The skin is an outward reflection of our internal health. Dull skin, for instance, may indicate dehydration, a lack of essential nutrients, or an inconsistent skincare routine. As the most visible organ, the skin also provides insight into the health of the body tissues it protects. It's more than just an aesthetic aspect—it’s a window into overall well-being. Disorders of the gut, blood, hormones, and even the heart can manifest as skin issues, such as rashes.

Ayurveda has long emphasized the importance of skincare. In today's fast-paced world, a proper skincare routine is indispensable, not only for physical health but also for mental well-being. While modern skincare offers a plethora of products, many come with side effects. Ayurveda provides a holistic solution, addressing skincare concerns naturally and sustainably.

Ayurvedic Skin Types

Ayurveda classifies skin types based on the three doshas:

1. Vata (Wind) Vata

Vatadominant individuals tend to have dry, rough skin that wrinkles easily if not properly moisturized.

• Oil application: Pinda taila is ideal for moisturizing dry skin.
• Internal care: Mahatiktaka ghrita helps reduce dryness.
• Face pack: Use Eladi churna or Navara rice face packs to moisturize and reduce dryness.
• Hydration: Drink plenty of water to combat dehydration.

2. Pitta (Fire) Pitta

Pitta dominant individuals often have oily skin, prone to acne, rosacea, and discoloration.

• Oil application: Nalpamaradi tailam is best for pitta skin.
• Cleansing: Wash your face with Eladi or Manjishtadi water to reduce discoloration and tone the skin.
• Cooling elements: Use aloe vera, turmeric, and sandalwood to combat inflammation, pimples, and redness.

3. Kapha (Water and Earth)

Kapha skin tends to be cold, oily, and prone to pimples, whiteheads, and water retention.

• Avoid oil-based creams: Use face masks regularly to control sebum production.
• Therapy: Dhara with Triphala churna or Eladi water is beneficial.
• Oil application: Eladi coconut oil is ideal.

Panchakarma for Healthy, Radiant Skin

Panchakarma therapies help detoxify the body and enhance skin health. Key treatments include:

Abhyanga and Pizhichil: These therapies pacify doshas, enhance skin tone, and act as natural moisturizers.

Navara Kizhi: Improves skin softness and complexion.

Snehapana: Internal lubrication with ghee to maintain hydration and promote a natural glow.

Ubtan: A traditional herbal paste for exfoliation and nourishment.

Lepam: Herbal poultices to soothe inflammation and heal skin conditions.

Garshan/Udwarthanam: Dry brushing to stimulate circulation and exfoliate dead cells.

Shirodhara: Oil pouring therapy to relax, de-stress, and improve sleep quality.

Panchakarma Detox: A five-step detoxification process to cleanse the body and rejuvenate the skin.

Internal Routine for Healthy Skin

1. Stay hydrated and drink 2–3 liters of water daily. Incorporate water-rich fruits and vegetables like watermelon, cucumber, and oranges. Herbal teas with ginger, lemon, or chamomile aid digestion and promote glowing skin.

2. Follow a balanced diet based on your Ayurvedic prakriti and elevated doshas. Include whole grains, dairy, seasonal fruits, and antioxidant-rich foods like tomatoes, broccoli, and papaya. Avoid fried, refined, and processed foods, as well as excessive sugar, salt, and red meat.

3. Regular exercise promotes blood circulation, detoxification, and skin nourishment. Activities like yoga, walking, or dancing improve oxygen flow, flushing out toxins and revitalizing the skin.

4. Maintain a consistent sleep schedule. Restful sleep stimulates growth hormones, promoting collagen and elastin production, which keeps skin firm and youthful.

Small, gradual adjustments in daily routines can lead to healthier, more radiant skin. Embrace an Ayurvedic skincare regimen, complemented by panchakarma therapies, to achieve sustainable and natural skin health.

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 Dr Bilal Ahmed, Prof and Head, Government Medical College, J&K 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.