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AIDS
Introduction:Acquired immune deficiency syndrome or acquired immunodeficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV) his condition progressively reduces the effectiveness of the immune system and leaves individuals susceptible to opportunistic infections and tumors. HIV is transmitted through direct contact of a mucous membrane or the bloodstream ith a bodily fluid containing HIV! such as blood! semen! vaginal fluid! preseminal fluid! and breast mil". #his transmission can involve anal! vaginal or oral se$! blood transfusion! contaminated hypodermic needles! e$change bet een mother and baby during pregnancy! childbirth! breastfeeding or other e$posure to one of the above bodily fluids.IV). #he symptoms of AIDS are primarily the result of conditions that do not normally develop in individuals ith healthy i#he symptoms of AIDS are primarily the result of conditions that do not normally develop in individuals ith healthy immune systemsimmunesystems%eople ith AIDS also have an increased ris" of developing various cancers such as &aposi's sarcoma! cervical cancer and cancers of the immune system "no n as lymphomas. Additionally! people ith AIDS often have systemic symptoms of infection li"e fevers! s eats (particularly at night)! s ollen glands! chills! ea"ness! and eight loss. (ost of these conditions are infections caused by bacteria! viruses! fungi and parasites that are normally controlled by the elements of the immune system that HIV damages.

Etiology:Sexual transmission:Se$ual transmission occurs ith the contact bet een se$ual secretions of one person ith the rectal! genital or oral mucous membranes of another

Exposure to blood-borne pathogens:#his transmission route is particularly relevant to intravenous drug users! hemophiliacs and recipients of blood transfusions and blood products.

Perinatal transmission:#he transmission of the virus from the mother to the child can occur in utero during the last ee"s of pregnancy and at childbirth. In the absence of treatment! the transmission rate bet een a mother and her child during pregnancy! labor and delivery is )*+.

Misconceptions:A number of misconceptions have arisen surrounding HIV,AIDS. #hree of the most common are that AIDS can spread through casual contact! that se$ual intercourse ith a virgin ill cure AIDS! and that HIV can infect only homose$ual men and drug users

Pathophysiology:#he pathophysiology of AIDS is comple$! as is the case ith all syndromes. #his ea"ens the immune system and allo s opportunistic infections# lymphocytes are essential to the immune response and ithout them! the body cannot fight infections or "ill cancerous

cells. #he mechanism of -D./ # cell depletion differs in the acute and chronic phases. During the acute phase! HIV0induced cell lysis and "illing of infected cells by cytoto$ic # cells accounts for -D./ # cell depletion! although apoptosis may also be a factor. -ontinuous HIV replication results in a state of generali1ed immune activation persisting throughout the chronic phase

Diagnosis:#he diagnosis of AIDS in a person infected ith HIV is based on the presence of certain signs or symptoms. Since 2une *! 3453! many definitions have been developed for epidemiological surveillance such as the 6angui definition and the 344. e$panded 7orld Health 8rgani1ation AIDS case definition. Ho ever! clinical staging of patients as not an intended use for these systems as they are neither sensitive! nor specific. In developing countries! the 7orld Health 8rgani1ation staging system for HIV infection and disease! using clinical and laboratory data! is used and in developed countries! the -enters for Disease -ontrol (-D-) -lassification System is used

Treatment:#here is currently no publicly available vaccine for HIV or cure for HIV or AIDS. #he only "no n methods of prevention are based on avoiding e$posure to the virus or! failing that! an antiretroviral treatment directly after a highly significant e$posure! called post0e$posure prophyla$is (%9%). %9% has a very demanding four ee" schedule of dosage. It also has very unpleasant side effects including diarrhea! malaise! nausea and fatigue -urrent treatment for HIV infection consists of highly active antiretroviral therapy! or HAA:#. #his has been highly beneficial to many HIV0infected individuals since its introduction in 344; hen the protease inhibitor0based HAA:# initially became available.-urrent optimal HAA:# options consist of combinations (or <coc"tails<) consisting of at least three drugs belonging to at least t o types! or <classes!< of antiretroviral agents.

Hepatitis
Introduction=0
Hepatitis (plural hepatitides) is an inflammation of the liver characteri1ed by the presence of inflammatory cells in the tissue of the organ. #he name is from the >ree" hepar (?@A)! the root being hepat0 (?@B0)! meaning liver! and suffi$ -itis! meaning <inflammation< (c. 3C)C). #he condition can be self0limiting (healing on its o n) or can progress to fibrosis (scarring) and cirrhosis. Hepatitis may occur ith limited or no symptoms! but often leads to Daundice! anore$ia (poor appetite) and malaise. Hepatitis is acute hen it lasts less than si$ months and chronic hen it persists longer. A group of viruses "no n as the hepatitis viruses cause most cases of hepatitis orld ide! but it can also be due to to$ins (notably alcohol! certain medications and plants)! other infections and autoimmune diseases.

Signs and symptoms:Acute:Initial features are of nonspecific flu0li"e symptoms! common to almost all acute viral infections and may include malaise! muscle and Doint aches! fever! nausea or vomiting! diarrhea! and headache. (ore specific symptoms! hich can be present in acute hepatitis from any cause! are= profound loss of appetite! aversion to smo"ing among smo"ers! dar" urine! yello ing of the eyes and s"in (i.e.! Daundice) and abdominal discomfort. %hysical findings are usually minimal! apart from Daundice in a third and tender hepatomegaly (s elling of the liver) in about 3E+. Some e$hibit lymphadenopathy (enlarged lymph nodes! in *+) or splenomegaly (enlargement of the spleen! in *+). Acute viral hepatitis is more li"ely to be asymptomatic in younger people. Symptomatic individuals may present after convalescent stage of C to 3E days! ith the total illness lasting ) to ; ee"s

hronic:-hronic hepatitis often leads nonspecific symptoms such as malaise! tiredness and ea"ness! and often leads to no symptoms at all. It is commonly identified on blood tests performed either for screening or to evaluate nonspecific symptoms. #he occurrence of Daundice indicates advanced liver damage. 8n physical e$amination there may be enlargement of the liver.

Etiology:Acute

Viral hepatitis= o Hepatitis A through 9 o Herpes simple$ o -ytomegalovirus o 9pstein06arr o Fello fever o Adenoviruses Gon viral infection

to$oplasma Heptospira I fever roc"y mountain spotted fever Alcohol #o$ins= Amanita to$in in mushrooms! carbon tetrachloride! asafetida Drugs= %aracetamol! amo$ycillin! antituberculosis medicines! minocycline and many others (see longer list belo ). Ischemic hepatitis (circulatory insufficiency) %regnancy Auto immune conditions! e.g.! Systemic Hupus 9rythematosus (SH9) (etabolic diseases! e.g.! 7ilson's disease
o o o o

hronic:

Viral hepatitis= Hepatitis 6 ith or ithout hepatitis D! hepatitis - (neither hepatitis A nor hepatitis 9 causes chronic hepatitis) Autoimmune o Autoimmune hepatitis Alcohol Drugs o methyldopa o nitrofurantoin o isonia1id o "etocona1ole Gon0alcoholic steatohepatitis Heredity o 7ilson's disease o alpha 30antitrypsin deficiency %rimary biliary cirrhosis and primary sclerosing cholangitis occasionally mimic chronic hepatitis

Pathophysiology: -aused by acute viral infection! to$icity! or drug induced Hiver is enlarged and congested Distortion of lobular pattern :esults in increased portal circulation pressure -irculation then decreased to liver 9dema of biliary channels :esults in obstructive Daundice

Diagnosis:-

-aused by acute viral infection! to$icity! or drug induced Hiver is enlarged and congested Distortion of lobular pattern :esults in increased portal circulation pressure -irculation then decreased to liver 9dema of biliary channels :esults in obstructive Daundice

Treatment: :est reduces metabolic demands and increase blood supply. Strict bed rest only during early icteric phase #hen alternate rest periods ith activity Diversional activities to reduce an$iety associated ith long recovery and needed rest Diet J also small freq meals! use favorite foods to stimulate appetite! may need supplements Inferon causes may side effects so some patients cant ta"e it = headache! fever! fatigue! n,v! anore$ia! hair loss! blood dyscrasias! depression Antivirals for Hep 6 K Vira1ole (ribavirin) and 9pivir (lamivudine).