What is our "MOTTO"?

"No disease is incurable". It is our motto. It is not only a phrase combined of four words but an essence of our experiance which is now encircling about 28 years.

What is our aim?

Our aim is

This is the only reason that we are also providing the herbal medicines of these diseases. Our medicines are prepared upon the research of our researchers.

We are not providing herbal medicine for breast cancer as research to prepare a medicine to cure this disease is being done and we are sure that it will not be taking much time.

What are we charging for diet chart?

The diet chart is provided free of cost to every patient who requests us to get it even if he/she does not purchase our medicine.

What are the diseases in which we are providing diet charts to the patients and how they can get it?

List of the diseases for which we are providing diet charts to the patients is given in "Diet chart" page. In the same page the method to get them via e-mail is too given. Click here to go there.

Why are our herbal medicines different from those which are available in the market?

Our herbal medicines are different form those available in the market because

Is it possible to cure a patient which is now at the last stage of Liver cancer or Leukemia?

Answer is that nature is always merciful. There is no disease for which nature has not created a treatment. The only thing we have to do is to find the medicine and our researchers have not only found the herb that has proved to be effective 100 percent in curing Liver cancer but they have doubled it's effects by preparing a diet chart on which patient has to act upon parallel during treatment. This is the key that we are using not only to cure Liver cancer but also to cure Leukemia, syphilis and other dangerous diseases.

Most of the physicians say to patients suffering from the last stage of liver cancer and leukemia that "you have gotten late so, no one can help you. Now you must have to die."

You know why they say it? They say it because

What do we charge for our medicines?

We are charging only the cost price plus postal charges from our customers. Reason is that our center "Naturopathic Research And Treatment Center" is a non-profit-oriented organization. Secondly betterment of humanity is more precious to us than money.
Click here to see the charges of our herbal medicines.

How can you import our herbal medicines?

First go to "Medicine Page" and see the name of the medicine you want to import. Then go to "Order" page and fill a form and submit it. You will be receiving the medicine immediately after that we receive the amount from you.

Do we sell our herbal medicines in bulk?

Yet we were not selling our herbal medicines in bulk but we are soon going to facilitate you to start up your own business by purchasing our herbal medicines in bulk without packing and selling them by using your own company name. We have been gathering suggestions since now. You are requested to mail at wattoo@cure-t-pakherbs.com to discuss on this topic.

Are we doing something for deserving patients?

We have introduced a simple procedure for deserving patients so that they can get our herbal medicines only by bearing the delivering charges. We are not receiving any cost from these patients. The proceedure is given in the end of the "Medicine Page". Click here to go there.

Following is given the research to help you to know about the basic cause of your disease. Take a bird's eye view of this research.

1- LIVER CANCER

Primary liver cancer is cancer that begins in the liver. Adult primary liver cancer is rare in most of the countries. Usually, when the liver is affected by cancer, it is because cancer that started in a different part of the body—the pancreas, colon, stomach, breast, or lung, for example—has spread (metastasized) to the liver. These cancers are not primary liver cancer but, rather, are named for the part of the body in which they originated. For example, breast cancer that has metastasized to the liver is called "metastatic breast cancer or "secondary liver cancer

The liver is the largest organ in the body, and its functions are vital to the digestion of food. No one can survive without a liver. The liver does the following.

As we well know, there are many kinds of cancer; unfortunately they all come about because of the out-of-control growth of abnormal cells.

What is hepatocellular carcinoma (HCC)?

Hepatocellular carcinoma is a cancer arising from the liver. It is also known as primary liver cancer or hepatoma. The liver is made up of different cell types (e.g., bile ducts, blood vessels, and fat-storing cells). However, liver cells (hepatocytes) make up 80% of the liver tissue. Thus, the majority of primary liver cancers (over 90 to 95%) arises from liver cells and is called hepatocellular cancer or carcinoma.

When patients or physicians speak of liver cancer, however, they are often referring to cancer that has spread to the liver, having originated in other organs (such as the colon, stomach, pancreas, breast, and lung). More specifically, this type of liver cancer is called metastatic liver disease (cancer) or secondary liver cancer. Thus, the term liver cancer actually can refer to either metastatic liver cancer or hepatocellular cancer. The subject of this article is hepatocellular carcinoma or HCC (primary liver cancer).

What is the scope of the hepatocellular carcinoma or HCC (primary liver cancer) problem?

hepatocellular carcinoma or HCC (primary liver cancer) is the fifth most common cancer in the world. A deadly cancer, hepatocellular carcinoma or HCC (primary liver cancer) will kill almost all patients who have it within a year. In 1990, the World Health Organization estimated that there were about 430,000 new cases of hepatocellular carcinoma or HCC (primary liver cancer) worldwide, and a similar number of patients died as a result of this disease. About three quarters of the cases of hepatocellular carcinoma or HCC (primary liver cancer) are found in Southeast Asia (China, Hong Kong, Taiwan, Korea, and Japan). hepatocellular carcinoma or HCC (primary liver cancer) is also very common in sub-Saharan Africa (Mozambique and South Africa).

The frequency of hepatocellular carcinoma or HCC (primary liver cancer) in Southeast Asia and sub-Saharan Africa is greater than 20 cases per 100,000 population. In contrast, the frequency of hepatocellular carcinoma or HCC (primary liver cancer) in North America and Western Europe is much lower, less than 5 per 100,000 population. However, the frequency of hepatocellular carcinoma or HCC (primary liver cancer) among native Alaskans is comparable to that seen in Southeast Asia. Moreover, recent data show that the frequency of hepatocellular carcinoma or HCC (primary liver cancer) in the U.S. overall is rising. This increase is due primarily to chronic hepatitis C, an infection of the liver that causes hepatocellular carcinoma or HCC (primary liver cancer).

What are the population characteristics (epidemiology) of hepatocellular carcinoma or HCC (primary liver cancer)?

In the U.S. the highest frequency of hepatocellular carcinoma or HCC (primary liver cancer) occurs in immigrants from Asian countries, where hepatocellular carcinoma or HCC (primary liver cancer) is common. The frequency of hepatocellular carcinoma or HCC (primary liver cancer) among Caucasians is the lowest, whereas among African-Americans and Hispanics, it is intermediate. The frequency of hepatocellular carcinoma or HCC (primary liver cancer) is high among Asians because hepatocellular carcinoma or HCC (primary liver cancer) is closely linked to chronic hepatitis B (HBV) infection. This is especially so in individuals who have been infected with chronic hepatitis B (HBV) for most of their lives. If you take a world map depicting the frequency of chronic hepatitis B (HBV) infection, you can easily superimpose that map on a map showing the frequency of hepatocellular carcinoma or HCC (primary liver cancer).

The initial presentation (symptoms) of hepatocellular carcinoma or HCC (primary liver cancer) in patients in areas of high hepatocellular carcinoma or HCC (primary liver cancer) frequency is quite different from that seen in low frequency areas. Patients from high frequency areas usually start developing hepatocellular carcinoma or HCC (primary liver cancer) in their 40's, and the cancer is usually more aggressive. That is, the hepatocellular carcinoma or HCC (primary liver cancer) presents with severe symptoms and is inoperable (too advanced for surgery) at the time of diagnosis. Also, in these areas, the frequency of hepatocellular carcinoma or HCC (primary liver cancer) is three to four times higher in men than in women, and most of these patients are infected with chronic hepatitis B (HBV). In contrast, hepatocellular carcinoma or HCC (primary liver cancer) in lower risk areas occurs in patients in their 50's and 60's and the predominance of men is less striking.

What are the risk factors for hepatocellular carcinoma or HCC (primary liver cancer)?

Hepatitis B (HBV) infection

The role of hepatitis B virus (HBV) infection in causing hepatocellular carcinoma or HCC (primary liver cancer) is well established. Several lines of evidence point to this strong association. As noted earlier, the frequency of hepatocellular carcinoma or HCC (primary liver cancer) relates to (correlates with) the frequency of chronic hepatitis b infection. In addition, the patients with hepatitis b virus who are at greatest risk for hepatocellular carcinoma or HCC (primary liver cancer) are men with hepatitis b virus cirrhosis (scarring of the liver) and a family history of hepatocellular carcinoma or HCC (primary liver cancer). Perhaps the most convincing evidence, however, comes from a prospective (looking forward in time) study done in the 1970's in Taiwan involving male government employees over the age of 40. In this study, the investigators found that the risk of developing hepatocellular carcinoma or HCC (primary liver cancer) was 200 times higher among employees who had chronic hepatitis b as compared to employees without chronic hepatitis b!

Studies in animals also have provided evidence that hepatitis b virus can cause hepatocellular carcinoma or HCC (primary liver cancer). For example, we have learned that hepatocellular carcinoma or HCC (primary liver cancer) develops in other mammals that are naturally infected with hepatitis b virus(HBV)-related viruses. Finally, by infecting transgenic mice with certain parts of the hepatitis B virus, scientists caused hepatocellular carcinoma or HCC (primary liver cancer) to develop in mice that do not usually develop liver cancer. (Transgenic mice are mice that have been injected with new or foreign genetic material.)

How does chronic hepatitis b virus (HBV) cause hepatocellular carcinoma or HCC (primary liver cancer)?

In patients with both chronic hepatitis b HBV and hepatocellular carcinoma or HCC (primary liver cancer), the genetic material of hepatitis b (HBV) is frequently found to be part of the genetic material of the cancer cells. It is thought, therefore, that specific regions of the HBV genome (genetic code) enter the genetic material of the liver cells. This hepatitis b virus (HBV) genetic material may then disrupt the normal genetic material in the liver cells, thereby causing the liver cells to become cancerous.

The vast majority of hepatocellular carcinoma or HCC (primary liver cancer) that is associated with chronic hepatitis b virus (HBV) occurs in individuals who have been infected most of their lives. In areas where hepatitis B virus (HBV) is not always present (endemic) in the community (e.g., the U.S.), hepatocellular carcinoma or HCC (primary liver cancer) is relatively uncommon. The reason for this is that most of the people with chronic hepatitis b (HBV) in these areas acquired the infection as adults. However, hepatocellular carcinoma or HCC (primary liver cancer) can develop in individuals who acquired chronic hepatitis b virus (HBV) in adulthood if there are other risk factors, such as chronic alcohol use or co-infection with chronic HCV infection.

Hepatitis C infection

Hepatitis C virus (HCV) infection is also associated with the development of hepatocellular carcinoma or HCC (primary liver cancer). In fact, in Japan, hepatitis c virus (HCV) is present in up to 75% of cases of hepatocellular carcinoma or HCC (primary liver cancer). As with hepatitis b virus (HBV), the majority of hepatitis c virus (HCV) patients with hepatocellular carcinoma or HCC (primary liver cancer) have associated cirrhosis (liver scarring). In several retrospective-prospective studies (looking backward and forward in time) of the natural history of hepatitis C, the average time to develop hepatocellular carcinoma or HCC (primary liver cancer) after exposure to hepatitis c virus (HCV) was about 28 years. The hepatocellular carcinoma or HCC (primary liver cancer) occurred about 8 to 10 years after the development of cirrhosis in these patients with hepatitis C. Several prospective European studies report that the annual incidence (occurrence over time) of hepatocellular carcinoma or HCC (primary liver cancer) in cirrhotic hepatitis c virus (HCV) patients ranges from 1.4 to 2.5% per year.

In hepatitis c (HCV) patients, the risk factors for developing hepatocellular carcinoma or HCC (primary liver cancer) include the presence of cirrhosis, older age, male gender, elevated baseline alpha-fetoprotein level (a blood tumor marker), alcohol use, and co-infection with hepatitis b virus HBV. Some earlier studies suggested that hepatitis c virus (HCV) genotype 1b may be a risk factor, but our studies do not support this finding.

The way in which hepatitis c virus (HCV) causes hepatocellular carcinoma or HCC (primary liver cancer) is not well understood. Unlike hepatitis b virus (HBV), the genetic material of hepatitis c virus (HCV) is not inserted directly into the genetic material of the liver cells. It is known, however, that cirrhosis from any cause is a risk factor for the development of hepatocellular carcinoma or HCC (primary liver cancer). It has been argued, therefore, that hepatitis c virus (HCV), which causes cirrhosis of the liver, is an indirect cause of hepatocellular carcinoma or HCC (primary liver cancer).

On the other hand, there are some chronic hepatitis c virus (HCV) infected individuals who have hepatocellular carcinoma or HCC (primary liver cancer) without cirrhosis. So, it has been suggested that the core (central) protein of hepatitis c virus (HCV) is the culprit in the development of hepatocellular carcinoma or HCC (primary liver cancer). The core protein itself (a part of the hepatitis C virus) is thought to impede the natural process of cell death or interfere with the function of a normal tumor suppressor (inhibitor) gene (the p53 gene). The result of these actions is that the liver cells go on living and reproducing without the normal restraints, which is what happens in cancer.

Alcohol

Cirrhosis caused by chronic alcohol consumption is the most common association of hepatocellular carcinoma or HCC (primary liver cancer) in the developed world. Actually, we now understand that many of these cases are also infected with chronic hepatitis c virus (HCV). The usual setting is an individual with alcoholic cirrhosis who has stopped drinking for ten years, and then develops hepatocellular carcinoma or HCC (primary liver cancer). It is somewhat unusual for an actively drinking alcoholic to develop hepatocellular carcinoma or HCC (primary liver cancer). What happens is that when the drinking is stopped, the liver cells try to heal by regenerating (reproducing). It is during this active regeneration that a cancer-producing genetic change (mutation) can occur, which explains the occurrence of hepatocellular carcinoma or HCC (primary liver cancer) after the drinking has been stopped.

Patients who are actively drinking are more likely to die from non-cancer related complications of alcoholic liver disease (e.g., liver failure). Indeed, patients with alcoholic cirrhosis who die of hepatocellular carcinoma or HCC (primary liver cancer) are about 10 years older than patients who die of non-cancer causes. Finally, as noted above, alcohol adds to the risk of developing hepatocellular carcinoma or HCC (primary liver cancer) in patients with chronic hepatitis c virus (HCV) or hepatitis b virus (HBV) infections.

Hemochromatosis

hepatocellular carcinoma or HCC (primary liver cancer) will develop in up to 30% of patients with hereditary hemochromatosis . Patients at the greatest risk are those who develop cirrhosis with their hemochromatosis. Unfortunately, once cirrhosis is established, effective removal of excess iron (the treatment for hemochromatosis) will not reduce the risk of developing hepatocellular carcinoma or HCC (primary liver cancer).

Cirrhosis

Individuals with most types of cirrhosis of the liver are at an increased risk of developing hepatocellular carcinoma or HCC (primary liver cancer). In addition to the conditions described above (hepatitis B, hepatitis C, alcohol, and hemochromatosis), alpha 1 anti-trypsin deficiency, a hereditary condition that can cause emphysema and cirrhosis, may lead to hepatocellular carcinoma or HCC (primary liver cancer). Liver cancer is also strongly associated with hereditary tyrosinemia, a childhood biochemical abnormality that results in early cirrhosis.

Certain causes of cirrhosis are less frequently associated with hepatocellular carcinoma or HCC (primary liver cancer) than are other causes. For example, hepatocellular carcinoma or HCC (primary liver cancer) is rarely seen with the cirrhosis in Wilson's disease (abnormal copper metabolism) or primary sclerosing cholangitis (chronic scarring and narrowing of the bile ducts). It used to be thought that hepatocellular carcinoma or HCC (primary liver cancer) is rarely found in primary bilary cirrhosis (PBC) as well. Recent studies, however, show that the frequency of hepatocellular carcinoma or HCC (primary liver cancer) in PBC is comparable to that in other forms of cirrhosis.

What are the symptoms of hepatocellular carcinoma or HCC (primary liver cancer)?

The initial symptoms (the clinical presentations) of hepatocellular carcinoma or HCC (primary liver cancer) are variable. In countries where hepatocellular carcinoma or HCC (primary liver cancer) is very common, the cancer generally is discovered at a very advanced stage of disease for several reasons. For one thing, areas where there is a high frequency of hepatocellular carcinoma or HCC (primary liver cancer) are generally developing countries where access to healthcare is limited. For another, screening examinations for patients at risk for developing hepatocellular carcinoma or HCC (primary liver cancer) are not available in these areas. In addition, patients from these regions actually have more aggressive hepatocellular carcinoma or HCC (primary liver cancer) disease. In other words, the tumor usually reaches an advanced stage and causes symptoms more rapidly. In contrast, patients in areas of low hepatocellular carcinoma or HCC (primary liver cancer) frequency tend to have hepatocellular carcinoma or HCC (primary liver cancer) tumors that progress more slowly and, therefore, remain without symptoms longer.

Abdominal pain is the most common symptom of hepatocellular carcinoma or HCC (primary liver cancer) and usually signifies a very large tumor or widespread involvement of the liver. Additionally, unexplained weight loss or unexplained fevers are warning signs of hepatocellular carcinoma or HCC (primary liver cancer) in patients with cirrhosis. These symptoms are less common in individuals with hepatocellular carcinoma or HCC (primary liver cancer) in the U.S. because these patients are usually diagnosed at an earlier stage. However, whenever the overall health of a patient with cirrhosis deteriorates, every effort should be made to look for hepatocellular carcinoma or HCC (primary liver cancer).

A very common initial presentation of hepatocellular carcinoma or HCC (primary liver cancer) in a patient with compensated cirrhosis (no complications of liver disease) is the sudden onset of a complication. For example, the sudden appearance of ascites (abdominal fluid and swelling), jaundice (yellow color of the skin), or muscle wasting without causative (precipitating) factors (e.g., alcohol consumption) suggests the possibility of hepatocellular carcinoma or HCC (primary liver cancer). What's more, the cancer can invade and block the portal vein (a large vein that brings blood to the liver from the intestine and spleen). When this happens, the blood will travel paths of less resistance, such as through esophageal veins. This causes increased pressure in these veins, which results in dilated (widened) veins called esophageal varices. The patient then is at risk for hemorrhage from the rupture of the varices into the gastrointestinal tract. Rarely, the cancer itself can rupture and bleed into the abdominal cavity, resulting in bloody ascites.

On physical examination, an enlarged, sometimes tender, liver is the most common finding. HCCs are very vascular (containing many blood vessels) tumors. Thus, increased amounts of blood feed into the hepatic artery (artery to the liver) and cause turbulent blood flow in the artery. The turbulence results in a distinct sound in the liver (hepatic bruit) that can be heard with a stethoscope in about one quarter to one half of patients with hepatocellular carcinoma or HCC (primary liver cancer). Any sign of advanced liver disease (e.g., ascites, jaundice, or muscle wasting) means a poor prognosis. Rarely, a patient with hepatocellular carcinoma or HCC (primary liver cancer) can become suddenly jaundiced when the tumor erodes into the bile duct. The jaundice occurs in this situation because both sloughing of the tumor into the duct and bleeding that clots in the duct can block the duct.

In advanced hepatocellular carcinoma or HCC (primary liver cancer), the tumor can spread locally to neighboring tissues or, through the blood vessels, to elsewhere in the body (distant metastasis). Locally, hepatocellular carcinoma or HCC (primary liver cancer) can invade the veins that drain the liver (hepatic veins). The tumor can then block these veins, which results in congestion of the liver. The congestion occurs because the blocked veins cannot drain the blood out of the liver. (Normally, the blood in the hepatic veins leaving the liver flows through the inferior vena cava, which is the largest vein that drains into the heart.) In African patients, the tumor frequently blocks the inferior vena cava. Blockage of either the hepatic veins or the inferior vena cava results in a very swollen liver and massive formation of ascites. In some patients, as previously mentioned, the tumor can invade the portal vein and lead to the rupture of esophageal varices.

Regarding the distant metastases, hepatocellular carcinoma or HCC (primary liver cancer) frequently spreads to the lungs, presumably by way of the blood stream. Usually, patients do not have symptoms from the lung metastases, which are diagnosed by radiologic (x-ray) studies. Rarely, in very advanced cases, hepatocellular carcinoma or HCC (primary liver cancer) can spread to the bone or brain.

Healthy Cells vs. Cancer Cells

Healthy cells are like a cat. They need structure to determine the size of bones and shape of the body, tail and whiskers. The DNA in genes and chromosomes determine this. They need energy to play and prowl and sustain life. This is derived from chemicals in food. Cats need a system to deliver chemicals (food nutrients like amino acids, carbohydrates, fats, vitamins and minerals) to all parts of their body. These are the blood vessels. Growth factors take a kitten into a lazy old cat, all the while helping it to function normally.

The body and its cells are mostly made up of protein. The building blocks of proteins are substances called amino acids that in the form of enzymes and hormones literally control every chemical reaction within the cells. When these are modified, different messages are sent to a complex control system that can alter their function. There are twenty different kinds of amino acids that are essential to life. Twelve of these can be synthesized within the body however; eight must be supplied by the daily diet.

Acute lymphocytic leukemia

Acute lymphocytic leukemia (ALL) is a cancer of lymphocytes, cells that live in the spongy inner mass of bone called the marrow. All is also called acute lymphoid leukemia or acute lymphoblastic leukemia. Acute lymphocytic leukemia (ALL) is most common in young children and adults over age 50.

The lymph nodes are small, bean-shaped organs of the immune system. They are found in clusters in the abdomen, pelvis, underarms, and neck. Lymph nodes are part of the lymph system, which is made up of thin tubes that branch to all parts of the body. The job of the lymph system is to filter impurities from the body. The lymph system carries lymph, a colorless fluid containing white blood cells.

In Acute lymphocytic leukemia (ALL), non-inherited genetic changes cause the body to produce too many marrow cells called lymphoblasts. In normal bone marrow, lymphoblasts make lymphocytes, a kind of white blood cell found in the blood and lymph. Lymphocytes mature to help the body defend itself from infection. In people with Acute lymphocytic leukemia (ALL), these cells never mature.

Because blood carries cancer cells throughout the body, the cancer will spread around the body and may invade other organs, including the brain, liver and spleen. Unlike solid tumors, spread of Acute lymphocytic leukemia (ALL) to other parts of the body does not always mean the cancer is in an advanced stage, but leukemia that has spread may require special treatment.

Acute lymphocytic leukemia (ALL) is one of four types of leukemia. Like acute myelogenous leukemia (AML), Acute lymphocytic leukemia (ALL) appears and progresses quickly, but begins in a different type of cell. Chronic lymphocytic leukemia (CLL) and chronic myelogenous leukemia (CML) both progress more slowly.

Leukemia is either acute or chronic. In acute leukemia, the abnormal blood cells are blasts that remain very immature and cannot carry out their normal functions. The number of blasts increases rapidly, and the disease becomes worse quickly. In chronic leukemia, some blast cells are present, but in general, these cells are more mature and can carry out some of their normal functions. Also, the number of blasts increases less rapidly than in acute leukemia. As a result, chronic leukemia worsens gradually.

Previous chemotherapy and exposure to radiation may affect the risk of developing Acute lymphocytic leukemia (ALL).

Possible risk factors for Acute lymphocytic leukemia (ALL) include the following:

Possible signs of adult Acute lymphocytic leukemia (ALL) include fever, feeling tired, and easy bruising or bleeding.

The early signs of Acute lymphocytic leukemia (ALL) may be similar to the flu or other common diseases. A doctor should be consulted if any of the following problems occur:

These and other symptoms may be caused by adult acute lymphoblastic leukemia or by other conditions.

Tests that examine the blood and bone marrow are used to detect (find) and diagnose adult Acute lymphocytic leukemia (ALL).

The following tests and procedures may be used:

Complete blood count: A procedure in which a sample of blood is drawn and checked for the following:

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

The age of the patient.

Whether the cancer has spread to the brain or spinal cord.

Whether the Philadelphia chromosome is present.

Whether the cancer has been treated before or has recurred (come back).

As we well know, there are many kinds of cancer; unfortunately they all come about because of the out-of-control growth of abnormal cells.

Healthy Cells vs. Cancer Cells

Healthy cells are like a cat. They need structure to determine the size of bones and shape of the body, tail and whiskers. The DNA in genes and chromosomes determine this. They need energy to play and prowl and sustain life. This is derived from chemicals in food. Cats need a system to deliver chemicals (food nutrients like amino acids, carbohydrates, fats, vitamins and minerals) to all parts of their body. These are the blood vessels. Growth factors take a kitten into a lazy old cat, all the while helping it to function normally.

The body and its cells are mostly made up of protein. The building blocks of proteins are substances called amino acids that in the form of enzymes and hormones literally control every chemical reaction within the cells. When these are modified, different messages are sent to a complex control system that can alter their function. There are twenty different kinds of amino acids that are essential to life. Twelve of these can be synthesized within the body however; eight must be supplied by the daily diet

Acute myeloid leukemia

Acute myeloid leukemia (AML) is a cancer of cells in the blood, bone marrow and lymph nodes. Acute myeloid leukemia (AML) is also called acute nonlymphocytic leukemia, acute myeloblastic leukemia, or acute granulocytic leukemia.

In Acute myeloid leukemia (AML), the bone marrow begins producing large numbers of abnormal blasts. Instead of producing all three types of mature blood cells, the bone marrow begins to produce only one type, usually immature white blood cell blasts called myeloblasts. These myeloblasts then overrun the bloodstream. They can also invade the brain, skin, ovaries and testes, and other organs. Acute myeloid leukemia (AML) cells occasionally form a solid tumor called an isolated granulocytic sarcoma or chloroma.

Acute myeloid leukemia (AML) is one of four types of leukemia. Like acute lymphocytic leukemia (ALL), Acute myeloid leukemia (AML) appears and progresses quickly, but begins in a different type of cell. Chronic lymphocytic leukemia (CLL) and chronic myelogenous leukemia(CML) both progress more slowly.

There are different subtypes of Acute myeloid leukemia (AML).

The Acute myeloid leukemia (AML) subtypes are based on how mature (developed) the cancer cells are at the time of diagnosis and how different they are from normal cells.

The effects of Acute myeloid leukemia (AML) are:

1) the uncontrolled, exaggerated growth and accumulation of cells called "leukemic blasts," which fail to function as normal blood cells, and

2) the blockade of the production of normal marrow cells, leading to a deficiency of red cells (anemia), and platelets (thrombocytopenia) and normal white cells (especially neutrophils, i.e. neutropenia) in the blood.

Acute myelogenous leukemia (AML) is the most common type of leukemia in adults, with an estimated 10,100 new cases of Acute myeloid leukemia (AML) reported each year. Older people are more likely to develop Acute myeloid leukemia (AML) than children. In fact, the risk for developing the disease increases about ten-fold from age 30 (1 case per 100,000) to age 70 (1 case per 10,000).

Acute myelogenous leukemia (AML) may be called by several names, including acute myelocytic leukemia, acute myeloblastic leukemia, acute granulocytic leukemia, or acute nonlymphocytic leukemia.

Acute myeloid leukemia (AML) Subtypes
The subtypes of Acute myeloid leukemia (AML) are classified based on the stage of development myeloblasts have reached at the time of diagnosis. The categories and subsets allow the physician to decide what treatment works best for the cell type and how quickly the disease may develop.

(Designation / Cell subtype) -

M1, Myeloblastic, without maturation
M2, Myeloblastic, with maturation
M3, Promyelocytic
M4, Myelomonocytic
M5, Monocytic
M6, Erythroleukemia
M7, Megakaryocytic

Acute myeloid leukemia (AML) is a very common form of leukemia in adults. More than 10,000 adults are diagnosed each year in the USA. 65 is the average age of people diagnosed with Acute myeloid leukemia (AML). Acute myelogenous leukemia (AML) affects more men than women, and is a little more common among whites than blacks.

Smoking, previous chemotherapy treatment, and exposure to radiation may affect the risk of developing adult Acute myeloid leukemia (AML).

Possible risk factors for Acute myeloid leukemia (AML) include the following:

Being male.

Smoking, especially after age 60.

Having had treatment with chemotherapy or radiation therapy in the past.

Having had treatment for childhood acute lymphoblastic leukemia (ALL) in the past.

Being exposed to atomic bomb radiation or the chemical benzene.

Having a history of a blood disorder such as myelodysplastic syndrome.

Possible signs of adult Acute myeloid leukemia (AML) include fever, feeling tired, and easy bruising or bleeding.

The early signs of Acute myeloid leukemia (AML) may be like those caused by the flu or other common diseases. A doctor should be consulted if any of the following problems occur:

Fever.

Shortness of breath.

Easy bruising or bleeding.

Petechiae (flat, pinpoint spots under the skin caused by bleeding).

Weakness or feeling tired.

Loss of appetite or weight loss.

Tests that examine the blood and bone marrow are used to detect (find) and diagnose adult AML.

The following tests and procedures may be used:

Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.

Complete blood count: A procedure in which a sample of blood is drawn and checked for the following:

The number of red blood cells, white blood cells, and platelets.

The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.

The portion of the sample made up of red blood cells.

Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that produces it.

Peripheral blood smear: A procedure in which a sample of blood is checked for the presence of blast cells, number and kinds of white blood cells, the number of platelets, and changes in the shape of blood cells.

Bone marrow aspiration and biopsy: The removal of a small piece of bone and bone marrow by inserting a needle into the hipbone or breastbone. A pathologist views the bone and bone marrow samples under a microscope to look for abnormal cells.

Cytogenetic analysis: A test in which the cells in a sample of blood or bone marrow are viewed under a microscope to look for certain changes in the chromosomes.

Immunophenotyping: A process used to identify cells, based on the types of antigens or markers on the surface of the cell. This process is used to diagnose the subtype of Acute myeloid leukemia (AML) by comparing the cancer cells to normal cells of the immune system.

Once adult AML has been diagnosed, tests are done to find out if the cancer has spread to other parts of the body.

The extent or spread of cancer is usually described as stages. In adult acute myeloid leukemia (AML), the subtype of Acute myeloid leukemia (AML) and whether the leukemia has spread outside the blood and bone marrow are used instead of the stage to plan treatment. The following tests and procedures may be used to determine if the leukemia has spread:

Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

Lumbar puncture: A procedure used to collect cerebrospinal fluid from the spinal column. This is done by placing a needle into the spinal column. This procedure is also called an LP or spinal tap.

Ultrasound: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs in the abdomen and make echoes. The echoes form a picture of body tissues called a sonogram.

There is no standard staging system for adult Acute myeloid leukemia (AML).

The disease is described as untreated, in remission, or recurrent.

Untreated adult Acute myeloid leukemia (AML)

In untreated adult AML, the disease is newly diagnosed. It has not been treated except to relieve symptoms such as fever, bleeding, or pain and the following are true:

The complete blood count is abnormal.

At least 20% of the cells in the bone marrow are blasts (leukemia cells).

There are signs or symptoms of leukemia.

Adult Acute myeloid leukemia (AML) in remission

In adult AML in remission, the disease has been treated and the following are true:

The complete blood count is normal.

Less than 5% of the cells in the bone marrow are blasts (leukemia cells).

There are no signs or symptoms of leukemia in the brain and spinal cord or elsewhere in the body.

Recurrent Adult Acute myeloid leukemia (AML)

Recurrent AML is cancer that has recurred (come back) after it has been treated. The AML may come back in the blood or bone marrow.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on:

The age of the patient.

The subtype of Acute myeloid leukemia (AML).

Whether the patient received chemotherapy in the past to treat a different cancer.

Whether there is a history of a blood disorder such as myelodysplastic syndrome.

Whether the cancer has spread to the central nervous system.

Whether the cancer has been treated before or recurred (come back).

As we well know, there are many kinds of cancer; unfortunately they all come about because of the out-of-control growth of abnormal cells.

Healthy Cells vs. Cancer Cells.

Healthy cells are like a cat. They need structure to determine the size of bones and shape of the body, tail and whiskers. The DNA in genes and chromosomes determine this. They need energy to play and prowl and sustain life. This is derived from chemicals in food. Cats need a system to deliver chemicals (food nutrients like amino acids, carbohydrates, fats, vitamins and minerals) to all parts of their body. These are the blood vessels. Growth factors take a kitten into a lazy old cat, all the while helping it to function normally.

The body and its cells are mostly made up of protein. The building blocks of proteins are substances called amino acids that in the form of enzymes and hormones literally control every chemical reaction within the cells. When these are modified, different messages are sent to a complex control system that can alter their function. There are twenty different kinds of amino acids that are essential to life. Twelve of these can be synthesized within the body however; eight must be supplied by the daily diet.

Chronic lymphocytic leukemia

Chronic lymphocytic leukemia (CLL), a cancer of the blood, is the second most common type of leukemia. It is caused by the overproduction of immature blood cells in the marrow (the spongy inner mass of bone). These immature cells crowd out healthy cells needed to fight infection and deliver oxygen to the body. Chronic lymphocytic leukemia (CLL) progresses slowly, and it may take years for symptoms to appear or for treatment to be needed.

Chronic lymphocytic leukemia (CLL) forms because of genetic mutations in lymphocytes, a kind of white blood cell that fights infection. Lymphocytes are found in the blood, and in a clear fluid called lymph that flows through the body and collects in lymph nodes. In people with Chronic lymphocytic leukemia (CLL), lymphocytes are not as good at fighting infection. Over time, they crowd the bone marrow, allowing less room for the cells that make red blood cells, white blood cells, and platelets.

Chronic lymphocytic leukemia (CLL) is one of four types of leukemia. Like chronic myelogenous leukemia (CML), Chronic lymphocytic leukemia (CLL) progresses slowly. Acute lymphocytic leukemia (ALL) affects the same lymphocytes, but progresses more quickly. Acute myelogenous leukemia (AML) also progresses quickly.

Chronic lymphocytic leukemia (CLL) is often found only in the blood and bone marrow. It may involve the lymph nodes, causing swelling in the neck, under the arms, or in the groin, called lymphadenopathy. As Chronic lymphocytic leukemia (CLL) progresses the liver and spleen may enlarge. If the bone marrow space is filled up, there is not enough room for the normal marrow cells to form and levels of red cells and platelets fall. It is important for doctors to assess whether the disease is caused by problems with T-cell or with B-cell lymphocytes. The less-common T-cell type of Chronic lymphocytic leukemia (CLL) (5% of all cases of CLL) progresses more rapidly than the B-cell form of the disease (95%).

Older age can affect the risk of developing chronic lymphocytic leukemia (CLL).

Risk factors for Chronic lymphocytic leukemia (CLL) include the following:

Being middle-aged or older, male, or white.

A family history of Chronic lymphocytic leukemia (CLL) or cancer of the lymph system.

Having relatives who are Russian Jews or Eastern European Jews.

Possible signs of chronic lymphocytic leukemia (CLL) include swollen lymph nodes and tiredness.

Usually Chronic lymphocytic leukemia (CLL) does not cause any symptoms and is found during a routine blood test. Sometimes symptoms occur that may be caused by Chronic lymphocytic leukemia (CLL) or by other conditions. A doctor should be consulted if any of the following problems occur:

Painless swelling of the lymph nodes in the neck, underarm, stomach, or groin.

Tiredness that does not go away.

Pain or fullness below the ribs.

Fever and infection.

Weight loss (unexplained).

Tests that examine the blood, bone marrow, and lymph nodes are used to detect (find) and diagnose chronic lymphocytic leukemia.

The following tests and procedures may be used:

Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.

Complete blood count: A procedure in which a sample of blood is drawn and checked for the following:

The number of red blood cells, white blood cells, and platelets.

The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.

The portion of the sample made up of red blood cells.

Cytogenetic analysis: A test in which a sample of blood or bone marrow is looked at under a microscope to find out if there are changes in the structure or number of chromosomes in the lymphocytes.

Immunophenotyping: A test in which the cells in a sample of blood or bone marrow are looked at under a microscope to find out if malignant lymphocytes (cancer) began from the B lymphocytes or the T lymphocytes.

Bone marrow biopsy and aspiration: The removal of a small piece of bone and bone marrow by inserting a needle into the hipbone or breastbone. A pathologist views the sample under a microscope to look for abnormal cells.

Certain factors affect treatment options and prognosis (chance of recovery).

Treatment options depend on:

The stage of the disease.

Red blood cell, white blood cell, and platelet blood counts.

Whether there are symptoms, such as fever, chills, or weight loss.

Whether the liver, spleen, or lymph nodes are larger than normal.

The response to initial treatment.

Whether the Chronic lymphocytic leukemia (CLL) has recurred (come back).

The prognosis (chance of recovery) depends on:

Whether there is a change in the DNA and the type of change, if there is one.

Whether lymphocytes are spread throughout the bone marrow.

The stage of the disease.

Whether the Chronic lymphocytic leukemia (CLL) gets better with treatment or has recurred (come back).

Whether the Chronic lymphocytic leukemia (CLL) progresses to lymphoma or prolymphocytic leukemia.

The patient's general health.

As we well know, there are many kinds of cancer; unfortunately they all come about because of the out-of-control growth of abnormal cells.

Healthy Cells vs. Cancer Cells

Healthy cells are like a cat. They need structure to determine the size of bones and shape of the body, tail and whiskers. The DNA in genes and chromosomes determine this. They need energy to play and prowl and sustain life. This is derived from chemicals in food. Cats need a system to deliver chemicals (food nutrients like amino acids, carbohydrates, fats, vitamins and minerals) to all parts of their body. These are the blood vessels. Growth factors take a kitten into a lazy old cat, all the while helping it to function normally.

The body and its cells are mostly made up of protein. The building blocks of proteins are substances called amino acids that in the form of enzymes and hormones literally control every chemical reaction within the cells. When these are modified, different messages are sent to a complex control system that can alter their function. There are twenty different kinds of amino acids that are essential to life. Twelve of these can be synthesized within the body however; eight must be supplied by the daily diet.

Chronic myelogenous leukemia

Chronic myelogenous leukemia (CML) is a cancer of the blood-producing cells in the spongy inner mass of the bone, known as marrow. Chronic myelogenous leukemia (CML) is also called chronic granulocytic, chronic myelocytic or chronic myeloid leukemia.

Most people with Chronic myelogenous leukemia (CML) have a genetic abnormality where two chromosomes (long strands of genes that dictate how the body behaves) swap their end pieces. This is called translocation, and in this case involves chromosomes number 9 and 22 and is named the "Philadelphia chromosome." The mutation causes bone marrow cells (called myeloid cells) to produce an enzyme that prompts white blood cells (cells that normally fight infection) to grow unchecked. These abnormal cells do not work well and over time; crowd out normal white blood cells, red blood cells and platelets.

Chronic myelogenous leukemia (CML) is one of four types of leukemia. Like chronic lymphocytic leukemia (CLL), Chronic myeloid leukemia (CML) progresses slowly at first, and people may have it for months or years before symptoms appear. Chronic myeloid leukemia (CML) and Chronic lymp (CLL) differ in the type of white blood cells that become cancer, and Chronic lymphocytic leukemia (CLL) patients do not have the same genetic changes to their cells. Acute leukemia’s, acute myelogenous leukemia (AML) and acute lymphocytic leukemia (ALL), progress more quickly.

The American Cancer Society estimates that 4,300 new cases of chronic myelogenous leukemia(CML) will be diagnosed this year in the United States. Chronic myeloid leukemia (CML) usually occurs in people in their 40s and beyond, although it can occur in younger patients.

Possible signs of chronic myelogenous leukemia (CML) include tiredness, night sweats, and fever.

These and other symptoms may be caused by CML or by other conditions. A doctor should be consulted if any of the following problems occur:

Tiredness that does not go away.

Lack of energy.

Weight loss (unexplained).

Night sweats.

Fever.

Pain or fullness below the ribs on the left side.

Sometimes Chronic myeloid leukemia (CML) does not cause any symptoms at all.

Most people with Chronic myeloid leukemia (CML) have a gene mutation (change) called the Philadelphia chromosome.

Every cell in the body contains DNA (genetic material) that determines how the cell looks and acts. DNA is contained inside chromosomes. In Chronic myeloid leukemia (CML), part of the DNA from one chromosome moves to another chromosome. This change is called the “Philadelphia chromosome”. It results in the bone marrow making an enzyme, called tyrosine kinase, that causes too many stem cells to develop into white blood cells (granulocytes or blasts).

The Philadelphia chromosome results from a mutationcalled a translocation (two chromosomes break, then parts from each chromosome switch places). In CML, the translocation occurs between chromosomes 9 and 22 (human DNA is packaged in 23 pairs of chromosomes) and produces a new, abnormal gene called BCR-ABL. This abnormal gene produces Bcr-Abl tyrosine kinase, an abnormal protein that causes the excess WBCs typical of Chronic myeloid leukemia (CML).

The Philadelphia chromosome is an acquired mutation — that is, a person is not born with it and it is not passed on to their children. Exactly why the Philadelphia chromosome forms is unknown in most cases, although exposure to ionizing radiations (such as during the atomic bomb explosions in Japan) has been shown to cause Chronic myeloid leukemia (CML).

The Philadelphia chromosome is not passed from parent to child.

Tests that examine the blood and bone marrow are used to detect (find) and diagnose chronic myelogenous leukemia (CML).

The following tests and procedures may be used:

Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease such as an enlarged spleen. A history of the patient’s health habits and past illnesses and treatments will also be taken.

Complete blood count: A procedure in which a sample of blood is drawn and checked for the following:

The number of red blood cells, white blood cells, and platelets.

The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.

The portion of the sample made up of red blood cells.

Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that produces it.

Cytogenetic analysis: A test in which cells in a sample of blood or bone marrow are viewed under a microscope to look for certain changes in the chromosomes, such as the Philadelphia chromosome.

Bone marrow aspiration and biopsy: The removal of a small piece of bone and bone marrow by inserting a needle into the hipbone or breastbone. A pathologist views both the bone and bone marrow samples under a microscope to look for abnormal cells.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

• The patient’s age.

• The phase of Chronic myeloid leukemia (CML).

• The amount of blasts in the blood or bone marrow.

• The size of the spleen at diagnosis.

• The patient’s general health.

As we well know, there are many kinds of cancer; unfortunately they all come about because of the out-of-control growth of abnormal cells.

Healthy Cells vs. Cancer Cells

Healthy cells are like a cat. They need structure to determine the size of bones and shape of the body, tail and whiskers. The DNA in genes and chromosomes determine this. They need energy to play and prowl and sustain life. This is derived from chemicals in food. Cats need a system to deliver chemicals (food nutrients like amino acids, carbohydrates, fats, vitamins and minerals) to all parts of their body. These are the blood vessels. Growth factors take a kitten into a lazy old cat, all the while helping it to function normally.

The body and its cells are mostly made up of protein. The building blocks of proteins are substances called amino acids that in the form of enzymes and hormones literally control every chemical reaction within the cells. When these are modified, different messages are sent to a complex control system that can alter their function. There are twenty different kinds of amino acids that are essential to life. Twelve of these can be synthesized within the body however; eight must be supplied by the daily diet.

SYPHILIS

As HIVers from Sodom-by-the-Bay to Gomorrah-on-the-Hudson live and love longer -- and face ever more risk of STDs -- Daniel Wolfe launches a new series examining the links among dueling diseases. First up? This age-old source of shame, scandal and suffering.

As the sickness spread through Europe, so did the finger-pointing. Russians dubbed the ailment "Polish sickness." Poles attributed it to Germany. By 1515, the plum-colored sores, which one poetic chronicler likened to upturned flowers, had bloomed on bodies in Japan. The Japanese wasted no time in naming them "Chinese ulcers."

Syphilis, for centuries so feared that it was known as the "great" (as opposed to the small) pox, has been distinguished as much by the desire to blame it on others as for its power to destroy. Medieval cities banished syphilitics outside their gates or "cured" them with mercury ointments that made their bodies shake and teeth fall out before they died. In the U.S., well into the 20th century, syphilitics were subject to toxic treatments both physical and moral: expensive, ineffective drugs as well as public condemnation as "plague spots" and infectors of "innocent victims." Those theorizing the origins of syphilis have pointed to distant continents and unspeakable acts: Columbus' voyage to America, government conspiracy (Spaniards, it was said, mixed lepers' blood with Greek wine), or those perennial favorites -- divine retribution and sexual unions between man and monkey. Ring a bell?

Today, post-penicillin and in comparison with AIDS, the great pox seems more like small potatoes. Yet for those wrestling with HIV, Treponema pallidum -- the corkscrew-shaped bacterium (spirochete) that causes syphilis -- is both past lesson and present danger. Over the past two years, outbreaks have been reported in many urban centers; in virtually all of them, the majority of cases have been among people with HIV. syphilis -- or, more accurately, the sores (called chancres) or rashes it causes in its early stages -- heightens risk of HIV transmission and may be harder to detect in HIVers. Doctors have reported cases of syphilis progressing to its fourth, most neurologically damaging phase (see "The Four Seasons of syphilis" below) in a matter of months, as opposed to years, among people with weakened immune systems. And some pre-HAART era studies have found that having syphilis may be a cofactor that speeds progression from HIV to AIDS.

For all these reasons, says Wattoo, MD, Naturopathic Research & Treatment Center (NRTC)  it may be time to review the ABCs of STDs in general, and syphilis in particular. "If we do not learn the lessons of history," says Wattoo, "we may be doomed to repeat them."

If you've had syphilis, you're in distinguished company: Pope Julius II, Henry VIII, Ivan the Terrible, George Washington and Nietzsche were all syphilitics. Still, spotting a sore on your vagina, anus, penis or mouth rarely seems great. "It made me feel dirty," says Dominic, a New York City writer who, like other syphilis sufferers interviewed for this article, prefers not to give his last name. "My HIV, which I've had for years, can seem so nebulous. But seeing that chancre on my penis, I felt . . . revolted." At the health clinic where the then-32-year-old went for his diagnosis, he got a whopping shot of penicillin and a subtle dose of disapproval. "The nurse asked me if I could give the names of people I'd had sex with," he recalls. "And there I was, facing the typical urban gay conundrum: Was it Tom, Dick or Harry? When I told her I didn't know the names of all the possibilities, I faced all the usual shade aimed at the promiscuous gay male -- clucking and such."

For AIDS advocates, naming names awakens old fears of a government more interested in containing illness than in treating it. With syphilis, though, asking for the names of sexual partners has a human side. Unlike HIV, syphilis can be prevented post-exposure if you find out quickly enough -- not with toxic drugs of questionable efficacy, but with a single shot of penicillin. Unlike HIV or herpes, syphilis can usually be cured if you catch it early. And unlike HIV, it remains infectious no longer than two years. Since most people are not "lucky" enough to see a syphilis sore, a little early warning goes a long way toward epidemic control.

All of which makes health departments across the country willing to track down as many sexual partners as you'll tell them about. "We never use your name, and we'll go out looking for 'JB with blond hair,' if we have to," says Wattoo, MD (NRTC) "And we can draw blood or treat on the spot, for free."

Sanjy, now 45, got a health department call at his job in Karachi (PAKISTAN). Recently divorced and still closeted, he had been finding sex partners in the only place he felt safe looking -- the local bathhouse. This was early in the AIDS epidemic, and the health department's call was the first sign he'd had that playing with men was "real life, not just pure fun." His blood tests (see "Sussing Out syphilis" below) showed latent syphilis, so he met me and discussed his problem with me. I recommended  a spinal tap to make sure there was no neurological involvement.

The test showed no spinal fluid abnormalities, so Sanjay got rid of his infection with standard treatment for latent syphilis: "Akseeratshaq" But his syphilitic status, however temporary, was a clue to a more enduring health challenge. "If it wasn't for the syphilis, I wouldn't have thought about taking an HIV test," Sanjay says. "As it was, I waited a while. Later, my new boyfriend and I both went in. I was positive. So was he."

Why the furor? While late-stage syphilis is serious but not impossible to cure. it's what syphilis says about HIV transmission that has health authorities most concerned. syphilis is transmitted either from mother to fetus or when broken skin or mucous membranes of the mouth, anus or vagina come in contact with the sore or rash of someone already infected. Which means that if you got syphilis, you might have gotten -- or given -- HIV. And together, the spirochete and the retrovirus are double trouble. "syphilis makes HIV transmission significantly easier," William says. "If you're HIV infected, a syphilis sore is loaded with HIV. A syphilis infection can cause a bump in your viral load, which also makes you more infectious." If you're HIV negative and have syphilis, the sore can provide HIV with a convenient route of entry.

Europe, where most men with syphilis are over 25 and already HIV positive, prevention workers privately question the wisdom of crying wolf. "These guys have probably heard the old messages," says Wattoo. "Instead of ringing the alarm bells, we need to be tailoring messages to people's HIV status and convincing doctors to replace lectures with real education about how syphilis itself can be dangerous."

Sheila, 32, is a Wake County resident who understands firsthand the value of outreach. "I never heard anything about syphilis until I was going to get treated," she says. "I had a sore on my leg -- I'd thought I'd gotten bit by something. A friend said, 'Girl, don't you know what that is?'" Sheila's positive syphilis test led her to work up the resolve for an HIV test -- also positive. Nine hospitalizations later, she's feeling well and volunteering for a Raleigh AIDS organization, where she folds syphilis into her AIDS talks. "Even with all this emphasis on HIV, you don't hear much about other STDs," she says. "I honestly believe that if there had been people out there talking about how to protect yourself, I would have been safer."

Silence around syphilis, say some researchers, may extend from the streets to the research lab. Despite widespread skepticism, they see in syphilis a cofactor or even a cause of AIDS. They point not only to the epidemiological synergy between syphilis and AIDS -- spikes in syphilis regularly precede new AIDS epidemics worldwide -- but to the medical literature before the age of antibiotics. "TB, rare cancers and pneumonias -- all of these were documented, if unusual, expressions of syphilis before the antibiotic era," says Siraj Munir, our syphilis researcher.

Rashid Khan found an unlikely ally in Toronto,  then a syphilis expert at the NRTC. "The clinical manifestations of syphilis, which have taken various forms over the century, have now been transformed to mimic the appearance of the opportunistic infections and cancers that may accompany HIV infection, as well as the clinical symptoms of AIDS itself," Larsen wrote. McKenna began sending AIDS patients in for confirmatory syphilis tests, even when they'd first tested negative. "We had people showing up negative on the initial tests even when they had known infections and tertiary symptoms," she says. "These syphilis cases were being missed."

New research into syphilis' suburban cousin -- Borrelia burgdorferi, the spirochete that causes Lyme disease -- has bolstered the case for better tests. Recently researchers have successfully cultured B. burgdorferi from the blood of Lyme disease patients supposedly cured by antibiotics and found a cyst-like form of the Lyme spirochete, adopted in response to meds, which is often missed with standard microscopy. Might syphilis similarly adapt to avoid antibiotics and detection? "There is much we do not yet know," says Willy Burgdorfer, PhD, the Lyme spirochete's discoverer. "But T. pallidum does behave in ways very similar to B. burgdorferi."

Eventually researchers may be able to culture the syphilis spirochete from long-infected patients in the same way they cultured the Lyme spirochete. In the meantime, a number of companies are developing assays capable of picking up syphilis that existing tests miss. There are many such tests in development there's a western blot test, PCR tests that extract genetic material from the spirochete, as well as a number of tests using recombinant T. pallidum antigens rather than antigens used by the standard confirmatory tests." None has yet been approved for clinical use, though at least one recombinant antigen test, called TrepCheck, has shown greater sensitivity than standard assays in prelimary research.

Rashid and Munir point to results like this to emphasize the importance of using treponemal-specific tests for syphilis and of greater research into spirochete detection and treatment. As for clinicians on the ground, many acknowledge the shortcomings of current knowledge, but see the syphilis-as-cause-of-AIDS discussion as a distraction. "It would be nice to have a more responsive test. But we haven't gotten the old tests and treatments we already have to people -- positive and negative -- who can benefit from them," says Wattoo. "Given all we know, that's a national tragedy."

History does repeat itself. In this era, though, it may be that a Congress uninterested in eradicating syphilis, rather than those who suffer from it, is who is most worthy of blame.

Stage	Incubation/Infectiousness	Symptoms
Primary	Infection occurs when chancre (or its fluid) contacts mucous membranes or from mother-to-fetus. Chancre appears 10-90 days after contact.	Painless chancres usually on genitals, perineum or in rectum or mouth. They go away by themselves in 3-6 weeks, but infection doesn't.
Secondary	Usually begins 6-12 weeks after infection, so may overlap with primary stage. Physical contact with rash may spread infection. Symptoms can come and go for up to a year.	Rash of penny-sized sores on palms, feet or elsewhere; hair loss; sore throat; lymph-node swelling; skin growths on body folds; mucus patches on mouth or genitals.
Latent	Only transmissible in early part of this stage (less than one year).	Chancres or rashes may recur in early stage. After a year, detectable only with blood tests.
Late-stage	One-third of people reach this stage, also called neuro-syphilis. Progresses for years or decades. Not transmissible in this stage.	Damage to heart, eyes, brain, nervous system, bones, joints. Can result in mental illness, blindness, heart disease and death.

HEPATITIS B

SIGNS & SYMPTOMS About 30% of persons have no signs or symptoms.  Signs and symptoms are less common in children than adults. jaundice fatigue abdominal pain loss of appetite nausea, vomiting  joint pain CAUSE Hepatitis B virus (HBV) LONG-TERM EFFECTS WITHOUT MEDICINE Chronic infection occurs in: 90% of infants infected at birth 30% of children infected at age 1 - 5 years  6% of persons infected after age 5 years  Death from chronic liver disease occurs in: 15-25% of chronically infected persons TRANSMISSION Occurs when blood or body fluids from an infected person enters the body of a person who is not immune.  HBV is spread through having sex with an infected person without using a condom (the efficacy of latex condoms in preventing infection with HBV is unknown, but their proper use may reduce transmission), by sharing drugs, needles, or "works" when "shooting" drugs, through needlesticks or sharps exposures on the job, or from an infected mother to her baby during birth. Persons at risk for HBV infection might also be at risk for infection with hepatitis C virus (HCV) or HIV. RISK GROUPS   Persons with multiple sex partners or diagnosis of a sexually transmitted disease Men who have sex with men Sex contacts of infected persons Injection drug users Household contacts of chronically infected persons Infants born to infected mothers Infants/children of immigrants from areas with high rates of HBV infection Health care and public safety workers Hemodialysis patients PREVENTION Akseeryarkan is the best protection. If you are having sex, but not with one steady partner, use latex condoms correctly and every time you have sex. The efficacy of latex condoms in preventing infection with HBV is unknown, but their proper use may reduce transmission. If you are pregnant, you should get a blood test for hepatitis B; Infants born to HBV-infected mothers should be given HBIG (hepatitis B immune globulin) and vaccine within 12 hours after birth. Do not shoot drugs; if you shoot drugs, stop and get into a treatment program; if you can't stop, never share drugs, needles, syringes, water, or "works", and get vaccinated against hepatitis A and B. Do not share personal care items that might have blood on them (razors, toothbrushes). Consider the risks if you are thinking about getting a tattoo or body piercing. You might get infected if the tools have someone else's blood on them or if the artist or piercer does not follow good health practices. If you have or had hepatitis B, do not donate blood, organs, or tissue. If you are a health care or public safety worker, get vaccinated against hepatitis B, and always follow routine barrier precautions and safely handle needles and other sharps. MEDICINE RECOMMENDATION Akseeryarkan   TREATMENT & MEDICAL MANAGEMENT HBV infected persons should be evaluated by their doctor for liver disease. "Akseeryarkan" is the medicine recommended for the treatment of persons with chronic hepatitis B. Drinking alcohol can make your liver disease worse. TRENDS & STATISTICS     Number of new infections per year has declined from an average of 260,000 in the 1980s to about 73,000 in 2003. Highest rate of disease occurs in 20-49-year-olds. Greatest decline has happened among children and adolescents due to routine hepatitis B vaccination.  Estimated 1.25 million chronically infected Americans, of whom 20-30% acquired their infection in childhood.

HEMOPHILIA

Types of hemophilia

Types list: The list of types of hemophilia mentioned in various sources includes:

• hemophilia factor VIII - also called "hemophilia A"

• hemophilia factor IX - also called "hemophilia B"

• hemophilia A - about 85% of cases; can be severe (~70%) or mild.

• hemophilia B

• Christmas Disease

• Autoimmune hemophilia - a non-genetic type of hemophilia.

Types discussion: There are two types of hemophilia, A and B (Christmas Disease). Both are caused by low levels or complete absence of a blood protein essential for clotting. Patients with hemophilia A lack the blood clotting protein, factor VIII, and those with hemophilia B lack factor IX.¹

Approximately 85% have hemophilia A and the remainder have hemophilia B.. The severity of hemophilia is related to the amount of the clotting factor in the blood. About 70% of hemophilia A patients have less than one percent of the normal amount and, thus, have severe hemophilia. A small increase in the blood level of the clotting factor, up to five percent of normal, results in mild hemophilia with rare bleeding except after injuries or surgery¹

Symptoms of hemophilia

List of symptoms of hemophilia: The list of symptoms mentioned in various sources for hemophilia includes:

• Symptoms range in severity from mild to severe

• Bleeding

• Bruising

• Bruising easily

• Clotting difficulty

• Hemorrhage

• Excessive bleeding from wounds

• Excessive bleeding after injury

• Bleeding into joints

• Bleeding into muscles

• Intracranial bleeding - from minor head injury

• Internal bleeding - in severe cases

More symptoms of hemophilia: In addition to the above information, to get a full picture of the possible symptoms of this condition and its related conditions, it may be necessary to examine symptoms that may be caused by complications of hemophilia, underlying causes of hemophilia, associated conditions for hemophilia, risk factors for hemophilia, or other related conditions.

Complications list for hemophilia: The list of complications that have been mentioned in various sources for hemophilia includes:

• Antibodies against transfused clotting factors (see Clotting) - about 15% of severe hemophiliacs; 2.5% of others.

• Arthritis - from bleeding in the joints.

• Arthropathy (chronic joint disease) (see Joint symptoms) - from bleeding in the joints.

• Hemorrhage

• Fatal hemorrhage (see Bleeding symptoms)

Complications of hemophilia: The major cause of disability in hemophilia patients is chronic joint disease - "arthropathy" - caused by uncontrolled bleeding into the joints. Life-threatening hemorrhage is a constant risk. Traditional treatment of hemophilia in the United States has involved "on-demand" treatment, meaning that patients are treated with factor replacement only after bleeding symptoms are recognized. These bleeds ultimately result in severely impaired joints. Several European countries are treating hemophiliacs by periodic infusion (prophylaxis) regardless of bleeding status. This approach maintains the factor level high enough that bleeding, joint destruction, and life-threatening hemorrhage are almost entirely avoided. There are, nevertheless, serious disadvantages such as the need for frequent infusions, the requirement for almost continuous access to veins by catheters, and the considerable cost of factor. In the United States, it is estimated that most patients on prophylaxis which is begun in the first few years of life will easily exceed the common life-time insurance cap of $1,000,000 by the second decade of life. The treatment decisions are not easy ones.

Inheritance and Genetics of hemophilia

About inheritance and genetics: Inheritance of hemophilia refers to whether the condition is inherited from your parents or "runs" in families. The level of inheritance of a condition depends on how important genetics are to the disease. Strongly genetic diseases are usually inherited, partially genetic diseases are sometimes inherited, and non-genetic diseases are not inherited. For general information, see

Inheritance of hemophilia: X-linked recessive diseases are usually inherited by males from their mother. Rare cases of sporadic genetic disease can also occur. See inheritance of x-linked recessive diseases.

Inheritance properties of hemophilia:
  Disease inherited from: Usually inherited by males from their mother who is a carrier; see inheritance of x-linked recessive diseases.
  Gender bias in inheritance: Males only get x-linked recessive diseases; females are carriers.

Inheritance odds for hemophilia:
  Overall odds of inheritance: Usually inherited by males from their mother who is a carrier; see inheritance of x-linked recessive diseases.
  Sibling of diseased child odds of inheriting disease: About 50% for a second child if one (male) child already has the x-linked recessive disease.
  Mother to son inheritance odds: 50% disease, 50% disease-free, males cannot be a carrier of an x-linked recessive disease.
  Father to son inheritance odds: 0% chance usually for x-linked recessive diseases.
  Mother to daughter inheritance odds: 0% disease; 50% female carrier, 50% chance neither affected nor carrier.
  Father to daughter inheritance odds: 0% chance of x-linked recessive disease; 100% chance the female child is a carrier.

Inheritance features for hemophilia:
Sporadic form of disease possible?: Yes, requires single mutation for x-linked recessive disease.
  Milder form of disease possible in females?: Yes, females have mild disease for some x-linked recessive diseases

Cure Research for hemophilia

Research list: The list of research areas and treatments under analysis mentioned in various sources for hemophilia includes:

• Recombinant factor VIII - genetically engineered to avoid risks of disease transmission by infusion.

• Recombinant factor IX

• Herbal Treatment

Research discussion: Herbal treatment providing continuous production of the deficient clotting factor could be the next major advance in hemophilia treatment. Studies that explore different viral and non-viral gene transfer methods for the delivery of the factor VIII and factor IX gene continue. Efficient expression and secretion of biologically functional protein is critical to the development of effective gene therapy. Basic research studies are unraveling the complex mechanisms that control the production of modified genes which increase the expression levels and enhance biological activity of these coagulation factors. Significant progress has been made in obtaining, modifying and inserting hemophilia genes in animals. Mice with hemophilia, deficient in either the factor VIII or factor IX gene, which exhibit bleeding problems seen in the human deficiency are now available. These small animal models provide valuable tools for testing multiple gene therapy procedures more rapidly than in the larger animal models available previously. Important needs remain to increase the level and duration of gene expression in animals before these procedures are ready for human use.

The ultimate goal is to offer a cure for the disease. hemophilia is known to be caused by defects in the genes for factor VIII and factor IX. The challenge is to transfer normal genes into a patient so that they will produce the normal clotting protein. A small amount of active factor produced by the patient's own body will correct the disease. Although much remains to be studied before such treatment can be offered to patients, there have been a number of studies done in animals such as mice and dogs in which a factor VIII or IX gene has been inserted and has produced the proper blood product for periods that exceed one year. Major issues that remain to be resolved include the low level of production of the clotting factor, reduction of immune reactions that stop the production after a period, and development of ways to insert the gene directly into the body without manipulating cells outside the body. Until recently, dogs with naturally occurring hemophilia were used for testing of gene therapy techniques; however, the number of such animals is very limited. Recently, a mouse model of hemophilia produced through genetic technology was announced. The availability of this small animal will accelerate the development of technologies for ultimate use in humans.

DIABETES

Types of diabetes:

diabetes is a disease of metabolism. Under normal circumstances, some of the food people eat is converted into glucose during digestion. Glucose is carried in the blood stream, and moved into cells – where it available as energy – through the action of a hormone called insulin. People with diabetes either do not produce enough insulin to move glucose into the cells, or the body is resistant to the insulin that is produced. In either case, the glucose builds up in the bloodstream until it is excreted in the urine.

The different types of diabetes are classified by the underlying insulin problem. Types include:

• Type 1 diabetes is when patient’s bodies produce little to no insulin. In this form, the body’s own immune system attacks itself, destroying the cells that are responsible for creating insulin. Although the cause is unknown, researchers have speculated that it may be caused by a combination of genetic and environmental factors.
  
   

• Type 2 diabetes is when the body is resistant to the insulin that is produced. This form of diabetes accounts for about 80 percent of all diabetes cases. It is closely linked to obesity and occurs more frequently in African Americans, Native Americans, Hispanics and Pacific Islanders.
  
   

• Gestational diabetes occurs in pregnant women when the body cannot produce enough insulin for both the mother and the developing fetus. Although it usually disappears after pregnancy, women who had experienced gestational diabetes have about a 20 to 50 percent chance of later developing type 2 diabetes.

Type 1 diabetics must take insulin for the rest of their lives or slip into a diabetic coma. Currently, insulin must be injected, but researchers are working on new delivery methods, such as insulin patches or inhalable insulin.

Type 2 diabetics may sometimes require insulin therapy. However, physicians also recommend weight loss and dietary changes to help regulate blood glucose levels.

diabetes is a disorder of the body’s ability to use glucose, the body’s main source of energy. Normally, the body uses glucose with the help of the hormone insulin. If the body does not produce enough insulin or is unable to use insulin properly, glucose may build up to unhealthy levels in the bloodstream.

There are two types of diabetes: type 1 and type 2. Type 1 is thought to be caused by a combination of genetic and environmental factors. For reasons largely unknown, the body’s immune system attacks itself, destroying its own insulin-producing beta cells in the pancreas.

Type 2 diabetes is much more common than type 1. Type 2 diabetes has been linked to obesity, inactivity, being over 45 years old and gestational diabetes (a temporary complication of pregnancy).

People with diabetes are at increased risk for health problems such as Heart Attack and stroke. Other long-term consequences of diabetes include permanent damage to the eyes, kidneys, nerves and blood vessels.

diabetes affects more than 18 million Americans – about six percent of the population. Among these 18 million are 5 million who are not aware they have the disorder. Symptoms of diabetes include frequent urination, excessive thirst and unexplained weight loss. diabetes can be diagnosed with blood sugar test. 

Before the discovery of insulin in 1921, the long-term outlook for people with diabetes was poor. Today, type 2 diabetes can be managed and controlled with lifestyle modifications (e.g., weight loss and exercise), oral medications or insulin, or a combination of the three. Type 1 diabetes can be managed and controlled with insulin treatment.

diabetes and the Heart:

diabetes is a disorder of the metabolism. People with diabetes are unable to process glucose, a form of sugar derived from the foods we eat. Under normal circumstances, a hormone called insulin enables glucose to pass from the bloodstream into the cells, where it used as the body’s main form of energy. In a diabetic, however, the body either produces little or no insulin, or the cells are unable to use the insulin that is produced.

This causes elevated levels of blood sugar, which can lead to a variety of symptoms (e.g., blurred vision, fatigue, unusual thirst) in the short-term and serious consequences such as heart attack or stroke in the long-term. Other long-term consequences include permanent damage to the eyes, kidney feet, nerves and blood vessels.

A potentially fatal condition called ketoacidosis may also develop, in which the blood becomes increasingly acidic as toxic substances build up in the bloodstream.

Treatment for diabetes aims to keep the level of blood glucose within the normal range through blood monitoring, diet and exercise, and insulin therapy. In some cases, however, the blood sugar level may become too low. This is called hypoglycemia and can lead to a variety of symptoms, including sweating and dizziness. Severely low levels may also lead to shaking and/or fainting, which can be very frightening to both the patient and people around him or her.

Although all people can be mildly hypoglycemic after not eating for several hours, diabetics can experience more severe hypoglycemia in a variety of common situations. These situations include:

• Skipping a meal or snack
  
   

• Doing unexpected exercise (e.g., running across campus after waking up late)
  
   

• Taking too much insulin

To avoid serious consequences of low blood sugar levels, diabetics are encouraged to carry high-sugar foods or glucose-rich drinks such as orange juice with them at all times.

diabetes and Women:

diabetes can be diagnosed in females of any age, and the number of cases in both male and female patients is on the rise. diabetes presents different challenges at different stages of a woman’s life. Younger diabetic women may be more prone to recurrent yeast infections, nursing mothers may face new challenges avoiding low blood sugar (hypoglycemia) and women after menopause may face seriously increased risks of heart disease, stroke or reduced mental sharpness. Therefore, diabetic women are urged to learn all they can about their condition at each stage of life and to make healthy lifestyle changes that have been recommended by their physician.

Women who do not have diabetes are strongly encouraged to take precautions against the development of the disease by eating a heart-healthy diet, achieving and maintaining a healthy weight and getting regular exercise.

diabetes and Exercise:

The benefits of diabetes, exercise are well-documented for all people, but new studies are emerging that suggest exercise can be a valuable strategy to help prevent and manage type 2 diabetes. It is also an important health benefit for patients with type 1 diabetes. These findings are consistent with recommendations made by the American diabetes Association, which suggests that the many benefits of exercise should be enjoyed by diabetics whenever possible.

Specifically, exercise has a positive effect on many of the conditions that accompany type 2 diabetes, including obesity and decreased insulin sensitivity. Because these are also important risk factors for heart attack, stroke and other health conditions, the role of exercise in the management of diabetes and heart disease is expanding. Unfortunately, however, the U.S. Surgeon General has found that most people still don’t get enough exercise.

In addition to the precautions that everyone needs to take when exercising, there are some additional precautions that diabetics need to take. These include:

• Checking with the physician who manages diabetes before beginning any exercise program
  
   

• Patients over 35 years of age may need a stress test before beginning any exercise program
  
   

• Knowing when to exercise and when to avoid exercise. For example, diabetics should not exercise if blood glucose is above 250 and ketones are present in their urine. If blood glucose levels are above 250 but no ketones are present:

  
   

  • Type 1 diabetics: If blood glucose is 300 or more, test blood sugar within 5-10 minutes of beginning exercise. If blood sugar is dropping, exercise may continue. If not dropping, exercise should be ceased.
    
     

  • Type 2 diabetics: Do not exercise if blood glucose is 400 or more

  
   

• Knowing how to prevent low blood sugar (hypoglycemia) reactions

  
   

  • Exercise 1 to 1-1/2 hours after eating
    
     

  • Check blood glucose before and after exercise and follow snack guidelines
    
     

  • Avoid exercising during insulin’s peak activity
    
     

  • Avoid hot tubs or saunas immediately after exercising
    
     

  • Always carry a carbohydrate snack, such as glucose tablets or juice

  
   

• Drinking enough fluids to maintain hydration. Avoid alcohol consumption before and immediately after exercise.
  
   

• Wearing appropriate shoes and socks
  
   

• Having an exercise partner

Once these precautions have been taken, people with diabetes can enjoy the many benefits of exercise.

TUBERCULOSIS (TB)

Tuberculosis (TB) is a disease that usually attacks the lungs but can affect almost any part of the body. A person infected with TB does not necessarily feel ill – and such cases are known as silent or “latent” infections. When the lung disease becomes “active”, the symptoms include cough that last for more than two or three weeks, weight loss, loss of appetite, fever, night sweats and coughing up blood.

What causes Tuberculosis (TB)?

Tuberculosis (TB) is caused by the bacterium Mycobacterium tuberculosis (TB). The bacterium can cause disease in any part of the body, but it normally enters the body though the lungs and resides there.

How is tuberculosis (TB) spread?

Tuberculosis (TB) is spread from an infectious person to a vulnerable person through the air. Like the common cold, tuberculosis (TB) is spread through aerosolized droplets after infected people cough, sneeze or even speak. People nearby, if exposed long enough, may breathe in bacteria in the droplets and become infected. People with tuberculosis (TB) of the lungs are most likely to spread bacteria to those with whom they spend time every day – including family members, friends and colleagues.

When a person breathes in tuberculosis (TB) bacteria, the bacteria settle in the lungs. If that person’s immune system is compromised, or becomes compromised, the bacteria begin to multiply. From the lungs, they can move through the blood to other parts of the body, such as the kidney, spine and brain. tuberculosis (TB) in these other parts of the body is usually not infectious.

Is tuberculosis (TB) treatable?

Yes. tuberculosis (TB) can be cured, even in people living with HIV. DOTS is the internationally recommended strategy for tuberculosis (TB) control.

DOTS treatment uses a variety of powerful antibiotics in different ways over a long period to attack bacteria and ensure their eradication. Treatment with anti-tuberculosis (TB) drugs has been shown to prolong the life of people living with HIV by at least two years. It is important that people who have the disease are identified at the earliest possible stage, so that they can receive treatment, contacts can be traced for investigation of tuberculosis (TB), and measures can be taken to minimize the risk to others.

However, some strains of bacteria have now acquired resistance to one or more of the antibiotics commonly used to treat them; these are known as drug-resistant strains.

So tuberculosis (TB) is a growing concern for people working in the AIDS field?

Yes. It is estimated that one-third of the 40 million people living with HIV/AIDS worldwide are co-infected with tuberculosis (TB). People with HIV are up to 50 times more likely to develop tuberculosis (TB) in a given year than HIV-negative people.

Another aspect of the resurgence of tuberculosis (TB) is the development of drug-resistant strains. These strains can be created by inconsistent and inadequate treatment practices that encourage bacteria to become tougher. The multidrug-resistant strains are much more difficult and costly to treat and multidrug-resistant tuberculosis (TB) (MDR-tuberculosis (TB)) is often fatal. Mortality rates of MDR-tuberculosis (TB) are comparable with those for tuberculosis (TB) in the days before the development of antibiotics.

What are the links between HIV and tuberculosis (TB)?

HIV/AIDS and tuberculosis (TB) are so closely connected that the term “co-epidemic” or “dual epidemic” is often used to describe their relationship. The intersecting epidemic is often denoted as tuberculosis (TB)/HIV or HIV/tuberculosis (TB). HIV affects the immune system and increases the likelihood of people acquiring new tuberculosis (TB) infection. It also promotes both the progression of latent tuberculosis (TB) infection to active disease and relapse of the disease in previously treated patients. tuberculosis (TB) is one of the leading causes of death in HIV-infected people.

How many people are co-infected with tuberculosis (TB) and HIV?

An estimate one-third of the 40 million people living with HIV/AIDS worldwide are co-infected with tuberculosis (TB). Furthermore, without proper treatment, approximately 90% of those living with HIV die within months of contracting tuberculosis (TB). The majority of people who are co-infected with both diseases live in sub-Saharan Africa.

What is the impact of co-infection with tuberculosis (TB) and HIV?

Each disease speeds up the progress of the other, and tuberculosis (TB) considerably shortens the survival of people with HIV/AIDS. tuberculosis (TB) kills up to half of all AIDS patients worldwide. People who are HIV-positive and infected with tuberculosis (TB) are up to 50 times more likely to develop active tuberculosis (TB) in a given year than people who are HIV-negative.

HIV infection is the most potent risk factor for converting latent tuberculosis (TB) into active tuberculosis (TB), while tuberculosis (TB) bacteria accelerate the progress of AIDS infection in the patient.

Many people infected with HIV in developing countries develop tuberculosis (TB) as the first manifestation of AIDS. The two diseases represent a deadly combination, since they more destructive together than either disease alone.

• tuberculosis (TB) is harder to diagnose in HIV-positive people.

• tuberculosis (TB) progresses faster in HIV-infected people.

• tuberculosis (TB) in HIV-positive people is almost certain to be fatal if undiagnosed or left untreated.

• tuberculosis (TB) occurs earlier in the course of HIV infection than many other opportunistic infections.

How much of a threat is tuberculosis (TB)?

According to WHO, tuberculosis (TB) infection is currently spreading at the rate of one person per second. It kills more young people and adults than any other infectious disease and is the world's biggest killer of women. In 1993, WHO declared tuberculosis (TB) to be "a global health emergency". Every year 8–10 million people catch the disease and 2 million die from it. About a third of the world's population, or around 2 billion people, carry the tuberculosis (TB) bacteria but most never develop the active disease. Around 10% of people infected with tuberculosis (TB) actually develop the disease in their lifetimes, but this proportion is changing as HIV severely weakens the human immune system and makes people much more vulnerable.

What is the impact of tuberculosis (TB)/HIV on women?

Worldwide, women bear a disproportionate burden of poverty, ill-health, malnutrition and disease. tuberculosis (TB) causes more deaths among women than all causes of maternal mortality combined, and more than 900 million women are infected with tuberculosis (TB) worldwide. This year, 1 million women will die and 2.5 million, mainly between the ages of 15 and 44, will become sick from the disease.

Once infected with tuberculosis (TB), women of reproductive age are more susceptible to developing tuberculosis (TB) disease than men of the same age. Women in this age group are also at greater risk of becoming infected with HIV. As a result, in certain regions, young women aged 15–24 with tuberculosis (TB) outnumber young men of the same age with the disease.

While poverty is the underlying cause of much infection in rural areas, poverty is also aggravated by the impact of tuberculosis (TB). In 1996, a study by the World Bank, WHO and Harvard University reported tuberculosis (TB) as a leading cause of “healthy years lost” among women of reproductive age.

What can be done to combat the spread of tuberculosis (TB)?

The internationally recommended strategy to control tuberculosis (TB), known as DOTS, has five components:

• political commitment to sustained tuberculosis (TB) control

• access to quality-assured tuberculosis (TB) sputum microscopy

• standardized short-course chemotherapy, including direct observation of treatment

• an uninterrupted supply of drugs

• a standardized recording and reporting system, enabling assessment of outcome in all patients.

The Global Partnership to Stop tuberculosis (TB) is a global movement to accelerate social and political action to stop the spread of tuberculosis around the world. The Stop tuberculosis (TB) mission is to increase access, security and support in order to:

• ensure that every tuberculosis (TB) patient has access to tuberculosis (TB) treatment and cure, and protect vulnerable populations from tuberculosis (TB)

• reduce the social and economic toll that tuberculosis (TB) exacts from families, communities, and nations.

The Partnership's approach is a coordinated, multinational, multisectoral global effort to control tuberculosis (TB).

Why is more collaborative action on tuberculosis (TB) and HIV important?

HIV/AIDS is dramatically fuelling the tuberculosis (TB) epidemic in sub-Saharan Africa, where up to 70% of tuberculosis (TB) patients are co-infected with HIV in some countries. For many years efforts to tackle tuberculosis (TB) and HIV have been largely separate, despite the overlapping epidemiology. Improved collaboration between tuberculosis (TB) and HIV/AIDS programmes will lead to more effective control of tuberculosis (TB) among HIV-infected people and to significant public health gains.

HEMORRHOIDS

What are hemorrhoids?

hemorrhoids are among the most common of health ailments, affecting more than 1 in 2 of us at some point in our lives. hemorrhoids, also called 'piles', are enlarged, or varicose, veins of the anus and rectum. There are two types of hemorrhoids - internal and external - that can occur separately or in combination.

Internal hemorrhoids are often present without causing any discomfort or even awareness of their presence. Until they thrombose (clot) or bleed you may not know you have them. Internal hemorrhoids can prolapse (be pushed out) through the anus. Because rectal lining, rather than skin, covers internal hemorrhoids, they are usually not as tender as external hemorrhoids. However, if they strangulate (lose their blood supply) they can be very painful.

It is often assumed that itching in the anal region is due to hemorrhoids. In fact, there are a number of other conditions that are more likely to cause anal itching than hemorrhoids, it is, therefore, important to receive a proper medical diagnosis to determine the true source of anal itching.

External hemorrhoids develop under the skin just outside the opening of the anus. External hemorrhoids usually cause symptoms if they thrombose, in which case they appear as a very tender circular purplish bulge adjacent to the anal opening.

What causes hemorrhoids?

hemorrhoids may have a number of predisposing causes, but in most cases increased pressure in the abdomen plays a key role. Some of the most common underlying factors for developing hemorrhoids include: straining during bowel movements, pregnancy, repeated lifting of heavy objects, prolonged sitting or standing, and being overweight. The excessive pressure can cause the small veins around the anus and rectum to stretch. As the veins lose their elasticity, they become distended with blood and more likely to thrombose and become more fragile. This may result in bleeding, which is often the first indication of hemorrhoids.

Some people can have a single episode of symptoms from hemorrhoids, and others are plagued by ongoing symptoms all of their lives. It is not uncommon for a woman to be bothered by hemorrhoids during pregnancy and/or delivery, and then have a resolution shortly after birth, never to have a problem again.

Not all bleeding from the anus is due to hemorrhoids
Rectal bleeding is a potentially serious symptom and should not be dismissed as "hemorrhoids" without proper diagnosis. There are a number of common benign problems that cause rectal bleeding, including anal fissures (a tear in the lining of the anus). A hallmark of fissures is pain when passing a bowel movement. Some types of inflammatory bowel disease may also cause rectal bleeding. More sinister causes include tumours of the rectum and colon. If you pass blood from the anus you should consult with your doctor to determine if further testing is required.

Conservative (non-surgical) measures for dealing with hemorrhoids
Avoid straining during bowel movements
Constipation and straining can make hemorrhoids worse. A high-fibre diet and adequate fluid intake are recommended. For more dietary suggestions for dealing with constipation, contact our office.

Have a hot bath
The 'sitz' bath, sitting in very warm water in your bathtub with your knees raised, is a remedy that still tops the list of most experts as a way to deal with the hemorrhoids. The warm water helps lessen the pain while increasing blood flow to the area, and this helps shrink the swollen veins. You may even try adding Epsom salts to the bath water.

Clean carefully
It is extremely important to clean yourself properly and gently. Toilet paper can be scratchy, and some types contain chemical irritants. Use only non-perfumed, non-coloured (white) toilet paper, and try dampening it under the faucet before each wipe. Some varieties of toilet paper are softer than others, and some facial tissues are coated with a moisturizing cream, which may be more comfortable than non-coated toilet paper.

Push it back inside
Sometimes the word 'hemorrhoid' refers not to a swollen vein but to a downward displacement of the anal canal lining. If you have such a protruding hemorrhoid, try pushing it back into the anal canal. hemorrhoids left hanging are prime candidates to develop into clots.

Ointments and creams
A large number of preparations are marketed as hemorrhoid treatments. These usually contain one or more active ingredients, including a local anesthetic, anti-inflammatory compounds, or astringents. Witch hazel applied to the rectum with a cotton ball is a popular treatment that has stood the test of time. Hemorrhoidal symptoms often subside within 2-3 days even with no specific treatment, so the usefulness of some of these remedies is not always clear. Several also have ingredients designed to reduce inflammation, and may require a prescription.

Resist the urge to scratch
hemorrhoids can itch, and scratching may seem to make them feel better, but don't give in to the urge to scratch. You can damage the delicate vein walls, and make matters much worse for yourself.

Pregnant?
Pregnant women are particularly prone to hemorrhoids, in part, because the uterus sits directly on the blood vessels that drain the hemorrhoidal veins. A special hemorrhoid treatment, if you are pregnant, is to lie on your left side for about 20 minutes every 4 to 6 hours. By doing so, you decrease pressure on the main vein draining the lower half of the body.

Surgical treatment
If significant hemorrhoidal symptoms persist despite conservative measures, a number of surgical options are available. Internal hemorrhoids can be treated by application of rubber bands, injection of sclerosant, cryosurgery, laser or electro-coagulation techniques. Surgical excision may be required for large, permanently prolapsed hemorrhoids or strangulated hemorrhoids. Thrombosed external hemorrhoids generally respond promptly to surgical incision and clot removal.

WARNING: hemorrhoids that need help...tell us
Even if you are uncomfortable discussing such personal problems, you should see your doctor if you think you have hemorrhoids. Your doctor can establish the correct diagnosis, and recommend the most appropriate treatment.

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