Pregnancy is usually a time of happiness and hope, but it also brings in the unexpected. While there is much talk placed on the health of the expectant mother, the quality sperm coming from the father could dramatically change the outcome of pregnancy. The latest study suggests the risks of sperm DNA damage, even increasing the risks of complications preeclampsia and birth prematurity.

In a groundbreaking research study conducted by scientists from Lund University in Sweden, scientists discovered that DNA damage in sperm increases the risk almost up to double that of preeclampsia, this is a dangerous condition that may arise during pregnancies characterized by high blood pressure. In addition, DNA anomalies also increase the risk of premature births, and this further entails increased related adverse health outcomes for infants born through such conditions.

The next step would be to find out which group of men respond best to methods to prevent and treat sperm DNA damage, and to test these methods to prevent pregnancy complications," said Dr. Amelie Stenqvist, a lecturer at Lund University. According to this study, a significant message is put forward that paternal health assumes an important role in a successful pregnancy.

It focused its research on men, specifically whose sperm contained high levels of DNA fragmentation. For instance, some 20% to 30% of babies born via in vitro fertilization have fathers whose sperm contains damaged DNA. The DNA fragmentation index, an indicator to assess the percentage of DNA damage in sperm, indicated that when the percentage of sperm with a DFI above 30% was observed, they had almost no chance of resulting in natural conception. Even a DFI greater than 20% showed that the chances of getting pregnant are highly risky as the risk factor for pregnancy complications like preeclampsia is much high.

Uncommon Complications during Pregnancy

The most alarming complication during pregnancy is preeclampsia. It affects approximately 5% to 8% of pregnancies worldwide, which can cause fatal conditions for both the mother and the baby. The new findings now point out that sperm DNA damage may contribute to this condition, especially if it is due to assisted reproductive techniques such as IVF pregnancies. The research found that a DFI above 20% doubled the risk of preeclampsia from a mere 5% to almost 11% per.

Apart from causing preeclampsia, DNA fragmentation in sperm is also known to increase the risk for prematurity. Most premature babies experience respiratory, neurological, and developmental complications. Therefore, some degree of early intervention might be important for prospective parents.

Some of the rarer, though serious complications include placental abruption, which is the separation of the placenta from the uterine wall and intrauterine growth restriction, a condition by which the baby does not grow normally in the womb. These conditions though rare are potentially catastrophic both to the mother and the child. Results from this study may help in establishing the contribution of the father in such pregnancies.

Further study into sperm DNA damage is of urgent interest with regard to its consequences for pregnancy outcomes. According to Professor Aleksander Giwercman of Lund University in the field of Reproductive Medicine, "the analysis of DFI should be introduced as routine test in all fertility clinics.". "It could give answers to couples who are having difficulties with infertility, but our latest result also shows that DFI analysis can be a method to identify high-risk pregnancies, explained Giwercman.

For many, DNA fragmentation in sperm is often treatable. Common causes are oxidative stress, age, smoking, being obese, and infections. Addressing these elements will likely reduce DNA damage in sperm for men, raising the chances for a healthy pregnancy and baby.

Overall, the study importance should take into consideration paternal as well as maternal health towards reaching for a healthy pregnancy. Though DNA fragmentation in the sperm is supposed to increase the risk factors for complications in pregnancies, the advances into novel treatment approaches and tests are likely to alleviate complications in many families. Thus the findings of this study offer optimism and pave a pathway to more holistic fertility treatments in the future.

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