WHAT IS HPV?
HPV stands for human papillomavirus. There are 100 types of HPV but only 13 of them are known to cause cancer. The others are harmless or cause conditions such as genital warts. HPV is the underlying cause for cervical cancer, a sexually transmitted and largely symptomless infection. Many young women contract HPV, but the infection may remain stable for a long time. In some cases, HPV leads to abnormal cell changes that can progress to cancer, but only over many years. This cancer is most common among women 35 years and older around the world.

HOW DO YOU GET HPV?
HPV is transmitted through intimate sexual contact including, but not limited to, sexual intercourse.

IS HPV COMMON?
Infection by HPV is common and at least half of all sexually active women are infected by a strain of genital HPV in their lifetimes. In India it is the most common form of cancer in women. Known to affect a large number of women in rural areas, it is becoming rampant in metros too, since occurrences of unprotected sex are high. In Mumbai, it is the most common form of cancer after breast cancer.

HOW CAN HPV LEAD TO CERVICAL CANCER?
Two particular strains of HPV, types 16 and 18, cause a majority of all cervical cancers in the world. Although HPV infection is usually symptom free, it can damage the lining of the cervix. Persistent infection can cause abnormalities of the cervix, which, if left undetected and untreated, can cause cervical cancer.

AT WHAT AGE DO WOMEN GET CERVICAL CANCER?
Cervical cancer is very rare for women aged under 25. Most women get cervical cancer in their 30s, or when they're older. But with recurring occurrences of unprotected sex with city women and teenagers, local gynaecs are calling the 18-30 age group as a high risk one. Being sexually active with multiple partners too increases their risk of contracting cervical cancer.

WHAT IS THE HPV VACCINATION?
The HPV vaccine protects against two strains of the virus (types 16 and 18) which cause over 70 per cent of cervical cancers. It is estimated to save the lives of hundreds of women each year. Although not available in India as yet, the vaccine is well on its way and will be available by the end of this year, doctors say. Major multinational pharma companies are in talks with experts and gynaecs to execute the same. Vaccination programmes in the west are common and compulsary. Trials of the HPV vaccine show that protection lasts for at least six years, but it is expected to be much longer lasting.

THE PAP SMEAR TEST AND TREATMENT
This test is the simplest and cheapest way to detect cervical cancer. It involves inserting a specialised brush or a cotton swab into the cervix and sending it for narco-analysis. If the patient is a victim of cervical cancer, the slide is likely to pick up the discarded cells and indicate a positive result thereafter. Ideally, the test is supposed to be carried out on all sexually active women at least once a year. But since this isn't being enforced in India, most gynaecologists and radiologists insist on getting the PAP SMEAR test or the HPV test done before any medical procedure. Though western countries have achieved success in early detection of cervical cancer with the 'Pap smear' test, India on the other hand has not reached majority of the women in need, mostly because of high costs involved and a lack of trained experts, especially in the rural areas.

THE GOOD NEWS
A positive way to look at this situation is that this type of cancer is one of the slowest to spread through the body and one of the quickest to be detected. If you detect it at an early stage, you can almost completely recover with treatment. Now, with advanced surgery, complete removal of the affected cells is also possible.

THE FACTS
• By July 2011 over 2 million girls will have been given the HPV vaccine

• This routine vaccine protects against two strains of the HPV virus — which cause over 70 per cent of cases of cervical cancer

• Cervical cancer is the second most common cancer amongst women worldwide. Around 3,000 new cases of cervical cancer are diagnosed

• The vaccine, given as a course of three doses over around six months, is estimated to save lives of hundreds of women each year.

TIME MANAGEMENT CRITICAL TO EXCEL AT THE WORKPLACE

If you examine the matter closely, time and timing is everything. If you want tell somebody something that in your opinion is critical, it is better to say it immediately rather than later. If our actions, for example, are not timed, they lose their impact. Missing the moment is to miss an opportunity.

You need to manage time efficiently because that is the best way of respecting yourself and others. Regularly coming late for meetings or appointments is actually a way of insulting friends and colleagues because it shows disrespect for time given to you by others.On the other hand, it is important to understand that a busy person is not somebody who does not have time but somebody who actually makes time. In the global context today, it is essential that your time is managed with care and precision.

Here are some useful tips that could go a long way in helping you manage your time productively both in the workplace and at home:

Understand context
It is critical to be mindful and observant of the environment around you. It is your understanding of your environment that helps you discriminate the wheat from the chaff and what deserves your immediate attention and what does not. Maintain focus
In the Mahabharata, Arjuna is asked by Drona, "Arjuna, What do you see? Do you the princes assembled here?" Arjuna answers in the negative. "Do you see your cousins?" Arjuna again answers in the negative. He is asked several questions in a s i m i l a r ve i n a n d he responds to all of them in the negative. Finally, he is asked: "What then do you see?" He replies: "I see the eye of the fish swirling in the fishbowl." Such was his focus. Focus on why you do what you do and why you need to do what you need to do.

Prioritise tasks
Distinguish between those tasks that need your immediate attention,those that can be dealt with in reasonable time and those that are important but not urgent.

Make speedy response a habit
As the old saying goes, 'fast and consistent always beats the slow and steady'.

Managing time helps everybody
When you manage your time efficiently, it helps everybody in the workplace including your boss, your peers, your team and its leader. It is good to be individually brilliant but teamwork involves rallying collective core competencies around a single purpose. You will under-perform if you cannot cohere with your team.

Finally, as Peter Drucker once said: "Everything requires time. It is the only truly universal condition. All work takes place in time and uses up time.Yet most people take for granted this unique, irreplaceable,and necessary resource.Nothing else, perhaps, distinguishes effective executives as much as their tender loving care of time."

Psoriasis Wellness Tips

What are the risk factors of psoriasis?
Although psoriasis is hereditary, people are unable to trace the disease through many generations. This is because a number of external and internal factors can determine whether a person will be affected by this disorder. This means that even with a family history, one may not suffer from the disease if he/she is not exposed to certain superadded triggers. It is estimated that if a child has one parent with psoriasis, the risk of developing the disease is about 15 to 25 percent. If however both parents have psoriasis, the child’s risk of developing the disease is about 50 percent.

Can psoriasis triggers be avoided?
One has to have a clear idea about what triggers it. These triggers can be person specific, for example some people find that they develop new eruptions each time they have alcohol. There are others who have flare-ups when they eat brinjal. One of my patients would develop a massive flare-up after he consumed the seasonal vegetable avarekalu. Preventing the skin from drying up in winter, treating skin injuries quickly, using stress reduction techniques and following wellness tips can be effective in preventing psoriasis flare-ups.

What are the wellness tips for psoriasis?
Wellness is about prevention rather than cure. It’s about adapting a certain lifestyle to suit the body needs. Patients prone to psoriasis or in the high risk category of it are most benefited by wellness tips. In mild to moderate cases of psoriasis, a few minutes of sun exposure every morning is healthy. However, one must be careful not to stay so long as to burn. Consumption of folate rich foods like asparagus and yeast and supplementing your diet with omega3 fatty acids plays a vital role in the management of psoriasis.

Claustrophobia is a mind game...

Vijay reminisces about his childhood and remembers hiding in the small cupboard without being suffocated or frightened of the dark. All that changed when Vijay, fresh into his teens got stuck in his building elevator. He pressed the alarm button but to no avail. When no help arrived, he panicked. After half an hour, when the elevator was repaired, he walked out, sweaty, suffocated and breathless. He had encountered his first tryst with claustrophobia.

Sadly, this experience hampered his growth in more ways than one. He stopped using the elevator from then on. His visits to the ‘stuffy’ theatre with his friends stopped. He avoided small rooms, tunnels and air travel with a vengeance. Claustrophobia had hampered Vijay for life. His friends never understood his condition and that made matters worse. It was only when he was employed on the 28th floor of a multinational company building that he decided to get himself treated for the condition.

What is claustrophobia all about?
Claustrophobia is an extreme fear of being confined or trapped in small spaces. A person dealing with claustrophobia often experiences great anxiety and difficulty breathing in small enclosed spaces and may experience feelings of panic or even have a full-fledged panic attack. Like Vijay, there are many of us who have claustrophobia, but we just don’t know it yet. We are called fussy or nit picky when we share our grievances about being suffocated in a small room, or are concerned about an airplane not having enough aisle space, or for that matter someone’s elbows touching ours in the train compartment. So what do we do? We avoid such places without really finding a solution for the problem and facing it head on. The good news is that claustrophobia is treatable.

Recollect a traumatic experience
The main cause of claustrophobia is often a bad past traumatic childhood experience which involves a temporary or permanent confined environment. Herein, the mind often makes a psychological connection that small spaces translate to danger. It can lead to a panic attack, this response then becomes data in the brain, establishing an irrational association between being trapped and out of control or experiencing anxiety.

Do you have claustrophobia?
Breathlessness, excessive sweating, heart palpitations, nausea or a parched dry mouth, light headedness, nausea, fainting, hyper ventilation and shaking are some symptoms. Other symptoms are a deep-seated fear of dying, losing one’s mind or losing control, being detached from reality or having a full blown panic attack and an inability to think or speak clearly. However, it’s only a phobia and can be treated.

Treatments for claustrophobia include:
Psycho-education, breathing exercises and relapse prevention.

• It’s all within: Psycho-education
This involves educating the individual about the meaning and causes of claustrophobia, and clarifying negative emotions such as fear, anxiety and phobia. Deep-seated notions involved in relating fear to cramped spaces are addressed, and the patient is encouraged to talk about his/her problem. Once the patient realises what triggered the claustrophobia, remedial measures can be taken to tackle the same.

• Rewind and erase: Past Life Therapy
This is a new-age technique wherein the counsellor takes the patient into a past life experience to delve into the present scondition of claustrophobia. Sometimes, a traumatic experience in a past life can be carried into the present. Once that is addressed, the patient discovers that the cramped phobia is gone forever in the present, paving the way for a phobia-free future.

• Learn to breathe again
This technique makes the individual change his fast breathing pattern to a slow breathing one. Anxiety provoking situations often cause hyperventilation. The consequences include an intensification of anxiety. This can be tackled by teaching patients a slow breathing technique to face the anxiety provoking situations in a more effective way.

• The way we perceive things: Cognitive therapy
Our responses to events or situations are the way we interpret them, what we think that situation really is and its meaning. Our thought patterns determine how we will feel about things. Sometimes, we make erroneous interpretations that can lead to distressing feelings. Applying cognitive techniques means trying to behave as scientists do: test whether our interpretations are right or wrong and find alternative ways of thinking about the situations that would lead to less distressing feelings and allow us to face situations more competently.

• Ignorance can be stuffy!
Ralph Waldo Emerson rightly said, “Fear always springs from ignorance.” So, the way out of that stuffy room, crowded airplane, or small office cubicle is to educate yourself by getting expert help.

Don’t tell all

IT happened to Nicole Kidman and Tom Cruise, Kareena and Shahid —were they too close for comfort? Did they know too much about each other? It doesn’t pay to be secretive, but in a relationship it’s good to tell some and hide some:

Let there be mystery:
Men fall for the mystery element, so maintain it and never reveal it. Be it your beauty tips, your exboyfriend, or your sex life, let it be a secret forever. Singer Raageshwari says, “I truly believe that mystery keeps the romance alive. Don’t give him every detail about your ex-boyfriend, certain things are best left unsaid. And if he compliments you on your looks, then don’t reveal your beauty routine, just say ‘Thank you’. ”

Share, if he understands:
Women can talk about their darkest secrets, but men are a different breed. You never know whether they understand. Mind you, men can be childlike and unreasonable. Model Shefali Talwar agrees, “It’s good to be frank and honest in a relationship about your past, but make sure that your partner understands.”

Keep it relevant:
Women all over the world have this habit of spilling everything, be it sex, money or boyfriends. Anchorperson, Shivani Wazir Pasrich says, “Live in the present, there’s no need to talk about irrelevant things from your past. Make sure you’re not pouring your life out to him.” Actress Suchitra Pillai confirms, “Somethings are better unsaid, unseen and unheard for life. My husband never asked me about my past relationships. You are not trying to be secretive; certain things are irrelevant after a point, then why to discuss them.”

Be adaptable:
Adaptability is the key. Be it dieting, travelling or shopping together, try to zero in on the things that can lead to problems. Emcee Geetika Ganju says, “Be it good, bad or ugly, sharing leads to a comfort level in relationships.”

Intensity counts:
Make sure you are aware where the relationship is heading. Don’t share your stories, if uncertain about the future. Dr Advesh Sharma, psychiatrist, suggests, “If you’re unsure where your relationship is heading, then don’t talk about the past. In arranged marriages, let the relationship be built strongly before sharing everthing. In intimate relationships, it’s good to reveal everything on your own. It will hurt your partner more if he gets to know it from someone else”.

The magic of honey

“Hi, honey!” That happy greeting may also apply to the yellowcapped squeezie bear in your pantry, because the contents are good for so much more than sweetening your tea. Honey is a natural antiseptic, moisturiser, and — thanks to all its antioxidants — an age-fighter, too.

The high concentration of sugar gives honey germ-killing power, which is why it’s been used for thousands of years to encourage wound healing. Honey’s thick, sticky consistency also makes it a natural, protective salve, sealing out infection and creating a moist, healing environment within. Use it in a pinch if you develop blisters on a camping trip.

Honey is a terrific moisturiser for the face and body, too. Honey is a natural humectant, meaning it draws ‘free water’ from interior tissues to the surface layers of the skin. That subtle fluid shift creates a plumping effect that temporarily improves the appearance of wrinkles — handy before a morning presentation or a big night out.

To see for yourself, try this moisturising honey mask, which also soothes dry, sensitive, or irritated skin:

Mix 2 tablespoons of honey and 2 teaspoons of whole milk. Warm slightly in the microwave. Smooth the mixture onto your face and lie down for 10 minutes. Rinse off with warm — not hot — water. As for the age-fighting effects, all types of honey contain antioxidants that appear to block skin-cell-damaging free radicals, though dark honeys — particularly the honeydew and buckwheat varieties —have more of them than paler clover honeys. While there’s still a debate on how effective antioxidants are when applied to the skin, have swirling dark honey with your yogurt every morning. It’s a simple way to nourish your skin from the inside.

Eat at the right intervals

There is now a view that people trying to count calories and lose weight should distribute their total calorie intake throughout the day. One school of thought is that if you are consuming 1200 calories daily, you should eat 450 in the morning, 450 at lunch and tea and only 300 at night. Others say it can be 200 cals for breakfast, 200 cals at lunch and 800 cals for dinner, making a total of 1200 calories in the day. Similarly, during the last few decades there has been a lot of debate about whether babies should be demand-fed, that is, given milk (breast or bottle) whenever they want or whether it is better to follow a schedule of a gap of 2-3 hours between each feed.

From the weight control point of view, a systematic feeding schedule is the ideal. When a baby has been fed at 6am, the mother’s milk production is at its highest. The baby is able to get a enough milk and will usually sleep again or not require another feed till 8 or 9 am. This is human nature and how the body works.

All human beings thrive with a good intake of food in the morning. It’s very important as one is fasting from 9 pm to at least 6 am. We need to break the fast and eat a healthy carbohydrate- and protein-balanced meal.

Usually after bed coffee at 6 am and breakfast at 8-9 am you will find that you may start feeling a little empty around 10.30-11.30 am. The ideal is to eat a fruit or have at least a cup of coffee, tea or buttermilk at this time.

Around 12.30 pm or 1.30pm is the ideal time for lunch. The ideal gap between breakfast and lunch is 4-5 hours. Lunch is a very important meal and should be the anchor meal of the day. It must again be a carbohydrate, protein balanced meal consisting of roti/rice with dal/sambar and cooked and raw vegetables. It is very important as we have to work after lunch till late evening and the gap between lunch and dinner is much longer. As this duration could be 6-7 hours we usually recommend two snacks during this time.

Tea time is 4-5 pm and a glass of milk, tea with coffee, biscuits or a sandwich is the ideal snack at this time. When you reach home at 6 or 7 pm a fruit and a glass of milk is ideal. This becomes a second snack.

Dinner ideally must be between 7.30pm and 9pm and must consist of only 20 per cent of the total calorie intake as we go to bed thereafter. However it must be a carbohydrate- and protein-balanced meal like roti, dal and salad. It is very harmful to have only a soup, salad or only a glass of milk for dinner. If you eat 50 per cent or 70 per cent of your calorie intake for dinner the body will store 30-50 per cent of the calories as fat when you sleep.