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?

Tonsils are the two oval-shaped tissue pads at the back of your throat, which function as a mechanism to protect you from diseases. Any infection of the tonsils is referred to as  tonsillitis .

You can suffer from tonsillitis at any age, but it is more commonly diagnosed in children. Tonsillitis is highly contagious.

There are two types of tonsillitis:

Chronic tonsillitis Longer episodes of acute tonsillitis
Recurrent tonsillitis Recurrent episodes of tonsillitis in a year
Causes

Tonsillitis can cause viral and bacterial infections. The  Streptococcus (strep) bacteria  is a common cause. Some other causes include:

Adenoviruses
Influenza virus
Epstein-Barr virus
Parainfluenza virus
Enteroviruses
Herpes simplex virus
Symptoms

Since tonsillitis has various causes, symptoms too tend to differ. Some symptoms include:

An extremely sore throat
Painful or difficult swallowing
Scratchy-sounding voice
Bad breath
Fever
Chills
Earaches
Stomach aches
Headaches
Stiff neck
Neck and jaw tenderness due to inflamed lymph nodes
Tonsils that become swollen and red in colour
Yellow or white spots on the tonsils
In children, symptoms such as excessive drooling, increased irritability or poor appetite are usually noticeable.

Treatment

If the tonsillitis is mild, especially caused by a virus, it usually doesn t require any treatment. More critical cases of tonsillitis might require treatments such as tonsillectomy (a surgical process used to remove the tonsils) or administration of antibiotics.

Penicillin is the most commonly administered antibiotic. Once commonly performed, tonsillectomy (surgical removal of tonsils) is now reserved for extremely critical cases. 

Causes, Symptoms and Treatment of Tonsillitis

Tonsillitis, in the easiest terms, is the swelling of tonsils in our throat that is accompanied by symptoms like throat pain, difficulty in swallowing/ drinking, altered voice and fever etc.

As in the case of most infections, the occurrence of tonsillitis is more common in children due to relatively lower immunity and habits that invite infections. Let's take a look at the first line of defence when you have a cranky child with swollen tonsils.

1. Make your child gargle with salty warm water: This treatment is most helpful in any infection in the mouth. Add half teaspoonful of salt to a glass of warm water and make the child gargle with the mixture as many times in the day as possible (to a maximum of 5 times). Continue till the condition prevails.

Make sure the child spits out the water and not drinks it.

2. Antibiotics: Consult the ent specialist and have the antibiotics if it is a bacterial cause as per the doctor. Take the alternative treatment prescribed in case of other causes. The entire course of medication should be completed even if the kid gets better sooner to eliminate all traces of bacteria.

3. Painkiller/numbing lozenges: Painkillers that are prescribed by the doctor can be given to ease the pain. Same is the case with lozenges but care should be taken that he/she should not have too many of these.

4. Allow him/her to take rest: It does help in a betterment of the condition!

5. Give warm (not hot) soothing food: Soup, ginger honey mixture, ginger tea can help soothe the inflamed tonsils in most cases. The condition, more often than not, gets better within 7-10 days.


Best Ways to Deal With Tonsillitis in Kids

Acute sinusitis is a type of infection of the sinus. It involves an infection or inflammation of your sinus membranes. The most common symptom of sinusitis is that you have trouble draining mucus from your nose. The sinus is the cavity around the nasal passage and it may swell up when this condition occurs. Usually, the symptoms are temporary. However, sometimes, especially if you suffer from chronic sinusitis,medical intervention is required.

Saline Nasal Spray: This is a spray you put into your nose several times a day to clean your nasal passages.
Nasal Corticosteroids: There are many types of nasal corticosteroids. They include fluticasone, budesonide, mometasone, beclomethsone. These nasal sprays not only help to treat inflammation, they help prevent to prevent inflammation as well.
Aspirin: This is a type of OTC pain relievers and they help relieve the pain of acute sinusitis. Acetaminophen and ibuprofen are two other OTC pain relievers which can be used instead of aspirin.
Antibiotics: Antibiotics are usually not required and should never be taken without the doctor's prescription. However, sometimes the doctor may recommend it if he thinks there is a bacterial infection or if the symptoms progress rapidly.
Immunotherapy: Immunotherapy is given when allergies are the reason you are having acute sinusitis. It is rarely needed, however.
Surgery: For sinusitis symptoms which are chronic or occur frequently, nasal surgery may be the best option for permanent relief. A number of different surgical procedures can be used to treat acute sinusitis such as balloon sinuplasty, endoscopic sinus surgery etc.

Treatment of Acute Sinusitis

If you find yourself suffering from coughing spells accompanied by breathlessness and phlegm, you may have bronchitis. Bronchitis is a respiratory disease that causes an inflammation of the bronchial tubes. This narrows the airway and does not allow sufficient oxygen to reach the lungs. There are two types of bronchitis; acute bronchitis that lasts for 1-3 weeks and chronic bronchitis that persists for 3 months to 2 years.

Causes of acute bronchitis
Acute bronchitis is usually a result of viral, lung infections. It can also be caused by bacterial infections and exposure to irritants such as tobacco smoke, dust, vapours and particulate matter in the air.

Causes of chronic bronchitis
Repeated attacks of acute bronchitis can weaken the bronchial passage with time and lead to the development of chronic bronchitis. This condition can also be caused by prolonged exposure to dust, pollution and industrial fumes. This puts coal miners, grain handlers and metal workers at a high risk of suffering from this disease. Smoking cigarettes can also irritate the bronchial tubes and contribute to the development of this condition. Chronic bronchitis worsens when a person is exposed to high levels of sulpher dioxide and other such air pollutants for prolonged time periods. Some of the symptoms of bronchitis are:

A persistent cough
Phlegm
Breathlessness
Tightening of the chest
Fever
If these symptoms last for over a week or begin to interfere with your regular lifestyle, you should seek medical attention as soon as possible. Self-medicating with an over the counter cough suppressant is counterproductive in the case of bronchitis as a cough is the only way for phlegm and mucus to be expelled from the body. Conventional treatment for bronchitis includes

Getting lots of rest
Drinking plenty of fluids
Avoiding exposure to smoke and dust
Steam inhalations
Along with this, your doctor may also prescribe cough medicines and a bronchial inhalator. In cases of chronic bronchitis, oral or inhaled steroids may also be needed. Your doctor may also suggest a flu vaccine as bronchitis make your lungs vulnerable to further infections. If you smoke, your doctor will also urge you to quit as cigarette smoke can aggravate your symptoms.

In cases of severe chronic bronchitis where the bronchial tube s ability to pass oxygen is compromised, oxygen therapy may be needed. In such cases, you may need to have an oxygen tank on hand to be used continuously or as required.

Bronchitis - Common Causes Behind It!

Pilonidal Sinus/ Cyst is Characterized By 
   Small nodular swelling in the lower spinal region with occasional discharges that may stain undergarments. Sometimes mild pain may also be noticed. 
   It is usually seen in adults of college/ school going age & with hairy skin. 

Pilonidal Sinus/ Cyst seldom heal with medicinal treatment. Any medication whether allopathic, Ayurvedic or homeopathic may show some temporary relief but do not eradicate the problem. In most of the patients having pilonidal sinus/ cyst, surgeons usually recommend surgical procedures like Z-plasty etc. Even after surgery the chances of recurrences are always there. Post operative pain, hospitalization and chances of recurrence are the factors which suggest that surgery is not the appropriate method of treating pilonidal sinus/ cyst. 

TREATMENT OF CHOICE (AYURVEDA) - 
In Ayurveda, a parasurgical treatment known as Ksharsutra therapy is an effective treatment for pilonidal sinus/ cyst. Treatment method includes proper identification of sinus tract wrt. to its depth, direction and branching pattern. This could be achieved via sinogram or skilled probing. Once the sinus tract has been properly identified, a super specialized medicated thread i.e. Graded ksharsutra  is placed in the tract. The medicine from the medicated thread is gradually released which leads to debridement of the sinus tract which means unhealthy tissue, pus, hairs are expelled out from the tract. The proper and complete debridement of the tract induces healing of the sinus which subsequently heals. The medicine coated thread remains effective for 7-10 days after which it has to be replaced by a new thread. 

Usually, in a sinus of approx. 5 cm length, 6-8 sittings of medicated thread replacement are required at a weekly interval. Ksharsutra therapy being a non surgical opd procedure doesn't involve any hospitalization or bed rest and patients can resume their routine work immediately after treatment. Graded ksharsutra  treatment is the treatment of choice for Pilonidal Sinus as chances of recurrence are seldom seen. The facility of Graded ksharasutra  is available only at Sushruta Anorectal Institute. 

Pilonidal Sinus/ Cyst Treatment FAQs 

Question 1 - What is Pilonidal Sinus/ Cyst Disease? 

Answer - Pilonidal Sinus disease is seen as a small nodular swelling in the lower spinal region with occasional discharges of pus & blood. It is most commonly found in people with hairy skin. Some times mild pain may also be noticed. The main problem is that it keeps on developing again and again after short period of remission. As the problem aggravates, the size of the swelling & pus discharges also increase. It is usually not noticeable in the beginning till it keeps recurring again and again. It is advisable not to get it operated as the chances of recurrence after surgery are pretty high, where as in Ayurveda with the help of Graded ksharsutra , this problem can be completely cured without surgery. *(There is no guarantee of specific results and the results can vary.) 

Question 2 - What are the Causes of Pilonidal Sinus Disease? 

Answer -Pilonidal sinus is also known as the jeep riders back problem. The problem was first recorded on a large scale during world war II in the soldiers who rode jeeps and motorbikes on a frequent basis. Though, the reason behind the occurrence of the issue is really not known it is believed that in growing hairs and hairs penetrating the skin are main cause. The problem is more common in people who have hairy skin. Home remedies for Pilonidal Sinus? Answer - Pilonidal Sinus is an infective condition usually seen in hairy skin individuals. As such there is no home remedy for Pilonidal Sinus. So instead of wasting time in searching for home remedies; you should plan for complete treatment i.e. Ksharsutra Treatment for Pilonidal Sinus as soon as possible. 

Question 3 - What are the ways of identifying a Pilonidal Sinus and Recognizing Signs of Infection? 

Answer -The main problem with identifying Pilonidal Sinus Infection is; it cannot be done till it grows to a certain extent. At first, it appears like a normal boil on the skin. When it does not go away with time; pus starts discharging out of it. We have demarcated a few of the signs that may help you in detecting the problem. 

Sensation of pain while sitting or standing in the low back region. 
The cyst appears swollen 
Pus and blood mixed watery discharge from the cyst 
eddened skin near the cyst 
Cyst forming again and again

Pilonidal Sinus - Say No to Surgery!

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