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A healthy immune system and optimum physical strength is maintained by an adequate nutritional status of the body. Unexpected loss of weight, loss of appetite, low dietary intake due to ulcers in the mouth and an altered rate of metabolism are common in HIV infected individuals. It is essential to regain the lost weight and the muscle mass in the early stages of the infection since the correction of nutritional status becomes difficult with the progression of the disease.
Certain measures like definitive anti-retroviral therapy combined with the treatment of opportunistic infections like TB, Candidiasis and other bacterial infections along with the provision of nutritive aid in the form of a balanced diet, regular physical activity, and use of appetite stimulants help in improving the general health of the body. A widespread deficiency of essential nutrition and micro-nutrients is observed among the HIV-infected people. Supplement composition, treatment given and characteristics of the patient vary widely across researches done.
The World Health Organization (WHO) recommends an intake of 1 Recommended Dietary Allowance (RDA) of each of the required micronutrient. This may sometimes require taking supplements of the micronutrients.There is a direct relation between HIV infection and malnutrition, where each makes an individual more susceptible to the other. HIV infection can increase the severity of malnutrition and vice versa.
Malnutrition can worsen the progression of HIV, which further in turn further worsens malnutrition. This is an unending cycle, until an intervention occurs. An increase in the nutritional needs, poor intake of nutrients and increased losses through vomiting and diarrhea lead to a poor nutritional status.
- This causes weight loss and wasting of muscles.
- Loss of the lean body mass is definitively linked to disease and morbidity.
- There is a sense of overall lack of energy, fatigue, lethargy and weakness.
- The immune system is composed of proteins.
- Reduced intake of proteins in the diet results in a decreased production of the immune cells.
- Certain amino acids are responsible to aid in the efficient functioning of the immune system.
- Deficiency of these amino acids impairs immune function.
- This impairment of the immune system makes the individual vulnerable to various infections.
- The opportunistic infections like tuberculosis (TB), Candida and bacterial pneumonias are commonly observed in individuals with HIV.
These diseases further strain the immune system and cause disease progression. It is important to know that nutrition acts as an adjunct to appropriate anti-retroviral therapy. Multivitamins, supplements of beta-carotene and Vitamin A, zinc, selenium and probiotics help in maintaining optimum nutrition in an HIV infected individual. Anabolic agents and appetite stimulants help in overcoming muscle wasting. Nutrient-dense meals consumed in small portions at frequent intervals are better accepted in the body rather than the regular 3 large meals.
Water consumption during meals should be avoided, to prevent a feeling of fullness in the stomach due to water rather than food. A healthy and balanced nutrition is essential in living a normal life. Maintaining the lost weight and stamina of the body, replacement of the lost nutrients, vitamins and minerals aid in improvement of the immune function. Proper nutrition can delay progression of the HIV infection into AIDS disease by improving the response of the body to the treatment given.
People who suffer from Human Immunodeficiency Virus, commonly known as 'HIV', are known as HIV positive people. The virus is the agent of AIDS that is currently incurable. HIV is known to alter the human immune system and makes people much more susceptible and vulnerable to diseases and infections.
Body fluids such as semen, blood, breast milk, vaginal fluids etc. of an infected individual contains the virus, which can be passed from one person to another during blood-to-blood and/or sexual contact. HIV positive women may even pass on this virus to their children during pregnancy, delivery or by breast feeding them. HIV is also transmitted during oral, anal or vaginal sex, by contaminated hypodermic needles and by blood transfusion.
- Menstrual Disorders: Changes in menstrual cycles are frequently reported by HIV infected women. However, menstrual dysfunctions are due to varied reasons that aren't directly related to the disease. Although most of the HIV positive women suffer from amenorrhea i.e. the unusual absence of periods, it is not just due to HIV but also because of weight loss or immunosuppression.
- Contraception: It is very important that the contraception a HIV positive woman chooses not only acts as birth control, but also to prevent the transmission of sexually transmitted diseases and HIV. Although condoms do not provide exceptional pregnancy prevention, they are excellent at preventing transmission of the HIV virus. Permanent sterilization is usually the most chosen contraceptive method for HIV serodiscordant couples.
- Surgical Complications: HIV positive women are at a higher risk of undergoing gynecologic surgery. This is because they are more vulnerable to pelvic infectious disease that requires surgical intervention. There is also a greater risk of developing vulvar cancer in HIV positive women.
- Fertility: There has been an increase in the number of seropositive women contemplating pregnancy and childbirth. Most couples resort to assisted reproduction to lower the risk of horizontal HIV transmission. Studies show that undergoing HIV treatment and having an undetectable viral load is helpful in preventing the transmission of HIV. It is important to consult a medical expert if you are unable to get pregnant after at least 6 months of trying. Fertility problems are more common in HIV positive women than HIV negative women.
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. In case you have a concern or query you can always consult an expert & get answers to your questions!
When you are potentially exposed to HIV, and if there is a way to prevent from getting infected, you will seek to perform it. One such procedure is Post Exposure Prophylaxis (PEP) which must be initiated within 72 hours of possible exposure to HIV.
What is PEP meant for?
The Human immune deficiency virus causes HIV infection that affects the immune system and is considered to be one of the deadly forms of infections. This virus spreads through bodily fluids such as blood, semen, vaginal fluids and breast milk. There are chances of encountering the infection under the circumstances such as having sexual intercourse or sharing needles with an infected person by accident. In such a case, PEP (Post Exposure Prophylaxis) can come to your aid in preventing the infection.
The medical term PEP refers to the intake of ARV or antiretroviral medicines after being exposed to the human immunodeficiency virus. To be more specific, PEP is a short-term antiretroviral treatment that works towards reducing the symptoms and likelihood of the HIV infection after being exposed to it.
Who should opt for PEP treatment?
PEP can be ideal for everyone who comes in contact with the HIV and is an HIV negative. Whether one is exposed to HIV through a needle stick injury during his/her work as a health care professional, or whether it’s unprotected sex that has exposed one to HIV, or the sharing of used needles or through sexual assault, opting for the PEP can be the next best step as it is particularly meant for emergency situations.
When and how long PEP can be taken?
As per the research, PEP should be taken within 3 days or 72 hours from the possible time of being exposed to HIV. If taken after 72 hours, the PEP most likely cannot help in preventing the HIV infection, hence the sooner, the better in this case. The course of PEP involves 3 ARV or more per day for almost 28 days. Along with taking the ARV medications, one must visit his/her health care professional at certain intervals for HIV testing and other related tests.
Are there any side-effects of taking PEP?
When opting for PEP treatment, some people may experience a few side effects due to it, which varies from person to person, such as vomiting, nausea, headaches, diarrhea, fatigue, etc. However, none of the side effects are life-threatening and can be easily treated. Often, it is due to the reaction of the PEP medications with other drugs that one is taking at the same time that the side-effects start showing. Moreover, as PEP can potentially prevent HIV infection, this benefit certainly outweighs the inconvenience caused as side effects.
PEP is considered to be one of the most effective and promising treatments available for preventing HIV infection if taken correctly and within the certain time duration. In case one thinks he or she has been exposed to HIV somehow, talking to a health care professional regarding PEP becomes crucial.
HIV infection is the causative factor of the acquired immune deficiency syndrome (AIDS). Worldwide research is being conducted and treatment strategies are being formulated to combat this fatal disease. Fighting HIV is not an easy task, since the disease cannot be completely reversed. However, worldwide use of anti-retroviral therapy has helped in controlling the spread and transmission of disease. Use of medications, regular screening and close contact with caregivers and physicians is necessary for proper management of the disease. Despite, available treatment options, a difficult obstacle that arises before or during the treatment is drug resistance.
Drugs are aimed at targeting the disease-causing pathogens like bacteria and viruses. These pathogens, over a period of time, develop the ability to acquire resistance against the targeted drugs. The pathogens continue multiplying despite the presence of the drug in the system. In today’s scenario, the potent drug combination of anti-retroviral therapy (ARV) has been successful in remarkably reducing HIV-related mortality. However, an increased emergence of resistance to the drug therapy is concerning.
Amongst the various drug classes available in the ARV, no drug is resistance-proof. The drugs belonging to the same class have a similar mechanism of action against the virus. So resistance developed against a particular class of drug inevitably leads to resistance against all the other drugs belonging to that class. An individual with HIV infection may have one or more drug-resistant mutations, which makes the person less sensitive to one or more anti-retroviral drugs. When the replication of virus in the system is not suppressed fully, a resistance towards it develops.
Non-compliance of the ARV results in resistance. Resistant viruses can spread the infection and affect ARV therapy. Drug resistance is usually attributed to inadequate adherence to the regimen. But in some cases, strict adherence to the drug is seen, yet there is a presence of resistance due to poor absorption. This implies that since the drug is not getting adequately absorbed in the body, it is unable to prevent the replication thus leading to drug resistance.
Anti-retroviral treatment is aimed at limiting the replication of HIV in the body. Various drug classes target different steps of replication, which stops further replicating and infecting of the cells. The nucleo-capsid contains viral genome and three enzymes vital to HIV life cycle:
- Reverse transcriptase - Transcribes viral RNA genome into complementary deoxyribonucleic acid (DNA)
- Integrase - Facilitates incorporation of pro-viral DNA into host cell genome
- Protease - Cleaves viral polypeptide into individual functional enzymes
Drugs targeted on these steps are as follows
- Nucleoside and non-nucleoside reverse transcriptase inhibitors like Nevirapine and Efavirenz act on the reverse transcriptase enzyme.
- Integrase inhibitor Raltegravir acts on the Integrase enzyme.
- Protease inhibitors like Ritonavir, Indinavir, Saquinavir act on the Protease enzyme.
- Fusion inhibitor Enfuvirtide acts to prevent fusion of HIV with cell membranes.
- CCR5 inhibitor Maraviroc block the CCR5 co-receptor.
- A viral mutation occurring at any stage of this process can affect the efficacy of the drug therapy.
The emergence of drug resistance can be managed by evaluation of drug absorption and ensure strict adherence to the drug schedule. Genotype tests can be done to look for drug-resistant mutations in genes. Phenotype tests are done for measuring the ability of a virus in an individual to undergo replication in different drug concentrations. A successfully administered and effectively acted first-line drug treatment, preferably a 3-drug combination, reduces the chances of drug resistance in future.
In case you have a concern or query you can always consult an expert & get answers to your questions!
People who have allergies react to things that wouldn't bother most others . If one can't avoid contact with an allergy trigger, he can atleast treat the rash and ease the itching. Also one can't pass it to anyone else. The best method of treating allergy is prevention. One should avoid such things which causes rash . Further there are more remedies that can be used for skin allergies.