Scoliosis is a fairly common spinal condition that is most often detected during adolescence. Each year, nearly 3 million new cases are diagnosed in the United States, and most of these fall under idiopathic scoliosis, a form that typically develops during the teenage years without a clear cause. In many cases, structural changes in the spine go unnoticed by parents until they begin to show outward physical signs. Scoliosis and kyphosis are among the most frequently seen spinal disorders, both involving abnormal curvature of the spine.

Scoliosis refers to a sideways curve of the spine and is most commonly seen in children and teenagers, though it can affect people at any age. Congenital scoliosis, in particular, may not be visible at birth. It can remain hidden for years and often becomes noticeable during periods of rapid growth. What begins as a minor internal change can gradually turn into a clearly visible curve as a child enters puberty.

To understand this condition better, we spoke with Dr Saraswati Viswanathan, Consultant – Orthopaedics at Manipal Hospital, Kanakapura Road, who shared her insights.

What Is Scoliosis?

Scoliosis is a condition in which the spine curves from side to side, unlike the spine’s normal front-to-back shape. In many cases, the curve is mild and may not cause noticeable symptoms, but it can sometimes lead to back discomfort and changes in posture. The condition is most commonly diagnosed during adolescence. According to the Cleveland Clinic, treatment options may include physical therapy, the use of braces, or surgery, depending on the severity.

Symptoms Of Scoliosis

As noted by the Cleveland Clinic, scoliosis often does not cause obvious symptoms. However, when symptoms do appear, they may include:

• Back pain.
• Trouble standing straight.
• Weakness in the core muscles.
• Pain in the legs, or sensations such as numbness or weakness.

What Are The Types Of Scoliosis?

There are three main types of scoliosis:

• Idiopathic scoliosis: This is the most common form. The term “idiopathic” means that the exact cause is unknown. Research suggests it can run in families and may have a genetic connection.
• Congenital scoliosis: This is a rare condition caused by abnormal spinal development before birth. It occurs when the vertebrae do not form properly during early embryonic growth.
• Neuromuscular scoliosis: This type is linked to conditions that affect the muscles and nerves supporting the spine. It is often seen alongside neurological or muscular disorders such as cerebral palsy, spina bifida, muscular dystrophy, or after certain injuries.

How Can We Identify This Condition Early?

According to Dr Viswanathan, while a visible S-shaped or C-shaped curve is a well-known sign of scoliosis, one of the earliest indicators parents can look for at home is uneven shoulder height. If one shoulder consistently appears lower than the other, it may suggest an underlying spinal curve. Other signs to watch for include a noticeable hump on the back, uneven rib or chest appearance, or hips that look tilted or asymmetrical when the child is standing straight.

If you notice any of these changes, there is no need to panic, but it is important to take action. One simple screening method is Adam’s Forward Bend Test. Ask your child to bend forward at the waist and look for any unevenness in the shoulders or a raised area on one side of the back. Early screening and timely care can make a significant difference in managing spinal health and preventing the condition from worsening. Scheduling a visit with a pediatrician or orthopaedic specialist for proper physical and clinical evaluation can help rule out structural issues and ensure your child gets the right support as they grow into adulthood.

Last week, the Royal Pharmaceutical Society (RPS) advised the public to not use nasal decongestant for more than seven days. The guidelines said that it contains xylometazoline or oxymetazoline. Prolonged use of which could cause 'rebound congestion' or increase dependency on these sprays to breathe easily.

Recently, with the flu cases rising, flu-like symptoms, including nose congestion too have gone up. It is because of this reason, many are using nasal spray continuously, which could cause rebound congestion.

To understand this better, Health and Me spoke to Dr Pranita Bauskar, ENT, Apollo Spectra, Pune.

What Did The Doctor Say About Nasal Spray Usage?

Nasal sprays are widely used by many people to relieve a blocked or stuffy nose caused by colds or allergies. Dr Bauskar explained, "These nasal sprays are known to provide immediate relief. Using decongestant nasal sprays for more than 5 to 7 days could worsen the congestion and steal the piece of mind."

Read: Nasal Spray Warning Over 'Rebound Congestion'; Experts Say It Should Not Be Used For More Than 7 Days

What Does Rebound Congestion Mean?

Doctor says that as the nose becomes more blocked once the medication wears off, this creates a cycle of dependency. "Hence, it is necessary to limit the use of decongestant sprays to a few days only."

What Can Be Used Instead?

Dr Bauskar says, "you can try safer alternatives such as saline nasal sprays or rinses to keep nasal passages moist." Furthermore, the doctor suggests to not to forget to take steam "at least two times a day". "Doing so will help to ease congestion. Ensure to take warm showers, and you will feel better," noted Dr Bauskar.

It is imperative to have allergy medications like antihistamines if allergies persist, as prescribed by the doctor, noted the doctor.

"Everyone is also advised to stay hydrated by drinking enough water and liquids. Try to use a humidifier at home. If a person has congestion for over a week and is unable to breathe ,then don’t rely on nasal sprays and consult the doctor to rule out infections or other underlying problems," said Dr Bauskar.

Is Rebound Congestion Preventable?

It is a preventable condition, and is scientifically known as rhinitis medicamentosa, which causes the symptoms to worsen. Patients become depended on the sprays to breathe more easily.

RPS survey of 300 pharmacists found that 59% think the public is not aware of the risks, while 75% said packaging should be clearer about the seven-day limit. 63% said they had intervened in cases of suspected overuse.

Professor Amira Guirguis, chief scientist at RPS told the ITV News, "Nasal decongestant sprays can be helpful for short-term relief, but using them for longer than seven days can make your congestion significantly worse. Our research shows that many people are unaware of this risk, which means they may continue using these sprays without realizing they could be prolonging their symptoms. We'd like to see clearer warnings on the packaging which you can't miss and greater awareness of the seven-day limit. If your congestion lasts more than a week, speak to your pharmacist. There are safe and effective alternative options to help you manage your symptoms."

Another survey by ITV News suggests that more than a fifth of adults have used the products for longer than seven days. This means 5.5 million people in the UK may have risked developing a dependency.

A one-year-old baby from Uzbekistan rom suffering from a rare genetic liver disorder and was saved by his father who donated a part of his liver. The child was suffering with Alagille syndrome. The timely intervention of the doctors as well as father stepping in saved the child from a life-threatening disease.

What Happened to The Child?

Right after birth the child got jaundice, while it is common for newborns, and appears two to three days after birth, it often resolves in one to two weeks. However, this was not the case with him. The baby required neonatal intensive care. When he was of just two months, he was diagnosed with biliary atresia, a condition that blocks the normal flow of bile from liver. The baby underwent a Kasai procedure, which is a surgery performed in infancy to help restore bile flow.

Also Read: The Great Healthcare Plan Explained: What Is In President Trump's Health Care Proposal?

However, his condition continued to worsen. The baby suffered from persistent jaundice, severe itching, poor weight gain, delayed growth and pale stools. All of these symptoms indicated progressive liver failure.

This is when the family sought help from specialized liver care in India. Upon a careful assessment, a serious heart ailment too was detected in the baby. The investigation confirmed that the baby had Alagille syndrome.

What Happens In Alagille Syndrome?

As per the National Institute of Health, Alagille syndrome is a multisystem autosomal dominant disorder with a wide variety of clinical manifestation. Johns Hopkins Medicine says it is an inherited condition in which bile builds up in the liver because there are too few bile ducts to drain the bile. This causes liver damage.

This is caused by JAG1 gene mutation and could be passed from parent to child. If the child has one parent with Alagille syndrome, the child has 50% chance of developing the condition. Its rarity makes it appear in one out of 70,000 babies.

Upon the case review, it was identified that only a liver transplant could save the child's life, this is when his father stepped in.

What Does The Expert Say?

Dr Ajitabh Srivastava, Director HPB Surgery and Liver Transplant, Max Super Speciality Hospital, Patparganj, whose team led the transplant said, "“Infants with prolonged jaundice are commonly evaluated for biliary atresia, for which the Kasai procedure is an early surgical treatment aimed at restoring bile flow and delaying the need for liver transplantation." However, he noted, rare conditions like Alagille syndrome could also mimic biliary atresia in early infancy.

"In such cases, the Kasai procedure may not provide lasting benefit because the underlying problem is genetic rather than structural and in fact the wrong procedure (Kasai) worsens the condition of the child. As the liver disease progressed despite early surgery, a timely living donor liver transplant became the only life-saving option," the doctor explains.

The transplant has been successful, noted Dr Srivastava, and the child is on a "steady path to recovery". The doctor especially pointed out how early diagnoses could save lives even from the rarest of the rare diseases.

Air quality has long been linked to lung and heart diseases, but its role in infertility among both women and men often goes unnoticed. In recent years, researchers have begun to better understand how long-term exposure to high levels of air pollution, especially in Indian cities, may harm fertility and reproductive health. Prolonged exposure can damage reproductive cells, interfere with hormone balance, and increase the risk of pregnancy-related complications. While pollution is not the sole cause of infertility, it adds to existing reproductive challenges and can worsen underlying problems.

We got in touch with Dr. Suchithra Reddy, Senior Consultant - Infertility Specialist, Rainbow Children’s Hospital, Sarjapur Road who helped us know more about the same.

Impact of Air Pollution on Male Reproductive Health

Male reproductive health appears to be particularly affected by sustained exposure to polluted air. Fine particulate matter, especially PM2.5, has been closely associated with lower sperm count, reduced motility, abnormal sperm shape, and increased DNA damage in sperm cells. Dr Reddy said, “These changes are largely driven by oxidative stress and chronic inflammation, which directly affect the seminiferous tubules where sperm are produced. In addition, heavy metals present in polluted air may disrupt testosterone levels, a hormone essential for proper sperm development and maturation.”

Effects of Air Pollution on Female Fertility

Air pollution can also negatively influence female fertility. A broad review of existing studies shows that exposure to common air pollutants around the time of conception can reduce the chances of successful pregnancy and raise the risk of miscarriage. Dr Reddy said, “Pollutants frequently found in urban environments, such as PM2.5, nitrogen dioxide, and polycyclic aromatic hydrocarbons, have been shown to impair ovarian function and interfere with embryo implantation.”

Beyond conception, polluted air is linked to a higher likelihood of pregnancy complications, including preterm birth and low birth weight. This is thought to occur because pollutants can limit the supply of oxygen and nutrients to the developing fetus, leading to adverse outcomes.

Hormonal Disruption Caused by Air Pollution

Studies have shown that air pollution exposure can disturb estrogen and progesterone levels and alter hormones involved in ovulation, such as FSH and LH. These changes may result in reduced ovarian function, poorer egg quality, irregular menstrual cycles, and a higher risk of miscarriage. Together, these disruptions directly affect ovulation, implantation, and early pregnancy health.

A significant portion of pollution-related fertility issues is driven by chronic inflammation and oxidative stress. Breathing in polluted air triggers widespread inflammatory responses that can damage hormone-producing organs like the ovaries, testes, and thyroid. It can also interfere with hormone receptors and disrupt communication between the brain and the endocrine system. These internal changes contribute to hormonal imbalance and impaired reproductive function. The severity of these effects varies, and not everyone exposed to pollution will experience fertility or hormonal problems.

Understanding PM2.5 and PM10 Exposure

Not all particulate matter carries the same level of risk. PM10 consists of larger particles that are often trapped in the upper respiratory tract, making them relatively less harmful. PM2.5 particles are much finer and more dangerous, as they can travel deep into the lungs, enter the bloodstream, and reach hormone-producing organs such as the ovaries, testes, and thyroid. Because of this ability to spread throughout the body, PM2.5 poses a greater threat to reproductive health than larger particles that mainly affect breathing.

Early Pregnancy Risks

There is also evidence suggesting that fetal growth and lung development may be affected, with risks becoming more noticeable at the population level rather than in individual cases.

Air pollution is one of several factors influencing fertility in India, particularly in urban areas. Although it is rarely the sole cause of infertility, reducing exposure to polluted air can improve reproductive outcomes. This is especially relevant for couples undergoing IVF and during the early stages of pregnancy, highlighting the need to view clean air not just as an environmental issue, but as an important aspect of reproductive health.