Irregular Heart Beats (arrhythmia)

Your heart contains a natural pacemaker called the sinoatrial or sinus node that triggers electrical impulses to spread over the heart, causing it to contract (beat).

Any abnormal rhythm of the heartbeat is known as an arrhythmia.

Common causes include:

• electrical impulses coming from other areas of the heart instead of the sinus node that regulates heartbeat
  
  
• electrical impulses coming from the sinus node but that take a different pathway through the heart
  
  
• a very fast heart rate (with either a regular or irregular rhythm)
  
  
• a combination of a regular and irregular heart rhythm.

Types of Heart Diseases

Following are the some types of Heart Diseases

• Irregular heart beats (arrhythmia)
• Cardiomyopathy
• Heart failure
• Congenital heart disease
• Heart attack
• Heart valve problems
• Infection

All will be described one by one in further posts...

What is Heart Disease?

When talking about heart conditions, doctors use the terms coronary heart disease (CHD) and the broader cardiovascular disease (CVD).

• CHD is used for any condition that affects heart function.
  
  
• CVD refers to both coronary heart disease and diseases of the circulation such as stroke, when a clot blocks blood supply to the brain. Stroke is the country's third biggest killer, claiming 70,000 lives each year.
  
  

Most doctors now prefer to use the term CVD because it is the major cause of premature death in the UK, causing around 32 per cent of premature deaths in men and 28 per cent in women.

One person in Britain dies from heart disease every three minutes - making us one of the world’s worst countries for this problem.

When should a child be taken to the doctor?

• If the child still wets the bed after the age of six.
  
• If the child suddenly starts wetting the bed without having done so earlier.
  
  
• If the child's urine has a strong smell, or if the child says that it hurts during or after urination.
  
  
• If the child starts to wet him or herself during the day.
  
  
• If the child urinates more than usual, day or night.
  
  
• If the child has constipation or defecates in their pants.

What can I do to help my child?

Try using a bedwetting alarm, which makes a ringing or buzzing sound or vibrates if the child wets the bed. These are successful in curing the condition in 70 per cent of cases.

The alarm is very effective because it makes your child wake up as soon as the first drop of urine hits the underwear or the sheet. Your child is thus made aware that they are urinating and what it feels like when their bladder is full.

There are different kinds of alarms. Some have a copper net which is placed under the sheet. The net is connected to a bell, which will go off as soon as the first drop of urine hits the sheet. Others have a small sensor, which is placed in the pants, and is also connected to a bell.

Both your GP and the local children’s continence nurse will be able to advise you on obtaining an alarm. The alarm is often required for up to five months to achieve success, being used for a minimum of three weeks following the child’s last wet night.

It is possible to use drugs and an alarm at the same time and this has been shown to be beneficial in some cases.

Do not make the bedwetting a big issue in the family. Most children are embarrassed about wetting the bed, so it will help if the family support the child and show a positive attitude. Don't get angry with the child or punish them if they wet their bed. This could only make matters worse.

Let the child know that many other children do it too. If someone in the family has had the same problem, tell the child about it. Knowing that others have been affected in the same way will help a child deal with the problem.

Make sure the child doesn't drink very much during the two hours prior to bedtime. There is still no guarantee that the child will not wet the bed, but it may help.

Ensure the child goes to the toilet before getting into bed. Protect the bed by using a waterproof mattress, or a fitted waterproof mattress cover under the bottom sheet. This must be fastened securely to prevent any danger of suffocation. Place clean nightclothes and sheets next to the bed so the child can change if they wake up.

Let the child change the sheets; not as a punishment, but in order to learn to deal with the problem. It will also make the child more aware of the situation. If the child is in agreement, keep a calendar or diary and mark dry nights with a star. Praise the child when he or she wakes up in the morning without having wet the bed. Encouragement is often the most helpful way of dealing with the problem.

Some children take longer than others to achieve night-time dryness - initially having maybe one or two dry nights a week and gradually building up the number of dry nights over the following months.

However, if your child is persistently wet every night for a week or two he or she may not be ready to become dry. In this case, as a temporary measure, you may wish to use absorbent night-time pants rather than going back to using nappies. You could then try again in about three to four months.

Many parents have been told to wake the child in the middle of the night and make them go to the bathroom. Studies show that the positive effect of this is almost non-existent, since the child does not wake up by him or herself because of the need to urinate.

It may take weeks or months before there is any change. Training a child will take time, so patience is required from all involved. Most children naturally stop wetting the bed eventually. Do not be embarrassed to discuss further options with your doctor or health visitor if none of the above suggestions appear to be effective.

Why do children wet the bed?

In a significant minority of children who wet the bed no reason can be found.

Often it is passed on through the family. About 70 per cent of children who wet their beds either have a brother, sister or a parent who has experienced the same problem. Studies have localised a genetic predisposition to this condition.

It may have a medical, social or psychological cause such as constipation, kidney disease, cystitis, diabetes, sensitivity to certain food or food additives; and problems at school, at home, or the divorce of parents.

One explanation could be that these children are heavy sleepers who do not wake up when their bladder is full. Also, some children develop bladder control later than others.

At night, some children produce too little of the antidiuretic hormone (ADH), which controls the production of urine. Tablets containing desmopressin (eg Desmotabs) may help. The child needs to be examined by a doctor who will then decide whether treatment is necessary.

Is bedwetting common?

Frequent bed wetting is common in children up to the age of six. The child should not be put under pressure if younger than six - children do not wet the bed on purpose.

Approximately 15 to 20 per cent of all five- and six-year-olds wet the bed and it is more common among boys. With teenagers, the figure is 2 to 3 per cent up to 14 years and 1 per cent at 15 years and over.

What is Bed Wetting?

Enuresis is the medical name for the involuntary passing of urine and the most common form of enuresis, i. e. that which occurs at night, simply referred to as bedwetting.

The medical definition of nocturnal enuresis is bedwetting over the age of five years. Primary nocturnal enuresis is when a child has never developed complete night-time bladder control. Secondary nocturnal enuresis is when a child suffers bedwetting after having been continually dry for more than six months.

Common Symptoms of Diabetes

Glucose is one of the body’s main fuels. If there isn't enough, blood sugar levels rise and glucose is secreted into urine. This causes:

• Increased thirst
• Frequent urination
• Tiredness
• Weight loss, although appetite often increases (especially in Type 1 diabetes)
• Itchiness, especially around the genitals
• Recurrent infections on the skin, eg boils.

People with Type 1 diabetes usually develop these symptoms within days or weeks.

In Type 2 diabetes, these symptoms often don't show for years. Many are diagnosed by chance through routine medical check-ups.

Heredity plays a part in diabetes, but only 10 per cent of people with Type 1 have a family history of diabetes. For Type 2, this rises to 30 per cent.

Causes and risk factors

Type 1 Diabetes

Type 1 diabetes develops when the insulin-producing cells in the pancreas have been destroyed. Nobody knows for sure why these cells have been damaged but the most likely cause is an abnormal reaction of the body to the cells. This may be triggered by a viral or other infection.

Type 2 Diabetes

If you are white and over 40 years old, or if you’re black, Asian or from a minority ethnic group and over 25 years old and have one or more of the following risk factors, you should ask your GP for a test for diabetes.

The Risk Factors

• A close member of your family has Type 2 diabetes (parent or brother or sister).
• You’re overweight or if your waist is 31.5 inches or over for women; 35
inches or over for Asian men and 37 inches or over for white and black men.
• You have high blood pressure or you’ve had a heart attack or a stroke.
• You’re a woman with polycystic ovary syndrome and you are overweight.
• You’ve been told you have impaired glucose tolerance or impaired fasting
glycaemia.
• If you’re a woman and you’ve had gestational diabetes.
• You have severe mental health problems.

The more risk factors that apply to you, the greater your risk of having diabetes.

Your age

You’re at risk of diabetes if you’re over 40 or you’re over 25 and black, Asian or from a minority ethnic group. The risk also rises with age so the older you get the more at risk you are.

The family

Having diabetes in the family puts you at risk. The closer the relative is, the greater the risk. So if your mum or dad has diabetes, rather than your aunt or uncle, it’s more likely you will develop the condition too.

Ethnicity

African-Caribbean or South Asian people who live in the UK are at least five times more likely to have diabetes than the white population.

Your weight

Not all people with diabetes are over weight but the stats show that over 80 per cent of people diagnosed with Type 2 diabetes are overweight. The more overweight and the more inactive you are the greater your risk. If you don’t know whether you’re overweight, ask your GP to measure your BMI.

Your waist

Women – if your waist measures 31.5in (80cm) or more you’ve got an increased risk.
Men – if you’re white or black and your waist is 37in (94cm) or more you have an increased risk of developing diabetes; if you’re an Asian man the figure is 35in (90cm) or more.

The other factors

If you’ve been diagnosed with any problems with your circulation, had a heart attack or stroke, or if you’ve got high blood pressure you may be at an increased risk of diabetes.

Pregnant women can develop a temporary type of diabetes – gestational diabetes. Having this – or giving birth to a large baby – can increase the risk of a woman going on to develop diabetes in the future.

Women with polycystic ovary syndrome who are overweight are at an increased risk of developing diabetes.

If you’ve been told you have either impaired fasting glycaemia (IFG) or impaired glucose tolerance (IGT) it means the level of glucose (sugar) in your blood is higher than normal but you don’t have diabetes and you should follow a healthy diet, lose weight if you need to and keep active, to help yourself prevent diabetes. But make sure you’re regularly tested for diabetes.

Other conditions such as raised triglycerides (a type of blood fat) and severe mental health problems can also increase your risk.

Types of Diabetes

There are two main types of diabetes. These are:

• Type 1 diabetes
• Type 2 diabetes

Type 1

Type 1 diabetes develops if the body is unable to produce any insulin. This type of diabetes usually appears before the age of 40. Type 1 diabetes is the least common of the two main types and accounts for between 5 – 15% of all people with diabetes.

Type 2

Type 2 diabetes develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly (known as insulin resistance). In most cases this is linked with being overweight. This type of diabetes usually appears in people over the age of 40, though in South Asian and African-Caribbean people often appears after the age of 25. However, recently, more children are being diagnosed with the condition, some as young as seven. Type 2 diabetes is the most common of the two main types and accounts for between 85 - 95% of all people with diabetes.

There are currently over 2.5 million people with diabetes in the UK and there are more than half a million people with diabetes who have the condition and don’t know it.

Diabetes

Diabetes mellitus is a condition where the amount of glucose in the blood is too high because the body cannot use it properly. Glucose comes from the digestion of carbohydrate containing food and drinks and is also produced by the liver. Carbohydrate comes from many different sources including starchy foods such as bread, potatoes and chapattis, fruit, dairy products, sugar and other sweet foods.

Insulin is vital for life. It is a hormone produced by the pancreas and helps the glucose to enter the cells where it is used as fuel for energy so we can work, play and generally live our lives.

Symptoms of Cancer

The following are symptoms that may occur in specific types of cancers:

Bladder cancer: Blood in the urine, pain or burning upon urination; frequent urination; or cloudy urine

Bone cancer: Pain in the bone or swelling around the affected site; fractures in bones; weakness, fatigue; weight loss; repeated infections; nausea, vomiting, constipation, problems with urination; weakness or numbness in the legs; bumps and bruises that persist

Brain cancer: Dizziness; drowsiness; abnormal eye movements or changes in vision; weakness, loss of feeling in arms or legs or difficulties in walking; fits or convulsions; changes in personality, memory or speech; headaches that tend to be worse in the morning and ease during the day, that may be accompanied by nausea or vomiting

Breast cancer: A lump or thickening of the breast; discharge from the nipple; change in the skin of the breast; a feeling of heat; or enlarged lymph nodes under the armColorectal cancer: Rectal bleeding (red blood in stools or black stools); abdominal cramps; constipation alternating with diarrhea; weight loss; loss of appetite; weakness; pallid complexion

Kidney cancer: Blood in urine; dull ache or pain in the back or side; lump in kidney area, sometimes accompanied by high blood pressure or abnormality in red blood cell count

Leukemia: Weakness, paleness; fever and flu-like symptoms; bruising and prolonged bleeding; enlarged lymph nodes, spleen, liver; pain in bones and joints; frequent infections; weight loss; night sweats

Lung cancer: Wheezing, persistent cough for months; blood-streaked sputum; persistent ache in chest; congestion in lungs; enlarged lymph nodes in the neck

Melanoma: Change in mole or other bump on the skin, including bleeding or change in size, shape, color, or textureNon-Hodgkin's lymphoma: Painless swelling in the lymph nodes in the neck, underarm, or groin; persistent fever; feeling of fatigue; unexplained weight loss; itchy skin and rashes; small lumps in skin; bone pain; swelling in the abdomen; liver or spleen enlargement

Oral cancer: A lump in the mouth, ulceration of the lip, tongue or inside of the mouth that does not heal within a couple of weeks; dentures that no longer fit well; oral pain, bleeding, foul breath, loose teeth, and changes in speech

Ovarian cancer: Abdominal swelling; in rare cases, abnormal vaginal bleeding; digestive discomfort

Pancreatic cancer: Upper abdominal pain and unexplained weight loss; pain near the center of the back; intolerance of fatty foods; yellowing of the skin; abdominal masses; enlargement of liver and spleen

Prostate cancer: Urination difficulties due to blockage of the urethra; bladder retains urine, creating frequent feelings of urgency to urinate, especially at night; bladder not emptying completely; burning or painful urination; bloody urine; tenderness over the bladder; and dull ache in the pelvis or back

Stomach cancer: Indigestion or heartburn; discomfort or pain in the abdomen; nausea and vomiting; diarrhea or constipation; bloating after meals; loss of appetite; weakness and fatigue; bleeding - vomiting blood or blood in the stool

Uterine cancer: Abnormal vaginal bleeding, a watery bloody discharge in postmenopausal women; a painful urination; pain during intercourse; pain in pelvic area

Causes of Cancer

The many causes of cancer

There are about 200 different types of cancer affecting all the different body tissues. What affects one body tissue may not affect another. For example, tobacco smoke that you breathe in may help to cause lung cancer. Over exposing your skin to the sun could give you a melanoma on your leg. But the sun won't give you lung cancer and smoking won't give you melanoma.

Apart from infectious diseases, most illnesses are 'multifactorial'. Cancer is no exception. Multifactorial means that there are many factors involved. In other words, there is no single cause for any one type of cancer.

Carcinogens

A 'carcinogen' is something that can help to cause cancer. Tobacco smoke is a powerful carcinogen. But not everyone who smokes gets lung cancer. So there must be other factors at work.

Age

Most types of cancer become more common as we get older. This is because the changes that cause a cell to become cancerous in the first place take a long time to develop.

Genetic make up

There have to be a number of genetic mutations within a cell before it becomes cancerous. Sometimes we are born with one of these mutations already. This does not mean we will get cancer. But with one mutation from the outset, it makes it more likely statistically that we will. Doctors call this 'genetic predisposition'.

The immune system

People who have problems with their immune systems are more likely to get some forms of cancer. This group includes people who

• Have had organ transplants and take drugs to suppress their immune systems to stop organ rejection
• Have AIDS
• Are born with rare medical syndromes which affect their immunity

Diet

Cancer experts estimate that changes to our diet could prevent about one in three cancer deaths in the UK. In the western world, many of us eat too many animal fats and not enough fresh fruit and vegetables. This type of diet is known to increase your risk of cancer. But how exactly we should alter our diets is not clear.

Viruses

Viruses can help to cause some cancers. But this does not mean that these cancers can be caught like an infection. What happens is that the virus can cause genetic changes in cells that make them more likely to become cancerous.

These cancers and viruses are linked:

• Cervical cancer and the genital wart virus, HPV
• Primary liver cancer and the Hepatitis B virus
• T cell leukaemia in adults and the Human T cell leukaemia virus

Cancer

Cancer (medical term: malignant neoplasm) is a class of diseases in which a group of cells display the traits of uncontrolled growth (growth and division beyond the normal limits), invasion (intrusion on and destruction of adjacent tissues), and sometimes metastasis (spread to other locations in the body via lymph or blood). These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize.

Most cancers form a tumor but some, like leukemia, do not.Cancer can involve any tissue of the body and have many different forms in each body area. Most cancers are named for the type of cell or organ in which they start. If a cancer spreads (metastasizes), the new tumor bears the same name as the original (primary) tumor.

How to avoid infection

• Wash your hands thoroughly (often one of the best ways to avoid catching a cold).
• Shaking hands with someone who has a cold is risky, so avoid rubbing your eyes or nose after wards.
• Food should be cooked or cooled down as quickly as possible.
• Vegetables and meat must be stored separately and prepared on separate chopping boards.
• Meat should preferably be served well-done.
• Remember that food with these invisible organisms does not necessarily smell bad.
• Some organisms are killed as the food is cooked, but they can still leave toxic substances that may cause diarrhea and vomiting.
• The use of condoms during sexual intercourse reduces the likelihood of spreading sexually transmitted diseases.

How are infections with viruses and bacteria spread?

Viral and bacterial infections are both spread in basically the same ways.

• A person with a cold can spread the infection by coughing and/or sneezing.
• Bacteria or viruses can be passed on by touching or shaking hands with another person.
• Touching food with dirty hands will also allow viruses or bacteria from the intestine to spread.
• Body fluids such as blood, saliva and semen can contain the infecting organisms and transmission of such fluids, for example by injection or sexual contact, is important, particularly for viral infections like hepatitis or AIDS.

What are bacteria?

Bacteria are organisms made up of just one cell. They are capable of multiplying by themselves, as they have the power to divide. Their shapes vary, and doctors use these characteristics to separate them into groups.

Bacteria exist everywhere, inside and on our bodies. Most of them are completely harmless and some of them are very useful. But some bacteria can cause diseases, either because they end up in the wrong place in the body, or simply because they are 'designed' to invade us.

What are viruses?

Viruses are too small to be seen by the naked eye. They can't multiply on their own, so they have to invade a 'host' cell and take over its machinery in order to be able to make more virus particles.

Viruses consist of genetic materials (DNA or RNA) surrounded by a protective coat of protein. They are capable of latching onto cells and getting inside them.

The cells of the mucous membranes, such as those lining the respiratory passages that we breathe through, are particularly open to virus attacks because they are not covered by protective skin.

What should I do?

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 bronchodilators, 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.

How does the doctor make the diagnosis?

The diagnosis is made on the basis of the patient's history of symptoms and on simple tests of the lungs' function but it is 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 it can be helpful to take blood samples and skin tests to look for hypersensitivity towards specific substances.

What can you do to help yourself?

• Avoid the substances you are allergic to, 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 your treatment with your doctor 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 of a peak flow meter, which can help you judge your asthma during spells when it is worse.
• Make sure you use your inhaler device correctly. If you are unsure your practice nurse, doctor or pharmacist will be able to help and advise you.

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

• Bluish skin colour and gasping breath.
  
  
• Exhaustion so severe that speech is difficult or impossible.
  
  
• Confusion and restlessness.
  

What are the warning signals of worsening attacks?

• Inhaled medicines appears less effective than usual.

• 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 does asthma feel like?

• It is difficult to breathe and there is shortness of breath.
  
  
• Wheezing when breathing out.
  
  
• Coughing, especially at night and with a little mucus.

What might trigger acute asthma attacks?

• Exertion.
  
  
• Cold.
  
  
• Smoke.
  
  
• Air pollution including exposure to certain chemicals. An example is isocynates which are used in some painting and plastics industries.
  
  
• Airway infection.
  
  
• Allergies, eg to pollens, house dust mites, domestic animals (especially cats), aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.

How do you get Asthma?

Asthma can be triggered by external agents, such as irritants in the atmosphere which are breathed in, or by internal reactions within the body that have been caused by an external influence. The kinds of provoking factors can be divided into two groups:

• Non-specific factors: all asthma patients are affected by a number of things that are referred to as irritants. They include exertion, cold, smoke, scents and pollution.
• Specific factors: these are irritants or allergens in the form of pollen, dust, animal fur, mould and some kinds of food. A virus or bacteria, chemical fumes or other substances at the workplace and certain medicines, eg aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs), may also cause asthma.

To acquire asthma, people seem to need to have been born with a predisposition to the disease. It may not reveal itself until they have been exposed to some asthma irritants.

Smoking mothers, low birth weight, a lack of exposure to infection in early life and traffic fumes have all been associated with the increase in asthma. Less draughty houses resulting in a higher concentration of house dust mites and cooking gases may also be part of the problem.

Currently, a great deal of research looking for the genes that allow asthma to develop is being carried out. But until we can prevent asthma, we have to suppress the symptoms and try to avoid the triggers where possible.

What is Asthma?

Asthma is a chronic disease in which sufferers have repeated attacks of difficulty in breathing and coughing. There seems to be an increase in the amount of asthma all over the world, especially in children. To understand what happens in asthmatic attacks it is helpful to visualise the basic structure of the airway tubes of the lung.

The main airway (windpipe, trachea) of the body is about 2-3cm across. It divides into its main branches (bronchi), which lead to the right and left lung, which divide 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 and also gives rise to the characteristic wheezy noise.

Asthmatics tend to be sensitive to various types of irritants in the atmosphere that can trigger this contraction response from the bronchial muscles.

The bronchi also have an inner lining that becomes inflamed in asthma, which makes the lining swell and produce an excess amount of the mucus (phlegm) it normally makes.

All of these processes contribute to the airway narrowing and the treatment for asthma is aimed at reversing them as much as possible.

People of all ages get asthma but 50 per cent of sufferers are children, mostly boys, under 10. Among adults, women are more likely to develop asthma than men.

Later Symptoms of HIV/AIDS

• Lack of energy
• Weight loss
• Frequent fevers and sweats
• A thick, whitish coating of the tongue or mouth (thrush) that is caused by a yeast infection and sometimes accompanied by a sore throat
• Severe or recurring vaginal yeast infections
• Chronic pelvic inflammatory disease or severe and frequent infections like herpes zoster
• Periods of extreme and unexplained fatigue that may be combined with headaches, lightheadedness, and/or dizziness
• Rapid loss of more than 10 pounds of weight that is not due to increased physical exercise or dieting
• Bruising more easily than normal
• Long-lasting bouts of diarrhoea
• Swelling or hardening of glands located in the throat, armpit, or groin
• Periods of continued, deep, dry coughing
• Increasing shortness of breath
• The appearance of discoloured or purplish growths on the skin or inside the mouth
• Unexplained bleeding from growths on the skin, from mucous membranes, or from any opening in the body
• Recurring or unusual skin rashes
• Severe numbness or pain in the hands or feet, the loss of muscle control and reflex, paralysis or loss of muscular strength
• An altered state of consciousness, personality change, or mental deterioration
• Children may grow slowly or fall sick frequently. HIV positive persons are also found to be more vulnerable to some cancers.

What Happens Inside the Body?

Once HIV enters the human body, it attaches itself to a White Blood Cell (WBC) called CD4. Also, called T4 cells, they are the main disease fighters of the body. Whenever there is an infection, CD4 cells lead the infection-fighting army of the body to protect it from falling sick. Damage of these cells, hence can affect a person's disease-fighting capability and general health.

After making a foothold on the CD4 cell, the virus injects its RNA into the cell. The RNA then gets attached to the DNA of the host cell and thus becomes part of the cell's genetic material. It is a virtual takeover of the cell. Using the cell's division mechanism, the virus now replicates and churns out hundreds of thousands of its own copies. These cells then enter the blood stream, get attached to other CD4 cells and continue replicating. As a result, the number of the virus in the blood rises and that of the CD4 cells declines.

Because of this process, immediately after infection, the viral load of an infected individual will be very high and the number of CD4, low. But, after a while, the body's immune system responds vigorously by producing more and more CD4 cells to fight the virus. Much of the virus gets removed from the blood. To fight the fast-replicating virus, as many as a billion CD4 cells are produced every day, but the virus too increases on a similar scale. The battle between the virus and the CD4 cells continues even as the infected person remains symptom-free.

But after a few years, which can last up to a decade or even more, when the number of the virus in the body rises to very high levels, the body's immune mechanism finds it difficult to carry on with the battle. The balance shifts in favour of the virus and the person becomes more susceptible to various infections. These infections are called Opportunistic Infections because they swarm the body using the opportunity of its low immunity. At this stage, the number of CD4 cells per millilitre of blood (called CD4 Count), which ranges between 500 to 1,500 in a healthy individual, falls below 200. The Viral Load, the quantity of the virus in the blood, will be very high at this stage.

Opportunistic infections are caused by bacteria, virus, fungi and parasites. Some of the common opportunistic infections that affect HIV positive persons are: Mycobacterium avium complex (MAC), Tuberculosis (TB), Salmonellosis, Bacillary Angiomatosis (all caused by bacteria); Cytomegalovirus (CMV), Viral hepatitis, Herpes, Human papillomavirus (HPV), Progressive multifocal leukoencephalopathy (PML) (caused by virus); Candidiasis, Cryptococcal meningitis (caused by fungus) and Pneumocystis Carinii pneumonia (PCP). Toxoplasmosis. Cryptosporidiosis (caused by parasites). HIV positive persons are also prone to cancers like Kaposi's sarcoma and lymphoma.

The Center for Disease Control (CDC), Atlanta has listed a series of diseases as AIDS-defining. When these diseases appear, it is a sign that the infected individual has entered the later stage of HIV infection and has started developing AIDS. The progression of HIV positive persons into the AIDS stage is highly individual. Some people can reach the AIDS stage in about five years, while some remain disease free for more than a decade. Measurement of the viral load and the CD4 count helps a doctor in assessing an infected person's health condition

Early Symptoms of HIV/Aids

Many people do not develop any symptoms when they first become infected with HIV. Some people, however, get a flu-like illness within three to six weeks after exposure to the virus. This illness, called Acute HIV Syndrome, may include fever, headache, tiredness, nausea, diarrhoea and enlarged lymph nodes (organs of the immune system that can be felt in the neck, armpits and groin). These symptoms usually disappear within a week to a month and are often mistaken for another viral infection.

During this period, the quantity of the virus in the body will be high and it spreads to different parts, particularly the lymphoid tissue. At this stage, the infected person is more likely to pass on the infection to others. The viral quantity then drops as the body's immune system launches an orchestrated fight.

More persistent or severe symptoms may not surface for several years, even a decade or more, after HIV first enters the body in adults, or within two years in children born with the virus. This period of "asymptomatic" infection varies from individual to individual. Some people may begin to have symptoms as soon as a few months, while others may be symptom-free for more than 10 years. However, during the "asymptomatic" period, the virus will be actively multiplying, infecting, and killing cells of the immune system.

Cuases of HIV/Aids

Normally, white blood cells and antibodies attack and destroy foreign organisms that enter your body. This response is coordinated by white blood cells known as CD4 lymphocytes. These lymphocytes are also the main targets of HIV, which attaches to the cells and then enters them. Once inside, the virus inserts its own genetic material into the lymphocytes and makes copies of itself.

When the new copies of the virus break out of the host cells and enter the bloodstream, they search for other cells to attack. In the meantime, the old host cells and some uninfected CD4 cells die from the effects of the virus. The cycle repeats itself again and again. In the process, billions of new HIV particles are produced every day. Eventually, the number of CD4 cells in the body decreases, leading to severe immune deficiency, which means your body can no longer effectively fight off viruses and bacteria that cause disease.

How HIV is transmitted
You can become infected with HIV in several ways, including:

• Sexual transmission. You may become infected if you have vaginal, anal or oral sex with an infected partner whose blood, semen or vaginal secretions enter your body. You can also become infected from shared sexual devices if they're not washed or covered with a condom. The virus is present in the semen or vaginal secretions of someone who's infected and enters your body through small tears that can develop in the vagina or rectum during sexual activity. If you already have another sexually transmitted disease, you're at much greater risk of contracting HIV. Contrary to what researchers once believed, women who use the spermicide nonoxynol 9 also may be at increased risk. This spermicide irritates the lining of the vagina and may cause tears that allow the virus into the body.
• Transmission through infected blood. In some cases, the virus may be transmitted through blood and blood products that you receive in blood transfusions. Since 1985, American hospitals and blood banks have screened the blood supply for HIV antibodies. This blood testing, along with improvements in donor screening and recruitment practices, has substantially reduced the risk of acquiring HIV through a transfusion.
• Transmission through needle sharing. HIV is easily transmitted through needles and syringes contaminated with infected blood. Sharing intravenous drug paraphernalia puts you at high risk of HIV and other infectious diseases such as hepatitis. Your risk is greater if you inject drugs frequently and also engage in high-risk sexual behavior. Avoiding the use of injected drugs is the most reliable way to prevent infection. If that isn't an option, you can reduce your risk by participating in a needle exchange program that allows you to trade used needles and syringes for sterile ones.
• Transmission through accidental needle sticks. Transmission of the virus between HIV-positive people and health care workers through needle sticks is low. Experts put the risk at far less than 1 percent.
• Transmission from mother to child. Each year, nearly 600,000 infants are infected with HIV, either during pregnancy or delivery or through breast-feeding. But if women receive treatment for HIV infection during pregnancy, the risk to their babies is significantly reduced. In the United States, most pregnant women are pre-screened for HIV, and anti-retroviral drugs are readily available. Not so in developing nations, where women seldom know their HIV status, and treatment is often limited or nonexistent. When medications aren't available, Caesarean section is sometimes recommended instead of vaginal delivery. Other options, such as vaginal disinfection, haven't proved effective.
• Other methods of transmission. In rare cases, the virus may be transmitted through organ or tissue transplants or unsterilized dental or surgical equipment.

Ways HIV is not transmitted
To become infected with HIV, infected blood, semen or vaginal secretions must enter your body. You can't become infected through ordinary contact — hugging, kissing, dancing or shaking hands — with someone who has HIV or AIDS.

What is Aids?

Acquired Immune Deficiency Syndrome (AIDS) is a term that is used to describe the latter stages of HIV, when the immune system has stopped working and the person develops a life-threatening condition, such as pneumonia (infection of the lungs).

The term "AIDS" was first used by doctors when the exact nature of the HIV virus was not fully understood. However, the term is no longer widely used because it is too general to describe the many different conditions that can affect somebody with HIV. Specialists now prefer use the terms "advanced" or "late-stage" HIV infection.

Human Immunodeficiency Virus (HIV)

The Human Immunodeficiency Virus (HIV) is a sexually transmitted virus that attacks the body's immune system. A healthy immune system provides a natural defence against disease and infection.

HIV infects special cells, called CD4 cells, that are found in the blood and are responsible for fighting infection. After becoming infected, the CD4 cells are destroyed by HIV. Although the body will attempt to produce more CD4 cells, their numbers will eventually decline and the immune system will stop working. This leaves a person who is infected with HIV with a high risk of developing a serious infection or disease, such as cancer.

There is no cure for HIV and no vaccine to stop you from becoming infected. However, since the 1990s, treatments have been developed that enable most people with HIV to stay well and live relatively normal lives.

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