Anxiety is seen as an obstacle to success. It is a thought that always lingers in your mind before you start to do something. If you are doing something new or trying to do something that you have already done it in your life and have bad memories with. This thought creeps in. This thought that sometimes sends chills down your spine, makes you shiver, or that makes you feel like you cannot breathe, as if someone has put a huge rock on your heart is what defines anxiety. However, emerging research suggests that it can in fact, serve as a valuable tool for focus, motivation and problem solving. Studies on performance and stress, including the widely known Yerkes-Dodson curve, indicate that moderate levels of anxiety can enhance productivity, while both excessive and insufficient anxiety can hinder it.

The Yerkes-Dodson curve demonstrates that when anxiety is too high, it can become paralyzing, preventing individuals from taking action. On the other hand, very low anxiety can lead to complacency, reducing motivation and attention to detail. The ideal state falls somewhere in the middle, where anxiety signals importance, sharpens focus, and encourages preparation.

This perspective challenges the common belief that anxiety should always be suppressed. Instead, researchers argue that learning to harness anxiety can be beneficial. Studies have shown that people experiencing moderate anxiety often generate more creative solutions to problems compared to those who remain entirely calm.

How Can You Use Anxiety To Your Benefit?

Anxiety can serve as a sort of increased awareness, motivating people to take action in critical situations. Medical decision-making research show that concerned people are more likely to follow up on health issues, stick to treatment plans, and aggressively seek medical help. For example, studies on heart transplant patients show that people with moderate levels of anxiety are more likely to seek adequate care, which leads to improved survival rates.

The same strategy is used to address everyday difficulties. Anxiety tells the brain that something is important and requires effort. Anxiety can encourage you to be prepared and attentive, whether you're preparing for a presentation, making a critical life decision, or dealing with an uncertain situation.

Is There A Thin Line Between Anxiety That Helps And That Harms?

Despite its potential benefits, anxiety can become debilitating when it causes what researchers term “functional impairment.” This occurs when excessive worry prevents individuals from fulfilling their daily responsibilities, whether in work, relationships, or personal well-being.

One method for distinguishing between helpful and harmful anxiety is cognitive reframing—shifting the perspective on stressors. Studies suggest that those who reframe anxiety as a performance-enhancing tool rather than a hindrance experience less distress and greater effectiveness in high-pressure situations. By viewing anxiety as a source of energy rather than a threat, individuals can improve their ability to navigate challenges.

Research on stress resilience indicates that experiencing a moderate amount of adversity in life can lead to stronger coping skills. Longitudinal studies on both humans and animals suggest that those who have faced and overcome moderate difficulties—such as personal loss or professional setbacks—tend to develop greater mental fortitude.

One study found that individuals who had endured a small number of adverse events exhibited better overall mental health than those who had either faced extreme hardship or had led relatively stress-free lives. This pattern aligns with the concept of "stress inoculation," where manageable levels of stress act as a form of psychological training, making individuals more resilient to future challenges.

So, What Can You Do?

Rather than attempting to eliminate anxiety, researchers suggest acknowledging it as a natural response that can be channeled productively. Psychological studies indicate that when people view their physiological responses—such as increased heart rate and adrenaline surges—as performance enhancers, their actual outcomes improve.

For instance, in high-stakes situations like public speaking or athletic competitions, individuals who interpret nervousness as a sign of readiness rather than fear tend to perform better. Physiologically, the body's response to excitement and fear is similar; the key difference lies in perception.

Research suggests that those who embrace a mindset of "anxiety as fuel" experience improved cognitive and physical performance. This approach aligns with studies showing that moderate stress prompts the release of hormones that enhance alertness and problem-solving ability, whereas overwhelming stress triggers a flood of cortisol, which can impair decision-making.

Hemophilia is a rare genetic bleeding disorder, usually inherited, wherein blood cannot clot properly due to low levels of clotting factors, causing prolonged bleeding or spontaneous internal hemorrhages.

Symptoms include easy bruising, joint pain/swelling, and excessive bleeding. While not curable, it is treated with factor replacement therapy and gene therapy.

India has the world's second-largest population of hemophilia patients, with estimates suggesting over 70,000 to over 1,36,000 cases of Hemophilia A and B. However, while around 13,000 to 19,000+ patients are registered, many remain undiagnosed.

This World Hemophilia Day, Dr. Sheikh Bilal, Head of Department, Pathology, Government Medical College, Srinagar, Kashmir, exclusively told Healthandme that the primary reason why thousands of Indians remain undiagnosed and unable to access proper care is due to budget constraints, lack of awareness among policymakers, and the need for technocrats to advocate boldly for regular replacement therapy.

Despite having the second-largest hemophilia population, only 9-10 percent receive treatment as compared to 80-100 percent in some European countries.

The expert explained: "Money plays an important role. Every center in India has, at their own level, their own policymakers and the people who are at the helm of affairs. We are the second home for the hemophilia and we can change the lives of these people by having the regular replacement but it is all depending upon the perception of individual centers."

He also noted that the government needed to introduce policy reforms endorsing regular replacement therapy as the gold standard to help ensure equitable access to patients.

The median age at diagnosis for severe hemophilia in India stands at 60 months—five full years—compared to under 12 months in high-income countries. This delay is not just a matter of time but one that poses a risk of serious clinical consequences. Late diagnosis often means repeated, unmanaged bleeding episodes during early childhood, particularly into joints, before appropriate treatment begins.

Early Warning Signs

The three types of this condition include :

• Hemophilia A: This is the most common type. You may develop this condition because you have low levels of clotting factor 8 (factor VIII).
• Hemophilia B: You may have this type if you don’t have enough clotting factor 9 (factor IX).
• Hemophilia C: Hemophilia C is also known as factor 11 (factor XI) deficiency. It’s the least common type of hemophilia.

• Bleeding into the joints. This can cause swelling and pain or tightness in the joints. It often affects the knees, elbows, and ankles.
• Bleeding into the skin (which is bruising).
• Bleeding into the muscle and soft tissue, which can cause a build-up of blood in the area (called a hematoma).
• Bleeding of the mouth and gums, including bleeding that is hard to stop after you lose a tooth.
• Bleeding after circumcision.
• Bleeding after having shots, such as vaccinations.
• Bleeding in the head of an infant after a difficult delivery.
• Blood in the urine or stool.
• Frequent and hard-to-stop nosebleeds.

Treatment Options

The treatments for haemophilia have never been more effective, but they work only for patients who have been diagnosed. In a condition where every missed bleed moves a joint closer to permanent damage, the most important clinical act is also the most basic one: recognition.

The main treatment for severe hemophilia involves replacing the clotting factor you need through a tube in a vein. This replacement therapy can be given to treat a bleeding episode in progress. It can also be given on a regular schedule at home to help prevent bleeding episodes. Some people receive continuous replacement therapy.

Replacement clotting factor can be made from donated blood. Similar products, called recombinant clotting factors, are made in a laboratory, not from human blood.

For many people, a normal weight brings a sense of reassurance. If the weighing scale looks fine, health is assumed to be in check. However, in clinical practice, we are increasingly seeing individuals who are not overweight yet show clear signs of fatty liver. This condition, often called lean fatty liver, is quietly becoming more common in India and is a major public health concern.

Dr Harshavardhan Rao B, HOD & Consultant, Department of Gastroenterology, Ramaiah Memorial Hospital, while talking about the possibility of people suffering from a lean fatty liver, despite normal body weight, answered all FAQs regarding the condition.

What is Lean Fatty Liver?

When fat accumulates in the liver of individuals who have a normal body mass index (BMI), it is referred to as "lean fatty liver." It falls under the broader category of metabolic dysfunction-associated steatotic liver disease (MASLD), but it occurs in people who do not fit the prototypical profile of being overweight with high sugar levels and uncontrolled blood pressure. It is also more common in younger age groups compared to the typical MASLD patient. This contradicts the general belief that a normal body weight and BMI are indicators of good metabolic health and, by extension, optimal liver function.

Why Are We Seeing More of It in India?

Metabolic diseases are presenting differently in the Indian population. Even individuals who appear lean may carry underlying metabolic risk. Several patterns are worth noting:

1. Diets high in refined carbohydrates—polished white rice, bakery products, packaged snacks
2. Low physical activity, particularly in urban, desk-bound settings (exacerbated in the post-COVID era)
3. Visceral abdominal fat accumulation (fat deposited around the internal organs) despite a normal overall weight
4. Diet quality and meal patterns tend to matter more than total intake
5. Abnormal sleep patterns (night shifts, doom-scrolling at night, Netflix marathon trends)
6. Chronic high-stress environments

Lean fatty liver produces no obvious symptoms in the early stages. Most individuals feel entirely well. The diagnosis is typically incidental—picked up during routine health check-ups when liver enzymes are mildly elevated or when an ultrasound shows fatty changes.

The absence of warning signs has two potentially serious downstream effects. Firstly, most cases are diagnosed at a later stage when liver damage has already set in, and secondly, it makes it easy to defer action since the patient perceives no discomfort and does not feel the need to prioritise this over routine work and personal stresses.

Why Normal Weight Can Be Misleading

Body weight does not give the full picture of metabolic health. A normal BMI can coexist with:

1. High visceral fat around internal organs
2. Reduced skeletal muscle mass
3. Borderline or elevated fasting blood glucose
4. Dyslipidaemia or abnormal cholesterol metrics

This forms the basis for the clinical category of “metabolically unhealthy, normal weight."

Less Talked About Contributors

Beyond the standard risk factors, several contributors tend to be underappreciated:

1. Irregular meal timing, including skipped meals and late-night eating
2. Poor sleep and sustained stress, both of which affect hormonal and metabolic regulation
3. Long-term use of certain medications
4. Low dietary protein, which can reduce muscle mass and impair metabolism
5. Vitamin D and B12 deficiencies, which are common in this population

Together, these factors can have profound effects on metabolic health and eventually lead to fatty liver and even long-term liver damage.

What Should Be Done?

The management of lean fatty liver focuses on metabolic improvement rather than weight reduction.

1. Balanced meals over calorie restriction
2. Reduced intake of refined carbohydrates and added sugars
3. Adequate dietary protein to preserve muscle mass
4. Regular physical activity — both aerobic and resistance-based (40%–60%)
5. Consistent meal timings; avoiding heavy meals late at night
6. Routine monitoring of blood glucose, lipid profile, and liver enzymes, not just body weight

Failure to conceive using IVF can be devastating, but one should realise that one failed attempt does not determine a couple’s fertility journey. The success of IVF is determined by various factors such as age, egg and sperm quality, and the uterine environment, as well as underlying medical conditions. An unsuccessful attempt can also be a valuable source of clinical information that can be used to guide future treatment procedures. It should be seen not as an ending but as a starting point for more individualised and effective care in future cycles.

What happens after an unsuccessful IVF attempt?

It is necessary to conduct a careful assessment after an unsuccessful IVF cycle. This involves a review of the stimulation protocol, the response of the ovaries, the quality of the retrieved eggs, fertilisation rates, and embryo growth. In some instances, issues with embryo quality, implantation, or hormonal imbalances may be identified. Further tests such as genetic testing of embryos, evaluation of the receptivity of the uterine lining, or screening for conditions such as endometriosis or thyroid disorders may be recommended. These insights can be used to make the subsequent cycle more precise.

Mental health

Emotional health is highly significant in the healing process. A failed IVF cycle may have a considerable psychological impact, leading to stress, anxiety, and self-doubt. Such feelings should not be disregarded, and appropriate support should be sought, whether through counselling, support groups, or simply by talking to a partner. Addressing emotional health not only aids coping but also has a beneficial effect on overall treatment outcomes.

Lifestyle changes to make

Lifestyle changes can also play a role in improving outcomes in future attempts. Maintaining a healthy weight, following a balanced diet, managing stress, and avoiding smoking or excessive alcohol consumption are important factors. Hormonal balance and reproductive health may also be supported through adequate sleep and moderate exercise. Small yet consistent lifestyle adjustments may help prepare the body for another cycle.

Treatment options

Treatment plans can be modified based on previous results. This might include changes in medication regimens or the use of advanced procedures such as intracytoplasmic sperm injection (ICSI), assisted hatching, or preimplantation genetic testing (PGT). In some instances, the use of donor eggs or sperm, or options such as frozen embryo transfer, may be considered. All approaches are personalised, taking into account the medical history of the couple and their previous response to treatment.

How to time the next IVF attempt properly?

The timing of the next attempt is another important aspect. While some individuals may be physically ready to proceed soon after a failed cycle, others may benefit from taking time to rest and recover both physically and emotionally. Such a break also allows for further evaluation and optimisation of health parameters before resuming treatment.

In the end, persistence combined with a personalised, evidence-based approach tends to increase the likelihood of success. Advancements in reproductive medicine continue to offer new hope, even after setbacks in IVF. With careful assessment, emotional support, and appropriate adjustments in treatment, many couples achieve successful pregnancies in subsequent cycles.