Diabetes insipidus (DI) is a rare medical condition that disrupts the body's ability to regulate water, resulting in excessive thirst and an unusually high volume of urine. This condition affects the kidneys' ability to concentrate urine and causes individuals to produce between 3 and 20 quarts of dilute, colourless urine daily, compared to an average of 1 to 2 quarts. It is pertinent to note that DI is not related to diabetes mellitus, which disrupts the body's insulin production.

Types Of Diabetes Insipidus

This condition results from damage to the hypothalamus or pituitary gland, which impairs the production or release of vasopressin, a hormone responsible for water retention. When vasopressin levels are inadequate, the kidneys fail to conserve water, leading to excessive urination. It can result from Brain injuries or surgeries, tumours, infections or inflammation and aneurysms.

Nephrogenic Diabetes Insipidus

This type occurs when the kidneys fail to respond to vasopressin, causing excessive fluid loss. Common triggers include chronic kidney disease, and electrolyte imbalances, such as high calcium or low potassium levels. Additionally, medications like lithium

and urinary tract blockages can also cause Nephrogenic DI.

Gestational Diabetes Insipidus

A rare condition seen only during pregnancy, this occurs when the placenta produces an enzyme that breaks down vasopressin or increases prostaglandin levels, reducing kidney sensitivity to the hormone. Symptoms of this are usually mild and often resolve postpartum but can recur in future pregnancies.

Symptoms And Warning Signs

• Severe thirst, often leading to the consumption of over a gallon of water daily
• Frequent urination (polyuria), sometimes exceeding 20 quarts per day
• Nighttime urination and bed-wetting
• Weakness, muscle pain, and preference for cold drinks

In severe cases, dehydration may develop, manifesting as fatigue, dizziness, dry mouth, confusion, nausea, or fainting. Infants and children with DI may exhibit crankiness, poor feeding, slow growth, fever, or vomiting.

Causes And Risk Factors

DI stems from issues with vasopressin production or response. Central DI arises from damage to brain structures, while nephrogenic DI relates to kidney dysfunction. Risk factors include:

- Genetic mutations affecting water regulation

- Certain medications like diuretics or lithium

- Metabolic disorders that alter calcium or potassium levels

- Brain injuries or surgeries

Diagnosis And Testing

Diagnosing DI involves a combination of medical history, physical exams, and specialized tests:

- Urinalysis: Evaluates urine concentration and glucose levels to distinguish DI from diabetes mellitus.

- Blood tests: Check electrolyte, glucose, and vasopressin levels.

- Water deprivation test: Measures changes in weight, blood sodium, and urine concentration during fluid restriction.

- MRI: Detects abnormalities in the hypothalamus or pituitary gland.

- Genetic screening: Identifies inherited risk factors.

Although DI is rare, affecting about 1 in 25,000 people, early diagnosis and targeted treatment can significantly improve quality of life. Researchers continue to explore its causes and treatments to better support those living with this challenging condition.

For many long-term cannabis users, the usual jokes about the munchies feel far removed from reality. Over recent years, emergency rooms have reported a steady rise in regular smokers arriving with sudden bouts of severe stomach distress that leave them curled up and unable to function. What makes it more troubling is that these episodes return several times a year, often leaving both patients and clinicians unsure of what is going on.

Scromiting: What is Cannabis Hyperemesis Syndrome (CHS)?

The source of the problem is cannabis hyperemesis syndrome (CHS), a difficult condition marked by unrelenting nausea, strong abdominal cramps and repeated vomiting that can occur four or five times an hour, according to the Cleveland Clinic.

What Is Scromiting?

Symptoms usually appear within a day of cannabis use and can linger for several days. These episodes can be so overwhelming that emergency staff have adopted the term “scromiting,” a blend of screaming and vomiting that captures how distressing it can be.

Although cases have become more common, many healthcare workers are still relatively unfamiliar with CHS because it was only identified in recent years. This makes it easy to confuse with other illnesses such as foodborne infections or stomach bugs.

“A person often will have multiple emergency visits before the condition is correctly identified, which can be very costly,” said Dr. Beatriz Carlini, a research associate professor at the University of Washington School of Medicine who studies the health risks linked to cannabis. Once a diagnosis is made, managing the condition can still be a challenge.

There are no approved treatments at present, and many standard nausea medications fail to bring relief, explained Dr. Chris Buresh, an emergency medicine physician with UW Medicine and Seattle Children’s Hospital.

This often pushes doctors to try less common options, including Haldol, a drug usually used to manage psychosis. Some people experience temporary improvement from applying capsaicin cream to the abdomen, as the warming sensation can help lessen discomfort for short periods.

Hot baths and showers are another frequent source of relief. Many patients report staying in the bathroom for long stretches to calm their symptoms.

“That is often something that helps confirm the diagnosis for me,” Buresh said. “People say a hot shower is the only thing that brings any comfort, and they end up using all the hot water in the home.”

Scromiting Recovery Challenges

Once the worst phase passes, long-term improvement is not always straightforward. Because CHS comes and goes, some cannabis users assume an episode was caused by something else and continue smoking, only to fall ill again, according to UW researchers.

Even for those who accept the diagnosis, quitting cannabis can be difficult due to dependence, which prolongs the cycle of nausea and vomiting, Carlini said. The only known cure is to stop cannabis use entirely.

Researchers still do not know the exact biological cause of CHS. The leading idea is that years of heavy cannabis use overstimulates receptors within the endocannabinoid system, which may disrupt the body’s usual control over nausea and vomiting, as outlined by the Cleveland Clinic.

Why this affects certain users and not others remains unclear. “We do not yet know if it is tied to wider access to cannabis, higher THC levels, or something else entirely,” Buresh said.

“There seems to be a point at which people become vulnerable to this condition, and that point varies from person to person,” he added. “Even small amounts of cannabis can trigger vomiting once someone crosses that threshold.”

A study released earlier this year by George Washington University researchers examined 1,052 people with CHS to learn more about potential risk patterns.

The findings showed that those who began using cannabis at younger ages were more likely to return to the ER with hyperemesis episodes. Many reported daily use and long-term consumption, with 44 percent using cannabis regularly for more than five years before symptoms began.

CHS is not limited to adults. Data shows that emergency visits among American adolescents have increased more than tenfold between 2016 and 2023. While overall rates tend to be higher in states where recreational cannabis is legal, the sharpest year-to-year rise in adolescent CHS cases has been recorded in states where recreational use is still against the law.

People who rely on a commonly prescribed medicine may face a kidney-related side effect that needs medical attention. This drug is routinely used for high blood pressure and heart failure, and doctors often prescribe it after a heart attack. In 2024 alone, it was issued 34.8 million times. Beyond lowering the risk of future heart attacks, strokes, and kidney problems, it also improves survival when taken for heart failure or after a cardiac event. But which medicine raises this concern?

NHS ‘Kidney’ Warning For People Taking Ramipril

Ramipril (sold under names such as Altace, Vostally, Tritace, Cardace) belongs to a group of medicines called ACE inhibitors. Doctors use it to treat a range of heart and blood vessel problems because it relaxes and widens the arteries, easing pressure on the heart and reducing blood pressure. It is usually taken as a tablet, capsule, or liquid. Although ramipril is helpful for many people managing long-term blood pressure or heart issues, it can occasionally trigger side effects. Some reactions may be strong enough to require urgent medical help.

Is Ramipril a Beta Blocker?

Ramipril is not a beta blocker. It belongs to a group of medicines called ACE inhibitors. Both ACE inhibitors and beta blockers are used for blood pressure and heart problems, but they do not work the same way.

How Ramipril Works (ACE Inhibitor)?

Ramipril stops the body from making a certain enzyme known as ACE. When this enzyme is blocked, the body produces less angiotensin II, a hormone that normally tightens the blood vessels. With less of this hormone active, the blood vessels stay more open, which lowers blood pressure and helps blood move through the body more easily.

Ramipril Side Effects

Not everyone who takes ramipril will feel unwell, yet it can cause problems for certain users. NHS advice notes that long-term use may reduce how well the kidneys work. For that reason, anyone on ramipril may need routine blood tests so that their doctor can keep an eye on kidney function.

More common side effects, which may affect more than one in a hundred people, include:

• A light skin rash
• Blurred eyesight
• A dry or tickly cough
• Diarrhoea
• Vomiting
• Headaches
• Feeling faint or dizzy

Ramipril can also lead to more serious issues, though these are rare. These include:

• Kidney concerns shown by blood in urine, little or no urination, or puffy ankles
• Possible bone marrow problems such as unusual tiredness, frequent bruising, dizziness, or fever
• Yellowing of the skin or eyes, which can suggest a liver problem
• Severe pain in the stomach

In rare situations, ramipril can cause a serious allergic reaction known as anaphylaxis. The NHS advises seeking emergency help if this happens. Signs include:

• Swelling of the lips, throat, or tongue
• A tight throat or trouble swallowing
• Sudden confusion
• Fainting and not waking up normally
• Blue, grey, or pale skin, lips, or tongue
• Very rapid breathing or difficulty breathing

More information about ramipril is available on the NHS website. Always speak with your doctor before beginning or stopping any prescribed medicine.

Every year on December 1, World AIDS Day reminds us that HIV continues to be a global concern, and in 2025 the focus is on "Overcoming disruption, transforming the AIDS response. Early testing and treatment are key to making that transformation real. The sooner HIV is detected and treated, the better the long-term health outcomes. India has made notable progress.

According to 2023 estimates, adult HIV prevalence is around 0.2%, and prevention and treatment programmes using medication continue to expand. Still, challenges remain: gaps in testing, delayed diagnoses, and interruptions in care persist—issues World AIDS Day 2025 urges us to address.

World AIDS Day 2025: Why HIV Diagnosis Is Important

HIV is still a very real health concern today. It can affect anyone, students, professionals, or those in stable relationships—especially if needles or syringes are shared or protection is not used.

Once HIV enters the body, it gradually weakens the immune system. If left undetected and untreated, it can progress to AIDS, leaving even minor infections dangerous. The good news is that this progression can be prevented. With early testing and proper treatment, people living with HIV can lead full, healthy, and normal lives.

Dr. R K Gattani, Senior Consultant Physician at Kailash Hospital & Heart Institute, Noida, says, "Early testing is an important form of self-care. Choosing to get tested shows you are taking responsibility for your health—it doesn’t mean something is wrong."

Meanwhile, Dr. Vaibhav Gupta, Senior Consultant in Internal Medicine, Critical Care, and Diabetology at Regency Health Kanpur, adds, "Detecting HIV early allows doctors to begin Antiretroviral Therapy (ART) straight away, keeping the immune system strong, preventing AIDS, and reducing transmission risk almost to zero. In a world where millions are diagnosed each year, early recognition is one of the strongest tools young Indians have to protect themselves and their partners."

What Is Modern Antiretroviral Therapy?

Today’s ART enables people diagnosed early to live long, healthy, and productive lives. It keeps the virus under control, safeguards the immune system, and dramatically lowers the chance of passing HIV to others. Early diagnosis also gives young people the knowledge to make safer lifestyle choices.

Dr. Aabid Amin Bhat, Medical Director at Ujala Cygnus Group of Hospitals, explains, "Encouraging open discussions, expanding access to youth-friendly testing, and fighting stigma are essential steps. When HIV is found early, it’s not the end; it’s the start of informed care, timely treatment, and a healthier future."

The challenge is that early HIV symptoms often look like common illnesses like fever, fatigue, sore throat, swollen lymph nodes, and rashes—which can be easily ignored. Without prompt testing, the virus may advance silently, making treatment more complex. Early testing also opens doors to preventive options like post-exposure prophylaxis (PEP), which can prevent infection if taken within 72 hours of potential exposure. Recognizing early signs and seeking confidential, judgment-free testing allows young Indians to stop HIV before it develops into AIDS, turning a potentially life-altering diagnosis into a manageable condition.

HIV prevention is simpler than many think. Basic precautions like using protection during intimate contact, avoiding sharing needles or items that could contact blood, and staying informed about your health—make a huge difference. Anyone who may have been exposed should immediately consult a healthcare professional for guidance. Above all, don’t hesitate to get tested, ask questions, or seek help. Taking care of your health is the most responsible and empowering way to protect your future. People living with HIV, when on proper treatment and taking necessary precautions, should not automatically be seen as a risk to others.

Education and awareness remain key. Safe practices, timely diagnosis, and access to treatment can transform HIV from a feared disease into a manageable condition, giving young Indians control over their health and future.