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!

Did you know keeping your private parts clean can avoid major health issues?

Private parts not only make or break intimacy but also also affect your overall health. Men and women - both need to keep them clean. Here are 5 things that you need to religiously follow.

1) Wash them everyday - In case you are not washing your private parts every day, let me share with you that it is a must-do! Your private parts are moist and house many bacteria. You can use soap to wash but an unscented or mild one. Wash them with lukewarm and clean water.

2) Clean them up before and after sex - Cleaning your private parts before and after sex is of great importance. Before sex because of etiquette. And, after sex for a healthy sexual life ahead! The body fluids or semen which gather on and near your reproductive organs, if not washed can harbour the growth of bad bacteria and set a stage for infections.

3) Groom them well - Untrimmed hair around the private parts is highly unhygienic. It can lead to too much of itching, increasing the chances of infection.

4) Wear fresh undergarments everyday - Unwashed shirts can do but unwashed boxer or briefs is a big no-no. You need to keep your underwears clean &amp; dry. Wear a fresh and clean undergarment every day. Changing your briefs after masturbation, sex, work-outs in gym is also highly recommended.

5) Don't delay visit to a doctor - If you are experiencing any sort of irritation, itching, redness, odour, swelling or other form of discomfort please do not delay in consulting a doctor. It can be a sign of a serious health problem or a severe infection.

5 Sexual Hygiene Musts For Men And Women

Vitiligo or Leucoderma is a genetic disorder triggered due to mental stress and constipation. Leucoderma or vitiligo is called Shivita kushta according to Ayurveda and is caused due to defect in brajak pitta. Brajak pitta is a color forming agent in body and defect in formation of brajak pitta causes vitiligo. There are many causes, which can trigger vitiligo other than stress and genetics.

There are certain food combinations , such as taking milk and sour fruits together can trigger vitiligo. Also, using excessive salty food and meat products with milk can trigger disease. Deficiency of copper and vitamin B12 can trigger this disease. So treatment of vitiligo is done taking in account many factors.

Toxins produced in body are neutralized using herbal medicines, which helps in stopping the spread of disease. External herbal application containing Wrightia Tinctoria help in repigmentation on white skin. According to modern science steroids are used in pulse therapy where steroids are used 2 times a week.

This also prevents the disease from spreading. In some severe cases integration of allopathic and Ayurveda is key to success.

There are few important points, which vitiligo patients should always take in account, such as:
When disease is spreading sitting in sun for prolonged period can trigger the spread.
Using Brinjal and raw tomatoes and excess of vitamin C is not good.
Irregular lifestyle is a trigger the disease along with consumption of alcohol.

All About Vitiligo

A couple of decades ago, medical professionals believed that a lot of females could not climax at all. There are a number of reasons for this. It is easy for the male to know when he has achieved an orgasm, which usually happens with ejaculation, which is quite evident. For the females, on the other hand, it is not so evident. It is a perceived feeling and while the media showcase it in a particular way, reality is far moved from it.
There are various reasons why it is very difficult to pin this down. Orgasms are not just an elusive feeling for the woman, it is an elusive topic for the medical professionals too. Read on to know some of the common causes (more beliefs or notions) about this and some simple but effective ways of managing this.
- Private topic: Girls are very shy compared to boys and both their exposure to sex education and discussion about this is limited compared to boys. We might tend to think of it as common in India alone, but this is true across a vast number of countries. We are not alone! This shyness continues into their later years too, and unless transformed by the partner, it may continue to be a topic that is shunned.
- Purpose: Sex is more deemed as a form of procreation rather than for sex. Therefore, while sex is necessary for conception, orgasm is not. This is one more reason (strange but true) that orgasm is very elusive for a woman.
- Psychological factors: It could be guilt from past relationships or fear of past abuse. It could be fear of losing control or fear of coming across as vulnerable. For any of these reasons, women can have difficulties climaxing during the act.
In men, the causes are more defined and physical in nature and include erectile dysfunction, premature ejaculation, retrograde ejaculation, and delayed ejaculation.
Whatever the cause of the problem, the first step in coping up with the issue is to acknowledge the issue. Being a private topic, this is not something that is going to draw the person towards medical help. However, this needs to be discussed frankly with the partner or with the doctor. Getting the partner involved removes a lot of psychological barriers (guilt, fear, anxiety, etc.) This would result in natural ironing out of issues, improving the performance of both the people involved.
If that does not happen, seeking professional help, be it medical help to correct physical issues or counselling, is the next suggestion. A frank discussion will do wonders, and what was once elusive can be well within your reach.

The Elusive Orgasm - Causes and Coping!

Top 10 Everyday Skin Care Hacks

You skin needs just a little care daily. There are some very simple ways in which we can provide that much needed affection and get back radiance and softness. And all this without any extra effort!

Try these everyday regimes for the glow.

1. Adopt Hydration - The first thing your skin needs to stay beautiful is adequate 'hydration,' or what they call in plain terms as plenty of water. So bottoms up to at least two liters of water daily.

2. Avoid Dehydration  - While you are busy hydrating your skin, remember to be careful and not dehydrate by staying out under the harsh sun for longer than 10-15 mins at a stretch. Ditch the caffeine habit (Soda, coffee, tea) as it dehydrates your body on the cellular level, inviting the onset of those dreaded wrinkles early than anticipated. 

3. Apply Lesser Layers - Your skin is your body's largest organ and it needs to breathe. So try and not swathe it under layers of heavy makeup and pore clogging chemical body butters on a regular basis.

4. Give It Fresh Air - To get your skin breathing truly fresh, put on your exercise gear and head outdoors to spend some quality time with Mother Nature at the nearest park or maybe you can take that long pending weekend trip out of the city!

5. Don’t Stress - Do not be stressed all the time unnecessarily. Learning how to manage stress effectively can take away years from your skin. 

6. Exercise - Run. Jump. Dance. Get moving, in short. The more your skin sweats, the better will it look and the elasticity would improve dramatically too. 

7. Get Nutrition - Get in the habit of starting the day with plenty of fruits and a healthy breakfast with the right amount of protein, carbs and essential fats. Fats are required by your skin to lubricate and moisturize from the inside. But make sure you stick to good fats found in olive oil, eggs, yogurt (the ones without any additives or artificial sugars), and whole grain breads etc.

8. Go Smoke-free - Just stop smoking and you would see a dramatic improvement in your skin tone within a few weeks (yes, it takes time to reverse that kind of damage) 

9. Wear Sunscreen - Slather on the sunscreen before you leave the house but make sure it's SPF index must be 30 and above for it to be effective under the harsh Indian sun.

10. Exfoliate & Detox - Scrub-rub-a dub every week. NOT every day though.. Make sure you use organic scrubs made with rice granules or sugar grains instead. Use a natural face mask such as Banana mash or a Tomato-Cucumber-Honey paste every alternate day to detoxify, cleanse and moisturize your face and body. 

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

From Lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over WhatsApp, Facebook and other media.


10 Only Skin Care Hacks You Will Ever Need

It is important for you to know about inflammatory bowel disease or IBD, it is a group of intestinal disorders, which leads to prolonged inflammation of your digestive tract. The digestive tract is made of the mouth, stomach, oesophagus, small intestine and large intestine. It performs the task of breaking down food, removing unusable materials and waste products, and for breaking down nutrients from food. Inflammation along with the digestive tract causes disruption in this process. IBD is a fatal condition which can be life threatening in some cases.

Major types of inflammatory bowel disease
The term inflammatory bowel disease is an umbrella term under which many diseases are included. The two major and most common diseases under IBD are ulcerative colitis and Crohn s disease. Crohn s disease (a chronic inflammatory disease of the intestines, especially the colon and ileum, associated with ulcers and fistulae) can lead to inflammation in any part of your digestive tract. It commonly affects the small intestine s tail end. In case of ulcerative colitis, inflammation takes place in the large intestine.

Causes of IBD
Although the exact cause of IBD is not known, several factors may lead to this condition. They are as follows:

Genetics: You are more likely to develop IBD if someone in your family has the disease. This is because of the genetic component of IBD.
The immune system: The body s immune system plays a role in IBD. Usually, your immune system defends your body from pathogens. A bacterial or viral infection in the digestive tract may lead to an immune response. The digestive tract becomes inflamed as the body fights against the bacteria or viruses. The inflammation goes away when the infection is gone.
However, in the case of IBD, the digestive tract inflammation may occur without any infection. Your immune system attacks your body s cells. This is called an autoimmune response. IBD can also occur when the infection is cured, but the inflammation remains.

Symptoms
The various symptoms of IBD depend on the severity and location of the inflammation. They are as follows:

Diarrhoea which occurs when the bowel cannot reabsorb water.
Bleeding ulcers which cause blood to show up in your stool.
Stomach pain, bloating and cramping because of bowel obstruction.
Weight loss and anaemia, which leads to delayed development and growth in children.
In patients with Crohn s disease, canker sores may develop in the mouth.
Ulcers and fissures may appear on the anus or genital area.
IBD may also be associated with problems such as eye inflammation, arthritis and skin disorders.
The major complications which may arise from IBD include colon cancer, malnutrition with weight loss, fistulas, intestinal rapture and bowel obstruction. It is important for you to consult a doctor on noticing any of the IBD symptoms.

Inflammatory Bowel Disease - Know the Types!

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