease present themselves differently in each patient. This makes diagnosis very difficult.

Constant pain all over the body is the most common symptom of fibromyalgia.
You may also feel constantly tired, and unable to get a restful sleep.
Some fibromyalgia patients also suffer from depression or anxiety and an irritable bowel syndrome.
Fibromyalgia patients may also feel hyper sensitive to cold or heat, and feel numbness in fingers and toes.

Fibromyalgia has no known cure, and like arthritis, treatment for this disease addresses its symptoms. Most treatment programs include a combination of drugs, physical therapy, and behavioral techniques.

Pain relievers or anti-inflammatory medication and antidepressants are the two types of drugs administered to fibromyalgia patients. However, these should not be counted on as a long-term solution, as the side effects of these medicines can cause additional problems. Therapeutic massages and chiropractic manipulations can also help ease the pain. Along with this, it is also important to rest and relax. This helps reduce stress which often triggers fibromyalgia symptoms.

To get a better night's sleep, try going to bed and getting up at the same time every day. A warm glass of milk or chamomile tea just before bedtime can also help induce sleep. As far as possible, avoid taking sleeping tablets, as the body can soon become dependent on these.

Though you may constantly feel tired, increasing the day to day activity levels can have a positive effect on your health. Consider adding low-intensity activities such as walking, cycling, yoga or dancing to your daily routine. Complement these with a well-balanced, nutritious diet that includes lots of fruits and vegetables. If you or a loved one has fibromyalgia, bad days may not be prevented. But with treatment, they can be controlled.

A Guide to Dealing with Fibromyalgia

Tuberculosis or TB is a highly contagious airborne disease, which is caused by Mycobacterium tuberculosis. It typically affects your lungs and is characterized by the formation of greyish, hard nodules or tubercles.

Pathology of Tuberculosis

Diagnosis of the disease depends essentially on identifying the bacteria from the tissue. Methods of diagnosis usually include the following  

Skin Test   The most common test for detection of tuberculosis is the skin test. During the procedure, a small dose of PPD tuberculin is injected onto the skin of the forearm. The injection site needs to be monitored after a couple of days. Swelling in the forearm, usually, a hard, red bump could mean that you have contracted tuberculosis.
An X-ray of the Chest   Chest X-ray can reveal calcification, cavitations, and nodes in the upper lobes
Sputum Cultures and Smears   These are mostly used to detect pulmonary tuberculosis. Three specimens of sputum early in the morning are collected on three separate days. The specimen is prepared on a slide and stained with an acid-fast dye before being observed under the microscope. The slide may show the characteristic AFB or acid-fast bacilli.
Gastric Aspirates Test   This involves placing a tiny nasogastric tube in the abdomen early in the morning and gastric contents are suctioned and processed for culture and smears.
Lymph Node Biopsy   The procedure involves removing an enlarged lymph node and culturing a portion of it. The remaining section is sent for staining and examined under a microscope.
Biopsy   Biopsy is conducted when an abnormality develops in the airways during bronchoscopy. This involves threading a thin wire through the bronchoscope and attaching tiny biopsy forceps to its end in order to remove multiple tissue samples from the bronchi. The samples are sent to the laboratory for complete analysis.
Treatment of Tuberculosis

Studies show that in the majority of cases, patients were cured with the help of the right medication. The type and dosage of antibiotic treatment precisely depend on factors like   the patient s age, health condition, and potential resistance to certain drugs, whether the disease is active or latent, and the infection site.
Patients with latent TB may require one type of antibiotic, while those having active TB   particularly MDR TB   are often prescribed multiple drugs for about 6-9 months.
Patients who received proper treatment on time have shown vast improvement on the health aspect. After a few weeks of undergoing treatment, you might be tempted to quit taking your TB medications, but it is important that you complete the full treatment course. Skipping doses may allow the bacteria to become drug-resistant, leading to tuberculosis that is more severe and difficult to cure.



Tuberculosis - All You Must Know!

If you are experiencing a whizzing sound while you breathe or having difficulty in breathing, you are suffering from asthma. It is a medical condition characterized by paroxysmal wheezing respiration dyspnoea. There is no definite way to prevent asthma, but by following a step-by-step daily plan, you can prevent asthma attacks or keep them in check. Here are some important measures to follow to prevent asthma:

You need to strictly follow your asthma action plan. The plan should be laid down after a detailed discussion with your doctor or healthcare team. All the medicines you require to prevent the asthma attacks will be written down for you.
You should get vaccinated for pneumonia and influenza. This will prevent these conditions from triggering asthma attacks or flare-ups.
You need to identify the asthma triggers and stay away from them. Several outdoors irritants and allergens from pollen to cold air can trigger asthma attacks.
You have to monitor your breathing. By recognising the warning signs of an attack like wheezing, slight coughing or shortness of breath, you can prevent an asthma attack. You need to measure and record your peak airflow regularly using a home peak flow meter.
By acting quickly, you can identify a fatal attack and prevent it from occurring. When the peak flow measurement decreases, you need to take your medicines immediately and abstain from any activity which may have triggered the attack.
You need to keep taking your prescribed medicines, even if your asthma symptoms have improved. You should not change your medication schedule without consulting a doctor. It is recommended that you to bring along the medicines you take at your doctor s appointment as he will be able to tell whether you are taking them right.
If you use your quick relief inhaler a lot, the asthma is not under control. You need to visit your doctor as soon as possible and he/she will make some modifications to your treatment.
For prevention of asthma, you should use allergy proof pillow covers and mattresses. You must wash your bedding every week in hot water to eliminate dust mites. You may use a dehumidifier for reducing excess moisture to prevent mold.
Do not allow your pets in the bedroom and on the furniture. Pet dander is a common trigger of asthma and it cannot be avoided by people who own pets.
You can also fit an air filtration system in your home. It will help in the elimination of asthma triggers such as pollen, dust mites and other allergens.
Many doctors suggest immunotherapy for asthma prevention in the form of allergy shots. Immunotherapy aims at altering a person s immune response by making it less sensitive to asthma triggers.

Asthma - 10 Ways to Keep it Under Control

Conditioning Before Shampoo VS Post Shampoo - What's Ideal?

Conditioners and shampoos, you need both for an appropriate hair care regimen. Just like most other people, you might have the confusion about conditioner use - whether to use it before you shampoo your hair or when you're done with shampooing.

Read on to find out what you should be doing.

1. Hair Type: A factor that determines your use of a conditioner before you shampoo or after it depends on your hair type. For individuals who have dry or thick hair, using a conditioner after you shampoo is the most apt, especially during the winter months when complaints of flyaway hairs are very common. Conditioning before you apply shampoo to your hair is ideal if you've fine hair as it provides your hair with much needed nourishment. Additionally, it allows the shampoo to distribute evenly all over your hair.

2. Greasy Hair: Applying a conditioner before you shampoo your hair is most apt for individuals whose hair is prone to oiliness. This is because it helps you in thoroughly washing away the grease that gets build up in your hair when it's time to shampoo. The regimen of shampoo and conditioning afterwards doesn't ensure a proper elimination of the problem.

3. The Problem of Residues: if you condition your hair before shampooing, you can rest assure that no residues get left behind on the scalp. This is not the case when you condition your hair afterwards. Many a time, if you don't rinse properly residues of the conditioner used get left behind, thereby weighing down your hair.

Unless your hair is of normal texture, conditioning before shampooing can prove to be beneficial for your hair.

If you would like to consult with me privately, please click on 'consult'.

Conditioning Before Shampoo Vs Post Shampoo - What's Ideal?

Performing physical activities on a daily basis always have its benefits, but doing exercise in a well-planned manner is essential for those people who suffer from either type-1 or type-2 diabetes. Becoming more active helps lower blood sugar levels and keep diabetes under control.

Relation between exercise and sugar levels
The food we consume contains sugars which are stored in our blood in the form of glucose. This glucose is absorbed by the muscles in our body, but body fat is the enemy of this absorption process. An obese person is prone to type-2 diabetes since excessive amounts of fat are present in the body which does not allow the muscles to absorb the glucose from the blood. This results in more glucose or sugar level in the blood which leads to diabetes.

By regularly exercising, a person not only burns his/her excessive body fat, but also makes use of the muscles in his body thus allowing the muscles to absorb the glucose present in the blood readily. This helps reduce the sugar level in the blood. Moreover, doing exercise on a regular basis helps increase insulin sensitivity. It helps cells to use available insulin in taking up glucose during and after physical activity.

Understanding blood glucose reaction
The duration for which you perform physical activities will determine your blood glucose level. Physical activity has its effect on your blood glucose level and can keep it in check for up to 24 hours by increasing your body s insulin sensitivity. Every individual needs to monitor how his body responds to physical exercise by regularly monitoring the blood sugar level before and after exercise or as advised by the doctor.
Once you are familiar with the results you achieve with respect to duration and types of exercises you perform you shall be able to control your blood sugar levels more effectively and prevent your sugar levels from going either too high or too low.

Hypoglycemia and physical activity
People who have diabetes should be prepared to treat hypoglycemia or low blood sugar level. Hypoglycemia is more common in people with type-1 diabetes, and people with type-2 diabetes are at lesser risk unless they are on insulin. Individuals who experience Hypoglycemia during or after exercise should consult a doctor immediately.

If you choose to resume your exercise routine, make sure you take a break and treat your low blood sugar level. Once your sugar level gets normal, you can begin your physical activity. What you need to know is that a drop, in sugar level, can occur just after exercise or even long after exercise.

Chances of a drop, in sugar level, occur in those diabetic people who either take insulin, skip meals, or exercise for too long or too hard. If you are finding it hard to keep your sugar level in check, consult a doctor immediately and follow his advice diligently.

In order to avoid hypoglycaemia, you can eat a fruit or nuts before exercise. It is also very important to hydrate yourself during the exercise. Ideally, take a fruit half hour before exercising. Keep yourself hydrated during the workout. Avoid energy drinks.

Why Exercising Is Important In Reducing Sugar Level In Blood?

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