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.

As artificial intelligence (AI) continues to transform healthcare worldwide, concerns about technology replacing doctors remain a topic of debate.

Dr. Santosh Sivaranjani, popularly known as "The ORS Lady of India," addressed these concerns at the Times Now India Health Summit 2026 – South Edition in Hyderabad.

The renowned pediatrician and social activist emphasized that AI can only assist doctors and cannot replace the core human qualities that define medical care.

Dr. Sivaranjani acknowledged that doctors are increasingly embracing innovations such as artificial intelligence to improve patient care and health education. However, she stressed that technology has clear limitations.

"No matter how much AI advances, it can only complement us. It cannot replace the human touch, clinical acumen, or the genuine empathy that doctors have towards their patients," she said. "We should be proud of being doctors" because such qualities cannot be replicated by machines, she said.

The Privilege and Challenge of Being a Doctor in India

Speaking before an audience of healthcare professionals, Dr. Sivaranjani also highlighted the unique challenges and rewards of being a doctor in India. She described the profession as both a privilege and an extraordinary challenge, citing the immense patient load, demanding work schedules, and personal sacrifices made by medical professionals every day.

"Our journey demands countless sleepless nights, missed birthdays, missed anniversaries, and even caring for other patients when our own loved ones are unwell," she said. "Yet the moment we see a patient recover and smile, all those sacrifices seem worthwhile."

Changing Perceptions of the Medical Profession

Dr. Sivaranjani also reflected on the changing perception of doctors in India. She noted that physicians were once regarded with deep respect and seen as pillars of strength during families' most difficult moments. While many doctors continue to uphold these values, she expressed concern that rising healthcare costs and changing public expectations have altered doctor-patient relationships.

"Most doctors work to the best of their ability and according to their conscience, not to please patients but to provide the right treatment," she said.

Concerns Over the Consumer Protection Act

The pediatrician further highlighted concerns about the inclusion of doctors under the Consumer Protection Act, arguing that it has contributed to a more defensive doctor-patient relationship.

"Medicine often requires difficult and sometimes risky decisions to save lives. However, fear of legal consequences can make doctors hesitant to take those necessary risks," she said.

Rebuilding Trust Through Empathy and Ethics

Calling for efforts to rebuild public trust, Dr. Sivaranjani urged medical professionals to prioritize empathy, transparency, ethical practice, and patient education. She emphasized that medicine is not only a science but also an art that requires compassion and effective communication.

"The moment a patient enters your consultation room, half of their illness should disappear because of the confidence and reassurance you provide," she said. "Arrogance has no place in our profession."

She also stressed the need to strengthen public healthcare infrastructure to ensure equitable access to quality medical services across the country.

Concluding her address, Dr. Sivaranjani paid tribute to healthcare workers across India for their dedication and resilience.

"It is a privilege to be a doctor in this great country and to make a difference in so many lives," she said. "At the same time, it is an extraordinary challenge to protect ourselves from violence, navigate legal pressures, and help people understand that we are here not to please them, but to heal them."

As oncologists, we often meet patients at some of the most difficult moments of their lives. Yet there are times where a patient's journey reminds of the extraordinary resilience that people can show while facing the challenges that cancer presents

I recently treated a 38-year-old woman whose story has stayed with me.

Having just welcomed her baby into the world, her demanding yet joyful routine revolved around feeding schedules and sleepless nights. It was during this period that she noticed a hard lump in her breast.

Breast Lumps Can Cause Aggressive Breast Cancer

A sonomammography revealed a suspicious BIRADS 4A lesion. A biopsy confirmed Triple-Negative Breast Cancer (TNBC), which is one of the more aggressive forms of breast cancer. It was classified as a Stage III disease after evaluation through PET-CT which showed involvement of the axillary lymph nodes. The tumor also had a high Ki-67 index, indicating that it was growing rapidly.

Facing Cancer While Caring for A Newborn

The untimely diagnosis found the mother facing difficult questions about cancer treatment, her future and her ability to care for her child. One of the immediate challenges was that she had to stop breastfeeding.

Under the guidance of her pediatrician, her baby was transitioned to bottle feeds. This can be an emotionally challenging process for mothers as the feeling of guilt tends to seep in when breastfeeding plans are disrupted by illness.

A Modern Treatment Approach

After detailed and prolonged discussions with the patient and her family, we initiated treatment with neoadjuvant immunotherapy using pembrolizumab in combination with chemotherapy. This approach has emerged as one of the more prominent advances in the treatment of high-risk Triple-Negative Breast Cancer, having significantly improved outcomes for many patients.

Motherhood is a physically and emotionally taxing experience but the patient showed incredible strength during her cancer therapy, driven by her child and the unwavering support of her family.

Following completion of neoadjuvant therapy, repeat PET-CT imaging showed a near-complete response. She subsequently underwent surgery, and the final pathology report revealed a pathological complete response, meaning no residual invasive cancer had been detected.

This was the desired outcome for the treating team as well as the patient. She later completed the remaining course of immunotherapy, bringing her total treatment duration to one year. Today, both mother and child are doing well.

Breast Cancer Can Occur During Pregnancy

This tremendous journey highlights an important message. The fact that breast cancer can occur during pregnancy and the postpartum period deserves wider attention. Any breast lump that persists or feels unusual should be evaluated by a healthcare professional, as early diagnosis remains one of the most important factors in achieving positive outcomes.

The process is reflective of the advances in cancer treatment that are changing the outlook for patients with aggressive cancers. These advances are done through the integration of immunotherapy into treatment protocols which is helping more patients achieve improved long-term outcomes. The mother’s story is a reminder that cancer and motherhood are not mutually exclusive journeys.

Her ability to navigate this path is due to her timely diagnosis, access to appropriate treatment, family support and personal resilience. What began as a frightening diagnosis soon after childbirth ultimately became a story of hope, courage and survival. This is a powerful reminder to every new mother who might discover an unusual breast lump, that listening to your body and seeking medical advice early can make all the difference.

Constipation is one of the most common digestive complaints affecting people of all ages. It is generally defined as having fewer than three bowel movements per week, passing hard stools, excessive straining, or a feeling of incomplete evacuation.

While occasional constipation is usually not a cause for concern and can often be managed through lifestyle changes, persistent or severe constipation may sometimes indicate an underlying health condition that requires medical attention.

Common Causes of Constipation

Several factors can contribute to constipation, including inadequate fiber intake, insufficient water consumption, lack of physical activity, stress, changes in routine, and certain medications. In many cases, improving dietary habits and maintaining an active lifestyle can help restore normal bowel function. However, when constipation becomes chronic or is accompanied by other symptoms, it should not be ignored.

Warning Signs

One of the most important warning signs is a sudden change in bowel habits, particularly in adults over the age of 50. Persistent constipation associated with unexplained weight loss, loss of appetite, fatigue, abdominal pain, bloating, or blood in the stool may indicate a more serious condition, such as colorectal cancer. Early detection is crucial, making timely medical evaluation essential.

What's Behind Chronic Constipation

Chronic constipation may also be linked to several medical disorders. Conditions such as hypothyroidism, diabetes, Parkinson’s disease, multiple sclerosis, and certain neurological disorders can affect the normal movement of the intestines. In some individuals, constipation may result from pelvic floor dysfunction, where the muscles involved in bowel movements do not coordinate properly.

Irritable Bowel Syndrome (IBS), particularly the constipation-predominant type, is another common cause of ongoing bowel difficulties. Inflammatory bowel diseases, intestinal narrowing, or bowel obstruction can also present with severe constipation and abdominal discomfort.

Many people rely on over-the-counter laxatives for relief. While these medications can be effective when used appropriately, long-term or excessive use without medical supervision may mask an underlying problem and can sometimes worsen bowel function over time.

How To Maintain Good Digestive Health

To maintain good digestive health, individuals should consume a fibre-rich diet that includes fruits, vegetables, whole grains, and legumes. Adequate hydration, regular exercise, and responding promptly to the urge to pass stools are equally important.

Constipation is often harmless, but persistent symptoms should never be dismissed. If constipation lasts for several weeks, becomes increasingly severe, or is associated with alarming symptoms such as bleeding, significant weight loss, or severe abdominal pain, seeking medical advice is essential. Recognizing these warning signs early can help identify serious health conditions and ensure timely treatment.

(By Dr. Pradeepta Kumar Sethy, Director Gastroenterology, Manipal Hospital EM Bypass & Mukundupur)