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 new study has revealed an alarming trend in stroke cases in the past three decades. Strokes have often been associated as an age-related disease. But according to a study published in Neurology, the rate of stroke among adults aged 20 to 54 has nearly doubled between 1993-94 and 2020.
Researchers examined data from the Greater Cincinnati and Northern Kentucky Stroke Study and identified 2,076 first-time strokes among people in this age group.
The rate of stroke rose from 33.9 cases per 100,000 person-years in 1993-94 to 62.2 in 2020. The increase was largely driven by ischemic stroke, which happens when a blood vessel in the brain becomes blocked.
The study points towards an alarming pattern, especially among younger age groups. It raises the question of why are strokes are occurring earlier in life?
The researchers found that several risk factors of stroke became more common among younger people. These included lifestyle disorders like high blood pressure, diabetes and atrial fibrillation, an irregular heart rhythm that can increase the risk of blood clots.
Apart from lifestyle diseases, researchers also saw an increase in substance use. Among younger adults who had suffered a stroke, substance use rose from 4.6% in 1993-94 to 40.2% in 2020. Much of this increase was linked to marijuana use.
However, the study does not prove that these factors caused the overall rise in stroke rates. Researchers did not have comparable information from people who had not suffered a stroke, making it impossible to determine whether the changing risk factors directly explain the surge in cases.
According to the study, the increase was concentrated mainly in ischemic strokes. The rate of ischemic stroke among 20- to 54-year-olds rose from 23.8 to 47.3 cases per 100,000 person-years during the study period.
Researchers did not observe a similar increase in intracerebral haemorrhage, which involves bleeding within the brain, or subarachnoid haemorrhage, which involves bleeding around the brain.
An ischemic stroke occurs when a blood vessel supplying part of the brain becomes blocked, cutting off oxygen and nutrients. Brain cells can start dying within minutes, which is why stroke treatment is highly time-sensitive.
The warning signs of stroke can appear suddenly. They include:
The commonly used FAST acronym stands for Face, Arm, Speech and Time. If these symptoms appear, emergency medical care should be sought immediately.
Also read: UK Student Nearly Dies After Accidental Paracetamol Overdose: Why It Can Cause Liver Failure
This is another interesting finding. Although stroke became more common among younger adults, the study found that the 30-day death rate declined modestly, from 11.7% in 1993-94 to 9.4% in 2020 after adjusting for age, race and sex.
That means more younger people may be surviving strokes but potentially living with their long-term consequences.
The researchers say the findings highlight the importance of identifying and managing stroke risk factors earlier in adulthood. More research is still required to understand what is behind the changing pattern and how it can be prevented.
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A 20-year-old UK student nearly died after accidentally taking two over-the-counter medicines that both contained paracetamol.
Riley Lubas, a first-year University of Bath student, developed a bad cold in March 2025. Days later, he developed severe stomach pain and was found to have serious liver damage.
Doctors initially suspected hepatitis, but Riley's condition rapidly worsened. He became delirious and hallucinated as his liver began to fail. His lungs and kidneys also stopped working, leaving him in multiple organ failure.
He was placed on life support and dialysis before being transferred to King's College Hospital in London, where doctors identified the cause after asking about his paracetamol use.
"It didn't necessarily help with a solution, but it was good to know the cause at last," his father, Chris, said.
Riley was assessed for a liver transplant after his parents were warned that some of the damage could be "irreversible". But his liver began to recover.
"We watched Riley's situation closely for a couple of days, and he continued to improve, until he was taken off dialysis and life support just a week later."
Riley spent six weeks at King's College Hospital and later moved to an ICU in Newport. After a tracheostomy and multiple organ failure, he had to relearn how to speak and walk.
"But just seeing him up and alive again was unbelievable," his father said.
Riley has since recovered and returned to work as a bartender.
"It was mad how quickly it all escalated," he said.
"Because I was already sick, when my stomach hurt I just assumed I'd caught a stomach bug, so I didn't notice the pain in my liver specifically."
"I'm just so grateful that I was able to come out the other end alright."
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Riley's case highlights the risk of taking multiple medicines without realizing they contain the same active ingredient.
Dr Will Mackintosh, a GP and chairman of RCGP Cymru Wales, said accidental paracetamol overdose in young people was "a fairly rare occurrence", but warned that people can inadvertently take two products containing paracetamol, BBC reported.
The Medicines and Healthcare products Regulatory Agency (MHRA) has warned that "simple misunderstandings" about medicines can have serious consequences, highlighting the importance of checking the ingredients beforehand.
The Royal College of General Practitioners Cymru Wales also advised people to "read the label carefully" before taking medicines.
For most adults, the usual dose is 500 mg to 1,000 mg at a time, with at least four hours between doses.
The usual maximum is 4,000 mg in 24 hours, although some people may need a lower dose because of their weight, liver or kidney problems, alcohol use or other health conditions.
The important point is to count paracetamol from all medicines, including cold and flu products.
The liver breaks down paracetamol. When too much is taken, a toxic substance can build up and damage liver cells. Severe overdose can lead to liver failure and death.
Early symptoms may include nausea, vomiting and stomach pain, but serious poisoning may not cause obvious symptoms immediately. Later signs can include jaundice, confusion and extreme sleepiness.
If you think you have taken too much paracetamol — including by combining medicines that contain it — seek urgent medical advice immediately.
Do not wait for symptoms. Early treatment can reduce the risk of serious liver damage.
Always check the active ingredients on painkillers and cold and flu medicines before taking them together.
Credit: AI
Doctors at a Mumbai hospital successfully performed a complex coronary angioplasty on an elderly diabetic patient with severely calcified coronary arteries using an advanced technique called Intravascular Lithotripsy (IVL), helping restore blood flow to the heart despite multiple procedural challenges.
The patient, who had been experiencing symptoms suggestive of coronary artery disease, was found to have extensive calcium deposits in the coronary arteries. Further evaluation also revealed poor blood flow in the leg arteries, making conventional vascular access for the procedure difficult.
Coronary artery calcification is commonly seen in elderly individuals and people with long-standing diabetes. Excessive calcium makes the arteries rigid and narrow, often making routine angioplasty technically challenging and increasing the risk of incomplete stent expansion, which can affect long-term outcomes
Severely calcified coronary arteries remain one of the biggest challenges in interventional cardiology. The calcium makes the arteries extremely rigid, making it difficult to properly expand the stent. In such situations, conventional angioplasty alone may not be sufficient.
Despite the patient’s complex anatomy and poor peripheral vascular access, the team successfully performed the procedure through the radial artery in the wrist, avoiding access through the diseased leg vessels.
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To prepare the artery for stenting, doctors used Intravascular Lithotripsy (IVL), an advanced technology that delivers controlled sonic pressure waves to fracture deep calcium deposits within the artery wall. This allows the blood vessel to expand more effectively, enabling safe and optimal placement of the coronary stent.
IVL works on a principle similar to the technology used for breaking kidney stones, but it is specifically designed for heavily calcified coronary arteries. By modifying the calcium before placing the stent, we can achieve better stent expansion, reduce procedural complications and improve long-term outcomes in appropriately selected patients.
The procedure was completed successfully, with excellent blood flow restored to the affected coronary artery. The patient recovered well and was discharged in a stable condition.
Doctors say the case highlights how newer technologies are expanding treatment options for patients who were once considered extremely difficult to treat due to severe coronary calcification.
Advanced techniques such as IVL are transforming the management of complex coronary artery disease, particularly in elderly diabetic patients, allowing us to safely treat lesions that would have been significantly more challenging with conventional techniques alone.
The case underscores the growing role of advanced interventional cardiology in treating complex heart disease while minimising procedural risk and improving patient outcomes.
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