Detailed about Asthma Disease and it's treatment ?

What is asthma?

Asthma is a chronic disease in which sufferers have repeated attacks of difficulty in breathing.
In recent decades there has been an increase in the number of people affected by asthma all over the world, especially in children.
However, since the 1990s the percentage of the population who are affected seems to have levelled out in the UK at least.
To understand what happens in an asthmatic attack, it's helpful to visualise the basic structure of the airway tubes of the lung.
The main airway (windpipe, trachea) of the body is about 2 to 3cm across. It divides into its main branches (bronchi), which lead to the right and left lung. Each bronchus divides further, like the branches of a tree, to supply air to all parts of the lungs.
The smallest tubes (bronchioles) are only millimetres wide and they are made up of ring-shaped muscles that are capable of contracting or relaxing.
Anything that makes them contract will narrow the passages, which makes it more difficult for the air to pass through (so making it harder to breathe) and also gives rise to the characteristic wheezy noise that a person makes when they have an asthma attack.
Asthmatics tend to be sensitive to various types of irritants in the atmosphere that can trigger this contraction response from the bronchial muscles.
The bronchioles also have an inner lining that becomes inflamed in asthma. This inflammation makes the lining swell (further narrowing the airway) and produce an excess amount of the mucus (phlegm) it normally makes, clogging up the tubes.
All of these processes contribute to the airway narrowing and the treatment for asthma is aimed at reversing them as much as possible. The airway inflammation and narrowing may be an on-going chronic problem which is intermittently made worse during acute asthma attacks.
People of all ages get asthma but 20 per cent of sufferers are children. Asthma is slightly more common among boys than girls. But after puberty the pattern reverses and among adults, women are more likely to develop asthma than men.
About 5.4 million people in the UK are currently receiving treatment for asthma (about 1.1 million children and 4.3 million adults), with it costing the NHS £1,000 million per year (stats from asthma UK).

How do you get asthma?

In most cases a person who develops asthma has been born with an inherited predisposition to the disease.
There may be a family history of asthma, and a great deal of research is being carried out to look for the genes that allow asthma to develop (some of these genes have been identified).
However environmental factors are important too, and asthma may not reveal itself until that person is exposed to a particular asthma trigger in their environment.
Some other links have been established.
A mother who smokes, a low birth weight, and exposure to traffic fumes have all been associated with asthma.
It's also thought that the modern obsession with a very clean environment in early life (avoiding exposure to infections and particularly parasites) may mean than a child's immune system is not 'primed' properly and an increased sensitivity to asthma triggers results.
Modern housing may also play a part, as less draughty, better heated homes result in higher levels of house dust mites or cooking gases.
Asthma can be dividied into two types.

1. In allergic or extrinsic asthma, an attack is triggered by agents which cause an allergic reaction, for example when pollen, dust mites or animal fur are breathed in. Some kinds of food can also trigger an attacks. These agents are known as allergens – they consist of foreign proteins which activate the immune system. A reaction to animal fur is actually a reaction to a protein in the animals saliva which been coated onto the fur as the animal grooms itself.
2. Asthma may also be triggered by non-allergic factors. This is known as intrinsic or non-allergic asthma and factors which cause an attack include anxiety, stress, exercise and cold air, as well as smoke, chemical fumes, and other irritants including viral infections. Certain medicines, eg aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs), may  also cause an asthma attack. Although these factors cause inflammation of the airways, they do not activate the immune system.

Most people with asthma are susceptible to either of these types.
Until we can prevent asthma, the aim is to try to avoid these triggers where possible, and then effectively manage symptoms during an attack.

What might trigger an acute asthma attack?

• Exertion and exercise.
• Cold air.
• Smoke.
• Emotional stress.
• Air pollution including exposure to certain chemicals. An example is isocynates, which are used in some painting and plastics industries.
• Airway infection, eg viral infections such as colds.
• Chemical irritants including chemicals in medicines such as aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.
• Allergies, eg to pollens, house dust mites, some foods, and the fur or dander from domestic animals (especially cats and horses). In these allergies, the immune system is reacting to a foreign protein or 'allergen'.

What does asthma feel like?

• It is difficult to breathe, with a feeling of tightness in the chest, and there is shortness of breath.
• Wheezing (a fine whistling sound) when breathing out.
• coughing, especially at night and there may be increased production of mucus or phelgm.

Symptoms vary from person to person and from attack to attack. In some they are mild and occasional while others have continuous or severe breathing problems.

What are the warning signals of worsening attacks?

• Symptoms become more severe.
• Inhaled medicines appears less effective than usual, and you may realise you are taking more of your reliever inhaler.
• Symptoms of cough or wheeze on exertion.
• Night-time wakening with wheeze or cough.
• Fall in the peak flow meter reading (a peak flow meter is a simple device that measures the maximum speed at which a person can breathe out).

When it appears that your asthma is becoming less well controlled, you should consult your doctor for advice on what to do.

What are the danger signals of severe attacks requiring immediate medical attention?

• Severe shortness of breath, so that you can't complete a sentence.
• Having to sit hunched forwards to breathe.
• Bluish skin colour (especially noticeable around the lips or fingernails) and gasping breath.
• Exhaustion so severe that speech is difficult or impossible.
• Fast breathing but with a silent chest (ie the wheeze disappears – a sign that very little air is even moving in and out of the lungs).
• Confusion and restlessness.
• Drowsiness.

What can you do to help yourself?

• Avoid the substances you know that you are allergic to, or that you know tend to trigger an attack for you if possible. It can be difficult to know which specific factors may give you trouble, but general irritants like tobacco smoke should be avoided.
• It is important to take your prescribed preventive medicines, even if you feel well.
• If you get a serious attack, contact your doctor or the emergency services.
• Discuss ur treatment with ur docter or practice nurse. You should know what to do if, for example, you get a bit worse during a cold. This will usually involve a temporary increase in the dosage of your treatment.
• Be familiar with the use peak flow meter, which can help you judge your asthma during spells when it is worse.
• Make sure you use your inhaler correctly. If you are unsure your practice nurse, doctor or pharmacist will be able to help and advise you.
• Make sure you have an adequate supply of your treatments, and don’t risk running out if symptoms get worse.

How does the doctor make the diagnosis?

A diagnosis of asthma is made on the basis of a patient's history of symptoms combined with simple tests of how the lungs are functioning (this may include a peak flow test, which uses a simple device to measure how fast you can breathe air out of your lungs).
Sometimes treatments such as reliever inhalers are tried, simply to see if they help symptoms (and therefore help establish the diagnosis). But it's not always easy to come to a diagnosis of asthma if the symptoms are mild and intermittent.
For those people whose asthma is associated with eczema and hay fever indicating an allergic aspect to their symptoms, it can be helpful to take blood samples and skin tests to look for hypersensitivity towards specific substances.

Can I safely exercise?

Be active. If you get attacks during intense activity it may be a good idea to take 'reliever' medicine before you begin to exercise.
These medicines, properly known as bronchodilter, have a relaxing effect on the muscle surrounding the bronchioles.
swimming is probably the best form of exercise for asthma patients but the most important thing is to stay active.

What are the prospects for asthma suffers?

• Although asthma cannot be cured it can usually be well treated so that the symptoms give little trouble.
• Half of the children who get asthma 'grow out of it'.
• It is vital to stop smoking to avoid developing long-term lung damage (chronic bronchitis 'smoker's lung'), which will reduce the lung function drastically.
• Severe attacks of asthma can be fatal but only if they are treated inadequately or not soon enough.

Medicine

Medicines for asthma are generally thought of in two main groups.

• Relievers (bronchodilater): these are quick-acting medicines that relax the muscles of the airways. This opens the airways and makes it easier to breathe. They are used to relieve symptoms.

• Preventers (anti-inflamentries): these act over a longer time and work by reducing the inflammation within the airways. They should be used regularly for maximum benefit. When the dosage and type of preventive medicine is correct, there will be little need for reliever medicines.

A number of other types of drugs may also be used, for example to reduce secretions.

Relievers

There are many different drugs used as asthma relievers, and they fall into three groups.

Beta-2 agonists

Beta-2 agonists act on molecule-sized receptors on the muscle of the bronchioles.
The medicine fits the receptor like a key fits a lock and causes the muscle to relax. Examples of those which act for a short time (three or four hours following a single dose
These start to work very quickly after inhalation and are used when required to relieve shortness of breath. They can also be used to open the airways before exercise.Longer-acting beta-2 agonists include salmeterol (eg Serevent) and formoterol (eg Foradil, Oxis).Their action lasts over 12 hours, making them suitable for twice-daily dosage to keep the airways open throughout the day.Formoterol works rapidly to open the airways like the short-acting beta-2 agonists.Some combination inhalers contain both a long-acting beta-2 agonist to open the airways and a steroid drug to reduce inflammation (ie preventer drugs). These include Seretide (which contains salmeterol and fluticasone) and Symbicort (formoterol and budesonide).Beta-2 agonists are inhaled from a variety of delivery devices, the most familiar being the pressurised metered-dose inhaler (MDI).Other devices include breath-actuated inhalers such as autohalers and dry powder inhalers such as turbohalers.

Anticholinergics

One of the ways in which the size of the airways is naturally controlled is through nerves that connect to the muscles. The nerve impulses cause the muscles to contract, thus narrowing the airway.Anticholinergic medicines block these nerve impulses, allowing the airways to open.The size of this effect is fairly small, so it is most noticeable if the airways have already been narrowed by other conditions, such as chronic bronchitis. An example of an anticholinergic drug is ipratropium bromide (eg Atrovent).It has a maximum effect 30 to 60 minutes after inhalation, which lasts for three to six hours.A longer lasting anticholinergic called tiotropium bromide need only be taken once a day and may sometimes be used in severe or chronic asthma but is slow in onset and so not for acute attacks.TheophyllinesTheophylline (eg Slo-phyllin) and aminophylline (eg Phyllocontin continus) are given by mouth and are less commonly used in Britain because they are more likely to produce side-effects than inhaled treatment.They are still in very wide use throughout the rest of the world.All three types of reliever can be combined if necessary.

Preventer.

Corticosteroids

Corticosteroids (or 'steroids') such as beclometasone (eg Beclazone), budesonide (eg Pulmicort) and fluticasone (eg Flixotide) have made an enormous difference to the management of asthma.  They work to reduce the amount of inflammation within the airways,

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Tips to prvent hair loss and detailed about it?

Hair Loss 

What is male hair loss (male pattern baldness/androgenic alopecia)?

Male hair loss is the most common type of hair loss.
It's caused by increased sensitivity to male sex hormones (androgens) in certain parts of the scalp, and is passed on from generation to generation.
In the past, baldness was often seen as something unfortunate or undesirable.
However, this attitude has changed over the years and nowadays a clean-shaven head is usually considered both fashionable and attractive.

What causes male hair loss?

Some men have areas on the scalp that are very sensitive to the male sex hormones that circulate in men's blood.
The hormones make the hair follicles – from which hair grows – shrink. Eventually, they become so small that they cannot replace lost hairs. The follicles are still alive, but are no longer able to perform their task.
The condition usually starts in men aged 20 to 30 and follows a typical pattern.
First, a receding hairline develops, and gradually the hair on top of the head also begins to thin.
Eventually, the two balding areas meet to form a typical U-shape around the back and sides of the head. The hair that remains is often finer and does not grow as quickly as it used to.

Can male hair loss be prevented?

Male hair loss is genetically determined (passed on from parents). Although a doctor can offer medical treatment to improve the condition, this may have side-effects.

What can be done at home?

You need to decide how you feel about hair loss. Male hair loss affects a large part of the male population and people react very differently to it.
It is important to try to accept hair loss for what it is – something natural.
Rather than trying to camouflage bald spots with remaining hair or a wig, it is probably a better idea to leave your hair as it is, or shave it off completely.
If, however, you decide to try to regain your hair, possible medical treatments are discussed below.

How is male hair loss treated?

Baldness is generally regarded as natural, and not a disease.
So if a person decides they wish to try to get their hair back, they will probably have to pay for the lengthy, expensive procedure themselves.

Treatment with medication

• Minoxidil lotion (Regaine regular strength or Regaine extra strength) is applied twice daily to the scalp. Minoxidil was originally invented as a treatment for high blood pressure; the hair growth is a side effect that, in this case, has proved useful. It is not available on NHS prescription, but can be purchased over-the-counter. About 60 per cent of patients benefit from it to varying degrees and its effects start to wear off as soon as it is stopped.
• Finasteride (propecia) is a medicine taken in tablet form that partially blocks the effects of the male hormones (an 'anti-androgen'). It is used in a higher dose to reduce the size of the prostate gland in men with benign prostatic hypertrophy. Propecia has been shown to halt further hair loss and promote re-growth of scalp hair in approximately 80 per cent of patients after three to six months. Treatment must be continued to sustain the improvement in hair growth. It is only available on private prescription and a months supply costs around £45.

Plastic surgery

Plastic surgery may be the only reliable way to replace lost hair, and techniques for restoring hair growth are constantly improving. These include:

• a transplant, where the surgeon moves non-sensitive hairs from the back of the head to the top. This is best for men whose hair loss is limited to the front of the scalp. Factors that determine whether a person is a suitable candidate include age, hair colour, the nature of hair loss, and whether the hair type is straight or curly/
• scalp reduction, a technique that is most suitable for men with a small, well-defined bald spot on the top of the head/
• flap-surgery, which involves making the part of the scalp that still contains hair larger. This is a possibility in cases of hair loss over a small area.

Hair loss in women

Women can also suffer hair loss, especially those with many relatives who are also prone to losing their hair.
The female pattern sets in at a later age than in men and is usually limited to the top of the head. Total baldness is rarely seen in women.

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Detailed about Ebola virus?

Ebola Virus

'I think it's important to say that survivors are heroes and we need to commend them and welcome them into our communities because we need them.
'With the increasing number of orphans that we have – and from the Ebola situation we have approximately 350 of them – we are aware that we need to find suitable families and homes for these children.
'The survivors are well-positioned to actually support these children, if not themselves looking after children, then helping them back into communities.'

What is Ebola virus?

In 2016 the Ebola virus will celebrate the 40th year of its discovery. It was first reported in 1976 in humans in both Zaire (now the Democratic Republic of the Congo – DRC) and Sudan.
This virus has five known subtypes, four of which can cause severe illness in man:

1. Bundibugyo ebolavirus (BDBV)
2. Zaire ebolavirus (EBOV)
3. Reston ebolavirus (RESTV)
4. Sudan ebolavirus (SUDV)
5. Taï Forest ebolavirus (TAFV).

Reston ebolavirus mainly affects monkeys. Although it can infect man, it does not cause any significant illness.
Ebola virus is one of three members of the Filoviridae family (filovirus). Marburg virus is one of the other two.

What causes Ebola?

How long this virus has existed is unknown, but we do know that it is carried by animals, such as fruit bats and other mammals.
Outbreaks in humans are thought to be caused by animal-to-human transmission after people consume or come into contact with animals harbouring the virus.
Interestingly, the virus is known to survive several weeks in semen, but we do not know if that is a definite mode of transmission.
Controlling this virus in a country with good public health, trust in medical services, non-traditional practices and rule of law was thought to be relatively straightforward.
However, recent events in the USA and Spain have now shown that this is not the case and that there may be significant risk during and after the removal of complicated personal protective equipment (PPE).
On the other hand, both Nigeria and Senegal contained the virus and prevented onward transmission in their countries.
The spread within Africa could be down to a lack of early political involvement, public health dysfunction and lack of trust (understandably) in poorly functioning health systems, in some cases with workers or burial teams reportedly not getting paid on time.

Which other viruses are like Ebola?

There are other haemorrhagic (bleeding) viruses. These include Marburg, Lassa, Crimean-Congo, Argentine, Bolivian, Brazilian and more than 10 others.
The Marburg and Ebola viruses are the most alike, both being string-like (filamentous) and relatively large.

How does Ebola spread?

Healthcare workers can become infected with Ebola through contact with blood or mucus, hence the need for basic precautions, such as gloves, masks, goggles, boots and, where available, bio-suits.
Infection can occur after removal of PPE if instructions are not followed to the letter.
Relatives become infected with the virus through caring for patients and becoming directly exposed to blood or mucus.
In many traditional African funeral practices, it is customary to wash and clean the dead body, which increases the risk for infection.
Non-medically trained nuns also spread the infection by using unsterilised needles on patients.

Where does Ebola occur and how many people are affected?

The virus has a predilection for Africa.
Outbreaks have occurred in the Democratic Republic of the Congo, Sudan, Guinea, Liberia, Sierra Leone, Nigeria, Central African Republic, Ethiopia, Gabon, Ivory Coast, Kenya, Uganda, Zimbabwe and Madagascar.
Governments have now decided on airport screening of passengers from affected areas.

What are the symptoms of the disease?

The symptoms of Ebola virus disease usually start five to seven days after becoming infected, but this can vary to between two to 21 days after becoming infected.
The symptoms are non-specific and include headache, joint and muscle pains, sore throat and muscle weakness. This is then followed by diarrhoea, vomiting, fever, rash and stomach cramps.
Internal bleeding quickly follows, accompanied by bleeding from the ears, eyes nose or mouth.
Ebola virus disease is fatal in 50 to 90 per cent of cases.

What can you do yourself?

We know that Ebola spreads by contact with infected blood or mucus. To date we do not know if the virus can be air-borne, but fortunately we think it is not.
To avoid Ebola, do not travel to an outbreak area when it can be avoided.
Use basic hygiene precautions at all times, such as hand washing with soap and water after contact with cases or suspected cases.
Health care workers and relatives need to take specific precautions as above.
If you are infected, you need to be isolated from other non-medical people.
If you have had exposure as a health care worker, a self-quarantine of 21 days with daily temperature measurements now seems to be a sensible precaution and in some areas, such as New York, it will be imposed.

How is the disease diagnosed?

Laboratories with high levels of bio-security can test for the virus or the antibody reaction to it.
The test will not be positive before symptoms occur, which is usually on day three of the infection.

How is Ebola treated?

There are no medicines that are effective against this virus, so doctors are advised to treat the symptoms.
Patients may require admission to an intensive care unit.
Patients with Ebola need their fluid levels managed by medical staff.
Experimental treatments, such as ZMapp, do exist. However, it is only available on a named patient, government ethics committee-backed basis.
Some experts think we should use the serum antibodies of those who survive Ebola to treat others.
There is no current vaccine against Ebola. But three companies including Glaxo Smith Kline (GSK) are fast-tracking the vaccine production process with the hope that something may be available in the first quarter of 2015.

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Fully described HIV and AIDS ?

HIV and AIDS

What is HIV?

HIV means 'human immunodeficiency virus'. This is the virus that causes AIDS.
HIV first emerged as a threat to humanity in the early 1980s. It spread so fast that initially there were fears that it might wipe us all out. Happily, there now seems no danger of that.
However, in 2012 the worldwide situation is this.

• About 34 million people have HIV.
• Around half of these are women.
• Over two million children have the virus.
• Each year, about 2.7 million people catch HIV.

In some countries, particularly those located in Sub-Saharan Africa, the HIV rates are very high. For instance, in the Republic of South Africa it's estimated that about 11 per cent of the population is HIV-positive.
Therefore, you should bear in mind that having sex with a new partner in certain areas of the globe could be very dangerous.
Please note that there are now known to be two types of HIV – called HIV-1 and HIV-2. The latter one is more common is some parts of the world, notably West Africa.

What are the common myths about HIV?

Many people believe the following stories that have become commonplace during the 30 years since HIV first emerged.

1. 'You can tell if someone is HIV-positive by looking at them'. This is nonsense. The great majority of people with HIV look perfectly normal.
2. 'You can't get HIV from straight sex'. This isn't true. Worldwide, vaginal intercourse is now the most common way of acquiring the virus.
3. 'Only gay men get HIV'. This is also untrue. Very large numbers of heterosexual men and women get it.

How does HIV infect people?

There are four main ways in which it can enter the body.

1. During sex. Rectal intercourse is a very 'efficient' way of transmitting the virus from one person to another. But nowadays, the majority of infections worldwide are caused by vaginal intercourse with an infected person.
2. Through sharing injection needles. Intravenous drug users are at particular risk, if they use needles that have already been used by someone else and which therefore may be contaminated with the virus.
3. From infected blood products. In some parts of the world blood intended for transfusion is still not tested for HIV. However, this is NOT the case in the UK.
4. Though infection of a baby by its mother.

A tiny number of cases occur for other reasons, for instance as a result of organ donation or sperm donation from a person who is HIV-positive, though these occurrences are very unlikely in the UK.

How does HIV attack the human body?

HIV cannot live on its own in the environment. So, in order to survive, the virus has to attack other living cells and use their metabolism to make copies of itself.
Unfortunately, HIV attacks some of the human cells that are vital to a healthy immune system, including the white blood cells known as T-helper cells or CD4 cells.
At the start of HIV infection – the primary infection – there are two possible outcomes. You can either have a short, flu-like illness that occurs one to six weeks after infection, or you can have a so-called 'dumb' infection, with no symptoms at all.
However, even if you don't have any symptoms – you can still infect other people.
Six to 12 weeks after the infection, the white blood cells have produced so many antibodies against HIV that they can be measured by a blood test. If you have HIV antibodies in your blood, you are now HIV-positive (HIV+).
An infected person will probably feel well for a long time. But the infection is still active inside the body and the virus, which can infect and destroy new blood cells, is constantly being produced.
The number of T-helper cells in the blood will slowly be reduced and when, after a number of years, the immune system has been weakened, the infected person will start showing symptoms of AIDS.

What is AIDS?

AIDS means 'acquired immune deficiency syndrome'.
It's a condition that sets in when the HIV virus has killed so many T-helper cells that the immune system is no longer able to recognise and react to attacks from everyday infections.
HIV may also attack the nervous system, possibly causing dementia. And it may affect the skin, on which small tumours develop. This condition is known as Kaposi’s sarcoma.
A number of different symptoms can occur in people who have AIDS:

• fatigue
• inexplicable weight loss
• repeated bronchial and skin infections that do not react to normal treatment
• fever
• swollen lymph nodes
• diarhhoea
• night sweats
• outbreaks of previous infections that have remained dormant (herpes and other conditions)
• so-called 'opportunistic infections' – serious infections by micro-organisms of the type normally prevented by the immune system. These in turn could lead to a number of related illnesses, such as cancer or dementia.

In the end, the disease can become so serious that the infected patient dies.

How common is AIDS?

In Britain during 2011, only 350 people were identified as new cases of AIDS.
But a total of well over 25,000 people have now been diagnosed with AIDS in the UK. Sadly, more than 19,000 of these have died.
Worldwide, about two million men and women die from AIDS each year.
In Britain, 375 people died from this disease in 2011.
On a positive note, modern treatments for HIV have greatly prolonged the lives of many people who have the virus.

How do you get infected?

These are the major risk factors.

• Unprotected sex – that is, sex without a condom. However, condoms cannot give you complete protection. Occasionally, they break. Rectal sex carries a higher risk than any other type of sexual activity.
• Blood-to-blood infection, when using a contaminated needle (which has been used by someone else) or through transfusions of contaminated blood. Today, all blood that's donated in the UK is tested for HIV, so this route of infection is now almost unknown in Britain.
• Mother infecting her child. The child can be infected during the pregnancy, during labour or after the delivery, through the brast milk.

Ordinary social interaction with HIV-positive people is not contagious.

Who is at risk?

It's common for HIV-campaigners to say that 'we are all at risk'.
Technically, this is so. But in reality, there are many factors that affect your level of risk.
For instance, if you live in a part of the world where HIV is still rare and only have sex with your spouse – you're not likely to get it.
In the UK, people who are at 'above-average' levels of risk include the following.

• Heterosexual men and women who do not practise safe sex, especially if their partners originate from areas of the world where HIV is widespread – Africa (south of the Sahara Desert), parts of Asia and some of the Caribbean Islands.
• Homosexual and bisexual men, who go in for anal sex with many different partners and who do not practise safe sex.
• Women who have unprotected sex with many different partners, especially if these include bisexual men or intravenous drug users.
• 'Straight' men who have unprotected sex with many different partners.
• Prostitutes who don't practise safe sex. Also at risk are their customers and these customers' other sexual partners.
• drug addict who share needles.
• Hospital workers whose work involves real risk of pricking or cutting themselves with infected instruments or needles.
• Babies of an HIV-infected mother.
• People who have had many blood transfusions overseas or who were treated with blood products before 1985.

How do you avoid infection?

• use a condom. This is not a guaranteed method of avoiding infection, but using a condom reduces the risk considerably. It must be worn all the way through sex.
• Avoid using recreational drugs that are injected with a syringe. Do not share syringes or needles with others.
• Avoid blood transfusions in certain countries, where they may not test the blood for HIV.

I might be infected – what should I do?

If you have been exposed to infection, you should contact a doctor as soon as possible for advice, testing and treatment.
In the UK, the best place to go is a genitourinary medicine (GUM) clinic because they're used to dealing with possible HIV cases. Also, their technical facilities are very good indeed.
Traditional HIV tests don't become positive until about three months after exposure to infection. But newer tests are now coming in, and these can provide an earlier diagnosis (see below).
If you know or suspect that your partner is HIV-positive or if you have been exposed to infection by accident – for instance through pricking yourself with a contaminated needle – treatment will be started to prevent an actual HIV infection. To be effective, it must commence within 72 hours of exposure.
The treatment may have some unpleasant side-effects, so before going ahead the real risk of infection should be estimated.
This should be decided by you, your doctor and your local HIV consultant.

How do I get tested?

If you're going to have an HIV test: you should talk to a doctor or counsellor first, in order to discuss the possible implications of the result.
Under the NHS, an HIV test at a GUM clinic is free of charge and anonymous. You can also have a free HIV test arranged by your GP, but this will appear on your medical records for the rest of your life.
Some people go for private HIV tests at one of the many commercial clinics that advertise their services in London and other large cities. Currently, the routine test will cost you about £110. The clinic shouldn't tell anyone else the result unless you authorise them to.
You might also encounter circumstances where HIV testing is obligatory. For instance, when people want to take out a large insurance policy, it is quite common for the company to ask for a preliminary HIV test.
Also, you're required to have a test if you want to do any of the following:

• become a blood donor
• donate some of your organs for transplantation
• use your sperm for artificial insemination
• adopt a child
• contribute an egg for transplantation.

What are the tests for HIV?

There are now various different tests for infection. Be guided by the GUM clinic or HIV consultant.

HIV antibody test

This is the basic, traditional test for HIV, and it's sometimes referred to as the INSTI test because you can get the result almost instantly.
It depends on the fact that when a man or woman gets infected with HIV, the body slowly reacts by producing protective proteins, called 'antibodies'.
These usually develop within three months of infection, so there's no point in doing the INSTI test before then.
It's possible to test for the antibodies in blood and saliva. If the result is negative, it's probably a good idea to have a re-test in a few months.

P24 (antigen) test

An antigen is the part of a virus that provokes the development of antibodies. In the case of HIV, the most important antigen is called 'P24'.
This antigen can often be detected in the early weeks after HIV infection.

Earlier diagnosis: the HIV DUO test

This is a newer test, which detects antibodies to both HIV-1 and HIV-2, as well as the P24 antigen. It becomes positive about 28 days after infection.
At private clinics, it currently costs about £110. Results should be available the same day.

Very early diagnosis: the HIV-1 Proviral (PCR) test

Also known as the RNA PCR test, this detects the genetic material in the HIV virus, and it can identify the virus within only about 14 days of infection.
Results take a few days to come back. If done privately, it is expensive – currently it's about £250.
A major drawback of this test is that it only detects HIV-1 infection, and not HIV-2.
So if you have recently had a sexual contact in West Africa, this would not be the ideal test for you.

Home tests

In 2012, a number of commercial companies are offering home tests for HIV. But this practice is illegal in some countries.
It's far better to have your test done by a specialist doctor, who can explain its implications to you.
Nevertheless, in July 2012 the American Food & Drug Administration approved a self-administered over-the-counter test called OraQuick.
You do the OraQuick test by taking a swab of your saliva and putting it into a tube containing a reactant.
If you think that the result is positive, you should then go and get more reliable testing from a clinic.

Treatment: what does it involve and what medication is used?

If you do have HIV, you should have expert treatment from a specialist. Please don't be persuaded by alternative 'cures'.
Rather alarmingly, statistics suggest that quite a lot of people who are HIV-positive and who need treatment are not actually receiving it.
In the first years of the HIV epidemic, back in the early 1980s, there was no specific treatment. And many people died very quickly of AIDS.
But in the late 1980s, it was discovered that treatment with virus-fighting drugs called anti-retrovirals could slow the onset of the disease. The first and most well-known of these drugs was zidovudine(azt). Unfortunately, it had many side-effects, and very often the HIV virus became resistant to it.
Happily, in the 1990s, other drugs from the same group as AZT (called 'reverse transcriptase inhibitors') became available. Shortly after that, several other classes of anti-virals were discovered, notably the protease inhibitors.
These days, people who have HIV, and whose CD4 cell count has dropped to dangerous levels, are treated with a combination of different groups of drugs – mainly as tablets or capsules.
These combinations reduce the chance of resistance occurring, and greatly increase the prospects of long life.
This combined treatment is generally known by the name HAART, which stands for highly active antiretroviral therapy.
All of the drugs which are used in HAART can have side-effects. But they do give you a really worthwhile lease of life.
As a result of HAART, there has been a very sharp decline in AIDS deaths in the UK.
New and more efficient treatments to fight HIV and reduce the content of virus in the blood are being developed all the time.
In additiion to anti-virus treatment, you will almost certainly need the following at times:

• Specific treatment of infections occurring as a result of HIV; please note that these can include tuberculosis.
• vaccination against illnesses such as flu, pneumonia and infectious hepatitis.
• Therapy for the symptoms connected with HIV infection and AIDS, for instance treatment of nausea and loss of appetite.

What can I do for myself?

If you do not have anyone to talk to about the situation, you might like to visit your GP, a counsellor with relevant experience or a psychotherapist. You should discuss your worries and the depression, which often follows the discovery that you are HIV-positive.
Your partner, if you have one, may well need counselling too.

• You should be treated for all infections and illnesses that result from the HIV virus. If these are serious, you will have to go to hospital.
• You should contact AIDS and HIV sorroport gp because these organisations can be helpful.
• Make sure you eat a varied and healthy diet.
• Avoid smoking and exessive drinking.
• Get adequate exercise.

Possible deterioration

Eventually, serious illnesses may develop as a result of HIV infection.
Commonly, these include infections that are normally prevented by the immune system.
These inlude:

• tubuculosis
• pneumonia caused by the germ Pneumocystis carinii
• toxoplasmosis infection in the brain
• reactivation of the germ cytomegalovirus
• infections involving the fungus candida albicans and also other fungal diseases
• cancer, especially skin cancer, and cancer in the lymph nodes
• meningitis and encephalopathy, a brain disease that may cause dementia.

Death may occur as a result of these illnesses. But at the present time, large numbers of HIV-positive patients are managing to avoid those complications and to remain perfectly well.

Future prospects

AIDS is not yet curable.
However, many of the illnesses resulting from the condition can be treated.
Generally, between 5 and 20 years pass from the time of infection until AIDS actually develops.
Previously, those infected only lived for a couple of years after developing AIDS.
Fortunately, with the new types of treatment available, the survival rate has greatly improved. There are patients alive today who caught the infection over 30 years ago.

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Tips to get firmer skin?

Tips to get fair skin?         by NAV JIVAN Hospital Mehnagar.

Why do we age?

After our twentieth birthday, we produce around one per cent less collagen a year. That causes skin to become thinner and more fragile.
Our sweat and oil glands don't function as well, we produce less elastin and there's less GAG formation too – glycosaminoglycans or GAGs keep the skin hydrated.
Those are the natural causes of ageing. But some external factors play a role too; sun damagr , smoking and exposure to pollution all lead to sun spots and an exaggerated loss of collagen, elastin, and GAGs – so your skin ends up looking uneven, patchy, thin and lined.
Too much sugar in your diet doesn't help either. When you eat sugar a natural process called glycation happens, where the sugar in your bloodstream attaches to proteins to form new molecules called AGEs.
The skin proteins most susceptible to glycation are collagen and elastin, which make your skin look plump and springy, so that excess glucose makes those fibres stiff and inflexible, leading to fine lines and wrinkles.

Fight back!

Boost collagen

Research shows that the antioxidant powerhouse vitamin C is 20 times more beneficial applied to the skin, rather than eaten through your diet. And vitamin C helps boost collagen to keep skin looking plump, minimises lines and fades pigmentation.
It also boosts the skin's immune system, helping to combat free radical damage from pollution and UV rays.

Lock in moisture

Hyaluronic acid helps your skin to draw in moisture, making it look plump, wrinkle-free and youthful.
Glycerine, lactic acid and urea all have the ability to hold and attract water in the skin too.
Look for lanolin in your skincare products; it's softening, smoothing and prevents moisture loss. Itis the main ingredient in cult moisturising products, such as carmex . It's also in sodocrem, which makes an excellent mask when polished off with a facecloth.

Even out patchy skin

Retinol helps stimulate cell regeneration and fades the appearance of age spots and scarring.
When battling pigmentation, it's best to make a beeline for brightening products, which even out your complexion.
Make sure you choose ones that contain UVA and UVB protection too, so you don't do any further damage.
Ingredients like kojic acid block the production of too much melanin and glycolic acid speeds up the elimination of the over-pigmented skin cells.
If you've got the budget for it, sessions of IPL (intense pulsed light) disperse pigmentation. Hydroquinone bleaching cream will fade dark patches.

Limit future damage

Research has found that daily use of sunscreen can stop skin ageing for up to four-and-a-half years so always use sunscreen with a minimum SPF of 30 – all year round.
Make sure it's 'broad spectrum' so that it protects against both UVA and UVB rays. UVA rays are present all year round and are responsible for premature ageing.
Mineral sunscreens, which contain zinc oxide and titanium oxide, are particularly effective because they act as a physical barrier to the sun and work immediately. It takes twenty minutes for most sunscreens nto be absorbed so apply yours thirty minutes before heading out and use a teaspoon-full for your face.

Perfect your technique

Smearing your beauty products on willy-nilly won't banish lines because the nutrients won't be properly absorbed.
Facial massage boosts circulation, flushes out toxins and delivers nutrients where they're needed, resulting in firmer, skin.
Apply products by making circles with your knuckles along the cheekbones, jaw and forehead for a minute, then lightly drum your fingertips over your face for another minute.

Eat your skin line-free

Good fats, found in avocados, oily fish and nuts help skin cell regeneration and lock in moisture.
Antioxidant-rich berries boost circulation and help your body to produce collagen.
Broccoli helps clear toxins that can lead to fine lines.
Wholegrains, like oats and wholemeal bread, are rich in B vitamins, which encourage the growth of skin cells.
Foods rich in beta carotene, like carrots and sweet potato help your body create active vitamin A, otherwise known as retinol, which promotes cell turnover.

Don't forget your neck

The skin on your neck is more delicate, thinner and constantly exposed to the elements, so it often gives your age away.
Avoid harsh products that contain sharp particles and instead go for a very mild exfoliator.
Your neck has fewer oil glands so it gets dry easily – combat that by using a rich and greasy cream specifically designed for your neck and give it as much attention as your face.
Cleanse and tone your neck every morning and evening and massage your cream in using upwards motions.
Don't forget to use a high SPF suncreen, whatever the weather. And for a more extreme answer, try Botox.
A Nefertiti Lift takes 15-minutes and involves up to 40 tiny injections of Botox into the neck and lower jaw.

Exercise wrinkles away

As you exercise, oxygenated blood rushes around your body. This improves the delivery of nutrients and oxygen to cells and flushes away toxins.
Increased blood flow brings toxins to the surface of your skin, so you can easily cleanse them post-workout, leaving your skin clean and glowing. It also helps boost collagen levels.
Not only that, a sweaty workout reduces levels of the stress hormone cortisol, which leads to collagen loss through glycation                                                                      

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Why do i need Vitamin C ?

What is vitamin C?

Vitamin C is also known as ascorbic acid. It has antioxidant properties.

Why do I need vitamin C?

Vitamin C is involved in the following processes in the body:

• protecting cells from oxidative damage caused by free radicals
• helping the body to synthesise collagen which is required in the structure and function of connective tissues, such as skin and bones
• maintaining the normal structure and function of blood vessels and neurological function
• increasing the absorption of iron from plant sources in the intestines.

How much vitamin C do I need?

The recommended daily allowance (RDA) of vitamin C in the UK for adults is 40mg a day. Vitamin C is a water-soluble vitamin, so is not stored in the body.

What happens if I don't have enough vitamin C?

Severe vitamin C deficiency leads to scurvy. Symptoms include:

• fatigue
• weakness
• red dots on the skin
• aching joints and muscles
• bleeding gums
• poor wound healing
• bone and tissue damage

Symptoms of scurvy only appear four to six months after an individual becomes deficient in vitamin C.
Scurvy can be quickly treated by taking vitamin C supplements and eating foods rich in vitamin C.

Where is vitamin C found?

Vitamin C can be found in the following food sources:

• citrus fruit
• berries
• blackcurrants
• green vegetables, eg broccoli and Brussels sprouts
• green, leafy vegetables such as broccoli, spinach and Brussels sprouts
• red and green peppers
• tomato
• new potatoes

What are the effects of cooking on vitamin C?

Exposure to water, air, light and heat leads to some loss in vitamin C.
When cooking, it is important to use fresh food, steam rather than boil and avoid overly long cooking times to preserve vitamins.

Do I need to take vitamin C supplement?

The Department of Health advises that you should be able to get all the vitamin C you need from a healthy balanced diet.
If you do decide to take a vitamin C supplement, take no more than 1000mg a day.
It is advised that infants and young children take vitamins A, C and D supplements up to the age of 5 years.

What are the side effects and safety precautions of taking a vitamin C supplement?

Vitamin B supplements are considered as likely safe for most people when taken orally or topically at the correct dosage.
Vitamin C may cause the following side-effects in some people:

• stomach pain
• nausea and/or vomiting
• headache
• heartburn

Dosages above the recommended safety limit in the UK (1000mg) are deemed possibly unsafe and may cause side-effects such as severe diorrhea and kidney stone.
Pregnant or breastfeeding women are advised that a healthy balanced diet containing fruit and vegetables such as broccoli, citrus fruit, tomatoes, bell peppers and blackcurrants should provide all the vitamin C they need.
Individuals undergoing angioplasty should avoid taking vitamin C supplements unless advised otherwise by a healthcare professional.
If you have cancer, check with your oncologist before using high concentrations of vitamin C, as research suggests that cancerous cells may collect high concentrations of vitamin C.
People with blood-iron conditions such as thalassaemia and haemochromatosis should avoid large doses of vitamin C as it increases iron absorption.
People with kidney stones or a history of kidney stones should also avoid large amounts of vitamin C as it can increase the risk of kidney stones.
People with a metabolic deficiency known as glucose-6-phosphate dehydrogenase deficiency (G6PDD) should avoid excessive vitamin C as it can destroy red blood cells in people with this condition.
People with sickle cell disease should avoid large amounts of vitamin C as it may worsen their condition.

What happens if I take too much vitamin C?

High doses (over 1000mg per day) of vitamin C may lead to stomach pain, flatulence and diarrhoea.
These symptoms are reversed when supplementation is stopped.

Do vitamin C supplements have any drug interactions?

Vitamin C has moderate interactions with the following:

• aluminium
• oestrogen
• fluphenazine (Prolixin)
• chemotherapy medications
• protease inhibitors (HIV/AIDS medication)
• statins
• vitamin b3
• warfarin

Vitamin C has minor interaction with these medications:

• aspirin
• choline magnesium trisalicylate
• nicardipine
• paracetemal                                   by NAV JIVAN Hospital Mehnagar azamgarh up
  

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