According to a study published in the November 6, 2024, online issue of Neurology, the medical journal of the American Academy of Neurology, older people who are sleepy during the day or lose interest in activities due to sleep issues may be more likely to develop a syndrome that can lead to dementia.

People with the syndrome walk slowly and report memory problems, but they do not have a mobility handicap or dementia. Motoric cognitive risk syndrome is a condition that can develop before dementia.

What The Study Found?

The study found that people with excessive daytime sleepiness and a lack of enthusiasm to get things done were more likely to develop the syndrome than people without those sleep-related issues. The study does not prove that these sleep-related issues cause the syndrome, it only shows an association.

“Our findings emphasize the need for screening for sleep issues,” said study author Victoire Leroy, MD, PhD, of Albert Einstein College of Medicine in the Bronx, New York. “There’s potential that people could get help with their sleep issues and prevent cognitive decline later in life.”

How Was It Conducted?

The study included 445 participants, with an average age of 76, who did not have dementia. Participants completed sleep surveys at the beginning of the trial. They were queried about memory problems, and their walking pace was measured on a treadmill at the beginning of the study and then once a year for the next three years.

The sleep assessment included questions about how frequently people had difficulties sleeping because they woke up in the middle of the night, couldn't fall asleep within 30 minutes, or felt too hot or cold, as well as whether they used sleep aids. The question to assess excessive daytime drowsiness asks how frequently people have had problems remaining awake when driving, eating meals, or were engaged in any other activity.

The Findings

In total, 177 participants fit the category of bad sleepers, whereas 268 satisfied the definition of good sleepers.

At the outset of the trial, 42 participants had motoric cognitive risk syndrome. Throughout the trial, 36 more persons got the condition.

35.5% of patients who experienced extreme daytime sleepiness and a lack of enthusiasm developed the syndrome, compared to 6.7% who did not. After accounting for other factors that could influence the risk of the syndrome, such as age, depression, and other health conditions, researchers discovered that people with excessive daytime sleepiness and a lack of enthusiasm were more than three times more likely to develop the syndrome than those who did not have those sleep-related issues.

“More research needs to be done to look at the relationship between sleep issues and cognitive decline and the role played by motoric cognitive risk syndrome,” Leroy said. “We also need studies to explain the mechanisms that link these sleep disturbances to motoric cognitive risk syndrome and cognitive decline.”

A limitation of the study is that participants reported their own sleep information, so they may not have remembered everything accurately.

The study was supported by the National Institute on Aging.

Rashes are common in children and can occur for many reasons. Most are harmless and settle on their own, but some may need medical attention. Knowing the warning signs can help parents decide when home care is enough and when to consult a doctor.

Why Do Rashes Happen?

Children’s skin is sensitive and can react to heat, friction, allergens, insect bites, irritants or infections. Common causes include heat rash, eczema, contact dermatitis, insect bites and viral infections such as chickenpox, hand-foot-and-mouth disease and roseola.

A rash can look worrying, but the child’s overall condition is often as important as the appearance of the rash itself.

When Home Care May Be Enough

If your child is active, reasonably comfortable, feeding and drinking well, and otherwise appears well, a mild rash can often be managed at home.

Home care may be appropriate when the rash:

• Is mild and limited to a small area
• Is not spreading quickly
• Causes only mild itching or discomfort
• Occurs without concerning symptoms
• Looks consistent with a known condition such as heat rash or eczema

Avoid applying multiple creams, powders, antiseptics or home remedies, as these may irritate the skin or make the rash harder to assess. Medicines or steroid creams should not be used without medical advice. Your paediatrician can recommend suitable treatment based on your child’s age, weight and the likely cause of the rash.

When Should You See a Doctor?

Seek medical advice if your child has:

• A rash with fever, particularly if the child appears unwell, unusually sleepy, less responsive or is becoming progressively worse
• A red or purple rash that does not fade or become lighter when pressed firmly with a clear glass, especially if the child has fever or appears unwell
• A rapidly spreading rash
• Large blisters, peeling skin or a painful/tender rash
• Signs of a secondary skin infection, such as increasing redness, warmth, swelling, pain or pus
• A new or unexplained rash in a newborn or young infant, especially if accompanied by fever, poor feeding or unusual sleepiness
• Unusual sleepiness, weakness, poor feeding or reduced drinking
• A rash that is getting worse, keeps recurring or does not improve with appropriate home care

Seek Emergency Care Immediately If

A rash is accompanied by:

• Difficulty breathing or swallowing
• Swelling of the lips, mouth, face or tongue
• Extreme sleepiness, marked weakness or a child who is difficult to wake
• Rapid deterioration in the child’s overall condition
• A concerning non-fading red or purple rash in a child who appears unwell

What Parents Should Remember

Most childhood rashes are temporary and harmless. However, it is important to look beyond the rash itself.

Note when the rash started, where it first appeared, whether it is spreading and whether your child has fever or other symptoms. A photo of the rash can also help your paediatrician understand how it has changed over time.

Trust your instincts. If your child seems unusually unwell, is getting worse or something simply does not feel right, it is always better to seek medical advice rather than waiting.

A Simple Rule for Parents

Home care may be enough if your child is well, active and comfortable. Seek medical attention if the rash is accompanied by significant illness, rapid worsening or any warning signs.

By Dr Navin Bhatia, Senior Consultant & HOD – Paediatrics & PICU, PB Health

India is facing a significant and growing cancer burden, with the latest National Cancer Registry Programme study estimating that the lifetime risk of developing cancer in the country is 11% — about one in nine people.

The 2025 study also found that India ranks second in Asia and third globally in cancer incidence.

SC Directs States To Notify Cancer

Around 17 states in India have already made cancer a notifiable disease, while the Supreme Court in August directed the remaining 19 states and Union Territories to comply with the requirement, aimed at enabling early detection and proper care of patients.

The petition before the court argued that the continued non-notification of cancer, despite its alarming and escalating burden in India, amounted to a grave abdication of the state's constitutional duty under Articles 14 and 21 of the Constitution. It said this denied uniform treatment to similarly situated citizens and undermined their fundamental right to health and a life of dignity.

The Supreme Court's order is legally binding on the remaining 19 states and Union Territories, which have until November 11, 2026, to comply with the directive.

By the deadline, the concerned administrations are required to transition cancer into a notifiable disease and formally submit their progress reports to the Supreme Court. States will also need to issue official Gazette notifications requiring public and private healthcare entities to report cancer cases and related data.

Why Cancer Notification Matters

Speaking to HealthandMe, experts said making cancer notifiable could strengthen cancer surveillance, improve data collection and support research and treatment planning.

Dr Karishma Kirti, Consultant Obstetrician & Gynaecologist, Jaslok Hospital, Mumbai, said cancer should be treated as a notifiable disease, but through a system different from the traditional notification process used for infectious diseases.

How Cancer Registration Can Help

Dr Kirti told HealthandMe that mandatory registration of cancer cases could help India understand cancer trends and generate more real-world data to guide research.

“Mandatory registration of cancer cases will in the future help in understanding trends, generating real-world data early, and guiding research. Most of the evidence-based medicine and treatment that we recommend comes from Western data and mandating cancer registration will help India generate its own data and understand the inherent characteristics of Indian cancers better.”

Notifying Cancer Could Strengthen Cancer Care

Dr Harit K Chaturvedi, CEO & Clinical Head, Apollo Oncology Network, said making cancer a notifiable disease could help improve cancer care and research as the country's cancer burden rises.

“No two cancers are the same and the disease cannot be fought in silos. As the burden of cancer cases is increasing, wherein India is projected to record 1.5 million cases in 2026, declaring cancer as a notifiable disease can enable better cancer care and research across India,” he told HealthandMe.

Chaturvedi said notification of cancer would also give impetus to the decades-old National Cancer Registry Program and enable proper and mandatory record-keeping of cancer cases, as seen in many developed nations.

“By making cancer a notifiable disease, we can ensure that all cancer cases are reported and documented accurately, enabling us to track cancer incidence, mortality, and survival rates.”

Importantly, he said, notification would also enable policymakers, healthcare providers and researchers to work with real-time data, which could help bring more awareness, strengthen prevention and early detection, and improve treatment outcomes and quality of life.

Recurring abdominal pain is often dismissed as acidity or indigestion. This becomes a matter of concern when persistent pain reaches the back and causes vomiting and weight loss. These are symptoms of a more serious disease such as chronic pancreatitis.

A recent case highlights the importance of recognizing the condition early. A 35-year-old mother of two had been living with severe upper abdominal pain for nearly three years. She experienced episodes that required hospital admission. Upon detailed investigations, it was confirmed to be a case of chronic idiopathic calcific pancreatitis. Long-standing inflammation had caused stones to develop within the pancreatic duct, which blocked the normal flow of digestive juices and triggered repeated attacks of pain. The underlying problem remained unresolved. To the patient, the mental toll of being a daily-wage worker came with loss of income and disruption to family life.

Chronic pancreatitis is when repeated inflammation causes permanent damage to the pancreas. Gradually, the gland becomes scarred, the pancreatic duct narrows, and stones develop. Pressure within the pancreas increases, thereby causing recurrent abdominal pain. As the disease advances, patients may also develop difficulty digesting food, unintended weight loss, nutritional deficiencies, and diabetes due to loss of pancreatic function. There exist multiple causes of chronic pancreatitis such as alcohol, gallstones, smoking, genetic disorders, autoimmune diseases and certain metabolic conditions. In a proportion of patients, no definite cause can be identified despite extensive evaluation.

Diagnosis is made on clinical grounds and imaging modalities such as ultrasound, CT scan, or MRI, which are helpful in identifying changes in the pancreas and detecting ductal stones. Early diagnosis is essential to prevent further complications and long-term outcomes. Treatment is modified according to the severity of the illness and the patient's signs and symptoms. Initial management is done in the form of dietary modifications, enzyme supplementation, and avoidance of substances such as alcohol and tobacco. However, when pain persists despite medical treatment, surgery may be required to relieve the obstruction and restore pancreatic drainage. This also occurs when stones obstruct the pancreatic duct,

In this patient's case, the severity of the case warranted surgery in order to ensure the best chance of lasting relief. Prior to the surgery, the patient consulted multiple hospitals before treatment. She underwent a minimally invasive robotic-assisted procedure to remove the pancreatic duct stones and create a new drainage pathway for pancreatic secretions. She had been advised open surgery but delayed it because she feared the large incision and long recovery; before this, she was admitted every 2-3 months for severe pain. The surgery was performed through small incisions with reduced tissue trauma as compared to conventional open surgery. The recovery was unsuccessful, and the patient was discharged with pancreatic enzyme supplementation.

Three months later, she was free from the disabling pain that had dominated her life. She had returned to work and was able to resume her daily routine.

Available treatment options have increased due to minimally invasive and robotic techniques for selected patients, but they may not be suitable for everyone. The choice of treatment is dependent on multiple factors such as the stage of the disease, the anatomy of the pancreas, and the patient's overall condition.

The more important message, however, extends beyond surgery. Persistent pain should never be ignored or considered a common passing occurrence; neither should it be repeatedly treated with painkillers without identifying the cause.

Earlier diagnosis and timely referral can be encouraged by raising awareness amongst the general public to prevent recurring hospital visits. Awareness can make the difference between years of repeated hospitalizations and a return to a healthier, more productive life.

(Dr. Sreedhara V., Surgical Gastroenterologist, Apollo Hospitals Bannerghatta Road, Bengaluru)