DM INFECTIOUS DISEASE, MD, MBBS Bachelor of Medicine and Bachelor of Surgery, Training in infections in oncology and bone marrow transplant recipients
Infectious Disease Physician, Delhi
एचआईवी यानी ह्युमन इम्युनोडेफिशिएंसी वायरस एक ऐसा वायरस है जो मनुष्य की प्रतिरक्षा प्रणाली को प्रभावित करता है। चूंकि यह वायरस प्रतिरक्षा प्रणाली पर ही हमला करता है इसलिए हमारी प्रतिरक्षा प्रणाली इस वायरस के खिलाफ रक्षात्मक प्रतिक्रिया करने में सक्षम नहीं है। इसका यह अर्थ है कि एचआईवी से पीड़ित व्यक्ति अन्य संक्रमणों और बीमारियों के प्रति अधिक संवेदनशील होता है।
एचआईवी एक संक्रमित व्यक्ति से ...more
एचआईवी यानी ह्युमन इम्युनोडेफिशिएंसी वायरस एक ऐसा वायरस है जो मनुष्य की प्रतिरक्षा प्रणाली को प्रभावित करता है। चूंकि यह वायरस प्रतिरक्षा प्रणाली पर ही हमला करता है इसलिए हमारी प्रतिरक्षा प्रणाली इस वायरस के खिलाफ रक्षात्मक प्रतिक्रिया करने में सक्षम नहीं है। इसका यह अर्थ है कि एचआईवी से पीड़ित व्यक्ति अन्य संक्रमणों और बीमारियों के प्रति अधिक संवेदनशील होता है।
एचआईवी एक संक्रमित व्यक्ति से दूसरे व्यक्ति में रक्त, वीर्य, या योनि के तरल पदार्थ के संपर्क में आने से फैल सकता है। गौर करने वाली बात यह है कि एचआईवी एड्स का पर्याय नहीं है। एक्वायर्ड इम्युनोडेफिशिएंसी सिंड्रोम (एड्स), जिसे स्टेज 3 एचआईवी भी कहा जाता है, यह एचआईवी का अंतिम चरण है।इसमें प्रतिरसंक्षा प्रणाली की कोशिकाएं इतनी बुरी तरह क्षतिग्रस्त हो चुकी होती हैं कि म संक्रमण से लड़ने में सक्षम नहीं रह जाता है।हालांकि उचित उपचार के साथ एचआईवी संक्रमित लोग भी सामान्य जीवन जी सकते हैं।
पुरुषों में एचआईवी के लक्षण
एचआईवी से संक्रमित महिलाओं औऱ पुरुषों में कुछ लक्षण तो समान होते हैं पर कई लक्षण ऐसे हैं जो सिर्फ पुरुषों में देखे जाते हैं। आज हम बात करेंगे पुरुषों में एचआईवी संक्रमण के लक्षणों के बारे में।
1. सेक्स ड्राइव में कमी
एचआईवी से संक्रमित पुरुषों में अकसर यौनेचेछा में कमी देखी जाती है। यह हाइपोगोनाडिज्म का संकेत है, जिसका अर्थ है कि आपके अंडकोष पर्याप्त सेक्स हार्मोन टेस्टोस्टेरोन नहीं बना पा रहे हैं। यह स्थिति एचआईवी से जुड़ी है। हाइपोगोनाडिज्म के कारण कई और भी समस्याएं आ सकती हैं जैसे:
नपुंसकता
डिप्रेशन
थकान
बांझपन
शरीर और चेहरे पर बालों का कम विकास
स्तन के ऊतकों में वृद्धि
2. लिंग पर घाव
एचआईवी संक्रमण का एक सामान्य संकेत आपको अंगों पर दर्दनाक घाव हो जाना है। ये आपके मुंह में या खाने की नली में अल्सर के रूप में हो सकते हैं।इसके अलावा ये घाव आपके गुदा या लिंग पर भी दिखाई दे सकते हैं। ये घाव काफी दर्द देने वाले होते हैं और एक बार ठछीक होने के बाद फिर से वापस आते रहते हैं।
3.पेशाब करते समय दर्द या जलन
एचआईवी से संक्रमित पुरुषों को अकसर पेशाब करते वक्त दर्द या जलन का अनुभव होता है। यह लक्षण गोनोरिया या क्लैमाइडिया जैसे यौन संचारित संक्रमण से मेल खाते हैं।पर एचआईवी में ये प्रोस्टेट की सूजन का संकेत दे सकते हैं।प्रोस्टेट एक ऐसी ग्रंथि होती है जो पुरुषों में मूत्राशय के नीचे पाई जाती है।एचआईवी से संक्रमित पुरुषों में ये प्रोस्टाइटिस का रूप ले लेती है। प्रोस्टेटाइटिस के अन्य लक्षणों में शामिल हैं:
वीर्य स्खलन के दौरान तेज़ दर्द
सामान्य से अधिक बार पेशाब करना
धुंधला या खूनी पेशाब
मूत्राशय, अंडकोष, लिंग या अंडकोश और मलाशय के बीच के क्षेत्र में दर्द
पीठ के निचले हिस्से, पेट या कमर में दर्द
प्रारंभिक एचआईवी लक्षण
एचआईवी से संक्रमित होने के 4 सप्ताह के भीतर फ्लू जैसे लक्षण देखने को मिल सकते हैं। यह एचआईवी संक्रमण के प्रति आपके शरीर की स्वाभाविक प्रतिक्रिया है। यह फ्लू जैसे संक्रमण के लक्षण कुछ दिनों से लेकर कई महीनों तक भी रह सकते हैं। इस दौरान आपको बुखार, सिरदर्द, थकान, गले में खराश, त्वचा पर लाल चकत्ते, टॉंसिल्स में सूजन, दस्त, मांसपेशियों या जोड़ों में दर्द, मुंह में छाले जैसे लक्षण देखने को मिल सकते हैं। पर ऐसा ज़रूरी नहीं कि एचआईवी से संक्रमित हर व्यक्ति में ये लक्षण देखने को मिले ही। कई लोगों में ये सारे लक्षण नहीं होते।
विशेषज्ञ इस चरण को तीव्र या प्राथमिक एचआईवी संक्रमण कहते हैं। यह तब होता है जब एचआईवी वायरस कुछ प्रकार की श्वेत रक्त कोशिकाओं में प्रवेश करता है। यह स्वयं की ढेरों प्रतियाँ बनाता है जो पूरे शरीर में फैलती है। इस दौरान आपके वायरस को अन्य लोगों तक पहुंचाने की अधिक संभावना होती है क्योंकि इस समय आपके शरीर के तरल पदार्थों में बड़ी मात्रा में वायरस होते हैं।
एडवांस स्टेज के एचआईवी लक्षण
एचआईवी आपकी प्रतिरक्षा प्रणाली के खिलाफ जीतने के बाद धीमी गति से फैलता है। एडवांस स्चेज को क्रॉनिक या क्लिनिकल लेटेंसी कहा जाता है। उपचार के बिना यह चरण 10 से 15 साल तक चल सकता है। लेकिन अगर आप नियमित रूप से दवाएं लेते हैं, तो आप लम्बा जीवन जी सकते हैं।
एड्स
एड्स एचआईवी का अंतिम चरण है। यह तब होता है जब वायरस आपकी प्रतिरक्षा प्रणाली को गंभीर रूप से क्षतिग्रस्त कर देता है। ऐसी अवस्था में आपका शरीर कई संक्रमणों से नहीं लड़ सकता है।ऐसे में इन सभी संक्रमणों के लक्षण आप में नज़र आ सकते हैं। बात एड्स के लक्षणों की करें तो इनमें:
रोगी कोअत्यधिक थकान महसूस होना
एड्स संक्रमित व्यक्ति का तेजी से वजन घटना
रोगी को लगातार दस्त की शिकायत जो एक सप्ताह या उससे अधिक समय तक रह सकती है
आसानी से न्यूमोनिया की चपेट में आ जाना
रोगी के मुंह, गुदा, या जननांगों में छाले या घाव हो जाना
संक्रमित को तेज़ और लगातार बुखार आना या रात में तेज पसीना आने की शिकायत
एड्स संक्रमित व्यक्ति की यादादश्त कमज़ोर हो जाना
शरीर में कई जगह त्वचा पर या उसके नीचे लाल, भूरे, गुलाबी या बैंगनी रंग के धब्बे नज़र आना
यदि आपको एड्स है, तो आपको चिकित्सीय देखरेख की ज़रूरत है। डॉक्टर आपकी प्रतिरक्षा प्रणाली को यथासंभव स्वस्थ रखने के लिए दवाएं लिखेंगे। चिकित्सक आपको किसी भी तरह के संक्रमण या से बचाने के लिए या आपकी कमजोर प्रतिरक्षा प्रणाली के कारण होने वाली समस्याओं के निवारण के लिए दवा की आवश्यक उपचार लेने की सलाह देते हैं।
The acronym for 'Acquired Immune Deficiency Syndrome' is AIDS. In fact, it must be understood that AIDS is not a singular disease, but a syndrome, or rather a set of diseases. People suffering from AIDS suffer from an immensely compromised immune system that makes them vulnerable to a number of diseases. Once infected with HIV, it may take anywhere between 5-10 years to develop AIDS.
Some of the ...moreThe acronym for 'Acquired Immune Deficiency Syndrome' is AIDS. In fact, it must be understood that AIDS is not a singular disease, but a syndrome, or rather a set of diseases. People suffering from AIDS suffer from an immensely compromised immune system that makes them vulnerable to a number of diseases. Once infected with HIV, it may take anywhere between 5-10 years to develop AIDS.
Some of the major symptoms of AIDS are:
Lethargy and fatigue Skin irritation Drastic loss of weight Loss of appetite Bronchial ailments- which often lead to end-stage tuberculosis of the lungs Diarrhea, gastritis and dysentery Prolonged fever Sleeplessness and others How is AIDS treated by Ayurveda? Tonics, also known as Rasayanas in Ayurveda are administered for stimulating appetite and strengthening immunity. Once enough strength is regained, an elimination technique is administered by incorporating enemas, emesis and purgation in the treatment. This process is known as Sodhana and is carried out to eliminate toxins from the body.
Next, the patient s blood is purified with appropriate herbal medications. Apart from this, AIDS patients are advised to perform regular exercise, yoga and pranayama.
What aids in best results after your hip replacement?
Practising these recovery tips will help you to have a smooth and successful recovery.
1-get in a healthy exercise routine
Most hip replacement patients are able to walk within the same day or next day of surgery; most can resume normal routine activities within the first 3 to 6 weeks of their total hip replacement recovery.
Once light activ...moreWhat aids in best results after your hip replacement?
Practising these recovery tips will help you to have a smooth and successful recovery.
1-get in a healthy exercise routine
Most hip replacement patients are able to walk within the same day or next day of surgery; most can resume normal routine activities within the first 3 to 6 weeks of their total hip replacement recovery. Once light activity becomes possible, it's important to incorporate healthy exercise into your recovery program. Recommended activities include gradually increased walking and light household activities (sitting, standing, climbing stairs). Movement is essential to a healthy recovery.
2-pay attention to diet and weight
Excess weight can put stress on your new hip prosthesis and increase wear and the risk of complication. Maintaining a healthy body weight before and after your surgery can help to improve your recovery process and the ultimate lifespan of your prosthesis. Additionally, make sure to maintain a balanced high protein diet during your recovery.
3-exercise to promote blood flow
Certain exercises can help to promote blood flow and prevent clots. These include:
Regularly squeezing the thigh and calf. Motion exercises for the legs that utilize full range of leg motions Walking with or without the assistance of supportive devices (such as walker/cane) Avoid squating 4-make household preparations
Your mobility and ability to accomplish normal, daily tasks following your surgery will be strongly reduced. Prior to your surgery, make practical modifications to your house like getting a western chair (commode) fitted.
5-alarming signs to be watched for
As you should be very well aware that prosthesis is a non living foreign body which now incorporated within your body to perform a proper function, such a body part is always susceptible to infection.
Any sort of fever or even respiratory tract infection should be well treated first hand to avoid infection around the prosthesis.
HIV and tuberculosis (TB) are two life-threatening and common diseases in the world. The two diseases are very closely connected so much so that their occurrence is normally labelled as a co-epidemic. In most cases tuberculosis is found to be the most transmissible contagion in HIV-Immunocompromised victims, proving to be the cause of their death.
What is HIV?
Human Immunodeficiency Virus, more c...moreHIV and tuberculosis (TB) are two life-threatening and common diseases in the world. The two diseases are very closely connected so much so that their occurrence is normally labelled as a co-epidemic. In most cases tuberculosis is found to be the most transmissible contagion in HIV-Immunocompromised victims, proving to be the cause of their death.
What is HIV? Human Immunodeficiency Virus, more commonly known by its abbreviation HIV, is a virus that attacks the immune system, which is the body's natural defense against illnesses. The virus terminates a kind of white blood cells (WBCs) in the immune system known as the T-helper cell also known as CD4 cells. This virus then proceeds to duplicate itself within these cells.
As HIV reduces the T-helper cells, by duplicating at an increasing rate, it slowly breaks down the patient s immune system. This leaves the individual susceptible to other deadly diseases such as tuberculosis. HIV infection is a permanent disease with three phases of progression. HIV medications can reduce or stop the evolution of the disease from one phase to another. The treatment can also decrease the chances of spreading HIV to other people.
What is tuberculosis (TB) Tuberculosis is a transmittable disease triggered by the presence of bacterium known as Mycobacterium tuberculosis. It is still considered a deadly disease in most developing countries where treatment is scarce. Generally, TB affects the lungs but it can also affect other parts of the body. Symptoms include coughing with blood, fever, night sweats and loss of weight.
The relation between TB and HIV In second world countries, most patients infected with HIV suffer from TB as the initial indicator of AIDS. Tuberculosis can occur at any phase of the HIV infection. The danger and severity of tuberculosis rises rapidly after infection with HIV. Even though tuberculosis can be a fairly primary indicator of HIV infection, it is imperative to observe that the risk of tuberculosis increases as the CD4 cell count reduces along with the progression of the HIV infection.
Treatment Positive treatment for TB usually entails 6 months of rigorous therapy. HIV patients with TB usually respond well to this therapy, if the regimen comprises INH and a rifamycin for the period of TB therapy and cure. TB generally reappears when the immune system is unable to respond to stop the development of mycobacteria. The cytokine IFN- plays a key role in the response of the immune system all through the contagion. HIV and TB infections area two-directional communication of the two pathogens. TB is one of the main causes of disease and fatality among patients with HIV in Africa and other severely affected regions. With almost a 50% kill rate around the world, raising awareness about this disease and consulting doctors when signs or symptoms appear is vital in reducing the extent of this epidemic.
Rifampicin- HIV treatment are complicated by the fact that one of the key drugs used in TB treatment, rifampicin, reduces blood levels of nevirapine (Viramune) by 30 to 55% and also reduces levels of most protease inhibitors.
MD - (Ayu.), CCP, B. A. M. S. (Bachelor of Ayurveda, Medicine and Surgery .)
Sexologist, Patna
Oral sex is a form of sexual activity, which involves the arousal of one's genitalia by his/her partner using the mouth (tongue, lips and throat). It is also called Cunnilingus (performed on a female) and fellatio (performed on a male). It is done before intercourse and during foreplay for sexual arousal. It is safe as compared to vaginal or anal sex, the rate of getting a sexually transmitted dis...moreOral sex is a form of sexual activity, which involves the arousal of one's genitalia by his/her partner using the mouth (tongue, lips and throat). It is also called Cunnilingus (performed on a female) and fellatio (performed on a male). It is done before intercourse and during foreplay for sexual arousal. It is safe as compared to vaginal or anal sex, the rate of getting a sexually transmitted disease or HIV is comparatively lower.
Oral sex can spice up your life and can also make your partner reach orgasm. It is also a safe way of getting sexual pleasure without getting pregnant. But necessary precautions must be taken in order to have safe oral sex.
Some of these necessary precautions are:
You can get throat cancer from oral sex: Human papillomavirus (HPV) is a cancerous virus found in the body of infected people. This virus can be transmitted to the person with whom you are engaging in oral sex. Studies show that people who engage with more than 6 sexual partners at once are more prone to get oral cancer. It is advisable to get your partner tested for HPV virus before engaging in oral sex. Oral sex also causes stress: Oral sex is generally related to hygiene, therefore the partner can be self-conscious and worried about his/her genital hygiene. If oral sex is performed on a daily basis, some people prefer to wax their pubic hair often. This is harmful because it can cause red bumps and burning sensation occurs. It is advisable to trim your pubic hair and wash it properly before engaging in oral sex. A condom should be worn by the male during oral sex so that there is no risk of male fluid entering the woman's body. A latex, which is made into a thin sheet called dental dam can be used on the vagina or anus. This creates a thin barrier between the mouth and the genitalia. Hence, the chances of getting infected by sexually transmitted diseases are greatly reduced. Oral sex can be pleasurable and fun, but the risks of getting sexually transmitted diseases like herpes, gonorrhea and crabs is not altogether misplaced. So it is advisable to use proper protection and to maintain hygiene before engaging in oral sex.
MBBS, MD - Internal Medicine, Post Graduate Program in Diabetology
General Physician, Gurgaon
The general acceptance is that, when someone suffers from Sexually Transmitted Disease or STD, the risk of getting affected by HIV increases for that particular person. This is true for both biological as well as for behavioral reasons.
HIV is one of the diseases which are caused as a result of sexual transmission. Before knowing the exact link between HIV and STD, understanding what the two conc...moreThe general acceptance is that, when someone suffers from Sexually Transmitted Disease or STD, the risk of getting affected by HIV increases for that particular person. This is true for both biological as well as for behavioral reasons.
HIV is one of the diseases which are caused as a result of sexual transmission. Before knowing the exact link between HIV and STD, understanding what the two concepts exactly are, would be beneficial.
Let us now look at the two concepts in detail:
STD -
As already mentioned earlier, STD basically stands for Sexually Transmitted Disease. This is used to refer to a condition that gets passed from one person to another by way of sexual contact. A person can develop a Sexually Transmitted Disease if anyone has unprotected sex either in the vagina, anal or orally with someone, who is already carrying a STD. Sexually Transmitted Disease can also be sometimes called as a Sexually Transmitted Infection (STI) or even as Venereal Disease. Still, this does not mean that sex is the only medium through which sexually transmitted diseases get transmitted from one person to another. On the basis of specific diseases under this, one can also get plagued by infections while sharing needles as well as breastfeeding. Now, we will discuss the symptoms of STD in men and women, which would give a clear picture as to how do they differ between the two sexes: Symptoms in Men -
Though there is a possibility that Sexually Transmitted Diseases may not come up with any kind of symptoms, still certain diseases under this do have some obvious symptoms. Among men, some of the common symptoms include: Discomfort or Pain experienced while having sex or at the time of urination. Men could also notice sores, bumps or rashes on or close to the penis, testicles, anus, buttocks, thighs and even mouth. There could be unusual discharge or even bleeding from the penis. Testicles might get swollen or they could cause a lot of pain. Symptoms in Women - Some of the common symptoms of STD among women include:
Discomfort or pain suffered at the time of having sex or while urinating. Rashes or sores around the vagina, thighs, anus or mouth. Unusual kind of discharge or bleeding from the vagina Itchy feeling in or just around the vagina. Types of STDs HIV happens to be one of the STDs. Other diseases include:
Chlamydia Gonorrhea Syphilis Pubic Lice Trichomoniasis Herpes Now, let us talk about HIV in detail: HIV is a kind of virus that tends to damage the immune system. The immune system primarily helps the human body in fighting against infections and different kinds of diseases. HIV that is untreated causes infection and also goes on to kill CD4 cells, which are a kind of immune cell known as T cells.
Some of the early symptoms include:
Fever Aches and Pains Chills Lymph nodes getting swollen Sore throat Headache Feeling of nausea Rashes Though these symptoms getaway within a month people can even carry HIV without having serious or any kind of symptoms that persist and live for many years.
Some of those symptoms are:
Fevers Recurrent fatigue Headaches Stomach problems The relation between STD and HIV
Research suggests that Sexually Transmitted Diseases like Gonorrhea and Syphilis not only look to provide HIV very easy access to cells and tissues of the body that are vulnerable but also STD co-infection can actually lead to an increase in the infections of the person with HIV, hence making them more probable towards transmitting the virus to others.
People, who are already suffering from Sexually Transmitted Diseases, can increase their susceptibility towards HIV through a number of ways. They are as follows:
Some kind of Sexually Transmitted Diseases can lead to open wounds or ulcers to get formed in the genital area. These kinds of wounds can provide the virus called HIV, a direct entry into a person s blood. Certain diseases that are sexually transmitted, do not result in having open wounds but the presence of the infection itself can cause one s body to have an increase in the concentration of CD4 T-cells in the genital region. The fact has been well established that increase in the concentration of these CD4 T-cells can give HIV with quite a favorable target for spreading the infection. People, who are infected with a Sexually Transmitted Disease or STD, also have quite heavy concentrations of HIV in the liquids of semen and also in the vaginal fluid. This leads to an increase in the possibility of HIV transmission. A study has even proved that Men having got infected with HIV and Gonorrhea, have HIV, at least 10 times more in their seminal fluid than those who are only infected with HIV. Some of the major concerns are Sexually Transmitted Diseases like Infective Syphilis, Gonorrhea, and Herpes, with the strong evidence getting established regarding the fact that Chlamydia can also lead to an increased risk of HIV among women.
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 ...moreA 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.
MBBS Bachelor of Medicine and Bachelor of Surgery, MS - General Surgery, MCh - Neuro Surgery
Neurologist, Raipur
People may suffer from visual impairment even though their eyes are perfectly normal. Such loss of vision may result from neurological impairment.
Vision is the combination of image formation and perception of various attributes of the image by the brain. When the brain is not able to perceive images or various attributes of images, the patient may suffer from neurological impairment of vision. S...morePeople may suffer from visual impairment even though their eyes are perfectly normal. Such loss of vision may result from neurological impairment.
Vision is the combination of image formation and perception of various attributes of the image by the brain. When the brain is not able to perceive images or various attributes of images, the patient may suffer from neurological impairment of vision. Such impairment owes its origin to the nervous system.
Causes of Visual Impairment:
There are various areas in the brain that process some or the other attribute of the image that has formed on the retina. Occipital cortex, the area situated at the rear side of the brain is a very important site. It is responsible for processing visual stimuli and allowing people to make an idea about shape, distance, movement, color, etc. The severity of loss of vision depends on the extent and location of damage in the brain.
Neurological loss of vision may result from acquired brain injury, difficulties with visual perception, impairment in coordination of the eyes, etc. All these may stem from damage areas in the brain that are responsible for vision. There are many areas in the brain that are responsible for vision.
These areas can get damaged from various accidents like:
Stroke: If a person suffers a stroke, a part of his or her brain is likely to get damaged due to a haemorrhage or a blocked blood vessel.
Traumatic Brain Injury: A traumatic brain injury such as in a car accident or a violent fall can damage visual perception of the brain.
Infections: Infections such as meningitis attack the brain and may impair various areas of it.
Lack of Oxygen: People may suffer from lack of oxygen if they experience accidents like a near-drowning episode or a heart attack or something else, which has the effect of interrupting blood flow to the brain.
Diseases: Diseases such as brain tumors, multiple sclerosis etc. can precipitate neurological vision loss.
Symptoms of Visual Impairment:
Symptoms of neurological vision loss depend on the type of vision impairment and the location of damage in the brain. It may include:
Blurry vision: In Blurry vision, a person will not see things clearly or may see something in light but find it difficult to see them in dim light.
Double vision: In double vision, the patient sees a single object as two and cannot merge them as one.
Problems with depth perception of objects
Problem with bright light: In this type of problem, a person experiences difficulty seeing an object in a bright light. One may also feel pain or discomfort in the eye in bright light.
Difficulty with interpreting the object the person is looking at
Partial loss in the visual field: In this problem, half of the visual field in each eye is missing.
Treatment of Visual Impairment:
There is hardly any treatment for such vision loss since the rectification of visual acuity is of no help. Depending on the location and degree of neurological impairment, vision may improve over time. Some children with acquired brain injury or impairment in the coordination of the eyes and difficulties with visual perception also tend to improve with age.
Conclusion:
This is a type of vision loss where glasses, contact lenses, surgeries, or eye drops are not going to help. Such vision loss is usually permanent. Children with similar symptoms need to be presented with pictures, bright light, etc., which may help to form an idea about the object.
HIV is a systemic disease which affects all parts of the body. The oral cavity also has some tell-tale symptoms which indicate HIV / AIDS. A careful examination and detailed history of symptoms is essential. In some cases, the oral manifestations could be the area where HIV is suspected. This can help in reducing morbidity and improves prognosis. The oral lesions that occur in HIV patients can var...moreHIV is a systemic disease which affects all parts of the body. The oral cavity also has some tell-tale symptoms which indicate HIV / AIDS. A careful examination and detailed history of symptoms is essential. In some cases, the oral manifestations could be the area where HIV is suspected. This can help in reducing morbidity and improves prognosis. The oral lesions that occur in HIV patients can vary and differ significantly in children and adults. While there are a variety of oral lesions in HIV-infected individuals, listed below are some common infections seen in HIV patients. These are a combination of fungal, viral and bacterial infections.
Candidiasis: Candida is an opportunistic fungus that is normally present in the oral cavity and with reduced immunity of HIV, recurrent bouts of the infection begins to show up. It can be in the form of regular thrush which is whitish and cannot be scraped off (pseudomembranous candidiasis), hyperplastic candidiasis (white patches which can be scraped off) or erythematous (reddish patches). Candida can involve any part of the oral mucosa including the pharynx and the palate. Herpes Simplex: This is the most common viral infection seen in patients with HIV/AIDS. There could be primary or secondary infection of herpes virus, especially inside the mouth and the vermillion border of the lips. Herpes zoster: This virus, when already present in the body, can be reactivated with HIV/AIDS and with oral herpes. The distinction with herpes simplex is from their distribution. These are unilateral, along the distribution of the maxillary or mandibular nerve. The lesions appear both on the facial skin and the oral mucosa. While the facial ones break open and form crusts, the mucosal ones coalesce to form larger lesions. Hairy Leukoplakia: This is present in about 20% of asymptomatic HIV patients. Onset of hairy leukoplakia is an indication of rapid progression of HIV with increased CD4 counts. The typical lesion is a non-movable, hairy lesion along the side of the tongue and can spread to the top and the undersurface of the tongue. There are large amounts of Epstein-Barr virus (EBV) identified from biopsies of hairy leukoplakia. Cytomegalovirus: If the ulcers have a necrotic base with a halo surrounding it, it is CMV infection, usually seen on any oral mucosal surface. Periodontal disease: This is one of the bacterial infections that manifests itself in HIV patients. It can take two forms such as Linear Gingival Erythema (LGE) which can subsequently lead to Necrotizing Ulcerative Periodontitis (NUP). The oral hygiene is generally good with minimal plaque and there is rapid bone loss and soft tissue reddening and swelling. The, mouth, therefore is certainly a window to one s health. Diagnosing HIV with Western Blot Test-
It is a series of blood screenings are performed to test for HIV. The enzyme-linked immunosorbent assay (ELISA), also known as an enzyme immunoassay (EIA), is the first test that your healthcare provider will order to screen for HIV. ELISA, like the Western blot test, detects HIV antibodies in your blood. Antibodies are proteins your immune system produces in response to the presence of foreign substances, such as viruses. If you test positive for HIV on the ELISA test, your provider will order the Western blot test to confirm HIV infection.
MD - Internal Medicine, DIM -Diploma in Industrial Medicine, Certificate in HIV Medicine
HIV Specialist, Mumbai
The human immunodeficiency virus (HIV) is a subgroup of retrovirus (lentivirus) that causes HIV infection. After a period of time, this infection leads to what is called acquired immunodeficiency syndrome (AIDS).
Epidemiology
According to the Centers for Disease Control and Prevention (CDC), from 2010-2015, the estimated rate of HIV infection in all 50 US states decreased from 14.2 per 100,000 p...moreThe human immunodeficiency virus (HIV) is a subgroup of retrovirus (lentivirus) that causes HIV infection. After a period of time, this infection leads to what is called acquired immunodeficiency syndrome (AIDS).
Epidemiology
According to the Centers for Disease Control and Prevention (CDC), from 2010-2015, the estimated rate of HIV infection in all 50 US states decreased from 14.2 per 100,000 population in 2010 to 12.3 per 100,000 population in 2015. In 2015, 39,513 individuals were diagnosed with HIV infection. From 2010 to 2014, the annual number of new HIV infections decreased by 9%.
Virology HIV-1 and HIV-2 are retroviruses in the Retroviridae family, Lentivirus genus. They are enveloped, diploid, single-stranded RNA viruses with a DNA intermediate. Upon entry into the target cell, the viral RNA genome is converted into double-stranded DNA by an enzyme, reverse transcriptase that is transported along with the viral genome in the virus particle. The resulting viral DNA is then imported into the cell nucleus and integrated into the cellular DNA by a virally encoded enzyme, integrase. HIV contains three retroviral genes, namely gag, pol, and env.
Gag gene: Encodes group-specific antigen; the inner structural proteins Pol gene: Encodes polymerase; it also contains integrase and protease Env gene: Encodes the viral envelope, the outer structural proteins responsible for cell-type specificity. Glycoprotein 120, the viral envelope protein, binds to the host CD4+molecule Pathophysiology
HIV infects vital cells in the human immune system, such as helper T cells (specifically CD4+ T cells), macrophages, and dendritic cells and leads to cellular immune deficiency. This results in the development of opportunistic infections and neoplastic processes.
Mode of Transmission Sexual intercourse: Unprotected sexual intercourse; especially receptive anal intercourse and different sexual partnersContact with or transfer of blood, pre-ejaculate, semen, and vaginal fluids infected with the virus. Spread from an infected mother to her infant through breast milk. An HIV-positive mother can transmit HIV to her baby both during pregnancy and childbirth due to exposure to her blood or vaginal fluid.
Signs and Symptoms There are 3 categories of infection
Category A: Asymptomatic HIV infection without a history of symptoms or AIDS-defining conditions Category B: HIV infection with symptoms that are directly attributable to HIV infection Category C: HIV infection with AIDS-defining opportunistic infections Investigation
A high-sensitivity enzyme-linked immunosorbent assay (ELISA) should be used for screening.
Management
Start with antiretroviral therapy (ART) in all HIV-infected adults ready to start therapy. CD4 count is no longer a criterion for starting the therapy. Use of nucleoside reverse transcriptase inhibitors and protease inhibitors. For refractory cases, during the failing treatment regimen and before switching therapy, use rapid confirmation, perform resistance testing and reevaluate.
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