Tuesday, 28 June 2016

HIV,AIDS,TEST,MYTHS, WINDOW PERIOD AND EVERYTHING ABOUT IT.

        *(photo taken from wikipedia )
I have worked as HIV specialist and district HIV nodal officer for 2 years in Government hospital. Today i will try to explain each and everything about Hiv, doubts related to it as per my experience, knowledge and academics . I hope this article would increase readers knowledge and awareness about aids

WHAT IS HIV?

Hiv or human immunodeficiency virus is the causative factor. This virus kills immunity cells of body. CD4 is one of the type immunity cells. So basically these virus decrease the immunity of the patient and eventually person starts getting multiple infection. There many types of virus means little change in structure or function produce different strains. Main strains are HIV-1  and HIV-2 . HIV-1 is world wide and more common. HIV-2 more common is Asia but still less than HIV-1. 

WHAT IS AIDS?

When Hiv enter body it remains silent for many years (5-7 years) and it keep on killing CD4 immunity cells. When immunity becomes very low and body start getting infections and other many virus related problem then all disease combined together called as AIDS. So patients do not get AIDS when HIV enter body but after many years when body start getting diseases and all. It full form is Acquired Immuno-deficiency Syndrome. Syndrome  means group of multiple diseases acquired due to low immunity. 

WHAT HAPPENS WHEN HIV ENTER BODY?

As i said Hiv remains silent in body and keep on multiply but when it enter body flue like symptoms which might go un noticed. Flu like symptoms are Mild fever, rashes, sore throat, body ache etc which remains for 4-6 weeks . This is the reaction of body against HIV. But after some times these symptoms go off. 


WHAT IS WINDOW PERIOD?

Window period is the time duration between Hiv enter to body and blood test start coming positive.  Blood test are negative at the time of entry of HIV and remains negative for 4-6 week. After certain period only it becomes positive so If somebody got exposed to HIV should repeat the blood test after 2-3 month. And if that comes negative that would be conclusive. Window period also depends of Test and person. Good test (4th generations test) has window period for 2 weeks only. 

TRANSMISSION and MYTHS 

There are only 3-4 ways of transmission of HIV. But i personally get so may queries regarding this . There so many myths regarding how HIV spreads.

1. Sexual intercourse
2. Mother to baby
3. Fluid to fluid touch ( semen, blood)
4. Infected blood transfusion
5. Drug abusers

MYTHS

Now there are so many misconception abut its transmission i every day gets questions about that i did this , I did that would i get hiv or not? here i tell where you wont get hiv

1. Oral sex is one most asked question. Answer is No. Until person has lesion , ulcer, cuts or fresh bleeding Other wise chance of transmission of HIV is zero .
2. Dry needle many people ask i got pricked a needle ( dry , not fresh blood contaminated) would i get HIV. Answer is no. HIV do not survive for long time out of body(few seconds only) So dry needle can not infect you.
3. Exposure to patients sweats, urine, saliva, food, sharing swimming pool, bathroom, touching do not cause hiv infection at all.
4. Same instrument used in patients if instrument do not have fresh blood of patient. HIV cant be transmitted.


I AM EXPOSED TO UNKNOWN STATUS PERSON WHAT SHOULD I DO?

1. Dont get panic just because you are in doubt that have you exposed to hiv or not?
2. If you are very much sure that you have exposed o hiv then start taking post exposure prophylaxis for that you need to go to government hospital and look for hiv clinic
3. Get the  test done 1st immediately and after 3 month. if both test are negative it means you are not positive.
4. Until everything clear use protection while sex

BLOOD TEST

I divide HIV test in to 4 part. People have so much confusion in quality , efficacy of test. So i have tried to simplify every thing


Rapid test - When you go to pathology and say that i want to get hiv test done. In this case lab does rapid test and give the result with in 20-30 minute. So rapid test are easy and result comes with 20-30 minute. In emergency when doctor need to go to surgery in that also we do rapid test.
Now rapid test are two type
1. 3rd generation ELISA - It is less specific and window period is longer. (about 4-6 week) It detects only body immunity which produce after 2-3 month of entry of HIV.
2. 4th generation ELISA - It window period is very less and it detects both Immunity and Hiv particle

TRIDOT test, and TRIDOT AB/AG (4th generation rapid test) are available in INDIA and other countries too.

ELISA, CLIA ,CMIA - 
Again these are screening test but takes time to get results. and yes same as rapid these also have 3rd generation and 4th generation types. Of course 4th generation is better and has low window period.
MICROLIS test (company name) is available in INDIA.

CONFIRMATORY TEST

Western blot, PCR are avilable . we should go for these if rapid or screening test comes positive. Other we should not do it.


HOW MANY TIMES WE SHOULD GET THE TEST

Well when you go for test window period should be consider. so I suggest to get test two times 1st when you feel that you have exposed to HIV. Although it is not much useful but it gives you  moral strength and clear your status regarding HIV at present. It would come negative then Get the test done after 3 month to clear everything.

WHAT IF TESTS COME POSITIVE. -(consider falls positive ) 

If tests come positive do not get panic. Some time falls positive result comes. So has to get confirmatory test done. (western blot, PCR) if these results come positive it means you are hiv positive if not then not.

HIV POSITIVE WHAT NEXT- (dont hide your status to doctors)

1st go to the Government hospital and medical college and get all medicine, precautions everything there. Indian government has highly strengthen system to handle HIV patients and treatment. This I can say with my personal experience as i have worked as HIV Specialist and officer in government hospital for 2 years.
Life is does not end here. You have more than 20 years if you take care of yourself and take medicine and all. Never loose hope. Help others , educate others, enjoy life as you were enjoying previously.

YO MAY LIKE TO READ
1. About sunscreen
2. alternative of hair transplant:lace hair system
3. effect of sun on skin
ANY QUESTION RELATED TO HIV, AIDS 

Friday, 24 June 2016

ONLINE SKIN CONSULTATION : YES IT WORKS.

ONLINE CONSULTATION 
Cosmetology, Dermatology, Hair Transplant Surgeon, Venereology, HIV Specialist 
FELLOWSHIP IN LASER AND COSMETOLOGY., 
FELLOWSHIP IN HAIR TRANSPLANT

Today is the era of Internet . There are so many services, markets, selling and buying etc growing successfully and giving satisfactory service to the costumer over internet and online websites. Health sector is also not behind others. Today I will explain that why  internet users can trust on websites which are giving online consultation related to health problem and here my focus would be online skin consultation which is getting more popular than other branches of medicine. I would add my own experience on online consultation as being very active in tele-dermatology


WHAT IS TELE-DERMATOLOGY or ONLINE DERMATOLOGY CONSULTATION 

Now a days tele-dermatology is becoming very popular . There are so many trustworthy websites which provide skin consultation with certified and qualified dermatologist. Infect now  online health sector is growing day by day even doctors are also adding this feature in their profile. In skin tele-dermatology itself became a branch in which dermatologists learn and become professional to give satisfactory and specific answer of online queries. How ever doctor has to be very specific and precised .



IS ONLINE SKIN CONSULTATION IS USEFUL?

Well , perhaps  Skin would be the only branch where doctor do not need to touch , or examine the patients. Dermatology is the only field where doctor needs only visual assessment to identify the skin disease and enough knowledge to give advice and treatment. As per multiple studies 70% skin problems are very common like acne, fungal, psoriasis, hair fall, dark circle, eczema, dermatitis, sunburn etc which can be treated easily by seeing photos or video consultation. So answer is Yes. atleast skin related problem can be treated effectively . This also saves time, money, energy and effort too. Patients can attach photos of skin disease with proper history and can get specific answer. 

ARE DOCTORS QUALIFIED ?

Yes , All online health services, websites, apps only allow qualified, registered practitioner only. They 1st verify the doctors credentials and degrees after that only a doctor can register and give consultation. 

DO THEY KEEP PRIVACY 

Of course yes. They keep patient's  all personal information safe. As far I know no online health service never disclose patient's personal information related to disease.



DO PRESCRIPTION CONTAIN LEGAL VALUE

No, Online consultation and prescription can not be used for legal purpose. Although online consultation is very useful but it is just a second opinion and mainly used for clarifying the confusion, doubts and interpretation. Prescription can treat the person's problems but do not have any legal importance. 

WHAT ARE GOOD SITES , APPS FOR CONSULTATION?

There are many good consultation services which have many experienced doctors. These are easily asses-sable and cheaper. They provide quick, trustworthy consultation which include chat, written queries , phone and video consultation. ICLINIQ, Healthcaremagic, justdocs, lybrate, evaidhya etc are popular and good consultation services.  

ASK YOUR SKIN PROBLEM 
SEND YOUR PHOTOS 

Tuesday, 21 June 2016

WHAT IS CHEMICAL PEEL: Medicated FACIAL

WHAT IS CHEMICAL PEEL


We can define Chemical peel as a medicated facial. Although there are wide range of chemical solution which can be used as chemical peel but simple explanation of chemical peel is that it works as peeler and peel off the dead part of skin. It is proven help full in may skin disease and gives glow , tightness and shining to skin. I regularly use chemical peel in acne, tanning, pigmentation, wrinkles and many other skin condition. So peel can be used  normally as well as some skin problem too.

MY SKIN IS FINE SHOULD I TAKE PEEL?

Yes as i said chemical peel basically remove dead skin. It helps in reducing wrinkles, tanning, acne, oily nature  and dust particles. It also acts on skin pores , open it and reduce chance of blackheads or white heads. So it is equally useful whether you have any skin disease or not. Infect it is sort of medicated facial by doctors . 

SHOULD I TAKE FACIAL AFTER PEEL?

No, peel is much far better and medically proven method to maintain skin tone, glow, tightness and texture. Once you enroll and start taking chemical peel you should not go to beauty parlor for non medicated beauty enhancing procedure. Actually we strictly should not use any other irritating chemical while peel procedures. 

CAN I USE MAKEUP?

2-3 days from peel we should avoid makeup and too much sun exposure. But after 2-3 days once the skin is healed you can get light make up. And after 1 week skin becomes normal and you can use any type make up and chemical over skin. 

PROCEDURE, TIME, SESSIONS 

Chemical peel is liquid solution which contain mild acid. Glycolic peel, salicylic peel, mandalic peel and many more the type of peel. Doctor chooses the peel type according to skin texture and condition. Peel should be done in session wise. Normally 6 to 8 sessions are required to complete the whole process and between two peel there should be gap of 2-3 weeks. Initially we take lesser strength of peel and per session increase the strength. Face, back, hand, or any desired skin part can treated and strength also varies with place. After chemical peel person should strictly use sunscreen and avoid sun exposure as much as possible. Chemical peel not only remove dead skin but also activates
deep dermal collagen system and suppress melanin system. So it cause improvement in skin texture , color, wrinkles, tightness, oilyness.

POST PEEL PRECAUTION AND COMPLICATION

Although procedure is very safe but if not done carefully then certainly cause trouble. In precaution person should use sunscreen, avoid sunlight, avoid other makeup or beauty related cosmetics , should not rub face wash or soap. Person should inform the doctor about any skin disease like herpes, rosacea, seborrhea etc.  
      Complication are less but few are very common but treatable. Pigmentation can come if strength of peel is more. Redness, itching, irritation , infection may come but can be minimize if done properly and carefully. 



PEELS IN SKIN PROBLEM

As i said peel can be optional as well as can be taken some important skin problem. Here I just mention a small list

1. Acne- salicylic peel, sali-mandalic peel
2. Tanning-  glycolic peel, TCA peel, yellow peel
3. Dark circle - Arginin peel , glycolic peel
4. Oily skin -  Salicylic peel
5. Acne scar -  yellow peel, salicylic peel
6. Pigmentation - glycolic peel, TCA

SHOULD NOT BE DONE IN?

Here i just writing a few important condition where we should not go for chemical peel
1.Infection or disease,
2.broken skin
3.Sunburn
4.active Herpes simplex 1 sore
5.pregnant
6.If you have taken isotretinoin in last 6 month

Know more about sunscreen
Effect of Sun on skin
If anybody further have any query or any skin disease 

Saturday, 18 June 2016

SUNSCREEN - How, Why, When to Use




What is SUNSCREEN

 Sunscreens are basically a lotion or cream base chemical which prevent the skin from UV Rays present in sun light and real cause of skin disease. It mainly stops UV-B rays but now few sunscreen has come in market which prevent both UV-B and UV-A. 


 What is SPF?

Sun protective factor is a unit to measure strength of sunscreen. There are wide range of SPF creams are available in market. More the SPF more the cost and more the strength. 30 SPF cream stops almost 95% of rays coming to skin and 50 SPF stops 99% of rays. So as SPF increases market prices also increase but there is not much change in work efficiency. I recommend 30-50 SPF Creams always. Although there are creams which claims SPF more than 50 but practically does not make much difference. 


How to use sunscreen?

Sunscreen should be used in day and does not matter whether sun light is present or not. Because UV Rays always comes to earth irrespective of cloud . Ideally sunscreen should be used every 3-4 hourly but I always advice patients to use it thrice in a day . I set the time on 9 O' clock then 12 O' clock and 3 O'clock. Sunscreen should be used not only face but all sun exposed part of body like hand , neck, Thicker the layer applied on skin more the effect of sunscreen . So i suggest the patient to apply multiple layer and thicker layer. Apply sunscreen half an hour before if going out in sun. 

Should i use cream in home ?


YES, normal light also contain same UV rays. Many people have tendency to get tanning even in home on exposure to normal light. i suggest to use sunscreen regularly while in home or out side of home. So to minimize the effect of light absolutely we should use sunscreen in day irrespective of presence of sun light and place. 

Does Sunscreen cause ACNE ,Black heads?

No, theoretically sunscreen does not cause any skin problems including acne. But very few people may have some kind of allergy to sunscreen. Sunscreen causes contact dermatitis and in such case we have to change the brand or completely stopped. 

I Have Oily Skin

There are lotions and creams which are greasy and does not suits oily skin. Initially we didnt have any options because greasy and sticky character of sunscreen increase the SPF but now non sticky , non greasy creams have come. Ranbaxy manufactures Suncros Soft lotion which is totally suitable for oily skin and i personally got very good response. 

Make up and SUNSCREEN

Sunscreen is a non reactive chemical and does not harm skin if used with makeup. Although i advice to use makeup minimally while using sunscreen. Eyeliner, lipsticks , can be used but other cosmetics used on face skin should be avoided. 

ANY QUESTION ABOUT SUNSCREEN 

Wednesday, 15 June 2016

CRACKED HEELS: CARE for FOOT

DO YOU HAVE ANY SKIN RELATED QUERIES 

I think cracked and fissured heal is most common problem in house working females. Due to busy schedule and negligence of proper care  of foot further increase this problem. Later it becomes painful and infected which might arise serious problems.

Why I get these cracks?

Extreme dryness of foot is the most important cause of cracked heels. It is also called as fissure foot. As we know foot is part of body which wear all weight of body. Mechanical pressure cause flattening of foot and due to dryness it gets torn. Not drinking enough water and poor nutrition are also risk factors for cracked heels. Wearing open shoe in hot summer days cause fat on the heel to move sideways and increases the  crack furtherFungal infection also can cause such type of cracks but nail infection and blackening of feet nail also present most of the times in fungal infection.




Is it serious problem?

No, it is not serious until you avoid it and keep it untreated for longer period. Improper care might cause secondary infection. Bacterial infection or fungal infection may complicate the problems. It may turned in to wound and becomes painful. 

Diabetes and foot cracks 

If u suffering from diabetes it could be serious. In diabetes patient's sensation power diminished. so may times patient is not able to sense pain and wound in fissure. Some times situation becomes worse but diabetic patients still can not notice it. 2nd thing diabetic patients are more prone to get fissure due to more dryness and sensation loss.

Water Increase fissure foot?

I always advice to avoid long contact with water and soap, washing powder because it may infect the fissure. 2nd thing water delay the healing process and further creates problems.

How to treat it?

It's very simple use some moisturizer daily. liq. paraffine or your home coconut oil also can be used. Many people use glycerin + lemon. it is also useful. Medically i prescribe salicylic  acid 3-6% with some mild steroids. We have to see infection. if I see any white pus or erosive lesions i give antibiotics and rule out fungal infection too. If diabetes is there have to treat that for better response. 


How to care my feet ?

You can get lot of things while searching over Internet. i also searched and compiled important points for you which will help you to care your foot. So these points are summery of my experience and from other sources. Lets have a look

  1. Drink more water to combat dryness and dehydration, which can cause cracked feet or make them worse.
  2. Get regular pedicures so that your feet are clean, healthy, and smooth.
  3. Avoid open-heeled or high-heeled shoes, as these can make cracked feet drier and more painful. Wear breathable shoes with or without cotton socks.
    Soak your feet in warm water with liberal amounts of baby oil. Pat dry and surround them in plastic wrap so that they stay moist.
  4. Try an oil-based moisturizing cream. Look for ones with vitamin E, shea butter, and aloe.
  5. Smooth wet feet regularly with a pumice stone. This reduces the thickness of hard, cracked, calloused skin. Be sure to scrub the pumice over the balls and heels of your feet.
  6. Try using a pumice sheet attached to a handle on dry feet. This quickly flakes off thick skin so that cracks are smoothed out. Use twice a day for two weeks.
  7. Never use a razor blade or Credo knife on cracked feet. It may hurt or cut too deeply, and it may cause infection.
  8. Never use scissors, a cuticle cutter, or a toenail clipper on cracked feet. You will cause additional injury.
  9. Don’t pick at the cracks in your feet. You will cause more cracks.
    Try immersing feet in warm water and honey for 15 minutes. Honey works wonders for treating cracked feet.
  10. Invest in an electric footbath to warm and massage feet, and fill with milk and water for an extra moisture boost.
  11. Coat your feet nightly with special foot ointment, available at most drugstores.
  12. Make your own foot lotion by combining baby lotion with spearmint and eucalyptus oil. Massage into feet and cover them in thin cotton socks. Sleep in your lotion-rich socks and then rinse carefully in the morning (your feet may be slippery!).
  13. Scrub your feet every morning with a homemade foot scrub made from 4 tablespoons of salt mixed with ½ cup of baby oil, almond oil, or coconut oil.
    Puncture vitamin E capsules and spread the contents on your feet. Vitamin E has been shown to help heal dry, cracked skin.
  14. Douse feet in petroleum jelly and cover them with clean, soft socks. Dab petroleum jelly on the cracks throughout the day.
  15. If all else fails, consult your doctor. You may need a prescription treatment to combat bacteria and infection

Friday, 10 June 2016

LASER HAIR REMOVAL


Hello , Laser Hair Removal is always a hot topic among patients. All want to get rid of monthly waxing, threading which is bit painful and irritating. Lets discuss about lasers, its type, precautions, its pro and cons. I hope i have covered all the important points and queries in this article.

WHAT IS LASER HAIR REMOVAL 

Laser hair removal is procedure in which laser acts on hair root and kill it permanently. Laser is kind of special waves which hit the the root of hair hair and activate the melanin ( pigment which is black and responsible for black hair) part of root. Due to activation of melanin it start burning whole hair root and permanently damage the hair as well as its growth. Due to damage of root hair falls of and never comes back. As i said laser works on melanin (black pigment ) so gray, white, red hair do not contain melanin and dont not respond to laser. 

TYPE OF LASERS

There are many types of laser which are used in hair removal. Now a days we are using two type of laser. One is ND Yag lasers. This laser is very effective and gives satisfactory results at the same time it is almost pain less. 2nd one is diode laser which is my favorite. It is bit pain full but results are better than Nd yag. Now Even modification of diode laser have come. There are various diode laser wavelength 800nm, 808nm, 810nm. Studies show 810nm diode laser wavelength seems better than others. So in cosmetology clinic you can check about it. 

PRECAUTIONS AND PREPARE BEFORE LASER HAIR REMOVAL

1. Do not wax, thread, bleach or get any other cosmetic procedure before few days of procedure.
2. Use sunscreen, avoid sun light exposure, keep the area covered for few days before procedure
3. Stop applying any cream until required 
4. Check the type of machine in clinic, credential of cosmetologist, 
5. Hair should be trimmed  just before procedure
6. Pre procedure patch test should be done few days before procedure in which small dose of laser is given to know whether patients has sensitivity to laser or not. 

PROCEDURE

Procedure is safe and takes time depending upon area. Although thick hair and black skin gives good response and require lesser number of sittings while thin hair and fair skin needs more sitting. Number of sittings may varies from 6-10 in number. Gap between two laser should be 2-3 weeks and sunscreen should used during laser sessions. During procedure hair should be trimmed and jelly is applied over area. Adjust the power of laser according to patients comfortability. Procedure should not be painful and patient should not feel burning sensation during procedure. Eyelashes, genital part should be avoided from laser exposure. Facial hair, arm pit hair, thighs, legs , arms hair can be removed effectively with laser.  

POST PROCEDURE PRECAUTIONS

1. Apply sunscreen over the area multiple times in day
2. avoid sun exposure and any kind of chemical application
3. Ice cold compression is good and would be helpful to reduce post complications. 
4. Black skin are more prone to get side effects so doses should be low in black skin
5. Apply moisturizer repeatedly  

POST PROCEDURE COMPLICATIONS 

Although procedure is safe but few complications can come and can be treated wisely.
1. Redness is very common and most of the time comes after every procedure. Mild steroid like flutivate works fine and redness goes off in 3-5 days.
2. Burning , pigmentation, are the other common complications which can be treated easily and do not bother the patients for long time
3. Blisters, eczema , these are bit serious but treatable complications due to high dose or sensitivity but oral steroids and topical steroid can cure the problem
4. Hair growth - yes some time laser may revers the effect and increase the hair growth if given in inadequate manner and in low dose then required. This is called low level laser therapy which is used in baldness. 

SELECTION OF PATIENTS

1. Sensitive to lasers, 
2. Any skin disease
3. Pregnancy 
4. Gray, white ,red hair
5. high expectations

RESULTS

Well results are good and almost up to 80% improvement can be seen after 4-5 sittings. Although it is not 100% and cant be remove all the hair and patients may require more sittings. Some times sittings go up to more 10 in number.  Effect of laser is last long but patient should go under laser every 1 year once in 5-8 month which is called maintenance sittings.  







Saturday, 4 June 2016

DOES SUN MAKE YOU DARKER??


                           


Well today I am going to discuss one of the very common problem. Almost everybody including me encounter this problem. Sun is very notorious culprit of many skin disease. Many people coming to me have this complain that they are getting darker day by day. This is because of sun. Continuous exposure to sunlight cause darkening of skin which is called as SUN TANNING.

WHAT is Skin Tanning??
In simple word darkening of skin due to continuous exposure to sun light for many years. This is due to uv rays in sunlight which activate melanin cells to produce more melanin. As melanin increase skin becomes darker slowly slowly. Fore head, around eye, nose, chin, malar area are the main part of face which very prone to get tanning. 

What is type of skin??
Theoretically dermatologist classify skin in six type. Western people have type 1 or 2 skin which means they don't get tanning on exposure but they get burning of skin. Indians have type 4 or 5 type skin which easily get tan but don't burn. Blacks have type 6 skin which never burn at all. So basically tanning is protective mechanism which prevent skin to get burn.


Type of tanning
It is basically called delayed type pigmentation which comes after repeated exposure to sun for long duration. It persist for long time and make skin darker permanently in absence of proper treatment.   There is immediate type of tanning too which persist for few hour to days.

HOW TO PREVENT TANNING?
Best prevention form sun tanning is ignore sun exposure. Keep the face covered while out of the home. it is very effective and easily can be done. Use sunscreen every four hourly till evening. SPF should be above 30 and around 50. Although greasy and sticky sunscreen are bit irritating but more effective than non sticky sunscreen. Sunscreen should'nt be stopped even after tanning goes off.

TREATMENT
There are multiple creams which can be applied like kojic acid, hydroquinon, triple combinations. But chemical peel is effective method. It needs multiple sessions with proper gap duration. There is another option that is ND YAG Q Switch carbon facial. It also require multiple sessions but it is costly than peel. Although effectiveness and response with peel and laser are variable.