World AIDS Day

Acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging your immune system, HIV interferes with your body’s ability to fight the organisms that cause disease. HIV is a sexually transmitted infection (STI). It can also be spread by contact with infected blood or from mother to child during pregnancy, childbirth or breast-feeding. There are 36.7 million people living with HIV worldwide.

There’s no cure for HIV/AIDS, but there are medications that can dramatically slow the progression of the disease. Combination antiretroviral therapy (ART) prevents HIV from multiplying in the body. If the reproduction of HIV stops, then the body’s immune cells are able to live longer and provide the body with protection from infections.

How HIV spreads

• Unprotected sexual intercourse (vaginal or anal) or oral sex with an infected person.
• Transfusions of contaminated blood.
• Sharing of contaminated needles or syringes or tattooing equipment.
• Transmission between a mother and child during pregnancy, childbirth and breastfeeding.

How HIV doesn’t spread

You can’t become infected with HIV through ordinary contact. That means you can’t catch HIV or AIDS by hugging, kissing, dancing or shaking hands with someone who has the infection. HIV isn’t spread through the air, water or insect bites.

Symptoms

The symptoms of HIV and AIDS vary, depending on the phase of infection.

• Primary infection (Acute HIV)

Most people infected by HIV develop a flu-like illness within a month or two after the virus enters the body. This illness, known as primary or acute HIV infection, may last for a few weeks. Possible signs and symptoms include fever, headache, rash, joint pain, mouth sores or swollen lymph glands. These symptoms can be so mild that you might not even notice them. However, the amount of virus in your bloodstream (viral load) is quite high at this time. As a result, the infection spreads more easily during primary infection than during the next stage.

• Clinical latent infection (Chronic HIV)

In some people, persistent swelling of lymph nodes occurs during this stage. Otherwise, there are no specific signs and symptoms. HIV remains in the body and in infected white blood cells. This stage of HIV infection generally lasts around 10 years if you’re not receiving antiretroviral therapy. But sometimes, even with this treatment, it lasts for decades.

• Symptomatic HIV infection

As the virus continues to multiply and destroy your immune cells — the cells in your body that help fight off germs — you may develop mild infections or chronic signs and symptoms such as fever, fatigue, swollen lymph nodes, diarrhoea, weight loss or thrush.

• Progression to AIDS

Thanks to better antiviral treatments, most people with HIV don’t develop AIDS. Untreated, HIV typically turns into AIDS in about 10 years. When AIDS occurs, your immune system has been severely damaged. You’ll be more likely to develop opportunistic infections or opportunistic cancers — diseases that wouldn’t usually trouble a person with a healthy immune system.

The signs and symptoms of some of these infections may include:

• Soaking night sweats.
• Recurring fever.
• Chronic diarrhoea.
• Persistent white spots or unusual lesions on your tongue or in your mouth.
• Persistent, unexplained fatigue.
• Weight loss.
• Skin rashes or bumps.

Infections common to HIV/AIDS

• Tuberculosis (TB). In resource-limited nations, TB is the most common opportunistic infection associated with HIV. It’s a leading cause of death among people with AIDS.
• Cytomegalovirus. This common herpes virus is transmitted in body fluids such as saliva, blood, urine, semen and breast milk. A healthy immune system inactivates the virus, and it remains dormant in your body. If your immune system weakens, the virus resurfaces — causing damage to your eyes, digestive tract, lungs or other organs.
• Candidiasis. Candidiasis is a common HIV-related infection. It causes inflammation and a thick, white coating on the mucous membranes of your mouth, tongue, esophagus or vagina.
• Cryptococcal meningitis. Meningitis is an inflammation of the membranes and fluid surrounding your brain and spinal cord (meninges).
• Cryptosporidiosis. This infection is caused by an intestinal parasite that’s commonly found in animals. You get it when you eat or drink contaminated food or water. It causes severe, chronic diarrhoea in people with AIDS.

Cancers common to HIV/AIDS include Kaposi’s sarcoma and Lymphoma. Other complications include neurological complications and kidney diseases.

Prevent HIV

There’s no vaccine to prevent HIV infection and no cure for AIDS. But you can protect yourself and others from infection.

• Practise safe sexual behaviour, use a condom, avoid multiple partners.
• Get tested an treated for sexually transmitted diseases.
• Avoid injecting drugs, if you do use only sterile needles and syringes.
• Ensure that any blood transfusions have been tested for HIV.
• Talk to your gynaecologist to prevent HIV transmission to your unborn child.

Risk factors

Anyone of any age, race, sex or sexual orientation can be infected. However, you’re at greatest risk of HIV/AIDS if you:

• Have unprotected sex. Use a condom every time you have sex. Your risk of HIV increases if you have multiple sexual partners.
• Have an STI. Many STIs produce open sores on your genitals. These sores act as doorways for HIV to enter your body.
• Use intravenous drugs. People who use intravenous drugs often share needles and syringes. This exposes them to droplets of other people’s blood.

India and AIDs

With prevalence of 0.26% in the adult population, India has an estimated 2.1 million living with HIV. The key populations most affected by HIV in India are sex workers (HIV prevalence of 2.2%), gay men and other men who have sex with men (HIV prevalence of 9.9%) and transgender people (HIV prevalence of 7.2%)

Get yourself tested. Be safe. Talk to experts at our Internal Medicine Department for more details, diagnosis and treatment of HIV. Please find below link:

https://www.kokilabenhospital.com/departments/clinicaldepartments/internalmedicine/hiv.html

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease that makes breathing progressively more difficult. COPD isn’t a single lung disease. It’s really two diseases that cause airflow blockage and breathing problems. It includes emphysema, which makes it hard to breathe, and chronic bronchitis, which is a mucus-producing cough that doesn’t go away. Most people with COPD have both. Roughly one-third, or 30%, of adults don’t know what COPD is, hence awareness of the diseases is the first step towards recovery.

Symptoms of COPD

COPD makes it harder to breathe by reducing the flow of air through the lungs. Reduced airflow may be caused by inflammation (airways may thicken and lose elastic quality), destroyed lung tissue and blockages of mucus.

Often, people don’t recognize the symptoms of COPD until later stages of the disease. Here are some symptoms to look out for:

• Chest tightness.
• Shortness of breath.
• Blueness of the lips or fingernail beds.
• Wheezing.
• The need to clear the throat of mucus first thing in the morning.
• A chronic cough that may produce mucus.
• Frequent respiratory infections.
• Lack of energy.
• Unintended weight loss (in later stages)
• Swelling in ankles, feet or legs.

Symptoms can be worse for a few days and become more manageable, then worsen again.

Causes of COPD

1. Smoking

About 85 to 90 percent of all COPD cases are caused by cigarette smoking. When a cigarette burns, it creates more than 7,000 chemicals, many of which are harmful. The toxins in cigarette smoke weaken your lungs’ defense against infections, narrow air passages, cause swelling in air tubes and destroy air sacs—all contributing factors for COPD.

2. Your Environment

What you breathe every day at work, home and outside can play a role in developing COPD. Long-term exposure to air pollution, second hand smoke and dust, fumes and chemicals (which are often work-related) can cause COPD. In rural India the burning of coal and wood for fuel also causes air pollution.

3. Alpha-1 Deficiency

A small number of people have a rare form of COPD called alpha-1 deficiency-related emphysema. This form of COPD is caused by a genetic (inherited) condition that affects the body’s ability to produce a protein (Alpha-1) that protects the lungs.

Treat COPD

There is no cure for COPD, but it can be treated. Those with COPD are at increased risk of developing heart disease, lung cancer and other conditions. Patients with COPD are encouraged to stop smoking and are often given medications to help with the symptoms and complications of the disease. Doctors may also prescribe lung rehabilitation or surgery to relieve symptoms. Sometimes, people with COPD receive lung transplants.

Prevent COPD

Here are some tips to keep your lungs healthy:

• Total abstinence from smoking. It is the worst possible thing someone can do to their lungs. Even second hand smoke is harmful.
• Patients with chronic lung disease such as asthma or COPD should try to minimize exposure to air of poor quality.
• Exercise, it allows your lungs to more efficiently supply the heart and muscles with needed oxygen.
• Eat antioxidant-rich foods, such as berries, other fruits with skins, leafy green vegetables, sweet potatoes, nuts, pomegranate juice. It is good for your lung health.
• Wear protective equipment (mask) when exposed to threats to the lungs at work (i.e., dust, particles, paint fumes and diesel exhaust).

COPD in India

Currently, COPD is the third largest killer affecting an estimated 210 million people worldwide. Almost 90 percent of COPD deaths occur in low and middle-income countries. In India, it is the second largest killer and causes 22 million deaths. However, the alarming fact is that 25-50 percent of people with clinically significant COPD are ignorant about the disease and there is rampant misdiagnosis too.

Quick facts on COPD

• COPD can make daily activities, such as walking up stairs, getting dressed, and doing chores around the house difficult.
• Inflammation in the lungs smolders on chronically for decades, resulting in progressive damage to the tissue that supports airway structures and the gas exchange surface of the lung.
• A characteristic of the inflammatory response of COPD is that it is not responsive to long-term medication with drugs such as corticosteroids, which are used successfully for prevention of asthma.
• As it takes many years for the inflammation in the lungs to have an effect, COPD is primarily a disease affecting people over the age of 40.
• Cessation of smoking is the only significant therapeutic intervention that can retard the accelerated decline in lung function experienced by smokers with COPD.
• Although there is no cure for COPD, there are medicines, procedures, and lifestyle changes that can slow the progress of the disease and lead to a higher quality of life.

Do not miss the warning signs of COPD. COPD is often not found until the disease is very advanced because people do not know the early warning signs. Shortness of breath is many times mistaken as a sign of aging. Consult experts at our Department of Pulmonary Medicine. Please find below link for more details:

https://www.kokilabenhospital.com/departments/clinicaldepartments/pulmonarymedicine/copd.html

Diabetes is India’s fastest growing disease with 72 million cases recorded in 2017. The prevalence of diabetes in adult Indians is 10.4%. It is estimated that by 2035, there will be a staggering 109 million diabetics in India.

Diabetes is a chronic medical condition, that is, it can be curbed at the initial level by introducing lifestyle changes and controlled after its incidence through medicines in early stages and administration of external insulin in advanced stages.

Over the years, occurrence diabetes has more than doubled for men (3.7 per cent to 9.1 per cent). It has also increased by 80 per cent among women in India (4.6 per cent to 8.3 per cent).

According to a World Health Organization (WHO) fact sheet on diabetes, an estimated 3.4 million deaths are caused due to high blood sugar in the world.

What is Diabetes?

Diabetes is a medical condition that is caused due to insufficient production and secretion of insulin from the pancreas in case of Type-I diabetes and defective response of insulin for Type-2 diabetes. Under normal body circumstances, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level.

When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level. In patients with diabetes, the absence or insufficient production of insulin causes hyperglycemia.

Why Indians are prone to Diabetes:

• Genetic or Ethnic Factor – Indians have a higher genetic predisposition to diabetes. According to researchers, our ethnicity appears to play a role in this current diabetes epidemic.
• Increased Insulin Resistance -Another factor that is not under our control is that we Indians have a greater degree of insulin resistance which means our cells do not respond to the hormone insulin. And when compared to Europeans, our blood insulin levels also tend to rise higher and more persistently when we eat carbohydrates.
• Lifestyle Changes – With the social and economic development and urbanization, our nutrition has improved, and we are living longer. However our lifestyle has changed and our diets have become unhealthy. Our traditional diet of unrefined grains is now substituted with refined varieties of the same and calorie rich foods.
• Obesity – Body mass index (BMI) is an indicator of our body fat. The relative risk of diabetes increases as the BMI increases. Indians comparatively have a higher body fat (especially around the waist) for any BMI. This, coupled with our inherent higher insulin resistance, significantly puts us at a higher risk of developing diabetes.

Take your health in your own hands. Be more conscious of your diet and make efforts to have a strict fitness regime. You age, family history, blood pressure, cholesterol, body weight determines your risk of getting Type 2 Diabetes. You can help reduce your risk of type 2 diabetes by understanding your risk and making changes to your lifestyle.

Here is how you can reduce your risk of type 2 diabetes:

• Manage your weight. Excess body fat, particularly if stored around the abdomen, can increase the body’s resistance to the hormone insulin. This can lead to type 2 diabetes.
• Exercise regularly. Moderate physical activity on most days of the week helps manage weight, reduce blood glucose levels and may also improve blood pressure and cholesterol.
• Eat a balanced, healthy diet. Reduce the amount of fat in your diet, especially saturated and trans fats. Eat more fruit, vegetables and high-fibre foods. Cut back on salt.
• Limit takeaway and processed foods. Fast foods are usually high in salt, fat and kilojoules. It’s best to cook for yourself using fresh ingredients whenever possible.
• Limit your alcohol intake. Too much alcohol can lead to weight gain and may increase your blood pressure and triglyceride levels. Men should have no more than two standard drinks a day and women should have no more than one.
• Quit smoking. Smokers are twice as likely to develop diabetes as non-smokers.
• Control your blood pressure. Most people can do this with regular exercise, a balanced diet and by keeping a healthy weight. In some cases, you might need medication prescribed by your doctor.
• Be regular in your medical checkups. As you get older, it’s a good idea to regularly check your blood glucose, blood pressure and blood cholesterol levels.

Diabetes is preventable. Let us fight this devil together. Talk to our experts at our Diabetes Clinic to know more about Diabetes. Please check the below link:

https://www.kokilabenhospital.com/departments/clinicaldepartments/endocrinologydiabetes/diabeticclinic.html

Diwali is almost here. And with this festive days comes another wave of endless parties, exchanging sweets, late nights of celebration, and all the irresistible festive food. How do you celebrate Diwali? Do you eat in moderation or you give in to the temptation and gorge on mithais and chocolates?

Everybody tends to let go their diet plan and indulges in the festive celebrations. While we all enjoy the feasting that is to follow in these couple of days, one cannot also deny the impact that it would have on our waistline soon after. Diwali bingeing may undo most of your dieting efforts. Wise choices, portion control and moderation can help ensure you eat healthy this festive week.

Here are some expert tips from our team on how to eat right this Diwali. Enjoy Diwali without compromising on your health.

• Avoid fried foods from shops – The biggest mistake that sweet shops make is that they tend to reuse the oil while frying sweets. Once the oil is used then it shouldn’t be reused as it is unhealthy. Reusing the oil leads to creation of free radicals which harm the body by clogging the arteries, causing acidity and heartburn. Opt for baked or steamed options or choose homemade fried snacks.
• Make fruits your best friends – Want to satisfy your appetite this season without getting an upset stomach? Make sure you have your daily dose of fruits. The fiber in the fruits will ensure that your digestive system functions properly. Maida and sugar in the sweets can make you constipated and leave you feeling full.
• Never skip meals – Never go empty stomach at a party or choose to skip an earlier meal. Skipping meals and then bingeing is the main reason for your weight gain. Choose to eat in moderation.
• Eat mindfully – When you are at a Diwali outing whether at home or outside, make sure you consciously exercise portion control. Choose well, eat everything you love and enjoy, but make sure not to overeat all the time. This will leave you feeling satisfied, but not bloated after having binged.
• Some home-cooked meals – Try and get at least one meal at home in between the hectic socializing and dining out. This way, you can use the opportunity to load up on fiber, vegetables, salads, and other nutritious stuff to off-set the sugar and carb-loading that’s likely to happen when you are out celebrating.
• Drink enough water – Sipping fizzy cold drinks during festive gatherings would make you dehydrated and increase your calorie intake. Drinking water regularly is a must as it helps to detox.
• Keep your alcohol intake in control – Have alcohol in moderation. Cocktails which are a combination of alcohol and juices should be avoided as they are a calorie bomb and are equally dehydrating.

Make moderation your key mantra this Diwali. Avoid foods made of maida and excess sugar. Here are a few foods to choose over calorie laden mithais:

• Non-salted nuts and dry fruits like dates and figs.
• Seasonal fruits like pomegranates, pears, bananas, oranges, grapes and avocados.
• Dark bitter chocolates, but in moderation.
• Coconut and coconut water.

Wishing a happy and Healthy Happy Diwali to all our readers! Eat well, eat guilt-free and enjoy the festivities.

A stroke occurs when a part of the brain loses its blood supply and stops working. This causes the part of the body that the injured brain controls to stop working. A stroke also is called a cerebrovascular accident, CVA, or “brain attack.”

The types of strokes include:

• Ischemic stroke (part of the brain loses blood flow)
• Hemorrhagic stroke (bleeding occurs within the brain)

Transient ischemic attack, TIA, or mini stroke -The stroke symptoms resolve within minutes, but may take up to 24 hours on their own without treatment. This is a warning sign that a stroke may occur in the near future.

From onset of symptoms, there is only a 3 to 4 1/2 hour window to use clot-busting drugs (thrombolytics) to try to restore blood supply to the affected part of the brain. Stroke is diagnosed by the patient’s symptoms, history, and blood and imaging tests. The prognosis and recovery for a person that has suffered a stroke depends upon the location of the injury to the brain.

Remember FAST if you think someone might be having a stroke:

• Face drooping
• Arm weakness
• Speech difficulty
• Time to call emergency

A stroke is a medical emergency because strokes can lead to death or permanent disability. There are opportunities to treat ischemic strokes but that treatment needs to be started in the first few hours after the signs of a stroke begin. The patient, family, or bystanders, should call emergency medical services immediately if they suspect a stroke.

Risk factors of stroke:

Overall, the most common risk factors for stroke are:

• High blood pressure.
• High cholesterol.
• Smoking.
• Diabetes.
• Family history.
• Age.

Heart conditions like atrial fibrillation, patent foramen ovale, and heart valve disease can also be the potential cause of stroke.

Stroke Symptoms and Signs:

The symptoms of a stroke vary depending upon the area of the brain affected by a lack of oxygen. All strokes involve symptoms that relate to impairment of nerve function. The symptoms typically arise suddenly and most commonly occur on one side of the body. Symptoms and signs of stroke can include:

• Acute change in level of consciousness or confusion.
• Acute onset of weakness or paralysis of half or part of the body
• Numbness of one half or part of the body
• Partial vision loss.
• Tingling or weakness.
• Headache, nausea, and vomiting.
• Double vision.
• Difficulty speaking or understanding speech.
• Difficulty with balance and vertigo.

Here are some Stroke Myths and facts:

• • Myth
  • Stroke cannot be prevented.
  • There is no treatment for stroke.
  • Stroke only affects the elderly.
  • Stroke recovery only happens for the first few months after a stroke.
  • Strokes are not hereditary.
• • Fact
  • Up to 80 percent of strokes are preventable.
  • At any sign of stroke call Emergency services, treatment may be available.
  • Stroke can happen to anyone at any time.
  • Stroke recovery is a lifelong process.
  • Family history of stroke increases your chance for stroke.

Prevent stroke attacks:

You can fight stroke on many fronts. Here are a few changes in your daily lifestyle to help prevent strokes:

• Know and control your blood pressure.
• Don’t smoke; stop if you do.
• Lose weight if needed.
• Become more active.
• Identify and manage atrial fibrillation.
• Be aggressive about treating a transient ischemic attack (TIA, or mini-stroke).
• Treat circulatory problems like peripheral artery disease, sickle cell disease, or severe anemia.
• Know and control your blood sugar and cholesterol.
• If you drink alcohol, do so in moderation.
• Adopt a healthy diet low in sodium and rich in potassium.
• Know the warning signs of stroke and respond immediately.

Is someone around you having a stroke attack? Call our Emergency department on 91-22-3091-9191. Act fast and contact our Stroke clinic immediately. Please find below link for more details:

https://www.kokilabenhospital.com/departments/clinicsatkh/strokeclinic.html