| HIV Infection showing decline! |
| Report released by UNAIDS today said that: the global response to AIDS is showing results. As the world marks 30 years of AIDS, UNAIDS estimates about 34 million people are living with HIV and nearly 30 million people have died of AIDS-related causes since the first case of AIDS was reported on June 5, 1981. |
Some of the facts:
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| HIV ~ Human Immunodeficiency Virus |
| HIV- Management |
| In HIV infection there is intense and persistent viral replication which leads to gradual depletion of CD4 cells. The primary goal in managing the HIV patients is to prevent this process of replication to as low as possible and to maintain it as long as possible. With this there is lower risk of clinical progression of the disease and prevention of opportunistic infection. |
| Classes of ANTIRETROVIRAL DRUGS: Anti retroviral drugs act by inhibiting the multiplication of the virus. The drugs mainly target 2 key enzymes the virus requires to multiply.These are PROTEASE , REVERSE TRASCRIPTASE. Drugs inhibiting the Reverse Transcriptase enzyme are divided into two types – Neucleoside Reverse Transcriptase Inhibitors (NRTIs) & Non-Neucleoside Reverse Transcriptase Inhibitors (NNRTIs). |
| Combination Therapy: HIV virus has the ability of developing resistance if any one drug is used alone. Hence current guidelines are to use at least 3 antiretroviral drugs in combination. This is the same principle used in the treatment of tuberculosis. This triple drug regime is commonly called HAART ( Highly Active Antiretoviral Therapy). HAART has been shown to inhibit viral replication to levels below the limit of detection. |
| Initiating Antiretroviral Therapy: The antiretroviral therapy is started in persons with sign of compromised immune system or indication of presence of Opportunistic infection. CD4+ cell count less than 500 cells/ micoliter or increase of viral load to more than 5,000 – 10,000 copies/ milliliter. are indications of reduced immune strength. All symptomatic patients with symptoms suggestive of active infection – wasting, thrush or unexplained fever for > 2 wks. should be started with antiretroviral drugs irrespective of the viral load. Proper counseling of the patients is also very important before commencing the therapy. Patients is told about the fact that the therapy has to be life long and it is not curative. Cost of the therapy and side effects should be known to the patient. Adherence to the treatment process should be thoroughly stressed. The patient should know that even if he or she is keeping fine transmission of the infection to others is possible and safe sex methods should be practiced. |
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Commonly used initial Antiretroviral regimens |
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Antiretroviral drug regimens are comprised of one choice each from column A and B. |
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Column A |
Column B |
| Efavirenz | Stavudine + Didanosine |
| Indinavir | Stavudine + Lamivudine |
| Nelfinavir | Zidovudine + Lamivudine |
| Nevirapine | Zidovudine + Didanosine |
| Saquinavir | |
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| Chewing Tobacco | |
| Apart from Smoking, Tobacco is taken in various other forms: Tobacco with betel leaves, Chewing tobacco (khaini), Guthkha, Tobacco snuff. | |
People who chew tobacco for many years are 50 times more likely to get oral cancer, gum disease and lose their teeth than people who do not chew.The risk of other cancers, heart disease, and ulcerative colitis is 50-70% higher among chewers.Nicotine addiction and dependence is also very real with chewing tobacco. Nicotine addiction leads to increased heart rate and blood pressure. Nicotine constricts the blood vessels and limits oxygen supply throughout the body.Chewing tobacco leaves irritating juices in contact with gums, cheeks and lips for prolonged periods of time. This can lead to a condition called leukoplakia which appears as a smooth, white patch or as leathery-looking wrinkled skin.Oral leukoplakic lesions have been seen upon continued use of tobacco use, which undergo transformation to a dysplastic state. The dysplastic lesions can further develop into carcinomas.Tobacco chewing leads to:
The potent carcinogens found in snuff and chewing tobacco include nitrosamines, polycyclic aromatic Oral lesions caused by chewing tobacco rarely cause pain and thus such persons should regularly undergo dental checkups. Some of the danger signs in those who chew tobacco:
More Dangers of Chewing Tobacco Hazards
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Smoking Tobacco Facts
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| Acupuncture: in aid of Smokers |
| MORE and more patients who fail to respond to modern medicine are turning towards alternative forms of therapy. Do these alternative systems work? Is it merely a placebo effect? Few doctors have done clinical studies to gather objective evidence to answer these questions. |
| In England, Dr. Tanvir Jamil, has systematically gathered information that suggests acupuncture could help patients quit smoking. He has used acupuncture on 21 patients who wanted to quit smoking and found that five of these gave up the habit, seven reduced the number of cigarettes smoked, and all found the therapy beneficial. |
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Basic principles Chinese physicians have practiced acupuncture for over 5000 years. It is based on the concept Qi or bio- |
| Many doctors in the West are using acupuncture to treat aches, pains, respiratory infections and allergies. Some claim that they have helped patients quit smoking, but there are no published data. So Dr. Jamil decided to bridge the gap by compiling information on patients who received acupuncture therapy in his clinic to help them quit smoking. |
| TherapyOver a six-month period, 15 women and 6 men received one acupuncture treatment every week for an average of four (range 2-5) weeks. At each session five ear points (see diagram) and two distal points in the hand were punctured and the needle was left in place for 20 minutes. Patients were also taught to use simple acupressure methods like applying firm pressure on the ‘lung point’ if they felt the urge to smoke. |
| ResultsFour patients withdrew from the therapy. Five quit smoking and seven decreased the number of cigarettes. Many found that acupuncture reduced stress and controlled craving. In one case, the patient had already stopped smoking and found the acupuncture helped in dealing with “withdrawal’ symptoms. Some noticed that the cigarettes started to taste terrible. Acupressure gave many patients something to do and distract themselves during periods of craving. Overall, patients found the therapy of ‘definite’ benefit.
One 66-year-old woman who had been smoking 20 cigarettes a day for more than 20 years could give up smoking because of this therapy. She had tried unsuccessfully to quit smoking five years earlier when her father died of bronchitis. Her husband had managed to quit with the help of nicotine patches. Neither nicotine patches nor smaller packs of cigarettes nor herbal cigarettes nor hypnotherapy helped her in any way. But after two sessions of acupuncture, she was down to five cigarettes a week. At the end of five sessions, she had stopped smoking. There was some craving initially but this settled rapidly after her second session. She found that acupressure helped her relieve stress. Three years after therapy, she continued to be a non-smoker. In this time, she had taken three sessions of acupuncture during periods of stress. |
| Scientific basisThe results seen by Dr. Jamil’s clinic could be due to release of endorphins and encephalins that were able to latch on to nicotine receptors in the brain. They could also have been due to hormonal stimulation that brought about the stress relief. Placebo effect cannot be ignored, especially as most of the patients were highly motivated and had wanted to give up smoking for a number of years.
Dr. Jamil has acknowledged that his sample size was too small with no control group to generalize the findings of his study. But data from an open study are better than no data at all. Besides, the results are encouraging enough to undertake further research. |
| Smoking |
hydrocarbons, and radiation-emitting polonium.
energy. The Chinese believe that Qi flows in the body through certain channels or ‘meridians’. Impaired flow leads to disease. ‘Acupoints’ are specific areas on the surface of the body which when stimulated modulate flow of Qi and influence the function of internal organs. Stimulation is achieved by puncturing the ‘acupoint’ with a needle or pressing it with the fingertip (acupressure). Doctors use special ‘maps’ that indicate the location of acupoints all over the body that can be stimulated to treat various conditions.
Manbir Online ~ for Health & Fitness 