Indications:
Objective:
Hysteroscopy is the commonest type of work up in the entire Infertility patient along with Diagnostic Laparoscopy. Only diagnostic hysteroscopy is the commonest work up recommended before IVF. We record Hysteroscopy diagnostic & operative procedure for future important record in Infertility patient, for second opinion & for deciding future treatment protocol.
Benefits of Hysteroscopy Surgery:
Pre-operative Check Lists:
Average Stay in Hospital:
2 to 4 hours. (DAY CARE SURGERY)
Average Duration of Surgery:
2 to 10 minutes
Average Blood loss during Surgery:
Negligible
Average time after operation to resume normal activities/work:
Within 12-24 hours.
General Anesthesia (Patient will not feel any pain in Operation Theatre during surgery)Procedure:Patient is given general anesthesia. Patient is put on lithotomy position. Local parts cleaning & paintings with antiseptic solution & draping are done. After P/V examination cervix is checked with uterine sound. For Diagnostic hysteroscopy after removing the air, hysteroscopy (varsascope/1.9 mm/ 2.9 mm Hysteroscopy along with irrigation of Normal saline is introduced inside the cavity. Systemically both corneal openings, cavity, both lateral walls and anterior & posterior wall of the uterine wall is noticed for any lesions or normalcy. For operative/therapeutic hysteroscopy cervix is dilated up to 7mm / 10 mm for introduction of Operating hysteroscopic sheath or resectoscope for operative hysteroscopy. Hysteroscopy requires dilatation of the uterine cavity to create working space inside the uterine cavity and flushes both fallopian tubes with high pressure fluid helps in achieving very good fertility enhancing results following Hysteroscopy in infertility patients. Addressing all the infertility related lesions like broad septum from the fundus, intra-uterine adhesions, polyps or tubal cannulation helps us in treating infertility patients in the same sitting
Post-operative Course:
Patient remains drowsy/sedated for 1-2 hours after hysteroscopy but conscious & pain free. Patient can take fluids 1-2 hours after hysteroscopy & light food after 2-4 hours. She may feel little discomfort after hysteroscopy for 6-8 hours but it can be relieved with pain killer tabs. Most of the patients can walk normally without support and can take normal diet 6-8 hours after the hysteroscopy. She can be discharged on the same day of the operation. Few patients may feel nausea & vomiting after hysteroscopy, which can be very well controlled with injection in post-operative room. Patient can do her normal activity within 12-24 hours after hysteroscopy. Patient is advised to take antibiotics & analgesic tabs for 5 days following hysteroscopy. Patient is advised to report to doctor for severe pain or bleeding or fever in postoperative period (Day-1 to Day-5) immediately. Patient is advised to come for follow up 7 days after the next period or on the day for IVF protocol & preparation for IVF. In case you have a concern or query you can always consult an expert & get answers to your questions!
How did we achieve HIV-Free Generation?
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:
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.
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:
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!
Pregnancy in the abnormal place like Fallopian tube is defined as Tubal Ectopic Pregnancy.
Indication:
Performed for pain in lower abdomen with H/o amenorrhea and Bleeding P/v and TVUSG showing tender adnexal mass or when medical treatment fails for ectopic.
Objective:
More than 90% cases of Ectopic pregnancy cases are now treated by Laparoscopy all over the world. Important pre-requisite for Laparoscopic management is – Patient should be haemodynamically stable. Ruptured Ectopic pregnancy should be treated by salpingectomy, as in subsequent pregnancy chances of repeat Ectopic will be more with Salpingostomy. Goal should be diagnosing Ectopic pregnancy in its asymptomatic -unruptured stage so that we can offer medical treatment with Methotraxate or Laparoscopic Salpingostomy or Tubal milking for preservation of affected tube. Recording the surgery helps another doctor for the decision of Salpingostomy/Salpingectomy during past surgery. Procedure takes hardly 30 minutes & patient can be discharged on the same day like Lap.T.L.
Benefits of Laparoscopy Surgery:
Pre-operative Check Lists:
No. Of Cuts on Abdomen:
Three cuts: all of 5 mm size.
Average Stay in Hospital:
4 to 6 hours. (DAY CARE SURGERY)
Average Duration of Surgery:
20-30 minutes
Average Blood loss during Surgery:
Bloodless and 50 to 500 cc if ruptured Ectopic with free blood in the abdomen.
Average time after operation to resume normal activities/work:
Within 24 hours. Many patients undergo laparoscopy as Day care procedure, returning home within 24 hours of surgery. For normal ectopic laparoscopy procedure takes about 15 to 30 minutes only. For chronic ectopic it may take 1-2 hours. Most begin feeling much better within one day.
Anesthesia:
General Anesthesia (Patient will not feel any pain in Operation Theatre during surgery)
Operative Procedure:
Inside the Umbilicus small needle is introduced and Co2 gas is insufflated inside abdomen. Rather than creating a large incision and opening up the body, tiny incisions are made and a laparoscope is inserted. This slim scope has a lighted end. It takes pictures – actually fiber optic images - and sends them to a monitor so the surgeon can see what is going on inside.
Performing laparoscopy usually only requires three tiny incisions less than one half inch, (about 5-10 millimeters) in length. One incision is made inside the navel, and another two are usually made near the bikini line. The first incision allows a needle to be injected into the abdomen so carbon dioxide gas can be pumped inside the cavity of the abdomen, which helps to keep intestines & omentum up and away from organs. This allows the surgeon a better view and more working space to maneuver the laparoscope and surgical tools as needed. Using small incisions rather than opening the abdomen lessens recovery time as well as discomfort and makes surgical scars less noticeable.
Blood from the abdomen is suctioned with suction irrigation cannula. Affected Ectopic tube is desiccated with bipolar desiccation & cut & removed. For Salpingostomy anti-mesenteric border is cut after pitressin injection in mesosalpinx and ectopic sac delivered gently with suction & irrigation cannula. Haemostasis achieved by compression with atraumatic grasper. Copious irrigation is necessary to prevent post-operative adhesions.
Post-operative Course:
Patient remains drowsy/sedated for 4-5 hours after laparoscopy but conscious & pain free. Patient can take fluids 5-6 hours after laparoscopy & light food after 6-8 hours. She may feel little abdominal & shoulder pain after laparoscopy for 24 hours but it cam be relived with pain killer tabs. Most of the patients can walk normally without support and can take normal diet 6-8 hours after the laparoscopy. She can be discharged on the same day of the operation. Few patients may feel nausea & vomiting after laparoscopy, which can be very well controlled with injection in post-operative room. Patient can do her normal activity within 24 hours after laparoscopy. Patient is advised to take antibiotics & analgesic tabs. For 5 days following laparoscopy. Patient is advised to report to doctor for severe pain or bleeding or fever in postoperative period (Day-1 to Day-5) immediately. Patient is advised to come for follow up 7 days after the Laparoscopy for dressing.
Patient’s parent’s visits to us when their daughter does not menstruate after the age of 15-17 years of age for her fertility concern & for planning surgery before her marriage. This operation is advised for Phenotype female i.e. normal secondary sexual characters & Genotype XX.
Objective:
In-patient with absent uterus is evaluated for associated renal malformations by USG & SOS IVP. As compared to commonly practiced method (skin graft from thigh & putting on neo vagina) patient’s on peritoneum is utilized for covering neo-vagina for Vaginoplasty. Vaginal space is dissected in usual way from below and laparoscopic access helps in avoiding injury to bladder & rectal injury. This technique gives two cms wide vagina & 8-10 cms long vagina and good quality of sexual function and patient discharged on the next day with minimum postoperative care. This surgery requires lot of experience & expertise.
Benefits of Laparoscopy Surgery:
The special advantages with our technique are:
Pre-operative Check Lists:
No. Of Cuts on Abdomen:
Three cuts: all of 5 mm size.
Average Stay in Hospital:
24 hours.
Average Duration of Surgery:
40-60 minutes
Average Blood loss during Surgery:
10-30 cc
Average time after operation to resume normal activities/work:
Within 24 hours.
Anesthesia:
General Anesthesia (Patient will not feel any pain in Operation Theatre during surgery)
Operative Procedure:
Inside the Umbilicus small needle is introduced and Co2 gas is insufflated inside abdomen. Rather than creating a large incision and opening up the body, tiny incisions are made and a laparoscope is inserted. This slim scope has a lighted end. It takes pictures – actually fiber optic images - and sends them to a monitor so the surgeon can see what is going on inside.
Performing laparoscopy usually only requires three tiny incisions less than one half inch, (about 5-10 millimeters) in length. One incision is made inside the navel, and another is usually made near the bikini line. The first incision allows a needle to be injected into the abdomen so carbon dioxide gas can be pumped inside the cavity of the abdomen, which helps to keep intestines & omentum up and away from organs. This allows the surgeon a better view and more working space to maneuver the laparoscope and surgical tools as needed. Using small incisions rather than opening the abdomen lessens recovery time as well as discomfort and makes surgical scars less noticeable.
Vaginal space is dissected in usual way after putting Folly’s catheter in urethra and rectal probe in rectum by 3 cms long incision at labia minora. Laparoscopic light & pnumo helps during vaginal dissection. Peritoneum is cathched with two artery forceps, opened from below under laparoscopic guidance and edges of the catched peritoneum is circumferentially mobilized down till we can take tension free stitch with dissected & pulled peritoneum & labia minora by few No1/0 Vicryl figure of ‘8” stiches. Then vagina is closed with mop to prevent leakage of pneumoperitoneum from below and laparoscopically neo fornices are created at the level of pelvic brim by purse string stitches taken to close vaginal upper end with No-1 Vicryl stitch & approximating with extra corporeal knot. This technique gives two cms wide vagina & 8-10 cms long vagina and good quality of sexual function and patient discharged on the next day & with minimum requirement of postoperative care.
Post-operative Course:
In case you have a concern or query you can always consult an expert & get answers to your questions!
Indications:
Diagnosis:
Confirmed by TVUSG as typical shadow towards endometrial linings. SOL/polyp can also be better visualized by Sono-salpingography by introducing 10-50 cc of normal saline with pediatric Foley’s catheter inside uterine cavity during TVUSG to delineate endometrial polyp better.
Objective:
Hysteroscopy is the commonest type of work up in the entire Infertility & BOH patient along with Diagnostic Laparoscopy. Only diagnostic hysteroscopy is the commonest work up recommended before IVF. We record Hysteroscopy diagnostic & operative procedure for future important record in Infertility patient, for second opinion & for deciding future treatment protocol.
Benefits of Hysteroscopy Surgery:
Pre-operative Check Lists:
No. Of Cuts on Abdomen: Nil
Average Stay in Hospital:
2 to 4 hours. (DAY CARE SURGERY)
Average Duration of Surgery:
Average time after operation to resume normal activities/work:
Within 12-24 hours.
Anesthesia:
General Anesthesia (Patient will not feel any pain in Operation Theatre during surgery)
Procedure:
Patient is given general anesthesia. Patient is put on lithotomy position. Local parts cleaning & paintings with antiseptic solution & draping are done. After P/V examination cervix is checked with uterine sound.
Hysteroscopy requires distention of the uterine cavity with Normal saline to create working space inside the uterine cavity and flushes both fallopian tubes with high pressure fluid also helps in achieving very good fertility enhancing results following Hysteroscopy in infertility patients.
First Diagnostic hysteroscopy is done after removing the air from sheath & hysteroscope (varsascope/1.9 mm/ 2.9 mm) assembled. Hysteroscopy along with irrigation of Normal saline is introduced inside the cavity. Systemically both corneal openings, cavity, both lateral walls and anterior & posterior wall of the uterine wall is noticed for any lesions or normalcy.
For endometrial polyp, hysteroscopic sheath is introduced & cervix is dilated up to 7mm / 10 mm for introduction of Operating hysteroscopic sheath or resectoscope for operative hysteroscopy. Endometrial polyp is cut with 6F scissor from the respective wall of the uterine cavity & sends for HPE. Both cornual ends & hemostasis checked.
Post-operative Course:
Patient remains drowsy/sedated for 1-2 hours after hysteroscopy but conscious & pain free. Patient can take fluids 1-2 hours after hysteroscopy & light food after 2-4 hours. She may feel little discomfort after hysteroscopy for 6-8 hours but it can be relieved with pain killer tabs. Most of the patients can walk normally without support and can take normal diet 6-8 hours after the hysteroscopy. She can be discharged on the same day of the operation. Few patients may feel nausea & vomiting after hysteroscopy, which can be very well controlled with injection in post-operative room. Patient can do her normal activity within 12-24 hours after hysteroscopy. Patient is advised to take antibiotics & analgesic tabs for 5 days following hysteroscopy. Patient is advised to report to doctor for severe pain or bleeding or fever in postoperative period (Day-1 to Day-5) immediately. Patient is advised to come for follow up 7 days after the next period or on the day for IVF protocol & preparation for IVF. In case you have a concern or query you can always consult an expert & get answers to your questions!
Treatment of Crohn’s Disease
Homeopathic Treatment of Crohn’s Disease
Acupuncture & Acupressure Treatment of Crohn’s Disease
Psychotherapy Treatment of Crohn’s Disease
Conventional / Allopathic Treatment of Crohn’s Disease
Surgical Treatment of Crohn’s Disease
Dietary & Herbal Treatment of Crohn’s Disease
Other Treatment of Crohn’s Disease
What is Crohn’s Disease
Symptoms of Crohn’s Disease
Causes of Crohn’s Disease
Risk factors of Crohn’s Disease
Complications of Crohn’s Disease
Lab Investigations and Diagnosis of Crohn’s Disease
Precautions & Prevention of Crohn’s Disease
Treatment of Crohn’s Disease
Homeopathic Treatment of Crohn’s Disease
Before prescribing a remedy, homeopaths take into account a person’s constitutional type like your physical, emotional, and psychological makeup. It helps to calm anxious feelings in those who suffer from flatulence and diarrhea, and helps ease the craving of sweet foods which may not be easily tolerated. Following are some homeopathy remedies for Crohn’s disease.
Mercurius
Podophyllum
Veratrum album
Argentum nit
Asafoetida
Ignatia
Podphylium
Acupuncture & Acupressure Treatment of Crohn’s Disease
Acupuncture has long been used in Traditional Chinese Medicine to treat inflammatory bowel disease. Acupuncture and moxibustion were effective specifically for treating Crohn’s disease. Moxibustion is a technique in which the herb mugwort is burned over specific acupuncture points. It is used because it is thought to reach deeper into the body than using needles alone.
Psychotherapy and Hypnotherapy Treatment of Crohn’s Disease
Hypnotherapy, Psychotherapy and counseling has been very helpful in the treatment with Crohn’s disease. It has been proven that when exposed to a stressful situation some children learn to develop gastrointestinal symptoms to cope with the stress. Crohn’s disease is stress related. Exercise is helpful to relieve stress therefore reducing symptoms of these particular diseases.
Conventional / Allopathic Treatment of Crohn’s Disease
The conventional treatment for Crohn’s disease involves first administering steroids in order to control the patient’s symptoms (abdominal pain and bloody diarrhea); the next step involves administering immune-suppressing drugs, which prepare the body to receive the third medication – an antibody that curbs the inflammatory response at the root of the disease.
Surgical Treatment of Crohn’s Disease
Some people who suffered with Crohn’s disease will need to have surgery at some point to treat the disease. Surgical treatments include:
Correction of a fistula or fissure
Draining of an abscess
Opening of a stricture or obstruction of the bowel
Removal of a segment of diseased tissue.
Dietary & Herbal Treatment of Crohn’s Disease
Eat six smaller meals a day, rather than three larger meals
Elimination food types such as grains or sugars.
Take a daily multivitamin
Avoid caffeine, alcohol, and tobacco
Avoid refined foods such as white breads and pastas
Other Treatment of Crohn’s Disease
Mild exercise can help reduce stress, relieve depression and normalize bowel function. Talk to your doctor about an exercise plan that’s right for you.
What is Crohn’s Disease?
Crohn’s disease is an inflammatory condition that affects the digestive tract – including the mouth, esophagus, stomach, small and large intestine, and anus. It can affect any portion of the digestive tract, but is most common in the ileum – the lowest portion of the small intestine, where it connects with the large intestine.
Symptoms of Crohn’s Disease
Abdominal pain and cramping
Rectal bleeding
Eye inflammation
Weight loss and reduced appetite
Ulcers
Arthritis,
Skin problems
Fever
Delayed growth or sexual development, in children
Causes of Crohn’s Disease
The exact cause of Crohn’s disease is unknown. Most researches think that it could be caused by a combination of inter-related factors that is listed below:
Previous infection
Genetics
The immune system
Diet high in fat or refined foods
Risk factors of Crohn’s Disease
Cigarette smoking
Age between 20 and 30.
Although whites have the highest risk of the disease
Family history.
People living in a city or an industrialized country and in northern climates
Arthritis and Skin problems
inflammation in the eyes or mouth,
kidney stones or gallstones
Diseases of the liver and biliary system.
Complications of Crohn’s Disease
Bowel obstruction – It includes abdominal pain, cramping, vomiting etc.
Fistula – It includes a high temperature, generally feeling unwell, a constant throbbing pain, blood or pus in your faeces(stools) etc.
Diagnosis of Crohn’s Disease
To perfectly diagnose Crohn’s disease(CD), a patient will likely experience a number of laboratory tests and one or more imaging procedures that allow a doctor to visually evaluate the intestine.
Laboratory tests
Blood tests
Stool cultures
Imaging procedures
Precautions & Prevention of Crohn’s Disease
There is no way to prevent Crohn’s disease because the cause is unknown. But you can take steps to reduce the rigorousness of the disease.
Get regular exercise.
Do not smoke.
Medicines taken regularly may reduce sudden attacks
Eat a healthy diet.
Never use antibiotics unless they have been prescribed for you by a doctor.
What is HIV and AIDS?
HIV is the acronym for the human immunodeficiency virus. It is a type of virus, which causes disease by infecting and killing blood cells (known as CD4 T-cells) central to the body's defence immune system. As these cells are progressively killed, the body becomes less and less able to defend itself against otherwise common illnesses.
AIDS is the acronym for acquired immunodeficiency syndrome. It is the stage of HIV infection where a person's immune system is fully compromised, leaving the body open to a wide range of potentially serious diseases known as opportunistic infections and or non-opportunistic diseases) HIV takes about 10 to 12 years, from initial infection, to fully culminate into AIDS.
HIV infection is predominantly a sexually transmitted Infection, by far the most common mode of infection, particularly in developing countries, is heterosexual transmission.
HIV Transmission:
Despite increased public awareness about HIV, there remains a lot of confusion about how one can get infected and how one cannot. HIV has a way of spurring anxieties in even the best of us and, with it, our sense of reason. We need to understand what conditions are required for an infection to take place and why things like hugging, touching, sneezing, or kissing simply do not satisfy those conditions.
Four Conditions Needed to Transmit HIV:
As serious an infection as HIV is, the virus itself is not all that robust, there four conditions that must take place in order for infection to occur:
1.There must be body fluids in which HIV can thrive. For HIV, this means blood, semen, vaginal fluids, or breast milk. HIV cannot survive for very long in the open air or in parts of the body where there is high acid content (such as the stomach or bladder).
2. There must be a way for the body fluids to enter the body. This happens primarily through sexual contact but can also be spread through shared needles, accidental blood exposure in health care settings, or transmission of the virus from mother to child during pregnancy.
3. The virus must be able to reach vulnerable cells and tissues inside of the body. It is not enough for a body fluid to come into contact with skin. It needs to either enter the bloodstream through a break in the skin or penetrate vulnerable mucosal tissues of the vagina or rectum. A deep cut or wound, for example, provides a more likely route of transmission than a minor scuff or scrape.
4. There must be sufficient amounts of virus in the body fluid. This is why saliva, sweat, and tears are unlikely sources of infection since the enzymes in these fluids actively break down HIV and its genetic structure.
A. Sexual Transmission. HIV is transmitted primarily by sexual contact, both heterosexual and male to male. This can happen while having unprotected sex, vaginal and anal sex with someone infected with HIV.
oral sex is much less efficient mode of transmission of HIV than is anal or vaginal intercourse and incidence of infection by oral sex is extremely low. However there have been well documented reports of HIV transmission that resulted from cunnilingus or fellatio. Therefore, the assumption that oral sex is completely safe is not warranted.
B. Perinatal Transmission. The mother can pass the infection on to her child during childbirth, pregnancy, and also through breastfeeding.
C. Blood Transmission. The risk of transmitting HIV through blood transfusion is nowadays extremely low, due to mandatory meticulous screening for HIV and other STIs of blood and blood products. Among injection drug users, sharing and reusing syringes contaminated with HIV-infected blood is extremely hazardous.
It’s possible to get HIV from tattooing or body piercing if the equipment used for these procedures has someone else’s blood in it or if the ink is shared. The risk of getting HIV this way is very low, but the risk increases when the person doing the procedure is unlicensed, because of the potential for unsanitary practices such as sharing needles or ink. If you get a tattoo or a body piercing, be sure that the person doing the procedure is properly licensed and that they use only new or sterilized needles, ink, and other supplies.
How HIV Cannot Be transmitted?
From both a biological and epidemiological evidence, HIV cannot and has never been shown to be passed from one person to another by the following means:
How Do I know If I have HIV?
Always consult a health care provider before going for HIV testing as pre and post counselling for HIV test is vital for proper guidance. Though self-testing by rapid test kits are available in the market, it is well advisable to consult a health care provider as soon as possible after any suspected exposure. Self-testing leads to unnecessary tests performed at very high costs, at incorrect time and intervals.
#Belief1: H.I.V. & AIDS are both same.
Fact: Both are different.
HIV is basically one type of Virus which is responsible for the infection. It means “Human Immuno Deficiency Virus. AIDS is the last stage after getting infected by HIV. This can be detected after 8 to 10 years of infection. It means Acquired Immuno Deficiency Syndrome.
#Belief2: HIV is transferred by working or being in contact with HIV infected people.
Fact: HIV is not transferred by Social contacts. HIV is not transferred by the given points.
By breathing in the same room & atmosphere.
By using common toilets & bathrooms.
By eating or drinking from the same utensils.
By hands shake or normal kissing.
HIV is transferred only by infected blood, sperms, vaginal fluid & breast milk.
#Belief3: If both husband & wife are HIV infected, no need to use a condom while physical relations.
Fact: HIV can be of two types, namely HIV-1 & HIV-2 and then there are several subtypes and strains of each them. HIV is a fast mutating virus so the strain gets changed over the time. Husband and wife, though initially may have been infected with same type, subtype of strain, can have different strains later on and hence can get the infection from each other with the different mutated strains of HIV. If a couple is not using a condom, one or both of them can keep infecting one another. It is possible that the type of virus which is drug resistant i.e. having very little effect of medicines may infect the other partner hence condom must be used. The only caveat is - the infected person is on regular ART and has become undetectable. “Undetectable is Untransmittable”!
#Belief4: HIV infection is mostly seen in sex workers and not found in people from common walk of life.
Fact: In the decades of 1980 & 1990, the HIV infection was found to have infected more sex workers & less common people. But by Public Awareness Programmes & other relevant intervention projects of the Government as well as NGOs like Peoples Health Organisation (India), infection of HIV is reduced by 80 to 90% in sex workers. While the infection of HIV is found to have increased among people in general society. HIV is not related to work or religion of the person. HIV can be found in any person who has one or more of the following behavioural activities or a risk factor-
Having unsafe sexual relations outside marriage
By transfusion of the infected blood
By Injection Drug Use (IDU)
Baby borne to the infected mother or breastfed by infected woman
#Belief5: HIV infection means death.
Fact: Not true. It is true that the HIV virus cannot be removed from the body of the infected person but the science has at least proved that HIV virus can easily be controlled by medicines. By proper medications called Anti-retroviral Treatment (ART), one can lead a normal life and early death can also be avoided. ART has to a combination of three anti-retrovirals (ARV). A total of 30 ARV medicines have been invented, one can remain free of AIDS for the whole life.
#Belief6: HIV negative report proves a person to be HIV free.
Fact: Not true. One can have HIV infection even though having negative blood report and this is possible during the window period. For confirmation, one has to retest blood after three months and should be free of any risky activities / fresh exposure during these months.
#Belief7: HIV is not transferred by the person under medication of HIV.
Fact: Due to ART the viral load is reduced but the virus never completely vanishes from the body. Hence the chances of infection are low, but are not at all zero. Some of the robust ARVs help reduce virus quickly and tremendously. Consult the expert.
#Belief8: Chances of HIV are zero from relations with a reliable and healthy-looking partner.
Fact: The symptoms of HIV/AIDS can develop even 8 to 10 years after the infection with HIV. However during these years the infected person has virus, tests positive and thus capable of transmitting the same. So healthy-looking person need not be HIV negative!
#Belief9: The Oral Sex does not lead to transfer HIV.
Fact: HIV can also be transferred through Oral Sex, but the chances are less. HIV is mainly transferred through sperms, vaginal fluid, mothers’ milk and blood transfusion. If one has a cut or ulcer or swelling of gums or oral or throat infection, the HIV in the sperm of the infected partner can enter the other partner’s blood steam through cuts, abrasions, wounds or ulcers transmitting HIV infection.
#Belief10: HIV can be cured by Ayurvedic or other alternative medicines.
Fact: No person till today is cured of HIV. HIV infected patient or any patient of the chronic disease are frustrated and are tired mentally, physically and financially. Some quacks takes advantage of such situations in HIV infected people and make tall promises of their ‘concoctions’ ‘therapies and often spurious medicines and cheat such frustrated patients who are in search of ‘cures’. Beware of fraudsters and Tom, Dick & Harry who can threaten your life with false promises. This will only lead to physical and financial loss and you to lose golden time to be treated properly, often lead you to death.
#Belief11: HIV infection is possible by kissing.
Fact: This has both possibilities. The infection depends on the type of kissing. The French kiss or prolonged mouth to mouth kissing may lead to infection but very rarely. Again only if both have cuts, injuries or ulcers in the mouth but chances of HIV transmission are extremely less.
#Belief12: Contraceptive pills can prevent the infection hence one need not use the condom.
Fact: This is wrong. The contraceptive pill works on the reproductive system, only to prevent pregnancy; while HIV virus enters through unprotected intercourse. A condom provides a barrier protection thus prevents one’s infected sexual fluid coming in contact with genital area of another. Infect condom works as contraception as well as HIV protection, but pill doesn’t.
#Belief13: One cannot have more than one Sexually Transmitted Disease (STD) simultaneously.
Fact: One can have more than one STDs at a time. If one has not been diagnosed and treated for STD, the chances of HIV transmission are almost 10 times more. If any ulcer has developed due to STD, the chances of HIV transmission are raised further.
#Belief14: If one has HIV & other is negative, then safe sex is not possible & such couples should not have physical relations or should not have pregnancy.
Fact: A conjugal relationship is an integral part of married life. It is possible to have protected relationship. It is the best strategy to start treatment of HIV infected partner at the earliest, so that s/he can become undetectable viral load. Pregancy is also possible and child can be born without HIV under expert guidance and proper treatment. A new therapy called Pre-Exposure Prophylaxis (PrEP) can be used by uninfected person during the period the infected person has still detectable viral load.
#Belief15: The test for HIV should not be done. If it comes positive it will have its own problem. Let ignorance be bliss!
Fact: The chances of being HIV infected are much less. So if your result comes negative, you do not have to lead a life of ambiguity and fear. If you are in that minor possibility and turned out to be HIV positive, by taking timely treatment you can lead a perfectly normal life with ART. In the pre-test counseling for HIV test, one is explained about the HIV other STDs; which will help you to prevent such infections in future.
#Belief16: HIV can be transferred by mosquito bites.
Fact: HIV virus has very short life outside the human body. As such mosquitoes suck the blood from our body, blood goes in their intestine and gets digested. Mosquitoes do not inject blood, hence mosquito bite cannot transmit HIV. Entomologists have done studies on mosquitoes fed on HIV infected people and did not find any evidence to support that mosquitoes can ever transmit HIV.
#Belief17: An HIV-infected woman should not give birth to a child as the newly born will be surely HIV infected.
Fact: If HIV-infected woman is not under treatment, the newly born baby has 30% to 45% chances of HIV in natural course. If the woman is under ART medications and infant is given medicines for 4 weeks, the chances of HIV are reduced to less than 1%. At Unison Medicare and Research Centre, we have at least 170 HIV infected mothers who had delivered during last decade, none of the child born to them is HIV infected, so we have 100% result in prevention of mother to child HIV infection.
#Belief18: HIV can be cured by physical relations with virgin girls (or even boys).
Fact: This type of myth prevail in some people in our country and in African Continent as well. This has no scientific logic and not true. Instead of the cure from HIV, the child can get HIV infection. Such person can be tried for heinous crime and inflicting deadly disease on the indefensible – the child.
#Belief19: HIV can be cured by physical relations with animals.
Fact: This myth does prevail in some tribes and people in our country as well as in African Continent. This has no scientific logic and not true. A perpetrator can be tried on inflicting cruelty on animals and be punished.
#Belief20: HIV medicines are very costly and not affordable by the middle-class people.
Fact: India is fortunate to have several companies that have launched the medicines for HIV. This has resulted in the reduction of cost of medicines and they are cheapest in India. The medicine for a month can be from Rs.1000.00 to 6000.00 depending on the ART combination chosen to treat.
#Belief21: HIV medicines have side effects; which will be troublesome to the patient.
Fact: This is not true. The fact is that HIV medicines do have some side effects, just as any medicine have, but not each patient get them. We have to weigh enormous beneficial effects that ART can provide versus miniscule side effects! Currently used ARVs have been otherwise very safe with least side effects. By and large 95-98% of those on ART do not face any major side effects. If anyone is inconvenienced with the side effects, then the medicines can be changed.
#Belief22: HIV is transmitted by placing the infected needle on the seats of the theatre or pricks by unknown people.
Fact: These are rumours and such rumours go viral in social media and traditional media. Speed of spreading misinformation is faster than speed of spreading educational information! HIV cannot be transferred like this as the virus has a very short life outside the human body. People should not pay attention to such rumours and should rather dissuade people from doing such rumour-mongering.
#Belief23: HIV is transferred through cold drinks.
Fact: Once again it is myth. Such rumours go viral as people keep forwarding without knowing reality. HIV cannot be transmitted like this as virus are very fragile and can survive only in human body and bodily internal fluids like blood, semen, vaginal secretions. It is not transmitted through saliva, tears, sweat and aerosols.
#Belief24: HIV medicines are to be used at the precise timings. People avoid medicines as they are not able to maintain the timings.
Fact: The fixed time for intake of the medicine has reason that the effect of the medicine shall prevail between two successive doses providing adequate dose at all the times. To obtain the maximum output, ART medicines are prescribed for 12 or 24 hours’ interval, depending on what combination is used. Some medicines have requirements to be taken with food or after food or on empty stomach. However, slight variations in timings will not affect much
#Belief25: Person suffering from both TB & HIV should start the treatment of HIV only after completion of TB treatment.
Fact: Normally, ART for HIV should be started after two to sex weeks of starting TB treatment. This is to prevent Immune Reconstitution Inflammatory Syndromme (IRIS). Starting both medicines simultaneously can result in IRIS, as anti-TB medicines act slowly and results come only after two weeks, but ART acts very fast. Under such situation sudden change in immunity levels increases TB and often at new places in the body.
#Belief26: If intake of medicine is skipped, it does not matter.
Fact: HIV is a virus and to keep it in constant control, the suitable medicine should be present all the time in the body. If a dose is skipped, the virus escapes the medicine cover and frequent skipping of the doses for a long time will result into virus becoming resistant to ART.
#Belief27: HIV positive person having no trouble may not require any medicine.
Fact: The time period between the infection and onset of symptoms / signs is 8 to 10 years. During this period, HIV slowly and steadily reduces CD4 cells of the immune system. Such reductions make way for attacks of several infections and some non-infectious conditions. The HIV virus damages the body parts internally though there may not be any obvious symptoms. Hence ART medicines for HIV should be started immediately on detection of HIV. Studies have shown that those who start ART earlier prevent several infectious and non-infectious conditions and thus their life spans get extended and without disease events.
#Belief28: If an HIV-infected person gets involved in unsafe sex, the possibility of HIV transmission is 100% even in one sex.
Fact: This is most commonly observed misunderstanding. If one has HIV chance of HIV transmission for a single relation is just less than 1%, precisely 0.3%. If the frequency of the unsafe physical relations increases, the chances of HIV infection increase. As every physical relation does not result in the conception, in the same way, the chance of HIV infection is just 1%. However, though the chance of HIV transmission is less than 1% precautions should be 100%, as one doesn’t know which attempt will transmit HIV!
#Belief29: HIV positive person should not marry.
Fact: This is a misunderstanding prevailing in the society. Especially when HIV had no proper treatment. An HIV-positive person can live a happy married life irrespective of his profession and HIV affliction. The best for such person would be to marry HIV infected person. However, if a positive-negative marriage has to take place, please go through counseling sessions, don’t marry someone deceitfully, that is a punishable crime. HIV positive person has the moral responsibility to take care not to transmit HIV to spouse. Take proper ART, if needed negative person should be put on PrEP.
#Belief30: Pharmaceutical companies have invented the medicines to cure HIV but are not launching them with the intention to earn more through present medicines.
Fact: Some people believe in this type of rumors. Actually, pharma companies can earn lot more by selling HIV cure medicine(s) if they have one, rather than current medicines.
#Belief31: HIV can be transmitted through shaving blade or toothbrush.
Fact: Not a single case is recorded till date, who has got HIV through barber, shaving or toothbrush. Though HIV is not transferred through blade or toothbrush, but hygienic precautions should not have holiday. By taking those precautions, you protect yourselves from several infections that can be transmitted through sharing razors and toothbrush.
#Belief32: HIV can be transferred by Fish pedicure.
Fact: HIV virus cannot survive outside human body hence HIV cannot be transferred by Fish pedicure. Do not believe in such rumors.
#Belief33: If HIV is detected, the laboratory staff and doctor may informs others in society; which can ruin your social prestige.
Fact: Nobody can do this. If they do, it is a punishable crime under the newly passed HIV/AIDS Act 2017. The result of HIV test is not disclosed to any other except the person himself. Details of the test are kept a confidential and cannot be disclosed to anyone without your permission, not even to your spouse.
#Belief34: Every HIV-infected person suffers AIDS and die a miserable death.
Fact: The first AIDS cases were diagnosed in 1981 in USA and in India in 1985-86. In the pre-ART period, every HIV positive person used to suffer from AIDS and die sooner than later. Presently, science has progressed very well and there are many medicines for treating HIV, called ARVs. Nearly 30 medicines are available in the world for HIV out of which 20 medicines are available in India and at affordable cost. The ART drugs are not able to completely cure HIV but restricts the growth of virus, thereby reduces the present virus to 99.99% making the infected person undetectable for HIV in few months. Taking ART can even revert person from AIDS to HIV and prevents person from going to AIDS stage if he/she start ART immediately.
#Belief35: HIV is found only in poor and in some specified class of people.
Fact: This is a totally wrong and convenient belief, in an attitude of ‘holier than thou’! HIV can be transmitted to any person without any distinction of caste, creed, race, religion, profession and economic or social status.
#Belief36: HIV is transferred through unsafe sexual relations only.
Fact: Though most people are infected through sexual transmission, in every case this may not be true. A wife getting HIV infection from her husband cannot be construed to be having unsafe sex! Sometimes, HIV is transferred through infected needle or contaminated blood transfusion.
#Belief37: It is not required to change the syringe in an injection. Only needle is to be changed to prevent HIV infection.
Fact: This belief prevails even among the healthcare workers, as the erstwhile injection practices used to be only replacing needles, that to reusable needle from the boiling water. However, current practices demand and uses disposable syringes and needles.
#Belief38: HIV infected people are always sick and have a very short life.
Fact: This is not true. Normally symptoms of HIV are seen only 8-10 years after the infection. If HIV is diagnosed early and treatment started soon, the infected person may lead a perfectly healthy life for a full lifespan.
#Belief39: HIV is found only in young people and old ones are free from HIV.
Fact: HIV infection can happen to anybody at any age, based on risk factors. Generally people believe that old people do not indulge in risky behaviours. Though proportionately chances of young people indulging in unsafe sexual practices are higher, old people are not free from such behaviours.
#Belief40: HIV leads to death only and hence medicines are useless. Why treat?
Fact: Presently, ART can provide perfectly healthy life, but needs to be taken regularly. ART can be obtained from ART centres free of charge and even in private they are affordable. So, don’t loose hope, support HIV positive person take the best possible ART.
#Belief41: HIV is transferred by using the same swimming pool.
Fact: HIV virus is very fragile and cannot survive outside the human body. Virus cannot survive in swimming pool water that has bleach/ chlorine and hence HIV cannot be transmitted through swimming pool. In case you have a concern or query you can always consult an expert & get answers to your questions!
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