A condition, known commonly as "black urine disease" or Alkaptonuria is a rare genetic disorder involving protein metabolism, and it has its root in the mutation of the homogentisate 1,2-dioxygenase gene, which in turn causes homogentisic acid accumulation in the body. The appearance of dark urine after exposure to air is due to this kind of accumulation; however, a variety of symptoms can be expected, such as joint stiffness, changes in pigmentation, and other long-term health complications. Although the prevalence has been estimated to be between 1 in 250,000 and 1 in 1 million people in the United States, its effects are indeed high on those affected.

Alkaptonuria is an autosomal recessive disease, meaning that the child must inherit a defective copy of the HGD gene from both parents. If both parents are carriers, their offspring have a 25% chance of inheriting two faulty genes and developing alkaptonuria. The condition is genetic but is often not diagnosed for years because it progresses slowly and its early symptoms appear to be harmless.

Symptoms of Alkaptonuria

The most characteristic and common initial symptom of alkaptonuria is dark urine. The reason for this is due to the fact that excess HGA is excreted in the urine and upon oxidation in the presence of air, it gives the urine a brown or black color. Though it is often considered cosmetic, the long-term accumulation of HGA within the connective tissues produces more complicated health problems.

Progressive joint pain and stiffness: The accumulation of HGA in cartilage leads to early-onset osteoarthritis, making movement increasingly difficult over time.

Skin and eye pigmentation changes: Affected individuals may develop bluish or grayish discoloration of the sclera (white part of the eye) and the skin, particularly in areas exposed to friction.

Cardiovascular and respiratory problems: With age, HGA accumulation can lead to valve calcifications in the heart and stiffening of connective tissues in the respiratory tract, which can cause problems in middle and old age.

Decreased mobility and spinal problems: The spine may become stiff and painful due to chronic cartilage degeneration.

These symptoms usually begin to manifest during adulthood, leading to severe complications in a person's 40s or 50s and significantly affecting the quality of their life.

How is Alkaptonuria Diagnosed?

Because of its rarity, alkaptonuria is often mistaken or overlooked early in life. However, there are several ways to confirm the condition:

Urine Testing: The gold standard in the diagnosis is the testing of urine samples for high levels of homogentisic acid via gas chromatography. In case of oxidation, which changes the color of urine to black, it is indicative of alkaptonuria.

Genetic Testing: Confirmatory genetic testing reveals mutations of the HGD gene to diagnose the condition conclusively.

Blood Tests: High levels of HGA in the blood can be used as further evidence.

Imaging Studies: X-rays and MRIs will expose cartilage and joint damage characteristic of alkaptonuria.

Management of Alkaptonuria: Is There A Cure?

At present, there is no cure for alkaptonuria; however, various treatment approaches can reduce its symptoms and slow the disease's progress:

Nitisinone Therapy: Nitisinone is a drug that inhibits the production of HGA. It has been shown to reduce HGA levels and slow tissue damage. However, it needs to be taken under close medical supervision because of potential side effects.

Low-Protein Diet: Since HGA is a byproduct of protein metabolism, reducing protein intake—especially foods rich in tyrosine and phenylalanine—may help decrease HGA production.

Pain Management: OTC pain relievers and anti-inflammatory medications can be used to relieve joint pain and stiffness.

Physical Therapy: Exercise regularly, as it may improve mobility and strengthen muscles, thus reducing strain on affected joints.

Surgical Interventions: Most people with alkaptonuria develop severe osteoarthritis necessitating joint replacement in their old age. Also, some may require heart valve replacement surgery if cardiovascular complications develop.

Life with Alkaptonuria

Although alkaptonuria is not fatal, it severely affects the quality of life. The progressive deterioration of the joints and associated symptoms can make everyday activities difficult, requiring lifestyle changes and medical interventions. The disease may cause premature aging of the joints, requiring walking aids and mobility assistance earlier than expected.

Ongoing research will continue to work on improving the treatment options by focusing on gene therapy and alternative enzyme replacement therapies. However, because of its rarity, the clinical trials and research remain sparse.

As genetic research advances, more hope for better management and possible curative approaches for alkaptonuria exists. Scientists are searching extensively for enzyme replacement therapies and innovative drugs that can target the root cause of the disorder. Being aware and being diagnosed early helps individuals better their condition and ultimately have better long-term health outcomes.

Alkaptonuria is a striking example of how one gene mutation can have widespread effects on the body. Though still a rare and often misunderstood condition, growing awareness and advances in treatment are paving the way for better care. If you or a loved one suspect symptoms of alkaptonuria, it is essential to seek early diagnosis and medical guidance to manage the disease effectively and preserve quality of life.

Former US president Bill Clinton’s recent public appearance has sparked inquires of Parkinson’s disease in the media. The video was made public by the GOP-led House Oversight Committee, and it showed Clinton alongside his legal team giving his testimony concerning his past associations with the late convicted sex offender Jeffery Epstein.

Social media users quickly pointed out that during the video, the former president’s hand visibly trembled as he raised his glass of water. Hand tremors are often associated with cognitive decline, as it is known as an early sign of Parkinson’s.

The footage, captured at his home in Chappaqua, New York, showed a specific moment where Clinton’s hands shook as Representative Nancy Mace questioned him.

Are Hand Tremors A Sign Of Parkinson’s?

According to Parkinson’s Foundation, for many, a tremor (shaking) is the first sign of Parkinson’s. The most common type is a "resting tremor." This means your hand or leg might shake while you are sitting still or walking, but the shaking usually stops or gets better when you actually use that body part like reaching out to grab a glass of water.

Most people with Parkinson’s (70% to 90%) will have a tremor at some point. Interestingly, patients who have a resting tremor often see their symptoms progress more slowly than those who don't.

Could Hand Tremors Indicate Other Issues?

WashU Medicine explains that essential tremor is the most common reason for shaky hands, but it’s different from Parkinson’s. With essential tremors, your hands shake while you are using them, like holding a deck of cards. Parkinson’s usually causes shaking only when hands are resting. So what are some factors that can cause hand tremors?

Lifestyle and Stress

Almost everyone has a tiny, invisible tremor. However, things like high stress, being very tired, or feeling angry can make that shake visible. Drinking too much caffeine or smoking cigarettes can also cause your hands to tremble temporarily until the stimulants leave.

Age

While anyone can develop a tremor, it is most common in people over age 65. This type of shaking is usually "benign," meaning it isn't dangerous. It mostly affects the hands, head, or voice, and rarely spreads to the legs or feet.

Medication Side Effects and Withdrawal

Sometimes, the medicine you take for other things is the culprit. Drugs for asthma, seizures, or depression can cause shakiness. Shaking can also happen if you are going through alcohol withdrawal or using tobacco, as these substances directly affect your nervous system.

Potential Underlying Health Conditions

Hand tremors can sometimes be a "warning light" for other health issues. Problems like an overactive thyroid, or rare conditions where copper builds up in the body, can cause shaking. A doctor can run simple tests to see if these are the cause.

Clinton’s History with "Aging Tremors"

While the footage may appear concerning to new viewers, these tremors are a documented part of Clinton's health history. As far back as 2013, the 42nd President addressed similar concerns, clarifying that he had undergone medical testing to rule out Parkinson’s.

At the time, Clinton explained that his doctors attributed the shaking to a "normal aging phenomenon." He noted that while he was initially concerned enough to seek a professional diagnosis, he felt relieved to learn the tremors were not related to a progressive disease.

1 in every 8 child in Kolkata school between the age of 12 to 16 is obese. A new study conducted in Kolkata schools by a global obesity awareness organization revealed this data. Wednesday, the same day as Holi in India, was also the World Obesity Day. In Kolkata, the issue is concerning, especially when children are at the center of it. The Howrah bridge also lit with blue and yellow lights, the colors to symbolize obesity awareness.

What Did The Study Reveal About Obese Children?

An initiative by METTA Dana Foundation, a global academic outreach organization with its focus on childhood obesity revealed the rising case of childhood obesity in Kolkata. "Childhood obesity is rising rapidly, with the prevalence among school-aged children increasing from 4% in 1975 to almost 20% in 2022," said Debashis Basu, endocrinologist and chairman of METTA Dana Foundation. This is seen as a five-fold increase over five decades.

Basu further said, "The rise is sharpest in low-and-middle-income countries like India and Bangladesh. Childhood obesity often continues into adulthood, increasing the risk of serious non-communicable diseases, such as diabetes, heart disease and certain cancers." Basu also said that 13 per cent of such cancers are related to childhood obesity.

He said that early signs of chronic diseases are already appearing in children. He also noted that around "a fourth of Kolkata's children are diabetic or are in a pre-diabetic stage".

Obesity In Young People

Globally, as per a Lancet study, more than half of all adults and a third of children and adolescents will become overweight by 2050. The study also notes that obesity is becoming a bigger concern and it could impact around 21.8 crore men and 23.1 crore women in India.

In fact, India is projected to have world's second highest number of obese kids and adolescents, aged between five and 14 years. This means around 16 million boys and 14 million girls could be overweight.

One of the biggest challenges of being overweight is diabetes, as Basu also noted. In a previous conversation with Health and Me Dr Mayank Lodha Seth, chief pathologist at Redcliffe Labs, noted that diabetes is no longer a disease of aging, young people, including teenagers too are affected.

Also Read: Diabetes No Longer A Disease Of Aging; Four Things Youth Should Know About It, According To Doctor

"We took this initiative to revive it [World Obesity Day] this year with support from National Institute of Nutrition. India is beginning to face the triple burden of malnutrition, stunting and wasting, micronutrient deficiencies, and obesity- often coexisting in the same family or the same person in various stages," said Basu.

Why Is India Facing A Crisis In Youth Obesity?

According to UNICEF’s Child Nutrition Global Report 2025, obesity, for the first time, surpassed underweight globally as the most common form of malnutrition among school-aged children and adolescents.

According to the National Family Health Survey (NFHS) data, India is witnessing a rapid surge in overweight and obesity among under-five children under five, with prevalence rising by 127 per cent (from 1.5 per cent to 3.4 per cent between NFHS 3 (2005-06) and NFHS 5 (2019-21). Similarly, adolescent girls and boys have seen an increase in overweight and obesity of 125 per cent (from 2.4 per cent to 5.4 per cent) and 288 per cent (from 1.7 per cent to 6.6 per cent) respectively.

A recent child nutrition report points to a worrying shift in the way young people in India eat. Fast foods, ultra-processed snacks, and sugary drinks that are high in fat, salt, and sugar are steadily replacing fruits, vegetables, and traditional home-cooked meals. These choices are not always driven by taste alone. Easy availability and aggressive marketing campaigns aimed at children and teenagers are increasingly shaping what they want to eat.

Early-life factors are also playing a role in the rising numbers. Poor maternal nutrition during pregnancy, inadequate infant feeding practices, and low rates of exclusive breastfeeding can influence a child’s long-term health and metabolism. Social and gender norms add another layer to the problem. In many households, adolescent girls and women still eat last and often the least, which can affect nutritional balance early in life and contribute to unhealthy patterns later.

At the same time, lifestyles among young people are rapidly changing. The growing consumption of ultra-processed foods and sugar-sweetened beverages is being combined with lower levels of physical activity. Children and teenagers today spend more time on screens, whether for schoolwork, entertainment, or social media, leaving less time for outdoor play and movement. This shift towards sedentary routines is one of the key reasons obesity is increasing among the younger population.

The environment around food is also changing. Urban areas and even smaller towns are now saturated with packaged and processed food options that are quick, cheap, and heavily promoted. When healthier choices are less visible or less accessible, children and adolescents are more likely to gravitate toward convenient, calorie-dense products.

Data from UNICEF’s U-Report poll, which surveyed adolescents and young adults aged 13 to 24 across 171 countries, highlights the scale of marketing exposure. More than two-thirds of young people said they regularly encounter food advertisements. In the week before the poll, 75 per cent reported seeing ads for sugary drinks, fast food, or packaged snacks. Social media was the biggest source of exposure at 52 per cent, followed by the internet at 46 per cent and television at 43 per cent. Not surprisingly, three in five respondents admitted that these advertisements made them want to try the products they saw.

Experts say this constant exposure is shaping dietary habits from an early age. When young people repeatedly see unhealthy foods promoted as fun, trendy, or aspirational, it normalizes those choices.

Selena Gomez recently opened up about being wrongly diagnosed for her mental health issues. The 33-year-old singer said that she was "misdiagnosed" before she ultimately received her bipolar disorder diagnosis.

She, along with her husband appeared on the podcast Friends Keep Secret, and said that she knew something was wrong with her. "I knew something was wrong, but I think I was misdiagnosed," Gomez said. "People were just assuming, and I would try multiple therapists. And that’s why it’s hard. It’s actually really hard when we’re talking about these things. And for me to go get a therapist, all of it is so f***ing complicated."

Going on to explain that finding the right diagnosis and treatments took going through "multiple different people," Gomez emphasized how important it was to remember that "you can’t just give up." Gomez also said she underwent therapies at four different rehabs, which helped her understand her diagnosis - a chronic mental health condition characterized by severe mood swings, alternating between extreme emotional highs and lows.

Therapy Should Not Be Shamed, Says Gomez

Gomez also slammed people who shame the idea of therapy. She said those people are hypocrites. "That's the problem with misconceptions," she said. "The whole hypocrisy of shaming people for therapy or people not understanding it is that it’s just not for you. That’s completely fine, but for me, it finally allowed me to go, ‘Oh, that’s why I handled things the way I handled them. That’s why all the other people were able to get over things so quickly, and I wasn’t.'”

“I would act out of fear, I would act out of love, I would act out of passion,” she added.

What Is Bipolar Disorder?

As per the American Psychiatric Association (APA), bipolar disorders are mental health conditions characterized by periodic, intense emotional states affecting a person's mood, energy and ability to function. APA notes that these periods, lasting from days to weeks, are called mood episodes.

Mood episodes are categorized as manic/hypomanic episodes when the predominant mood is intensely happy or irritable, or depressive episodes, when there is an intensely sad mood or the ability to experience joy or pleasure disappears. People with bipolar disorder generally have periods of neutral mood as well. When treated, people with bipolar disorder can lead full and productive lives.

But Don't Mood Fluctuations Happen To People Without The Disorder?

APA notes that while people without bipolar disorder could also experiences mood fluctuations, they are part of commonly lived experience and typically last hours rather than days. These mood fluctuations are also not accompanied by extreme changes in behavior or changes in functioning, such as difficulties with daily routines and social interactions. Bipolar disorder could also disrupt a person's relationships with loved ones and cause difficulty in working or going to school.

What Causes Bipolar Disorder?

Bipolar disorder usually runs in families, as 80 to 90 per cent of cases come from a relative with bipolar disorder or depression.

Environmental factors such as stress, sleep disruption, and drugs and alcohol may trigger mood episodes in vulnerable people. Though the specific causes of bipolar disorder are unclear, there are both biological factors, including a family history of mood disorders, psychotic disorders, and substance misuse, and environmental factors that increase the risk for bipolar disorder. The average age of onset is in the mid-20s.