Diwali is the time of the year when our nation’s children are on holiday and festivities are rampant. Sadly this fun time for children is also when firecrackers and fireworks are available in plenty. The word “firecrackers” evokes quite a bit of emotion and is often associated with great joy but one must realize that the chemical smoke and gases released from firecrackers can be regarded as a serious concern for the capacity of eyes for children.

It is shocking to know that mothers and fathers have been using firecrackers for this long despite it being scientifically proven to be a pollutant and one that can heavily damage children’s eyesight.

But now, as a parent, most people see things differently—firecracker smoke, while dazzling, risks young eyes and health. From choosing eco-friendly lights and indoor activities, ensuring a festive, safe celebration for your children’s well-being is important and necessary. Dr. Neeraj Sanduja, MBBS, MS - Ophthalmology, Ophthalmologist, Eye Surgeon shares all about the toxic effects of smoke from the firecrackers kids so lovingly enjoy bursting and how harmful they can be for their eyes.

Hazardous Effects of Firecracker Smoke

The smoke from firecrackers is a blend of toxic chemicals and fine particles, each carrying potential harm for the delicate tissues of the eyes. Here are some key pollutants present in firecracker smoke that pose specific dangers:

Particulate matter: These are the fumes exhaled from burning that are extremely small but can infiltrate deep into the lungs and eyes creating lesions and scars.

Sulfur dioxide & nitrogen oxides: These gasses emit acid rain, it's easy to comprehend how detrimental it is to the human body.

Heavy metals: If consumed through the skin lead arsenic or any other toxic metals emitted through firecrackers will inflict great damage.

Common Eye Conditions Linked to Firecracker Pollution in Children

Exposure to firecracker smoke can cause a range of immediate symptoms in children, as well as chronic eye problems that may not become apparent until much later. Children are at high risk of developing some symptoms upon exposure to firecracker smoke, and these include:

Red eye syndrome: Clinical eye examinations show that the eyes can be red and watery, as well as itchy due to the smoke's chemicals.

Eye pain: Another common complaint in children is a burning and stinging sensation in the eye areas.

Intolerance to light: The burning of firecrackers leads to the emission of smoke that can irritate the eyes and increase their sensitivity.

Corneal damage: Severe inflammation of the outer layer of the eyeball caused by exposure to smoke may be a more damaging injury caused than previously mentioned damages of the inner layer.

Long-Term Effects of Firecracker Smoke on Eye Health

While some eye issues may appear right after exposure, others may develop subtly and manifest over time, resulting in chronic eye conditions. Dr Neeraj exclaims, "Of great concern is the fact that parents may not notice these initial signs and the signs that are causes are others since these are only some of the diseases that are dangerous but children who continuously come into contact with air polluted by firecrackers may consider the following risks:

Cataracts

Glaucoma

Dry eye syndrome

Tips for Protecting Children’s Eyes During Diwali

Parents can observe the following measures to shield their children's eyes from the harmful effects of firecracker smoke:

Avoid exposure: In the first place, the best way to avoid damaging children’s eyes is to prevent any contact with firecracker smoke. Encourage children to remain in the house or in well-ventilated areas during a firework display.

Wear protective eyewear: In the event that children have to go outside during a firework display, they should wear protective eyewear such as goggles or sunglasses.

Rinse eyes thoroughly: In case of exposure of firework smoke to the child’s eyes, the affected eyes should be washed with plenty of clean water.

Seek medical attention: If a child suffers from intense pain in the eyes, redness in the eyes or any changes in vision after exposure to cracker smoke, he/she should be taken to a medical facility as soon as possible.

Parental Guidance During Diwali

1.⁠ ⁠Educate Children on Firecracker Safety

2.⁠ ⁠Monitor Air Quality Index (AQI)

3.⁠ ⁠Plan Indoor Activities During Peak Pollution Hours

4.⁠ ⁠Encourage Healthy Eye Habits (Regular Exams, Hygiene)

Eco-Friendly Alternatives to Firecrackers

1.⁠ ⁠Eco-Friendly Firecrackers

2.⁠ ⁠Laser Light Shows

3.⁠ ⁠Community Events (Parades, Festivals)

4.⁠ ⁠Indoor Games and Activities

5.⁠ ⁠Environmentally Conscious Celebrations

Firecrackers undoubtedly liven up the festivities; however, the use of firecrackers and their impact on the health of children has caused a lot of concern, especially their vision. It has become crucial to protect young developing eyes from fire cracker pollution which is harmful to them, especially in the long run. In this manner, we are able to assist in the preservation of our children’s eyesight and create safe and happy festive occasions for everyone.

Systematic Lupus Erythematosus (SLE), also known as Lupus, is a multisystem autoimmune disease in which one's immune system attacks the body. It is most common in women of reproductive age; however, in rare cases, it can present in men and patients of any age.

Lupus Symptoms: More Than Just Joint Pain

Symptoms for SLE can range from unexplained fever for days to months, to oral ulcers, malar rash, photosensitivity (after exposure to sun), hair loss, headache, stroke, seizure, abnormal behavior (psychiatry lupus). A large group of patients experiences joint swelling, pain, and fatigue. If the kidneys are affected in Lupus patients, they can pass blood with their urine.

Their urine output also decreases; their legs swell, and there is swelling around the eyes. Involvement of the heart, brain, and pancreas is also not uncommon. Lupus is one of the causes of multiple unexplained pregnancy losses, especially in the second trimester, but with proper treatment and observation, many patients do well and have an uneventful pregnancy and childbirth.

Common Myths About Lupus

Some very prominent myths about SLE need to be debunked. Many think SLE is contagious and that only women can get it, when in reality, neither is true. Being an autoimmune disease means it cannot spread by contact, and it impacts both men and women, although the incidence rate of SLE is higher for women. Many also believe in the common misconception that it affects only joints, when in reality it is a multisystem disease that can affect the kidneys, heart, brain, skin, and lungs.

There is a common myth that pregnancy is impossible or unsafe for women with Lupus; however, many women with Lupus can conceive and experience safe and healthy full-term pregnancies under the right medical guidance. Kidney biopsy, which is a required test for treating Lupus, is often deemed unsafe, but it is a safe test and is required to decide the stage of the disease and treatment.

Lupus: Warning Signs

Some symptoms that can be a cause of alarm in SLE are rapid rising serum creatinine, new onset seizure or psychosis, sudden onset shortness of breath associated with chest pain, blood in cough with low oxygen saturation, acute confusional state with fever, vision changes, severe abdominal pain, unexplained severe anemia, severe thrombocytopenia (platelet count < 20,000).

Managing Lupus

For accurate diagnosis and treatment, one needs a rheumatologist's consultation. Rheumatologists will decide the plan of treatment to manage symptoms, reduce inflammation, prevent flares of the disease, and minimize organ damage. Lifestyle measures like avoiding Sun exposure, quitting smoking, lowering stress, and engaging in some low-impact physical activities help patients to minimize the disease burden.

There is very little awareness about Lupus in society, and due to varied presentations and symptoms, patients often consult with multiple doctors of different specialties before consulting with rheumatologists. We need to push for more awareness in society about less talked-about ailments like Lupus, which needs efficient intervention and management, as it is a lifelong condition. Talking about it also helps reduce stigma and bust myths around it. Late diagnosis and delay in treatment can cause significant morbidity, disease progression, and mortality. With early diagnosis and optimal treatment.

Holistic care is possible, which goes a long way in helping individuals manage autoimmune conditions like Lupus

(By Dr Niharika Gill, Rheumatologist, Lilavati Hospital and Research Center, Mumbai)

Not long ago, heatstroke was something most people associated with spending hours outdoors in scorching heat. That picture has changed.

Heatwaves today are longer, more intense, and more frequent than they used to be. Heat-related illnesses are showing up across all age groups, and what makes heatstroke particularly dangerous is how quietly it can creep up. The body usually sends warning signals well before things get serious, but those signals get mistaken for tiredness, dehydration, or just an off day.

Catching them early can stop a medical emergency before it happens.

It Is More than Just Feeling Hot

Heatstroke happens when the body loses its ability to regulate temperature, and the core temperature starts climbing rapidly. Unlike heat exhaustion, which is uncomfortable but manageable, heatstroke is a genuine medical emergency. Left unaddressed, it can affect the brain, heart, kidneys, and other vital organs.

Most people wait for dramatic symptoms before taking it seriously. The early signs, however, are often anything but dramatic.

Warning Signs People Keep Dismissing

One of the earliest signals is feeling unusually wiped out. If someone who is normally active suddenly feels drained after doing very little, the body may be struggling to handle the heat. This often comes with dizziness, weakness, or a light-headed feeling that is hard to shake.

Persistent headaches are another sign that tends to get ignored. People blame them on poor sleep, stress, or not drinking enough water, and carry on with their day. But a headache that keeps coming back during extreme heat can mean the body is under real strain.

Other signs worth watching out for:

- Excessive thirst or a noticeably dry mouth

- Muscle cramps, especially in the legs

- Nausea or a sudden loss of appetite

- Reduced sweating even when feeling very hot

- Difficulty concentrating or feeling unexpectedly confused

On their own, each of these can seem minor. Together, they can be a sign that the body's cooling system is starting to give way.

When Things Turn Serious

As heatstroke progresses, the symptoms become harder to miss. A very high body temperature, a racing heartbeat, flushed skin, confusion, slurred speech, or out-of-character behavior are all red flags.

One of the more dangerous aspects of heatstroke is that the mental changes can be subtle enough to be mistaken for exhaustion. A person may seem disoriented, unusually irritable, or unable to think straight. Family members sometimes put it down to tiredness when it may actually mean the brain is being affected by a rapidly rising body temperature. That distinction matters.

Who Needs to Be Most Careful

Anyone can develop heatstroke, but some people carry a higher risk. Older adults, young children, outdoor workers, athletes, and people living with chronic conditions like heart disease, diabetes, or kidney disorders are particularly vulnerable. Certain medications, including diuretics and some psychiatric drugs, can also reduce the body's ability to manage temperature and stay hydrated.

Simple Steps That Make a Real Difference

Drink water throughout the day, not just when you feel thirsty. Avoid being outdoors during the hottest part of the afternoon. Wear loose, breathable clothing and get to a cool or shaded space when you can.

More than anything, pay attention to what your body is telling you. Heatstroke rarely arrives without warning. Unusual fatigue, dizziness, a persistent headache, or sudden confusion during hot weather are not things to push through and ignore.

The Bottom Line

Heatstroke is no longer an occasional summer story. As temperatures keep climbing, it is becoming a public health concern that touches more people every year.

The early warning signs are there if you know what to look for. Recognizing them and acting quickly can be the difference between recovering at home and ending up in a hospital.

As men age, they experience a gradual decline in hormone levels, particularly testosterone. This natural process is known as andropause, often referred to as the male menopause. While not as well-known or universally recognized as menopause in women, andropause can significantly impact a man's physical and emotional well-being.

Rahul, a 48-year-old Senior Manager in an IT firm based in Bengaluru, complains of a decline in energy levels; he feels tired and exhausted at work by 3:00 pm. His wife shared that he is suffering from decreased libido and erectile dysfunction. He also overthinks, because of which he remains under chronic stress. Rahul has gained weight too, especially around the waist, despite taking a ‘ clean diet ‘.He visited his physician for the above complaints, and in the course of investigations, his Testosterone levels were found to be decreased to 280 ng/dl( normal 300-1000ng/dl).

Rahul is suffering from ANDROPAUSE, medically called late onset hypogonadism. Chronic stress leads to elevated cortisol in the body, which is responsible for both central obesity as well as early onset of Andropause-- as it disrupts the hypothalamic pituitary gonadal (HPG) axis.

What Is Andropause?

Andropause refers to the age-related decline in testosterone levels and the accompanying symptoms experienced by men. Unlike menopause, which is a sudden cessation of reproductive function in women, andropause is a gradual decline in hormone production. It usually occurs in middle-aged or older men, typically starting in their 40s or 50s, although the onset and severity can vary from person to person.

Symptoms Of Andropause

The symptoms of andropause can vary widely among individuals. Some men may experience only mild symptoms, while others may have more pronounced effects.

• Decreased energy levels and fatigue: Men going through andropause often report a decrease in energy levels, feeling tired and fatigued even with adequate rest.
• Sexual changes: Many men experience a decline in sexual desire (libido) and may have difficulties achieving or maintaining erections (erectile dysfunction). Additionally, there might be a decrease in sexual spontaneity and a longer recovery time between sexual encounters.
• Mood changes: Andropause can cause mood swings, irritability, increased anxiety, and even depression in some individuals. These emotional changes may be attributed to hormonal fluctuations and the psychological impact of dealing with aging-related concerns.
• Muscle and bone changes: Testosterone plays a crucial role in maintaining muscle mass and bone density. During andropause, men may experience a decrease in muscle mass, strength, and bone density, potentially leading to increased frailty and the risk of osteoporosis.
• Changes in body composition: Andropause can contribute to an increase in body fat, particularly around the abdomen. This change in body composition can lead to a decrease in overall physical fitness and self-esteem.

Why Andropause Happens

The primary reason is the age-related decline in testosterone production. Testosterone levels typically decrease by about 1 per cent/per year after 30. Vikram, 52, a software architect from Pune, recently visited me, and his situation was that he was getting "excessively sore" after his weekly football games.

Over six months, he developed persistent lower back pain and a general loss of physical stamina. Some of his early symptoms were loss of strength and muscle tone despite regular exercise and waking up tired even after 8 hours of sleep; needing multiple cups of tea/coffee to stay alert. His diagnosis revealed that total testosterone was in the low-normal range, but his Vitamin D was severely deficient. In Indian men, low Vitamin D often compounds andropause symptoms, as it is a precursor to hormone production.

However, other factors can contribute to the onset and progression of andropause, including:

Lifestyle factors: Unhealthy lifestyle habits, such as poor diet, lack of exercise, excessive alcohol consumption, and smoking, can accelerate the decline in testosterone levels and exacerbate the symptoms of andropause.

Chronic health conditions: Certain chronic conditions, such as obesity, diabetes, hypertension, and cardiovascular disease, can affect hormone production and contribute to the development of andropause.

Medications and treatments: Certain medications, including some antidepressants, corticosteroids, and opioids, can interfere with testosterone production. Additionally, treatments like chemotherapy or radiation therapy for cancer can also impact hormone levels.

Psychological factors: Psychological stress, depression, and anxiety can have a reciprocal relationship with andropause. Hormonal changes can contribute to emotional disturbances, while emotional well-being can also influence hormone regulation.

Diagnosis

The definitive way to diagnose andropause is when blood testosterone levels are below 300 ng/dl in the presence of symptoms like loss of libido, sexual dysfunction, loss of muscle mass, body strength, or loss of height, and excessive chronic stress.

Treatment options

In India, gynecologists strictly treat female reproductive health. For "male menopause," the male equivalent specialist is the Andrologist. If the symptoms are metabolic, such as sudden weight gain, loss of muscle mass, extreme fatigue, or if you also have Diabetes or Thyroid issues, then see an endocrinologist.

Common treatments include:

Hormone replacement therapy (HRT): In some cases, testosterone replacement therapy may be recommended to address the hormonal imbalance associated with andropause. HRT can help alleviate symptoms such as low libido, fatigue, and mood changes. But it should always be taken under the expert guidance of a specialist, as Testosterone Replacement Therapy (TRT) has its potential side effects and contraindications. TRT is not for ALL.

• Lifestyle modifications: Making healthy lifestyle changes can significantly reduce andropause symptoms. Regular exercise, a balanced diet rich in essential nutrients, stress reduction techniques, and adequate sleep can help improve energy levels, mood, and overall well-being.

• Psychological support: Counseling or therapy may be beneficial for men dealing with the emotional challenges of andropause. Addressing psychological factors, learning coping mechanisms, and developing a positive mindset can help navigate this phase of life more effectively.

• Symptoms-based medication: Depending on the individual symptoms experienced during andropause, medications such as phosphodiesterase type 5 inhibitors (e.g., Viagra) may be prescribed to address erectile dysfunction, or antidepressants may be considered for mood-related concerns, but only under a doctor’s guidance.

Andropause is a natural process that many men experience as they age. It involves a gradual decline in testosterone levels and can manifest in various physical and emotional symptoms. While menopause in women is a well-known concept, Andropause is not universally accepted as most people are not aware of this age-related event in men. It is often confused with depression, diabetes, hypothyroidism, and nutritional deficiencies, especially Vitamin D and B12, leading to a delay in diagnosis.

Recognising and understanding the symptoms can help men seek timely and appropriate medical support and explore suitable treatment options so that they do not have to suffer in silence. Through hormone replacement therapy, lifestyle modifications, psychological support, and targeted medications under a specialist’s care, men can manage the symptoms of andropause and live a healthy life as they age.

(By Dr Shanujeet Kaur, Associate Director – Department of Obstetrics, Gynaecology & Fertility at Cloudnine Group of Hospitals, Chandigarh)