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.
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A Doppler test is a specialized type of ultrasound that uses sound waves to measure blood flow through blood vessels rather than simply creating images of organs and tissues. Unlike a regular ultrasound, which produces pictures of internal structures, a Doppler ultrasound shows how blood moves through arteries and veins, helping doctors detect circulation problems.
While commonly associated with pregnancy, Doppler ultrasound is also used to investigate conditions such as leg pain, swelling, varicose veins, blood clots, peripheral artery disease, and stroke risk. Understanding when this test is needed can help detect serious conditions early and guide timely treatment.
During pregnancy, a Doppler ultrasound is often recommended in high-risk cases to assess blood flow between the mother, placenta, and baby.
"It helps doctors monitor whether the fetus is receiving adequate oxygen and nutrients, making it especially important in pregnancies complicated by high blood pressure, diabetes, fetal growth restriction, or previous pregnancy-related complications," Dr. Vandana Mittal, Principal Consultant, Obstetrics and Gynecology, Paras Health Panchkula, told HealthandMe.
Dr. Vandana Jain, Principal Consultant - Obstetrics, Gynecology, Infertility & Advanced Laparoscopic Surgery, Yashoda Medicity, added that the test is commonly recommended in high-risk pregnancies, including fetal growth restriction, preeclampsia, hypertension, gestational diabetes, oligohydramnios, multiple pregnancies, and decreased fetal movements.
"By evaluating how effectively oxygen and nutrients are reaching the baby, the test helps detect signs of fetal compromise at an early stage, enabling timely monitoring, appropriate medical intervention, and informed decisions regarding the timing and mode of delivery."
By identifying potential issues early, Doppler studies help doctors monitor pregnancies more closely and intervene when necessary. However, the test is performed only for specific medical indications and is not a replacement for routine pregnancy ultrasounds.
According to the Mayo Clinic, a Doppler ultrasound can help diagnose:
How Doppler Ultrasound Can Help People With Leg Pain
Dr. Jain said Doppler ultrasound is also commonly advised for patients with suspected Deep Vein Thrombosis (DVT), peripheral arterial disease, carotid artery narrowing, or chronic venous insufficiency.
"It is commonly advised for patients with suspected Deep Vein Thrombosis (DVT), peripheral arterial disease, carotid artery narrowing, or chronic venous insufficiency," she told HealthandMe.
The expert added that people with persistent leg pain while walking, unexplained swelling, non-healing wounds, or symptoms of poor circulation may require a Doppler evaluation.
Recently, gastroenterologist Dr. Pal Manickam highlighted the importance of Doppler ultrasound during a podcast discussion. He urged people not to ignore sudden leg pain or swelling, noting that these symptoms could indicate deep vein thrombosis (DVT) and require prompt evaluation.
The procedure is painless, non-invasive, and usually takes 30 to 60 minutes, depending on the area being examined. It is also radiation-free.
A Doppler ultrasound is performed by a trained sonographer using a hand-held device called a transducer. The transducer sends sound waves into the body and measures how they bounce off moving blood cells, allowing the machine to assess blood flow in real time.
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For years, excess weight has been considered one of the biggest risk factors for fatty liver disease. However, doctors are now seeing a growing number of Indians being diagnosed with Grade-1 fatty liver despite having a normal or only slightly elevated body mass index (BMI).
The emerging pattern is challenging the long-held belief that only people with obesity are at risk. Ahead of the World Hepatitis Day, observed every year on July 28, the health experts said it highlights the need to look beyond the number on the weighing scale, as excess abdominal fat, insulin resistance, poor diet, sedentary lifestyles, and genetic predisposition are increasingly being linked to early liver damage.
Speaking to HealthandMe, Dr. Pankaj Sharma, Director of Dept. Robotics, Bariatric, Laparoscopic and General Surgery, Fortis Hospital, Shalimar Bagh, said the trend reflects the rise of hidden metabolic problems rather than visible obesity.
"Many Indians develop excess fat around internal organs even when their BMI is within the normal range. Sedentary lifestyles, processed foods, sugary drinks, poor sleep and insulin resistance all contribute to fat accumulation in the liver. Grade-1 fatty liver is often the body's first signal that metabolic health is beginning to suffer," he said.
The doctors highlighted that many Indians develop visceral fat despite having a normal BMI, making them vulnerable to metabolic disorders. This means a healthy weight alone does not always translate to a healthy liver.
Also read: 1 In 4 Diabetic Patients in India Suffer from Liver Fibrosis, Finds Lancet Study
The effects of fatty liver may extend beyond liver health, said Dr. Shobha Gupta, Medical Director and Infertility Specialist at Mother's Lap IVF Centre, Pitampura, New Delhi. She noted that metabolic disorders are increasingly affecting fertility in younger adults.
"Fatty liver is often part of a larger metabolic imbalance. In women, it may coexist with insulin resistance and PCOS, affecting ovulation, while in men, poor metabolic health can compromise sperm quality. Improving metabolic fitness before conception can support both fertility and a healthier pregnancy," she told HealthandMe.
Doctors also recommend assessing liver and overall metabolic health early during fertility treatment.
The experts emphasized that Grade-1 fatty liver is one of the few lifestyle-related conditions that can often be reversed if detected early.
"Instead of waiting for symptoms, people should pay attention to routine health check-ups, stay physically active and make sustainable lifestyle changes. Prevention is always easier than treating advanced liver disease," Dr. Sharma said.
Doctors recommend regular exercise, a balanced diet, maintaining a healthy waistline, and controlling blood sugar and cholesterol to prevent further liver damage.
Read More: NAFLD to MASLD: Experts Explain Why This Common Yet Dangerous Liver Condition Got Renamed
Grade-1 fatty liver, also known as mild steatosis, is the earliest and usually reversible stage of fatty liver disease. In this stage, about 5-10% of the liver contains excess fat.
If left untreated, the disease can progress to liver fibrosis, where scar tissue gradually replaces healthy liver tissue due to chronic inflammation. Advanced fibrosis can eventually lead to irreversible liver damage (cirrhosis), increasing the risk of liver failure and liver cancer.
The doctors warned that liver disease often remains unnoticed until it has significantly progressed. But some people may experience:
Doctors may diagnose fatty liver using a combination of:
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For decades, fluoride has been the gold standard in oral care. It promotes remineralization, strengthens enamel, and has played a central role in reducing dental caries worldwide. But as oral care science advances, a question has emerged: can we do more?
Research suggests we can. One of the most promising developments in preventive oral care is the use of arginine, a naturally occurring amino acid, alongside fluoride. Together, they offer a dual-action approach that not only repairs weakened enamel but also helps create the optimal oral environment to prevent future damage.
To understand why this matters, it helps to look at how far oral care has come. For decades, the message was straightforward -- brush twice a day, use fluoride toothpaste, limit sugar. While that foundational advice still holds, the science of oral health has moved well beyond the basics. We now understand that dental care is not simply a matter of sugar and bacteria; it is a dynamic, multifactorial process driven by the interplay between acid-producing microorganisms, saliva, diet and the delicate balance between demineralization and remineralization on the tooth surface.
When pathological factors such as acidogenic bacteria and frequent sugar intake outweigh protective factors, enamel begins to weaken. This understanding has prompted researchers to explore ingredients that do not just protect teeth passively but actively support the mouth's natural defense mechanisms.
Arginine is a semi-essential amino acid found naturally in dietary proteins and in human saliva. In the oral cavity, it plays a unique and important role. It serves as fuel for beneficial bacteria that help keep the mouth's pH balanced.
Arginine acts like a prebiotic for the mouth, nourishing the good bacteria while making it harder for harmful ones to thrive. Research has shown that caries-free individuals tend to have significantly higher levels of arginine-metabolizing activity in their saliva and plaque compared to those with active cavities.
Fluoride and arginine work through distinct but highly complementary mechanisms. Fluoride promotes the uptake of calcium and phosphate into weakened enamel, forming a more acid-resistant mineral structure.
Arginine, on the other hand, addresses the root cause of enamel damage (the acidic environment created by cariogenic bacteria) by modulating plaque pH and supporting a healthier oral microbiome. When combined, these two ingredients offer a dual-action approach: fluoride repairs and strengthens the enamel surface, while arginine creates the favorable conditions that help sustain that repair over time.
Clinical evidence supports this synergy. A comparative in vitro study published in Cureus (2024) found that the combination of arginine with fluoride demonstrated superior remineralisation potential compared to established agents such as Bioactive Glass and CPP-ACP technology used individually. Similarly, research published in the Journal of Dental Research demonstrated that fluoride and arginine together synergistically suppressed Streptococcus mutans, a key caries-causing bacterium, while enriching health-associated species within dental biofilms.
A clinical study conducted by Cantore et al confirmed that toothpaste containing 1.5% arginine and 1000ppm fluoride significantly increased oral ammonia concentration, an indicator of active pH buffering. A study done by Fatima et al demonstrated the shift in the oral microbiome toward a healthier composition. In short, the arginine-fluoride combination works with the mouth’s chemistry and biology to give better Enamel remineralization than Fluoride alone.
However, while the evidence supporting this dual-action approach continues to grow, not all products reflect the same level of clinical validation.
In a market crowded with oral care products making various claims, consumers need to look beyond marketing language and understand the science behind what they use. Not all ingredient combinations are created equal, and not every claim is supported by rigorous clinical evidence.
The arginine-fluoride combination is backed by a substantial body of peer-reviewed research -- from laboratory studies and in situ models to randomized clinical trials. As a consensus report published in the International Journal of Clinical Pediatric Dentistry notes, several clinical studies using 1.5% arginine combined with fluoride3 have provided robust evidence for its use in preventing dental caries and supporting enamel health.
Choosing oral care products grounded in clinical evidence is not just a matter of efficacy; it is a matter of trust. When an ingredient's benefits are validated through independent, published research, consumers can make more informed choices about their oral health.
Fluoride remains a cornerstone of oral care. But the science has moved forward, and so should our approach to strengthening teeth. Arginine represents a significant advance, not as a replacement for fluoride, but as a powerful complement that addresses oral health at both the chemical and microbial levels. By choosing formulations that combine arginine with fluoride, consumers can benefit from an approach that goes beyond surface-level protection, one that actively supports the mouth's natural ability to repair, strengthen and defend itself against decay.
As oral care continues to evolve, the future will be defined not by single-ingredient solutions, but by science-led formulations that work with the body’s natural biology. The combination of arginine and fluoride is a step in that direction.
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