JC Virus DNA, PCR Tips

Oral cancer (OC) occurs when DNA mutations develop in the cells lining the lips and the mouth cavity. It commonly affects the tongue, floor of mouth, buccal mucosa, lips, palate, gum etc all. Mostly, oral cancers are squamous cell carcinomas that begin in the squamous cells lining the lips and the inside of mouth.

1. Type: of oral cancer are as enumerated below -

   1. Squamous cell carcinoma: is the most common, as described above.

   2. Adenocarcinoma: affects the salivary glands.

   3. Lymphoma: affects the tissues of the tonsil(s) or those involving the lymphatic system.

   4. Melanoma: may affect the mucous tissues of the oral cavity.

2. Gender: affects the male populace predominantly. But, it can affect both male and female. It’s the commonest cancer in India currently, and accounts for a significant percentage of the total cancer mortality.

3. Etiology: consumption of “khaini” (tobacco & lime mix), betel nut, areca nut, slaked lime, chronic irritation due to irregular teeth, smoking, alcohol consumption, oral infection with Herpes Simplex Virus (HSV) / Human Papilloma virus (HPV), nutritional deficiencies, chronic infections & poor dental/ oral hygiene are the common risk factors that can trigger oral carcinogenesis. It is noteworthy that the local effects of tobacco and alcohol are both dose-dependent and synergistic.

4. Features: the various presentations (of signs & symptoms) of Oral cancer are as given below –

   1. Cheek cancer - hard and painless thickening, with an ulcer sometimes that does not heal for weeks together.

   2. Lip cancer - white patch on the inner lining of the lip on which a hard mass slowly develops.

   3. Palate cancer- persistent sore on the hard palate that may ulcerate.

   4. Throat cancer - difficulty swallowing, sore throat, voice changes, feeling of hard lump in the throat.

   5. Tongue cancer - ulcer on the side of the tongue that bleeds occasionally and does not heal.

   6. Gum cancer and cancer of the minor salivary glands - loose teeth, bad breath and sensory loss of the feelings in the face

5. Screening: is generally recommended for asymptomatic populations goal of which, as usual, is to be able to detect & diagnose oral cancer at an early stage which is potentially curable. Visual screening by healthcare personnel including dentists, general practitioners, oncologists, surgeons etc all is crucial to detect not only early asymptomatic oral cancers but also the oral pre-cancerous lesions including oral submucous fibrosis (OSMF), oral leukoplakia, erythroplakia et al which carry a high risk of malignant transformation to in-situ and invasive cancers.

6. Diagnosis: a complete physical exam of the local parts basis the features mentioned above arouses suspicion that prompts diagnosis -

   1. Biopsy (punch or removal of mass of tissue (excision) for cytology) clinches the diagnosis of oral cancer. Should there be a neck mass that arises suspicion of a regional metastatic disease, a fine needle biopsy (FNB) can be attempted.

   2. Initial staging workup includes CT, MRI scans etc all. PET CT scan though frequently employed, is not usually used for the initial workup.

   3. A triple endoscopy that includes laryngoscopy, esophagoscopy and bronchoscopy can help definitive staging of the disease. Biopsies obtained during this procedure help confirm the primary diagnosis, define the extent to which the primary site disease has spread, and identify additional pre-malignant lesions and metastasis, if any.

7. Treatment / Prognosis: preventive measures, earlier diagnosis and right early treatment is key for better prognostication and efficient/ effective therapeutic management of oral cancer. Conventional treatment includes surgery, radiotherapy, chemotherapy as deems appropriate. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical endpoints and facilitate recovery as would be feasible contextually. As seen with other cancers, the site, stage, histopathological grading etc all determine the treatment outlook. The number of micronucleated oral mucosal cells can be a useful biomarker for predicting course of oral pre-cancerous lesions and prognosis thereof.

8. Prevention: rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an increased focus on protective factors and avoidance of the risk factors can be of help. Especially, abstaining from use of tobacco/ products, alcohol, regularly maintaining oral health and hygiene and daily intake of fresh seasonal fruits and vegetables can help prevent a vast majority of oral cancers. Also, timely screening/ detection of the pre-cancerous lesions of the oral cavity and prompt treatment thereof is crucial to preventing a malignant transformation of the same. If you wish to discuss about any specific problem, you can ask a free question.

HIV, which is short for Human Immunodeficiency Virus, penetrates your body and directly attacks your immune system. In this process, the virus weakens your body's natural defense mechanism against diseases and infections. A compromised immune system makes the body prone to minor infections, which healthy people would generally overcome. The virus itself doesn't cause any physical symptoms. It only serves to ease the entry of other bacteria and viruses into the body.

The following are some of the ways HIV affects your body:
1. Immune system - The human immunodeficiency virus destroys CD4 cells, the white blood cells that help the immune system ward off foreign substances. If left unchecked, HIV can develop into AIDS. During such time, the virus may damage the immune system to an extent that it wouldn't be able to ward off minor infections that a healthy immune system would. A person with HIV could thus suffer from fever, chills, sweats, shortness of breath, white spots in the mouth, fatigue, skin rash and weight loss from time to time.
2. Respiratory system - As HIV develops into AIDS, the body can contract infections such as pneumocystis pneumonia (PCP), tuberculosis and Kaposi's sarcoma. These conditions lead to serious respiratory problems. PCP is found to be one of the most common infections among people with HIV. 85% of the people would develop the infection if the condition is left untreated.

Herpes is caused due to the presence of the herpes simplex virus in your body. Herpes can appear on multiple areas of your body, but more commonly manifests in the genitals as well as the mouth. The two types of herpes are HSV-1 (oral herpes) and HSV-2 (responsible primarily for the outbreak of genital herpes). 

Causes of Herpes Simplex:

1. Herpes is contagious in nature and can be passed to you by having sexual intercourse with anyone who has been infected. HSV 2 is the primary form of the virus, which is transmitted in this manner. 
2. Herpes could be transmitted to an infant from their mother if she was infected while pregnant. 
3. It can also get passed through direct contact like using the same plates or spoons or even the sharing of lip balm. Even kissing can spread the virus if the infected person has cold sores.

Symptoms of Herpes Simplex:

1. The presence of blistering sores within the mouth or in the genital area is a telltale sign that you may have contracted genital herpes.
2. If you are having painful urination then you should check with your doctor for the herpes virus.
3. Continuous itching in certain areas such as the genitals.
4. Not wanting to eat, having a fever could also be symptoms of herpes simplex virus in your body.
5. Herpes can spread to your eyes and is known as herpes keratitis. It can cause pain in your eyes.

Diagnosis of Herpes Simplex:

1. The common way to diagnose herpes is with an actual physical exam. Doctors will generally look out for sores on your body and may also check for some similar symptoms which might indicate herpes simplex. 
2. HSV testing (alternately called herpes culture) is done to check the presence of a virus on the genitals. A fluid sample from the genitals is sent to laboratory for tests and will require a visit to the health center.
3. There are blood tests to look for antibodies for both forms of HSV to diagnose the infections. However, this test is done only when there is and absence of sores or visible symptoms. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

In case you have a concern or query regarding gynaecological issues, you can consult a gynaecologist online & get the answers to your questions through online doctor consultation via video call.

Contaminated food is one of the most common sources of infections in the human body and so the stomach is one of the most commonly affected organs. Whether it is eating raw food or unhygienically prepared foods, the stomach has very high chance of getting infected than other body parts.

One of the most common causes of stomach infection is the norovirus also called as cruise ship virus. Spread through vomitus and faecal material, it is quite contagious and can affect large amounts of people in confined areas like a cruise ship. The common symptoms would include nausea, vomiting, diarrhoea, bloated feeling, abdominal pain (generalised or localised), fatigue, and tiredness.

On the brighter side, there are well-proven measures listed below which are simple and easy to follow that can help avoid stomach infection.

1. Restore bacterial balance: The good bacteria in the stomach are lost with the stomach flu and restoring it will help in managing the flu. A good amount of probiotics and fermented foods including yoghurt, sour curd, etc., will do wonders by restoring natural flora. Supplements can be taken if required, and these bacteria will restore the ability of the stomach to fight the virus.
2. Isolation and separation: If there is a close family member affected by the virus, ensure they are staying separately and all their clothing (bedding included) are maintained in an isolated manner. Children and elderly need extra protection, whether they are affected or are in the same household.
3. Cleaning methods: Since the virus spreads by contaminated faecal matter, vomitus and through surfaces, it is necessary to prevent the spread.
   • When in doubt, washing hands is very useful. Use soap and water instead of a hand wash. Staying away from picking nose and touching eyes are also useful.
   • The infected person’s clothes should be washed separately in extra hot water and bleached to get rid of the virus.
   • Using the dishwasher or soaking the washed utensils in extra-hot water is a good way to get rid of the virus.
   • Surfaces like laptops need to be cleaned more regularly and rigorously
   • Steam cleaning of carpets is a good idea to get rid of the virus that may be locked there.
   • Avoid going out or being in close contact for about a week, as the virus needs that much time to clear out completely.
4. Food habits
   • Do not eat raw or uncooked foods
   • Drink loads of water, clear soups, sports drink and lime juice to replace lost fluid.
   • Eat whole grains and fresh fruits and vegetables that are well-cooked to ensure you get the essential vitamins and minerals.

Following the above measures can help avoid the stomach flu and stay healthy.

In case you have a concern or query you can always consult an expert & get answers to your questions!

The Human Papillomavirus or HPV is a large group of about 170 related viruses, each of which is given a number also called its type. This dangerous virus serves as one of the most commonly occurring cancer. The pre-cancerous lesions increase the risk of cancer of the cervix, vulva, vagina, penis, anus, mouth or throat. Out of the 170 viruses, about 40 of them are transmitted through sexual contact and are responsible for developing pre-cancerous conditions.

What are the symptoms and how do you detect them?
HPV infection is transmitted through sexual contact. Usually, when you have vaginal, anal and oral sex with someone carrying the HPV virus, you are bound to be affected by it. Genital areas provide the virus with a much suitable environment for them to survive. As it is a sexually transmitted infection, people with more active sex life (with multiple partners) are at risk of being infected with this virus.

Depending upon the type of infected virus, symptoms vary from person to person and some don't seem to experience any symptoms. General warts and genital warts are the most commonly seen symptoms. If one experiences genital warts, they surely have HPV. Not all genital warts look the same. Some just look like raised or flat pink, flesh-like, whereas some seem to have a cauliflower-like an outgrowth. There may be one wart to several numbers of them. Some are bigger, and some are insignificantly small.

These symptoms may take up weeks to appear after you have sexual contact with an infected one. If these symptoms start appearing it might happen that the cells of those areas have already begun developing pre-cancerous stages.

How to avoid such infections and what to do if I start observing such symptoms?
There is not much to do, to eradicate any case of HPV infection. As it strikes the most sexually active ones, keep a healthy check on your sex-life. Make sure the ones whom you have intercourse with are not infected already. But as this is not possible every time, maintain proper intimate hygiene. Keep your private areas clean, and besides that, you may opt for a periodic check-up of your intimate areas to make sure you don't get infected.

But if you have already started observing such symptoms, better not be late to pay a visit to your doctor as soon as possible. If caught at an early stage such infections are easily curable as it is one of the most commons ones. Although there is no HPV test for men in the healthcare sectors, for women HPV tests are available which are not to be confused with Pap smear tests. Your doctor may carry out a lab test to detect the virus.

What are the treatments?

Most of the HPV infections get destroyed over time, but if that is not the case, your doctor may use methods like cryotherapy, conization, laser therapy and loop electrosurgical excision procedure, which are to cure you easily.

Yearly flu vaccination is the best tool currently available to protect against influenza (flu).

While how well the flu vaccine works can vary, the Centers for Disease Control and Prevention (CDC) recommends a yearly flu vaccination as the first and most important step in protecting against flu and its potentially serious complications. Millions of people have safely received flu vaccines for decades. Flu vaccination can reduce flu illnesses, doctors' visits, and missed work and school due to flu, as well as prevent flu-related hospitalizations.

A flu vaccination does not guarantee protection against the flu. Some people who get vaccinated might still get sick. However, people who get a flu vaccine are less likely to get sick with flu or hospitalized from flu than someone who does not get vaccinated.

Why do I need to get vaccinated every year?

New flu vaccines are released every year to keep up with rapidly adapting flu viruses. Because flu viruses evolve so quickly, last year's vaccine may not protect you from this year's viruses.

After vaccination, your immune system produces antibodies that will protect you from the vaccine viruses. In general, though, antibody levels start to decline over time — another reason to get a flu shot every year.

Flu vaccines bring down the risks of suffering from flu. However, its effectiveness is based on different factors.

1. Age: Usually, the flu vaccine happens to work the best for healthy adults. However, these vaccines cannot work as well with children, especially infants (below the age of 2-3 years). Nevertheless, the efficacy improves with age. Since older people are more prone to contracting the flu virus, it is essential that they get themselves vaccinated. Even if the vaccine is not able to ward off the flu entirely, it can still help reduce the risks to some extent.

2. General Health: Vaccine spurs immunity into action. It helps your body in identifying and fighting the virus. The efficacy of the flu vaccine solely depends on the capability of your body’s immunity system and how well it responds to the virus. Chronic illnesses weaken your body’s defense mechanism and with a poor immunity system, the vaccine may not work properly.

3. The time of the vaccination: For optimal protection, it is advised to go for the vaccination every year right before the ‘flu’ season starts. This is because after the flu season gets done with, old vaccines may not work as effectively.

The flu vaccine needs to be updated every season to guard you against the kind of flu dominant in that particular year. Getting yourself vaccinated is also not a guaranteed foolproof protection, however, it does render partial immunity and helps reduce the severity of the symptoms. However, it should be noted that flu vaccine cannot shield one from cold viruses.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Contaminated food is one of the most common sources of infections in the human body and so the stomach is one of the most commonly affected organs. Whether it is eating raw food or unhygienically prepared foods, the stomach has very high chance of getting infected than other body parts.

One of the most common causes of stomach infection is the norovirus also called as cruise ship virus. Spread through vomitus and faecal material, it is quite contagious and can affect large amounts of people in confined areas like a cruise ship. The common symptoms would include nausea, vomiting, diarrhoea, bloated feeling, abdominal pain (generalised or localised), fatigue, and tiredness.

On the brighter side, there are well-proven measures listed below which are simple and easy to follow that can help avoid stomach infection.

1. Restore bacterial balance: The good bacteria in the stomach are lost with the stomach flu and restoring it will help in managing the flu. A good amount of probiotics and fermented foods including yoghurt, sour curd, etc., will do wonders by restoring natural flora. Supplements can be taken if required, and these bacteria will restore the ability of the stomach to fight the virus.
2. Isolation and separation: If there is a close family member affected by the virus, ensure they are staying separately and all their clothing (bedding included) are maintained in an isolated manner. Children and elderly need extra protection, whether they are affected or are in the same household.
3. Cleaning methods: Since the virus spreads by contaminated faecal matter, vomitus and through surfaces, it is necessary to prevent the spread.
   • When in doubt, washing hands is very useful. Use soap and water instead of a hand wash. Staying away from picking nose and touching eyes are also useful.
   • The infected person’s clothes should be washed separately in extra hot water and bleached to get rid of the virus.
   • Using the dishwasher or soaking the washed utensils in extra-hot water is a good way to get rid of the virus.
   • Surfaces like laptops need to be cleaned more regularly and rigorously
   • Steam cleaning of carpets is a good idea to get rid of the virus that may be locked there.
   • Avoid going out or being in close contact for about a week, as the virus needs that much time to clear out completely.
4. Food habits
   • Do not eat raw or uncooked foods
   • Drink loads of water, clear soups, sports drink and lime juice to replace lost fluid.
   • Eat whole grains and fresh fruits and vegetables that are well-cooked to ensure you get the essential vitamins and minerals.

Following the above measures can help avoid the stomach flu and stay healthy.

HPV refers to Human Papillomavirus. This is a common virus, which has got more than 100 different types and over 40 of these types are transmitted sexually. This virus may cause cervical cancer and cases of genital warts. It is likely to occur in people who are sexually active to contract genital HPV, and it is not accompanied by any signs or symptoms. The virus is transmitted via skin to skin contact and is severely infectious in nature. Using condoms may reduce the risk of spreading of this virus, but is not always successful.

There are two major vaccines for HPV.

1. Gardasil: This vaccine prevents the most common HPVs which are associated with genital and anal cancer, and also warts of both genital and anal type.
2. Cervarix: This type of vaccine prevents HPV associated with the occurrence of cervical cancer.

Reasons for vaccination against HPV

HPV vaccines are recommended to girls between 11 and 12 years. It is also given to girls and women between the age of 13 and 26 years, who have never been vaccinated against HPC before. These vaccines should be given to females before they start being active sexually and get exposed to the HPV virus. Sexually active females benefit from these vaccines as well, but the effect is less.

Here are three reasons why you should vaccinate against HPV:

1. All types of HPV vaccine help in the elimination of the viruses which cause cervical cancer. Viruses causing cancer in the vulva, vagina or anus are also targeted by these HPV vaccines. The HPV vaccines also protect against genital or anal warts. HPV vaccines work effectively in the prevention of cancers caused by HPC viruses and also curb the common health problems which are accompanied.
2. The effect of HPV vaccines is quite long lasting in an individual who is vaccinated against HPV. Usually it lasts for ten years or more without having any related disorders or cancers. The protection does not weaken over time and remains stable.
3. HPV vaccines are licensed by the FDA to be completely safe and efficient to use. Extensive studies have been carried out globally, and no safety concerns have ever arisen. The side effects of HPV vaccines are usually quite mild. However, a little amount of pain, dizziness and nausea are involved.

HPV vaccines are a series of effective vaccines, which prevent the occurrence of cervical cancer and other cancers which are sexually transmitted. They are generally given to women before getting sexually active to prevent transmission of HPV viruses. Some HPV vaccines are prescribed to males as well. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

Children are highly at risk of developing a common cold. It has been said that 22 million school days are lost each year because of the common cold. This can easily be prevented by a number of simple measures. Here are the most common methods which people take to make sure that they do not catch the flu:

1. Make your child wash their hands: This is the most common reason for children getting the common cold. It is possible that whatever you touch may get infected with your germs and pass on to your children. This can happen even hours later. Therefore, it is crucial that you wash your hands as often as possible and if this is not possible, you should at least make your child use a hand sanitizer.
2. Do not sneeze into your hands: When you sneeze into your hands, the virus clings to your hands. Therefore, when you sneeze, try to sneeze into a tissue or at least into the inside of your elbow so that your child does not get a cold.
3. Make your child not touch your face: Colds can only enter your body through the eyes, nose and mouth. Tell your kids not to touch their faces so that they do not catch a virus.
4. Make your child do aerobic exercise: Aerobic exercise increases your heart rate and this means, that it also increases the ability of the body to kill viruses.
5. Give your child foods with phytochemicals: Green, red and yellow vegetable and fruits are very good at fighting off viruses. Eat them so that the natural virus fighting ability of the body is increased.
6. Do not allow your child to come near smoke: Smoking reduces the body's ability to fight off cold. This is why smokers get more severe and more frequent colds. It has been said that one cigarette can stop cilia from working for 30 to 40 minutes.
7. Relax: There is also a lot of evidence that your immune system is stronger when you are not stressed out. Try to see that your child is not stressed from school or any other place which may cause them stress.