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!

People have a common perception that most injuries, medical conditions only affect those who spend several hours working outdoors. But what if we tell you that people who stay indoors- such as homemakers - are also susceptible to numerous health problems?

There s a saying:  Home is where the heart is.  But for countless homemakers, home is the place where  hurt  is! Scores of Indian homemakers encounter various injuries every year while engaging in household chores like cleaning and washing. The most common ones are-

Sprain- if you re a neat freak, you wouldn t mind spending half of your day cleaning the entire house. Here s a small tip- go slow if your cleaning duties include shifting heavy appliances and furniture from one place to another. There s a high chance that you may end up with a sprain injury. Sprains occur when you accidentally twist your ligaments. Another major cause of sprain injuries is a sudden fall. If you re mopping the floor or cleaning the bathroom, there s a fair chance that you may slip or lose balance. One must be cautious when working with water.
Back injuries- These are the most common types of injuries at home. Bending, lifting a heavy bucket or an abrupt movement, can strain your back muscles or ligaments leading to back injury. Many times the injury can result in a persistent, sharp stabbing pain, and hinder your usual routine.
Joint compression- Homemakers spend a considerable amount of time standing in the kitchen. As tiring as it is, standing for prolonged periods puts pressure on your joints- knee joint, hip joint as well as those in the feet and the ankle. This leads to wear and tear of the synovial joints, eventually causing them to tear. In due course of time, you will find it difficult to move around and walk even a meagre distance.
Prevention-
Starting to get worked up? Don t be. These problems can easily be prevented if you follow these steps-

Avoid overstretching, bending and twisting
Avoid lifting heavy weights. If possible, use a waist belt to keep away from traumatic injuries.
Keep your body weight in check. Mild exercises can help you with that.
Maintain a healthy diet- calcium intake can help your bones get stronger.
Use muscle braces to keep your joints protected.
Treatment-
The most preferred and effective choice of treatment for curing muscle injuries and joint inflammation is physiotherapy. Physiotherapy uses manual therapy, mechanical force and exercise therapy to promote mobility.

The most common method of treating such injuries is the RICE technique.  RICE  stands for Rest, Ice, Compression and Elevation. Keep the injured part at rest. Put an ice bag on the injured portion. Compress the injured area. Elevate the wound/injury for faster relief.
Anti-inflammatory drugs like Ibuprofen and Aspirin are prescribed to reduce inflammation and swelling. Painkillers can offer you instant relief from pain.
Physiotherapy treatment can effectively cure you of such injuries, that too in a short span of time. If you follow the treatment guidelines, recovery will take about 2-4 weeks. 

Common Problems Faced By Homemakers Who Stay Indoors - How Physiotherapy Can Be Of Help?

Female condoms are generally pouches made of latex and polyurethane, which are used by women during sex in order to prevent pregnancy and thereby reduce the chances of infection by sexually transmitted diseases. Each end of these pouches are made of rings that are flexible. They should be inserted deep inside the vagina before sex is initiated and held in the position by utilizing the rings available at the closed end while the rings which are at the open end remain outside the vagina during sex.

Even though it can be safely used by most people, some women would find female condoms to be an inappropriate form of contraception and would not feel comfortable with their genital areas being touched. Thus, it is very important that the appropriate form of contraception be considered for you and your partner. Condoms should be used correctly. In case of need for extra protection, other options of contraception should be considered.

Pros of female condoms
1. Since the exchange of bodily fluids, such as semen and vaginal fluid is prevented, female condoms aid in offering protection against many sexually transmitted diseases such as HIV.

2. Condoms can prove to be reliable pregnancy averting methods if they are properly and consistently used.

3. Female condoms are only needed during the time of sex. Any form of advance preparation is not required, hence making them suitable for unplanned sex.

4. Prescriptions are not needed

5. The condoms are usually small in size, disposable as well as easy to carry

6. Usually, using condoms does not show any medical side effects.

7. Insertion of female condoms can be done up to a duration of eight hours before sex. The responsibility for utilizing condoms properly should be shared by the woman as well as the partner.

Cons of female condoms
1. Even though condoms are generally very strong, they are prone to splitting or tearing in case of improper use.

2. Availability of female condoms pales in comparison to the male counterparts and they are usually more expensive.

3. The outer ring might produce a cumbersome feeling.

Pros and Cons of Female Condoms

Psoriasis, in general, is a persistent autoimmune condition that causes the speedy development of skin cell. This increase in the number of cells causes unhealthy scales on the surface of the skin.

Symptoms of nail psoriasis
Symptoms to watch out for are the nails cracking right from the nail bed. This, in medicinal term, is known as onycholysis and it creates space that can get contaminated by germs. Soreness or a sponge like feeling beneath the nails, pitting, warping and hardening of the nails, discoloration, painful chalk like build up beneath the cuticles which causes the nail to move upwards, are common symptoms as well. This is known as subungual hyperkeratosis. As a rule, almost everybody who is affected by general psoriasis, suffer from nail psoriasis.

Sometimes nail psoriasis may be accompanied by fungal infections. A parting amid the nail and nail bed is the perfect environment for the fungi to grow. If the symptoms you are experiencing are extremely moderate, treatment may not be required. If the discoloration, nail hardening or chipping of the nails is severe, it is probably a good time to make an appointment with a dermatologist.

Causes
A diet deficient in Calcium, Vitamin C or B12 can lead to this condition. Unhygienic habits can aggravate the condition. Psoriasis, in most cases, is acquired genetically. A weak immune system can also be a marker. Certain steps can be taken to keep the nails healthy. Keeping the nails clipped short and clean helps. Wearing gloves while working in the kitchen, during gardening or washing is another preventive measure you can always take.

Treatment
It may be hard to treat nail psoriasis; while topical medicines are prescribed, they usually don t work that well. Oral D3 supplements can be taken. D3 ointments, light or photo therapy and finally corticosteroid injections directly aimed to the nail bed may ease the situation. In very severe cases, nails may need to be removed with the help of surgery, so as to help new nails to grow back. Patience is the key word.

Nail Psoriasis - How To Know If You Are Suffering From It?

Hoarseness in the simplest sense means, 'hoarse voice'. It may be defined as an abnormal voice change. It is experienced in the form of strained, rough, thick, harsh and grating voice. Variations can be felt even in the loudness and pitch of the voice.

Hoarseness is a temporary infection associated with the larynx, which is also known as the voice box in animals as well as humans. Vocal cords are present inside the voice box. Depending on the vibration of the vocal cord, different sounds are produced.

What are the general causes of hoarseness?

Hoarseness may be caused by common cold, viral infection, cough, irritation due to screaming, smoking, allergy, thyroid problem, acute laryngitis and benign tumor. In adults, the stomach asset comes up to the throat causing hoarseness. Heartburn can also be one of the causes.

When hoarseness arises due to common cold and cough, it will last for 2 to 3 days and will subside using cough suppressant and home remedies like salt water gargling, drinking hot milk with turmeric and pepper powder. As cough or cold suppress, hoarseness will also reduce.

When to see an Otolaryngologist (ENT specialist)?

ENT stands for ear, nose, throat. Serious infections in these areas are treated by an otolaryngologist. It is very essential to consult this specialist if hoarseness lasts for more than 2 to 3 weeks; pain in ENT is not due to cold or flu, coughing up blood, lump in the neck.

Evaluation

The medical specialist starts his diagnosis by physically examining the vocal cord. Flexible light weight fiber optic tube scope is also used to visually examine the larynx area. Videotaping, acoustic analysis is also done to study voice irregularities, airflow to guide treatment.

How can hoarseness be treated?

The mode of treatments depends on underlying the cause of the problem. The patient may be advised:

In most cases, hoarseness can be treated just by resting your throat or modifying the use of your voice.
To avoid smoking or passive smoking
Referred to a speech therapist to improve sound of voice.
In case of benign tumor the nodule or polyp is removed by surgery.
How can you prevent hoarseness?

We've all heard the phrase, 'prevention is better than cure'. Alas, it is. Preventing hoarse voice and throat is a much better option than treating it. Here are some tips on how to prevent hoarseness:

Avoid smoking
Avoid overconsumption of caffeine and alcohol.
Consume plenty of water
Avoid eating spicy food.
Avoid speaking loudly for long intervals of time.

How Hoarseness Can be Treated

Dealing with Migraine through Homeopathy

A migraine is a headache that causes a distinct pulsating pain, usually in one side of the head. It is different from normal headaches in the sense that the pain is much more intense and it may be accompanied by nausea or vomiting as well. Some patients have also complained about light sensitivity while others have also complained about pain in all areas of the head.

Some of the factors that separate a migraine from a normal headache are as follows:

While a headache may last at best a day, migraines may last longer, sometimes even up to 3 days.

- Feelings of nausea or actual vomiting
- Sensitivity to light
- Extreme sensitivity to changes in sound

Causes Behind Migraines

Some of the common and known causes, which may trigger migraines in people are:

- Hormonal changes in the body that may have adverse effects
- Dehydration is also known to trigger migraines
- Patients with hypoglycemia may also face migraines if the blood sugar level drops within their body
- Change in air pressure due to change in altitude may also cause migraines to appear
- Lack of sleep
- Stress
- Lifestyle issues such as smoking and excessive alcohol consumption.

Remedies for Migraine in Homeopathy

Migraine is treated in homeopathy by attacking the root causes that may trigger them. Rather than temporarily alleviating pain, homeopathic treatments aim at curing the problem completely.

Some of the medicines that are known to be effective are:

Natrum Mur: This provides great relief from migraines, which may have been caused by stress. Also, if a proper dosage is taken, it can help cure it as well.

Belladonna: This had been known to be a great provider of relief for people who regularly face throbbing headaches.

Glonoine: For people who frequently have migraines due to congestion of the sinuses, this medicine has been known to be very effective.

Spigelia: To treat migraines in the left side of the head.

Sanguinaria: Is highly effective for situations where the migraine is on the right side of the head.

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

Dealing with Migraine through Homeopathy

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