With the holiday season high, there is festive cheer, family gatherings and also an undeniable increases in alcohol consumption that fills the air. Christmas and New Year's Eve celebrations to spring break and bachelor parties and sporting events that bring together huge crowds for celebrations mean that drinking becomes synonymous with partying. But behind the revelry lies a much darker behavior: high-intensity drinking.

Alcohol is the most widely used substance in the United States; it has been reported that 84% of adults aged 18 and older reported lifetime use. Moderate drinking is socially acceptable, but high-intensity drinking is an alarming trend. The behavior of consuming eight or more drinks over a few hours for women and 10 or more for men exceeds binge drinking and significantly increases risk for harm.

High-intensity drinking is far from being just a mere passing concern; it is instead a public health crisis. The burden is even greater as 29 million people in the United States suffer from alcohol use disorder. That has caused over 140,000 deaths annually while accounting for 200,000 hospitalizations and 7.4% of visits to emergency departments in the United States. However, only 7.6% of these affected get treated, thus forming a glaring gap in handling this concern.

What Is High-Intensity Drinking?

High-intensity drinking is a dangerous escalation from traditional binge drinking, characterized by consuming double or triple the standard binge amounts. While binge drinking involves four or more drinks for women and five or more for men, high-intensity drinkers often surpass these levels, leading to blood alcohol concentrations (BAC) exceeding 0.2%—a level that significantly impairs judgment and motor skills.

According to Dr. George Koob, the director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), high-intensity drinking is one of the factors that intensify the risks of injuries, overdose, and death. It is also very highly associated with the onset of AUD, since the chance of addiction increases with increased alcohol consumption per occasion.

Blackouts and Memory Loss Risks

One of the most troubling consequences of high-intensity drinking is alcohol-induced blackouts, periods of amnesia where individuals may appear functional but are incapable of forming memories. Blackouts occur when alcohol disrupts the hippocampus, the brain region responsible for memory formation.

Blackouts are often categorized into two types:

1. Fragmentary Blackouts: Characterized by spotty memory, where recalling certain details can trigger partial recollection.

2. En Bloc Blackouts: Significant amnesia for hours, wherein no memory is created at all, even if tried to be recalled.

Aside from memory loss, intense binge drinking is linked with poor decision-making, violence, injury, and conflicts in personal relationships.

Why Holidays and Special Events Are Hotbeds for Excessive Drinking

Holidays and celebrations create the perfect storm for high-intensity drinking. According to research, adults drink nearly double the amount of alcohol during holidays like Christmas and New Year's Eve than they do at any other time of the year. It is during these periods of social gathering, holiday stress, and seasonal sadness that people drink in excess.

For college students, experiences like spring break and 21st birthdays increase the danger. Some studies indicate that students, especially those who travel with buddies to spring break, indulge in more alcohol and make more serious decisions than any student who remains at home or goes with their family to other destinations. Sporting events are, too, notorious for promoting drunk consumption, especially among male customers. Alcohol consumption usually goes high during Super Bowl Sunday, thus leading to games day violence and arrests.

Consequences of Heavy Intensity Drinking

High-intensity drinking impacts not only physical health and mental well-being but also social relationships.

Acute Risks

- Alcohol poisoning

- Severe dehydration and electrolyte imbalances

- Hypoglycemia

- Risky sexual behavior

- Injuries and accidents

Chronic Risks

- Liver damage, alcoholic hepatitis, and cirrhosis

- Cardiovascular diseases such as arrhythmias and cardiomyopathy

- Neurological damage, including memory deficits and blackouts

- Progression to alcohol dependence or AUD

Psychological Impact

High-intensity drinking is strongly linked with increased risks of depression, anxiety, and suicidal ideation. Poor decision-making during episodes can lead to long-lasting consequences, including damaged academic, professional, or personal outcomes.

How to Address the Problem

Combating high-intensity drinking requires education, early intervention, and accessible treatment options. The NIAAA has defined high-intensity drinking to be distinct from binge drinking and has called for targeted approaches to decline prevalence and associated harms.

One promising treatment option is naltrexone, which a medication helps control alcohol cravings. Encouraging in preliminary evidence, more extensive clinical trials will be necessary to ascertain its efficacy more specifically in high-intensity drinkers.

As we head into the holiday season and other special occasions, it is important to heighten awareness of the dangers of high-intensity drinking. A good understanding of long-term consequences and seeking help when alcohol-related issues arise can be the difference between life and death. Celebrations should be about joy and connection, not about the gateway to harm.

If you or someone you know drinks at dangerous levels or have an alcohol use disorder, there is help available. Remember, for suspected cases of alcohol poisoning, dial 911. In this way, we can foster healthier relationships with alcohol and create safer environments for everyone.

Many couples are battling infertility and are keen on opting for ARTs to conceive and fulfill the dream of parenthood. However, the country continues reeling under severe heatwave conditions. Currently, a large number of couples who are planning fertility treatments are becoming stressed regarding how heatwaves can impact IVF procedures and even the success rates. Patients frequently ask fertility consultants whether extreme outdoor heat can affect the IVF laboratory environment, embryos, sperm samples, or even egg quality. However, there is no need to panic, as labs are designed to function even under highly controlled conditions throughout the year, and it is possible for couples to conceive successfully.

In an interaction with Health and Me, Dr. Aswati Nair, Fertility Specialist, Nova IVF Fertility, Rajouri Garden, Delhi, spoke about how extreme temperatures can affect the IVF process and what the consequent impact is on the outcome.

Read more: Heatwaves And Toxic Air Create A Growing Health Crisis In Delhi

Does a heatwave affect the IVF lab?

Usually, all the IVF labs have Air Handling Units (AHUs), which maintain the internal condition of the lab throughout the year at the same condition and temperature, and all the parameters are maintained throughout the year with the help of this equipment and gadgets. So, the internal environment of the lab does not get affected by an external heatwave. Understand that the temperature-sensitive procedures that are carried out inside the IVF lab, such as handling eggs, sperm, and embryos, are performed in a controlled setting and are monitored constantly. Hence, external heatwaves do not directly impact the IVF lab environment or the development of embryos. But only from the patient's perspective; they need to be hydrated and careful when there is scorching heat outside.

Too much heat can lead to dehydration, weakness, fatigue, dizziness, and stress, which can impact the patient’s health during fertility treatment. Women undergoing IVF cycles are put on hormonal medications, and staying hydrated is necessary for everyone. It is the need of the hour for the patients to take charge of their well-being right away!

Read more: Heatwave In India: Temperatures Continuously Rising; Stay Hydrated, Says PM Modi

Precautions to take

The precautions that patients can take are to stay well-hydrated and adhere to a balanced diet with lots of fruits and seasonal fruits like watermelon and muskmelon, which can improve hydration. They can have coconut and lemon water and avoid beverages, carbonated drinks, caffeine, and alcohol. They can follow these crucial tips to stay healthy during the heatwave. Patients should be sure to follow the guidelines given by the fertility consultant.

Even if the heatwaves can lead to discomfort, it doesn’t affect the functioning of modern IVF laboratories. By paying attention to various factors such as hydration, nutrition, and self-care, patients can safely continue their fertility journey even if there is extreme heat outside.

Mrs. Radha Sharma, 78, was brought to the hospital with sudden confusion, irritability, and restlessness. She had no fever, no pain, and no typical urinary complaints. Her family worried it could be dementia or a brain-related issue. However, a simple urine test revealed the real cause— a urinary tract infection (UTI). With timely treatment, fluids, and care, she recovered within a few days. This is a common but often overlooked reality—UTIs in older adults don’t always look like UTIs.

In another case, 72-year-old Mr. Pankaj Verma had repeated UTIs over a year. Each time, antibiotics provided temporary relief, but the infection kept returning. On further testing, doctors found an enlarged prostate that was preventing his bladder from emptying fully. Once this was treated, his infections reduced significantly.

These examples show an important pattern: in the elderly, UTIs are often missed, misunderstood, or keep recurring because the root cause is not addressed.

Why Are UTIs So Common In Older Adults?

As we age, the body goes through changes that make infections like UTIs more likely. In women, menopause leads to a drop in estrogen levels. This weakens the natural lining of the urinary tract, making it easier for bacteria to grow. Women also have a shorter urinary passage, so that bacteria can reach the bladder more easily.

In men, an enlarged prostate is a common issue. It can block the flow of urine, causing some urine to remain in the bladder. This leftover urine becomes a breeding ground for bacteria. Other common reasons include weaker immunity, conditions like diabetes, urinary incontinence, use of catheters, reduced movement, and dependence on caregivers for hygiene.

Symptoms Are Not Always clear

Unlike younger people, elderly individuals may not complain of burning urine or urgency. Instead, the signs can be subtle and confusing, such as:

• Sudden confusion or unusual behavior
• Increased falls
• Weakness or tiredness
• Loss of appetite

These symptoms are often mistaken for ageing or dementia, which can delay treatment.

Men vs Women: What’s the Difference?

UTIs are more common in older women due to hormonal changes and bladder control issues. Many women also experience repeat infections. In men, UTIs are less common but usually more serious. They are often linked to problems like prostate enlargement or urinary blockage, which need proper evaluation. Chronic illnesses play a big role. Diabetes, for example, increases the risk because excess sugar in urine helps bacteria grow. Poor sugar control also weakens the body’s ability to fight infections.

Conditions that affect bladder control, such as stroke or Parkinson’s disease, can also lead to incomplete emptying of the bladder, increasing infection risk.

Diagnosis Needs Careful Attention

Not every bacterium found in urine needs treatment. Many older adults have bacteria in their urine without symptoms—a condition called asymptomatic bacteriuria. Treating this unnecessarily can lead to antibiotic resistance. Doctors usually rely on urine tests, cultures, symptoms, and medical history before deciding on treatment.

Treatment: More Than Just Antibiotics

While antibiotics are important, they are only one part of the solution. Repeated courses without finding the cause often lead to recurring infections.

Treatment should also focus on:

• Drinking enough fluids
• Managing diabetes or other health conditions
• Treating prostate problems in men
• Avoiding unnecessary catheter use
• Reviewing medications that may affect bladder function

Early treatment is crucial. Ignoring symptoms can allow the infection to spread to the kidneys, which can be serious. Recurrent UTIs are common in the elderly. This can happen due to:

• Incomplete treatment
• Underlying problems like prostate enlargement
• Ongoing issues, such as incontinence or catheter use
• Antibiotic resistance

Prevention: Simple But Effective Steps

Preventing UTIs doesn’t always require complex measures. Small daily habits can make a big difference:

• Encourage regular water intake
• Avoid holding urine for long periods
• Maintain proper personal hygiene
• Manage conditions like diabetes well
• Limit catheter use
• Consider probiotics or cranberry products (after medical advice).

Caregivers play a key role in ensuring these habits are followed, especially for elderly individuals who need assistance. Immediate medical attention is needed if there is:

• Fever or chills
• Sudden confusion
• Blood in urine
• Lower back pain

UTIs in the elderly are common but often not straightforward. They may present differently, recur frequently, and require more than just antibiotics. The key is early recognition, identifying the underlying cause, and taking simple preventive steps. With the right care, recurrent UTIs can be reduced—helping older adults live healthier, more comfortable lives.

(By Dr. Sunita Goyal, Senior Consultant – Obstetrician and Gynecologist, Cloudnine Group of Hospitals, Ludhiana)

Systematic Lupus Erythematosus (SLE), also known as Lupus, is a multisystem autoimmune disease in which one's immune system attacks the body. It is most common in women of reproductive age; however, in rare cases, it can present in men and patients of any age.

Lupus Symptoms: More Than Just Joint Pain

Symptoms for SLE can range from unexplained fever for days to months, to oral ulcers, malar rash, photosensitivity (after exposure to sun), hair loss, headache, stroke, seizure, abnormal behavior (psychiatry lupus). A large group of patients experiences joint swelling, pain, and fatigue. If the kidneys are affected in Lupus patients, they can pass blood with their urine.

Their urine output also decreases; their legs swell, and there is swelling around the eyes. Involvement of the heart, brain, and pancreas is also not uncommon. Lupus is one of the causes of multiple unexplained pregnancy losses, especially in the second trimester, but with proper treatment and observation, many patients do well and have an uneventful pregnancy and childbirth.

Common Myths About Lupus

Some very prominent myths about SLE need to be debunked. Many think SLE is contagious and that only women can get it, when in reality, neither is true. Being an autoimmune disease means it cannot spread by contact, and it impacts both men and women, although the incidence rate of SLE is higher for women. Many also believe in the common misconception that it affects only joints, when in reality it is a multisystem disease that can affect the kidneys, heart, brain, skin, and lungs.

There is a common myth that pregnancy is impossible or unsafe for women with Lupus; however, many women with Lupus can conceive and experience safe and healthy full-term pregnancies under the right medical guidance. Kidney biopsy, which is a required test for treating Lupus, is often deemed unsafe, but it is a safe test and is required to decide the stage of the disease and treatment.

Lupus: Warning Signs

Some symptoms that can be a cause of alarm in SLE are rapid rising serum creatinine, new onset seizure or psychosis, sudden onset shortness of breath associated with chest pain, blood in cough with low oxygen saturation, acute confusional state with fever, vision changes, severe abdominal pain, unexplained severe anemia, severe thrombocytopenia (platelet count < 20,000).

Managing Lupus

For accurate diagnosis and treatment, one needs a rheumatologist's consultation. Rheumatologists will decide the plan of treatment to manage symptoms, reduce inflammation, prevent flares of the disease, and minimize organ damage. Lifestyle measures like avoiding Sun exposure, quitting smoking, lowering stress, and engaging in some low-impact physical activities help patients to minimize the disease burden.

There is very little awareness about Lupus in society, and due to varied presentations and symptoms, patients often consult with multiple doctors of different specialties before consulting with rheumatologists. We need to push for more awareness in society about less talked-about ailments like Lupus, which needs efficient intervention and management, as it is a lifelong condition. Talking about it also helps reduce stigma and bust myths around it. Late diagnosis and delay in treatment can cause significant morbidity, disease progression, and mortality. With early diagnosis and optimal treatment.

Holistic care is possible, which goes a long way in helping individuals manage autoimmune conditions like Lupus

(By Dr Niharika Gill, Rheumatologist, Lilavati Hospital and Research Center, Mumbai)