Have you ever been so tired that the moment you hit the bed, you feel like you are sinking in your mattress? Or did you ever feel your leg twitch in middle of your sleep? Did you feel like you moved your leg to prevent yourself from falling down? If yes, then you are in for a great read!

Why does this happen?

You are not alone, this happens to around 70% of the total population in some way or another. Although these are signs of sleep disorders, it can also happen to people who are otherwise healthy. Sleep disorder specialists believe that there are certain common triggers that leads to such a sensation.

Our brain is exceptional and sometimes when we dream, it makes us believe that we our part of the dream. And if you are falling from somewhere in your dream, chances are, you would feel like you are falling in real life. This experience is known as hypnic jerk, the movement of your muscle that helps you be safe from that fall, or the imaginary one.

What causes it? When we sleep, our bodies become paralyzed, but that does not mean that our muscle control is not totally off. Rather, a slow, dimmer switch. When the dim switch randomly is turned on, we get jerky movements in our sleep.

This involuntary muscle movement is also called myoclonus or hypnic myoclonus, that transitions as you shift from one sleep phase into another.

ALSO SEE: What is sleep paralysis?

What Could Cause It?

There are many theories on what might be causing it. One of them is that when you are at this stage of sleep, you are still not in deep sleep and your brain misinterprets it as wakefulness, however, at the same time your brain does not recognize your muscles to be moving. This is what leads your brain to send a message to your muscles to check-in. It is a way your brain tries to protect you.

Another theory is of course that of stress. When you are stressed, your mind might be racing, while your body is in stationary. This can also affect your sleep cycle and your sleep can be disrupted.

If you are on stimulant drugs or alcohol, it too can prevent you from achieving a good night sleep. If you have consumed too much caffeine then too your muscles can twitch to make you stay awake.

Furthermore, lack of sleep could also be the reason why your mind is used to staying awake even if your body really needs the rest.

Periodic Limb Movement Disorder

While the falling sensation in sleep is quite common, and happens to healthy people, a severe form is the Periodic Limb Movement Disorder (PLMD). PLMD is a repetitive cramping or jerking of legs during sleep. It is a movement disorder that happens only during sleep. It is called "periodic" because the movements are repetitive and rhythmic, which means it occurs in every 20 to 40 seconds. It is also often linked with restless legs syndrome, however, the two are not the same thing.

Restless leg syndrome on the other hand is a condition that involves strange sensations in the legs and arms while awake and an irresistible urge to move the limbs to relive the sensations.

What causes PLMD may be more severe things, including diabetes, iron deficiency, spinal cord tumor, spinal cord injury, sleep apnea, uremia, anemia, narcolepsy, or certain medications.

Fatty liver and liver damage are not identical. While fatty liver refers to a buildup of excess fat inside the liver cells, liver damage describes harm caused to the liver due to inflammation, scarring, toxins, infections, or any long-term disease.

What Is Fatty Liver?

The liver turns fatty, when the body stores too much fat in the liver. This can be caused due to obesity, insulin resistance, type 2 diabetes, high cholesterol- referred to as MASLD (Metabolic dysfunction associated Liver Disease). High consumption of alcohol or chronic hepatitis infection can also lead to fatty liver.

In many cases, fatty liver causes no obvious symptoms, especially in the early stages. Some people may feel tired or notice discomfort in the upper right side of the abdomen, but many often know about it incidentally- either during blood tests or through an ultrasound scan.

What Is Liver Damage?

Liver damage, on the other hand, can range from mild irritation to severe and permanent injury. The damage may be caused by viral hepatitis, alcohol misuse, certain types of medicines, autoimmune diseases, inherited conditions, or fatty liver that has turned serious.

Liver damage may be referred to inflammation, liver-cell injury, fibrosis, cirrhosis, or a reduction in the function of the liver. In short, fatty liver is one condition, while liver damage points to a wider range of liver diseases.

Also read: Healthcare In India No Longer A Privilege, Becoming A Right: PM Modi

How Are They Related?

The relationship between the two is important. Fatty liver does not always mean that the liver is badly damaged. Certain people have a simple fatty liver, where fat is present but there are little or no inflammation or scarring in the liver. This stage often improve with weight loss, a healthy diet, exercise, and a reduction in alcohol intake, if alcohol is a factor. However, in some people, fatty liver can progress.

When this fat buildup causes liver swelling and cell damage, it is called MASH (Metabolic Dysfunction-Associated Steatohepatitis) which can lead to an injury and the formation of scar tissue in the liver. Over a period of time, this can progress to fibrosis and, in advanced cases, cirrhosis. At this stage, the liver is damaged and may not be in a position to function properly.

Symptoms and Warning Signs

Symptoms also differ. Early fatty liver is often silent. More serious liver damage may cause jaundice, swelling in the legs or abdomen, easy bruising, severe fatigue, confusion, itching, or dark urine. These symptoms suggest the liver is under undue stress and needs proper medical management.

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Diagnosis

Doctors diagnose these conditions by taking note of the medical history, getting blood tests done, scans, and sometimes specialized tests or even a liver biopsy. Blood tests will show any signs of liver inflammation or liver dysfunction, whereas scans will reveal the presence of fat or scars on the liver.

Key Takeaway

The key message is this: fatty liver is not always severe liver damage, but it can damage the liver if left ignored. The earlier it is diagnosed, the better is the chance of stopping or reversing the problem. Healthy weight management, regular exercise, balanced nutrition, control of diabetes and cholesterol, and abstinence of alcohol are the important protective steps.

When to Seek Medical Advice

If someone has ongoing fatigue, yellowing of the skin, abdominal swelling, or abnormal liver tests, they consult a doctor at the earliest. Early attention can make a major difference in protecting long-term liver health.

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The process of becoming parents is one of hopes, anxieties, and numerous waits for many couples. Infertility does not only refer to a medical problem but is a psychological and sociological problem that can influence relationships, confidence, and overall psychological state of an individual. The World Health Organization states that about one out of six individuals experience infertility at some point in life.

Infertility Needs Couple-Based Evaluation

Infertility cannot be considered a problem for women only from the perspective of obstetrics and gynaecology. Infertility problems in women can be associated with ovulatory disorders, PCOS, endometriosis, blocked fallopian tubes, fibroids, decreased ovarian reserve, or declining quality of eggs due to the advanced age of the woman.

In men, infertility may relate to low sperm count, impaired sperm mobility or morphology. Correct diagnosis is the key point of developing the appropriate treatment program.

Also read: 'You Are Just Tired': When Postpartum Depression Goes Unnoticed At Home

IVF: A Scientific Pathway to Parenthood

With the emergence of in-vitro fertilization, known as IVF, people can now have children even if they do not possess the ability to conceive through natural means.

This technique is achieved through stimulation of ovaries, egg collection, fertilizing collected eggs using sperm in laboratory conditions, and implantation of a healthy embryo into the womb. Nonetheless, this method is not a simple one-time process but rather a medically guided journey. Every treatment is based on individual factors of the woman.

Embryology: The Silent Backbone of IVF

Embryology in the modern age has revolutionized the results of IVF procedures. Embryo selection can be done through procedures like ICSI, blastocyst culture, grading of embryos, cryopreservation and, in some cases, genetic screening to select healthier embryos.

ICSI is especially helpful in the case of male infertility, in which a single sperm is introduced into an egg.

Also read: Miles Apart, But Planning A Family Together: The Fertility Reality Of Long-Distance Marriages In India

Safer Pregnancy, Not Just Positive Pregnancy

The purpose of IVF is not just conception but the creation of a successful and safe pregnancy. In the past, many embryos were used to increase the chances of conception, but that caused complications with either twins or triplets. But now, because of better screening, fewer embryos can be transferred where appropriate, thus decreasing pregnancy risk. According to CDC figures, 37.5% of ART cycles ended in live-birth delivery.

The advances in IVF and embryology have revolutionized fertility treatments into an arena of hope and possibilities. With proper counselling, couples can embark upon their fertility journey with certainty. Being parents was once the dream of many people; however, with the advancements in the scientific field, science is now enabling many couples to fulfill this dream.

By Dr. Nisha Mangal, Senior Consultant - Obstetrics & Gynaecology, Cocoon Hospital, Jaipur

For most people, the arrival of monsoon brings welcome relief from the scorching summer heat. For physicians, however, it also signals the beginning of a season when managing chronic lifestyle diseases becomes significantly more challenging.

High humidity, fluctuating temperatures and a sharp rise in seasonal infections create conditions that can quietly destabilise diabetes, hypertension and heart disease, even in people whose conditions are otherwise well controlled.

Lifestyle diseases are often thought of as long-term conditions that progress gradually. Yet they are also highly sensitive to environmental changes. During the monsoon, the body works harder to regulate temperature and maintain normal circulation. High humidity reduces the body'sability to cool itself efficiently, increasing the workload on the heart. At the same time, sudden shifts between hot outdoor conditions and cold indoor environments can influence blood vessel function, leading to fluctuations in blood pressure. These physiological changes may seem subtle, but for individuals living with chronic illnesses, they can increase the likelihood of complications.

The season also brings a surge in viral, bacterial and mosquito-borne illnesses. Infections such as influenza, gastroenteritis, dengue, and fungal diseases are becoming more common, placing additional stress on the body. For people living with diabetes, even a relatively minor infection can upset blood sugar control. The body's response to illness triggers the release of stress hormones that increase blood glucose levels. In contrast, changes in appetite and food intake during illness may increase the risk of both hyperglycaemia and hypoglycaemia if medications or insulin are not adjusted appropriately under medical supervision.

Beyond infections, the monsoon often disrupts everyday routines that are essential for effective diabetes management. Reduced physical activity due to persistent rainfall, missed walks, and a greater tendency to indulge in fried, calorie-dense comfort foods can contribute to poor glycaemic control. Prolonged exposure to damp conditions, particularly from wearing wet or closed footwear for extended periods, also increases the risk of fungal infections and delayed wound healing—complications that people with diabetes are already more susceptible to. While these changes may appear routine, together they can make diabetes significantly more difficult to manage during the rainy season.

Seasonal changes equally influence hypertension, although the effects are often less obvious. Variations in temperature and atmospheric pressure can cause blood vessels to constrict or relax, leading to fluctuations in blood pressure. Dietary habits also tend to shift during the rainy season, with increased consumption of salty snacks, pickles, and processed foods, which contribute to sodium overload and fluid retention. Because hypertension frequently remains symptomless, many people assume they are doing well despite missing medicines or delaying routine blood pressure checks. Unfortunately, uncontrolled blood pressure often comes to light only after a serious complication such as a stroke, heart attack, or acute cardiac event.

By Dr. Manjeeta Nath Das, Associate Director – Internal Medicine, PB Health