On Monday night, a magnitude 6.6 earthquake struck Japan, leading to a tsunami warning. Fortunately, authorities reported minimal damage, and the warning was soon lifted. According to local media, there was only one minor injury involving a man who fell at his own home.

Japan, located in the Pacific Ring of Fire, experiences approximately 1,500 tremors annually. However, these quakes have a long-lasting impact on one's health—both physical and mental.

Health Impacts Of Earthquakes

1. Wound Infections

Earthquake-related injuries range from cuts and bruises to fractures and crush injuries. If not attended to on time, these wounds can lead to infections like sepsis, tetanus, or even amputations if untreated. Regions with scarce medical resources face higher risks of untreated injuries and antimicrobial resistance. Ensuring prompt medical care and deploying teams to assess building safety is critical to preventing further injuries and fatalities.

A recent study examined infections in 225 earthquake survivors with musculoskeletal injuries treated between February and April 2023. It found that gram-negative bacteria were common in the wounds of the victims. Acinetobacter baumannii (49.4%) and enterococci (28.6%) were the most prevalent. Many pathogens were multidrug-resistant, with 76% from wound cultures and 58% from deep tissue cultures showing resistance. Common infections included surgical site infections (32.8%), urinary tract infections (5.3%), bloodstream infections (5.7%), and pneumonia (0.4%). Intensive care was required for 35.6% of patients, with a mortality rate of 2.7%.

2. Infectious Diseases

Earthquakes disrupt water supplies, leading to unsanitary conditions that spread waterborne diseases such as cholera. Meanwhile, it also pushes people to take shelters in dingy places, which can outbreaks of measles, respiratory illnesses, and parasitic infections like leishmaniasis. Cold conditions and stress suppress immunity, increasing the risk of disease spread.

3. Chronic Conditions

Access to medication and medical care is often disrupted by earthquakes. Studies show increased rates of heart attacks, strokes, and diabetes following earthquakes due to stress and disrupted routines. Destruction of health records and facilities exacerbates these issues, especially in disaster-prone regions.

4. Healthcare Disruption

Damaged medical facilities and transport links hinder healthcare delivery. Pregnant women and individuals with chronic diseases face heightened risks. Refugees and displaced populations encounter accessibility barriers to healthcare services.

5. Psychological Trauma

Survivors of these earthquakes often suffer from anxiety, depression, and Post Traumatic Stress Disorder (PTSD). Tailored mental health programs are crucial for recovery, especially for those already living in conflict zones or displacement.

On April 14 2010, a 7.1-magnitude earthquake struck Qinghai Province, China, devastating Yushu County. A psychological relief study, published in the Journal Of Affective Disorders in 2011, assessed the mental health of 505 survivors three to four months post-disaster. Using tools like the PTSD Checklist-Civilian version (PCL-C) and Hopkins Symptoms Checklist-25 (HSCL-25), the study found prevalence rates of 33.7% for probable PTSD, 43.8% for anxiety, and 38.6% for depression, with one-fifth of participants experiencing all three. Key risk factors included being female, experiencing intense fear during the quake, and having limited social support, as measured by the Perceived Social Support Scale (PSSS).

Kidneys are two bean shaped structures, located on the back side of the abdomen, one each on right and left side. It filters blood by removing waste products via urine. Besides this it also functions as an endocrine organ, producing hormones like renin (for blood pressure control), erythropoietin (for hemoglobin production) and aids in active vitamin D formation (for bone health).

Though human beings have two kidneys usually, there are situations where individuals can lead a healthy life on one kidney. This could be developmental anomaly (since birth). Congenital absence of one kidney is called renal agenesis, and these individuals lead a normal life with normal kidney function.

Sometimes, a single kidney is acquired due to removal of one kidney for donation. As in a healthy donor gives their kidney to someone in need, whose both kidneys have failed. This is indeed a noble gesture and one that does not come with any significant impact on the donor’s quality of life.

Can You Live With One Kidney After Donation?

Also read: When a Fever Is More Than a Fever: Recurrent UTIs in Children Can Put Kidneys at Risk

The process of organ donation, where a healthy person’s healthy kidney is removed for the therapeutic purpose to benefit another individual suffering from kidney failure, is called donor nephrectomy. The first such surgery was done in the USA in the year 1954, with open surgery.

Now a days, most donor nephrectomies are done either with laparoscopy (key hole surgery) or robot assisted. Thus, a question that often arises in such times is, whether one can live with one kidney after kidney organ donation? To understand this, one should first understand that a donor undergoes a thorough rigorous fitness evaluation to determine if kidney donation is viable.

During this evaluation process, kidney function of both kidneys are evaluated. The kidney donor is deemed fit to donate the kidney only after it is ascertained that the donor has two healthy kidneys free from any disease, and the donor would be able to lead a normal life with one kidney. it is also ascertained that the other kidney transplanted in another is also having good kidney function to survive in the recipient.

What Happens To The Donor After Kidney Donation?

Another commonly asked question that doctors often get is, what happens to the kidney donor with one kidney after donation? Most kidney donors live long healthy life after organ donation. However, it should be appreciated that every individual is different, and age at the time of organ donation matters a lot. Risk is generally low, and they carry out their regular activities as before. Rarely the donor has a slight chance of developing high blood pressure or protein leak in the urine.

However, overall risk of significant kidney disease is <1%, which is considered less than having the similar risk in general population. Though, there may be slightly higher chances of developing high blood pressure during pregnancy in a kidney donor. However, in majority of cases, Kidney donation is generally a safe procedure, and most donors continue to lead healthy, active lives with one kidney. With appropriate long-term follow-up and healthy lifestyle choices, donors can maintain excellent kidney health after donation.

By Dr. Hemant Mehta, Consultant Interventional Nephrologist, Lilavati Hospital and Research Center, Mumbai

Common metabolic conditions such as obesity and diabetes are increasingly becoming a serious public health concern in India. Their health implications extend beyond the conditions themselves, with obesity and diabetes associated with a range of chronic diseases and complications that can affect long-term health and wellbeing. As lifestyles become more sedentary and the prevalence of these conditions continues to rise, understanding their wider implications on women’s health is becoming increasingly important.

What many women may not realize is that this metabolic burden can carry a deeper, less visible consequence one that reaches into the domain of gynecological cancer.

One such concern is endometrial cancer. A form of uterine cancer, it develops in the lining of the uterus and is becoming an increasingly important health issue globally. Yet, many women remain unfamiliar with the disease, its risk factors, and the symptoms that require prompt medical attention.

The Metabolic Health Connection

Increasing evidence points to a link between metabolic syndrome and endometrial cancer, particularly through conditions such as obesity and diabetes. Excess body weight and metabolic disturbances can disrupt hormonal balance, such as by increasing estrogen production without a corresponding increase in progesterone. Over time, this hormonal imbalance may stimulate abnormal growth of the endometrial lining, increasing the likelihood of cancer development.

Diabetes, too, has been associated with an increased risk. As obesity and diabetes become more prevalent, recognizing these less-discussed consequences is an important part of strengthening women’s preventive health.

For women, maintaining a healthy weight, staying physically active, managing metabolic conditions effectively and paying attention to unusual symptoms can all form part of a broader approach to preventive health.

Watching Out For Unusual Symptoms

One of the most important characteristics of endometrial cancer is that it often presents with abnormal vaginal bleeding. Bleeding or spotting after menopause is one of the most significant warning signs and should never be ignored.

For women who have not reached menopause, heavier-than-normal periods, prolonged bleeding, or bleeding between periods should be discussed with a healthcare professional.

Why Awareness Matters

Improving awareness is important because there is currently no recommended routine screening test for endometrial cancer in asymptomatic women. As a result, recognizing symptoms and seeking timely medical advice are among the most effective ways to support earlier diagnosis.

At the same time, the conversation should not end with cancer awareness alone. As India continues to face a growing burden of obesity and diabetes, prioritizing metabolic health has become increasingly important for overall wellbeing.

Maintaining a healthy weight, staying physically active, eating a balanced diet, and effectively managing conditions such as diabetes can help reduce the risk of a range of serious health complications, including certain cancers. For women, understanding the connection between metabolic health and endometrial cancer can empower more informed decisions about prevention, symptom recognition, and long-term health. By addressing obesity and diabetes early and seeking medical advice when unusual symptoms arise, women can take meaningful steps towards protecting their health at every stage of life.

(By Dr. Shefali Sardana, Medical Oncologist, Apollo Hospitals, New Delhi)

Melanoma is often considered one of the more challenging cancers to treat, particularly when it has spread to distant organs. For early-stage disease, surgery remains an important treatment option. But once melanoma reaches stage IV, treatment becomes considerably more complex.

Understanding The Biology Of Advanced Melanoma

According to Dr. Mandeep Singh Malhotra, Cheif Mentor AOHC, cytotoxic chemotherapy has traditionally had a limited role in melanoma, while immunotherapy has changed the treatment landscape for many patients.

When melanoma is detected at an early stage and can be completely removed, surgery is generally considered the preferred treatment. Depending on the disease, this can involve removal of the primary tumour and assessment or treatment of regional lymph nodes.

But stage IV melanoma presents a very different challenge.

A Complex Case With Multiple Tumour Sites

Dr. Malhotra recalls the case of Sarah, who came to the team with multiple nodules in the scapular region. There were also lesions on both legs and a lesion in the pancreas. So there were multiple nodules. One in the right side of the leg, another in the left side of the leg. And there was a lesion in the pancreas.

Rather than relying on a standard treatment approach alone, the team first tried to understand the biology of the disease. As a standard protocol for this type of case, we first try to understand the disease biology. In Sarah’s case, the team used extensive testing, including chemosensitivity testing, transcriptomic analysis and next-generation sequencing.

Also read: Cancer Should Be Made Notifiable In India, Say Experts: Here’s Why

When Imaging Initially Suggests Progression

The results suggested sensitivity to certain drugs. When we analysed those reports, we were able to understand that cytotoxic drugs like temozolomide were effective. And checkpoint inhibitors like pembrolizumab, nivolumab were effective.

Based on these findings, the team developed a treatment protocol in which the main component was an immune checkpoint inhibitor along with low-dose temozolomide. Other agents, including lower doses of anti-VEGF, anti-FGF and CDK inhibitors, were also incorporated based on the analysis.

After around four weeks, the response became difficult to interpret on imaging. The PET scan suggested that all the lesions have had a pseudo progression.

Pseudo progression is a recognised phenomenon during immunotherapy. A tumour may appear larger initially because of immune-cell infiltration, even when the treatment is actually producing an anti-tumour response.

This is particularly relevant in melanoma treated with immune checkpoint inhibitors. However, doctors cannot simply assume that every apparent progression is pseudo-progression; true progression must also be considered and confirmed through Histopathology

Also read: French Court Links Flight Attendant’s Breast Cancer To Workplace Radiation; How Does Flying Increase Cancer Risk?

Histopathology Reveals A Dramatic Treatment Response

The team then proceeded with surgery, removing the nodules from the scapular region and both thighs. The specimens were sent for histopathological examination. And histopathology results were amazing. The tumours had gone necrotic.

The pathology showed extensive treatment-related changes, with inflammation and fibrosis around the nodules and only small areas containing viable melanoma cells.

Also read: _{Daraxonrasib: US FDA Approves Once-Daily Pill for Metastatic Pancreatic Cancer}

What Comes Next For The Patient?

For now, the plan is to continue the treatment for a few more cycles and then reassess the pancreatic lesion. The team is considering NanoKnife (irreversible electroporation) for the pancreatic lesion followed by Vaccines.

Certain cancer vaccines are being developed in certain labs in Germany and Europe and they are available for our patients in India on compassionate grounds. It's a very, very good response. And to achieve disease NED in stage four melanoma, I think we are really lucky and it's all due to the grace of God.

Why Individualised Treatment Matters In Stage IV Disease

The case also highlights an important point about advanced melanoma: treatment may need to be individualised according to the biology of the disease and the patient's response. At the same time, he stresses the need for hope. I hope that more people can benefit from this protocol and use this protocol to treat melanomas across the world.

For Sarah, the journey is still ongoing. The next step will be to reassess the pancreatic lesion and determine whether further local treatment can help achieve no evidence of disease (NED). A stage IV melanoma involving multiple sites, including the pancreas, reaching a point where NED may become a possibility is certainly an encouraging development. But it remains an individual clinical experience, rather than proof that the same protocol will work for every patient with metastatic melanoma.

By Dr. Mandeep Singh Malhotra, Director of Surgical Oncology at CK Birla Hospital and Chief Mentor at AOHC