AIDS threat to women
Dr Meenal Kumar

On the occasion of World’s AIDS Day we must think deeply to understand that AIDS is a serious problem, and we should not be powerless to reduce its impact.

According to UNAIDS estimates, there are 40 million people living with HIV at the end of 2004, and during the year 4.9 million new people became infected.

Ways in which you can be infected:

HIV is transmitted through body fluids, in particular blood, semen, vaginal secretions and breast milk. In fact, there are only four ways you can become HIV-positive. Most HIV infections come from heterosexual sex in which women are more likely to become infected.

* Having unprotected sexual intercourse with an infected person: Sexual intercourse without a condom is risky, because the virus which is present in an infected person’s sexual fluids can pass directly into the body of their partner. The same is true of unprotected anal sex. Oral sex carries a lower risk, but again HIV transmission can occur here if a condom is not used — for example, if one partner has bleeding gums or an open cut, however small, in their mouth.

* Contact with an infected person’s blood: If sufficient blood from an infected person enters the body of an uninfected person, it can pass on the virus to them.

* Breast-feeding: HIV can also be in the breast-milk of infected women, and can be passed on to their babies. Mother-to-child transmission of HIV accounts for 90 per cent of all babies infected.

* Use of infected blood-products : Many people in the past have been infected with HIV by the use of blood transfusions and blood products, which were contaminated.

* Injecting drugs: People who use illegal drugs are also vulnerable to HIV infection. A tiny amount of blood can transmit HIV, and can be injected directly into the bloodstream with the drugs.

It is not possible to become infected with HIV through

* sharing crockery and cutlery

* insect/animal bites

* touching, hugging or shaking hands

* eating food prepared by someone with HIV.

* toilet seats

The child victims
Neelam Sharma
Tribune News Service

Chandigarh: HIV/AIDS, which has been spreading fast in the country, is affecting many children, making them orphans and homeless.

As many as 3,777 children, below the age of 14 years, are living with AIDS in India today. Roughly more than 55,000 children in the country are HIV-positive. According to the National AIDS Control Organisation (NACO), "Based on the census (2001) information of male-female distribution and tabulation of data of HIV estimates in 2003, there will be 17.8 lakh women with HIV infections. Out of these, only 5,696 pregnant women who are HIV-positive have availed themselves of PPTCT services during 2003 in identified institutions.

"Considering the GFR (General Fertility Rate) among women as 103.2 per thousand, there will be 1.84 lakh pregnant women in the HIV-infected pool. If the transmission rate of HIV infection from infected mothers to children is taken as 30 per cent in a worst case scenario, there will be 55,145 HIV-infected children in the country.’’

But, unlike adults, children suffer on two fronts — being infected by the HIV- (where they are tested HIV- positive) and being affected (where they are HIVnegative but their parents were HIV-positive).

"The problems of children infected with HIV are more severe as they are victimised and discriminated against from the very first day, says Ms Madhavi Shinde of the Committed Community Development Trust (CCDT), Mumbai.

In its effort to rehabilitate both the affected and infected children, the CCDT, has so far been successful in finding a foster home for three HIV-affected children in Mumbai, but, despite trying hard, no one has come forward to adopt the HIV-infected children.

"Due to their vulnerability, children face homelessness, displacement and abuse more. They face the frustration of their parents who are infected by the disease and later on cope up with their treatment and death. We have seen that it is hard for the children when they are made aware that their parents have been infected by the disease,’’ adds Ms Shinde.

Counsellors reveal that normally it is the mother who informs the child that their parents are suffering from the disease. But when it comes to revealing the status of the HIV-positive child, the counsellors do not disclose until the guardian has consented and is present at the time of revealing the status.

"Children face several practical problems while dealing with HIV. Things like resolving property issues and coping with incorrect entries made into ration cards by their parents become huge problems after the demise of the parents, ’’ she adds.

Prevent leg cramps with exercises
Dr Ravinder Chadha

Muscle cramps are a common problem. Almost everyone experiences them at some stage in life. Cramps are caused due to sudden uncontrolled contraction of a muscle. The contracted muscle does not relax, thereby leading to symptoms varying from mild discomfort to agonising pain.

The exact cause of muscle cramps is not known, but it is believed that muscle fatigue and inadequate stretching lead to abnormalities in the mechanism that controls muscle contraction. Other factors leading to muscle cramps are exercising in intense heat, dehydration and depletion of salt and minerals.

Certain medicines too can cause muscle cramps like Diuretics. Similarly, patients on dialysis often complain of leg cramps.

Leg cramps are common during pregnancy, especially after second trimester. Cramps can also occur due to circulation problems in the legs when enlarged uterus puts pressure on the blood vessels that return blood from the legs to the heart.

To avoid cramps during pregnancy, one should avoid sitting or standing with crossed legs for a long time. Massage, stretching calf muscles and rotating ankles and toes several times a day are helpful. Sodium chloride, calcium and magnesium supplements prevent cramps during pregnancy.

a. Walk on or move the foot up and down and then elevate it.

b. For a calf muscle cramp, pull up the toes towards the head with legs as straight as possible.

c. Apply an ice pack to the cramped muscle.

d. Take a hot shower or warm bath.

Repetitive activities like writing, typing, etc, may produce cramps of the hands due to muscle fatigue. For immediate treatment, pressing the hand on the flat surface will stretch the cramping finger muscles

Massage of the muscles is very useful in treating cramps as it increases blood circulation to the muscles which helps in its relaxation.

The most important aspect of dealing with the muscle cramps disorder is prevention. The important preventive measures are:

* Persons undertaking vigorous physical activities must do adequate warm-up, stretching before the event.

* Cramps associated with dehydration due to vigorous physical activities can be treated with fluid and electrolyte replacement. Therefore, drinking water before, during and after these activities is very important.

* Doing calf stretching two or three times just before going to bed can prevent night cramps. Also, stretch calf muscles regularly throughout the day.

* Ride a stationary cycle before bed-time for a few minutes only for night cramps.

* Place a blanket loose at the foot end to prevent the toes and feet pointing downward while sleeping.

* Cramps are very common in people who suddenly increase their exercise. Therefore, one should gradually increase the training intensity. The best way is to increase exercise only by 10 per cent of the previous week’s regimen.

The exercises that can prevent muscle cramps:

Calf muscle stretch-Stand about two to two and a half feet away from the wall. Lean on with the forearms against the wall with the knees and back straight and heels in contact with the floor. Hold the stretched position for 30 seconds. Repeat three times. Practice this exercise at least three times a day.

Hamstring muscle stretch— Sit with one leg folded in and the other straight out, foot upright and toes and ankle relaxed. Lean forward slightly, touch the foot of the straightened leg. Hold the stretch for 15 seconds. Repeat three times for each leg.

Quadriceps muscle stretch — While standing, hold the top of the foot with a hand from back and gently pull the heel toward buttocks. Hold on for 10 seconds, repeat three times.

Persistent and severe cramps can be treated with quinine sulfate, Vitamin ‘E’, muscle relaxants, etc

Most of the cramps are benign in nature with no serious complications. Cramps can cause discomfort and inconvenience. Proper precautions along with exercises can prevent cramping. Cramps which are severe and frequent and do not respond to the usual modes of treatment must be investigated properly.

The writer is a former doctor/physiotherapist, Indian Cricket Team.