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.

Many people associate allergies with outdoor pollution, dust, or seasonal changes. However, doctors are increasingly seeing another factor contributing to allergic reactions: the indoor environment.

Allergies Worsening Even When You Stay Indoors?

Over the last two years, there has been a definite increase in patients coming in with respiratory issues. Many people who develop asthma-like symptoms later in life often ask, “Doctor, we hardly go out. How can we develop these problems?” The answer often lies in the indoor pollutants and allergens that go unnoticed in everyday life.

Most people spend nearly 90% of their time indoors — at home, in offices, malls, cars, and other climate-controlled spaces. While staying indoors may feel safer than being exposed to outdoor pollution, it can sometimes mean longer exposure to allergens trapped inside. These may trigger a runny nose, itchy eyes, cough, sinus congestion, asthma, rashes, or hives.

Many indoor irritants are invisible. Common sources include dust mites, pet dander, fungi, chemical vapours from cleaning products, air fresheners, mosquito repellents, and cooking smoke. Poor ventilation or inadequate air exchange allows these allergens to remain trapped for long periods. In many urban homes, indoor air quality can sometimes be worse than outdoor air.

Primary Indoor Irritants That Trigger Allergies

Smoke is one of the most overlooked indoor triggers. Incense sticks, dhoop, and agarbattis, which are part of daily routines in many homes, generate smoke and fine particulate matter that can irritate the airways. Cooking smoke can also be harmful, especially when food is fried, roasted, or cooked with heavy spices. Mosquito coils are another common source. In short, any form of indoor smoke can affect respiratory health, particularly in people who already have allergies or asthma.

Dust is another major concern. Many households practise dry dusting every day, but this can push dust particles back into the air and worsen symptoms in those with dust allergy or asthma. Wet mopping, wet wiping, or vacuum cleaning are safer alternatives.

Air conditioning is another factor. AC filters that are not cleaned regularly can become clogged with dust, pollen, and fungal spores, which keep circulating indoors. Closed rooms with little fresh air make this worse. If anyone in the family smokes or uses vaping products, these are well-established indoor pollutants that can significantly impact respiratory health.

Modern interiors can add to the problem. Fabric sofas, heavy curtains, carpets, and excess furniture increase the surface area where dust collects, and dust mites thrive. Plug-in mosquito repellents, strong floor cleaners, aerosol sprays, room fresheners, smoking, and vaping indoors are also important for indoor pollutants.

How To Tackle It?

Lifestyle changes after the pandemic have worsened exposure. Work-from-home routines, online classes, longer screen time, and reduced outdoor activity mean people spend more hours in closed spaces with limited fresh air.

Small steps help - open windows when outdoor air quality allows, let sunlight in, wash bed linen and curtains regularly, clean AC filters, avoid dry dusting, check damp areas for mold, reduce incense smoke, mosquito coils, and strong fragrances, and air out stored clothes before use.

Pollution remains a concern, but it is no longer the only culprit. The way we live indoors today is quietly shaping our respiratory and immune health. Recognizing these hidden triggers early can prevent allergies from becoming a long-term lifestyle problem.

By Dr Sameer Bansal, Pulmonology Respiratory Medicine Specialist, Apollo Hospitals, Bangalore

The monsoon season brings a respite from scorching heat, but it also increases the risk of contracting various diseases and infections. Apart from common illnesses like dengue, malaria, and typhoid fever, states and cities in India also face the risk of specific infections based on climate, geography, infrastructure, parasites, and sanitation.

Prevention Of Gut Infections During Monsoon

In a conversation with Health and Me, Dr Aabha Nagral, Director of Gastroenterology, Chief Hepatologist and Liver Transplant Physician at Jaslok Hospital and Research Centre, explained how rains can lead to contamination of water sources, increasing the spread of fecal-oral infections.

As the monsoon has set in, several states in India, including Maharashtra, Kerala, Karnataka, and Tamil Nadu are facing an alarming rise of gastrointestinal infections. Heavy rains are one of the reasons behind contamination of drinking water and food supplies.

Bacteria, viruses, and parasites in food and drinking water often result in a spike in diarrhea, vomiting, food poisoning, and gastroenteritis. Increased bacterial growth in warm and humid conditions, combined with poor food hygiene and subpar sanitation facilities, contributes to the rise of gut infections in urban areas like Mumbai.

Recent research and seasonal trends also support the increase in these infections. A 2025 review published in Frontiers in Tropical Diseases found that tropical infections like cholera, giardiasis, and enterotoxigenic E. coli infections disrupt the gut microbiome by reducing beneficial bacteria and increasing harmful microbes.

Faecal-oral diseases and infections like hepatitis A and E mainly cause jaundice, whereas gastroenteritis presents with diarrhea. On the other hand, typhoid can present with high fevers.

Dr Nagral says, “You can have various other diseases during the rains by what we call faecal-oral contamination of water. So, we know that during the rainy season, the water gets contaminated more easily. So, make sure that you are boiling your water for at least 10 minutes, or if you are using RO or any other means of sterilising the water. Also, make sure your systems are well serviced regularly so that the water you drink is well filtered and sterile.”

The water source is among the first to get contaminated during the monsoon. Dr Nagral suggests these tips to prevent gut infections.

• Avoid foods and drinks that contain water in different forms

• Avoid street-side juices during monsoons to prevent gut infections

• Avoid any drink that contains ice or that has been sitting out for a long time

Dr Aabha Nagral also spoke about avoiding consuming street foods as they are more likely to be contaminated during the monsoon.

She explains, “Also, I would say avoid all street food because that’s how diseases spread. They spread through flies which sit on the faeces, which are often unfortunately there on our roadside, and then onto your food or drinks.”

Common Monsoon Diseases

Monsoon diseases can vary across India depending on rainfall, flooding situation, sanitation, and local mosquito populations. Some of the most common ones include dengue, malaria, typhoid, and diarrheal diseases. These infections affect nearly every state during the rainy season.

Specifically, Kerala, Maharashtra, Karnataka, and Tamil Nadu have seen a higher likelihood of leptospirosis following floods.

Odisha, Chhattisgarh, and Jharkhand continue to record high malaria cases, while flood-prone states like Odisha, Assam, and Bihar are vulnerable to water-borne illnesses, including cholera and gastroenteritis.

A recent study has found proof that an autoimmune reaction is triggering certain neurological symptoms seen in some long COVID patients. The study, conducted in healthy mice, found that the mice exhibited symptoms mirroring those of affected patients to some extent.

What is Long COVID?

While it has been a long time since the end of the COVID pandemic, its effects continue to linger even today. Several patients who contracted COVID continue to suffer.

Autoantibodies Behind Long COVID Symptoms?

A US NIH-funded research group, directed by Drs. Akiko Iwasaki and Tamas L. Horvath of the Yale University School of Medicine and Dr. David Putrino of the Icahn School of Medicine at Mount Sinai recently found that autoantibodies could be triggering these neurological symptoms in some long COVID patients.

Antibodies, in a healthy person, help fight infections. In patients with autoimmune diseases, these antibodies target the body’s own tissues. They are called autoantibodies.

The study also discovered that patients who had these autoantibodies are more likely to experience similar symptoms. For example, people with autoantibodies are more likely to face symptoms like loss of taste and smell. They are also more likely to experience nausea and joint pain.

The Mouse Experiment

The researchers conducted the study by transferring purified antibodies from long COVID patients into healthy mice. It was discovered that the mice developed the following changes that resembled the donors' symptoms:

• Antibodies from patients with chronic pain caused increased pain sensitivity

• Antibodies from patients with dizziness caused balance problems

• Antibodies from fatigued patients reduced treadmill endurance

The recent breakthrough in long COVID research has brought the healthcare industry one step closer to personalizing care for those affected.

Dr. Putrino says, “Our study now shows that if you are in a subgroup of Long COVID patients who have autoantibodies circulating in your body, this is a quantifiable sign that you may be a good candidate for these drugs.”

Long COVID Patients More Likely To Develop Heart Diseases

The study finds that cardiovascular diseases were more common among long COVID patients. It concluded that 11.9% of those with long COVID have CVD compared to 6.8% without this condition.

Specifically, it further revealed that long COVID was associated with a higher risk of chest pain and heart attack, but not coronary heart disease and stroke.