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
People living with obesity and diabetes often feel healthy in their day-to-day life, but some of the most dangerous changes may be happening silently inside their bodies.
The liver is one of the first organs to be affected. In many cases, fat slowly accumulates in the liver without causing any pain, discomfort, or obvious symptoms. This is why fatty liver disease is often called a “silent condition.” By the time it is detected, it may already have progressed to an irreversible stage.
Excess body fat, particularly around the abdomen, disrupts how the body processes sugar and fats, placing continuous stress on the liver. Because of this silent progression, experts now strongly recommend that people living with obesity and type 2 diabetes should proactively check their liver health, even when they feel completely well.
Obesity is closely linked with liver damage through a series of metabolic changes that develop over time. When the body becomes resistant to insulin, fat begins to accumulate in liver cells, triggering inflammation and gradual injury.
If this continues unchecked, the condition can progress from simple fat accumulation to more serious stages, including metabolic dysfunction-associated steatohepatitis (MASH), where inflammation and liver cell damage become more significant.
Over time, this may lead to fibrosis (scarring of the liver), and in advanced cases, cirrhosis, which can severely affect liver function. Further, patients with fatty liver may directly present with liver cancer, which can occur in up to 20% of patients.
In India, the burden of metabolic dysfunction-associated steatotic liver disease (MASLD) or fatty liver is rising and is now recognised as a common metabolic condition. Studies from the Indian subcontinent estimate that 1 in 3 people may have MASLD. Fatty liver is particularly common among individuals with metabolic risk factors.
It is seen in nearly 40–80% of people with type 2 diabetes and 30–90% of those with obesity, often without clear symptoms.iv Hospital-based trends also suggest increasing detection in younger age groups, reflecting changes in diet, reduced physical activity, and more sedentary lifestyles.
Preventive measures to be followed:
Also read: From Liver Inflammation to Cancer: When Hepatitis Becomes a Serious Warning Sign
With rising obesity rates in India, early liver screening should become a routine part of preventive healthcare. Even modest weight reduction, improved diet quality, and regular exercise (approximately 150 minutes per week of moderate-intensity exercise (example: brisk walking, gardening, swimming, cycling) or 75 minutes of vigorous exercise (example: weight training) can significantly reduce liver fat and inflammation within 3-6 months.
However, once the disease progresses to MASH or fibrosis, reversal becomes more difficult and may require long-term medical management. Early-stage fatty liver disease is reversible in many cases. In fact, medications can even reverse liver fibrosis (early scarring), but in only 25% of patients. Simple homemade food is sufficient to prevent these lifestyle diseases, and there is no need for “fancy online diets or supplements”.
Our forefathers lived longer by consuming homemade food and water without any supplements. Newly approved therapies such as semaglutide (GLP1 analogues) have been shown to resolve steatohepatitis and reduce liver fibrosis. These liver benefits do not appear to be explained solely by weight loss, suggesting a broader potential impact on liver health.
The absence of symptoms does not mean the absence of risk. Taking care of the liver early is not just about preventing disease; it is about protecting long-term health, energy, and quality of life.
By Dr. Anand V. Kulkarni, Senior Consultant Hepatologist & Director – Critical Care Hepatology, AIG Hospitals, Hyderabad
Credit: AI
There is a conversation that comes up in almost every consultation, and it is rarely the one the patient came prepared for. After graft numbers, hairline design, cost and downtime have been discussed, the question of smoking and drinking inevitably follows — and the answer is usually a shrug: occasionally, socially, nothing serious.
Yet of all the variable that determines what a patient sees in the mirror eighteen months later, these two are among the very few fully within their control, and among the most underestimated.
The hair follicle is one of the most metabolically demanding structures in the body, dividing faster than almost any other cell population and depending entirely on a dense network of microscopic vessels feeding its base. Nicotine constricts those vessels; over years, repeated narrowing combined with low-grade inflammation contributes to perifollicular fibrosis — scarring that gradually chokes the follicle.
Alcohol takes a different route, depleting the zinc, iron, folate, B12 and protein hair is built from, while fragmenting sleep and raising cortisol — both of which push follicles prematurely into their resting phase. For a transplant candidate, this matters twice over: it reflects donor-area quality, and it signals the kind of healing environment the grafts are about to enter.
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For the first few days after surgery, a transplanted follicle is essentially cut off from its blood supply, surviving on nutrients diffusing in from surrounding tissue.
New capillaries begin connecting around day four or five, with full revascularisation taking seven to ten days — the most vulnerable window in the graft's life. Smoking attacks it from two directions: nicotine causes sustained vasoconstriction after every cigarette, while carbon monoxide binds haemoglobin more readily than oxygen, so the reduced blood reaching the scalp also carries less oxygen.
The result is rarely dramatic — just poorer graft survival, patchier density, and a final outcome thinner than the graft count promised. Patients often read this as bad luck; it usually isn't. Notably, this applies equally to vaping, hookah and smokeless tobacco like gutkha or khaini — the delivery method changes, but the nicotine doesn't.
Alcohol's damage is more mechanical. It causes vasodilation and impairs clotting, meaning patients who've been drinking beforehand bleed more during surgery — which makes graft placement less precise and can dislodge grafts already sited.
Afterward, the same vasodilation worsens normal post-op swelling, its diuretic effect fights the hydration healing tissue needs, and its immune-suppressing effect arrives just as the scalp carries thousands of small open wounds. There's a medication risk too: alcohol combined with post-op antibiotics, anti-inflammatories or steroids raises the chance of gastric irritation or a genuinely unpleasant systemic reaction.
For smoking: stop at least two weeks before surgery (four is better), and stay off it for two weeks to a month afterwards — the long lead-in accounts for how slowly small-vessel and immune function normalise, and the long tail covers graft revascularisation.
For alcohol: stop five to seven days before, and avoid it for ten to fourteen days after, or as long as medication continues, since its effects reverse faster. One caveat worth repeating: patients often say they've "stopped" when they've merely cut back. A single cigarette produces measurable scalp vasoconstriction — in this window, occasional isn't the same as fine.
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A costly misconception is that once surgery is done, lifestyle no longer matters. It's a half-truth: transplanted follicles, taken from the DHT-resistant back and sides of the scalp, are permanent and won't miniaturise. But a transplant only redistributes existing hair — every native follicle remains susceptible to ongoing loss.
If that native hair keeps thinning, overall density falls even though every graft survives, and patients often mistake this for transplant failure. In reality, the surroundings have receded, accelerated by smoking, poor sleep, chronic stress and poor nutrition. Surgery buys a foundation; lifestyle determines how long the picture around it holds.
Honesty at consultation matters — knowing a patient smokes heavily changes the surgical plan toward more conservative density and staging, which protects the result. The pre- and post-op window should be treated as non-negotiable, even if permanent quitting feels distant; a defined four-week commitment is far more achievable than an open-ended one.
Switching to vaping or nicotine gum isn't automatically safe — it removes carbon monoxide and tar, but nicotine, the actual vasoconstrictor, remains, so replacement therapy should be discussed with the surgeon. Fundamentals also help: adequate protein, iron and vitamin D, seven to eight hours of sleep, hydration, and gentle movement once cleared.
Finally, surgery itself can be motivating. Patients who've just invested significant money and recovery time in their appearance are often more driven to quit than at any other point in
By Dr. Harikiran Chekuri, Hair Transplant Surgeon, Founder and Chief Plastic Surgeon, Redefine Hair Transplant & Plastic Surgery Center
Credit: AI
It is difficult to determine emotions because of the neurological differences, the surrounding in childhood, the psychological ways of survival, and absence of emotional training.
Alexithymia or "emotional blindness" is the neuropsychological trait associated with severe problems with identification, recognition, and description of the person's emotions. Alexithymia is not a psychiatric disease but a personality trait.
It is characterized by the inability to identify and distinguish emotions and body sensations, difficulty of finding the words to express feelings, inability to understand facial expression and body language of another person and emotional detachment during stressful situations.
It is diagnosed in people with autism spectrum disorder, depressive disorder, generalized anxiety disorder and after traumatic brain injuries. It can be inherited or acquired as a result of childhood trauma, abuse or neurological damage.
The Brain Science Behind Alexithymia
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The cause of alexithymia is the brain wiring and neurological differences. Therefore, there is impaired interception, which is the inability of the brain to recognize its own physical sensations. Also, an unusual structure of the brain regions like amygdala and insula, that regulate emotions, makes difficult to decode emotional signals.
Early childhood environment and emotional competence must be developed in childhood, because, without that, there can be emotional neglect and emotional vocabulary deficiency. Due to the inability to interpret emotional data, the person misses the compass that directs decisions and self-calming. This leads to emotional outburst, panic, hyperarousal, social and psychological consequences.
How Alexithymia Differs From Emotional Numbness
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Emotional numbness is the transient psychological state caused by acute trauma, deep grief or burnout.
The lack of emotional intelligence is the lack of social and emotional competence, when the person feels his emotions correctly, but he cannot control temper, lacks empathy, makes inappropriate social decisions or do not know what kind of effect his behaviour causes on the room.
But alexithymia is different since it is long-term personality trait and the person is unaware of the particular emotion.
In terms of neurodevelopment, the insular cortex and the anterior cingulate cortex (ACC) are the structural core of the brain's salience network. They work as a translator, transforming chaotic physical sensations into recognizable emotional experience.
Although there isn't any cure for alexithymia, one can improve his emotional awareness through certain measures. Interoceptive training where individuals are taught how to associate physical body sensations (such as tightness in the chest) with particular emotions (such as stress).
The use of emotion wheel or list of emotional words to bridge the link between vague physical sensation and precise description. Mindfulness, which involves observing oneself without judgment or without trying to suppress those internal feelings right away. And it is always good to seek professional help from a psychologist or a counselor.
By Dr. Arun Shah, Director - Neurosciences, Sir H.N. Reliance Foundation Hospital
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