Genital Herpes With Special Reference To Pregnancy

Genital herpes is a sexually transmitted disease (STD) caused by herpes simplex viruses type 1 (HSV-1) and type 2 (HSV-2). The anxiety for a pregnant woman is that she may transfer the virus to her baby during pregnancy and childbirth with potentially severe consequences. In this article measures to avoid such disaster are discussed.

Herpes simplex virus type 1 and type 2 are common infections worldwide. Herpes simplex virus type 2 is the cause of most genital herpes and is almost always sexually transmitted whereas the type 1 virus is more commonly associated with sores around the mouth. There is no exclusivity with some ulcers around the mouth being caused by the type 2 virus and some genital infections being related to the type 1 virus. These are probably related to oral sex.

Herpes simplex infections can be diagnosed by visual inspection by a doctor. Swabs from the affected area can be taken and the virus cultured in the laboratory. When a person contracts infection, the immune system produces antibodies that can be measured in the serum (blood with its cells removed).

In the USA one adult in five has antibodies to type 2 herpes. The number of people who have been diagnosed with the condition rose from 10% to 14% between 1988 and 1999. Seroprevalence of HSV-1 decreased from 62.0% in 1988-1994 to 57.7% in 1999-2004, a relative decrease of 6.9%.

Herpes infections may be primary, secondary, recurrent or asymptomatic with viral shedding. In a primary infection, the infection is apparent but there are as yet no antibodies to either HSV-1 or HSV-2 at the time of the outbreak indicating no prior exposure. Typically, lesions appear 2-14 days after contact. Without antiviral therapy, the lesions last for 20 days. Viral shedding lasts 12 days, with the highest rates of shedding occurring before symptoms develop and during the first half of the outbreak. Viral shedding ceases before complete resolution of the lesion. Antibody response occurs 3-4 weeks after the primary infection and is life-long. However, unlike protective antibodies to other viruses, antibodies to HSV do not prevent local recurrences. The symptoms associated with local recurrences tend to be milder than those occurring with primary disease.

The lesions of a primary infection begin as tender vesicles (blisters), which may burst to become ulcers. The vagina is commonly inflamed and the cervix is involved in 80% of patients. Pre-existing HSV-1 antibodies can alleviate clinical manifestations of subsequently acquired HSV-2. More than 75% of patients with primary genital HSV infection are asymptomatic. Asymptomatic primary HSV infections in pregnant women at term are responsible for most neonatal (newborn) HSV infections.

Symptoms associated with primary infections may be local and constitutional. Local symptoms include intense pain, dysuria (pain passing urine), itching, vaginal discharge, and lymphadenopathy (swelling of the lymph glands). Constitutional symptoms include fever, headache, nausea, malaise, and myalgia (aching muscles).

A non-primary first episode infection is a first genital HSV outbreak in a woman who has HSV type 1 antibodies. Because of the partial protection of the pre-existing antibodies, these women tend to have fewer and shorter systemic symptoms. The duration of lesions is shorter, averaging 15 days, and viral shedding lasts for approximately 7 days.

A recurrent infection is defined as a genital HSV outbreak in a woman with type 2 antibodies. Recurrent HSV outbreaks may be symptomatic or asymptomatic. Lesions typically last for 9 days, and viral shedding lasts for approximately 4 days. The viral load tends to be lower in recurrent outbreaks than with primary lesions, and shedding tends to occur during the prodrome (pre-symptomatic phase) and early stage of the clinical outbreak.

Primary infections in pregnancy are over diagnosed. Correct classification of gestational genital herpes infections can only be accomplished when clinical evaluation is combined with viral isolation and serologic testing using a type-specific assay. Most severe first clinical episodes of genital herpes infections among women in the second and third trimesters of pregnancy are not primary infections and are not commonly associated with perinatal morbidity.

Most herpes affected babies acquire the virus at the time of delivery. Just 5% of all cases of neonatal (newborn) HSV infection result from transplacental transmission during pregnancy. In this regard, it is one of the TORCH (toxoplasmosis, rubella, cytomegalovirus, and herpes simplex) infections, which are associated with microcephaly (small head), microphthalmia (small eyes), intracranial (within the brain) calcifications, and chorioretinitis (inflammation in the eyes). The acquisition of genital herpes during pregnancy has been associated with spontaneous miscarriage, prematurity and congenital and neonatal herpes.

Neonatal herpes is a severe systemic (involving all the body) viral infection with a high morbidity (illness) and mortality. Neonatal herpes can cause skin, eye or mouth infections, damage to the central nervous system and other internal organs and mental retardation. It is relatively uncommon in the UK with an incidence of 1.65 per 100 000 live births annually, which compares to 11 per 100, 000 deliveries in the USA.

Neonatal herpes may be caused by herpes simplex type 1 (HSV-1) or herpes simplex type 2 (HSV-2), as either viral type can cause genital herpes. The risks are greatest when a woman acquires a primary infection during late pregnancy, so that the baby is delivered before the development of protective maternal antibodies. All women should be asked at their first antenatal visit if they or their partner have ever had genital herpes. Female partners of men with genital herpes, who themselves give no history of genital herpes, should be advised about reducing their risk of acquiring this infection.

Women who report a history of genital herpes can be reassured that, in the event of an HSV recurrence during pregnancy, the risk of transmission to the neonate is extremely small, even if genital lesions are present at delivery. Women with no history of genital herpes may reduce their risk of acquiring herpes during pregnancy by avoiding sexual intercourse at times when their partner has an HSV recurrence. The impact of this intervention is limited because sexual transmission of HSV commonly results from sexual contact during periods of asymptomatic viral shedding.

Aciclovir is well tolerated in late pregnancy and there is no clinical or laboratory evidence of maternal or fetal toxicity. Aciclovir has been used extensively in pregnancy and it appears to be safe. The use of intravenous aciclovir may reduce the risk of neonatal herpes by minimising maternal viraemia and reducing exposure of the fetus to HSV for women who develop first episode genital herpes within six weeks of delivery. A randomised controlled trial for women with recurrent herpes was unable to demonstrate that acyclovir in late pregnancy significantly reduces the number of caesarean sections. The conclusion was that there is little evidence to suggest that acyclovir should be used for the suppression of recurrent genital herpes infection during pregnancy.

Where first-episode genital herpes lesions are present at the time of delivery and the baby is delivered vaginally, the risk of neonatal herpes is about 40%. The risk of transmission is associated with duration of rupture of the membranes, the risk increasing considerably after the membranes had been ruptured for more than four hours.

Caesarean section is recommended for all women presenting with first-episode genital herpes lesions at the time of delivery, but is not indicated for women who develop first episode genital herpes lesions earlier in the pregnancy. If the first episode of genital herpes lesions within six weeks of the expected date of delivery or onset of preterm labour, elective caesarean section may be considered at term, or as indicated, and the paediatricians should be informed.

In the 1980s, it was common practice to take swabs for viral cultures weekly from women with a history of genital herpes during the last six weeks of pregnancy and if the results were positive delivery would be by elective caesarean section. This practice is no longer recommended as it has been demonstrated that antenatal swabbing did not predict the shedding of virus at the onset of labour.

For women presenting with recurrent genital herpes lesions at the onset of labour, the risks to the baby of neonatal herpes are negligible with two major studies showing no transmission to the baby. In one study, one baby in 34 with active recurrent herpes was affected. The practice of caesarean delivery for women with a history of genital herpes lesions that recur at delivery would result in more than 1580 excess caesarean deliveries being performed for every poor neonatal outcome prevented at a cost per neonatal herpes case averted of $2.5 million at 1993 rates. Furthermore, there could well be more maternal deaths by this practice than newborn babies saved. In Holland, caesarean sections have not been routinely performed for this indication since 1987 and there has been no increase in the reported incidence of neonatal herpes.
by: David Viniker

Read Full Article...>>>

Vaccine Safety

The premise of vaccines is a good one: modify an infective agent (bacteria, virus) in the laboratory so it is no longer virulent (disease-producing) without destroying its antigenic characteristics (immune-stimulating). When administered, a vaccine will then theoretically not produce the disease but will create immunity to it.

The approach is similar to that used in homeopathy whereby the toxin responsible for the disease condition is diluted and administered to stimulate the body to fight the disease. Like fighting like.

But, as always, there are slips between the theory and practice of vaccines. For one thing, because large, not homeopathically small, doses of modified infective agents are in vaccines, the immune system can be taxed. Give several different vaccines and repeat them periodically and the immune system can be exhausted. The immune system has finite, not infinite capacity. The net result can be increased vulnerability to cancer, autoimmunities and other infective agents.

There is also the problem of route of administration. The normal point of entry for disease agents is across oral, digestive or respiratory mucous membranes. The exposure is usually only to a small number of organisms, maybe even one. In contrast, vaccines are commonly given by injection, bypassing several layers of important immune-stimulating mechanisms with the mucous membrane barriers and can contain tens of thousands of modified disease agents.

Some vaccines are modified, but are still living. Who is to say what such living creatures do over time when injected into the body in enormous quantities? Viruses are very clever and capable of remarkable change and adaptation. I'm not sure I like the idea of these guys floating around in my body trying to decide how best to attack me. When we take such vaccines, we are volunteering for an experiment.

I will not go into a litany here of all the proven dangers of vaccines or enumeration of tragic results. This has been done elsewhere.

But here are a couple of new problems. Some vaccines contain high levels of thimerosal mercury. Mercury is a potent toxin and its level in some vaccines exceeds Federal Safety Guidelines. Problems linked to thimerosal include autism and speech disorders, as well as heart disease.
J Am Physicians Surgeons, 2003; 8(1):6-11
http://www.jpands.org/vol8no1/geier.pdf

A new vaccine is being developed for Alzheimer’s based upon the theory that increased brain plaque is the cause of the disease. However, plaque is not the likely cause, but a symptom (similar to high cholesterol in atherosclerosis), and initial trials of the test vaccine caused 6% of the participants to suffer from severe brain swelling.

In the recent effort to prepare the population for bioterrorism, almost 26,000 people were vaccinated with small pox. So far, seven cases of cardiac problems and ten cases of myopericarditis have been associated with the vaccine. Although this temporal association is being downplayed (like smoking being associated with respiratory disease), it is reason for caution. Additionally, the smallpox vaccine is known to cause hypercoagulability, a condition particularly threatening to those with vessel narrowing atherosclerosis. Some researchers believe that the pox vaccine virus (along with a host of other pathogens) has the capability of adhering to the endothelium (lining) of blood vessels. These nodules stimulate an inflammatory response resulting in platelet adhesion, thrombin release and fibrin formation. When this occurs, the vessel is narrowed depriving distal (downstream) tissue from oxygen and creating the ideal anaerobic (oxygen devoid) environment for proliferation of pathogens (infection), neoplasia (cancer) and sclerotic plaque (heart attack, stroke).
by: Dr. Randy Wysong
Read Full Article...>>>

Safety First: Properly Using and Tips to Finding Alternative Herbal Medicine Effectively

Herbal products are the perfect choice for individuals who want to avoid using expensive synthetic medical products and their documented side-effects. It's true that synthetic medicines are carefully formulated for maximum treatment, but we can never deny that there might be certain reactions on our bodies when take them in.

The Safe Alternative Solution To Health Problems

Being an affordable medical solution, herbal medicines can be seen in large quantities being sold in the market and quite a lot of consumers today are opting for this method than those normally prescribed by medical practitioners. Doctors and other medical specialist today are even prescribing the use of alternative herbal medicines for a speedy recovery and boosting a person's immune system for a permanent health improvement.

These products make use of 100 safe to use and would often take more than the prescribed dosage in order to speed up the effects. This is a misconception that often leads to more complications than getting rid of your health problem. Before using your herbal product, it is very important to read the label for the correct dosage. You can also ask your doctor for some advice if you don’t trust the indications on the herbal product.

As with the old medical adage, following the right process of healing will results to a speedy recovery; and making up your own prescription and instruction would only bring around disastrous results. Just follow the prescription and instructions in taking in your alternative herbal medicine to get the best treatment for your declining health.

Tips To Look For A Safe Alternative Herbal Medicine Online

Alternative herbal medicine is the latest trend in modern medical technology. Modern societies are known to make use of this method for addressing common health-related problems or to improve their body's overall performance. They are free from side-effects commonly attributed to synthetic medicines distributed and used today.

If you are planning to take this method of healing for better results and savings then you might want to look for the best herbal medicine in the online market. There are quite a lot of them around but you have to be careful before buying one to ensure that you are not scammed by frauds active on the Web.

1. Consult An Expert Before Purchase

Consumer should always take extra care in what they drink or eat -- especially in the case of medicines. Even if herbal medicines are reputed to be 100 safe to use. Since identity is a common problem related to the Internet, it would be best to do your research first to ensure that you won't be having troubles with its use later on.

You can use search engines to pull out some information about the pharmaceutical company that made the herbal product. You can use the name of the herbal medicine or the company that made it as keywords and try to check out reviews from different consumers who tried it out. While you're at it, you might want to check if these companies are affiliated with known government health services and credible medical companies in the market.

3. Determine The Ingredients Used

If you don’t want to have any allergic reaction to a specific herbal medicine then you need to check out the details indicated on the label. Since the product is advertised online, there should be a specific page on the distributor's homepage that details the natural ingredients and other chemicals used in it. If you have no idea what to look for then you better consult an expert to determine whether it is safe for you to use or not. Don’t buy herbal medicines on the Web without proper information of its ingredients, dosage, or usage to avoid compromising your health.

4. Look For Consumer Testimonies Online

It would be prudent if you look for testimonies of people who have used the herbal product before making the purchase. We can never be too sure how it would affect our health when used so you can base your research on those who have tried it out and to determine whether it worked for them or not and whether it could be useful for your health concern. Don’t stick only with the positive comments but concentrate more on the negative postings from consumers to make sure that you get the advantages and disadvantages listed down to help you decide.
by: Colin Palfrey

Read Full Article...>>>

What is Your Body Type?

Your body and its features are greatly determined by your genetics. This is why certain people can have a real hard time loosing weight and others have a real hard time gaining weight. To understand why your body acts in certain ways you needed to learn more about your body type. Doing so will help you determine the best manner to achieve your goals of a healthier body.

Most people can be placed into three categories of body types. Each body type has its own unique characteristics and genes have a lot to do with that.

THE ECTOMORPH: "Ecto" refers to the slim/thin body type. People with this body type are usually the ones that have the hardest time putting on weight. They can eat anything they want and as much as they want without gaining a single pound. People with this body type are naturally skinny and have been skinny throughout their entire lives.

Ectomorphs are the most fragile of all three body types. They have long, slender limbs with small, thin bones and joints along with the very little fat and muscle mass.

Ectomorphs are also known as "hard-gainers" as they have the hardest time of all three body types to gain weight. This is due to the incredibly high metabolic rate of their bodies. This is why they can eat whatever they want without gaining a single pound. This is good if you are not trying to gain weight, but for most ectomorphs that is not their goal.

Ectomorphs have the hardest time of all to put on muscle and this can become very frustrating. I know this because I am an ectomorph. All throughout my childhood I had been very skinny. In face when I started college I was about 5'11'' and 127 pounds. So when I decided to start working out and put on muscle, it was an extremely difficult and frustrating task. I had to eat a constantly (and still do) and a lot in order to put on weight. Eventually, however with patience and hard work I have been able to put on quite a bit of muscle.

As an ectomorph, you just have to remember to stay eat constantly, maintain a good workout routines, and most importantly remain patient to achieve your goal of your ideal body type.

Key Features: Skinny, lean, fragile, fast metabolism, hard-gainers.

Famous Ectomorphs: Kiera Knightly, Johhny Depp, Paris Hilton, Bruce Lee.

THE ENDOMORPH: "Endo" refers to the large/heavy body type. People of this body type have the easiest time gaining weight and hardest time losing weight. Their bodies are naturally inclined to store more fat which makes losing fat incredibly difficult for them.

Most endomorphs have a majority of their weight focused at the centers of their body giving their bodies a round look. Also due to their weight, they gain the appearance of being stocky and can be described as having pear-shaped-bodies.

Endomorphs can literally eat a minute fraction of what Ectomorphs eat and still gain weight. This can become extremely frustrating when trying to loose weight. Endomorphs have a hard time losing weight due to their extremely slow metabolism rate and are essentially the complete opposites of ectomorphs.

If you are an endomorph, you will have to be patient just like ectomorphs to achieve your goals of weight loss. A steady, healthy diet of small meals along with regular exercise should help you achieve your ideal body type. But like with all goals, discipline and routine are the keys to success.

Key Features: Large, big-boned, slow metabolism, easy gainers.

Famous Endomorphs: Jack Black, Queen Latifah, Cedric the Entertainer, Kirstie Alley.

THE MESOMORPH: "Meso" refers to the strong/muscular body type. People with this body type can consider themselves to be lucky. Basically they are a combination of all the good traits of ectomorphs and endomorphs without any of the bad traits. Unlike ectomorphs, they can easily gain muscle mass and unlike endomorphs they have no trouble loosing weight. They essentially have the ideal muscular and athletic body type that ectomorphs and endomorphs envy.

Mesomorphs have well built bodies with well-defined muscles and strong bones. They are broad in their pectoral regions and narrow in the abdominal regions.

Mesomorphs do not need any special routines to gain or loose weight. As long as they maintain a healthy lifestyle with a combination of weight training and cardio, they can achieve the body they want.

Key Features: Hard-bodied, well-defined, muscular, strong features.

Famous Mesomorphs: Lebron James, Halle Berry, Anna Kournikova, Arnold Schwarzenegger.

Most people do not strictly have one of these three body types, but rather a combination of two or all three. Your body type is determined by your genes and your goal when trying to determine your body type is to use that information to figure out the best workout routines. You can not change your genes, but you can change your body. All it takes is hard work, determination and discipline and then anything is possible. So go out there and make it happen!!!

My name is Ronek Bhatt. I am 22 years old and a fitness enthusiast. I started working out 5 years ago and since then have dedicated numerous hours learning and researching about fitness, bodybuilding, diets, and other sources of healthy living.
by: Ronek Bhatt
Read Full Article...>>>

Jaundice Causes

When a pathological process interferes with the normal functioning of the metabolism and excretion of bilirubin just described, jaundice may be the result. Jaundice is classified into three categories, depending on which part of the physiological mechanism the pathology affects. The three categories are:

* Pre-hepatic: The pathology is occurring prior the liver.
* Hepatic: The pathology is located within the liver.
* Post-Hepatic: The pathology is located after the conjugation of bilirubin in the liver.

Pre-hepatic

Pre-hepatic jaundice is caused by anything which causes an increased rate of hemolysis (breakdown of red blood cells). In tropical countries, malaria can cause jaundice in this manner. Certain genetic diseases, such as sickle cell anemia, spherocytosis and glucose 6-phosphate dehydrogenase deficiency can lead to increased red cell lysis and therefore hemolytic jaundice. Commonly, diseases of the kidney, such as hemolytic uremic syndrome, can also lead to coloration. Defects in bilirubin metabolism also present as jaundice. Jaundice usually comes with high fevers. Rat fever (leptospirosis) can also cause jaundice.

Laboratory findings include:

* Urine: no bilirubin present, urobilirubin > 2 units (except in infants where gut flora has not developed).
* Serum: increased unconjugated bilirubin.

Hepatic

Hepatic jaundice causes include acute hepatitis, hepatotoxicity and alcoholic liver disease, whereby cell necrosis reduces the liver's ability to metabolise and excrete bilirubin leading to a buildup in the blood. Less common causes include primary biliary cirrhosis, Gilbert's syndrome (a genetic disorder of bilirubin metabolism which can result in mild jaundice, which is found in about 5% of the population), Crigler-Najjar syndrome, metastatic carcinoma and Niemann-Pick disease, type C. Jaundice seen in the newborn, known as neonatal jaundice, is common, occurring in almost every newborn as hepatic machinery for the conjugation and excretion of bilirubin does not fully mature until approximately two weeks of age.

Laboratory findings include:

* Urine: Conjugated bilirubin present, urobilirubin > 2 units but variable (except in children).

Post-hepatic

Post-hepatic jaundice, also called obstructive jaundice, is caused by an interruption to the drainage of bile in the biliary system. The most common causes are gallstones in the common bile duct, and pancreatic cancer in the head of the pancreas. Also, a group of parasites known as "liver flukes" can live in the common bile duct, causing obstructive jaundice. Other causes include strictures of the common bile duct, biliary atresia, ductal carcinoma, pancreatitis and pancreatic pseudocysts. A rare cause of obstructive jaundice is Mirizzi's syndrome.

The presence of pale stools and dark urine suggests an obstructive or post-hepatic cause as normal feces get their color from bile pigments.

Patients also can present with elevated serum cholesterol, and often complain of severe itching or "pruritus".

No one test can differentiate between various classifications of jaundice. A combinations of liver function tests is essential to arrive at a diagnosis.
Pre-hepatic Jaundice Hepatic Jaundice Post-hepatic Jaundice
Total bilirubin Normal / Increased Increased Increased
Conjugated bilirubin Increased Normal Increased
Unconjugated bilirubin Increased Normal / Increased Normal
Urobilinogen Increased Normal / Increased Decreased / Negative
Urine Color Normal Dark Dark
Stool Color Normal Normal Pale
Alkaline phosphatase levels Normal Increased Increased
Alanine transferase and Aspartate transferase levels Normal Increased Increased
Conjugated Bilirubin in Urine Not Present Present Present
http://en.wikipedia.org
Read Full Article...>>>

Classification Influenza

Of the three genera of influenza viruses that cause human flu, two also cause influenza in pigs, with Influenzavirus A being common in pigs and Influenzavirus C being rare.Influenzavirus B has not been reported in pigs. Within Influenzavirus A and Influenzavirus C, the strains found in pigs and humans are largely distinct, although due to reassortment there have been transfers of genes among strains crossing swine, avian, and human species boundaries.

Influenza C

Influenza C viruses infect both humans and pigs, but do not infect birds. Transmission between pigs and humans have occurred in the past.For example, influenza C caused small outbreaks of a mild form of influenza amongst children in Japan and California.Due to its limited host range and the lack of genetic diversity in influenza C, this form of influenza does not cause pandemics in humans.

Influenza A

Swine influenza is known to be caused by influenza A subtypes H1N1,H1N2,H3N1, H3N2,and H2N3.In pigs, three influenza A virus subtypes (H1N1, H3N2, and H1N2) are the most common strains worldwide.In the United States, the H1N1 subtype was exclusively prevalent among swine populations before 1998; however, since late August 1998, H3N2 subtypes have been isolated from pigs. As of 2004, H3N2 virus isolates in US swine and turkey stocks were triple reassortants, containing genes from human (HA, NA, and PB1), swine (NS, NP, and M), and avian (PB2 and PA) lineages.
http://en.wikipedia.org
Read Full Article...>>>

WHO: Wabah Flu Babi Tidak Terhentikan

JENEWA - Badan Kesehatan Dunia (WHO) menyatakan laju penyebaran flu Babi "tidak terhentikan". Seluruh negara harus memiliki akeses mendapatkan vaksin.

Inggris, Thailand, dan Filipina, kembali mengumumkan korban meninggal akibat virus A(H1N1), Senin kemarin. Sementara Arab Saudi menutup sebuah sekolah internasional setelah 20 siswanya didagnosa terjangkit virus itu.

Seiring semakin bertambahnya korban meninggal, pejabat WHO menyatakan vaksin mulai tersedia pada awal September.

Direktur penelitian vaksin WHO, Marie Paul Kieny seperti dikutip AFP, Selasa (14/7/2009), mengatakan sekelompok ahli pembuatan vaksin menyimpulkan bahwa laju penyebaran flu A(H1N1) tidak dapat dihentikan. Oleh karena itu seluruh negara harus memiliki akses untuk mendapatkan vaksin.

Negara-negara akan dibebaskan untuk menentukan prioritas nasional. Namun berbagai kalangan meminta agar perempuan hamil dan warga yang usianya di atas enam bulan, termasuk golongan rentan terjangkit dan harus menjadi prioritas.

Menurut Kieny, perhatian utama juga harus diberikan kepada anak-anak. Banyak kasus flu yang telah menjangkiti di lebih dari negara itu, menyebar di kalangan anak-anak sekolah.

Sejauh ini WHO telah mengonfirmasi lebih dari 90.000 kasus flu A(H1N1). Sebanyak 429 orang meninggal.
Sumber : okezone.com

Read Full Article...>>>