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!

The HIV (human immunodeficiency virus) is a critical disease. This virus invades a person's immune system which is the body's defense against infections such as viruses and bacteria. The immune system doesn't work properly and becomes deficient once attacked by HIV. One social acknowledgement to HIV that has gained enough recognition is the HIV counselling due to the crucial need to counsel the patient about sexual behavior and the risks associated with it. 

Importance of HIV counselling 
The human immunodeficiency virus has become an epidemic in nature and has reached to a distressing proportion worldwide as it is in its third decade. Thus, counselling becomes remarkably crucial part of the treatment. 

HIV prevention counselling is a significant mode of behavioral invasion particularly in the deficiency or lack of an effective curative treatment or vaccine. HIV counselling varies from other forms of counselling sessions. Apart from being a health obstacle, the disease is equally overwhelming for the family as well as people around you. family. It is also connected with endless and intense human suffering which stimulates multiple emotional responses. Such reactions involve self-denial, grief, fear, loss, anxiety, anger, annoyance, depression self-blaming, pity, self-condemnation isolation and suicidal thoughts. 

Also, the risk of passing the virus to the partner during sexual activity is high and the patient must be aware of safe sex and the risks associated with unprotected sex. Hence, counselling becomes paramount. 

Counselling session s information Self-care counselling: 
The patient must be well informed about the disease and should be supported in embracing attitudes, actions, and beliefs which will defend and serve as a protective shield to the body s immune system. Improving, enhancing, and transforming nutrition is required. A few other things that are emphasized are, encouraging physical activity, avoiding objects, actions, and events that threaten the body, overcoming anxiety and stress that compromise the psychological, mental, physical and welfare of the body, and seeking and giving support for self-care. 

Types of counselling: 

Patient centered counselling: It changed the focus of counselling from a single informative one to one that concentrated on a patient s circumstances and needs. This involved active listening, to render better support and managing client's particular prevention needs. 
Risk reduction counselling: This includes examining client s awareness about sexual activity and their feelings.Using their current HIV knowledge as an appealing tool, the limitations they have for protected sex is discussed. A better understanding is ensured in the patients so that unsafe behaviors can be avoided. 
Grief counselling: People who are contaminated with HIV have an elevated risk of acquiring depression. Counselling helps you to deal with any emotional outburst. 
Aims of counselling in HIV infection-

Prevention is the first purpose of HIV counselling. It decides whether the lifestyle puts that individual at a higher risk. Helping to recognize and distinguish the definitions of high-risk behavior. The counselling contributes to behavioral change and also aims at working with the person and his family to obtain and sustain that change in approach and behavior.

HIV Counselling - Why It Is Important To Get It?

Certain diseases are a major cause of concern as often these diseases can cause severe health complications. Various campaigns and awareness have been spread both by the government and NGOs for practicing safe sex to fight against these sexually transmitted diseases. Here are a few tips on how to avoid contracting sexually transmitted diseases.

1. Selective Abstinence: Selective abstinence is when people indulge in certain sexual activities, but limit in what they do to avoid the chances of contracting sexually transmitted diseases. People who do practice selective abstinence run a lower risk of contracting sexually transmitted diseases, which is also dependent on the type of sexual activity they indulge in as certain sexual acts have a higher chance of spreading STDs than others.

2. Using condoms: Using latex condoms decreases the chances of contracting sexually transmitted diseases. If you use lubricants, make sure that they are water based. Condoms are however not 100% effective at preventing sexually transmitted diseases, but reduce the chance of infection to a great extent. It is highly advised to learn how to properly use condoms.

3. Mutual monogamy: Another way to avoid getting infected by STDs is to practice mutual monogamy. If you and your partner do not have sex with anyone else, then it greatly reduces the chances of getting infected with sexually transmitted diseases.

4. Getting tested: Getting tested for sexually transmitted diseases as well as asking your partner to do so decreases the chances of transmitting sexually transmitted diseases. Refrain from having sex if either of you test positive.

5. Avoid alcohol and recreational drugs: Avoiding the usage of recreational drugs and alcohol reduces the chances of contracting STDs. Indulging in sexual activities while being highly intoxicated can both cause you to forget practicing safe sex.

6. Practicing healthy habits: Practicing certain healthy habits also reduces the chances of contracting sexually transmitted diseases. These include avoiding sharing towels and undergarments, washing before and after sexual intercourse and getting a vaccination for hepatitis B.

7. Low risk and high risk activities: Certain sexual activities such as open mouth kissing and hand to genital contact have a lower risk of infection. Other activities such as oral sex, vaginal intercourse, and genital to genital contact have a higher chance of infection. Understanding the risks better would allow you to avoid contacting diseases easily.

7 Tips to Avoid Sexually Transmitted Diseases

Vitiligo is a condition wherein the affected person starts losing the color of the skin, resulting in white patches. It can affect people of any age, sex, class, race, and ethnicity. Though Vitiligo is a lifelong condition, it can be managed with proper care and treatment.

Understanding the problem 

Vitiligo is a skin disorder where certain areas of the skin start losing its normal pigment. The total area of the skin that can be affected by the disease may vary from one person to another. It may even affect the inner side of the mouth, eyes and in some cases, even the hair.

Vitiligo is a photosensitive skin disorder which means that the affected areas shall be more sensitive to the rays of the sun than the unaffected areas. It is very difficult to determine whether the patches will start spreading or not, and to what extent. It may take weeks to spread, or the patches may remain stable for months or even years together. The lighter patches become more visible in people with dark and sun-tanned skin.

Causes

The destruction of pigment-causing cells called the melanocytes cause Vitiligo. The exact cause of vitiligo remains unknown, some conditions that contribute to vitiligo are mentioned below:

Albinism: It is a rare genetic disorder that lead to loss of color of the skin, hair, and the eyes.
Alopecia Areata: It is an auto-immune disease that leads to hair loss in patches. It can also lead to vitiligo.
Hashimoto s thyroid: It is also an autoimmune disease that leads to discoloration of the skin. This also makes the skin more sensitive.
Symptoms

Patchy loss of skin color
Premature whitening or graying of the hair on your scalp, eyelashes, eyebrows or beard
Loss of color in the tissues that line the inside of your mouth and nose (mucous membranes)
Loss of or change in color of the inner layer of the eyeball (retina)
These white patches are more common in areas where the skin is exposed to the sun. The patches may be on the hands, feet, arms, face, and lips. Other common areas for white patches are:

The armpits and groin (where the leg meets the body)
Around the mouth
Eyes
Nostrils
Navel
Genitals
Rectal areas
Complications

If leaft untreated, patient can have an increased risk of:

Sunburn and skin cancer
Social or psychological distress
Hearing loss
Eye problems, such as inflammation of the iris (iritis)
Treating vitiligo
Vitiligo is described as more than a cosmetic problem; it is rather a health issue requiring clinical attention. Several remedies can aid in making the condition less visible, and some of them include:

Using sunscreen regularly: Using sunscreen protects the lighter areas of the skin which are more sensitive to sun rays. Since there are several types of sunscreen available, consulting with a dermatologist is safe before choosing a sunscreen.
Phototherapy using UVB light: Controlled exposure to UVB light is an effective treatment option for vitiligo. When this treatment is done at a clinic, you will need around 2 to 3 visits in a week, and the time required for the treatment will also be longer. UVB phototherapy can also be used when there are numerous white spots all over the body. Since this is a full-body treatment, it is performed in a hospital. This treatment, together with other treatments can have a substantial effect on vitiligo, but it is always necessary to have realistic expectations about the treatment.
Skin camouflage: Those who are suffering from mild instances of vitiligo can greatly benefit from the camouflage treatment done with cosmetic creams or white patches.
Laser therapy: People suffering from limited, stable patches of vitiligo can immensely benefit from vitiligo. Laser therapy is a safe and effective way to treat this condition. It may not be very cost effective, but the results are totally worth it, a patient may have to be treated twice a week and take 24-48 session to treat the localised lesions of vitiligo.
It is best to start the treatment of vitiligo as soon as possible to manage the condition to a substantial extent. So, visit a dermatologist today and understand which treatment option would work best for you.

Vitiligo - How Can The Condition Be Treated?

When a person is aroused there are a host of hormonal changes within the person's body. These changes do manifest on the surface in the form of certain physical variations. Sexual stimulation happens to alter the state of human genitalia and that too in obvious ways. The blood flow to the concerned area increases, there is enough of natural lubrication in and around the organ and for women, the vagina loosens up and the clitoris swells. Intercourse followed by a climactic release will make the clitoris regain its original size. However, worries crop up when that is not the case with every single female. This serious medical condition of a swollen clitoris should never be overlooked; it must be treated by seeking experienced medical assistance.	 

1. Trauma: Any slight scratch or one wrong touch can cause a swollen clitoris. Even a scratch of your fingernail while you are masturbating or a rough sexual intercourse can and is enough to create trauma in your clitoris.

2. Hair: Hair grows normally around your genital area. It is very common for a woman to have pubic hair. But sometimes small hair splinters lead to trouble and hair gets stuck into your clitoris and causes swelling. This is a very annoying process, sometimes you may have to use a magnifying glass to remove the hair from your clitoris.

3. Clothing: sometimes your tight clothes can result in a swollen clitoris. The friction from your rough clothing material can cause your clitoris to swell. Sometimes you may be using a detergent that is not suitable for you or you may be wearing a dress material, which you're allergic to. You should always wash your clothes in plain water and dry it before using.

4. Infection: you may also have some bacterial and fungal infection in your clitoris, which can cause a swollen clitoris. This infection can also invite itchiness and redness and these can make it even worse. If it doesn't subside within some days then you should definitely see a doctor.

5. Cysts: small cysts known as Bartholomew's cysts can grow on the clitoris. This thing hampers the natural lubrication of the body.  If you are having clitoris swelling because of cysts then you should seek medical attention immediately.

Your clitoris is naturally sensitive and if you are having a swollen clitoris after intercourse then you should pull back from sexual intercourse for a few days. At times the swelling goes away on its own.

Swollen Clitoris - 5 Main Reason Behind Enlarged Clitoral  

Vitiligo is a type of skin disorder. It is an autoimmune disease in which the melanin cell stops functioning or starts dying, and forms blotches on the skin. It can affect any part of the skin. It may also affect the inside of the mouth and hair.

There are many treatments available to restore the pigmentation of the skin. However, one of the most trusted and reliable treatments is described in Ayurveda. According to Ayurveda, there are tons of ways available in the house. By using these remedies, one can easily and adequately treat Vitiligo without any side effects. In Ayurveda, Mustard oil is one of the most significant remedies. Mustard oil is very beneficial to heal this type of skin disease.

Know More About Mustard Oil:

Mustard oil is extracted from the mustard seed by the process of steam distillation. The connotations of this oil may vary depending upon the part of the world the mustard seed is coming from. In some countries, mustard oil is only used for massage purposes. However, in many countries, it is considered edible. In both cases, mustard oil has millions of medicinal values and health benefits.  

Nutritional Value of Mustard Oil:

Mustard oil is packed with all the nutrients of the mustard seed. In 1 litre of mustard oil, there are 844 calories. Mustard oil has a total fat content of 100 grams which includes 21 grams of polyunsaturated fat, 12 grams of saturated fat, and 59 grams monounsaturated fat. It has zero content of sodium, carbohydrates, and protein. It also contains some important fatty acids such as  linoleic, oleic, and erucic acid along with some important substance called Allyl isothiocyanate, that has several health benefits.

Benefits of Mustard Oil:

There are many health and medicinal benefits of mustard oil. Some of them are:

Mustard essential oil improves blood circulation.

Mustard oil helps in digestion by keeping the digestive system intact.

Mustard oil boosts appetite and makes a person feel full.

Mustard essential oils fight bacterial infections.

Mustard essential oils prevent fungal infections.

Mustard oil repels insects.

Mustard oil is good for hair.

It is also beneficial for many orthopaedic problems like arthritis, lumbar pain, cervical pain, vertigo, etc.

Mustard is also used for the treatment of Vitiligo.

How Is Mustard Oil Used To Treat Vitiligo?

Mustard oil is one of the most popular home remedies used to heal Vitiligo. It helps in producing intense melanoid pigments and one can observe pigment initiation within 10 days. Regular use of mustard oil in food, massaging, or in the form paste will help to treat this skin disorder.

According to a recent study, mustard or mustard oil has enormous therapeutic potential for treating Vitiligo. Paste of mustard oil and turmeric will help intensify the pigments of the skin.  

Take Away:

There are many home remedies available used to cure Vitiligo and mustard oil is one such ingredient. It is the most popular and scientifically proven method for the treatment of Vitiligo. However, it is best to consult a dermatologist or physician before opting for any of these remedies. Everyone s skin and internal function is different and hence it is better to always go for the options which are prescribed for better and safe result.

How Is Mustard Oil Beneficial In Vitiligo Treatment?

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