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    Presentation of DR Ishwar Gilada of AIDS Society of India in World AIDS Day 2016 Webinar

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    bobbyramakant
    This is the presentation of Dr Ishwar Gilada, President of AIDS Society of India (ASI) and Secretary of People's Health Organisation (PHO) who was one of the panelist on World AIDS Day webinar 2016, held on Tuesday, 18th October 2016, 1:00pm Geneva time. PANEL OF EXPERTS included: ------------------------ * Dr Anthony D Harries, Senior Advisor and Director, Department of Research, International Union Against Tuberculosis and Lung Disease (The Union) * Dr Ishwar Gilada, President, AIDS Society of India (ASI) and Co-Chair (org.), 18th National Conference on Pulmonary Diseases (NAPCON 2016) * Nomampondo Barnabas, will share personal experiences on why community engagement is key to health responses * Monisola Ajiboye, will share personal experiences of living with HIV and why community engagement is key to health responses * Ashok Ramsarup, Award winning senior journalist from Durban, South Africa; formerly Program Producer, SABC Lotus FM; and Webinar Moderator * Shobha Shukla, CNS Managing Editor and webinar co-Moderator More information is online at: http://www.citizen-news.org/2016/11/call-to-register-webinar-for-media-to.html Thanks CNS Webinars Team Email: webinar@citizen-news.org Website: www.citizen-news.org Twitter: @CNS_Health Facebook.com/CNS.page

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    Presentation of DR Ishwar Gilada of AIDS Society of India in World AIDS Day 2016 Webinar

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    bobbyramakant
    131 views29 pages
    This is the presentation of Dr Ishwar Gilada, President of AIDS Society of India (ASI) and Secretary of People's Health Organisation (PHO) who was one of the panelist on World AIDS Day webinar 2016, held on Tuesday, 18th October 2016, 1:00pm Geneva time. PANEL OF EXPERTS included: ------------------------ * Dr Anthony D Harries, Senior Advisor and Director, Department of Research, International Union Against Tuberculosis and Lung Disease (The Union) * Dr Ishwar Gilada, President, AIDS Society of India (ASI) and Co-Chair (org.), 18th National Conference on Pulmonary Diseases (NAPCON 2016) * Nomampondo Barnabas, will share personal experiences on why community engagement is key to health responses * Monisola Ajiboye, will share personal experiences of living with HIV and why community engagement is key to health responses * Ashok Ramsarup, Award winning senior journalist from Durban, South Africa; formerly Program Producer, SABC Lotus FM; and Webinar Moderator * Shobha Shukla, CNS Managing Editor and webinar co-Moderator More information is online at: http://www.citizen-news.org/2016/11/call-to-register-webinar-for-media-to.html Thanks CNS Webinars Team Email: webinar@citizen-news.org Website: www.citizen-news.org Twitter: @CNS_Health Facebook.com/CNS.page

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    Presentation of Dr Ishwar Gilada of AIDS Society of India in World AIDS Day 2016 webinar

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    This is the presentation of Dr Ishwar Gilada, President of AIDS Society of India (ASI) and Secretary of People's Health Organisation (PHO) who was one of the panelist on World AIDS Day webinar 2016, held on Tuesday, 18th October 2016, 1:00pm Geneva time. PANEL OF EXPERTS included: ------------------------ * Dr Anthony D Harries, Senior Advisor and Director, Department of Research, International Union Against Tuberculosis and Lung Disease (The Union) * Dr Ishwar Gilada, President, AIDS Society of India (ASI) and Co-Chair (org.), 18th National Conference on Pulmonary Diseases (NAPCON 2016) * Nomampondo Barnabas, will share personal experiences on why community engagement is key to health responses * Monisola Ajiboye, will share personal experiences of living with HIV and why community engagement is key to health responses * Ashok Ramsarup, Award winning senior journalist from Durban, South Africa; formerly Program Producer, SABC Lotus FM; and Webinar Moderator * Shobha Shukla, CNS Managing Editor and webinar co-Moderator More information is online at: http://www.citizen-news.org/2016/11/call-to-register-webinar-for-media-to.html Thanks CNS Webinars Team Email: webinar@citizen-news.org Website: www.citizen-news.org Twitter: @CNS_Health Facebook.com/CNS.page

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    131 views29 pages

    Presentation of DR Ishwar Gilada of AIDS Society of India in World AIDS Day 2016 Webinar

    Uploaded by

    bobbyramakant
    This is the presentation of Dr Ishwar Gilada, President of AIDS Society of India (ASI) and Secretary of People's Health Organisation (PHO) who was one of the panelist on World AIDS Day webinar 2016, held on Tuesday, 18th October 2016, 1:00pm Geneva time. PANEL OF EXPERTS included: ------------------------ * Dr Anthony D Harries, Senior Advisor and Director, Department of Research, International Union Against Tuberculosis and Lung Disease (The Union) * Dr Ishwar Gilada, President, AIDS Society of India (ASI) and Co-Chair (org.), 18th National Conference on Pulmonary Diseases (NAPCON 2016) * Nomampondo Barnabas, will share personal experiences on why community engagement is key to health responses * Monisola Ajiboye, will share personal experiences of living with HIV and why community engagement is key to health responses * Ashok Ramsarup, Award winning senior journalist from Durban, South Africa; formerly Program Producer, SABC Lotus FM; and Webinar Moderator * Shobha Shukla, CNS Managing Editor and webinar co-Moderator More information is online at: http://www.citizen-news.org/2016/11/call-to-register-webinar-for-media-to.html Thanks CNS Webinars Team Email: webinar@citizen-news.org Website: www.citizen-news.org Twitter: @CNS_Health Facebook.com/CNS.page

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    of 29

    Approach to Management of TB-HIV Infection

    Dr. I. S. Gilada
    President, AIDS Society of India,
    Consultant in HIV/AIDS,
    Unison Medicare & Research Centre
    Indias first Private Sector Comprehensive
    HIV Care Centre

    Grant Road (E), Mumbai-400 007


    gilada@usa.net; Tel. 022-23061616

    Major Challenges in HIV M/t


    ~70% of HIV+ve people do not know their HIV status
    Most doctors un-interested in HIV, keep away from HIV pts.
    < 1% infected, 99% cant be kept intact without their
    cooperation
    Delayed public sector ART roll-out - increased morbidity initially
    Second-line ART is still not available widely, only one option
    Frequent stock-outs in ARVs and follow-up test kits
    Network of Labs and trained people lacking
    Lack of trained and committed workforce at ART centres
    T/t guidelines changed frequently, yet to be implemented as
    widely as thoroughly as it should have been
    With improved range of ARVs, major challenge remains with OIs
    and Co-infections as well metabolic disorders management

    Gilada/UMRC, Mumbai

    T.B. node

    P.G. L.
    Gilada/UMRC, Mumbai

    Scrofuloderma

    Rare Case of Tuberculosis

    Post AKT (after 5 months)

    RESPIRATORY SYSTEM
    ACUTE:
    -Bacterial pneumonias
    -Fungal- PCP
    -Viral

    CHRONIC
    TB, Atypical mycobacteria
    Fungal
    Malignancy

    ALWAYS, look for UNDERLYING TB

    PCP

    PCP (ground glass appearance)

    TB HIV
    Coinfection

    TB & HIV CONJOINT


    TWINS
    TUBERCULOSIS

    HIV
    100% Preventable,
    Zero% Curable
    Highly glamorous
    Within 30 years, HIV
    has 22 molecules and
    over 30 in pipeline
    No dearth of budget
    HIV may not follow TB

    Zero% Preventable,
    100% Curable
    Least glamorous
    After over a century of
    existence, only 12-13
    molecules
    Always short of funds
    TB follows in almost all
    HIV patients
    Despite such contradictions, they co-exist!
    Importance to TB has come after HIV

    Advantage India! Generic Competition Brings


    Prices Down & the reason- Why US President
    Obama is Furious with India/Indians?

    Current lowest quote: 69$/year


    ~1% of Intl. cost, 100% Bio-equivalence

    11

    Courtesy: MSF

    What has TB (success and


    failures) taught us?

    1. Adherence to prevent resistance


    2. Fixed Drug Combinations
    3. Research on newer molecules
    4. Case finding and early treatment
    5. Commitment for long-term involvement
    and working in coordination with several
    agencies, organisations and individuals
    6. TB follows in almost all HIV patients,
    but reverse not true

    Pleural effusion

    Hilar node
    Gilada/UMRC, Mumbai

    Extensive Pulmonary TB

    14

    Pericardial effusion

    Mediastinal
    lymphadenopathy
    Gilada/UMRC, Mumbai

    Abdominal lymph nodes

    Spleenic abscesses
    Gilada/UMRC, Mumbai

    A.F.B.
    Liver T.B.
    Gilada/UMRC, Mumbai

    Scrofuloderma with Warts

    19

    TB
    Lymphadenopathy
    For > 5 years

    Montoux test - Blistering

    Poas Abscess TB : IRIS

    Unusual TB Lymphadenopathy ?
    Lymphoma

    23

    COMPREHENSIVE
    MANAGEMENT
    PSYCHO-SOCIAL, EMOTIONAL,
    RECREATIONAL, PHYSICAL
    NUTRITIONAL
    MEDICAL
    VIROLOGICAL
    IMMUNOLOGICAL
    BUT, Everything should be COST-EFFICIENT!
    Always Keep Public Health in mind, but
    honour fullest confidentiality of patient!!
    Gilada/UMRC, Mumbai

    Comprehensive HIV
    Management
    Supportive Care: Anybody can provide this
    Symptomatic Treatment: General
    Practitioner
    Prevent/Treat Opportunistic Infections like
    TB & other Co-Infections : GPs /Consultants
    Anti-Retroviral Treatment : Specially
    trained/qualified physicians; ART Centres
    Managing Complications : Only
    experienced HIV/TB physicians
    25

    CHALLENGES FOR TOMORROW

    MDR and XDR TB and MDR and XDR HIV


    Resistance in OI management
    Convergence of National TB and HIV programmes
    IRIS sometimes with fatal conditions
    Lypodystrophy
    HIV and Aging
    HIV+ marriages young and old
    Several eligible bachelors among gen-next
    Generic CD4, Viral Load and Xpert kits like ARVs
    Socio-economic impact
    Lack of medical care givers
    Cure and vaccine
    Gilada/UMRC, Mumbai

    Other Emerging Issues

    Multiple infections in a family, prioritization


    Children with HIV/AIDS & AIDS orphans
    Exploitation at the hand of Quacks/Doctors/Police
    Proper investigations and haphazard treatment
    Cheating by spouses, especially husbands
    Jobs/Occupations for recovered patients
    Migrants, Homeless people, No provision for treatment
    ARVs:indiscriminate use, emerging resistance
    IDUs: Lack of clear policy guidelines and & Clean
    Needle policy
    MSM: section 377 of IPC, decriminalization
    Many Swasthya Bigad Kendras,
    hardly any Swasthya Sudhar Kendra
    Gilada/UMRC, Mumbai

    FAMILY FRIENDS, WELL-WISHERS AND CARE-GIVERS ON ONE


    PLATFORM

    PHO Icon: World AIDS Day 2003

    Perhaps time has come to also have posters that display old
    people along with those with children!

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