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.

Delhi's AQI on Tuesday morning seemed to be doing somewhat better than Monday morning. The AQI has brought some relief to the residents who had been dealing with 'severe' pollution levels, with visibility being hit. As per Tuesday's AQI, according to Central Pollution Control Board (CPCB), Delhi's air pollution stood at 381 AQI as of 6.30 am. This has placed the air quality in the 'very poor' category.

While it has become a habit of many to check AQI before stepping out of the house, how many of us actually understand what AQI really means?

Recently, Delhi's Chief Minister Rekha Gupta claimed that AQI and temperature are the same. At a summit hosted by a news channel, Delhi CM Gupta referred to AQI as "temperature".

Such statements could further lead to misconceptions, and add to everyday confusions. Health and Me is breaking down what AQI really means and why is it not the same as temperature.

How Air Quality Index Work And What It Means

As the Delhi CM claimed that AQI is like temperature and could be "measured using any instrument", is not true. Though it is understandable why such comparisons may have been drawn as you can easily check the AQI report on your phones, like we do with temperature.

However, in real sense, AQI or the air quality index is a tool used for communicating outdoor air quality and health. The AQI includes six-color coded categories, each of which corresponds to a range of index values. The higher the AQI value, the greater the level of air pollution and the greater the health concern.

Air quality is made of dust and small particles like PM2.5 and PM10, along with gases like nitrogen dioxide from car exhaust, sulphur dioxide from factories, and carbon monoxide from vehicles. The levels are measured through specialized machines. In India, the standard of the machines are carried out by the Central Pollution Control Board or CPCB.

What Makes Delhi So Polluted?

As per a review of Delhi's air quality from 1990 to 2022, published in Sustainability (MDPI), an open access journal, these are the following sources of Delhi's Air Pollution:

• Transports emit around 10 to 30% of pollution. This includes all road, rail, and aviation modes and combustion of petrol, diesel, and gas.

• Dust make up another 10 to 30% of pollution. Dust from resuspension on the roads and construction activities.

• All industries, including small, medium, and large industries, including power plants and brick kilns lead to 10 to 30% of pollution.

• In summers, all residential activities, including cooking, lighting, and heating activities lead to 10% of pollution, whereas in winter, it makes up for 30%.

• Waste burning, including residential sides and landfills leads to 5 to 15% of pollution.

Power plants from outside the city leads to less than 7% of pollution. Dust storms contribute to less than 5% of pollution. Agricultural residue burning, which is a seasonal source of pollution leads to less than 3% of pollution, whereas firecrackers, another seasonal source, leads to less than 1% of pollution.

Earlier in November, the Public Health Ontario's (PHO) data revealed that Ontario and Canada as a whole could be in a "very tough" flu season this year, thanks to the Influenza A or the flu A. The PHO data revealed a 1.8% rise in influenza cases in the last week of October. Now, amid the influenza A outbreak, 3 children have died from the same in Ottawa and Eastern Ontario region.

Influenza A: Can Flu Kill People?

As per the infectious physician at the Johns Hopkins University Center for Health Security, as reported in Scientific American, "Dying from the flu is not like dying from a bullet or a black widow spider bite. The presence of the virus itself isn't going to be what kills you. An infectious disease always has a complex interaction with its host.”

Once the virus enters someone's body usually via their eyes, nose, or mouth, the influenza virus begins hijacking human cells in the nose and throat to make copies of itself. This triggers a strong response from the immune system, and sends battalions of white blood cells, antibodies and inflammatory molecules to eliminate the threat.

T cells work by targeting and destroying virus-infected tissue, especially in the respiratory tract and lungs where the infection usually settles. In most healthy adults, this response clears the virus and leads to recovery within days or weeks. In some cases, however, the immune reaction becomes excessive, damaging large areas of lung tissue and impairing oxygen delivery to the blood, which can cause hypoxia and, in severe cases, death.

What Is Influenza A?

As per the National Institutes of Health, US, influenza viruses that contains single-stranded RNA that are classified into three types: A, B, and C. Type A and B cause annual epidemics and even pandemics, while type C is a less common disease.

As per the Centers for Disease Control and Prevention (CDC), Influenza A viruses are descendants of the 2009 H1N1 pandemic virus that emerged in the spring of 2009 and caused a flu pandemic. These viruses, scientifically called the "A(H1N1)pdm09 virus," and more generally called "2009 H1N1," have continued to circulate seasonally since 2009 and have undergone genetic and antigenic changes.

Influenza A(H3N2) viruses also change genetically and antigenically. Influenza A(H3N2) viruses have formed many separate, genetically different clades in recent years that continue to co-circulate.

It is a fast-spreading respiratory virus responsible for seasonal flu outbreaks and, at times, global pandemics. It changes quickly through genetic shifts, which makes new strains harder to predict and control. The virus is grouped based on surface proteins called hemagglutinin and neuraminidase, with H1N1 and H3N2 among the most common strains in circulation. It spreads mainly through coughs, sneezes, or close contact and often comes on suddenly, causing fever, cough, body pain, and extreme tiredness. In some cases, it can lead to serious complications, especially in vulnerable groups.

Influenza A: Common Signs And Symptoms

• Fever or chills
• Dry cough
• Sore throat
• Headache
• Fatigue
• Some people could also get symptoms like diarrhea or vomiting, especially kids.

The symptoms usually appear 1 to 4 days after exposure and could linger for a week.

Hemoglobin is a key protein found in red blood cells. Its main job is to carry oxygen from your lungs to the rest of your body. When hemoglobin levels drop, the body may not receive enough oxygen to function well. Low hemoglobin can happen for several reasons, including health conditions, blood loss, or gaps in nutrition.

What Is Low Hemoglobin?

Hemoglobin is the oxygen-carrying protein in red blood cells. Adequate hemoglobin levels are essential for keeping organs and tissues properly supplied with oxygen. Without enough of it, the body begins to struggle to meet its basic energy needs.

Low hemoglobin is usually identified through a blood test. It is most often measured as part of a complete blood count (CBC), which checks different components of the blood, including red and white blood cells and platelets, as per Healthline.

While exact reference ranges can vary slightly between laboratories, healthy adult hemoglobin levels usually fall within the ranges listed below. These values are different for babies, children, and teenagers.

Normal Hemoglobin Count in Grams per Deciliter (g/dL) | Normal Hemoglobin Count in Grams per Liter (g/L)

Adult Males: 13.8–17.2 | 138–172

Adult Females: 12.1–15.1 | 121–151

Any reading below these ranges in adults is considered low hemoglobin and suggests that oxygen delivery in the body may be reduced, as per Mayo Clinic.

Is Low Hemoglobin Ever Dangerous?

Low hemoglobin is not always an emergency. In many cases, it develops gradually and can be managed with treatment. That said, very low levels can be dangerous. A hemoglobin level below 5.0 g/dL has been linked to serious complications, including heart failure and even death. Levels under 6.5 g/dL may be considered life-threatening and require urgent medical care.

What Causes Low Hemoglobin?

One of the most common reasons for low hemoglobin is anemia. Anemia occurs when the body does not have enough healthy red blood cells. The most frequent type is iron-deficiency anemia, which develops when the body lacks enough iron to produce hemoglobin.⁵

Other forms of anemia include pernicious anemia, which occurs when the body cannot properly absorb vitamin B12, and hemolytic anemia, where red blood cells are destroyed faster than they are produced.¹

Low hemoglobin can also be caused by:

• Blood loss or internal bleeding
• Certain cancers, including leukemia, lymphoma, multiple myeloma, and cancers that spread to the bone marrow
• Chronic kidney disease
• Deficiencies of folate or vitamin B12
• Hypothyroidism
• Liver disease
• Poor nutrition or malnutrition
• Myelodysplastic syndrome (MDS)
• Sarcoidosis
• Sickle cell disease and other inherited blood disorders
• Systemic lupus erythematosus
• Thalassemia, a genetic condition that reduces hemoglobin production
• Excess fluid in the body
• Cancer treatments such as chemotherapy and radiation can also lower hemoglobin levels, particularly in adults over the age of 65.

What Does Having Low Hemoglobin Feel Like?

Some people with mildly low hemoglobin may not notice any symptoms at first. Others may begin to feel unwell as levels drop further or remain low over time.

Common signs and symptoms include:

• Feeling dizzy or lightheaded, sometimes fainting
• Muscle weakness
• Ongoing fatigue or low energy
• Pale or washed-out skin
• Frequent headaches

How Is Low Hemoglobin Treated?

Treatment depends entirely on what is causing the low hemoglobin. A healthcare provider will first identify the underlying reason before recommending treatment.

Possible treatment options include:

Blood transfusion: If hemoglobin is low due to heavy blood loss, a transfusion may be needed to restore levels quickly.

Vitamin supplements: When nutritional deficiencies are the cause, iron, folate, or vitamin B12 supplements are often prescribed. Hemoglobin levels usually begin to improve within six to eight weeks.

Intravenous (IV) therapy: In cases where iron or B12 levels need to be raised rapidly, IV infusions may be recommended.

Bone marrow transplant: This may be required when low hemoglobin is linked to certain cancers or bone marrow disorders.

If a long-term illness is responsible, managing that condition becomes the key part of treatment, alongside monitoring hemoglobin levels regularly.