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.

Gastroesophageal reflux disease (GERD), commonly known as acid reflux, occurs when stomach contents flow backward into the esophagus, causing heartburn, regurgitation, chest discomfort, and sometimes chronic cough or hoarseness. This happens because the lower esophageal sphincter (LES), a muscle that normally prevents backflow, becomes weak or relaxes inappropriately, allowing acid to irritate the food pipe repeatedly. If left untreated, persistent reflux can lead to inflammation (esophagitis), ulcers, scarring, and in rare cases, pre-cancerous changes known as Barrett’s esophagus.

The global prevalence of GERD has been increasing in recent years, with around 14 % of adults worldwide affected according to recent meta-analyses. In India, community studies show notable rates, with higher prevalence in urban populations compared to rural areas and estimates ranging from about 8 % in some regions to higher figures in cities, reflecting shifting lifestyles. In Kolkata, according to Dr. Pradipta Sethy, Director, Gastroenterology, Manipal Hospital, EM Bypass and Mukundupur, the major patients are women, mostly pre-menopausal and menopausal, between the ages of 30-55 years. This rise can be attributed to several interconnected lifestyle and environmental factors.

One major contributor is dietary change. Traditional diets rich in fiber and whole foods are increasingly replaced by high-calorie, processed, and high-fat foods, along with frequent consumption of spicy and fried items. These foods can relax the LES and increase gastric acid production, making reflux more likely. In addition, habitual late-night meals followed by lying down soon after eating are common in urban settings and further promote reflux episodes.

Obesity and sedentary lifestyles are also important risk factors. Excess abdominal fat increases pressure on the stomach, forcing acid upward into the esophagus. Many adults with GERD in India and globally have overweight or central obesity, a trend growing alongside reduced physical activity. Stress and irregular eating patterns that accompany modern work life are additional contributors, often exacerbating symptoms and prompting unhealthy habits like caffeine or alcohol use, both of which can aggravate acid reflux.

Thankfully, GERD can often be managed effectively through simple lifestyle modifications. Eating smaller, more frequent meals and avoiding known trigger foods such as citrus fruits, chocolate, caffeine, and high-fat foods can reduce reflux episodes. Waiting 2–3 hours after eating before lying down and elevating the head of the bed during sleep helps keep acid in the stomach by using gravity to support digestion. Maintaining a healthy weight through regular physical activity reduces abdominal pressure, while quitting smoking and limiting alcohol intake supports LES function and esophageal health. Managing stress with techniques such as meditation or yoga further helps control symptoms by improving overall digestive function.

In conclusion, the rise of GERD in India mirrors global trends driven largely by dietary shifts, obesity, and modern lifestyle pressures. While medication is valuable for many patients, sustainable improvements often begin with these evidence-based lifestyle changes that address the root causes of acid reflux and improve long-term digestive health.

Rashes are common in children and can occur for many reasons. Most are harmless and settle on their own, but some may need medical attention. Knowing the warning signs can help parents decide when home care is enough and when to consult a doctor.

Why Do Rashes Happen?

Children’s skin is sensitive and can react to heat, friction, allergens, insect bites, irritants or infections. Common causes include heat rash, eczema, contact dermatitis, insect bites and viral infections such as chickenpox, hand-foot-and-mouth disease and roseola.

A rash can look worrying, but the child’s overall condition is often as important as the appearance of the rash itself.

When Home Care May Be Enough

If your child is active, reasonably comfortable, feeding and drinking well, and otherwise appears well, a mild rash can often be managed at home.

Home care may be appropriate when the rash:

• Is mild and limited to a small area
• Is not spreading quickly
• Causes only mild itching or discomfort
• Occurs without concerning symptoms
• Looks consistent with a known condition such as heat rash or eczema

Avoid applying multiple creams, powders, antiseptics or home remedies, as these may irritate the skin or make the rash harder to assess. Medicines or steroid creams should not be used without medical advice. Your paediatrician can recommend suitable treatment based on your child’s age, weight and the likely cause of the rash.

When Should You See a Doctor?

Seek medical advice if your child has:

• A rash with fever, particularly if the child appears unwell, unusually sleepy, less responsive or is becoming progressively worse
• A red or purple rash that does not fade or become lighter when pressed firmly with a clear glass, especially if the child has fever or appears unwell
• A rapidly spreading rash
• Large blisters, peeling skin or a painful/tender rash
• Signs of a secondary skin infection, such as increasing redness, warmth, swelling, pain or pus
• A new or unexplained rash in a newborn or young infant, especially if accompanied by fever, poor feeding or unusual sleepiness
• Unusual sleepiness, weakness, poor feeding or reduced drinking
• A rash that is getting worse, keeps recurring or does not improve with appropriate home care

Seek Emergency Care Immediately If

A rash is accompanied by:

• Difficulty breathing or swallowing
• Swelling of the lips, mouth, face or tongue
• Extreme sleepiness, marked weakness or a child who is difficult to wake
• Rapid deterioration in the child’s overall condition
• A concerning non-fading red or purple rash in a child who appears unwell

What Parents Should Remember

Most childhood rashes are temporary and harmless. However, it is important to look beyond the rash itself.

Note when the rash started, where it first appeared, whether it is spreading and whether your child has fever or other symptoms. A photo of the rash can also help your paediatrician understand how it has changed over time.

Trust your instincts. If your child seems unusually unwell, is getting worse or something simply does not feel right, it is always better to seek medical advice rather than waiting.

A Simple Rule for Parents

Home care may be enough if your child is well, active and comfortable. Seek medical attention if the rash is accompanied by significant illness, rapid worsening or any warning signs.

By Dr Navin Bhatia, Senior Consultant & HOD – Paediatrics & PICU, PB Health

India is facing a significant and growing cancer burden, with the latest National Cancer Registry Programme study estimating that the lifetime risk of developing cancer in the country is 11% — about one in nine people.

The 2025 study also found that India ranks second in Asia and third globally in cancer incidence.

SC Directs States To Notify Cancer

Around 17 states in India have already made cancer a notifiable disease, while the Supreme Court in August directed the remaining 19 states and Union Territories to comply with the requirement, aimed at enabling early detection and proper care of patients.

The petition before the court argued that the continued non-notification of cancer, despite its alarming and escalating burden in India, amounted to a grave abdication of the state's constitutional duty under Articles 14 and 21 of the Constitution. It said this denied uniform treatment to similarly situated citizens and undermined their fundamental right to health and a life of dignity.

The Supreme Court's order is legally binding on the remaining 19 states and Union Territories, which have until November 11, 2026, to comply with the directive.

By the deadline, the concerned administrations are required to transition cancer into a notifiable disease and formally submit their progress reports to the Supreme Court. States will also need to issue official Gazette notifications requiring public and private healthcare entities to report cancer cases and related data.

Why Cancer Notification Matters

Speaking to HealthandMe, experts said making cancer notifiable could strengthen cancer surveillance, improve data collection and support research and treatment planning.

Dr Karishma Kirti, Consultant Obstetrician & Gynaecologist, Jaslok Hospital, Mumbai, said cancer should be treated as a notifiable disease, but through a system different from the traditional notification process used for infectious diseases.

How Cancer Registration Can Help

Dr Kirti told HealthandMe that mandatory registration of cancer cases could help India understand cancer trends and generate more real-world data to guide research.

“Mandatory registration of cancer cases will in the future help in understanding trends, generating real-world data early, and guiding research. Most of the evidence-based medicine and treatment that we recommend comes from Western data and mandating cancer registration will help India generate its own data and understand the inherent characteristics of Indian cancers better.”

Notifying Cancer Could Strengthen Cancer Care

Dr Harit K Chaturvedi, CEO & Clinical Head, Apollo Oncology Network, said making cancer a notifiable disease could help improve cancer care and research as the country's cancer burden rises.

“No two cancers are the same and the disease cannot be fought in silos. As the burden of cancer cases is increasing, wherein India is projected to record 1.5 million cases in 2026, declaring cancer as a notifiable disease can enable better cancer care and research across India,” he told HealthandMe.

Chaturvedi said notification of cancer would also give impetus to the decades-old National Cancer Registry Program and enable proper and mandatory record-keeping of cancer cases, as seen in many developed nations.

“By making cancer a notifiable disease, we can ensure that all cancer cases are reported and documented accurately, enabling us to track cancer incidence, mortality, and survival rates.”

Importantly, he said, notification would also enable policymakers, healthcare providers and researchers to work with real-time data, which could help bring more awareness, strengthen prevention and early detection, and improve treatment outcomes and quality of life.