Patients Must Be Told To Undertake Lifelong Art. Start Treatment For Symptomatic Patients Regardless Of Cd4 Cell Count. Start Drugs For Asymptomatic Individuals With Cd4 Cell Counts <500/l. Do Risk Reduction Counseling At Each Patient–clinician Interaction. Regimen: Consider Resistance–testing Results And Predicted Virologic Efficacy, Toxicity And Tolerability, Pill Burden, Dosing Frequency, Drug–drug Interactions, Comorbidities, Patient And Practitioner Preference, And Cost And Affordability. Combine Two Nucleoside Reverse Transcriptase Inhibitors And A Potent Third Agent From Another Class. Prefer A Fixed–dose Formulations And Once–daily Regimen. Suppress Hiv To Less Than 50 Copies/ml (polymerase Chain Reaction) Or 75 Copies/μl (branched Dna) By 24 Weeks. To Detect Failure: Repeat Testing Of Hiv–1 Rna 2 To 8 Weeks After Initiation, Every Four To Eight Weeks Until Suppressed, And Then Every 3 To 4 Months For At Least The First Year. Monitor Cd4 Cell Counts At Least Every 3 To 4 Months After Starting Therapy, Especially In Patients With Counts <200/μl, To Assess Whether Prophylaxis Is Needed For Opportunistic Infections. Do More Frequent Monitoring In Patients Who Have Changed Therapy Because Of Virologic Failure. Even If One Or More Regimens Have Failed, The Therapeutic Goal Should Still Be Undetectable Plasma Hiv–1 Rna Levels. Achieve This Goal With New Drugs And Regimens. If An Elevation In Viral Load Occurs After Complete Suppression Is Achieved, Consider Poor Adherence, Drug–drug Interactions, Concurrent Infections And Recent Vaccinations As Possible Causes Before Changing Regimens. Repeat Testing For An Isolated Detectable Viral Load To Exclude Errors Or Self–resolving Low–level Viremia. When Changing Regimens After First– Or Multiple–regimen Failure, Consider The Stage Of Hiv, Nadir And Current Cd4 Cell Count, Comorbidities, Treatment History, Current And Previous Drug Resistance Tests, And Drug Interactions. Include At Least Two Drugs, And Preferably Three Fully Active Drugs Or Drugs From New Classes. Single–agent Switches To Decrease Toxicity, Avoid Drug Interactions, Or Improve Convenience And Adherence Are Possible, Provided The Potency Of The Regimen Is Maintained And Drug Interactions Are Managed. Boosted Protease Inhibitor Monotherapy Is Not Recommended, Except When Other Drugs Raise Issues Of Toxicity Or Tolerability. Delaying Such Switches May Affect Adherence And Risk Development Of Resistance

International Seminar On 'glomerular Diseases' Being Organized At Muljibhai Patel Urological Hospital, Nadiad, On 19-20 August 2011 Kidney Diseases Have Attained Epidemic Proportion All Over The World. End Stage Renal (kidney) Disease (esrd) Affects As Much As 1.8% Of Our Population And About 17% Are At A Risk Of Developing Kidney Diseases. Treatment Of Esrd Is Beyond The Means Of Common Man Even In Advanced Rich Countries. Glomerular Disease Contributes To 25% Of Esrd Patients. These Are Treatable Diseases And Can Be Prevented In Several Situations. Prof. John Feehally, President, International Society Of Nephrology, Will Be The Main Speaker In This Two Day Seminar. Several Reputed Teachers In Nephrology From All Across India Will Also Be Deliberating As A Faculty. The Seminar Will Be Attended By 150 Nephrology Professionals Consisting Of Nephrologists And Postgraduate Students In Nephrology. This Seminar Is Expected To Give A Boost In Understanding Of Glomerular Disease, It's Treatment And Cutting Edge Research In This Field In Our Country. Joseph@mpuh.org

Everyday I Hear The Same Complaints From The Same People About How Tired They Are, How Stressed They Are Etc. With No Solution In Sight! The Key Is To Correct The Situation Versus Standing Idle And Accepting It. Forget About The Energy Drinks Or Pills. Learn To Increase Your Energy Naturally, And Have A Healthy Steady Supply To Get You Through Each Day. By Adjusting Your Personal Eating, Sleeping And Exercise Habits, You Can Boost Your Energy The Natural Way And Settle Into A Self-sustaining Rhythm. * Essential Water – Keep Your Body Hydrated Throughout The Day. The First Sign Of Dehydration Is Fatigue. Your Body Can’t Function At Capacity Without That Good Old H2o. A Steady Supply Of Water Will Naturally Keep Things Flowing–including Your Energy. * Improve Sleeping Habits – Often A Small Adjustment Of Your Sleeping Habits Can Already Do Wonders For Your Energy Levels. . Lying In Bed Is Not Sleeping: Don’t Go To Bed If Your Not Sleepy And End Up Lying In Bed Pondering And Stressing. If You Are Drifting Off At The Computer, While Reading, Or Watching Tv, It’s Time To Get To Bed. Your Bedtime Should And Will Vary From Night To Night. Let Your Body Tell You When To Sleep As Opposed To The Following The 8-hour Rule. . Rise And Shine: Put An Alarm And Get Up At The Same Time Everyday. Sleepy At Noon?: Try A Powernap Of 20 Minutes In A Quiet Place. Experiment And Find Out What Your Optimal Sleep Levels Are. * Yoga, Exercising & Stretching – It Sounds Counter-intuitive, Perhaps, But By Expending Energy On A Regular Basis, You Will Actually Give Yourself More Of It In The End. The Key Is To Set Up A Fairly Regular Schedule–about Three Times A Week–and Push To The Point That You Feel Refreshed, Not Exhausted. Don’t Overdo It. It May Take A Couple Of Weeks To Get Into The Natural Rhythm, So Have Patience And Higher Energy Levels Will Follow. * Deep Breathing Exercise – Another Great Way To Re-energize Your Body Is With A Quick Deep Breathing Exercise. Sit On A Chair With A Straight Back And Breathe Deeply While You Focus On Your Breath Going In – Going Out. At The Same Time Use A Powerful Affirmation To Invigorate Your Mind And Body. * Eliminate Energy-sappers From Your Diet – Have More Alkaline-forming Foods Like Fruits And Vegetables. Avoid Excess Sugar And Coffee As They Lead To Lower Blood Sugar Levels–and Less Energy–after They Give You An Initial Kick. Also One Could Pack Some Almonds And Nuts For A Quick And Convenient Protein Snack.