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.

A Himalayan zoonotic disease, which is transmitted by mite bites, known as Scrub typhus, is re-emerging. However, the attention and recognition to its threat remains poor. A Mongabay report noted the life of Maya Rai, 38, from Dajeeling, who works throughout the day. Her packed schedule does not allow her to stop working. When there is a febrile illness, it is "just another fever".

However, one monsoon, the fever hit her hard, while she thought it will pass too with some rest. She felt too weak to work. She received no clear diagnosis at the local Public Health Center (PHC), and was sent home with just painkillers. However, her condition did not improve. She experienced fever with cough, nausea, breathlessness and discomfort. Being a wage worker, she missed seven days, which meant no money for a week. She was finally taken to a private hospital in town, hours away from her village and the rapid test confirmed 'scrub typhus'.

This is an infectious disease caused by a bacterium Orientia tsutugamushi. Maya was prescribed antibiotics and was able to survive. However, there are many cases where this febrile fever is treated like any other fever, until it is too late. Many cases arise much later in front of a medical healthcare provider, when complications like acute respiratory distress, liver inflammation, kidney failure, and multiorgan dysfunction syndrome (MODS) have already happened.

Another case is from rural west Sikkim, where a 35-year-old Ganga Chhetri also had similar symptoms. However, by the time she was diagnosed, her organs were already critical. Ganga was also breastfeeding her two-year-old child and caring for her four-year-old.

Re-emergence of Scrub Typhus

The disease is locally known as kira le toke ko bimari, which literally translates it as a disease from an insect bite. This is re-emerging in the Dajeeling-Sikkim region of the Indian Himalayas, and is a public health concern in India. The cases have been reported across the country in India, as well as in other Southeast Asian countries. This affects one million people annually around the globe.

Scrub typhus was once confined to the Asia-Pacific’s ‘Tsutsugamushi Triangle’, a geographic stretch from northern Japan to Russia and northern Australia. Today, while this has changed, the disease still poses threat to many, including those living in the Himalayan region.

What Is Scrub Typhus And How Does It Spread?

It is an acute, potentially fatal, rickettsial infection that is caused by Orientia tsutsugamushi and transmitted by larval mites (chiggers) in rural areas.

At its core, scrub typhus in humans is associated with four interconnected elements: small mammals, particularly rats, tiny parasitic mites, the bacterium Orientia tsutsugamushi, and the environment they inhabit together. The disease is spread specifically by the larval stage of trombiculid mites, commonly known as chiggers. Only the larvae transmit the infection, passing it to humans through their bite.

These chiggers feed on the blood of small mammals such as rats, which play a key role in sustaining mite populations. Rats can also carry Orientia tsutsugamushi and pass the bacteria to mites that feed on them. In contrast, the nymph and adult stages of the mite, typically found in soil and vegetation, do not spread the disease.

Humans become infected when they enter areas infested with mites or environments with high rat populations, allowing infected chiggers to shift from rodents to people. The likelihood of such spillover events increases when rodent numbers grow, mite populations expand, or human contact with rats intensifies.

Factors such as land use changes, shifting weather patterns, natural disasters, deforestation, rapid urbanization, and increased garbage accumulation can create conditions that favor rodent and mite proliferation, thereby raising the risk of disease transmission.

Priyanka Chopra and Nick Jonas, we all know them as a power couple. However, there are moments that have broken them and they both have talked about it. This was the moment of their daughter Malti Marie Chopra Jonas' birth.

On February 4 episode of the Jay Shetty Podcast, Jonas, 33, opened up about his daughter's birth. "She came to the world under sort of very intense circumstances, which I have not really talked about ever. She came out, she was one pound and 11 ounces, and purple basically. These angels at the NICU kind of resuscitated her in that moment, got her taken care of really quickly, and intubated and everything else."

Also Read: Shingles Can Strike More Than Once, Vaccination Offers Protection, say experts

In fact, recently a video has been circulating of Priyanka Chopra Jonas talking about the premature birth of her daughter too. She described this period as "tough" and said that it was extremely hard on her. She also called Malti a "miracle baby".

On the Jay Shetty podcast, she revealed that the couple were forced to announce her birth, whereas they wanted to wait till her health gets better. They had put everything on halt and visited the NICU every single day. "We received a text saying that her (Malti) birth would be out in the newspapers, if we don't, they are going to put it in within three hours. So we were kind of forced into announcing her birth because we wanted to control our own narrative. We weren't ready. We didn't know what would happen with her or how she would be."

Malti's Premature Birth

Priyanka shared that she was informed about her premature delivery in the 27th week. This is what made her completely "shut down". She also recalled sitting in front of the fireplace for nine hours and was not able to process the situation.

Like Jonas, Priyanka too noted that Malti was purple at birth and required immediate NICU attention. She also said that the nurses' fingers were too big for her small mouth. She recalled feeling "numb" at that time.

However, Jonas shared that Priyanka and him "had a lot of tough conversations day in, day out about caring" for Malti. He also appreciated his wife's strength on handling the situation. "The way in which she handled it was so inspiring to me, and you know, allowing for those days to be tough, but to be tougher for our little girl was the focus."

Malti received six blood transfusions and gained weight in the hospital. After nearly three and half months, she was able to go home.

Priyanka reveals that in her house there is a "big mandir" with "a large Shiv Ji murti". This is where everyone sat as a family and she cried not out of fear, but out of gratitude. "Gratitude that she survived, that she was home, that she chose us, and that we were able to make it happen. IVF is tough."

Read: What Parents of Premature Babies Must Know About the NICU, According to a Neonatologist

What Parents Of Prematurely Born Babies Must Keep In Mind?

Health and Me had earlier spoken to Dr Sanjay Wazir, Medical Director, Neonatology and Pediatrics at Motherhood Hospitals, Gurugram who pointed out that Neonatal Intensive Care Unit or the NICU may seem overwhelming, however, it must be seen as a sanctuary of healing.

"In the NICU, premature or unwell newborns receive specialized medical attention, constant monitoring, and compassionate care from expert hands. Here, the mother and the baby are well taken care of. This will help the baby lead a healthy life. Hence, NICU care is important for all the premature or unwell babies," he says.

What Happens Inside The NICU?

The doctor explains that the NICU provides a controlled and nurturing environment where babies can grow stronger outside the womb. "It helps maintain their body temperature, supports breathing, and ensures proper nutrition through feeding tubes if necessary," he says.

Every machine in the NICU is for a specific purpose, right from oxygen support to heart rate monitoring, ensuring that each baby receives precisely what they need. Parents often find comfort knowing that the experts in the NICU are constantly watching over their child’s progress, explains the doctor.

The doctor points out that parents are essential part of the NICU journey. "Your touch, your voice, and your calm presence can help your baby feel safe and comforted," he tells to all the parents. However, what is extremely important is to maintain hygiene guidelines, staying involved in daily care, and communicating regularly with the doctors and nurses to "strengthen your bond and confidence as caregivers." The doctor says that during this time, the mother will also be taught about Kangaroo care, which is skin-to-skin contact that helps the mother bond with her baby.

Cases of scrub typhus, one of the deadliest infections affecting multiple organs, or even death, have significantly increased from previous year. Once relevant to people working in fields, new studies show it migrating to human settlements.

In 2025, Andhra Pradesh reported 1,566 scrub typhus cases, and nine suspected deaths, according to data from the Integrated Health Information Platform, Integrated Disease Surveillance Programme (IDSP-IHIP) on 8 December. Followed by Karnataka with 1,870 cases, Tamil Nadu 7,308 cases, and Telangana, 309 cases.

What Is Scrub Typhus?

Scrub typhus, also known as bush typhus, is a bacterial infection caused by bacteria infection, caused by bacterium Orientia tsutsugamushi. It is spread through bites of infected larval mites, Chiggers.

Most cases of scrub typhus occur in rural areas of Southeast Asia, Indonesia, China, Japan, the Indian subcontinent and northern Australia. Until now, it was believed that chiggers only lurked in the tall grasses of remote paddy fields or dense forests. Due to this, it is commonly known as "farmers' disease", only confined to the fields.

However, new PLOS study data revealed the opposite. The study is led by researchers from Christian Medical College (CMC) Vellore and international collaborators and suggests that the bulk of infections are now even occurring within human settlements.

The study monitored over 32 000 people in Tamil Nadu, which led to the conclusion that agricultural activities, long considered the primary risk factor, were only weakly associated with the disease in high-prevalence areas.

How are Human Settlements A Prime Factor?

Risk for scrub typhus is significantly higher for those living in clustered houses or homes with fewer rooms. If the micro environment around the residence is unmaintained, gardens are patched, or even the damp corners of a courtyard, it could lead to breeding ground for the mites and the rodents that carry Chiggers.

Who Is At Most Risk?

It was once believed that working-age men were the most affected, but the new study tells otherwise. According to the new data, women over 60 are at the highest risk of infection.

As women spend most of their time in and around the home, due to household work, from the kitchen to the laundry, these activities are now the primary cross point of contact with infected mites.

What Is the Risk Factor Of Infection?

As initial symptoms of infection, such as fever, headache, and muscle pain, are the same as viral flu or dengue, many first seek help from untrained practitioners or local pharmacies.

By the time they reach the hospital, the disease has already progressed to severe complications like acute respiratory distress syndrome (ARDS), Kidney failure, or Meningoencephalitis, which is inflammation of your meninges and brain at the same time, a life-threatening condition.

Not only this, the researchers revealed that nearly 10 percent of affected households exceed 25 percent of their income in the treatment.

For severe cases, the cost of treatment can be up to approximately INR 110,000, a staggering sum for rural and peri-urban families earning a fraction of that monthly.

Prevention

• Do not let the grass grow tall around your house
• Tightly maintain kitchen gardens and remove piles of wood or debris where rodents (the primary hosts for mites) might nest.
• As chiggers are usually found close to the ground, do not sit directly on the grass or soil. Use chairs or mats. For children, make them wear socks and full- length trousers while playing in the yard.
• If you notice a small, dark, cigarette-burn-like mark, it is usually left behind by mites. It is most likely "Eschar". It is an important critical clue. As the bite is painless, it often goes unnoticed.
• Do a thorough skin check for an eschar, especially in warm, moist areas like the armpits, groin, or behind the knees.

Early intervention is necessary, as if a fever lasts more than two days, don't just treat it as "seasonal fever".

Consult a qualified doctor and specifically ask about scrub typhus. Infection can be treated with doxycycline common antibiotic, in the early stages. The case fatality rate in this study was 1.5 percent, hospital based studies in South India have previously recorded mortality rates as high 30 percent when treatment is delayed