World Aids Day
The global challenge of HIV/AIDS remains one of the most pressing public health issues today. According to the latest data from UNAIDS, around 38.4 million people worldwide are living with HIV/AIDS, underlining the need for not only medical intervention but also comprehensive awareness, education, and social change. Despite the significant strides made in treatment and prevention, the confusion surrounding the relationship between HIV and AIDS still persists.
Young people have become influential advocates in the fight against HIV/AIDS. Research from UNICEF shows that youth-led initiatives can lower HIV transmission rates by as much as 45% in targeted communities. These young activists utilize digital platforms and peer-to-peer education to dispel myths, promote safe practices, and foster supportive environments for those affected by HIV/AIDS.
Dr Gowri Kulkarni, an expert in Internal Medicine, explains that while the terms HIV and AIDS are often used interchangeably, they are distinctly different. "HIV (Human Immunodeficiency Virus) is a virus that attacks the immune system, whereas AIDS (Acquired Immunodeficiency Syndrome) is a condition that occurs when HIV severely damages the immune system," she clarifies. To understand the implications of these differences, it's important to explore the fundamental distinctions between the two.
HIV is the virus responsible for attacking the body’s immune system, specifically targeting CD4 cells, which are crucial for the body’s defense against infections. As HIV progresses, it destroys these cells, weakening the immune system over time. If left untreated, this continuous damage can lead to AIDS.
AIDS, on the other hand, is a syndrome, not a virus. Dr Kulkarni further elaborates that AIDS is a collection of symptoms and illnesses that emerge when the immune system is severely compromised due to prolonged HIV infection. It represents the most advanced stage of HIV, and is characterized by very low CD4 counts or the onset of opportunistic infections like tuberculosis, pneumonia, or certain cancers.
A key distinction to remember is that not everyone with HIV will progress to AIDS. Thanks to advancements in medicine, particularly antiretroviral therapy (ART), individuals living with HIV can manage the virus and maintain a healthy immune system for many years, or even decades, without ever developing AIDS. ART works by suppressing the virus to undetectable levels, effectively preventing the damage HIV would otherwise cause to the immune system.
Without treatment, however, HIV progresses through three stages:
- Acute HIV Infection: This stage occurs shortly after transmission and may include symptoms like fever, fatigue, and swollen lymph nodes.
- Chronic HIV Infection: Often asymptomatic or mildly symptomatic, the virus continues to damage the immune system but at a slower rate.
- AIDS: This is the final stage, marked by severe immune damage and the presence of infections that take advantage of the compromised immune defenses.
Another key distinction between HIV and AIDS is the way in which they are transmitted. HIV is highly contagious and can be transmitted through the exchange of bodily fluids such as blood, semen, vaginal fluids, and breast milk. It is primarily spread through unprotected sexual contact, sharing needles, or from mother to child during childbirth or breastfeeding.
AIDS, however, is not transmissible. It is not a disease that can be passed from one person to another. Rather, AIDS is the result of untreated, advanced HIV infection and is a direct consequence of the virus’s damage to the immune system.
HIV and AIDS are diagnosed through different methods. HIV is diagnosed through blood tests or oral swabs that detect the presence of the virus or antibodies produced by the immune system in response to the virus. Early detection of HIV is crucial, as it allows for timely intervention and treatment, which can prevent the virus from progressing to AIDS.
AIDS, on the other hand, is diagnosed using more specific criteria. Dr Kulkarni notes that the diagnosis of AIDS is made when the individual’s CD4 cell count falls below 200 cells/mm³, or when opportunistic infections or certain cancers (such as Kaposi's sarcoma or lymphoma) are detected. Diagnosing AIDS involves a more thorough assessment of the individual’s immune function and overall health, as opposed to just the detection of HIV.
The treatment goals for HIV and AIDS differ significantly, although both involve antiretroviral therapy (ART). For HIV, the primary treatment goal is to suppress the virus to undetectable levels, thus maintaining a strong immune system and preventing further transmission of the virus. People living with HIV can often live long, healthy lives if they adhere to ART.
For individuals diagnosed with AIDS, the treatment plan becomes more complex. While ART remains an essential part of managing the virus, treatment for AIDS also focuses on addressing the opportunistic infections and secondary health complications associated with severe immune suppression. The goal of treatment for AIDS is not only to manage the HIV virus but also to improve the quality of life and extend survival by treating these secondary health issues.
While the medical community has made great strides in managing HIV, the battle to curb its transmission is also a social and cultural issue. Dr Daman Ahuja, a public health expert, highlights that HIV/AIDS awareness and education are vital to reducing transmission rates and supporting those affected by the virus. "Young people, especially, have become key advocates in the fight against HIV/AIDS," says Dr Ahuja. "Research from UNICEF shows that youth-led initiatives can lower HIV transmission rates by as much as 45% in targeted communities."
Additionally, grassroots activism plays a significant role in raising awareness and addressing stigma. As the World Health Organization reports, community-based interventions have been proven to increase HIV testing rates and improve treatment adherence, which are crucial in the fight against the pandemic.
The ultimate goal of organizations like UNAIDS is to eliminate the HIV/AIDS pandemic by 2030. Achieving this requires global collaboration, from medical treatment advancements to public health strategies, education, and advocacy. Dr Kulkarni’s insight underscores the importance of early detection, treatment adherence, and community support in the fight against HIV/AIDS.
Dr Gowri Kulkarni is Head of Medical Operations at MediBuddy and Dr Daman Ahuja, a public health expert and has been associated with Red Ribbon Express Project of NACO between 2007-12.
Credit: AI
Air pollution has now become an inevitable aspect in many Indian cities, whether it is vehicular emissions, dust from construction activities, industrial pollutants, or smoke from burning crops. Some of the worst pollutants from the health point of view are those comprising PM2.5 (particulate matter 2.5).
Particulate matter 2.5 means the fine particulate matter measuring 2.5 microns in diameter or smaller, which is roughly 30 times smaller than the diameter of a human hair.
Due to their microscopic size, these particles can enter deep inside the lungs and even the blood stream. The WHO and the IARC have labeled outdoor air pollution and particulate matter as a carcinogen, which implies that it can lead to increased risk of cancer.
Long-term exposure to PM2.5 is responsible for causing inflammation and oxidative stress within the body. Inflammation and oxidative stress will eventually result in DNA damage leading to an abnormal growth of cells.
The link between exposure to PM2.5 and cancer is well-documented, with lung cancer being the most established one, while others are still under investigation. According to WHO guidelines, long-term exposure to PM2.5 is linked to higher lung cancer mortality rates, even at lower concentrations.
This is highly relevant to India because air pollution in many Indian cities exceeds WHO recommendations.
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Even though individual measures may not solve the problem of air pollution completely, they do help to minimize personal exposure.
Monitor the AQI index before engaging in any outdoor physical activity and on polluted days, try to reduce the amount of time you spend outdoors.
Early morning and late evening are typically times when pollution level is high. Plan your outdoor activities on less polluted days.
When going out, especially commuting, during the days of high pollution use an N95 mask that helps to filter fine particles.
Close windows during heavy air pollution and install a HEPA filter air purifier if needed, especially for kids, elderly people and those who suffer from lungs diseases.
Do not smoke indoors; use less incense and mosquito coil indoors, and make sure there is a good ventilation system in the kitchen when you cook.
Never smoke, keep physically active during the days of decent air quality, and eat nutritious food with lots of fruit and veggies.
Protecting yourself from the health risks of PM2.5 can be done by both individual means and also collective efforts. More sustainable modes of transport, better emission control policies, improved waste disposal facilities, and sound urban planning practices will become necessary eventually. In the meantime, we only have our knowledge and preventive steps to safeguard our health.
By Dr. Reshma Puranik, Cancer Physician, MOC Pune
Credit: AI
Robotic thyroid surgery is a minimally invasive technique in which the surgeon uses robotic instruments to remove part or all of the thyroid gland. Unlike conventional surgery, which requires an incision on the front of the neck, the robotic approach uses small incisions hidden in the armpit and chest to access the thyroid, thereby avoiding a visible neck scar while maintaining surgical precision.
However, one of the biggest misconceptions about robotic surgery is that the robot performs the operation independently. It does not. Every movement is completely controlled by the surgeon, who sits at a console and guides the robotic instruments with exceptional precision. The technology essentially extends the surgeon's capabilities by providing a high-definition, three-dimensional and magnified view of the surgical field, along with highly flexible, wristed instruments.
The absence of a visible neck scar is undoubtedly a major advantage, especially for patients concerned about their appearance. However, robotic thyroid surgery is far more than a cosmetic procedure.
The robotic system provides high-definition, magnified 3D vision and wristed instruments that allow meticulous dissection around delicate structures such as the recurrent laryngeal nerves and parathyroid glands. This precision helps preserve these vital structures, minimizing the risk of nerve injury, voice changes, and parathyroid dysfunction. Tremor filtration and enhanced dexterity further improve surgical accuracy.
Together, these advantages result in less tissue trauma, reduced postoperative pain, faster recovery, and excellent functional and cosmetic outcomes.
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Not every thyroid patient is a candidate for robotic surgery. Patients with thyroid nodules, selected early thyroid cancers and certain benign thyroid enlargements may be considered after detailed evaluation.
So, patients with very large goitres, advanced thyroid cancers involving surrounding structures or certain complex medical conditions may be better suited to conventional open surgery.
Therefore, patient selection remains one of the most important aspects of robotic thyroid surgery.
There is a common belief that robotic thyroid surgery is meant only for young patients who want to avoid a neck scar. Is that true?
No. While the absence of a visible neck scar is certainly an attractive cosmetic benefit, it is not the main advantage of robotic thyroid surgery. The real strength of robotic technology lies in its precision, which minimizes tissue trauma, reduces postoperative pain, and promotes faster recovery.
Most patients require pain medication for only 48–72 hours after surgery. These benefits are particularly valuable for elderly patients, who often recover more comfortably and can avoid prolonged use of painkillers. Therefore, age is not a criterion for robotic thyroid surgery. Suitability depends on the nature of the thyroid disease and careful patient selection.
One of the major concerns after thyroid surgery is voice alteration, as the recurrent laryngeal nerve, which controls the vocal cords, lies in close proximity to the thyroid gland. The magnified 3D view and wristed robotic instruments enable meticulous identification and preservation of this delicate nerve during surgery.
Although no surgical technique can completely eliminate the risk of complications, the enhanced precision and superior visualization offered by robotic surgery help minimize the risk of nerve injury while ensuring careful preservation of other vital structures.
Recovery after robotic thyroid surgery varies from patient to patient. Most patients are able to walk within a few hours after surgery and are discharged within one to two days. In our experience, pain is usually mild, with most patients requiring pain medication for only 48–72 hours.
As there is no incision on the front of the neck, swallowing and neck movements are often more comfortable during recovery. Reduced postoperative discomfort can be particularly beneficial for elderly patients, in whom prolonged use of pain medication may be undesirable.
Our Department of Advanced Robotic Surgery has emerged as one of the highest-volume centres for robotic thyroid surgery in Eastern India, currently performing approximately 3–4 robotic thyroid procedures every month. As awareness among patients and referring physicians continues to grow, this number is steadily increasing.
Our experience has been highly encouraging, with no permanent voice changes or major complications reported among our robotic thyroid surgery patients to date. These results reinforce an important message: while robotic technology is a powerful tool, its success ultimately depends on careful patient selection and the experience of the surgical team.
Thyroid surgery need not be a cause for fear. Modern surgical techniques have made treatment safer, more precise, and increasingly patient-friendly. For appropriately selected patients, robotic thyroid surgery offers the advantages of exceptional surgical precision, reduced tissue trauma, faster and more comfortable recovery, and the significant cosmetic benefit of avoiding a visible neck scar.
By Dr. S. K. Bala, Surgical Oncologist and Robotic Surgeon, CK Birla Hospitals, CMRI
Credit: AI
Many women may come across the term "breast density" following a mammogram, but not all of them fully understand what it implies. The fact that someone has dense breasts does not mean that they have cancer or that they will definitely get it.
On the other hand, greater breast density can be linked to a higher risk of breast cancer and may also make it more difficult to detect certain cancers on a mammogram.
The breast density is the ratio of fibrous and glandular tissue to fatty tissue in the breast. Dense breast tissue is a normal variation and is especially frequent in younger women. It should be clear that women cannot tell themselves if their breast has dense tissue or not; it has to be assessed using breast imaging, typically a mammogram.
Breast density is usually divided into four types, going from almost all fatty tissue to very dense tissue, and women who have heterogeneously dense or extremely dense breasts are at a greater risk of developing breast cancer than women whose breasts are mainly fatty.
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A major concern is that on a mammogram dense tissue appears white, just as many breast abnormalities—some of which are cancers—do too. This makes it harder for radiologists to spot certain abnormalities. Women need not be alarmed if their mammogram report states that their breasts are dense.
Breast density is just one of the factors to take into account when evaluating the risk of breast cancer; family history, age, past breast conditions, genetic mutations, hormonal factors, reproductive history, and lifestyle must also be considered.
It will depend on a woman's total risk level whether or not further screening is needed. Although mammography is still an important method of screening, in certain individual cases a doctor may suggest extra imaging, for example breast ultrasound or magnetic resonance imaging (MRI). Such tests are not required automatically for every woman who has dense breasts.
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Women should also know what is normal for their breasts. If a new lump is detected, there is a persistent change in the shape or size of the breast, the skin becomes dimpled, the nipple turns inwards, there is an unusual discharge from the nipple or there is ongoing discomfort, then it is advisable to have a healthcare professional look at it. Yet the majority of breast changes are not cancerous and symptoms by themselves are not enough to make a diagnosis.
Lifestyle plays a big role in maintaining breast health. One way of reducing the overall risk of breast cancer is to keep a healthy weight, remain physically active, limit alcohol intake, avoid tobacco, eat a well-balanced diet and stick to the recommended screening programmes.
Women must not regard breast density as a diagnosis. The main point is that women should not be afraid of dense breasts but should understand what this means for them. They must talk to their family doctor about their mammography report and their individual risk factors and then follow a screening programme suitable to their risk.
Breast density is therefore a valid reason for having a screening examination, not one for concern. By understanding breast density and talking to a breast specialist, women can make informed choices regarding screening and make sure that any potential abnormalities are assessed as early as possible.
By Dr. Meghal Sanghavi, Consultant Onco Surgeon, Wockhardt Hospital, Mumbai Central
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