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.

COVID-19 is not only a name but a terrible memory for the world, which made people stuck in their homes for months and caused thousands of deaths. Although after the advent of vaccines, normal life regained its pace, the impact of that turbulent time persists in everyday life. One example of a negative after-effect is the rising number of hip replacement surgeries among young Indians, which is, without a doubt, a worrying post-pandemic orthopaedic trend.

This very trend of rising cases of hip replacement surgeries is so serious that it was a major issue of discussion in the 2nd DELHI HIP 360 Conference, held at Crowne Plaza New Delhi. Where doctors reported a significant rise in cases of hip arthritis and avascular necrosis (AVN), a painful condition caused by disruption of blood supply to the hip bone, particularly among younger and middle-aged adults. The conference was organised by the Delhi Orthopaedic Association in association with the Indian Arthroplasty Association.

In the second edition of this conference, Dr. L Tomar, Organising Chairman of DELHI HIP 360 and Director, Department of Orthopaedics and Joint Replacement at Max Hospital, New Delhi, said, “We are observing 40% rise in hip replacement surgeries in younger people. Steroids played a life-saving role during the COVID pandemic, but indiscriminate or prolonged use in some patients has been associated with a rise in osteonecrosis and early degenerative changes in the hip joint." He also added that they are now seeing relatively younger patients coming with severe hip damage, collapse of the femoral head, and advanced arthritis requiring early hip replacement surgeries.

Dr. L Tomar further added, “India is witnessing a silent rise in hip disability due to a combination of post-COVID complications, obesity, sedentary lifestyle, trauma, alcohol consumption, and increasing life expectancy. Early diagnosis is critical because if AVN is detected in the initial stages, joint-preserving procedures may still be possible before destruction of the hip occurs.”

Dr. Karun Jain, Organising Secretary of the conference, said, “One of the biggest challenges with AVN is that patients often ignore early symptoms such as groin pain or stiffness, assuming it to be muscular pain. By the time they seek medical advice, the hip joint may already have undergone irreversible collapse. Awareness, timely MRI evaluation, and early intervention can help reduce disability.”

The conference has brought together leading orthopaedic surgeons, arthroplasty specialists, fellows, and residents from across India to deliberate on the latest advances in Total Hip Arthroplasty (THA), complex hip reconstruction, robotic-assisted surgery, rehabilitation, and management of post-COVID hip complications.

The experts at the conference emphasize that the AVN, which was thought of as a disease of the elderly, is no longer limited to a certain age bracket. It can affect young people as well due to the modern sedentary lifestyle. Thus, doctors at the conference are also expecting even greater demand for hip replacement surgeries.

World Thyroid Day is observed on 25 May every year. This day aims to spread awareness about thyroid disorders, their symptoms, and management options that can help women. However, one concern that continues to linger with respect to thyroid disorders is why they occur more often in women. Hormonal changes, lifestyle factors, and a higher risk of autoimmune conditions can increase the risk of thyroid problems in women. Yes, that’s right! Hence, women should ensure they go for timely health check-ups. Here, an expert highlights vital tips for women. Read on to know more about this and seek timely help. Remember, thyroid problems should not be left untreated at all.

In an interview with Health and Me, Dr Shruti Kotangale, Consultant Gynaecologist, Obstetrician, and Infertility Expert at AIMS Hospital, Dombivli, explained why thyroid problems are more common among women. Read here to know how gender makes a difference.

Why do thyroid disorders occur more often in women?

Thyroid disorders are rising among many women. The thyroid is a small gland in the neck, but it plays a critical role in controlling metabolism, energy levels, and maintaining hormonal balance. Women can suffer from thyroid problems because of frequent hormonal changes during puberty, pregnancy, and menopause. These changes can impact thyroid health. Lifestyle factors such as stress, poor diet, and lack of sleep can also worsen thyroid imbalance. Hence, women are at a higher risk of suffering from autoimmune conditions, where the body’s immune system attacks the thyroid gland.

Hypothyroidism vs hyperthyroidism

Conditions such as hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) are commonly seen in women. Hypothyroidism occurs when the thyroid gland is underactive. Symptoms can include tiredness, weight gain, dry skin, hair fall, constipation, feeling cold, a slow heartbeat, and low mood or depression. Hyperthyroidism occurs when the thyroid gland becomes overactive, and women may experience weight loss, a fast heartbeat, sweating, anxiety, tremors, irritability, frequent bowel movements, and even difficulty sleeping. Women are advised to seek immediate medical attention and manage these symptoms without any further delay.

How to manage thyroid disorders?

Thyroid disorders may be concerning, but they are manageable with appropriate care and management tips as recommended by experts. Both hypothyroidism and hyperthyroidism can be managed with timely diagnosis, regular screening, and taking medications as suggested by the doctor. It is also important to eat a balanced diet, exercise daily for at least 30 minutes, get sound sleep at night, and de-stress through yoga and meditation. This World Thyroid Day, the focus should be on awareness, regular check-ups, and taking small steps to stay healthy and manage thyroid problems. Moreover, follow the doctor’s advice and do not self-medicate, as doing so can be risky.

So ladies, this World Thyroid Day, make an effort to know more about this group of disorders that affects your gender more often than men. Be it fatigue, mood swings, or weight fluctuations, it is imperative to know the early warning signs of this condition in order to work towards a more preventive approach.

IBD or Inflammatory Bowel Disease is a growing health concern worldwide - particularly amongst young adults. The two main types of IBD are Ulcerative Colitis and Crohn’s disease. However, these can be confused because they share symptoms.

Some of these are abdominal pain, diarrhea, fatigue, and weight loss. They affect the digestive tract differently, thus also have different complications and treatment plans. It is important to understand these differences so that patients may seek out timely diagnosis and better disease management.

1. Different Parts of the Digestive Tract Are Affected

Ulcerative Colitis is limited to the colon and rectum. Inflammation begins in the rectum and spreads continuously upwards. In Crohn’s disease, any part of the digestive system can be impacted. Including the mouth, esophagus, stomach, small intestine, and colon. However, it is most commonly the small intestine that is involved in Crohn’s disease.

2. Inflammation Pattern is Different

In ulcerative colitis, inflammation is continuous. There are no healthy gaps in between the affected areas. Crohn’s disease causes patchy inflammation. Meaning, there are sections of healthy tissue known as “skip lesions”.

3. Crohn’s Disease causes more serious damage

Ulcerative colitis affects only the innermost lining of the bowel. Crohn’s disease, on the other hand, can involve all layers of the intestinal wall. This increases the risk of complications such as fistulas, bowel obstruction, and intestinal narrowing.

4. Symptoms May Look Similar, But Often Differ

Both conditions can cause diarrhea, abdominal cramps, fatigue, and unintended weight loss. However, bloody stools are more common in ulcerative colitis. Crohn’s disease may also cause mouth ulcers, severe nutritional deficiencies, and pain in the anal region.

5. Nutritional Problems Are More Common in Crohn’s Disease

Because Crohn’s disease frequently affects the small intestine, patients may struggle to absorb nutrients properly. This struggle results in anemia, a vitamin B12 deficiency, low iron levels, and weight loss.

6. Surgery Has Different Outcomes

Ulcerative colitis can be cured by removing the colon. In Crohn’s disease, surgery is used mainly to treat complications, but inflammation can affect another part of the digestive tract.

7. Smoking Affects the Diseases Differently

Smoking worsens Crohn’s disease. It increases the risk of flare-ups, complications, as well as repeat surgeries. However, Ulcerative Colitis does not show the same pattern. Some studies have found lower rates of ulcerative colitis among smokers. Although smoking is never recommended as a treatment because of its serious health risks.

8. Treatment Approaches

Both conditions are treated with anti-inflammatory medications, immunosuppressing drugs, and dietary changes. But in Crohn’s disease, often more aggressive and long-term treatment is required. This is because it can affect the deeper layers of the bowel and multiple parts of the digestive tract.