Diarrhea or diarrhoea (from the Greek διάρροια, δια dia "through" + ρέω rheo "flow" meaning "flowing   through" ) is the condition of having three or more loose or liquid bowel movements per day. The most common cause is gastroenteritis. Oral rehydration solutions (ORS) with modest amounts of salts and zinc tablets are the treatment of  choice and have been estimated to have saved 50 million children in the past 25 years. In cases where ORS is not available, homemade solutions are often used. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can causedehydration and electrolyte disturbances such as potassium deficiency or other salt imbalances. In 2009 diarrhea was estimated to  have caused 1.1 million deaths in people aged 5 and over and 1.5 million deaths in children under the  age of 5.
Diarrhea is defined by the World Health Organization as having three or more loose or liquid stools per  day, or as having more stools than is normal for that person.
Secretory diarrhea means that there is an increase in the active secretion, or there is an inhibition of absorption. There is little to no structural damage. The most common cause of this type of diarrhea is a cholera toxin that stimulates the secretion of anions, especiallychloride ions. Therefore, to maintain a charge balance in the lumen, sodium is carried with it, along with water. In this type of diarrhea intestinal  fluid secretion is isotonic with plasma even during fasting. It continues even when there is no oral food intake.
Osmotic diarrhea occurs when too much water is drawn into the bowels. If a person drinks solutions with excessive sugar or excessive salt, these can draw water from the body into the bowel and cause osmotic  diarrhea. Osmotic diarrhea can also be the result of maldigestion (e.g., pancreatic disease or Coeliac disease), in which the nutrients are left in the lumen to pull in water. Or it can be caused by osmotic laxatives (which work to alleviateconstipation by drawing water into the bowels). In healthy individuals, too much magnesiumor vitamin C or undigested lactose can produce osmotic diarrhea and distention of the bowel. A person who has lactose intolerance can have difficulty absorbing lactose after an extraordinarily high intake of dairy products. In persons who have fructose malabsorption, excess fructose intake can also cause diarrhea. High-fructose foods that also have a high glucose content are more absorbable and less likely to cause diarrhea. Sugar alcohols such as sorbitol (often found in sugar free foods) are difficult for the body to absorb and, in large amounts, may lead to osmotic diarrhea. In most of these cases, osmotic diarrhea stops when offending agent (e.g. milk, sorbitol) is stopped.
Exudative diarrhea occurs with the presence of blood and pus in the stool. This occurs with inflammatory bowel diseases, such asCrohn's disease or ulcerative colitis, and other severe infections such as E.  coli or other forms of food poisoning.
Motility-related diarrhea is caused by the rapid movement of food through the intestines (hypermotility). If the food moves too quickly through the gastrointestinal tract, there is not enough time for sufficient nutrients and water to be absorbed. This can be due to avagotomy or diabetic neuropathy, or a  complication of menstruation . Hyperthyroidism can produce hypermotility and lead to pseudodiarrhea and occasionally real diarrhea. Diarrhea can be treated with antimotility agents (such
or autoimmune problems such as inflammatory  bowel diseases. Entamoeba histolytica. It can be caused by bacterial infections. celiac disease.
There are many causes of infectious diarrhea. Crohn's disease. colon cancer. Norovirus is the most common cause of viral diarrhea in adults. microscopic colitis. which include viruses. bacteria and   parasites. Dysentery is a symptom of. and Salmonella. and astroviruses cause  a significant number of infections. Hypermotility can be observed in people who have had portions of their bowel removed. and enteritis. which leads to a passive loss of protein-rich fluids and a decreased ability to absorb these lost fluids.
Generally. it is not diarrhea. 17) In travelers however bacterial infectionspredominate. which accounts for 40% of cases in   children under five. among others.
Inflammatory diarrhea occurs when there is damage to the mucosal lining or brush border. Chronic diarrhea can be the part of the presentations of a number of chronic medical conditions affecting the intestine. irritable bowel syndrome and bile acid malabsorption. Common causes include ulcerative colitis. but dysentery. Various toxins such as mushroom poisoning and drugs can also cause acute diarrhea. Shigella. parasitic infections. It can also be caused by tuberculosis. if there is blood visible in the stools. but rotavirusis the most   common cause in children under five years old.
Diarrhea is most commonly due to viral gastroenteritis with rotavirus.
. allowing less total time for absorption of nutrients. (p. The blood is trace of an invasion of bowel tissue.as loperamide). viral infections. Adenovirus types 40 and 41. Features of all [clarification needed] three of the other types of diarrhea can be found in this type of diarrhea.
vomiting or diarrhea may occur. a rash. a person may experience a brief period of influenza-like illness. AIDS  has caused nearly 30 million deaths (as of 2009). throat inflammation.Human immunodeficiency virus infection / acquired immunodeficiency syndrome(HIV/AIDS) is a disease of the human immune system caused by infection with human immunodeficiency  virus (HIV). or breastfeeding.  headache. these symptoms are not often recognized as signs of HIV infection. including opportunistic infections and tumors that do not usually affect people who have working immune systems. Between 50 and 70% of people also develop persistent generalized lymphadenopathy. making the person much more likely to get infections. these medications are expensive and may be associated with side effects. primarily through safe sex andneedle-exchange programs. it is recommended that HIV be  considered in patients presenting an unexplained fever who may have risk factors for the infection. large tender lymph nodes. As of 2010. such as saliva and tears.
Signs and symptoms
The initial period following the contraction of HIV is called acute HIV. approximately 34 million people are living  with HIV globally. HIV is transmitted primarily via unprotected sexual intercourse (including anal and evenoral sex). These individuals are classified as HIV
.  delivery. weight loss. During the initial infection. Gastrointestinal symptoms such as nausea. Prevention of HIV infection. non-painful enlargement of more than one group of  lymph nodes (other than in the groin) for over three to six months. antiretroviral treatment can slow the course of the disease and may lead to a near-normal life expectancy. As the illness progresses. There is no cure or vaccine. Thus.
The initial symptoms are followed by a stage called clinical latency. While typically there are few or no symptoms at first. Symptoms occur in 40–90% of cases and most commonly include fever. do not transmit  HIV. and/or sores of the mouth and genitals. While antiretroviral treatment reduces the risk of death and complications from the disease. hypodermic needles. which occurs in 20–50% of cases.  presents itself on the trunk and is maculopapular. gastrointestinal  problems and muscle pains. asymptomatic HIV. This is typically followed by a prolonged period without symptoms. Since its discovery. is a key strategy to control the spread of the disease. Due to their nonspecific character. it interferes more and more with the immune system. Without treatment. AIDS is considered a pandemic—a disease outbreak which is present over a large  area and is actively spreading. Many individuals develop an influenza-like illness or a mononucleosis-like illness 2–4  weeks post exposure while others have no significant symptoms. near the end of this stage many people experience fever. Although most HIV-1 infected individuals have a detectable viral load and in the absence of treatment will + eventually progress to AIDS. The duration of the  symptoms varies. characterized by unexplained. Some people also develop opportunistic  infections at this stage. as  may neurological symptoms of peripheral neuropathy or Guillain-Barre syndrome. Genetic research indicates that HIV originated in west-central Africa during the early twentieth  century. Some bodily fluids. contaminated blood transfusions. AIDS was first recognized by the Centers for Disease Control and Prevention (CDC) in 1981  and its cause—HIV infection—was identified in the early part of the decade. a small proportion (about 5%) retain high levels of CD4 T cells (T helper  cells) without antiretroviral therapy for more than 5 years. about eight years). or chronic  HIV. but is usually one or two weeks. classically. Even cases that do get seen by a family doctor or a hospital are often misdiagnosed as one of the many common infectious diseases with overlapping symptoms. however. primary HIV or acute retroviral  syndrome. this second stage of the natural history of HIV infection can last from about    three years to over 20 years (on average. and from mother to childduring pregnancy. The rash.
with an average of 0.4% per act. nasal secretions. viruses. needle stick injury. saliva. sputum. sweat. fungi and parasitesthat are normally  controlled by the immune system. There is no risk of acquiring HIV if exposed to feces. tears. or breastfeeding (known as vertical transmission).
Acquired immunodeficiency syndrome
Acquired immunodeficiency syndrome (AIDS) is defined in terms of either a CD4 T cell count below 200  cells per µL or the occurrence of specific diseases in association with an HIV infection. The majority of all transmissions worldwide occur through heterosexual contacts (i.
. Which infections occur partly depends on what organisms are   common in the person's environment. In the United States intravenous drug users made up 12% of all new cases of HIV in   2009. delivery. the pattern of transmission varies significantly among countries. They represent approximately 1 in 300 infected persons.8%. exposure to infected body fluids or tissues.63 and 2. around half of people infected with HIV develop AIDS within ten years.
HIV is transmitted by three main routes: sexual contact. Other common signs include recurring respiratory tract infections. cachexia in the form of HIV wasting syndrome (20%) andesophageal   candidiasis. however. The risk of acquiring HIV from a needle stick from an HIV-infected person is estimated as 0. or  vomit unless these are contaminated with blood. The most common initial conditions that alert to the presence of AIDS are pneumocystis pneumonia (40%).  In the United States. Opportunistic infections may be caused by bacteria. transfusion of contaminated blood or blood product.09% (about 1 in  1000) per act. as of 2009. Blood-borne transmission can be through needle-sharing during intravenous drug use.
The second most frequent mode of HIV transmission is via blood and blood products. In the absence  of specific treatment.controllers or long-term nonprogressors (LTNP). most sexual transmission occurred in men who had sex with men. The risk from  sharing a needle during drug injection is between 0. sexual contacts between  people of the opposite sex).e. and  from mother to child during pregnancy.3% (about 1 in 333) per act and the risk following mucus membrane exposure to infected blood as 0. and in some areas more than 80% of people who inject drugs are HIV positive. It is possible to be co-infected by more than one strain  of HIV—a condition known as HIV superinfection.
The most frequent mode of transmission of HIV is through sexual contact with an infected person. Another group is those who also maintain a low or undetectable viral load without anti-retroviral treatment who are known as "elite controllers" or "elite  suppressors". or medical injections with unsterilised equipment. These infections may affect nearly every organ system. urine. with  this population accounting for 64% of all new cases.
But that did not happen because the accumulated water from the first flood wave had yet not flushed out effectively during the ebb period because of a choked drainage system.L.m. Other places to be severely affected were Raigad.m. and discharged 5. Adding to the chaos was the lack of public information. The floods were caused by the eighth heaviest ever recorded 24-hour rainfall figure of 994 mm (39. Large numbers of people were stranded on the road. The previous record high rainfall in a 24hour period for Mumbai was 575 mm (22. Khed.m.. one between 2:30 & 20. a city located on the coast of the Arabian Sea. of rain for the 24 hours ended at 08:30 a. Water logging and submergence of certain low lying pockets of the region such as Dharavi. due to which. Mumbai Police commissioner Anami Narayan Roy requested all residents to stay indoors as far as possible on 31 July after heavy rains disrupted the city once again. brought it to a grinding halt. Milan Subway and Sion either slowed down traffic. 644 mm (25.T. and intermittently continued for the next day. due to the water logging on the tracks. now is.m. the second wave would have harmlessly drained because of the prevalent low-tide. on 28 July. lost their homes.m. Chiplun.95 million cubic meters of water into the Mithi River.Maharashtra floods of 2005
The 2005 Maharashtra floods refers to the flooding of many parts of the Indian state of Maharashtra including large areas of the metropolis Mumbai. around 2:00 p. The situation worsened when the cellphone networks went down around 5 p. it took about 4 hours for a BEST bus to reach from Churchgate to Mahim.m. Bandra-Kurla Complex. The Met department blamed it on the lack of sophisticated weather radars which would have given a 3 hour prior warning which came due to high tides.1 inches) which lashed the metropolis on 26 July 2005. grounding all flights for the day. were also only partially functional.m.
On 26 July 2005. The Municipal Corporation of Greater Mumbai [MCGM] control room started receiving phone calls reporting the heavy rain and water logging in suburban areas. in which at least 5.
. With sudden rush of vehicles after around 4 p. Chembur. The government also ordered all schools in the affected areas to close on 1 August and 2 August.4 inches) was received within the 12-hour period between 8am and 8pm. the Mumbai Metropolitan Region was struck with a heavy storm. or in some areas. Ghatkopar.m. Radio stations and many television stations did not receive any weather warnings or alerts by the civic agencies. The highest 24-hour period in India was 1.000 people died.30 p. vehicular traffic intensity on roads increased. The Maharashtra state government declared 27 July and 28 July as a state holiday for the affected regions. There was some relief in sight only when the second ebb period commenced at 6 p. Local train movement came to a halt by 2:30 p. The term 26 July. in context always used for the day when the city of Mumbai came to a standstill.0 inches) in Aminidivi in the Union Territory of Lakshadweep on 6 May 2004 although some reports suggest that it was a new Indian record. Ratnagiri and Kalyan in Maharashtra and the southern state of Goa. The Powai Lake had started overflowing at 4 p. Normally.Chunabhatti. and many walked for long distances back home from work that evening.coinciding with the high tide period and another between 8 and 10 p.6 inches) in 1974. The rains slackened between the 28 July and 30 July but picked up in intensity on 31 July.. The result was that the flood situation kept on aggravating throughout the night. Land-lines of M. It occurred just one month after the June 2005 Gujarat floods. Torrential rainfall continued for the next week. The rainfall hydrographs of 26 & 27 July later revealed that two flood waves were generated in the streams and river basins of Mumbai.N. The Indian Meteorological Department (IMD) station in Santacruz had recorded a record 944 mm. on the western coast of India.m.168 mm (46. on 27 July.
Effect on Mumbai's links to the rest of the world
For the first time ever. and hospitals and health centers geared up to distribute free medicines to check any outbreak. The Traffic Police and Fire Brigade cleared 26. Reports in the media warned of the threat of waterborne diseases. Sahar andJuhu aerodrome) were shut for more than 30 hours due to heavy flooding of the runways.000 dumpers & J. Thousands of animal carcasses floated in the flood waters. plied extra buses to Mahim and Sion to facilitate movement of around 1. Mumbai's domestic and international airports (including Chatrapati Shivaji International Airport.5 lakh stranded commuters at the C.
.C. and reports on late evening of 30 July indicated cancellation of several long distance trains till 6 August 2005. Power and water supply were restored gradually. there were 185 departures and 184 arrivals.Bs deployed from all over the State with the support of NGOs and the Transport Commissionerate. with increase in water logging of the runways and different parts of Mumbai. & Churchgate Railway Stations.
Threat to public health
The rain water caused the sewage system to overflow and all water lines were contaminated.T. rescue and thereafter in the mission for restoring the city to normally.S. Over 700 flights were cancelled or delayed. The evacuated people were sheltered in public buildings including schools and transit shelters. submerged Instrument Landing Systemequipment and extremely poor visibility.000 animal carcasses were disposed and more than 2 lakhs tonnes of garbage was mopped up with the help of about 1. The Fire Brigade and the ―Rescue Teams‖ of MCGM undertook 282 major and minor rescue operations of around 3. The airports reopened on the morning of 28 July  2005. The Government ordered all housing societies to add chlorine to their water tanks while they decontaminate the water supply.E. Rail links were disrupted. raising concerns about the possibility of disease.S. Again from early morning of 31 July.700 stranded people including rescuing school children as well as rescuing people from 140 marooned BEST buses.T. 24.Rescue and Relief Measures
The entire Government machinery along with the local offices of the MCGM immediately got into action for the desired relief. most of the flights were indefinitely cancelled.000 vehicles stranded by the roadside on the following day. The B. Rescue boats of the Navy were requisitioned and deployed in Kurla and Kalina. Within 24 hours of the airports becoming operational. Community kitchens were started and free food grains were provided by the Government of Maharashtra [GOM] and MCGM as well as voluntary NGOs and individuals. The Municipal machinery tried to organize safe evacuation of people through boats and buses. Train services returned to normalcy on 28 July. including international flights.