The US Food and Drug Administration has approved TNKase or Tenecteplase, which is a thrombolytic or clot-dissolving agent, for the treatment of acute ischemic stroke in adults.

Ischemic strokes happen when a blood clot blocks a blood vessel in your brain. It can cause permanent brain damage and death. If enough brain cells die, you can also lose the abilities or body functions those cells control. They are also the most common types of stroke, with 80% of all strokes being ischemic strokes.

How is TNKase administered?

It is delivered as a single five-second intravenous bolus, which is faster than the standard of care Activase or alteplase, which is administered as an intravenous bolus followed by a 60-minute infusion. The manufacturer of TNKase, Genetech said a new 25-mg vial configuration will also be available in the coming months.

How Was TNKase approved?

The approval came at the backdrop of a study that compared TNKase to Activase in patients with acute ischemic stroke. These patients also presented with a disabling neurological deficit. Results show that TNKase was comparable to Activase in terms of efficacy and safety.

How Common Are These Strokes?

In the United States it self, it affects more than 795,000 people each year and is the leading cause of long-term disability. It is also the fifth leading cause of death. Since brain damage can happen if this progresses rapidly, one needs an immediate, fast-acting medical care.

TNKase thus provide a faster and simpler administration which can be critical for anyone. The chief medical officer and head of global product development at Genetech, Levi Garraway, MD., PhD., said, "Today's approval is a significant step forward and underscores our commitment to advancing stroke treatment options for patients."

What Are The Symptoms Of Ischemic Strokes?

Some of the most common symptoms include weakness or paralysis on one side of your face and body. You may also feel trouble speaking or have loss of speech, also known as aphasia. You may faced slurred or garbled speaking, also known as dysarthria. Other symptoms include loss of muscle control on one side of your face, or sudden worsening or loss of your senses, including vision, hearing, smell, taste, and touch.

Other symptoms include:

• Loss of coordination or clumsiness
• Blurry vision or double vision
• Dizziness or vertigo
• Nausea and vomiting
• Neck stiffness
• Mood swings or sudden personality changes
• Confusion or agitation
• Seizures
• Memory loss (amnesia)
• Headaches which are sudden and severe
• Passing out or fainting
• Coma

Are There Any Warning Signs?

While these are symptoms one has who is prone to this condition. However, often, many may confuse it with other illnesses. It is best to keep an eye out for warning signs. These could be looking out for yourself or your loved one. Note if there is a sudden loss of balance. Look out for sudden vision loss or changes in one or both eyes. Look for a droop on one or both sides of your face, especially when you smile. Raise both arms and see if one arm sags or drops in a way it usually does not. Note for your speech. Are you as fluent? Are you have trouble speaking? If you see any of such signs, start tracking it and talk to your healthcare provider.

Amid the rising number of Ebola cases and deaths in Africa, nearly 16 people in Gujarat and Maharashtra have been quarantined after travelling from affected countries such as the Democratic Republic of Congo and Uganda, with some showing suspected symptoms.

This comes after the Ebola alert in Bengaluru over a woman who returned from Uganda and later tested negative.

Ebola Alert In Gujarat

A businessman from Congo and three individuals who came into contact with him have been admitted to isolation wards at separate hospitals in Gujarat's Ahmedabad. All four samples have been sent for Ebola virus testing, said Gujarat Health Minister Praful Pansheriya.

The 37-year-old businessman arrived from Congo earlier this month in Mumbai and stayed there for five days before travelling to Silvassa and Daman over the next few days, eventually reaching Vadodara on May 22. After developing Ebola-like symptoms, including high fever and cold, he was hospitalized on May 26 in Vadodara.

After doctors in Vadodara learned about his travel history, he was referred to a government hospital in Ahmedabad, where he has been kept in an isolation ward.

The man has been kept under observation, and tests are being conducted, with reports still awaited. The admitted patient is currently stable and safe, and his temperature is under control, Pansheriya said, adding that the people associated with the patient are not showing any symptoms.

"Two other individuals who had accompanied him have also been admitted to isolated wards at SVP Hospital in Ahmedabad as a precautionary measure. Another person who came in contact with these individuals has also been isolated," the minister added.

“Till now, there is no Ebola case anywhere in Gujarat or India, so nobody needs to fear,” the minister said.

In addition, media reports cited a total of 11 people who arrived in Ahmedabad from Ebola-affected African countries being placed under home isolation at their residences.

According to the Ahmedabad Municipal Corporation Health Department, all these 11 passengers live in the western areas of Ahmedabad. None of them have shown any symptoms of Ebola or have been in contact with Ebola virus-infected patients in African countries.

However, as a precautionary measure, the authorities have made home isolation mandatory for anyone arriving from affected African countries.

Also read: Ebola: Inside India’s RT-PCR Tests For The Bundibugyo Strain| Explained

Ebola Alert In Maharashtra

In Maharashtra's Nagpur, health authorities issued a high alert at the airport after placing a 47-year-old man who returned from Uganda under 21-day home isolation.

The Nagpur Municipal Corporation (NMC) health department is closely monitoring the man's health round the clock. Officials said he has not shown any symptoms of Ebola so far.

The individual stated that he did not come into contact with any Ebola patient during his stay in Uganda. However, as per health protocols, a medical team will regularly check his condition during the isolation period.

If any symptoms develop, arrangements have been made to immediately shift him to a hospital.

Experts Question Continued Travel From Affected Countries

Ebola has been declared a Public Health Emergency of International Concern (PHEIC) globally by the WHO. To mitigate the risk, the Directorate General of Civil Aviation (DGCA) and the Ministry of Civil Aviation have imposed strict rules for all airlines and airports in India.

The government has also issued guidelines for passengers arriving from Ebola-affected countries. As part of the precautionary measures, travelers entering the country from such nations are required to undergo a 21-day quarantine period.

Epidemiologist Dr. Amitav Banerjee, professor at DY Patil Vidyapeeth, Pune, told HealthandMe that the National Institute of Virology (NiV) in Pune is equipped to test for the Bundibugyo strain.

"The RT-PCR done by NIV is very sensitive and not likely to miss Ebola infections. A proper history of movement and contacts with sick persons during a visit to Congo and Uganda will provide more important information," he said.

The expert added that these people should also be tested for malaria, as it is endemic in Uganda and more easily transmitted than Ebola. After a couple of weeks, they can be tested for IgM antibodies against Ebola.

However, Dr. Ishwar Gilada, a Mumbai-based infectious disease expert, raised questions about why India is still allowing travelers from Ebola-affected countries.

"Our policy should be so strict that we do not allow anybody coming from those kinds of countries where there is already an outbreak of Ebola, because Ebola has neither a treatment nor a cure nor a preventive vaccine," Dr. Gilada told HealthandMe.

India’s RT-PCR testing system is capable of detecting the Bundibugyo strain of the Ebola virus, and the chances of missing a confirmed infection are very low when standardized protocols are followed, said health experts after the suspected Ebola case in Bengaluru involving a Ugandan woman tested negative.

The woman, who arrived in Bengaluru from Kampala, Uganda, on May 23, was suspected of Ebola infection after developing mild symptoms including body ache. She was shifted from a hotel to the state-run Epidemic Diseases Hospital on May 26, and her samples were sent to the National Institute of Virology (NIV), Pune. The tests today returned negative. India currently has no reported case of Ebola, the Health Ministry said.

Let’s take a look at how testing for Ebola takes place in India’s virology labs.

Speaking to HealthandMe, Dr. NK Ganguly, former Director General of ICMR, said that RT-PCR remains the confirmatory test for Ebola infection, while rapid diagnostic tests (RDTs) are mainly used for initial screening with limited sensitivity — of around 85-89 per cent.

According to him, the World Health Organization recommends that RT-PCR should only be carried out in specialized reference laboratories due to biosafety requirements. India currently has two designated Ebola reference laboratories — the National Institute of Virology (NIV), Pune, and the National Centre for Disease Control (NCDC).

"The Altona RT-PCR kit is the real star and is highly standardized. It rarely misses Ebola cases when proper protocols are followed,” Dr Ganguly said.

Can India Detect The Bundibugyo Strain?

Bundibugyo is one of the strains of the Ebola virus currently linked to outbreaks in parts of Africa, including Uganda and the Democratic Republic of the Congo (DRC). The rare strain has caused over 900 cases and more than 200 deaths.

Dr. Ganguly said the incubation period for the Bundibugyo strain can range from six to seven days up to 15 days or even three weeks.

“If a person tests RT-PCR negative during this period, the chances of being infectious are lower. However, isolation is still necessary because there may be a short window period during which the infection may not be detected,” he said.

The expert added that travelers arriving from outbreak-hit countries should remain under quarantine even if their initial Ebola test is negative.

Why Ebola Testing Is Complicated

Dr. Ganguly explained that Ebola belongs to the filovirus family, which includes several strains such as Bundibugyo, Sudan, Taï Forest and Zaire viruses.

He noted that Ebola has a high fatality rate, with nearly 50 per cent of infected individuals dying from the disease. He added that the virus can spread through several body fluids including tears, saliva, milk and urine.

In the early stages, Ebola symptoms can resemble flu, malaria or other viral illnesses, including fever, cough, sore throat, headache, diarrhea, skin rashes and body ache, making early diagnosis difficult.

Dr. Ishwar Gilada, a Mumbai-based infectious disease expert, told HealthandMe that the Bengaluru patient’s symptoms were similar to common viral infections, which is why epidemiological history and travel exposure become critical in suspecting Ebola infection.

“The symptoms of Ebola can be a little confusing because they are just like any other flu,” Dr. Gilada said, adding that travelers arriving from Ebola-affected countries should remain under observation for up to 21 days.

Are There Any Limitations In India’s Ebola PCR Testing?

Dr. Jatin Ahuja, Consultant, Infectious Diseases, Indraprastha Apollo Hospital, Delhi, told HealthandMe, there are no major loopholes in India’s Ebola PCR testing system, but there are certain limitations common to all diagnostic tests.

"One key limitation is the timing of testing. If RT-PCR is performed very early in the infection, there is a possibility of a false-negative result because the viral RNA levels may still be too low for detection," he said.

Dr. Ahuja also pointed out that test accuracy depends on whether the PCR targets are correctly aligned with the specific Ebola strain being tested. Improper alignment may reduce sensitivity.

He added that pre-analytical factors such as sample collection, storage, transport and RNA extraction also influence the final test outcome.

“Negative Ebola PCR substantially reduces concern, but interpretation always depends upon the clinical picture, travel history and exposure risk,” Dr. Ahuja said.

Hypertension is the “number one killer” in India, with nearly 1.6 million people dying from the condition every year, said Dr. Ambuj Roy, Professor of Cardiology at the All India Institute of Medical Sciences, New Delhi, today.

Speaking to media persons on hypertension, Dr. Roy said the deaths “linked to high blood pressure are five times higher than tuberculosis fatalities and exceed the combined toll of communicable diseases such as TB, malaria, dengue, and HIV”.

Calling hypertension a “silent but deadly disease,” he said most people remain unaware they have high blood pressure because symptoms are often absent.

“Ninety per cent of the time, hypertension does not cause symptoms. The only way to detect it is through regular screening,” he said.

Dr. Roy also cited the ICMR and NFHS-5 data showing that nearly 30 crore Indians are living with hypertension.

According to him, one in four adults in rural India and one in three adults in urban areas have the condition. However, “only one in three people know they are hypertensive, one in five receive treatment, and just one in twelve achieve proper blood pressure control below 140/90 mmHg”.

Lifestyle Changes Surging Hypertension Risk

Dr Roy said lifestyle changes are driving the growing burden of hypertension in India. Poor diet, obesity, physical inactivity, air pollution, stress, and poor sleep habits are major contributors, particularly among younger people.

He highlighted excessive salt intake as a key concern. While the recommended salt intake is less than 5 grams per day, average consumption in India is around 12 grams daily. He also stressed the importance of potassium-rich foods such as fruits and vegetables, noting that most Indians fail to consume the recommended 400 grams of fruits and vegetables per day.

Pollution: An Emerging Concern

Further, the Cardiologist linked pollution exposure to rising hypertension rates. Referring to studies conducted by AIIMS in collaboration with IIT Delhi, Dr. Roy said areas exposed to crop burning showed a 15 per cent higher prevalence of hypertension.

Another study found that every 10 microgram increase in PM2.5 levels was associated with a 5 per cent higher risk of hypertension.

How To Reduce Hypertension

Dr. Roy said reducing blood pressure by just 10 mmHg can significantly lower the risk of

• cardiovascular mortality by 20 per cent,
• stroke 28 per cent,
• heart failure by 28 per cent,
• coronary artery disease by 17 per cent,
• mortality by 13 per cent.

He also referred to the “TOPSPIN trial,” a large Indian hypertension study, which found that a single-pill combination therapy using two medicines reduced blood pressure by 30–40 mmHg and helped nearly 70 per cent of patients achieve blood pressure control.

The expert stated that around 70 per cent of patients may require long-term treatment or may need it lifelong. However, for nearly 30 per cent of people, hypertension can be reduced by stopping medication through:

• sustained lifestyle changes
• weight loss,
• low-sodium diets,
• exercise,
• better sleep.

‘Do Not Stop BP Medicines Abruptly’

Importantly, Dr Roy cautioned people against stopping blood pressure medicines abruptly once readings improve.

“Blood pressure is controlled because of the medicine. If you stop it suddenly, BP can rise sharply and may trigger a brain stroke or hemorrhage,” he said.

Dr. Roy also dismissed fears around side effects of antihypertensive medicines, calling them among the safest long-term drugs available. “The only side effect they have is benefits,” he remarked, adding that these medicines reduce the risk of heart attack, stroke, and kidney failure.

To reduce blood pressure naturally, the expert advised people to

• remain physically active for at least 150 minutes per week,
• reduce processed and salty foods,
• maintain hydration during heatwaves,
• adopt DASH-style diets rich in fruits and vegetables.