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Cervical Cancer Prevention: The Role of HPV Vaccines and Government Initiatives in India

Cancer Care

31 Jan 2025

7 mins

Cervical Cancer Prevention: The Role of HPV Vaccines and Government Initiatives in IndiaCervical cancer is the second most common cancer among women in India, yet it is one of the few cancers that can be prevented. Every year, over 1.2 lakh women in India are diagnosed with this disease, and more than 75,000 lose their lives to it. The good news? A simple vaccine can prevent most cases of cervical cancer. The HPV vaccine [https://www.mrmed.in/molecule/hpv-vaccine-human-papilloma-virus] has been a game-changer in reducing cervical cancer [https://www.mrmed.in/health-library/cancer-care/cervical-cancer-causes-symptoms-treatment] cases worldwide. However, despite its availability, awareness and access remain major challenges in India. The government has stepped in with vaccination programs, screening initiatives, and awareness campaigns to ensure more women are protected. Let’s break it down—what is the HPV vaccine, how does it work, what are the government’s initiatives, and why should every eligible woman and girl get vaccinated? WHAT MAKES THE HPV VACCINE A GAME-CHANGER? The HPV vaccine is designed to protect against the high-risk strains of HPV that cause cervical cancer. Think of it as your body’s personal bodyguard against the virus. According to Dr. Princess Nothemba Simelela, WHO Assistant Director-General, “The HPV vaccine is highly effective in preventing infection with HPV types 16 and 18, which are responsible for 70% of cervical cancer cases.” This makes the vaccine a powerful tool in cervical cancer prevention. Two major vaccines are available in India: 1. CERVAVAC [https://www.mrmed.in/medicines/cervavac-injection] – India’s first indigenously developed cervical cancer vaccine, launched in 2023. It’s affordable and targeted at making HPV prevention accessible to all. 2. Gardasil [https://www.mrmed.in/medicines/gardasil-injection] – A globally recognised HPV vaccine available in India for years, offering strong protection against multiple HPV strains. WHY SHOULD YOU GET VACCINATED EARLY? Doctors recommend the vaccine for pre-teens, ideally between 9–14 years, as it’s most effective before exposure to the virus. But if you missed it in your teens, don’t worry—adults up to 45 years can still benefit! WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization highlights that “Expanding access to the HPV vaccine, especially through a single-dose regimen, has the potential to significantly reduce cervical cancer rates, particularly in low- and middle-income countries.” By ensuring early vaccination, we take a crucial step toward reducing cervical cancer cases worldwide and making protection more accessible to everyone. WHAT DOES HPV VACCINATION COST IN INDIA? While the cost of the HPV vaccine in India varies, it’s now more affordable than ever, thanks to government initiatives. A single dose of CERVAVAC costs around ₹200-400, compared to Gardasil, which ranges from ₹2,500–₹4,000 per dose. This price difference has made CERVAVAC a beacon of hope for millions of middle- and lower-income families. WHAT ARE THE GOVERNMENT’S INITIATIVES FOR CERVICAL CANCER PREVENTION? The Indian government has recognised the urgency of combating cervical cancer and is taking bold steps to address it. 1. MISSION INDRADHANUSH This flagship program aims to achieve universal vaccination coverage, with a focus on including the HPV vaccine. By integrating HPV vaccination into the broader immunisation framework, the government hopes to reach girls in rural and underserved areas. Click here [https://missionindradhanush.in/] to learn more. 2. INTERNATIONAL AGENCY FOR RESEARCH ON CANCER The IARC Screening Group (International Agency for Research on Cancer) plays a crucial role in promoting cervical cancer prevention in India. This initiative, supported by the World Health Organization (WHO), focuses on research, implementation, and capacity-building for cervical cancer screening programs globally, including India. The program provides training, technical resources, and guidelines to strengthen India's screening efforts, ensuring early detection and timely treatment. For more information, you can visit their official website: IARC Screening Group [https://screening.iarc.fr/index.php]. 3. NATIONAL CANCER REGISTRY PROGRAMME (NCRP) Initiated in 1982 by the Indian Council of Medical Research (ICMR), the NCRP collects data on cancer incidence and trends, including cervical cancer. This information aids in understanding the magnitude and patterns of cancer, thereby informing policy and program development. For more info, click here [https://www.ncdirindia.org/All_Reports/PBCR_2001_04/PBCR_2001_04.pdf] HOW CAN YOU PROTECT YOURSELF AND YOUR LOVED ONES? 1. GET VACCINATED If you or your children haven’t received the HPV vaccine yet, make it a priority. Remember, prevention is always better (and cheaper!) than treatment. 2. REGULAR SCREENINGS Screening methods like Pap smears [https://www.mrmed.in/health-library/cancer-care/pap-smear-test] and HPV tests can catch abnormal changes in the cervix early. Women aged 21–65 should undergo regular cervical cancer screening every 3–5 years. 3. SPREAD AWARENESS Talk to your friends, family, and community about the importance of the HPV vaccine and cervical cancer prevention. The more we normalise these conversations, the faster we can break the stigma. 4. LEVERAGE GOVERNMENT SCHEMES Take advantage of programs like Mission Indradhanush or government subsidies on vaccines to ensure that finances don’t become a barrier to health. WHY IS INDIA STILL STRUGGLING WITH CERVICAL CANCER AWARENESS? Despite the availability of vaccines and government support, several challenges persist: * Cultural barriers: Conversations about reproductive health remain taboo in many parts of India. * Lack of education: Many families aren’t aware of cervical cancer or the HPV vaccine’s role in preventing it. * Healthcare access: Women in rural areas often lack access to basic health services, let alone specialised vaccinations or screenings. ARE THERE ANY SIDE EFFECTS OF THE HPV VACCINE? The HPV vaccine is generally safe and well-tolerated, with millions of doses administered worldwide. Like any vaccine, it may cause mild side effects, including: * Pain, redness, or swelling at the injection site * Mild fever or headaches * Fatigue, dizziness, or nausea These side effects typically resolve on their own within a few days. Serious reactions, such as severe allergies, are extremely rare. Multiple studies confirm that the benefits of the HPV vaccine far outweigh any risks, as it significantly reduces the chances of developing cervical cancer and other HPV-related diseases. IS THE HPV VACCINE THE SAME AS THE BCG VACCINE FOR CERVICAL CANCER? Nope! The BCG vaccine, primarily used for tuberculosis, is not a substitute for the HPV vaccine. Here's a small comparison table between the BCG and HPV vaccines: Feature BCG Vaccine HPV Vaccine Primary Purpose Prevents tuberculosis (TB) Prevents human papillomavirus (HPV) infections, which can lead to cervical cancer Cancer Prevention No direct prevention of cervical cancer Prevents cervical cancer caused by HPV strains Target Diseases Tuberculosis (TB) HPV-related cancers (e.g., cervical, anal, throat cancers) Recommended Age Group Given mainly to infants and children Recommended for adolescents (both boys and girls) Effectiveness Effective for TB prevention Highly effective in preventing HPV infections and associated cancers HOW FAR HAS INDIA COME IN THE FIGHT AGAINST CERVICAL CANCER? In 2021, the World Health Organization (WHO) set a global target to eliminate cervical cancer by 2030. India, too, is aligning with this mission by increasing HPV vaccination coverage, enhancing cervical cancer screening, and launching awareness campaigns [https://www.mrmed.in/health-library/cancer-care/cervical-cancer-awareness-month]. Here’s a striking stat: * In India, over 1.2 lakh women are diagnosed with cervical cancer annually, but widespread HPV vaccination could prevent 70–90% of these cases. That’s the power of prevention! FREQUENTLY ASKED QUESTIONS (FAQS) 1. IS THE HPV VACCINE MANDATORY IN INDIA? No, the HPV vaccine is not mandatory in India, but it is highly recommended for cervical cancer prevention. The government and health organisations promote it through immunisation programs and awareness campaigns. Schools and hospitals often encourage vaccination, especially for young girls before exposure to HPV. While not compulsory, getting vaccinated significantly reduces the risk of cervical and other HPV-related cancers. 2. HOW MANY DOSES OF THE HPV VACCINE DO YOU NEED? The number of doses depends on your age at the time of the first shot. If you're under 15, you need two doses given six months apart. If you're 15 or older, three doses are required over six months for full protection. It’s important to complete the entire series for maximum effectiveness. Consult your doctor for the best schedule based on your age and health status. 3. CAN ADULTS GET THE HPV VACCINE? Yes! While the ideal age for HPV vaccination is 9–14 years, adults up to 45 years can still benefit. The vaccine is most effective before exposure to HPV, but it can still offer protection against new infections. If you're sexually active or above the recommended age, discuss with your doctor to see if getting vaccinated is still beneficial for you. 4. WHAT ARE THE SYMPTOMS OF CERVICAL CANCER? Cervical cancer often doesn’t show symptoms in its early stages, which is why regular cervical cancer screening is essential. As it progresses, symptoms may include abnormal vaginal bleeding, pelvic pain, unusual discharge, or pain during intercourse. If you notice any of these signs, seek medical advice immediately. Early detection through Pap smears and HPV testing greatly improves treatment success. 5. IS THE HPV VACCINE EFFECTIVE AGAINST ALL TYPES OF CERVICAL CANCER? The HPV vaccine protects against the most common high-risk HPV strains responsible for 70–90% of cervical cancers. While it doesn’t cover all possible cancer-causing HPV types, it significantly lowers the overall risk. Regular cervical cancer screening alongside vaccination offers the best protection. THE BOTTOM LINE Cervical cancer is one of the few cancers that we can truly prevent. Thanks to HPV vaccines like CERVAVAC and government schemes like Mission Indradhanush, India is making progress in safeguarding women’s health. But prevention starts with awareness. So, let’s break the silence, share knowledge, and ensure that every woman has the chance to live a healthy, cancer-free life. After all, when it comes to health, there’s no such thing as “too early” or “too careful.” Take the first step today—you won’t regret it! ALSO READ 1. HPV Vaccination in India - Everything You Need To Know [https://www.mrmed.in/health-library/cancer-care/cervical-cancer-hpv-vaccination-in-india] 2. HPV-Negative Cervical Cancer [https://www.mrmed.in/health-library/cancer-care/hpv-negative-cervical-cancer] 3. Symptoms, Causes and Treatment of Cervical Cancer [https://www.mrmed.in/health-library/cancer-care/cervical-cancer-causes-identification] 4. Early warning signs of Cervical cancer [https://www.mrmed.in/health-library/cancer-care/cervical-cancer-warning-signs-screening-vaccine] REFERENCES 1. https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html [https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html] 2. https://www.cdc.gov/cervical-cancer/prevention/index.html [https://www.cdc.gov/cervical-cancer/prevention/index.html] 3. https://pmc.ncbi.nlm.nih.gov/articles/PMC3385284/ [https://pmc.ncbi.nlm.nih.gov/articles/PMC3385284/] 4. https://www.who.int/news-room/fact-sheets/detail/cervical-cancer [https://www.who.int/news-room/fact-sheets/detail/cervical-cancer] 5. https://www.nhs.uk/vaccinations/hpv-vaccine/ [https://www.nhs.uk/vaccinations/hpv-vaccine/] 6. https://pmc.ncbi.nlm.nih.gov/articles/PMC8170054/ [https://pmc.ncbi.nlm.nih.gov/articles/PMC8170054/] 7. https://www.who.int/news/item/11-04-2022-one-dose-human-papillomavirus-(hpv)-vaccine-offers-solid-protection-against-cervical-cancer [https://www.who.int/news/item/11-04-2022-one-dose-human-papillomavirus-(hpv)-vaccine-offers-solid-protection-against-cervical-cancer] Disclaimer: The information provided in this blog is for general informational purposes only and is not intended as medical advice. Always consult with an oncologist before making any decisions related to vaccinations or health treatments. The availability of vaccines and government programs may vary by location, and it is important to stay informed through local health authorities and medical professionals.

Sakshi Anil More

Skin Care

2 Jan 2025

8 mins

Lupus Symptoms, Causes, and Treatment GuideWhen was the last time you heard about lupus? For most people, it’s a passing mention in a medical drama or a vague term they can’t quite pin down. But for those living with it, lupus is far from vague—it’s a chronic autoimmune disease that impacts every aspect of life. The scope of this blog is to shed light on this often-misunderstood condition by exploring its symptoms, causes, and treatment options. Our objective is to create awareness, provide clarity, and empower readers with actionable knowledge about lupus in a way that’s clear, conversational, and most importantly, human. WHAT IS LUPUS DISEASE? Lupus, or aka systemic lupus erythematosus (SLE), is an autoimmune disease [https://www.mrmed.in/health-library/immune-disorders/most-common-types-of-autoimmune-diseases]. To put it simply, your immune system, which is designed to protect you, gets a little overzealous and starts attacking your own tissues and organs. Think of it as an overprotective security system that mistakes you for the intruder. This autoimmune assault causes inflammation, pain, and damage that can affect almost any part of the body—including the skin, joints, kidneys, heart, and even the brain. There are several types of lupus, with SLE being the most common. Others include: * Cutaneous lupus: Affects the skin, often causing rashes and lesions. * Drug-induced lupus: Triggered by certain medications, but symptoms usually disappear after stopping the drug. * Neonatal lupus: A rare condition affecting newborns of mothers with lupus. WHAT ARE THE SYMPTOMS OF LUPUS? Here’s the tricky part: lupus is a master of disguise. Its symptoms often mimic other conditions, earning it the nickname “the great imitator.” But while the disease can be elusive, there are hallmark signs that can help identify it: 1. THE LUPUS BUTTERFLY RASH One of the most recognisable signs of lupus is the butterfly-shaped rash across your cheeks and nose. While it sounds poetic, the reality is far from glamorous. This rash can be itchy, painful, and emotionally taxing for those who experience it, often appearing or worsening after sun exposure. 2. LUPUS JOINT PAIN Achy, swollen joints are another classic symptom of lupus. For some, it feels like waking up after running a marathon—except you haven’t left your bed. 3. LUPUS FATIGUE Fatigue is a cornerstone of lupus symptoms. This isn’t your average “I need a nap” tired; it’s a bone-deep exhaustion that can make even the smallest tasks feel insurmountable. 4. LUPUS KIDNEY DISEASE Also known as lupus nephritis, this condition occurs when lupus attacks the kidneys, leading to symptoms like swelling in the legs and feet, high blood pressure [https://www.mrmed.in/health-library/hypertension/high-blood-pressure-symptoms], and foamy urine. Without proper treatment, it may progress to kidney failure. 5. OTHER SYMPTOMS The list doesn’t stop there. Lupus can also cause: * Hair loss * Chest pain due to swelling surrounding the heart or lungs * Memory issues and difficulty concentrating (“lupus fog”) * Sensitivity to sunlight * Fever without infection It’s important to note that not all symptoms appear at once. They can come and go, making lupus even harder to diagnose. WHAT IS THE MAIN CAUSE OF LUPUS? The million-dollar question: what causes lupus? Unfortunately, there’s no single answer, but research points to a combination of factors: 1. GENETICS Having a close family member with lupus or another autoimmune disease can increase your risk. But it’s not a guarantee—genes may load the gun, but something else pulls the trigger. 2. ENVIRONMENTAL TRIGGERS Factors like sunlight, infections, and even certain medications can trigger lupus in folks who are genetically predisposed. For instance, ultraviolet (UV) light is a known trigger for lupus rashes and flares. [https://pubmed.ncbi.nlm.nih.gov/17153842/] 3. HORMONAL FACTORS Lupus is most common in women, especially during their childbearing years, suggesting a strong link to hormones like estrogen. In fact, women make up about 90% of lupus cases. 4. STRESS AND LIFESTYLE While not a direct cause, chronic stress and unhealthy lifestyle choices can exacerbate symptoms or contribute to flares. HOW IS LUPUS DIAGNOSED? Diagnosing lupus can feel like solving a complex jigsaw puzzle. There’s no single test to confirm it, so doctors rely on a mix of: 1. BLOOD AND URINE TESTS * Antinuclear Antibody (ANA) Test: About 97% of people with lupus have a +ve ANA test, but a positive result alone isn’t conclusive. * Complete Blood Count (CBC): Can detect anaemia [https://www.mrmed.in/health-library/haematology/main-causes-iron-deficiency-anemia], low white blood cell counts, or low platelet levels, all of which are common in lupus. * Urinalysis: Checks for proteins or red blood cells in the urine, which may indicate kidney involvement. 2. IMAGING TESTS X-rays and echocardiograms can help detect damage to internal organs caused by lupus inflammation. 3. BIOPSIES A kidney or skin biopsy may be needed to confirm the diagnosis, especially if lupus nephritis is suspected. It’s worth noting that according to the Lupus Foundation of America [https://www.lupus.org/news/lupus-foundation-of-america-survey-more-than-half-of-americans-lack-awareness-understanding-of-lupus], it takes an average of six years for someone to receive a proper lupus diagnosis after the first symptoms appear. This delay highlights the need for greater awareness and more precise diagnostic tools. WHAT’S THE TREATMENT FOR LUPUS? There’s no cure for lupus (yet), but treatment options have come a long way in helping people manage symptoms and prevent complications. The goal is simple: control inflammation, suppress the overactive immune system, and protect organs from damage. 1. LUPUS MEDICATIONS * Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter options like ibuprofen or prescription NSAIDs can relieve pain and reduce inflammation. * Antimalarial Drugs: Medications like hydroxychloroquine are a game-changer for many lupus patients, helping with skin and joint symptoms as well as preventing flares. * Corticosteroids: These powerful anti-inflammatory medicines are often used for severe lupus, but they come with side effects like weight gain and high BP (blood pressure). * Immunosuppressants: Medications like azathioprine [https://www.mrmed.in/molecule/azathioprine] or mycophenolate suppress the immune system, helping to control more severe cases. * Biologics: A newer class of drugs, such as belimumab, targets specific parts of the immune system, offering a more tailored approach. 2. LIFESTYLE ADJUSTMENTS * Lupus Diet: While there’s no one-size-fits-all diet for lupus, anti-inflammatory foods like leafy greens, berries, and fatty fish can help. Avoiding processed foods, excessive salt, and alcohol is crucial, especially for those with kidney or cardiovascular complications. * Exercise: Low-impact activities like yoga, swimming, or walking can improve joint pain, boost energy, and enhance overall well-being. * Stress Management: Constant stress is a known trigger for lupus flares. Meditation, journalling, mindfulness, and even simple breathing exercises can make a big difference. 3. REGULAR MONITORING Frequent check-ups with your healthcare team are essential to track disease activity and catch complications like kidney or heart damage early. WHICH HOSPITAL IS BEST FOR LUPUS TREATMENT IN INDIA? Finding the right hospital for lupus treatment is crucial for managing this chronic autoimmune disease effectively. Here are some of the best hospitals you can consider for lupus & Other Fatal Autoimmune Diseases [https://www.mrmed.in/health-library/immune-disorders/fatal-autoimmune-diseases] treatment: Hospital Specialisation Financial Aid & Special Schemes Apollo Hospitals Advanced diagnostic and treatment facilities for autoimmune diseases, including lupus. - Patient assistance programs for low-income individuals. - Health insurance partnerships. - Easy EMI options for treatment costs. AIIMS (All India Institute of Medical Sciences), New Delhi - Prestigious government institution offering comprehensive care for autoimmune diseases. - Highly subsidised treatment for affordability. - Special schemes for financially disadvantaged patients. Medanta – The Medicity, Gurgaon - Specialised Department of Rheumatology for lupus diagnosis and treatment. - Multi-disciplinary approach. - Financial assistance through insurance programs. - Customised packages based on patient needs. - Discounts for long-term treatment. Fortis Memorial Research Institute, Gurgaon - Advanced care for lupus and related complications like kidney disease and joint pain. - Financial assistance program for underprivileged patients. - Discounted consultation fees. - Free or reduced-cost diagnostic tests. Christian Medical College (CMC), Vellore - Renowned rheumatology department for managing lupus. - Holistic approach, including mental health support. - Financial aid through community outreach programs and NGO partnerships. - Subsidised treatment for financially constrained patients. LIVING WITH LUPUS: THRIVING, NOT JUST SURVIVING Living with lupus can feel overwhelming, but it’s possible to lead a fulfilling life. Here are some tips: * Understand Your Triggers: Keep a journal to identify patterns—whether it’s certain foods, stress, or environmental factors like sunlight. * Build a Support System: Whether it’s joining a local support group or connecting online, sharing experiences with other people who “get it” can be incredibly validating. * Educate Yourself: The more you know about lupus, the better equipped you’ll be to advocate for your health. SURPRISING STATS ABOUT LUPUS * Lupus affects an estimated 5 million people worldwide, with 1.5 million in the U.S. alone. * Lupus is 2-3 times more prevalent among women of colour compared to Caucasian women. * 10-15% of lupus patients develop severe kidney disease [https://www.mrmed.in/condition/kidney-disease] requiring dialysis or transplant. * Early diagnosis and proper treatment have improved the 5-year survival rate for lupus patients to over 90%. FREQUENTLY ASKED QUESTIONS Q.1) IS LUPUS TREATABLE? Lupus is not curable, but it is highly manageable with the right medical care and lifestyle changes. Treatment typically involves a combination of medicines like immunosuppressants, corticosteroids, and antimalarials to control symptoms and prevent flare-ups. Early diagnosis and a tailored treatment plan are crucial to reducing complications. Advances in biologics and research into targeted therapies are offering hope for more effective treatments in the future. Q.2) CAN PEOPLE WITH LUPUS LIVE A NORMAL LIFE? Yes, with proper management, many people with lupus can lead a normal and fulfilling life. Key factors include adhering to treatment plans, regular monitoring of symptoms, and adopting a healthy lifestyle to reduce stress and inflammation. While flare-ups can occur, understanding triggers and working closely with healthcare providers can help minimise their impact. Emotional support and self-care are also important for lupus patients. Q.3) WHAT FOOD TO AVOID WITH LUPUS? People with lupus should avoid foods that can trigger inflammation or interfere with medications, such as processed foods, red meat, and high-sodium snacks. Alfalfa sprouts are particularly risky as they contain amino acids that may trigger lupus symptoms. Limiting alcohol and caffeine intake is also recommended, as these can exacerbate fatigue and affect medication efficacy. Instead, focus on an anti-inflammatory diet rich in fresh fruits, vegetables, omega-3 fatty acids [https://www.mrmed.in/molecule/omega-3-fatty-acids], and whole grains. Q.4) WILL LUPUS RASH GO AWAY? Lupus rashes, such as the characteristic butterfly rash, often subside with effective treatment and by avoiding triggers like sun exposure. Using prescribed topical steroids or anti-inflammatory creams can speed up healing. Protecting the skin with sunscreen and wearing protective clothing can prevent rashes from worsening. However, chronic or recurrent rashes may require systemic treatments, and consulting a dermatologist can provide additional options for managing skin symptoms. Q.5) IS LUPUS CAUSED BY LIFESTYLE? Lupus is not directly caused by lifestyle, as it primarily stems from genetic and environmental factors that trigger an immune system malfunction. However, lifestyle choices can influence the severity and frequency of symptoms. Chronic stress, lack of sleep, and an unhealthy diet can exacerbate flare-ups, while a balanced lifestyle may help in managing the disease. Maintaining a healthy weight, staying physically active, and avoiding known triggers can significantly reduce lupus complications. Q.6) IS LUPUS FATAL? While lupus itself is not always fatal, complications from the disease can be life-threatening. Conditions like lupus nephritis, cardiovascular disease, or severe infections can arise if the disease is not managed effectively. So, can lupus kill you? In severe cases, it is possible, but advancements in medical care have significantly improved survival rates. Early diagnosis and treatment play a crucial role in reducing risks. For most people, lupus is manageable with the right approach, and with proper care, it’s unlikely that lupus disease will kill you. Q.7) HOW DANGEROUS IS LUPUS? Lupus can be highly dangerous due to its systemic nature, which allows it to impact multiple organs and lead to severe complications. Can lupus disease kill you? The answer lies in how well the disease is managed and whether complications like kidney failure or heart disease occur. Will lupus kill you if left untreated? While this is a possibility in severe cases, timely medical intervention and lifestyle adjustments can greatly reduce the likelihood of fatal outcomes. The unpredictability of lupus makes vigilance and proactive care essential. FINAL THOUGHTS Lupus isn’t just a medical condition—it’s a life-altering journey that requires resilience, support, and proactive care. While it can be challenging, advances in research and a better understanding of the disease are giving patients more tools than ever to manage it effectively. If you or someone you know has lupus, remember you’re not alone. By staying informed, advocating for yourself, and embracing a supportive community, it’s possible to live a full and vibrant life despite the challenges. REFERENCES 1. https://www.nhs.uk/conditions/lupus/ [https://www.nhs.uk/conditions/lupus/] 2. https://www.niams.nih.gov/health-topics/lupus [https://www.niams.nih.gov/health-topics/lupus] 3. https://www.niams.nih.gov/health-topics/lupus/diagnosis-treatment-and-steps-to-take [https://www.niams.nih.gov/health-topics/lupus/diagnosis-treatment-and-steps-to-take] 4. https://www.apollohospitals.com/book-doctor-appointment/lupus/treatment/ [https://www.apollohospitals.com/book-doctor-appointment/lupus/treatment/] 5. https://www.nature.com/articles/s41590-024-01898-7 [https://www.nature.com/articles/s41590-024-01898-7] 6. https://www.sciencedirect.com/science/article/abs/pii/S1568997224001393 [https://www.sciencedirect.com/science/article/abs/pii/S1568997224001393]

Sakshi Anil More