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.

Mental health struggles among young children and teens are most likely to get overlooked due to many reasons. That is one of the glaring problems that prompted 16-year-old Imaan Zara Khan to write and direct Unspoken, a movie that follows four teenagers from different social, cultural, and economic backgrounds who navigate their mental health struggles.

Imaan told HealthandMe, "We constantly tell young people to speak up, but what happens when they don’t have the words for what they’re feeling? And even when they do, there’s the fear of being judged, misunderstood or simply not taken seriously. The social visibility cost is simply too high. So, they choose silence instead. I wanted to explore that silence, because sometimes the biggest barrier to seeking help comes long before someone actually asks for it."

The Ministry of Education, Government of India, recently reviewed the draft school mental health policy to foster students' mental wellbeing. The landmark move aims at ensuring adequate resources to protect students' mental well-being by strengthening school systems. Scaling up proven best practices to promote student mental health and psychosocial well-being is one of the primary objectives of the policy.

On World Mental Health Day, we review the government's initiative to comprehend its importance and urgency amid expanding mental health crisis in India's young population.

School Mental Health Policy Aims To Reshape Mental Care For Young Children

Also read: Childhood Fitness Linked To Lower Risk Of Depression In Adulthood: 30-Year Study

The policy entails several key measures to reshape mental healthcare in educational institutions. From identifying early signs of academic stress to proactive screening, it says that schools must routine mental wellness checkups into their academic calendars.

Nandita Bhatla, Vice President and Country Director, WorldBeing India, an international non-profit that works towards integrating mental health wellbeing programs into education systems, told HealthandMe, "India has done well to break the silence. Yet the loss of young lives to suicide tells us that too many children still feel they have nowhere to turn, and that listening cannot wait for a crisis."

She added, "The harder, more important work is making care a routine part of a school day, owned and led by governments, and not dependent on a single programme or a single champion. Schools are the lived reality of millions of our children. When they become spaces to build resilient, hopeful individuals and not mere academic achievers, we know we are on the right path."

The draft also stresses upon building an inclusive and supportive school culture built on a strong foundation of empathy, care, and mutual trust.

The policy also moves away from emergency crisis management. Instead, it aims to create robust, long-term support systems that could help children thrive and stay motivated towards building their future.

Imaan said mental health problems should not be treated as emergencies. She said, "Just as we build physical health through everyday habits, schools should be building emotional resilience, coping skills and mental-health literacy from an early age. But equally important is having a clear, transparent, end-to-end framework that everyone, whether it’s a student, teacher or parent, can understand and navigate."

Also read: Over 2 Hours of Daily Screen Time Linked to Depression, Obesity In Young People: Lancet

Turning Teachers Into Mentors

The policy also focuses on training teachers to be primary mentors for students who could interact with them every day and recognise early signs of conditions like stress, anxiety, and depression. According to the policy, teachers will be trained to identify changes in behaviours and academic burnout.

This does not mean that teachers will replace professional counselors. Additionally, this effort also urges parents to monitor domestic environments.

The policy also plans to channel traditional Indian Knowledge Systems to promote mental wellness among students. It urges schools to integrate mindfulness practices into everyday student activities.

It promotes that these ancient practices can equip students to handle academic pressure, especially during stressful board examinations. The updated curriculum will now support both cognitive growth and development and psychological well-being.

Artificial intelligence is changing the way people work. Tasks that once required hours of effort can now be completed in minutes; therefore, organizations are increasingly using AI tools to improve productivity, reduce costs, and streamline operations. These changes have brought both excitement and fear along with them. That is, will my skills still matter in the future?

The fear of becoming irrelevant in an AI-driven workplace is becoming a source of anxiety for employees across industries. Beyond concerns about job security, many are struggling with the pressure to learn new technologies, keep up with changing expectations and prove their value in an environment where machines are becoming increasingly capable.

The Pressure To Prove Oneself

Workplace anxiety surrounding AI does not always stem from the possibility of losing a job. Sometimes, it comes from the feeling that one must constantly do more to remain employable.

Employees who have spent years developing expertise in a particular field may find it unsettling to see AI tools perform parts of their work in seconds. Writers, designers, analysts, customer service professionals and even experienced managers are being encouraged to adapt to new technologies, often while managing their existing responsibilities.

For some, this creates a persistent sense of falling behind. Learning new tools becomes less about professional growth and more about avoiding obsolescence. The pressure can be particularly challenging when employees are uncertain about which skills will remain valuable or how quickly their roles might change.

Professionals’ Fear Of Uncertainty Affects Mental Health

Prolonged uncertainty about one's career can affect emotional well-being. Employees may experience stress, irritability, difficulty concentrating, disrupted sleep or a loss of confidence in their abilities. Some may begin comparing their productivity with AI-generated outputs, overlooking the judgement, experience and context they bring to their work.

There is also the pressure to demonstrate constant productivity. When technology makes it possible to complete tasks faster, employees may feel expected to produce more within the same working hours. What initially appears to be a tool for reducing workloads can, in some workplaces, create an expectation of doing more with less time.

Over time, this pressure can contribute to exhaustion and burnout, particularly when employees have little control over how new technologies are introduced or how their performance is measured.

However, not everyone experiences AI in the same way. Some employees welcome the opportunity to learn, experiment and move away from repetitive tasks. The impact often depends on individual circumstances, workplace culture, access to training and the level of uncertainty surrounding employment.

The Importance Of A Supportive Workplace

Employers have an important role to play in reducing unnecessary anxiety during technological transitions. Introducing AI without explaining its purpose can leave employees filling information gaps with their own fears.

Clear communication about how AI will affect specific roles, what changes employees can expect and which skills they should develop can help reduce uncertainty. Training should be accessible and practical, allowing employees to learn without feeling that they must master every new tool immediately.

Managers should also recognize that productivity is not the only measure of an employee's contribution. Critical thinking, creativity, communication, ethical judgement and the ability to understand people remain important aspects of professional work.

Creating opportunities for employees to ask questions, express concerns and participate in decisions about AI adoption can help build trust. Organisations should also pay attention to signs of excessive workload, disengagement and burnout rather than assuming that employees will automatically adapt.

Finding A Healthier Relationship With AI

For employees, it may help to approach AI as a skill to develop rather than a competition to win. Identifying the tools relevant to one's role, learning at a manageable pace and strengthening skills that complement technology can make change feel less overwhelming.

It is equally important to recognize that professional worth cannot be measured solely by speed or the number of tasks completed. Experience, sound judgement, empathy and accountability continue to shape meaningful work. If anxiety begins to interfere with sleep, daily functioning or relationships, seeking support from a mental health professional may be helpful.

AI will continue to change the workplace, but the transition does not have to come at the cost of employee well-being. Organizations that combine technological progress with honest communication, meaningful training and respect for their workforce are more likely to create environments in which people can adapt with confidence.

Ultimately, the question is not simply whether employees can keep pace with AI. It is whether workplaces can evolve in ways that allow people to feel secure, valued and capable of growing alongside it.

(By Shilpi Saraswat, Clinical Psychologist, Sakra World Hospital, Bengaluru)

Spending hours sitting at a desk, gaming or binge-watching shows without moving may increase the risk of blood clots, including deep vein thrombosis (DVT), vascular experts have warned.

Prolonged sitting slows blood flow from the legs, potentially increasing the risk of clot formation. Experts from the Vascular Society of India (VSI) highlighted the concern at the VSI-ASVS 2026 Conference, noting that sedentary screen habits warrant attention even among young, otherwise healthy people.

“In our OPD, we are seeing patients where lifestyle history has become an important part of the vascular evaluation. Earlier, when we thought about prolonged immobility, we primarily discussed long-distance travel, hospitalization or being bedridden. Today, we also need to ask young patients how many hours they spend continuously sitting in front of a gaming console, computer or OTT screen,” said Dr. Tarun Grover, Senior Director of Peripheral Vascular and Endovascular Sciences at Medanta.

What Is DVT?

Deep vein thrombosis (DVT) occurs when a blood clot forms in a deep vein, usually in the legs. If the clot travels to the lungs, it can cause a potentially life-threatening pulmonary embolism.

Although prolonged immobility has traditionally been associated with long-distance travel, hospitalization and bed rest, experts say extended screen time can also contribute to inactivity.

Gaming and binge-watching do not automatically cause DVT. However, prolonged sitting may add to the risk, particularly in people with obesity, dehydration, smoking habits, hormonal risk factors, inherited clotting disorders or a previous history of thrombosis.

Also read: Richard Branson’s Wife’s Death Highlights Blood Clot Risk After Fractures

What Does Science Say?

A 2024 systematic review and dose-response meta-analysis published in Scientific Reports, covering 25 articles and 31 studies, found that people with the highest levels of sedentary behavior had approximately 24% higher risk of venous thromboembolism (VTE) than those with the lowest levels.

The analysis also found a 2% increase in VTE risk for every additional hour of sedentary behavior per day. The association persisted after accounting for physical activity, suggesting that exercise may not fully offset the potential risks of prolonged sitting.

The experts explained that when people sit for hours, their calf muscles—which help pump blood back toward the heart—remain relatively inactive, slowing venous circulation.

A separate study of 11 adolescents with thrombosis found that all reported at least four hours of daily screen exposure, averaging approximately six hours. Eight had DVT in the legs, two had pulmonary embolism and one had subclavian vein thrombosis.

Many also had inherited thrombophilia, a predisposition to blood clots. Researchers noted that prolonged screen-related inactivity may act as an additional trigger rather than the sole cause of thrombosis.

“The evidence showing a 24% higher VTE risk with higher sedentary exposure should make us take this issue seriously. A young age should not create a false sense of security, particularly when prolonged sitting is combined with other risk factors,” Dr. Grover said.

How Can You Reduce The Risk?

Experts recommend taking regular movement breaks during work, gaming and streaming sessions to avoid prolonged uninterrupted sitting.

“Just as smoking increases vascular and clotting risks, prolonged sitting can also increase the risk of blood clots. When a person remains seated for hours, the calf-muscle pump becomes inactive, venous blood flow from the legs slows down and blood can stagnate in the deep veins," said Dr. Bhupesh Garg, Senior Vascular and Endovascular Surgeon, Vascular Society of India.

The message should be simple: if you are going to spend hours on a screen, do not spend those hours completely still, the experts said.