When something is going wrong in your body, there will be signs. They may be subtle, but they are visible in close observation. If you are a smoker, you may be worried about the smell of smoke emanating from your mouth or clothes. However, there are other signs that tell whether you smoke or not and these signs are difficult to get rid of!

Smoking is the harmful act of inhaling tobacco infused smoke and is a common activity all over the world. According to the Center of Disease Control and Prevention (CDC), over 480,000 deaths happen each year due to smoking or smoke inhalation. The organization explained that smoking causes harm to nearly all organs and quitting lowers the risk of early death and other smoking related diseases.

Like many other substances, there are clear tell-tale signs when someone is smoking. This is especially important for finding lung problems like Chronic obstructive pulmonary disease (COPD), which is a lung disease that makes it hard to breathe, sooner so people can get help.

Why Does Smoking Affect Your Physical Appearance?

Action on Smoking and Health (ASH) explains that tobacco smoke has more than 7,000 harmful chemicals like nicotine, carbon monoxide, and various metals like arsenic, cadmium, and lead, quickly reach your lungs and then travel through your blood to all your organs, including your skin. Smoking damages your skin's ability to heal because it increases an enzyme metalloproteinase (MMPs) that breaks down collagen. Collagen is what keeps your skin smooth and elastic. As you lose collagen, your skin sags. Squinting from the smoke and puckering your mouth when smoking also cause wrinkles around your eyes and mouth.

Smoking also reduces blood flow to your skin, which means it gets less oxygen and nutrients. All these things together lead to what doctors call a "smoker's face." Quitting smoking can help prevent or slow down these skin problems."

Visible Signs Of Smoking

Here are some visible signs of smoking in people, according to 2013, Lung India

Fingers and Nails

When people smoke, the tar and other chemicals in the smoke stick to their fingers and nails. This repeated contact causes a yellow stain that's hard to wash off. It's a very common sign that someone regularly handles cigarettes or biris.

Moustaches

Especially in older people with white moustaches, smoking causes a yellowing effect. This is most noticeable in the center of the moustache, where the smoke from the nose directly hits the hair. The consistent exposure to smoke colors the hair over time.

Lips

Heavy smokers often have a bluish-black tint to their lips. This discoloration happens because the chemicals in tobacco smoke affect the blood flow and the color of the skin on the lips. The constant exposure changes the lip's natural color.

Teeth

Smoking causes teeth to stain both inside and out. The outside of the teeth turns yellow from the tar, while the inside develops a brownish-black stain. This happens because the smoke seeps into the enamel and discolors the teeth over time.

Premature Wrinkling

Smoking makes the skin age faster. This leads to wrinkles like "crow's feet" around the eyes and "cobblestone wrinkles" on the neck. This happens because smoking reduces blood flow, limiting oxygen to the skin, and damages collagen, which keeps skin elastic.

Nodular Elastosis

This condition, also known as "Favre–Racouchot syndrome," causes blackheads and wrinkles, especially around the eyes and temples. It is made worse by both sun exposure and heavy smoking. The skin becomes discolored with visible nodules and wrinkles.

Facial Wrinkling and COPD

A study published in Thorax 2006 found a connection between wrinkles on the face and COPD, a lung disease. It's thought that smoking affects both the skin and lungs through similar processes. If doctors notice signs like "crow's feet" on a smoker's face, they might recommend tests for COPD. This early detection can help people get treatment sooner and improve their lung health.

Recurring abdominal pain is often dismissed as acidity or indigestion. This becomes a matter of concern when persistent pain reaches the back and causes vomiting and weight loss. These are symptoms of a more serious disease such as chronic pancreatitis.

A recent case highlights the importance of recognizing the condition early. A 35-year-old mother of two had been living with severe upper abdominal pain for nearly three years. She experienced episodes that required hospital admission. Upon detailed investigations, it was confirmed to be a case of chronic idiopathic calcific pancreatitis. Long-standing inflammation had caused stones to develop within the pancreatic duct, which blocked the normal flow of digestive juices and triggered repeated attacks of pain. The underlying problem remained unresolved. To the patient, the mental toll of being a daily-wage worker came with loss of income and disruption to family life.

Chronic pancreatitis is when repeated inflammation causes permanent damage to the pancreas. Gradually, the gland becomes scarred, the pancreatic duct narrows, and stones develop. Pressure within the pancreas increases, thereby causing recurrent abdominal pain. As the disease advances, patients may also develop difficulty digesting food, unintended weight loss, nutritional deficiencies, and diabetes due to loss of pancreatic function. There exist multiple causes of chronic pancreatitis such as alcohol, gallstones, smoking, genetic disorders, autoimmune diseases and certain metabolic conditions. In a proportion of patients, no definite cause can be identified despite extensive evaluation.

Diagnosis is made on clinical grounds and imaging modalities such as ultrasound, CT scan, or MRI, which are helpful in identifying changes in the pancreas and detecting ductal stones. Early diagnosis is essential to prevent further complications and long-term outcomes. Treatment is modified according to the severity of the illness and the patient's signs and symptoms. Initial management is done in the form of dietary modifications, enzyme supplementation, and avoidance of substances such as alcohol and tobacco. However, when pain persists despite medical treatment, surgery may be required to relieve the obstruction and restore pancreatic drainage. This also occurs when stones obstruct the pancreatic duct,

In this patient's case, the severity of the case warranted surgery in order to ensure the best chance of lasting relief. Prior to the surgery, the patient consulted multiple hospitals before treatment. She underwent a minimally invasive robotic-assisted procedure to remove the pancreatic duct stones and create a new drainage pathway for pancreatic secretions. She had been advised open surgery but delayed it because she feared the large incision and long recovery; before this, she was admitted every 2-3 months for severe pain. The surgery was performed through small incisions with reduced tissue trauma as compared to conventional open surgery. The recovery was unsuccessful, and the patient was discharged with pancreatic enzyme supplementation.

Three months later, she was free from the disabling pain that had dominated her life. She had returned to work and was able to resume her daily routine.

Available treatment options have increased due to minimally invasive and robotic techniques for selected patients, but they may not be suitable for everyone. The choice of treatment is dependent on multiple factors such as the stage of the disease, the anatomy of the pancreas, and the patient's overall condition.

The more important message, however, extends beyond surgery. Persistent pain should never be ignored or considered a common passing occurrence; neither should it be repeatedly treated with painkillers without identifying the cause.

Earlier diagnosis and timely referral can be encouraged by raising awareness amongst the general public to prevent recurring hospital visits. Awareness can make the difference between years of repeated hospitalizations and a return to a healthier, more productive life.

(Dr. Sreedhara V., Surgical Gastroenterologist, Apollo Hospitals Bannerghatta Road, Bengaluru)

Liver cancer rarely announces itself. It creeps in without warning, and by the time symptoms surface, the disease has often progressed to a stage where treatment options shrink, and outcomes worsen. That's why doctors have long called it a "silent killer."

In India, the threat is growing. Rising rates of hepatitis infection, fatty liver disease, and lifestyle-driven risk factors are pushing the numbers up.

Data from the World Health Organization's International Agency for Research on Cancer (IARC) shows more than 40,000 new liver cancer cases reported in India, a figure that underscores a mounting public health challenge. The disease also carries a high mortality rate, largely because most cases surface only once treatment options have narrowed.

This fits into a much larger global picture: WHO's newly released Global Status Report on Cancer 2026 warns that annual cancer cases worldwide could climb from 20.6 million today to nearly 35 million by 2050 without urgent intervention, with infections like hepatitis B and C among the preventable risk factors driving a significant share of the burden.

Why Does Liver Cancer Stay Hidden?

The liver is a workhorse organ, filtering toxins, storing nutrients, and keeping the body running, and it can keep functioning almost normally even after cancer takes hold. That resilience is precisely what makes early detection so difficult. When symptoms do appear, they're vague enough to be mistaken for something else entirely:

• Unexplained weight loss
• Persistent fatigue and weakness
• Upper abdominal pain
• Loss of appetite
• Yellowing of the skin and eyes
• Abdominal swelling

Because these signs surface late, patients often delay seeking care, which is exactly why regular health checkups matter most for high-risk groups, including people with chronic liver disease, hepatitis infection, or fatty liver.

What's Driving the Risk?

Liver cancer doesn't appear overnight; it's the result of years of accumulated damage. Key contributors include:

• Chronic Hepatitis B and C infections, among the leading causes worldwide
• Liver cirrhosis, where scar tissue replaces healthy liver tissue
• Fatty liver disease, increasingly common in India amid rising obesity and diabetes
• Excessive alcohol consumption, which steadily damages liver cells
• Family history of liver disease or cancer
• Exposure to toxins through contaminated food
• Smoking, which raises overall cancer risk

India's shifting disease landscape, sedentary routines, poor dietary habits, and metabolic disorders like obesity and diabetes, means liver cancer is no longer just an infectious-disease concern. It's increasingly a lifestyle disease too.

Can It Be Prevented?

The good news: much of this risk is manageable.

• Get vaccinated against Hepatitis B to block the long-term viral infection that often leads to cirrhosis
• Maintain a healthy weight through diet and regular activity, as obesity is closely tied to fatty liver disease
• Manage diabetes and metabolic health, since insulin resistance accelerates liver damage
• Limit or avoid alcohol, a leading cause of cirrhosis
• Avoid tobacco, which compounds cancer risk
• Stay on top of routine screening if you're at risk; this is one of the most critical preventive steps and includes:
  • Liver function tests (LFTs) to catch early signs of inflammation or damage
  • Ultrasound scans every 6 months for those with cirrhosis, chronic hepatitis B or C, or advanced fatty liver disease
  • Alpha-fetoprotein (AFP) blood tests, used alongside imaging to flag early tumour changes
  • Advanced imaging (CT or MRI) for more detailed evaluation in high-risk cases

Paired with lifestyle changes and timely medical care, these steps can meaningfully lower the risk of developing liver cancer and support long-term liver health.

Know When to Seek Medical Help

Because liver cancer tends to progress silently, early detection is everything when it comes to improving outcomes. Doctors typically rely on a combination of diagnostic tools, ultrasound scans, AFP blood tests, CT or MRI imaging, and in some cases a liver biopsy, to catch the disease at a more treatable stage.

When caught early, treatment can significantly improve survival odds. The right approach depends on the stage of disease, liver function, and the patient's overall health:

• Liver resection, surgically removing only the cancerous portion of the liver, when the disease is localized
• Liver transplant, replacing the entire diseased liver with a healthy donor liver, in select cases
• Ablation, using radiofrequency or microwave energy to destroy cancer cells with heat
• Targeted therapy, drugs designed to attack specific cancer cells while sparing healthy ones
• Immunotherapy, strengthening the body's own immune system to identify and fight cancer cells

Liver cancer is serious and life-threatening, but early diagnosis through screening, paired with timely medical intervention, can meaningfully improve treatment success and survival rates.

(By Dr. Kundan, Consultant - Surgical Oncology, Manipal Hospital, Ghaziabad_

Women have a higher overall risk and prevalence of Alzheimer’s disease and certain other forms of dementia, partly because they tend to live longer than men and because of changes in estrogen levels after menopause.

A new study by researchers from the University of East Anglia (UEA) and the University of Exeter suggests that hormone replacement therapy (HRT) may be associated with a lower risk of dementia in some women.

“Dementia affects millions of people worldwide, with women making up almost two-thirds of Alzheimer’s disease cases, the main form of dementia. As populations age, understanding how sex-specific factors influence dementia risk is increasingly important,” said Prof Anne-Marie Minihane from UEA’s Norwich Medical School, who led the study.

HRT Linked To Lower Alzheimer’s Risk

The study, published in the journal Alzheimer’s & Dementia, analyzed health data from more than 180,000 postmenopausal women in the UK.

The findings showed:

• 16% lower risk of Alzheimer’s disease among women who had used HRT compared with those who had never used it.
• 10% lower risk of dementia overall was associated with HRT use.
• 26% lower risk of any dementia among women who had undergone surgical menopause and used HRT.
• 16% lower risk of any dementia among women with lower lifetime estrogen exposure due to later menstruation or earlier menopause.

Which Groups Benefited More From HRT?

The association between HRT use and lower dementia risk was stronger in certain groups. These include:

• Women who underwent surgical menopause: Those who used HRT had a 26% lower risk of dementia compared with non-users.
• Women with lower lifetime estrogen exposure: Those who started menstruating later or experienced menopause earlier had a 16% lower risk of dementia with HRT use.
• APOE4 carriers: The association between HRT use and lower dementia risk was stronger among women carrying the APOE4 gene variant, a known risk factor for Alzheimer’s disease.
• Women who started HRT between ages 46 and 56: This group experienced the greatest reduction in dementia risk.
• Timing may matter: The findings support the “critical window” hypothesis, suggesting HRT may offer greater benefits when started closer to the menopausal transition rather than later in life.

Could HRT Support Personalized Care?

The researchers said the findings add to growing evidence that the effects of hormone therapy on brain health are complex and may vary between women.

“While HRT has long been prescribed primarily to relieve menopausal symptoms such as hot flushes and night sweats, this work suggests it may also play a role in long-term cognitive health for some women,” Prof Minihane said.

The latest findings build on previous research from UEA, which found that HRT use was associated with better memory, cognition and larger brain volumes later in life among women carrying the APOE4 variant.

The team said the findings could help support more personalized approaches to HRT prescribing, taking into account factors such as menopause type, genetic risk, lifetime hormone exposure and age at HRT initiation.

Prof David Llewellyn of the University of Exeter Medical School said the findings help identify which women may be more likely to benefit from HRT and when treatment may have the greatest effect.