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 highly contagious skin condition that is caused by the infestations of tiny burrowing mites but is treatable with medication is Scabies. When the skin comes in direct contact with infested bedding or clothing, microscopic human mites, known as Sarcoptes Scabiei, are transmitted into the skin, burrowing into the epidermis. Once the mites reach the epidermis, it lays eggs there and continues to live, causing scabies which results in skin rashes and itchy bumps.

Causes:
Scabies is caused by the microscopic human itch mite when it burrows inside the epidermis. And there are two ways that a person can be infected with scabies, which are:

Contact with objects infested: Sometimes, when the mite is present on an object, such as the bed sheet or the upholstered furniture, the towel or the bedding, and the skin comes in contact with these objects, scabies may spread. However, one must know that without human skin contact, the mite can survive only for 48 to 72 hours and this makes the risk of causing scabies through contact with infected objects less common.
Direct skin to skin contact: Scabies is contagious but not highly contagious. Skin contact for a small period of time can not infect a person. Close physical with the infected person can lead to the spread of mites.
It is to be noted here that getting scabies from animals is not possible even if the animal has mites as this kind of scabies infest the human skin only.

Treatment
Scabies is often confused with other skin issues like eczema and psoriasis. Therefore, every person with severe itching should be tested for scabies. Once diagnosed, the treatment is relatively simple. Listed below are some of the treatment options:

Antibiotics: Patients who are suffering from excessive skin rash, itching and infections are usually treated with antibiotics to ease the itchy sensation.
Decontamination: The decontamination involves washing the clothes of the infected person in hot water and keeping the objects that cannot be washed in a bag for around 2 to 3 days to kill mites and their eggs.
Scabicides: Depending on the severity, overall health and age, the patient may be prescribed oral medication and creams.
Antihistamine: Antihistamine refers to over-the-counter anti-allergy drugs that can also be of help in managing the itching and rashes.
Things to remember:

In case of infected adults, scabicide cream or lotion needs to be applied all over infected person s body, starting from the neck down to the toes.
If a child is infected with scabies, the scabicide cream or lotion needs to be applied from head to toe.
In case of an infant, it is advised that only sulfur ointment or permethrin may be used. It is essential that the medication is applied only over a clean body.
All the people living with the infected person should also be treated simultaneously to avoid reinfestation.
As scabies spread moderately contagious, early diagnosis and treatment can prevent it from spreading further and causing any more trouble.

A Brief Insight Into Scabies, Its Causes, And Treatment!

An anorectal condition can be difficult to live with and often remains undiagnosed, due to it being perceived as an embarrassing ailment. Fistulas are conditions where two body parts, that are not meant to be connected, become linked as part of the disorder. Rectal fistulas can be painful and standard treatments are available, which can cure the condition. However, these treatments come with serious side effects.

Most people prefer Ayurvedic fistula treatments over the conventional medications for the lack of side effects as such. Ksar sutra is one such branch of treatment in Ayurveda, which has shown tremendous results against fistulas. Here is a look at all that you need to know about Kshar Sutra.

What does Kshar Sutra mean?
Kshar Sutra is a form of treatment, which uses threads laced with the juices of medicinal herbs to treat rectal fistulas.  Kshar  refers to the herbs and  Sutra  stands for the thread used for the treatment. It is a minimally invasive surgical procedure with almost no side effect or danger. The Kshar Sutra form of treatment was first discovered by Sushruta, Vagbhata and Charak. In recent times, BHU s Shalya Tantra Department has once again proved its efficacy in case of rectal disorders.

How is the treatment done?
Once the thread has been coated with the medicinal herbs, the same thread needs to be inserted into the fistula in ano. The patient is anaesthetized and the thread is inserted into the fistula using a probe. The thread is then taken out from the other side and the two ends of the thread are tied together. This thread is changed after every 7 days. This thread insertion effectively cuts the tract and unhealthy tissue is removed from the region.

Why is Kshar Sutra beneficial?
Benefits for this form of treatment include-

Lower risk of anal incontinence, which may occur in case of conventional medicine and surgery.
Lower risk of the anal canal getting narrower after the treatment is completed.
Minimally invasive treatment, which is why patients can resume normal life after just 3-4 days of recovery.
Apart from the treatment, patients should also follow a diet rich in fibre, fruits and vegetables. Drinking large quantities of water will also result in a better prognosis. Lastly, engaging in daily walks will also help you deal with the condition. 

Ksharsutra in the Treatment of Fistula in Ano, Anorectal Disorders!

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?

In addition to pumping blood to various organs, the heart also has its own blood supply, through which it receives its oxygen and nutrient supply. In patients with coronary artery disease and atherosclerosis, there is a narrowing of the blood vessels which reduces the amount of blood flow to the target organs, including the heart. 

When this happens in the heart, there is chest pain due to overexertion of the heart muscles. There could be two patterns to this chest pain. With regular exertion like exercise, there would be chest pain, and most patients are familiar with this pattern.

This is known as angina pectoris or stable angina. In some people or in some instances, chest pain occurs which is sudden and not of a predictable pattern. It could be related to extreme exertion or stress. This is known as unstable angina and can lead to heart attack and be life-threatening.

Stable angina or angina pectoris has a stable, predictable pattern which most patients get familiar with over a period of time and learn to manage. Read on to know more about the signs and symptoms and management techniques.

Signs and symptoms: Stable angina usually occurs after a round of physical exertion. The patient feels a feeling of tightness in the chest which feels like the chest being squeezed. The pain can gradually spread to the shoulder, arms and even the neck. The pain can also be induced by eating, exposure to cold, emotional stress. It lasts for about 15 minutes and is relieved by rest and sublingual nitroglycerin. The pain intensity does not change with position or coughing. In addition, the patient may also experience shortness of breath, fatigue, profuse sweating, nausea, and dizziness.
The patient may be able to detect signs on further testing including ECG, echocardiography and stress testing. Features like cardiomegaly, altered ejection fraction would be detected based on the severity of the disease.

Treatment: Immediate treatment to relieve the pain includes resting and sublingual nitroglycerin. On an ongoing basis, the treatment would include 3 approaches   lifestyle changes, medications, and surgery.

Lifestyle changes: Regular exercise, smoking cessation, reduced fat intake, reduced alcohol consumption, weight loss, and stress management are some lifestyle changes to be made to improve symptoms.
Medications: A number of medications would be used depending on patient s symptoms. Aspirin to prevent clotting, medications to control blood pressure and cholesterol and diabetes.
Surgery: In patients with advanced coronary artery disease, revascularization methods may be required, which includes angioplasty and coronary bypass.
In a person with known risk factors, it is advisable to have regular checkups so that the disease progression can be controlled and symptoms managed with minimal intervention.

Predictable Chest Pain Pattern - What Does It Indicate?

Hypoglycemia, commonly referred to as low blood sugar is the condition of the body, when the level of blood sugar falls down below the normal level. This accounts for clumsiness, feeling shaky, feeling confused, losing consciousness, serious seizure. Severe lowering of blood sugar may cause death. You are likely to feel exhausted and very hungry. The symptoms usually show quite quickly.

Hypoglycemia is commonly caused due to diabetes medicine like insulin, sulfonylureas or biguanides. Starving for long hours, over straining the body or extreme alcohol consumption may lead to hypoglycemia. Failure of the kidneys, liver diseases, metabolism disorders also lead to hyperglycemia.

Fall in the the blood sugar level must be taken very seriously and never be ignored. If you feel the symptoms of lowered blood sugar, it is advised that you immediately take a sugar test. You must also indulge in high calorie food items such as sweets or chocolates. You need to increase the glucose intake, so that the blood-sugar level rises up.

Here are some steps you should follow to control hyperglycemia.

1. Keep away from the practices, which lead to hyperglycemia
The best way of keeping away from hyperglycemia is by taking all measures, which would avoid the condition to develop. The medical schedule of diabetic patients should be closely monitored and optimized by the patient's caregivers. Their lifestyle should be kept under check. It should be ensured that the patients do not skip meals. Insulin should be avoided as much possible.

2. Discuss problems with the patient
Patients and their guardians must be properly educated about the disease and what important steps they should take, in spite of all kinds of prevention treatments they take. Teach them about the symptoms and the steps to be taken in case of any emergency. Use of glucose tablets should be encouraged. They must know that the process is ongoing. Every patient is different from another and hyperglycemia differs from person to person.

3. Use glucagon
Glucagon is basically a hormone, which stimulates the liver to release pre-stored glucose all over your bloodstream in case your blood-sugar level falls down steadily. Glucagon is usually injected, and kits are available. Prescribed by doctors, glucagon can be used to treat a person who has fallen unconscious after a fatal reaction due to insulin. You should consult an expert before buying a glucagon kit.

Hypoglycemia is a serious problem. Lowering or fall in your blood sugar level must never be ignored, and measures must be taken to regain your sugar balance immediately.

Hypoglycemia: Going Lower Is Not Always Good

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