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.
Metabolic dysfunction-associated steatotic liver disease (MASLD), previously called fatty liver disease, is becoming extremely common in people with type 2 diabetes in India.
Studies suggest that 50–70 percent of Indians with type 2 diabetes may have fatty liver, and a significant proportion can progress to inflammation, liver fibrosis, cirrhosis, or even liver cancer if the condition is not detected early. Because India already has one of the world’s largest populations with diabetes, MASLD is emerging as a major but under-recognized public health problem.
The recently published consensus guidelines developed by Indian experts aim to provide practical, India-specific recommendations for diagnosing and managing MASLD in people with type 2 diabetes.
In fact, these are the first global guidelines for MASLD and type 2 diabetes, albeit restricted to India. This matters because most existing international guidance—including from organizations such as the American Diabetes Association—is largely based on evidence and healthcare systems in high-income Western countries. These recommendations often assume easy access to expensive diagnostic tests and medications, which may not always be feasible in India.
In India, healthcare costs are frequently paid out-of-pocket by patients. Advanced imaging tests or newer medications can therefore be unaffordable for many people.
The Indian consensus addresses this reality by recommending step-wise and cost-effective screening strategies, beginning with simple clinical risk assessment and basic laboratory tests, followed by non-invasive fibrosis scoring tools and ultrasound when appropriate. This approach helps identify high-risk individuals without overburdening patients or the healthcare system.
Another important reason these guidelines matter is that Asian Indians have a unique metabolic profile. Compared with Western populations, Indians often develop diabetes and fatty liver at younger ages and lower body weight, partly because of higher abdominal fat and insulin resistance. Therefore, early screening for liver disease in people with diabetes becomes particularly important in India.
Dietary recommendations are also adapted to local eating patterns. Instead of focusing on Western dietary models, the guidelines emphasize reducing refined carbohydrates, excess sugars, and unhealthy fats common in Indian diets while promoting traditional, healthier foods, whole grains, legumes, and increased physical activity.
In simple terms, these India-specific guidelines aim to ensure that more patients with diabetes are screened early, treated appropriately, and protected from severe liver complications, using strategies that are practical, affordable, and suited to the realities of the Indian healthcare system.
Guidelines for MASLD developed in Western countries provide important scientific guidance, but they are often designed for healthcare systems with greater resources and different patient characteristics. The Indian consensus recommendations differ in several key ways to make them more suitable for local populations and healthcare settings.
First, screening strategies are more pragmatic and cost-conscious. Western guidelines often recommend advanced imaging tests or specialized biomarkers to assess liver fat and fibrosis. However, these tests can be expensive and not widely available in many parts of India.
The Indian recommendations emphasize simple, widely available tools—such as routine blood tests and non-invasive fibrosis scoring systems—before considering more advanced imaging. This stepwise approach ensures that patients who are most at risk are identified while keeping costs manageable.
Second, the guidelines recognize the unique metabolic risk profile of Asian Indians. Compared with Western populations, Indians tend to develop metabolic diseases such as type 2 diabetes and fatty liver at younger ages and lower body mass index (BMI). Abdominal obesity and insulin resistance are particularly common.
Therefore, the Indian recommendations stress earlier and more vigilant screening for MASLD in people with diabetes, even if they are not severely obese.
Third, treatment priorities differ because of affordability and access to medications. Western guidelines may emphasize newer and often expensive drugs that show benefits for fatty liver disease. While these therapies can be effective, they may not be accessible to many patients in low- and middle-income countries.
The Indian consensus places stronger emphasis on lifestyle interventions, weight reduction, improved diet, and physical activity as the foundation of treatment, while suggesting pharmacotherapy selectively based on evidence, availability, and cost.
Fourth, perhaps the most important difference, dietary advice is culturally tailored. Western guidelines typically discuss Mediterranean-style diets.
In contrast, the Indian recommendations translate healthy eating principles into Indian dietary patterns, focusing on reducing refined carbohydrates, sugar-sweetened foods, and excess saturated fats while promoting whole grains, pulses, vegetables, and traditional balanced meals.
Finally, the Indian document highlights the need for public health awareness and primary care involvement, since a large proportion of patients with diabetes are managed outside specialized centers.
Overall, the key difference is that while Western guidelines provide strong scientific foundations, the Indian recommendations adapt those principles to local realities.
Credits: Wikimedia Commons and Instagram
Bristol Palin, an American real estate agent, who was a former public speaker and reality television personality started experiencing facial paralysis over a tear ago. On March 9, her 35-year-old daughter Sarah Palin posted a video on her Instagram Stories that shared an update on her ongoing health struggles. The story revealed that she is now considering plastic surgery to fix her paralysis.
"I am going to have a consultation today with a plastic surgeon in Austin," she said. "I have read that she specializes in facial paralysis type stuff so we will see what she says."
She also said, "Prayers because maybe she can help mostly with this eye," while pointing to her left eye. "When I smile or when I am expressive, it closes. I don't really care about my crooked mouth but my eye...so embarrassing to me. I feel like I should wear an eyepatch or something."
She went on to say, "It looks crazy and I just feel like I cannot even smile because it just closes. So maybe she can do some Botox or maybe there is some options with surgery. So we will see. Maybe she ca help with this eye or just the overall symmetry."
She also said that she had just returned from Alaska, where she visited another specialist who does her facial nerve blocks to help her paralysis. She also posted another update on her Instagram Stories and said that her consultation went well and that she will be sharing the information with her followers soon.
It was in January 2025, when she revealed her facial paralysis on Instagram. "I woke up nine days ago with a little weird sensation in my face. My mouth was pulling this way and it just felt a little off. So I went, looked in the mirror. I'm like 'Wow. This is looking a little weird. I feel like everything is pulling to the left."
She said that hours later her condition got worse and the left side of her face was having a "delayed" reaction.
Read: Why Does Your BBL Smell? Doctor Explains 4 Reasons That Could Cause It
As per a 2020 study published in the Indian Journal of Plastic Surgery, botulinum toxin (Botox) injections are helpful and are minimally invasive technique to restore facial symmetry. However, the study noted that a "surprisingly small minority of aesthetic injectors treat this condition."

The study also gives a case study of a patient with longstanding facial nerve paralysis after resection of an osteogenic sarcoma, before and after two weeks after first treatment with botulinum toxin. The improvements could be seen in mentalis synkinesis, more symmetrical smile, and improved eye apertures on animation.
It is an FDA-approved, injectable neurotoxin derived from Clostridium botulinum bacteria. It temporarily relaxes muscles by blocking nerve signals, commonly used to smooth dynamic wrinkles and treat medical conditions like chronic migraines, excessive sweating, and muscle spasms. Its effects last from three to four months.
Botox prevents the release of a neurotransmitter that signals muscles to contract, causing them to relax and soften wrinkles. Results typically appear in 3 to 14 days.
Credits: Canva and iStock
The US Food and Drug Administration approved leucovorin for cerebral folate deficiency in the receptor 1 gene, a rare genetic condition. However, last year, in September, this drug was noted as the possible and potential treatment for children with autism. The Trump administration noted that Tylenol may be triggering autism in children when is consumed by pregnant mothers. The same conference touted this drug as a potential treatment, while not enough scientific evidence was there to support the claim. Yet, many parents looked for the prescription to support their children.
Health and Me also reported a story of a mother who looked for the drug for her three-year-old son. Another case of four-year-old Jose Morales-Ortiz, who struggled to speak even two-word sentences. As per a CNN report, he was diagnosed with severe autism and rarely responded when someone called his name.
However, something changed, in early summers, he began telling his guardian Keith Joyce about the conversation with his classmates and answering follow-up questions. For Keith, it was a moment of joy. It was also the first time Keith had a conversation with him.
Joyce believes the change began after Jose started taking leucovorin, a medication originally approved to reduce the side effects of certain chemotherapy drugs. Now, researchers are investigating whether the drug may help some children with autism—particularly those with a condition known as cerebral folate deficiency.
However, scientists caution that while early studies are promising, the evidence is still limited and the treatment remains controversial.
Leucovorin, also known as folinic acid, is a biologically active form of vitamin B9 or folate. Unlike standard folic acid supplements, it does not require the body to convert it into an active form before it can be used. Due to this very feature, it can bypass certain metabolic steps and deliver folate more directly to the cells.
It is a high-dose B vitamin, which is commonly used as a treatment to counteract the side effects of chemotherapy. It has been approved by the FDA for cerebral folate deficiency in the receptor 1 gene. The disease is rare and fewer than 50 cases have been identified worldwide. FDA Commissioner Dr Marty Makary called this approval "a significant milestone" for patients with the condition.
Doctors have used the drug for several purposes, which also include:
Recently, scientists began exploring whether leucovorin could also help certain neurological conditions.
Read: Leucovorin Approved By FDA But For A Rare Genetic Disease, Not For Autism
Folate is essential for brain development and neural function.
It helps in:
During pregnancy, folate is so critical that many countries fortify foods with folic acid to prevent birth defects such as neural tube defects.
However, in some children, the issue may not be a lack of folate in the diet—but a problem with how folate reaches the brain.
In 2005, researchers discovered an unusual phenomenon in some children with developmental disorders.
Although their blood folate levels were normal, their brain folate levels were extremely low.
The reason appeared to be autoantibodies—immune proteins that mistakenly attack the body’s own tissues. In this case, the antibodies targeted folate receptor alpha, the protein responsible for transporting folate across the blood-brain barrier.
This condition is called cerebral folate deficiency.
Researchers also developed a diagnostic blood test called the Folate Receptor Autoantibody Test (FRAT) to detect these antibodies.
It could work in such a case because it is able to bypass the blocked folate receptors. It does not rely on the usual transport system and is able to enter the brain through alternative transport pathways, which allow neurons to access the folate they need. Scientists also believe that this could improve neurotransmitter production, support neural communication, and enhance brain metabolism in certain children.
Some clinical studies have suggested that leucovorin may improve language and communication skills in certain children with autism.
However, the results have been mixed.
Some studies have found only modest improvements, and large placebo-controlled trials—considered the gold standard in medical research—are still lacking.
Because autism is a complex spectrum condition with many biological pathways involved, researchers emphasize that no single medication is likely to work for every child.
The growing interest in leucovorin reflects a broader shift in autism research: looking for biological subtypes of the condition that might respond to targeted treatments.
If cerebral folate deficiency proves to be one of those subtypes, leucovorin could become an important therapy for a specific group of children.
But scientists emphasize that autism is highly complex. “There’s no autism pill,” many researchers say.
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