It was a typical morning. My mother was getting ready; this was her usual routine: bustling around the house. When she suddenly stopped and shouted, blood was oozing from her nose. As kids, my siblings and I were terrified. We scrambled to help, but it wasn't until later that we learned the cause of that alarming moment: high blood pressure. That day was our first lesson in the silent yet powerful effects of hypertension. Nosebleeds, or epistaxis, are common, and nearly everyone experiences at least one in their lifetime.

While most are minor and often caused by dry air or irritation, some can signal underlying health concerns. One recurring question is whether high blood pressure causes nosebleeds or is merely coincidental.

Where Exactly Does a Nosebleed Occur?

The nose is covered by a rich plexus of small blood vessels, making it prone to bleeding. Most nosebleeds are anterior in origin, occurring at the front of the nose, and are relatively benign. They often occur because of irritants such as dry air, frequent nose-blowing, or trauma.

On the other hand, posterior nosebleeds are caused by a source that is located deeper within the nasal cavity. They are less common but more severe, as the blood tends to flow backward into the throat, making them more difficult to control. Common causes of posterior nosebleeds include trauma, medical conditions, or high blood pressure.

Connection Between Nosebleeds and High Blood Pressure

Hypertension is the condition whereby the pressure of blood against the arterial walls is consistently too high. Over time, this may damage the fine blood vessels in the nose, causing them to rupture more easily.

Significant studies have shown a strong relationship between hypertension and severe cases of nosebleeds necessitating urgent care. A certain study showed that patients diagnosed with high blood pressure had 2.7-fold increased chances of having nosebleeds that were not slight.

However, it should be noted that mild hypertension by itself does not cause nosebleeds. Nosebleeds are more likely to happen during a hypertensive crisis when the blood pressure suddenly rises to above 180/120. A hypertensive crisis can also have other symptoms such as a severe headache, shortness of breath, and anxiety. Therefore, it is considered a medical emergency.

Why Does Hypertension Increase the Risk?

Chronic hypertension makes the walls of blood vessels weaker and less elastic, which easily causes them to tear. In the nose, this is especially vulnerable because the blood vessels are close to the surface. Sudden surges in blood pressure, such as in a hypertensive crisis, can cause tears in these weakened vessels, resulting in nosebleeds.

While hypertension is a contributing cause, nosebleeds occur infrequently as the only manifestation of high blood pressure. This makes regular monitoring for blood pressure all the more crucial, as hypertension has the reputation of being the "silent killer" since people often do not present symptoms until the disease has run its course.

Other Causes of Nosebleeds

• Dry Air: Cold weather or house heating dries out membranes that line the nose, hence susceptible to cracking.
• Trauma: Blows in the nose, nose picking or excessive nose blowing can traumatize blood vessels.
• Intrinsic Disease: Liver disease and kidney disease and drug therapy that affect clotting such as blood thinners enhance the risk of nose bleeding.
• Foreign Bodies: Children especially tend to insert objects up their noses, which can be irritating and bleed.
• Allergies or Infections: Chronic nasal inflammation resulting from allergies or colds causes irritation to the nasal mucosa.

Managing Nosebleeds at Home

For most nosebleeds, you can manage them yourself at home:

1. Sit up and lean slightly forward to prevent swallowing blood.

2. Press your nostrils together for at least 10 minutes.

3. Use a cold compress on the bridge of your nose to constrict blood vessels.

4. If the bleeding continues, use a nasal decongestant spray.

Consult a doctor if the bleeding persists beyond 20 minutes, is heavy, or follows a head injury.

Preventing Nosebleeds

Preventive measures can decrease the incidence of nosebleeds:

• Use a humidifier to maintain moisture in the air.
• Apply saline sprays or gels to keep nasal passages hydrated.
• Avoid nasal trauma by being gentle when blowing your nose.

For patients with hypertension, managing blood pressure is the best way to minimize the risk of complications. A combination of lifestyle changes, such as maintaining a healthy diet, regular exercise, and prescribed medications, can help keep blood pressure in check.

When to Worry About Nosebleeds

Most nosebleeds are harmless, but they can sometimes be signs of an underlying health condition. In adults with high blood pressure, frequent or severe nosebleeds should never be ignored. A health provider should be consulted in order to rule out any serious conditions and ensure appropriate treatment.

Regular check-ups, a healthy lifestyle, and awareness about the relationship between nosebleeds and high blood pressure would go a long way to protect your health. Indeed, prevention is always better than cure.

Epistaxis and hypertension. Post Graduate Medical Journal. 1977

According to the World Health Organization (WHO), hernia repair is one of the most important surgical procedures, with published estimates suggesting that around 20 million hernia repairs are performed each year globally. For most patients, recovery is smooth, steady, and uncomplicated. It is one of the most performed surgeries globally, and for most patients, recovery is steady. Mild pain, swelling, and discomfort during the first few weeks are usually part of the healing process and improve with time. However, when a wound refuses to heal, pain continues to worsen, or there is persistent discharge from the surgical site, these symptoms should never be ignored.

Although complications following hernia mesh repair are uncommon, delayed recognition can make treatment far more challenging. One of the more serious complications occurs when the surgical mesh erodes into surrounding organs, particularly the intestine, leading to infection, chronic wounds and, in rare cases, an entero-cutaneous fistula, an abnormal connection between the bowel and the skin.

A recent patient cases highlights why early medical attention is so important. An umbilical hernia surgery performed years ago led to complications for a 32-year-old lady from Bengaluru. What was supposed to be a simple procedure turned out to be a prolonged medical ordeal for the patient. The injury could not be healed completely, and as time went by, the patient developed persistent drainage from the injury site, which made her daily tasks increasingly difficult.

A further assessment revealed that the mesh had eroded into the bowel and caused an entero-cutaneous fistula. At this point, the surgery was going to be much more complicated than a regular hernia repair. This is a particularly challenging case for surgeons, requiring very detailed planning, since there is always a high probability of finding dense scar tissue and adhesions, which made it impossible to properly detach the bowels.

The surgery was done as a complicated laparoscopic revision operation, during which the adhesions were freed; both meshes were removed, and the part of the bowel that was affected by them was recovered, and the abdominal wall structure was restored. The postoperative period went quite well, and the man was relieved of all the discharge, and his intestinal function was restored within a few weeks.

Such cases may be quite rare, but they send a clear message – never neglect prolonged symptoms, thinking that they are just a part of the recovery process. Hernias are easily repaired, but if healing goes slowly, it is always better to do additional tests to avoid complications.

Signs that might arouse concern about the patient’s condition after the hernia surgery:

1. The wound is not healing properly while waiting for the healing process.

2. The wound is continuously oozing secretions.

3. An unexpected increase in pain in contradiction to the healing phase.

4. Body temperature is above normal or other symptoms of infection are present.

5. An unexpected formation or swelling has appeared in the surgical area.

It should also be mentioned that not everyone suffering from pain after the operation faces a serious complication. However, those with ongoing or worsening health conditions should not perform self-treatment and wait for the issues to resolve.

Advances in minimally invasive laparoscopic surgery have made it possible to successfully manage many complex hernia mesh complications while reducing pain, hospital stay, and recovery time. At the same time, successful treatment depends not only on surgical expertise but also on timely diagnosis and appropriate follow-up.

The goal is not to create anxiety around hernia surgery. Mesh repair remains a safe and effective treatment for most patients. The key message is simple: listen to your body. If your recovery process takes much longer than expected, or there is something that appears abnormal, you should consult with a doctor right away. There are instances where timely action prevents complications and allows for a full recovery.

By Dr. Kiran K. J., Senior Consultant, Department of General, Laparoscopy, GI, Bariatric & Robotic Surgery, Apollo Hospitals, Bannerghatta Road, Bengaluru.

A globally introduced, newer-generation cataract lens was used in India for the first time, enhancing patient’s recovery journey and treatment outcome

Since her diabetes diagnosis 5 months ago, Mrs Vani Vaish had done what doctors tell every diabetic to do - turn up regularly for an eye exam because diabetes can quietly damage the blood vessels and nerves in your eyes. The eye damage often gives no major noticeable warning until real damage has been done, which is exactly why the screening isn't optional, symptoms or not.

How A Routine Eye Check-Up Revealed A Cataract

During one of these routine visits, Mrs Ahuja complained of blurring in her vision and increasing glare around headlights and streetlamps at night. Her ophthalmologist identified a cataract. For people living with diabetes, regular eye examinations can be important for more than monitoring diabetic retinopathy, as diabetes can also increase the risk of developing cataracts and may lead to their occurrence at a younger age.

The treatment options were discussed with her in detail, including the potential benefits and limitations of the technology, individual variations in outcomes and the considerations involved in selecting a presbyopia-correcting lens. Following a detailed evaluation, Mrs Ahuja underwent cataract surgery with implantation of the Clareon PanOptix Pro, a newer-generation trifocal intraocular lens that had recently become available in India.

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What The Newer-Generation Lens Is Designed To Do

The significance of the technology lies in what it is designed to change in cataract vision correction. Trifocal lenses split incoming light to provide vision across near, intermediate and distance ranges. The newer-generation optical design used in PanOptix Pro is intended to use available light more efficiently and reduce light scatter — an advancement that aims to support better quality of vision across different distances while addressing some of the visual compromises associated with multifocal lens technology.

Because no two patients have the same visual demands, expanding access to newer technologies plays a critical role in modern care. Our role is to evaluate each patient’s unique needs and ensure that the most suitable and advanced treatments available actually reach the patient, giving them every opportunity for a better quality of life.

The procedure marked the first use in India of the globally introduced Clareon PanOptix Pro lens. For MRs Vaish, the outcome of the treatment has matched what she hoped for. She reports clear vision and no floaters or other visual disturbances. Her recovery has also been smooth, and she has not even needed the temporary protective glasses in the days following the procedure.

Why Regular Eye Exams Matter For People With Diabetes

Her case highlights two important aspects of modern eye care. Regular eye examinations are important especially for people living with diabetes. A routine screening intended to monitor retinal health can also help identify other conditions affecting vision, including cataracts.

It also demonstrates that access to advanced medical technologies can significantly expand treatment possibilities and enhance the patient's recovery journey. When newer innovations are combined with careful clinical evaluation and personalised decision-making, they can help doctors move beyond a one-size-fits-all approach to treatment and offer patients options better suited to their individual visual needs and lifestyles.

By Dr Sudipto Pakrasi, Chairman, Ophthalmology, Medanta Mediclinic Defence Colony

Major sporting events such as the IPL, FIFA World Cup, Olympics and Asian Games have become powerful platforms for brands to promote unhealthy products through sponsorships, endorsements and social media.

In an exclusive interview with HealthandMe, Dr. Robin Ireland, public health activist and honorary research fellow at the University of Glasgow, UK, discussed how the commercialization of sport has helped normalize junk food, sugary drinks and alcohol, and its impact on children “who may not always recognize the difference between advertising and fact”.

“It's an awful lot healthier to play sport than to watch it, because sport is now associated with junk food, sugary drinks and alcohol,” he said.

Excerpts from the interview

Q: How does unhealthy-product marketing in sport affect children? And do “zero sugar” or “alcohol-free” labels change that?

Dr. Robin: I think it has a huge impact. Worldwide, we're seeing major problems with overweight and obesity from a very early age, as well as type 2 diabetes. Many causes of cancer and heart disease are preventable through healthier lifestyles, yet we're constantly being promoted things that aren't good for us.

Alcohol companies often promote alcohol-free products. In India, I'm aware of surrogate marketing, where alcohol companies produce packaged drinking water using the same brand, colourway and distribution networks. So it's hardly surprising these brands are normalised to young people. Even where alcohol advertising is banned, alcohol can still be heavily promoted.

A lot of this comes down to what we eat, but very specifically what we drink — alcohol, sugary drinks and now energy drinks. For most of us, we're much better off drinking water.

Q: Does elite sport give sugary drinks, fast food and alcohol a “health halo”?

Dr. Robin: Sport presents glamour and excitement, and children look up to big performers and superstars who often promote products they probably don't consume themselves because they're not good for sporting performance. Yet their names and images are used to create that excitement and, as you described, a health halo.

Brands want to be associated with that healthy image. Athletes think that if they want to perform like a Sachin Tendulkar or another superstar, they need a sports drink or energy drink. And of course, they don't. But that's what the brands are trying to do.

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Q: Cristiano Ronaldo famously pushed away a soft drink and asked for water. Where should athletes and sports bodies draw the line on unhealthy-product sponsorships?

Dr. Robin: It was one of those iconic moments, wasn't it, where he pushed the sponsored bottle away and said, “Agua.” The line is difficult for sportspeople. I don't necessarily want to blame them. It's the rules set by the governing bodies. I've just looked up the IPL sponsors, and you immediately find cola brands across the teams and on shirt branding. It's everywhere.

So it's hard to criticise individual athletes. Some earn huge sums of money, so perhaps it would be nice if one or two took the Ronaldo position. There are also athletes who, because of their religion, will not drink alcohol or associate themselves with alcohol products.

But I think it's the governing bodies. How have we allowed this to happen? This deluge of sugary drinks at a time when we have high levels of type 2 diabetes and children living with overweight and obesity. It's really wrong.

Q: What can sport learn from the ban on tobacco advertising when regulating alcohol, sugary drinks and ultra-processed foods?

Dr. Robin: The short answer is I believe yes, but I think we're quite a long way from that. I grew up with tobacco advertising all over the place, particularly in cricket and F1. I remember F1 saying, “We're not going to be able to survive without tobacco advertising.” They were basically mobile tobacco packet ads with Marlboro ads on the cars going past; it was completely absurd. And we've got rid of it.

That was partly through the World Health Organization Framework Convention on Tobacco Control. We simply have to take these things much more seriously.

I get very cross with people who say we couldn't survive without this. I love sport, but I think we probably could. Across pretty much all sport, there is a lot of money coming in from other places. We don't have to be dependent on junk food and alcohol. It's completely inappropriate.

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Q: Are food labels enough, or should sports advertising also be restricted?

Dr. Robin: Labelling helps, but it's only part of the solution. Not everybody has the time or resources to read labels, and people will still buy what they can afford and what is accessible.

In the UK, we've had some advertising controls, but as we saw with tobacco, sport does its own thing. Sport seems to be allowed a free ride.

In India and the UK, sport is huge, and politicians are in love with it. Advertising, particularly for junk food, is everywhere. Sport will find a way around restrictions unless it's specifically mentioned. In India, you're not allowed to have alcohol advertising, but sport seems to have found a way around it.

We need to take regulation more seriously and recognise that people will find ways around it. It has to be robust to work.

Q: What would effective regulation of unhealthy-product marketing in sport look like?

Dr. Robin: We could be talking about that a long time, so let's come up with one or two manageable measures. I don't think sugary drinks companies or alcohol should be named in event titles. I also don't think brands should appear on the front of shirts or uniforms.

You can also have rules around advertising when events are broadcast. In the UK, we've taken steps around gambling. In the English Premier League, gambling brands have been removed from the front of shirts, and gambling ads can't be shown during the advertising break in the middle of games. It's a limited move, but it's a start.

The IPL has a cola sponsor and a packaged drinking water sponsor that happens to be an alcohol brand. We need to get away from that. It's inappropriate. The Asian Games, interestingly, has 62 sponsors. As far as I can tell, only one is particularly unhealthy, and I'd rather they weren't there either, because it's an official hydration partner that is yet again a sugary drink. But it shows there are people willing to support sport outside these industries, and we perhaps need to look at them more.