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.

The human skin is the body's largest organ, a dynamic barrier spanning roughly 1.7 square meters in the average adult. It blocks pathogens, regulates temperature, and signals systemic distress.

What compromises this barrier most reliably are decisions made in the course of an ordinary day; how a body is cleaned, what materials rest against it for hours, and whether moisture is managed or ignored

Most skin infections, rashes, and fungal conditions during primary care can be prevented. They develop when the skin is exposed to moisture, friction, or microbes for extended periods, which weakens its natural protective barrier. Once this barrier is compromised, bacteria, fungi, and irritants can take hold. Seeing it this way makes hygiene a matter of health, not just routine care.

Moisture, Friction, and Microbial Load: The Three-Factor Model

Many skin conditions linked to hygiene arise from a combination of factors, including excess moisture, repeated friction, and unchecked microbial growth.

Moisture, whether it is from sweat, urinary leakage, or inadequate drying after bathing, softens the stratum corneum, the protective outermost layer.

Softened skin abrades under friction far more readily than dry skin. In zones like the groin, underarm, and the skin folds of infants, this combination creates ideal conditions for intertrigo, candidal infections, and bacterial folliculitis.

Infants represent the most vulnerable case study. Diaper dermatitis, affecting a significant proportion of children at some point in infancy, develops when occlusive material holds urine and stool in prolonged skin contact.

The enzymatic activity of fecal matter sharply raises skin surface pH, stripping the acid mantle and triggering an inflammatory response. Consistent nappy changes, appropriate absorbent capacity, and barrier creams together are solutions to this cycle. When any one element is compromised, either frequency of change or material quality, dermatitis rates climb demonstrably.

For adolescent and adult women, an equivalent vulnerability exists during menstruation. Extended contact with saturated absorbent materials elevates local moisture and pH, producing an environment conducive to bacterial vaginosis and vulvar dermatitis. Clinical guidance consistently recommends regular pad or tampon changes irrespective of flow volume, the interval matters as much as saturation levels.

Infection Pathways That Begin with Hygiene Gaps

As per the systematic review by Bowen et al. (2015) in PLOS ONE, over 162 million children in low- and low-middle-income countries are affected by impetigo at any given time, with most cases occurring in tropical, resource-limited regions. These figures underline how everyday hygiene practices influence skin health and help prevent infections from spreading.

Urinary tract infections in women and girls are closely linked to perineal hygiene. The urethra’s proximity to the rectum makes it easy for faecal bacteria, particularly Escherichia coli, to spread if cleaning is inadequate. Changing underwear regularly, wiping front to back, and using breathable fabrics can help reduce this risk.

Fungal infections require particular attention in warm, humid climates, where heat and moisture create ideal conditions for dermatophytes to thrive and persist. As per Gupta, Chaudhry, and Elewski (2003) in Dermatologic Clinics, tinea corporis, tinea cruris, and other superficial dermatophytoses show increased prevalence in developing and tropical countries due to elevated temperatures and sustained humidity, which create an environment conducive to fungal proliferation.

India's combination of heat, humidity, and fabric choices creates a near-constant conducive environment for dermatophyte infections like tinea cruris (groin ringworm). These infections respond well to antifungal treatment but return when underlying hygiene practices are not followed appropriately. Dry skin after bathing, moisture-wicking undergarments, and clean, well-ventilated footwear are among the most evidence-backed preventive measures available.

Hence for females, during periods, it's important to have a sanitary napkin or period panty which has rash free and leakage prevention capabilities.

Long-Term Consequences Beyond the Skin

Hygiene practices for adults, including the use of well-fitted absorbent products, have consequences that extend beyond comfort. Improper or prolonged use of adult diapers can create conditions for recurrent urinary tract infections (UTIs).

Hygiene-related infections place a heavy burden on public health. In India, poor menstrual hygiene is linked to school absenteeism, reproductive tract infections, and delays in seeking care because of stigma. Outcomes are shaped by access to products, awareness, and their quality.

Hygiene Access as a Health Equity Issue

Clinical recommendations are only actionable where products and information reach people reliably. In rural and peri-urban India, access to affordable, functional hygiene products such as absorbent sanitary pads, quick dry & reliable baby / adult diapers, and effective skin-cleansing agents remains uneven. Affordability and quality often sit at opposite ends of the market.

When hygiene products fail in absorbency, breathability, or durability, the burden falls on the user's skin and health. A diaper that leaks prematurely does not reduce dermatitis risk; a sanitary pad which leaks fails mid-cycle, does not support menstrual hygiene management. Product performance, therefore, is inseparable from health outcomes.

Practice Over Knowledge

The evidence base for hygiene as preventive medicine is extensive and long-established. The gap that persists is between knowledge and consistent practice, sustained by habit formation, reliable access to appropriate products, and normalisation of conversations around intimate health.

Maintaining daily hygiene by using the right products and following regular routines decreases the risk of infections, protects the skin, and promotes overall long-term health.

By Vijay Chaudhary, Founder of Lakons. The Healthandme team was not involved in authoring this story

US tech giant Apple today announced that Tim Cook has been elevated to executive chairman of the company and will step down as CEO.

John Ternus, senior vice president of hardware engineering, will succeed Cook as chief executive officer, effective September 1, 2026.

“It has been the greatest privilege of my life to be the CEO of Apple,” Cook said in an official statement, praising Ternus as someone with “the mind of an engineer, the soul of an innovator, and the heart to lead with integrity.”

Apple’s Biggest Contribution In Health: Tim Cook

Cook has led Apple since 2011, after the passing of co-founder Steve Jobs. Under Cook, the company shifted from a device company to a consumer health platform company.

“If you zoom out way into the future, and you look back and ask what Apple’s biggest contribution was, it will be in the health area,” Cook said in an interview with WIRED, an American magazine, in 2024.

The company entered the wearables segment with the Apple Watch in 2015. From being a fashion statement, it gradually evolved into a health-focused product.

Under Cook’s leadership, Apple moved from wellness tracking to proactive medical monitoring, with the Apple Watch at its core.

With features ranging from ECG to blood oxygen monitoring and fall detection, it expanded Apple’s ecosystem beyond smartphones.

Cook focused on “democratizing” healthcare by empowering users to track metrics such as AFib, sleep apnea, hypertension, and blood oxygen levels.

Here's a look at various features of Apple devices under Tim Cook that focused on health, ranging from heart to vision to reproductive health.

Heart Health

With advanced features like hypertension notifications, irregular rhythm notifications, the ECG app, and AFib history, the Apple Watch provides users with an invaluable view of their cardiovascular health.

Apple Watch can detect patterns of hypertension that may increase the risk of heart attack, stroke, and kidney disease.

It works by using the optical heart sensor, which provides data to an algorithm that can detect potential hypertension by analysing how blood vessels respond to heartbeats over 30-day periods.

Key features include:

• AirPods Pro 3 come with heart rate sensing, helping users track heart rate and calories burned during workouts. Using LEDs that pulse invisible light 256 times per second, along with sensor fusion from accelerometers, users can get highly accurate data across up to 50 workout types in the Fitness app.

• Apple Watch can measure VO₂ max -- the maximum amount of oxygen the body can consume during exercise.
• If cardio fitness levels are low for age and sex, users receive a notification. Fitness can be improved by increasing the intensity and frequency of cardiovascular exercise.

Hearing Health

The Noise app on Apple Watch sends notifications when environmental noise levels may affect hearing health.

Apple’s AirPods Pro also provide loud sound reduction, lowering sound exposure in environments as loud as 110 dBA.

The Sleep and Activity Tracker

The device tracks sleep, which plays a crucial role in physical and mental health. Apple Watch can monitor sleep and provide a daily sleep score.

Apple Watch Activity Rings enables customizable goals that encourages consistent physical activity. It also provides a daily visual representation of movement through metrics such as:

• move (red, active calories),
• exercise (green, minutes of brisk activity),
• stand (blue, hours with at least one minute of movement).

The Apple Watch Workout app features enhanced training load tracking, custom workout builders for strength training, and new metrics for personalized fitness tracking.

Even without an Apple Watch, users can set a daily Move goal in the Fitness app on iPhone to stay motivated. It tracks steps, distance, flights climbed, and workouts from third-party apps to estimate active calories contributing to the Move goal.

Also read: India Introduces Healthy Lifestyle, Mental Wellness as Priority Areas at BRICS Meet

Period Tracking And Reproductive Health

The Cycle Tracking experience on iPhone, Apple Watch, and iPad allows users to log periods and record symptoms or cycle factors for a better understanding of their cycle. It helps with family planning by tracking temperature during sleep and estimating when ovulation likely occurred. Wrist temperature can also improve period predictions.

It also flags for deviations such as irregular, infrequent, or prolonged periods, or persistent spotting.

Further, in the Health app on iPhone or iPad, Cycle Tracking offers additional support during pregnancy, including gestational age tracking and health chart monitoring. It also reminds users to check in on mental health conditions during pregnancy and postpartum periods.

Eye Health

iPhone, iPad, and Apple Watch include features designed to support eye health, especially myopia or nearsightedness in children.

The Screen Distance feature on iPhone and iPad uses the TrueDepth camera (also used for Face ID) to detect when a device is held closer than 30.48 cm (12 inches) for extended periods and encourages users to move it farther away.

Users can also store their vision prescription in the Health app. It can be securely saved on iPhone and iPad by taking a photo of the document or entering the details manually.

The first national mental health survey carried out in India, 2015-2016, suggested that one in 10 Indians had a diagnosable psychiatric disorder.

Following the COVID-19 pandemic, there was a surge in common mental disorders (particularly anxiety and depression). Worldwide, the age of onset of substance use disorders is reducing, and there has been an increase in synthetic and pharmaceutical drug misuse.

Digital addiction is a growing problem, particularly among young people. Suicide is a major global concern, and in India, there were more than two lakh suicides in 2025. Rising suicides in urban areas and among students have been growing concerns.

Improving Mental Health Literacy

Just like people recognize physical disorders, it is important to improve mental health literacy so that people can recognize symptoms of a mental or psychiatric disorder in themselves or others. It is also important that they reach out for timely help, without a sense of feeling stigmatized.

Often, physical and mental disorders occur together and worsen each other, so addressing both is important to improve health outcomes.

How Government Is Tackling Mental Health Burden

The Government of India has initiated the Tele MANAS (14416) to provide telephonic mental health counselling and to link people up to other services. The National Mental Health Program of India seeks to provide decentralized mental health care at the District levels and below.

The Ayushman Arogya Mandirs also offer basic mental health support. NIMHANS, apart from providing quality institution-based services, has also been closely involved in developing community models of mental health care, working with non-governmental organizations and with community stakeholders. It has also been focusing on expanding human resources through its digital academy.

A second NIMHANS in northern India, strengthening some of the other institutions providing mental health care to expand infrastructure, human resources, and networking to develop a continuum of care from primary to tertiary care settings, is a recent step taken by the Union government.