Diseases & Condition--Prostate Cancer


Prostate cancer is cancer that occurs in a man's prostate — a small walnut-shaped gland that produces the seminal fluid that nourishes and transports sperm.
Prostate cancer is one of the most common types of cancer in men. Prostate cancer usually grows slowly and initially remains confined to the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.
Prostate cancer that is detected early — when it's still confined to the prostate gland — has a better chance of successful treatment.

 Symptoms of Prostate Cancer






Diseases & Conditions-Sudden cardiac arrest

Sudden cardiac arrest is the sudden, unexpected loss of heart function, breathing and consciousness. Sudden cardiac arrest usually results from an electrical disturbance in your heart that disrupts its pumping action, stopping blood flow to the rest of your body.
Sudden cardiac arrest is different from a heart attack, which occurs when blood flow to a portion of the heart is blocked. However, a heart attack can sometimes trigger an electrical disturbance that leads to sudden cardiac arrest.
Sudden cardiac arrest is a medical emergency. If not treated immediately, it causes sudden cardiac death. With fast, appropriate medical care, survival is possible. Administering cardiopulmonary resuscitation (CPR), treating with a defibrillator — or even just compressions to the chest — can improve the chances of survival until emergency personnel arrive.

Symptoms & Causes---->         

Heart Diseases & Condition-HEARTBURN

Heartburn

 

Heartburn is a burning pain in your chest, just behind your breastbone. The pain is often worse when lying down or bending over.
Occasional heartburn is common and no cause for alarm. Most people can manage the discomfort of heartburn on their own with lifestyle changes and over-the-counter medications.
Heartburn that is more frequent or interferes with your daily routine may be a symptom of a more serious condition that requires medical care.


Heart Diseases & Conditions-Heart Murmurs




Heart murmurs are sounds during your heartbeat cycle — such as whooshing or swishing — made by turbulent blood in or near your heart. These sounds can be heard with a stethoscope. A normal heartbeat makes two sounds like "lubb-dupp" (sometimes described as "lub-DUP"), which are the sounds of your heart valves closing.

Heart murmurs can be present at birth (congenital) or develop later in life. A heart murmur isn't a disease — but murmurs may indicate an underlying heart problem.
Often, heart murmurs are harmless (innocent) and don't need treatment. Some heart murmurs may require follow-up tests to be sure the murmur isn't caused by a serious underlying heart condition. Treatment, if needed, is directed at the cause of your heart murmur.

Symptoms (Heart Murmurs)

If you have a harmless heart murmur, more commonly known as an innocent heart murmur, you likely won't have any other signs or symptoms.
An abnormal heart murmur may cause no obvious other signs or symptoms, aside from the unusual sound your doctor hears when listening to your heart with a stethoscope. But if you have these signs or symptoms, they may indicate a heart problem:
  • Skin that appears blue, especially on your fingertips and lips
  • Swelling or sudden weight gain
  • Shortness of breath
  • Chronic cough
  • Enlarged liver
  • Enlarged neck veins
  • Poor appetite and failure to grow normally (in infants)
  • Heavy sweating with minimal or no exertion
  • Chest pain
  • Dizziness
  • Fainting

Causes (Heart Murmurs)

There are two types of heart murmurs: innocent murmurs and abnormal murmurs. A person with an innocent murmur has a normal heart. This type of heart murmur is common in newborns and children.
An abnormal heart murmur is more serious. In children, abnormal murmurs are usually caused by congenital heart disease. In adults, abnormal murmurs are most often due to acquired heart valve problems.

Innocent heart murmurs

An innocent murmur can occur when blood flows more rapidly than normal through the heart. Conditions that may cause rapid blood flow through your heart, resulting in an innocent heart murmur, include:
  • Physical activity or exercise
  • Pregnancy
  • Fever
  • Not having enough healthy red blood cells to carry adequate oxygen to your body tissues (anemia)
  • An excessive amount of thyroid hormone in your body (hyperthyroidism)
  • Phases of rapid growth, such as adolescence
Innocent heart murmurs may disappear over time, or they may last your entire life without ever causing further health problems.

Abnormal heart murmurs

The most common cause of abnormal murmurs in children is when babies are born with structural problems of the heart (congenital heart defects).
Common congenital defects that cause heart murmurs include:
  • Holes in the heart or cardiac shunts. Known as septal defects, holes in the heart may or may not be serious, depending on the size of the hole and its location.
    Cardiac shunts occur when there's an abnormal blood flow between the heart chambers or blood vessels, which may lead to a heart murmur.
  • Heart valve abnormalities. Congenital heart valve abnormalities are present at birth, but sometimes aren't discovered until much later in life. Examples include valves that don't allow enough blood through them (stenosis) or those that don't close properly and leak (regurgitation), such as mitral valve prolapse.
Other causes of abnormal heart murmurs include infections and conditions that damage the structures of the heart and are more common in older children or adults. For example:
  • Valve calcification. This hardening or thickening of valves, as in mitral stenosis or aortic valve stenosis, can occur as you age. Valves may become narrowed (stenotic), making it harder for blood to flow through your heart, resulting in murmurs.
  • Endocarditis. This infection of the inner lining of your heart and valves typically occurs when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and lodge in your heart.
    Left untreated, endocarditis can damage or destroy your heart valves. This condition usually occurs in people who already have heart valve abnormalities.
  • Rheumatic fever. Although now rare in the United States, rheumatic fever is a serious condition that can occur when you don't receive prompt or complete treatment for a strep throat infection. It can permanently affect the heart valves and interfere with normal blood flow through your heart.

Treatments and drugs (Heart Murmurs)

An innocent heart murmur generally doesn't require treatment because the heart is normal. If innocent murmurs are the result of an illness, such as fever or hyperthyroidism, the murmurs will go away once that condition is treated.
If you or your child has an abnormal heart murmur, treatment may not be necessary. Your doctor may want to monitor the condition over time. If treatment is necessary, it depends on what heart problem is causing the murmur and may include medications or surgery.

Medications

The medication your doctor prescribes depends on the specific heart problem you have. Some medications your doctor might give you include:
  • Medications that prevent blood clots (anticoagulants).Your doctor may prescribe anticoagulants, such as aspirin, warfarin (Coumadin, Jantoven) or clopidogrel (Plavix). An anticoagulant prevents blood clots from forming in your heart and causing a heart attack or stroke.
  • Water pills (diuretics). Diuretics remove excess fluid from your body, which can help treat other conditions that might worsen a heart murmur, such as high blood pressure.
  • Angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors lower your blood pressure. High blood pressure can worsen underlying conditions that cause heart murmurs.
  • Statins. Statins help lower your cholesterol. Having high cholesterol seems to worsen some heart valve problems, including some heart murmurs.
  • Beta blockers. These drugs lower your heart rate and blood pressure. They're used for some types of heart valve problems.

Surgery

Many valve conditions can't be treated with medications alone. Depending on your heart condition, your doctor may recommend one of these options to treat a damaged or leaky valve:

Valve repair

To repair a valve, your doctor may recommend one of the following procedures:
  • Balloon valvuloplasty. This procedure is performed to relieve a narrowed valve. During a balloon valvuloplasty, a small catheter containing an expandable balloon is threaded into your heart, placed into the valve and then expanded to help widen the narrowed valve.
  • Annuloplasty. In this procedure, your surgeon tightens the tissue around the valve by implanting an artificial ring. This allows the leaflets to come together and close the abnormal opening through the valve.
  • Repair of structural support. In this procedure, your surgeon replaces or shortens the cords that support the valves (chordae tendineae and papillary muscles) to repair the structural support. When the cords and muscles are the right length, the valve leaflet edges meet and eliminate the leak.
  • Valve leaflet repair. In valve leaflet repair, your surgeon surgically separates, cuts or pleats a valve flap (leaflet).

Valve replacement

In many cases, the valve has to be replaced. Options include:
  • Open-heart surgery. This is the primary surgical treatment for severe valve stenosis. Your surgeon removes the narrowed valve and replaces it with a mechanical valve or a tissue valve.
    Mechanical valves, made from metal, are durable, but carry the risk of blood clots forming. If you receive a mechanical valve, you'll need to take an anticoagulant medication, such as warfarin (Coumadin, Jantoven), for life to prevent blood clots.
    Tissue valves — which may come from a pig, cow or human deceased donor — often eventually need replacement. Another type of tissue valve replacement that uses your own pulmonary valve (autograft) is sometimes possible.
  • Transcatheter aortic valve replacement (TAVR). A less invasive approach, TAVR involves replacing the aortic valve with a prosthetic valve via an artery in your leg or in a small incision in your chest.
    In some cases, a valve can be inserted via a catheter into a tissue replacement valve that needs to be replaced (valve-in-valve procedure).
    TAVR is usually reserved for individuals with severe aortic valve stenosis who are at increased risk of complications from aortic valve surgery.
Doctors used to recommend that most people with abnormal heart murmurs take antibiotics before visiting the dentist or having surgery due to possible complications from a bacterial infection that affects the lining of your heart (infective endocarditis).
Doctors no longer recommend antibiotics before procedures, except for people at highest risk of complications of infective endocarditis, such as those who have an artificial heart valve or people with certain congenital heart defects.

Prevention (Heart Murmurs)

While there's not much you can do to prevent a heart murmur, it is reassuring to know that heart murmurs are not a disease and are often harmless. For children, many murmurs go away on their own as children grow. For adults, murmurs may disappear as the underlying condition causing them improves.
                                                                                                             

Abdominal Pain-Causes, Symptoms & Remedies

Abdominal Pain


Everyone experience abdominal pain time to time. Other terms used to describe abdominal pain are stomachache, tummy ache, gut ache and bellyache. Abdominal pain can be mild or severe. It may be continuous or come and go. Abdominal pain can be short-lived (acute) or occur over weeks and months (chronic).
Call your doctor right away if you have abdominal pain so severe that you can't move without causing more pain, or you can't sit still or find a comfortable position. Also, seek immediate medical help if pain is accompanied by other worrisome signs and symptoms, such as fever, bloody diarrhea or severe tenderness in your abdomen.

Causes:

Abdominal pain has many potential causes. Many causes, such as gas pains or a pulled muscle, aren't serious, while other conditions require timely medical attention.
Often, the location of the abdominal pain can provide an important clue as to its cause. At other times, abdominal pain may occur in unexpected patterns, and its cause is less obvious. Nonetheless, it is helpful to think about abdominal pain in terms of its location.
The following conditions may cause generalized abdominal pain, which is abdominal pain that isn't focused in one specific area:
  1. Appendicitis
  2. Crohn's disease
  3. Diabetic ketoacidosis (high levels of ketones in the blood)
  4. Diverticulitis
  5. Injury
  6. Intestinal obstruction
  7. Intussusception (in children)
  8. Irritable bowel syndrome
  9. Lead poisoning
  10. Mesenteric lymphadenitis (swollen lymph nodes in the folds of membrane that hold the abdominal organs in place)
  11. Pancreatitis (pancreas inflammation)
  12. Pelvic inflammatory disease (PID) (infection of the female reproductive organs)
  13. Peritonitis (infection of the abdominal lining)
  14. Sickle cell anemia
  15. Strained or pulled abdominal muscle
  16. Thoracic aortic aneurysm
  17. Ulcerative colitis
  18. Uremia (buildup of waste products in your blood)
  19. Urinary tract infection (UTI)
  20. Viral gastroenteritis (stomach inflammation)
The following conditions often cause lower abdominal pain, sometimes described as pelvic pain:
  1. Appendicitis
  2. Cystitis (bladder inflammation)
  3. Diverticulitis
  4. Problems with the cervix, such as a cervical infection, inflamed cervix or growths on the cervix
  5. Endometriosis
  6. Intestinal obstruction
  7. Mittelschmerz (pain associated with ovulation)
  8. Ovarian cysts
  9. Pelvic inflammatory disease (PID) (infection of the female reproductive organs)
  10. Salpingitis (inflammation of the fallopian tubes)
The following conditions often cause upper abdominal pain:
  1. Angina (reduced blood flow to the heart)
  2. Appendicitis
  3. Cholangitis (bile duct inflammation)
  4. Cholecystitis (gallbladder inflammation)
  5. Duodenitis (inflammation of the initial portion of the small intestine)
  6. Hepatitis
  7. GERD (gastroesophageal reflux disease)
  8. Heart attack
  9. Hepatitis (liver inflammation)
  10. Intestinal obstruction
  11. Mesenteric ischemia (decreased blood flow to the intestines)
  12. Non-Hodgkin's lymphoma
  13. Nonulcer stomach pain
  14. Pancreatitis (pancreas inflammation)
  15. Peptic ulcer
  16. Pericarditis (inflammation of the tissue around the heart)
  17. Pleurisy (inflammation of the membrane surrounding the lungs)
  18. Pneumonia
  19. Pneumothorax (lung collapse caused by air that leaks inside chest wall)
  20. Pyloric stenosis (in infants)
  21. Thoracic aortic aneurysm
The following conditions often cause pain in the center of the abdomen:
  1. Appendicitis
  2. Diabetic ketoacidosis (high levels of ketones in the blood)
  3. Injury
  4. Intestinal obstruction
  5. Mesenteric thrombosis (blood clot in a vein carrying blood away from your intestines)
  6. Pancreatitis (pancreas inflammation)
  7. Thoracic aortic aneurysm
  8. Uremia (buildup of waste products in your blood)
The following conditions often cause lower left abdominal pain:
  1. Appendicitis
  2. Cancer
  3. Crohn's disease
  4. Diverticulitis
  5. Problems with the cervix, such as a cervical infection, inflamed cervix or growths on the cervix
  6. Endometriosis
  7. Inguinal hernia
  8. Injury
  9. Intestinal obstruction
  10. Kidney infection
  11. Kidney stones
  12. Mittelschmerz (pain associated with ovulation)
  13. Ovarian cysts
  14. Seminal vesiculitis (inflammation of the seminal vesicles)
  15. Thoracic aortic aneurysm
  16. Torn colon
  17. Tuboovarian abscess (pus-filled pocket involving a fallopian tube and an ovary)
  18. Ulcerative colitis
The following conditions often cause upper left abdominal pain:
  1. Angina (reduced blood flow to the heart)
  2. Cancer
  3. Diverticulitis
  4. Empyema (infection of the lining around the lungs)
  5. Enlarged spleen (splenomegaly)
  6. Fecal impaction (hardened stool that can't be eliminated)
  7. Gastritis (inflammation of the stomach lining)
  8. Heart attack
  9. Hiatal hernia
  10. Injury
  11. Kidney infection
  12. Kidney stones
  13. Pancreatitis (pancreas inflammation)
  14. Pneumonia
  15. Pulmonary infarction (loss of blood flow to the lungs)
  16. Pyloric stenosis (in infants)
  17. Ruptured spleen
  18. Shingles
  19. Spleen infection
  20. Splenic abscess (pus-filled pocket in the spleen)
  21. Thoracic aortic aneurysm
  22. Torn colon
The following conditions often cause lower right abdominal pain:
  1. Appendicitis
  2. Cancer
  3. Cholecystitis (gallbladder inflammation)
  4. Diverticulitis
  5. Problems with the cervix, such as a cervical infection, inflamed cervix or growths on the cervix
  6. Endometriosis
  7. Inguinal hernia
  8. Injury
  9. Intestinal obstruction
  10. Kidney infection
  11. Kidney stones
  12. Mittelschmerz (pain associated with ovulation)
  13. Ovarian cysts
  14. Salpingitis (inflammation of the fallopian tubes)
  15. Seminal vesiculitis (inflammation of the seminal vesicles)
  16. Thoracic aortic aneurysm
  17. Tuboovarian abscess (pus-filled pocket involving a fallopian tube and an ovary)
  18. Viral gastroenteritis (stomach inflammation)
The following conditions often cause upper right abdominal pain:
  1. Appendicitis
  2. Cholangitis (bile duct inflammation)
  3. Diverticulitis
  4. Fecal impaction (hardened stool that can't be eliminated)
  5. Gallbladder cancer
  6. Hepatitis
  7. Gastritis (inflammation of the stomach lining)
  8. Hepatitis (liver inflammation)
  9. Hiatal hernia
  10. Injury
  11. Intestinal obstruction
  12. Kidney cancer
  13. Kidney infection
  14. Kidney stones
  15. Liver abscess (pus-filled pocket in the liver)
  16. Liver cancer
  17. Liver hemangioma
  18. Pancreatic cancer
  19. Pancreatitis (pancreas inflammation)
  20. Peptic ulcer
  21. Pericarditis (inflammation of the tissue around the heart)
  22. Pleurisy (inflammation of the membrane surrounding your lungs)
  23. Pneumonia
  24. Pulmonary infarction (loss of blood flow to the lungs)
  25. Pyloric stenosis (in infants)
  26. Shingles
  27. Stomach cancer
Causes shown here are commonly associated with this symptom. Work with your doctor or other health care professional for an accurate diagnosis.

How to make Tasty Crab Kebab-Taste of Home

Tasty Crab Kebab-Taste of Home

Ingredients: (Crab Kebab)

  • 1 cup shelled crab meat
  • 1-2 green chilies, chopped
  • 1″ ginger grated
  • 1 garlic bead, minced
  • 2 shallots, chopped
  • curry leaves few
  • salt to taste
  • 1 pinch of turmeric
  • dash of garam masala
  • 2 turns from a peppermill
  • few cilantro leaves
  • 1/4 cumin seeds
  • 2 tsp rice flour
  • 1 egg white
  • oil for frying

Procedure:

  1. The preparation is very simple if you opt to buy already shelled crab meat. Just mix all the above mentioned ingredients together (except oil).
  2. Divide them into equal parts and shape them up into tiny-kebabs or in a desired fashion.
  3. Heat oil in a griddle, and shallow fry them until reddish brown and crisp.
  4. Serve warm as an appetizers or as a finger food for your cocktail party.

Beautifull Moon o the Road


What to Make Tasty Hamburgers With Oven Chips

  • Serves4
  • Hands-On Time
  • Total Time

NUTRITIONAL INFORMATION

Per Serving

  • Calories597 calories
  • Calories301 calories from fat
  • Fat34 g
  • Sat Fat8 g
  • Cholesterol75 mg
  • Sodium766 mg
  • Protein28 g
  • Carbohydrate44 g
  • Sugar4 g
  • Fiber3 g
  • Iron5 mg
  • Calcium98 mg

INGREDIENTS

  1. 1pound new potatoes, sliced 1/8 inch thick
  2. 2tablespoons olive oil
  3. kosher salt and pepper
  4. 1pound ground beef
  5. 4hamburger buns
  6. 1/4cup mayonnaise
  7. 1pickle, sliced
  8. 1small head butter lettuce
  9. 1beefsteak tomato, sliced

DIRECTIONS

  1. Heat oven to 400° F.
  2. In a bowl, toss the potatoes and oil. Spread on a baking sheet and roast, stirring occasionally, until crisp, about 30 minutes. Sprinkle with ¼ teaspoon salt.
  3. Meanwhile, heat a grill or grill pan to medium.
  4. Shape the beef into four 1-inch-thick patties. Season with ½ teaspoon each salt and pepper. Cook to desired doneness, about 3 minutes per side for medium.
  5. Transfer the patties to buns and top with the mayonnaise, pickle, lettuce, and tomato. Serve with the chips.

Easy Drop Biscuits

How to Make Quick & Easy Drop Biscuits


These smooth, buttery biscuits make a no-fuss side dish.

  • Makes6 biscuits
  • Hands-On Time
  • Total Time

Nutrition Information: (per serving)
  • Calories315 calories
  • Fat17 g
  • Sat Fat10 g
  • Cholesterol44 mg
  • Sodium614 mg
  • Protein6 g
  • Carbohydrate35 g
  • Sugar2 g
  • Fiber1 g
  • Iron2 mg
  • Calcium106 mg

INGREDIENTS

  1. 2cups all-purpose flour, spooned and leveled
  2. 1/2cup (1 stick) cold unsalted butter, cut into small pieces
  3. 1tablespoon baking powder
  4. 1teaspoon kosher salt
  5. 1cup whole milk

DIRECTIONS

  1. Heat oven to 400° F. In a food processor, combine the flour, butter, baking powder, and salt; pulse until pea-size clumps form. Add the milk and pulse just until moistened.
  2. Drop 6 large mounds of the dough (about ½ cup each) onto a baking sheet. Bake until golden, 18 to 20 minutes.

How to Make Tasty Miso Mac and Cheese


How to Make Tasty Miso Mac and Cheese

Miso paste has all the excellent qualities of cheese; it's savory, rich, and packed with umami flavor. 

Serves 6 (or 4 hungry people)

 Ingredients:

  • 8 ounces dried pasta (I like elbows or cavatappi)
  • 3 tablespoons butter
  • 3 tablespoons flour
  • 2 cups milk, warmed slightly
  • 2 1/4 cups shredded cheese (I like a mix of cheddar, Pecorino, and Gruyère), divided
  • 1/4 cup sweet white miso paste, or to taste
  • 1/4 teaspoon kosher salt
  • freshly ground pepper
  • 1 cup panko breadcrumbs 

  1. Preheat oven to 375° F.
  2. Bring a large pot of heavily salted water to boil. Add your pasta and cook until a minute or two (do not cook it all the way to al dente!). Drain (don't rinse) and set aside.
  3. In a large pan, heat the butter until it melts. Add the flour and cook, whisking constantly to break up any clumps, for a minute or two.
  4. Whisk in the warm milk and bring the mixture to a boil, then reduce to a simmer and cook until the mixture thickens and coats the back of a spoon.
  5. Remove from the heat and stir in 2 cups of the cheese, salt, pepper, and miso paste. (N.B.: Start with just two tablespoons of the miso paste, and taste. Add more as you like but it's important to taste and decide what you like!)
  6. Add the cooked pasta to the cheese sauce and stir to coat.
  7. Pour the pasta into a greased baking dish (big enough to hold your pasta—a 9- by 13-inch dish works, or a 2-quart or 3-quart dish) and sprinkle the top with the remaining 1/4 cup cheese and the panko.
  8. Bake the pasta for about 25 minutes. The pasta should be bubbling and the breadcrumbs should be browned.
  9. Remove from the oven, let cool slightly, and serve the tasty ......
 

 

How Zika Virus Transmit?

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Through mosquito bites

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Zika virus is transmitted to people primarily through the bite of an infected Aedes species mosquito. These are the same mosquitoes that spread dengue and chikungunya viruses.
  • These mosquitoes typically lay eggs in and near standing water in things like buckets, bowls, animal dishes, flower pots and vases.  They prefer to bite people, and live indoors and outdoors near people.
    • Mosquitoes that spread chikungunya, dengue, and Zika are aggressive daytime biters. They can also bite at night.
  • Mosquitoes become infected when they feed on a person already infected with the virus. Infected mosquitoes can then spread the virus to other people through bites.

Rarely, from mother to child

  • A mother already infected with Zika virus near the time of delivery can pass on the virus to her newborn around the time of birth, but this is rare.
  • It is possible that Zika virus could be passed from mother to fetus during pregnancy. This mode of transmission is being investigated.
  • To date, there are no reports of infants getting Zika virus through breastfeeding. Because of the benefits of breastfeeding, mothers are encouraged to breastfeed even in areas where Zika virus is found.
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Through infected blood or sexual contact

  • Spread of the virus through blood transfusion and sexual contact have been reported in present.

How Zika Virus Could affect Pregnant Women

Zika Virus & Pregnancy

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The full spectrum outcomes that might be associated with Zika virus infections during pregnancy is unknown and requires further investigation.
Zika virus disease is similar to that in the general population.  No evidence exists to suggest that pregnant women are more susceptible or experience more severe disease during pregnancy. It is not known if pregnant women are more susceptible to Guillain-Barré syndrome.
There have been reports of congenital microcephaly in babies of mothers who were infected with Zika virus while pregnant. Zika virus infections have been confirmed in several infants with microcephaly; it is not known how many of the microcephaly cases are associated with Zika virus infection. Studies are under way to investigate the association of Zika virus infection and microcephaly, including the role of other contributory factors (e.g., prior or concurrent infection with other organisms, nutrition, and environment).

pregnant women in any trimester should consider postponing travel to an area where Zika virus transmission is ongoing. If a pregnant women is considering travel to one of these areas, she should talk to her healthcare provider. If she travels, she should strictly follow steps to avoid mosquito bites during the trip.
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Pregnant women with a history of travel to an area with Zika virus transmission and who report two or more symptoms consistent with Zika virus disease (including acute onset of fever, maculopapular rash, arthralgia or conjunctivitis) during or within two weeks of travel should be tested. In addition, pregnant women with a history of travel to an area with Zika virus transmission and who have ultrasound findings of fetal microcephaly or intracranial calcifications should also be tested for Zika virus infection.  Testing should be performed in consultation with state or local health departments.