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.

Yoga may offer benefits beyond flexibility and stress relief, with doctors from the All India Institute of Medical Sciences (AIIMS), New Delhi, ahead of International Yoga Day 2026, saying that studies have shown the ancient practice could help improve outcomes in conditions ranging from unexplained male infertility to autoimmune disorders such as rheumatoid arthritis and fibromyalgia.

This year marks the 12th International Day of Yoga, observed annually on June 21. The theme for this year, "Yoga for Healthy Ageing," highlights the practice's potential to enhance mobility, balance, flexibility, and mental well-being, helping people maintain health and independence at every stage of life.

Yoga And Unexplained Male Infertility

Dr. Rima Dada, Professor at the Laboratory for Molecular Reproduction and Genetics, Department of Anatomy, AIIMS Delhi, told HealthandMe that cases of unexplained male factor infertility have increased in recent decades. In many of these cases, standard sperm parameters appear normal, but sperm cells are affected by oxidative stress and DNA damage.

According to Dr. Rima, studies conducted in men with unexplained infertility found that regular yoga practice reduced oxidative stress, decreased sperm DNA damage, and normalized the expression of genes critical for early embryonic development. These benefits, however, generally require consistent practice for more than six months.

Also read:International Yoga Day 2026: 10 Desk Yoga Poses That Can Undo Hours of Sitting

Dr. Rima described yoga as an “art of living” that combines

• mindful asanas,
• relaxation techniques,
• pranayama,
• meditation,
• healthy nutrition,
• adequate sleep.

According to her, such lifestyle measures may improve sperm DNA quality, motility, and overall reproductive health while potentially reducing the burden of genetic and epigenetic disorders in future generations.

Yoga And Rheumatoid Arthritis

Dr. Rima also highlighted the role of yoga in rheumatoid arthritis, an autoimmune disease that typically affects small joints initially and may later involve larger joints as well as organs such as the lungs, heart, and brain.

She described yoga as an "art of living" that should be incorporated into daily life through mindful asanas, relaxation techniques, pranayama, meditation, a whole plant-based diet, and adequate sleep.

Read More: Trying to Quit Tobacco? Yoga Could Improve Your Chances, Suggests Study

She added that research has shown that yoga, including asanas, pranayama, and meditation, can help reduce inflammatory cytokines linked to swelling, pain, stiffness, and joint damage. Pranayama practices such as Anulom Vilom, Bhramari, and Ujjayi were highlighted as particularly beneficial.

For people living with rheumatoid arthritis, she recommended beginning with gentle loosening exercises under the supervision of a trained yoga therapist and avoiding strenuous postures during acute flare-ups. Pranayama and meditation, she said, may help reduce inflammation, improve emotional resilience, and support longer periods of remission.

Yoga As An Adjunct Therapy

Dr. Uma Kumar, Head of the Department of Rheumatology at AIIMS New Delhi, explained that autoimmune diseases occur when the immune system mistakenly attacks the body’s own tissues and organs.

Conditions such as rheumatoid arthritis, systemic lupus erythematosus, Sjogren’s syndrome, myositis, antiphospholipid antibody syndrome, and IgG4-related disease can significantly affect quality of life, often leading to pain, fatigue, depression, sleep disturbances, and reduced mobility.

“All these components are improved by yoga,” Dr. Kumar said.

However, she stressed that yoga should be viewed as an adjunct to medical treatment rather than a replacement. According to her, yoga may complement conventional therapies by improving sleep, flexibility, mental well-being, lifestyle habits, and overall quality of life.

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Yoga's Benefits For Fibromyalgia

Dr. Renu Bhatia, Additional Professor in the Department of Physiology at AIIMS Delhi, said supervised yoga therapy may help improve physical activity, sleep quality, muscle blood flow, pain levels, and flexibility in people with fibromyalgia.

The experts described fibromyalgia as a condition characterized by widespread pain despite normal laboratory findings and the absence of obvious inflammation.

Dr. Renu noted that studies have shown six weeks of supervised yoga intervention can reduce tender points while improving sensory symptoms, brain function, and neural excitability. However, she cautioned that yoga should be practiced under supervision, as excessive joint movement may aggravate symptoms in some patients.

Sickle cell disease (SCD) is one of India’s most pressing inherited blood disorders, with an estimated 1 in 86 births among tribal and disadvantaged groups affected.

Despite advances in diagnostics and treatment, families continue to face uncertainty, stigma, and limited awareness.

Why Genetic Counselling Matters

A crucial distinction often overlooked is between sickle cell trait (SCT) and sickle cell disease. Carriers with one gene are usually healthy but can pass the trait to their children, while those with two defective genes live with lifelong complications.

When both parents carry SCT, each child has a 50% chance of inheriting the trait and a 25% chance of developing the disease. This is why genetic counselling must be recognized as an integral part of the care continuum.

Genetic counselling provides clarity on inheritance patterns, transmission risks, and reproductive choices. In high-prevalence communities, it serves as a preventive strategy. Counselling is equally vital after diagnosis, guiding parents on managing complications, navigating education and employment, and preparing adolescents to understand their carrier status before marriage.

Also read: Sickle Cell Disease: Why India Must Add Curative Treatment to Meet Its 2047 Elimination Goal

The Role of National Sickle Cell Anemia Elimination Mission

India’s National Sickle Cell Anaemia Elimination Mission (2023) prioritizes screening in high-burden states, with clear objectives:

• to provide affordable, accessible, and quality care to all SCD patients;
• reduce prevalence through awareness campaigns and premarital genetic counselling;
• conduct targeted screening and early detection using validated Point-of-Care Testing (POCT) kits;
• ensure holistic management through primary, secondary, and tertiary healthcare facilities;
• enable community involvement by linking patients with social security schemes.

Embedding counselling into primary healthcare ensures every positive test is followed by culturally sensitive, professional support.

Sickle Cell Disease: Tackling Stigma and Misconceptions

SCD is often misinterpreted as a curse or lifestyle issue, leading to stigma and blame. Such misconceptions not only deepen emotional distress but also delay timely medical intervention. Genetic counselling reframes the condition as a scientifically understood, inherited disorder, shifting the narrative from superstition to evidence-based care.

By normalizing dialogue, it drives empathy-centered healthcare conversations and strengthens community resilience.

SCD is also often misinterpreted as a curse or lifestyle issue, leading to stigma and often blame. Such misconceptions not only deepen emotional distress but also delay timely medical intervention.

Genetic counselling reframes the condition as a scientifically understood, inherited disorder, shifting the narrative from superstition to evidence-based care. By normalizing dialogue, it encourages empathy-driven healthcare conversations and strengthens community resilience.

Sickle Cell Disease: Why Genetic Counseling Is Important

Sickle cell care cannot stop at diagnosis; counselling must accompany patients across every life stage from childhood through adolescence, marriage, pregnancy, and adulthood. This continuity transforms care from reactive to proactive, ensuring families are never left alone in their journey.

At the same time, awareness, education, and collaboration among clinicians, policymakers, patient groups, and communities are essential. Genetic counselling serves as the bridge between science and lived experience, enabling informed choices, reducing stigma, and promoting compassionate care that strengthens both families and the wider community.

(The author is Dr Manisha Madkaikar, Director - ICMR-National Institute for Research on Blood and Immune Disorders – Mumbai).

In today's busy routines, acidity is a common complaint — almost one in five people take an acidity tablet. Most of us don't think twice before reaching for one.

A little heartburn after dinner, some burning in the chest, a feeling of heaviness - one pantoprazole tablet and the problem seems solved. And for many people, it quietly becomes a habit that they continue taking for weeks and sometimes even months.

Why This Matters for Cancer Patients

In limited doses and under medical guidance, an acidity tablet is largely considered safe. But this is not true for everyone. For patients undergoing immunotherapy for kidney cancer, that small tablet may be doing more than just controlling acidity.

A patient comes in for follow-up. The scans look encouraging. Treatment is going as planned. And then, almost casually, they mention that they have been taking pantoprazole every morning for acidity for several years without proper medical advice. Most patients genuinely don't think it's important enough to mention. But newer research suggests it might be.

The Gut Microbiome Connection

It is because the digestive system holds trillions of bacteria collectively called the gut microbiome. Once thought to help only with digestion, they are now known to be deeply connected to the immune system.

Our gut bacteria are a training ground for our immune army. If that ecosystem is disturbed, the immune response may not be as effective as we want it to be.

This is where these proton pump inhibitor medicines, such as pantoprazole, omeprazole, and rabeprazole, can also alter the balance of gut bacteria by suppressing acid production in the stomach. This seemingly minor change may have a stronger effect.

What Does Research Show

A study published in the Journal of Cancer Research and Clinical Oncology looked at patients with advanced kidney cancer receiving immunotherapy, comparing those who regularly used PPIs with those who did not.

The difference surprised many oncologists. Patients who were not taking daily PPIs had a progression-free survival of around 9.7 months, and for regular PPI users, it was around 6.4 months. When overall survival was measured, the gap was even wider — about 14.6 months for daily PPI users compared with roughly 30 months for non-users.

And this is not a one-off finding. When researchers pooled fourteen studies covering 6,716 cancer patients on immunotherapy, PPI users still carried roughly a 39 percent higher relative risk of death and a 29 percent higher risk of the cancer progressing. A larger 343-patient kidney cancer study echoed the very same direction. Although not every analysis agrees on how big the effect is — some of the most recent data suggest it may be more modest — but the arrow keeps pointing the same way.

An Important Caveat

One important caveat runs through all of it: these are observational studies, not controlled trials. PPI users are often older and have more illnesses, which can independently worsen outcomes, so the pill cannot yet be said to cause the difference.

A finding this consistent cannot simply be ignored. It deserves to be part of the discussion before treatment starts. He added that PPIs are also recognized, quite separately, as an occasional cause of kidney injury — one more reason their use is worth reviewing rather than continuing on autopilot.

Don't Stop Your Medication Suddenly

At the same time, stopping acidity medicines overnight is not the solution. When patients suddenly stop PPIs, they can experience severe rebound acidity. That's why any change should happen only after discussing it with the treating doctor.

Simple Steps Patients Can Take

A practical piece of advice would be to carry a complete list of medicines to every oncology appointment — not just cancer medicines, but everything.

Prescription drugs, over-the-counter tablets, supplements, and even home remedies. Sometimes alternatives are available. Sometimes simple dietary changes help — smaller meals, less spicy food, avoiding late-night eating. Simple measures, but often effective.

Remember, cancer treatment is not only about the drug. It is also about everything happening around the drug. The food people eat. The medicines they take. Their daily habits. Small things can sometimes influence big outcomes.

(Dr Veenoo Agarwal, Head of Medical Oncology at Shalby International Hospital, Gurugram)