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Living Healthy with HIV – Reality or Myth

 

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Have you seen the latest#CondomEmoji campaign by Durex, the Global Sexual-well-being brand depicting an “Umbrella with Raindrops”? This was the unofficial safe sex emoji launched ahead of World AIDS Day today. It was an interesting campaign to communicate ‘Safe Sex’ among the young adults. The campaign called for putting a safe sex emoji on every smartphone in order to help young people communicate about safe sex. The campaign has trended both on Twitter and Facebook with supporters from over 160 countries backing the movement.

The survey findings noted while more than 60 per cent of young people surveyed admitted to being uncomfortable discussing safe sex, 72 per cent of respondents admitted that they found it easier to express emotions using emojis and more than three quarters admitted that they use emojis to discuss sex and relationships.

Why is this discomfort about talking of sex or sex related diseases such as HIV/Aids even in the 21st Century?
One of my earliest memories of AIDS would be the movie PHILADELPHIA where Tom Hanks sues his Company for being fired from his workspace for being HIV positive.

Whenever we hear the word AIDS or HIV the word itself it creates a lot of fear and makes one judgmental. This is not the case only among the lay man but also is the case equal judgment, not only among general public but also within the medical fraternity. Unfortunately more than a the disease, AIDS is considered to be a social stigma and a taboo.
It’s become imperative to understand why this stigma is attached to HIV/AIDS?

AIDS (Acquired Immunodeficiency Syndrome) as we all know is a syndrome caused by the Human Immunodeficiency Virus (HIV) which directly attacks the immune system of the patient leaving the body vulnerable to a host of infections. Aids is the last stage of HIV infection where the disease progresses and the body can no longer defend itself leading to more severe infections, malignancies and eventually death (if left untreated).
Let me try to look into the ways one can get infected with this Virus which are considered some of the main reasons for fear and stigma.

1. Unprotected sex- with an individual who is infected with HIV is the biggest cause of new HIV cases be it vaginal or anal sex. Oral sex also predisposes one to HIV if there are any cuts, ulcers or sores in the mouth. Wearing a condom is the easiest way to protect yourself and your partner against the disease. Unprotected Sex is more prevalent among young adults.
2. Blood transfusion with infected blood. This is one of the most unfortunate ways to contract the disease as the recipient is unaware of the blood being infected. It is always a good idea to make sure that the blood has been screened for HIV infection.
3. HIV infected mother can pass on the virus to her baby during pregnancy lactation or even delivery. These mothers can now take treatment to protect their babies.
4. Sharing razors or needles with infected people also puts you at risk of contracting the virus like in the case of drug abuse or needle prick in hospital.
In short the virus can be transmitted through infected blood, semen and vaginal fluids. In fact, when the disease first came to light in India, it was the sex workers and their clients who had the maximum prevalence followed by truck drivers.

The latest ‘DIPPER’ at night campaign where the Condom is disguised as the dipper is a great way to create awareness among truck drivers in India to frequent sex workers often.
But, honestly it’s not so bad as it’s been made out to be over the years. Currently, experiments are being conducted to find a cure for this disease. The good news in India is that we are seeing an overall reduction in HIV infections among the adult population.

According to more recent National AIDS Control Organisation data, India has demonstrated an overall reduction of 57 percent in estimated annual new HIV infections (among adult population) from 0.274 million in 2000 to 0.116 million in 2011.

HIV-data pic

India has the third largest number of people living with HIV in the world, according WHO.

LIVING WITH HIV / AIDS:

It’s not as bad. One can live with HIV.

The diagnosis is confirmed by a blood test and depending on the extent of severity of the immune deficiency, anti-viral medication is started which improves the number of immune cells which help fight infections and restore near normal life.

The medicines though expensive are distributed free of cost to patients at Government and NGO run clinics.Psychological help for not getting overwhelmed after the diagnosis, is also readily available. Confiding in a trusted person who won’t be judgmental. Judgmental helps in calming your nerves.

One must realize and believe that they can live to their potential  inspite of being HIV positive. Having social and emotional support is very essential, hence patients must not isolate themselves from their near and dear ones and f.amily and friends should also not ostracize the patient.

The Constitution of India prevents any discrimination against anyone having HIV and AIDS and neither is it a legal ground for dismissal from occupational services.

Patients living with HIV must maintain a healthy lifestyle just like diabetics or any other chronic disorders. Having a healthy diet and exercising regularly are a must to boost your immunity along with the medication. Till date HIV and AIDS has no cure but anti-retroviral therapy (ART medicines) are helping people live a healthy and happy life for almost 2 to 3 decades.

Currently, Art drugs have become ‘very good’ at controlling infection but patients need use the medication for life. If they stop the treatment, the virus rapidly replicates, eventually leading to the fatal AIDS disease.

Pregnant mothers have successfully delivered children without HIV with the help of anti-viral medication.
Lot of research by brilliant minds is being done around the globe to find more effective medicines and a cure.
HIV facts to know

• According to the WHO, more than 70 million people have been infected with HIV so far and about 35 million people have died of from the virus.

• In 2015, an estimated 36.7 million people were living with HIV and so far the infection remains incurable.

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DECODING DIABETES

Diabetes-Day

Last month, I had 2 patients on the same day diagnosed with Diabetes- one an overweight 34 year old IT professional and the other a 6-year-old girl. The reason, why this incident comes to my mind today is because they were both diabetics but, had different diabetes and even their course of treatments was different.

But, the first question I was asked in both the cases was whether they will need to be put on insulin injections immediately. Well, this is a common question asked by patients. To understand this condition better, let me try and explain a bit about the different types of diabetes on the basis of which the required treatment is normally recommended.

Diabetes is a group of metabolic disorders in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body’s cells do not respond properly to insulin or both. Common symptoms of either diabetes are unexplained weight loss, excess hunger, and excess thirst and delayed wound healing.

Today, I would like to take you through specifically 3 major types of diabetes namely, Type 1, Type 2 and gestational Diabetes.

Let’s talk about

Type 1 Diabetes: is caused by a loss or malfunction of the insulin-producing cells in the pancreas, called beta cells. Damage to beta cells results in absence or insufficient production of insulin. Most cases of Type 1 Diabetes have an autoimmune basis in which immune system mistakenly attacks and destroys its own beta cells. These cases are detected either in childhood or teenage years. There are many theories about what causes type 1 diabetes like autoimmune disease, viral infection, genetic predisposition and environmental factors may also play a role.

Whatever be the cause, this missing insulin has to be replaced as insulin is necessary to sustain life. It is responsible for entry of glucose into the body cells from where the glucose is further utilized for energy and other activities. This glucose which is not entering the cells is circulating in the blood which gets detected as high blood sugar. The replacement insulin is administered by injection using a syringe or an insulin pump. Thanks to the invention of Insulin clubbed with a healthy lifestyle, a Type 1 diabetic is able to lead a happy good quality life.

Coming to Type 2 diabetes most often than not your tissues will be resistant to insulin, so the insulin is being produced but unfortunately not being utilized properly. It is the most common form of diabetes worldwide and accounts for 90-95% of the cases.

Insulin resistance in type 2 diabetes means the signal insulin gives to a cell is weakened. This results in less glucose uptake by muscle and fat cells and a reduction in insulin mediated activities inside cells.

Risk factors for Type 2 Diabetes include an Unhealthy Lifestyle (being physically inactive or less active, erratic food and sleep habits, stress), being overweight or obese and importantly family history of diabetes in close relatives.

Diabetes-Risk

We have ample medicine combinations for type 2 diabetes like tablets which keep the blood sugar under control. But if sufficient sugar control is not achieved in spite of oral medications and a healthy lifestyle, then insulin might be required for further management.

Another type of Diabetes I would like to talk about is Gestational diabetes which basically refers to diabetes diagnosed during pregnancy.

Pregnancy hormones can interfere with the way insulin works in the mother’s body which can lead to elevated blood glucose levels during pregnancy. Women are typically screened for gestational diabetes at 24-28 weeks of pregnancy, however, women who have risk factors may be screened earlier.

Risk factors for developing gestational diabetes include having a family history of diabetes, being overweight, or over 28 years old. Blood glucose control during pregnancy is critical as elevated maternal glucose levels can lead to pregnancy complications and pose risks to the health of the baby. Gestational diabetes is likely to recur during subsequent pregnancies.

Gestational diabetes requires specialized treatment for the rest of the pregnancy. After the pregnancy is over, most women will have normal blood sugars again; however, up to 20-50 % can develop type 2 diabetes within 10 years. Regular screening is recommended.

A study conducted on people at risk of type 2 diabetes, it was seen that those who lost just 7% of their weight and exercised about 30 minutes a day cut their risk of diabetes by nearly 60%. In a nutshell, irrespective of the type of diabetes the best prevention or diabetes management strategy is to eat healthy, stay active and keep a check on your weight.

Reference: University of California, San Francisco – Diabetes online Education website.

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Whole Grains slash Pre-Diabetes Risk!

Whole grains

Whole grains are packed with nutrients, including protein, fiber, B vitamins, anti-oxidants, and trace minerals (iron, zinc, copper, and magnesium). A diet rich in whole grains has been shown to reduce the risk of heart disease, type 2 diabetes, obesity, and some forms of cancer.

The addition of more whole grains into a healthy diet is associated with a decreased risk of deteriorating glucose tolerance, including progression from normal glucose tolerance to pre-diabetes, according to a new study published in the American Journal of Clinical Nutrition.

According to a research paper titled Food Product Design, dated Dec 26, 2012 published in Health and Nutrition, researchers at Karolinska Institute and Karolinska University Hospital investigated whether a higher intake of whole grains protects against the development of pre-diabetes and type 2 diabetes and tested for modulation by polymorphisms of the TCF7L2 gene. Participants included 5,477 Stockholm residents aged 35 to 56 years who were not diagnosed with diabetes and who kept food journals of how much whole and refined grains they consumed. Researchers measured blood glucose in study participants and followed up 10 years later.

Participants who ate 59 grams of whole grains a day had a 34% lower risk to deteriorate in glucose tolerance compared to those who ate 30 grams of whole grains a day. Risk reduction was significant in men, but not in women. Participants who consumed 59 grams of whole grains a day also had a 27% reduced risk of becoming pre-diabetic.

Whole grains are rich in fibre. Fibre in the diet does not allow the blood glucose levels to rise thereby controls the rise in sugar levels in the body. Fibre also helps in lowering cholesterol as it helps in decreasing the low density lipoprotein whch is bad cholesterol and increases high density lipoprotein which is good cholesterol.

What foods are in the grains group?

Any food made from wheat, rice, oats, cornmeal, barley or another cereal grain is a grain product. Bread, pasta, oatmeal, breakfast cereals, tortillas, and grits are examples of grain products.

It is advised that at least half the grains in your diet should be whole grains. Whole-grain versions of rice, bread, cereal, flour and pasta can be found at most grocery stores. Many whole-grain foods come ready to eat. These include a variety of breads, pastas and cereals.

Examples of whole grains include:

  • Barley
  • Brown rice
  • Buckwheat
  • Bulgur (cracked wheat)
  • Millet
  • Oatmeal
  • Popcorn
  • Whole-wheat bread, pasta or crackers
  • Wild rice

It’s not always easy to tell what kind of grains a product has, especially bread. For instance, a brown bread isn’t necessarily whole wheat — the colour may come from added colouring. If you’re not sure something has whole grains, check the product label or the Nutrition Facts panel. Look for the word “whole” on the package, and make sure whole grains appear among the first items in the ingredient list.

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BE – AWARE: CERVICAL CANCER

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Recently, I received a call from a friend whose aunt complained of post-menopausal bleeding. My first thought was could it be ‘cervical cancer’ but, I did not voice my concern, instead asked her to take her aunt for a PAP SMEAR Test.

Unfortunately, the results indeed matched my concern. She was diagnosed to have Cervical cancer. This was not the first time that I had come across a case of Cervical Cancer as the numbers have been on the rise for the last decade.

According to a study titled Epidemiology of cervical cancer with special focus on India, every year in India 1,22,844 women are diagnosed with cervical cancer and 67,477 die from the disease. India has a population of 432.2 million women aged 15 years and older who are at risk of developing cancer. It is the 2nd most common cancer in women aged 15–44 years.

(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404964)

As per world statistics, India’s contribution to cervical cancer cases is 25.4%.  Majority of the Indian women diagnosed with cervical cancer have never been screened for the disease and around 70% of these cases present in advance stages due to absence of any organized cervical cancer screening program. The most important risk factor for development of cervical cancer is persistent infection by a high-risk subset of Human Papilloma Virus (HPV). Cervical cancer being the third most common cancer in the world, very little is known about it among the masses.

What is cervical cancer? 

Cervical cancer is a disease that develops very slowly and begins with the precancerous condition known as dysplasia. Dysplasia is easily detected in a routine pap smear and is treatable.

High risk
1)Sexual history- has had multiple sexual partners OR established sexual relations before the age of 18 OR has a partner who has had sexual contact with a woman with HPV infection.
2) Smoking
3) Weakened Immunity
4) Giving birth at very young age
5) Long-term use of contraceptive pills
6) Family history

You need to look out for these signs

1) Bleeding that occurs between regular menstrual periods.
2) Bleeding after sexual intercourse, douching, or pelvic exam.
3) Menstrual periods that lasts longer and are heavier than before.
4) Bleeding after completingMenopause.
5) Increased vaginal discharge.
6) Pelvic pain

If you have noticed any of these symptoms, kindly consult your Doctor at the earliest.

Prevention:

As we know Prevention is better than Cure especially for any cancer, creating awareness becomes the first step towards that milestone.

Lifestyle plays an important role in the prevention of cervical cancer. Foods that are rich in Flavonoids (apples, black beans, broccoli, cabbage, garlic, onion, soy, and spinach), Folate (Avocados, strawberries, oranges, lentils) and Carotenoids (Carrots, sweet potatoes, pumpkin) are seen to reduce the chances of cervical cancer.

Other than diet make sure you follow the below habits to keep Cervical cancer at bay;

  1. Regular Screening (PAP SMEAR) post the age of 30
  2. HPV vaccine (most effective when administered before start of sexual intercourse)
  3. Practising Safe sex
  4. Avoid Multiple sexual partners
  5. Delaying first sexual intercourse
  6. NoSmoking

There is an HPV Vaccination that is certified by the Indian Academy of Pediatrics (IAP). 2 doses of either of the two HPV vaccines for adolescent/pre-adolescent girls aged 9-14 years is recommended. However, this vaccination is optional. One should consult a Gynaecologist to know more about the vaccine and how it helps.

It is always better to be safe than sorry and as we have now seen. Being safe is the best way to prevent Cervical cancer.

From Terminal Illness To Complete Wellness! Ananda Mukherjee Health Story

As we observe World Cancer Day under the powerful theme ‘United by Unique’ (2025-2027)**, we are reminded that every individual’s journey with cancer is distinct, yet united by shared resilience, hope, and the collective fight against this disease. This theme places people at the centre of care and their stories at the heart of the […]