by Faranaaz Vahed (2445110)

1. by Faranaaz Vahed (2445110)

2. Temperament Organs involved Aids is not a single disease, but a combination of signs and symptoms resulting from damage to the immune system. It primarily affects the vital organs. H & M H & D M & H HIV AIDS C & M D & H C & D

3. Definition HIV • An infection caused by one of the several related retroviruses • This becomes incorporated into host cell DNA and result in a wide range of varying clinical presentations: from asymptomatic carrier states to severely debilitating and fatal disorders. AIDS • A secondary immunodeficiency syndrome resulting from HIV infection • Characterized by opportunistic infections, malignancies, neurologic dysfunction, and a variety of other syndromes. Tibb Philosophy • HIV/AIDS is classified as having a phlegmatic temperament. • It possesses cold and moist imbalance. • This condition leads to a weakened immune system, since it affects the vital organs.

4. Diagnosis WHO disease staging system

5. Diagnosis cont. HIV Test

6. Signs & Symptoms Immediately after infection and for a prolonged period there may be an antibody-negative asymptomatic carrier state. During this time the virus may be truly latent or reproducing so slowly that it is not recognized by the immune system. Within 2 to 4 wks after infection, a 3-14 day acute mononucleosis-like syndrome (primary HIV infection) with fever, malaise, rash, arthralgias, and generalized lymph adenopathy. Usually followed in 1- 3 months by seroconversion for antibody to HIV. Subsequently, these manifestations disappear (lymphadenopathy usually persist) and the patient may become antibody-positive asymptomatic carriers. During the asymptomatic, seropositive stage, most patients have reduced CD4+ lymphocytes. Some of these patients develop mild, remittent symptoms and signs that do not meet the definition of AIDS or AIDS-related complex (e.g. persistent generalized lymphadenopathy) The AIDS-related complex (ARC) is a constellation of chronic symptoms and signs manifested by the HIV-infected persons who have not had the opportunistic infections or tumors that define AIDS. These signs, symptoms and laboratory abnormalities include generalized lymphadenopathy, weightloss, intermittent fever, malaise, fatigue, chronic diarrhea, thrush. A sever manifestation of ARC is the wasting syndrome, which is chracterised by progressive weight loss ≥ 15% body weight.

7. Treatment & Management

8. Treatment & Management cont. Medication • ARV’s • Highly active antiretroviral therapy, with at least 3 drugs used in combination, has lead to a marked decline in the mortality and morbidity associated with HIV. • The aim of ARV therapy is to suppress viral replication for as long as possible. • The Tibb approach is aimed at: • Strengthening the immune system to allow the body to fight infection • Where necessary to take medication that has specific immune boosting properties. • Tibb medication for AIDS is not targeted at destroying the HIV virus but rather at strengthening the functioning of the body’s immune system and vital organs, such as the liver and spleen, thereby improving your health and state of well being.

9. Treatment & Management cont. Tibb Treatment Regimes

11. Treatment & Management cont. Lifestyle Factors Good foods Processed or canned foods Cold foods and drink from the fridge Dairy products White sugar and highly refined foods Fizzy energy drinks Frozen foods Chocolate and sweets Diet • Eggs, organ meats and protein rich foods • Fresh fruit and vegetables • Room temperature water • Warm or room temperature foods • Foods in their natural states • Fresh clean water • Fresh, pure fruit juices • Garlic, olive oil, chilies • Heating spices: ginger and cumin • Honey • Of all the lifestyle factors, food is by far the most effective and easiest to implement since it is entirely in your control. • Our bodies are designed to function at 37°C and this temperature must be maintained. A weakened immune system leads to decreased heat in the system, hence to strengthen the immune system one has to adopt healthy eating habits which will include eating and drinking foods that increase heat in the body. Good foods

12. Treatment & Management cont. Good foods Good foods Do not eat sour foods Use supplements under medical supervision only Do not eat deep fried foods Do not eat hydrogenated oils Avoid alcohol Avoid fast foods • The period between main meals should be about 4-5 hrs • Caffeinated tea, coffee and cold beverages should be avoided. • 2L of water per day • Avoid sweet, greasy, oily and insipid food and dinks • Avoid iodated salt. Use rough salt, table salt or herbal salt • Choose foods which are high in nutrients, minerals and vitamins • Eat foods and fruts that are in season • Drink only 2 to 3 sips of water during meals. Large quantities of liquid will hamper digestion • Never eat food that is too hot or too cold, as this may demand unnecessary use of your body’s energy resources • Never suppress hunger with tea or coffee. • Chew well, eating at a moderate pace • Eat calmly and do not rush your meal

13. Treatment & Management cont. Environmental air and breathing • Try and get as much fresh air as possible, but avoid going out in cold, rainy or humid weather • Your environment should be warm, avoid air conditioners • If necessary, heat your bedroom with a heater, but take care not to go from the very hot to cold conditions. • Try to sit in the sun each morning, wear sun protection • Breathing exercises and meditation can also be most beneficial, especially early in the morning Movement & rest • Exercise increases the heat in the body. • Choose a balance between the physical activity and relaxation. An exercise progrmme consistent with age, gender and state of health should be adopted. • Walking at a reasonable pace for 15-20 min in the afternoon will be beneficial. If you’re feeling stronger, try exercise such as swimming or yoga which will improve stamina.

14. Treatment & Management cont. Sleep patterns • Sleep is beneficial as it allows the body time to rest, giving physis time to work. • You should have atleast 6-8 hours sleep at night. If required, take a 10-15 min nap in the afternoon. • Sleep early and wake at around 6am. • Before retiring drink either ginger or mint tea. Emotions • Our emotional state plays a vital role in our wellbeing. Both fear and anxiety will hinder your healing as these emotions will affect the immune system negatively. Try to e aware of your feelings and maintain a positive outlook. • Whilst anxiety is often experienced during illness, establish an environment that is relatively free from stress, fear and worry. Elimination & retention • Keep the colon clean by following the recommended diet. • Use a mild herbal laxative every fortnight, egSenna • Do not eat n excess of foods that are difficult to digest, e.g. oily and fatty foods.

15. Alternative therapies Cupping Liver: tonifify and improve liver function Spleen: tonifify and improve spleen function Le13: general health Aroma therapy & Massage • Massage increases heat • Massage the body especially hands, feet and head with a heating oil such as olive oil, eucalyptus or black seed oil each evening, before or after a warm bath. Meditation • fear and anxiety will hinder your healing as these emotions will affect the immune system negatively. Try to be aware of your feelings and maintain a positive outlook. • Meditation will help relax and calm you

16. Prognosis • Although there have been no complete recoveries from AIDS, a few patients are long term (>5 yrs) survivors. • The prognosis of patients with HIV/AIDS has improved dramatically since 1996 for those who have access to appropriate treatment. • Due to the success of combination antiretroviral therapy since 1996 as well as improvements in the prevention and treatment of HIV complications, over 80% of patients are now alive 10 years after sero-conversion. • Deaths from opportunistic infections have declined while mortality from other co-morbidities has become more common (Hep B & C, renal failure, non-HIV elated cancers, cardiovascular disease, suicide and complications of substance abuse). In fact patients with CD4 counts >200 cells/mm3 are more likely to die from non-HIV related illnesses, than they are from complications of AIDS, at least over a time frame of 1 decade.