As another world AIDS day passes by and the epidemic shows no sign of end, we need to evaluate the status of AIDS in India. Our country is one of the hotspot of acquired immunodeficiency syndrome (AIDS), an incurable syndrome that eventually befalls on large fraction of human immunodeficiency virus (HIV) positive individuals. While globally the number of AIDS patients has started to stabilize but epidemic is nowhere close to being over. This global epidemic has already turned out to be a major killer of humankind on an epic scale comparable to black death and smallpox. As per the latest estimates by UNAIDS, it is the fourth leading cause of death. In India, the state of affairs is so unsatisfactory that we still have frequent cases of mass infection of poor patients due to the negligence of hospitals, horrible mistreatment of HIV positive individuals and lack of even basic care for millions of AIDS patients. While the problems of AIDS in India are manifold and would require efforts from all the sectors of Indian society, in this article we want to bring forward key failures of the Indian government. We focus on five core issues that require immediate attention, if we wish to see the tail of this AIDS epidemic:
Demographic and epidemiological understanding
Screening and counselling
Treatment facilities and medicines
Need to develop indigenous cures
Demographic and epidemiological understanding: In India, it is difficult to trust the total number of AIDS patients, as grossly contradicting government figures makes one wonder if the actual magnitude of the epidemic is even larger than what is currently reported. The latest estimates released by the National AIDS Control Organization (NACO), an organization run under the auspices of the ministry of health, indicates that national adult HIV prevalence in India is approximately 0.29%, which corresponds to an estimated 3.4 million plus people living with HIV in our country (Annual report NACO 2009-2010). In contrast in 2005, NACO reported 5.21 millions HIV positive individuals. One can only wonder if such a change in the figures is an effort to put lipstick on the pig or there was a fundamental error in one of the two estimates. There has been some beating around the bush, blame laying and unsatisfactory explanations in response to this contradiction but if there was a genuine error then what is conclusively being done to avoid future errors, is currently not clearly known. Apart from getting the right overall numbers, what is also needed, is detailed demographic and epidemiological data. Different strains of HIV are prevalent in the different parts of the world and progression of AIDS is also different in people of different genetic background, for example there is a very small fraction of people that innately do not contract AIDS. Such trends of immunity to AIDS are either absent or currently not known in the Indian population. It is rather appalling that in India, the land that holds genetic diversity next to the continent of Africa, we for some silly reasons have been using data solely from the White Caucasian populations. This over dependency on western data is wrong for three reasons: 1) The strains of HIV prevalent in different regions are different, 2) The genetic diversity of India makes comparison to one ethnic group meaningless and 3) Apart from the Anglo-Indians with significant European heritage, no ethnic group in India, whatever be their surname and notions of self identity, share that close of genetic identity with the European populations to justify the current usage. What is needed is to understand the spread of different strains of HIV in India and the progression of diseases in individuals with a different genetic background.
Awareness: The first case of AIDS in India was diagnosed way back in 1986. Subsequently some apparent movement of bureaucratic and political machinery took place that in the following year resulted in the formation of National AIDS control program (NACP). In reality, the understanding of Indian government and media on the danger of this disease was largely missing until recently and is still rather poor. Even till late nineties, it was not entirely uncommon to hear voices in the Indian media claiming that AIDS is likely a trouble of promiscuous foreign lands and not of a conservative India. The media and the government forgot that this land of billion plus is first the land of Kamasutra and then of Gandhian moral curtains. Such ethnic biases that come wrapped in moral judgments cost lives everywhere. Even in the United States, initially AIDS was largely thought to be a disease of homosexuals and Afro-Americans, a curse of God for the decadent. In India, the lackadaisical approach in dealing with AIDS was also due to undermining the spread of HIV through blood transfusion and not realizing the severity of needle sharing by drug addicts and poor hospital administrative/clinical measures. As an addition to the existing policy, firstly the government needs to be aware of the full cost of AIDS and then it needs to take action to better inform the health care professionals and public at large. Media also adds to the trouble by rarely looking beyond less glamorous issues than some odd cricketing century of Tendulkar or birth of Bachchan granddaughter, occasionally mentioning somewhat sensational denial of basic services to HIV positive individuals or some innocent people being infected at a mass scale, instead of serious discussion of issues. Serious discussions, even when managing to creep in from the nooks and crannies of the sensational mainstream news, fails to gather attention beyond one media cycle.
Screening and counselling: Roughly 85% of new infections are via the heterosexual route and efforts towards premarital counselling for HIV can reduce half to three fourth of this spread. In Goa and Andhra, the high prevalence states, the state governments proposed bills in 2006 to make HIV testing compulsory before marriage, but ethical concerns and political issues have thus far stopped the actual implementation. This issue of mandatory testing poses a real ethical concern as on one hand we do not have any patient confidentiality where people are denied their due rights due to their HIV status and on the other hand, who can justify the infection to innocent spouses, mostly females via their less than faithful counterparts? One needs to evolve a system where an employer and an insurer, cannot know the HIV status of the patient but a spouse can. It is not going to an easy nut to crack for any government, leave alone Indian, but the administration has not even started inching in the right direction of evolving such a mechanism.
Treatment facilities and medicines: National AIDS control program (NACP-III, 2007-2012) of India has a total budget of about 2.6 billion dollars but only a minor fraction of it is for the treatment. This is unacceptably low amount of money being spent on treatment, especially the amount that finally trickles down the bureaucratic apparatus. One may wonder what do we mean by treatment of an incurable syndrome? The progression of HIV positive individuals to AIDS is very different. Once patient contracts full blown AIDS his/her survival can vary from months to decades. This survival, apart from patient to patient variability, depends on the availability of antiviral drugs and treatment facilities. It is possible that India may have lost much of its potential to produce generic and cheap anti-retroviral relief due to twists in the international politics and India’s easy compliance with pressures. It is possible that recent aid to African countries to counter AIDS, has likely come with strings attached as they have almost stopped use of cheaper generic anti-retroviral drugs. Indian anti-retroviral drugs that were much cheaper than Western products have not just lost a market in Africa but their share in India is also tapering. We would recommend evolution of an informed policy that considers efficacy and costs of all compounds with the goal to save as many lives as possible.
Need to develop indigenous cures: Let us focus on vaccines, a preventative approach that actually holds a long-term cure of AIDS. While there have been some sporadic islands of successes in the ocean of failure in finding vaccine for AIDS, the international efforts are finding new promises and ruling out failed ideas with every passing day. We wonder why not a single significant effort worthy of mention is being pioneered in India? Given that we as Indians have become comfortably numb to the thought of India as a second or third grade country that is a recipient of high-end technology and fruits of scientific research, an average Indian, even if bluntly reminded of the state of affairs, howsoever offended, will not break sweat for long about the lack of innovation. The concern is far graver than the lack of innovation and the lack of national pride. If we need vaccine for AIDS, as soon as it is available in the West, unlike the case with polio or smallpox, we cannot take our begging bowl to world as we did in early years after independence or grossly overpay our way out, as we frequently do to procure any technology, ranging from our medicines to our warplanes. The problem with HIV vaccine stems from to the issues of demographics and epidemiology. Different strains of HIV are prevalent in different parts of the globe. HIV is very diverse, in fact some strains only show 40% homology between each other, not that different of genetic homology between you and a banana and in fact less than you and an earthworm. Thus to combat a hyper-mutable virus one needs to work on local strain and keep local population genetic profile and overall epidemiology in mind to solve the AIDS epidemic in India.
Will India rise to the challenge novel anti-retrovirals and indigenous vaccine? Likely not. Even in the well developed sectors like information technology, India only delivers small software packages for foreign products and does not manufacture a single major internationally recognizable product. This is not due to dearth of scientists or of money. In fact, India has very high numbers of biomedical scientists and research institutions spread across the country for the size of its economy. The problem is of incompetence, lack of management, corruption and nepotism. The political infestation of research is palpable in Delhi where corruption and lack of accountability permeates all levels of research epithet. One need not go into the obvious appointment of unqualified vice chancellors and administrators of universities and directors of research institutes based on proximity to political parties in power. A look at say, the University of Delhi University, a supposed prime University of India, can give you an idea of the political stooges running the show of research in India. Apart from corrupt management, there exist a large number of the so-called scientists who do not have a single major internationally known finding to their name but are busy sliding papers in “friendly” obscure journals and frequently get awarded national and regional honours. This abysmal state of affairs keeps very successful and patriotic scientists out of this Indian swamp that is sure to kill any good science.
In summary, current government efforts are either missing or misplaced and are largely wrought with corruption and inefficiency. A significant blow can be landed to AIDS epidemic with effective government policies. We hope that this article along with many other efforts raises awareness of public and its representatives for better combating the scourge of AIDS.
Cryotherapy, the hidden beauty secret of celebrities to burn 600 calories in 3 minutes
Cold and ice have been used as a treatment for physical ailments for a long time. In ancient Greece,
Nowadays, is used as a fundamental therapeutic treatment of physical complaints such as sprains, dislocations, contractures, spams, pulled muscles and swollen tissues.
As well, to manage diverse pathologies symptoms as fibromyalgia, psoriasis, chronic pains, among others.
Cryotherapy benefits have gone way beyond of what we can imagine. Not only is a pain management treatment but has become a top model treatment of celebrities and supermodels.
Film stars, high performance athletes and celebrities like Tom Cruise, Jennifer Aniston, Cristiano Ronaldo and Kim Kardashian are a few example of the many followers of this therapy that recommend it in their social media by showing their experience after each session because of it multiple benefits
What is cryotherapy?
Cryotherapy is the exposure of the skin surface of the body to very low temperatures (between -110ºC and -196ºC) by using a cryotherapy cabin which uses “vaporized” liquid nitrogen.
Because nitrogen has a very low temperature without applying extra cold, it can easily achieve the extreme temperature required for this treatment.
At a room temperature, liquid nitrogen can easily pass from a liquid state to a gaseous state. This is the reason of nitrogen use in this kind of treatments and this is why it is said that uses nitrogen “vaporized”.
When exposing the body to very low temperatures because of liquid nitrogen evaporation, the body responds at different levels involving the circulatory system, muscles and the neuroendocrine system. This happens because the brain receives a cold shock caused by a drastic reduction of body’s temperature. The hypothalamus releases series of substances in our body to combat an imminent hypothermia situation. Among these substances we can find dopamine, serotonin and endorphins, which increases blood flow, lipolysis and the production of free radicals catalytic enzymes, while reducing the production of inflammatory cytokines.
One of the main benefit of cryotherapy -and the reason why it is so popular, is the burn of calories. The extreme cold application causes a decrease in body’s temperature, and to compensate this situation the body generates energy by burning localized fat deposits –such as the fat in the belly, therefore a loss of weight occurs togheter with a swelling in the lower abdomen. This same process works for all the body fat deposits. It also reduces, considerably, the annoying cellulite giving an appearance of youth to the body. Additionaly, cryotherapy builds up tissues tone and prevents flaccidity, allowing the body to remain firm and giving the skin a smoothly and healthy look.
Among other benefits, cryotherapy has been proven to be a non-invasive treatment helping to manage and alleviate symptoms of chronic skin diseases such as psoriasis, neurodermatitis, dermatitis, seborrheic complex syndrome, eczema, erythematosis and scleroderma. This due to the peripheral vasodilatation that occurs because of the decreasing in body’s temperature, carring a large amount of oxygen to the body and increasing the blood flow.
Experts explain that there are several and diverse cryotherapy benefits:
- It helps fight migraine and insomnia.
- It improves blood circulation and inhibits varicose veins.
- It reduces inflammation, stress, anxiety and fatigue.
- It accelerates metabolism generating a boost of energy.
- It increases the caloric expenditure -between 500 and 800 kilocalories in the next few hours after a 3-minute session.
Finally, research show that cryotherapy helps in recovery processes and chronic pain issues, and it is also recommended for diseases such as fibromyalgia, arthritis, or multiple sclerosis.
Is cryotherapy dangerous?
Like any other medical-aesthetic treatment, if handled properly there is no risk for our health and integrity.
Provided temperatures reached by liquid nitrogen are very low, it could cause burns when used incorrectly. This is why the skin is only exposed for a very short period of time on the skin -from 2 minutes to 4 minutes, and always in a controlled environment under medical supervision.
As a general rule, cryotherapy is a safe treatment for everybody. However there are exceptional cases where the use of cryotherapy is not recommended:
- People with heart problems and serious health problems, because the sudden decrease in temperature could have a negative effect on the health of people suffering from heart problems.
- People with little resistance to cold, as they would suffer excessively during the session due to the low threshold of pain towards the cold.
- Pregnant women and children. This due to negative effects this treatment could have on fetus of a pregnant women and in children it is not advised because of they are still developing their bodies.
Dental tourism, actually one of the most popular
Commonly known as dental holidays in Europe, it is actually a subset of medical tourism which is experiencing an important growth in this late times, since people from all around the globe is on a more frequent basis using their vacations to seek dental care outside their local healthcare systems. Today, globalization has created an interdependent market which is developing exponentially, where technologies spread out throughout the world quicker than ever, allowing people to find good dental care services at locations where costs are way lower than those at their places of origin.
But, why is this happening?
This has become an unstoppable phenomenon due to the economical differences existent nowadays amongst countries, especially between those that share borders. Obviously people seeking dental care, travel for a huge variety of reasons but an undeniable fact that affects decisions is driven by money, being able to have access to the necessary solution at a significant lower cost, is a strong element in decision making, even more when the quality of the service is as good as the local one only by passing over to a neighbor country.
For example, people from Austria travel to Albania, Hungary, Ukraine, Slovenia, Bulgaria, Romania and Bosnia. Citizens from the United States and Canada go to Dental Solutions Algodones Mexico in Mexico, Costa Rica, Peru and Ecuador; patients from the Republic of Ireland to Northern Ireland, Turkey, Bulgaria, Ukraine, Hungary, Ukraine and Poland; and from Australia to other countries of South-East Asia. Some people travel because the funding of public healthcare at their place of choice turns out to be more convenient, or the general access to healthcare at that specific place fits their personal needs.
Freedom of practice
But not all the reasons for dental tourism are due to economics. In Europe, dental professionals are allowed to move their practice from one country to another and they are required only a minimum set of qualifications approved by the country of destination, giving them a greater freedom of practice. This is intended by the union to standardize dental services all over the areas of its members. Furthermore, dentistry universities of the union have developed programmes to help their students on completing some of their education at foreign facilities. This standardization brings down barriers for patients mobility within the area.
How about quality?
Since the main reason in most cases is related to pricing, low prices come with dentists that offer minimum fixed costs, less government issues and lower expenses including those derived from insurance to patients with a high income. Outside the country of origin, many bureaucratic steps are inexistent, allowing dentists to focus more freely on their task. Procedures such as porcelain veneers or dental implants become affordable for many people that can not pay for them back at home. And right here is where the main questions about this matter are focused. First, does price differentials imply lower quality results?, and second, Is it safe to undergo a large scale dental procedure abroad on a short period of time?.
The answers here are NO and YES, and here is why. As previously mentioned, globalization has a lot to do with this, because the latest technologies, materials and techniques are more accessible today than ever before anywhere in the world. In the first case, a dentist with a proven professional record, will charge the appropriate fees according to the country where they work, and the lower price does not necessarily mean poor quality, it means that the patient comes from a place where income is higher but expenses are higher too. In the second case, it is easy to figure out that the answer is affirmative since, as stated in the previous point, quality has nothing to do with the price in this case, and regardless of whether the procedure is something simple or complex, if the work is well done, there is no reason to expect any further problems.
PRAMA, the new revolutionary interactive fitness program taking the wold by storm
This revolutionary new fitness and training method is proving that with the addition of modern technology you really can get amazing results in improving your fitness levels.
The technology used plays a vital role in every training session. This is PRAMA, where you train to the rhythm of music and lights set according to a session programmed to suit you. It add a true sense of fun and achievement. Demand for PRAMA classes are already high as word travels about this new interactive exercise, and it is now the new hot trend in gyms across the US and UK.
This revolution is reaching gyms that are at the forefront of modern fitness, who are adapting their available spaces to cater for this new concept in interactive fitness that combines music, choreography and technology.
But what is PRAMA? The easiest way to describe it is to quote Jennifer Coccia, the Director of Asfalt Fitness in New York, who said that her clients felt as if they were entering a crossover between an arcade game and a playground, “yet getting the best workout of their lives”.
The PRAMA system coordinates music, lights and time and for those who their normal training has become mundane can revitalise that motivation and help them get that joy from working out once again. This is what lies behind the whole concept, bring the fun and party element to fitness, in an immersive, interactive and very motivating experience.
“A crossover between an arcade game and a playground”
The treadmills, static bicycles and all the usual paraphernalia you expect to find in a usual gym are put aside to make way for what seems to be like “a crossover between an arcade game and a playground,” says Marcos Requena, CEO of Pavigym.
But PRAMA is not about improvisation or random workouts. These approaches are not productive for getting the best results. Instead the trainers will push their clients through a series of electrical choreographed workouts, interacting with them through the floor, walls and other areas, to complete a series of exercise circuits with high intensity.
PRAMA is already being spoken about in all the major media, and we are seeing many famous athletes, such as FC Barcelona, Boca Juniors or Nicolás Anelka players have trained using the PRAMA methodology. It is really taking off across cities like New York, London, Paris … all this has only served to increase demand that is exceeding all expectations of the gym directors who have deployed it..
The users of gyms are demanding it because, even though the primary focus of improving fitness and health is still there, because it is provided through a fun concept, it becomes enjoyable for those who previously would have found the work out a real chore. You almost forget you are working out!
What can you expect from the PRAMA experience?
The musical factor is key to the experience, it has long been known that music helps with a workout. PRAMA goes one step further and throws lighting into the mix as well to make it truly immersive. The LEDs work in time to the music and move at the rhythm of those taking part. The walls and the floor are all part of the game.
To give a practical example, those who have spent their childhood playing the Twister from time to time, -the game consisting of putting one foot in the blue circle, one hand in the red one and so on until you can’t do anymore without falling over- can understand a little of what this revolutionary method is about, although in a very simplified way.
Another example is those console dance games carried out at home where you have to follow the choreographed moves, or using a dance mat, is similar and known to be great for fitness and losing weight.
Of course the issue with those examples is that movement is restricted, you can’t stop or pause without the game ending. It is not adaptable to help you achieve fitness goals and it doesn’t help you grow. You can waste a lot of calories stopping and starting.
PRAMA easily adapts to the needs of adults, families, children and athletes
The system is programmed according to each person, be it an elite athlete or a beginner but you can also find programs for children and families. The sessions are 45 minutes and are beneficial for the body and mind, so they can even be rolled out in centers with children with ADHD and other problems, but also can be practiced as a family as a way to improve the time spent together but also improving fitness.
Each 45 minute session can also be ramped up for more intensive workouts, and gives a huge advantage to practitioners of the force program. In this program the floor and walls are complemented by medium to high load accessories, to transition the interactive elements into a more HIIT format that doesn’t work well for everyone.
So there really is a workout intensity for every age group and capability, including an innovative one in which you can play a PRAMA version of basketball, a combination as healthy as addictive, which can only be a good thing when it comes to forming those lifelong fitness habits.
In fact if you know you’re going to the gym, it will make people more inclined to use their membership and actually go, and better attendance means better member retention.
A definitive full body workout suitable for any age and ability, and highly adaptable.
It is not only for losing weight, although results there are pretty good so far with PRAMA, given that it is a system more likely to be stuck with long term. It is also a change to gain strength and agility, and have fun with friends and family.
The ground and walls are sensitive to pressure, and the interactive screens and light combinations that attune to the body’s highs and lows during a workout show just how clever this new system really is.
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