“I'm not great at the advice. Can I interest you in a sarcastic comment?”

This is what ‘Friends’ actor Matthew Perry’s character Chandler Bing was known for. He was known for being funny. However, he had his own struggles in his personal life and those struggles were acute depression. He was treating it with ketamine infusion therapy which is legal in the US and the UK.

What is Ketamine infusion therapy?

Ketamine is an anaesthetic used to treat depression, anxiety and pain under supervised and controlled medical settings. However, it does have its side effects, which can lead to distortion of sight, sound and time. It can also produce calming and relaxing effects.

Ketamine increases a person’s heart rate and blood pressure. If overdosed, it can leave users confused and agitated and can cause them to hurt themselves without even realising it. It can also lead to liver damage and bladder problems.

However, when used in moderation and under the supervision of medical doctors, it can treat depression where traditional antidepressants have failed.

Prof Rupert McShane, a University of Oxford psychiatrist who runs an NHS ketamine treatment clinic told BBC that ketamine “probably turns off the area of the brain that is involved in disappointment.”

Can Ketamine Infusion Therapy Kill Someone?

In simple terms, it cannot, be if the dosage is given in a controlled setting and as prescribed. Ketamine infusion therapy uses drugs in small doses than those used for anaesthesia. It acts faster than traditional anti-depressants, but the effects also wear off way quickly. Which is why it is important to monitor patients’ mental state for relapsing back into depression and discouraging them from overdosing on it.

There are ways of giving people ketamine. One of the ways is through “infusing”, which means to use an IV drip. However, injections, nasal sprays and capsules are also methods used to give people ketamine.

Since the dosage of ketamine used in the infusion treatment is small, it being the reason of actor Perry’s death was ruled out. The medical examiner also noted that Perry’s last ketamine infusion therapy session happened more than a week before his death, which means by the time he had died, it must have worn off.

So, What Happened To Perry?

Though Perry’s last session was more than a week before, his post-mortem showed that his blood contained a high concentration of ketamine. He had died of the “acute effects” of ketamine.

If it was not his session, then how did he get ketamine?

Prosecutors alleged that his assistant gave him at least 27 shots of ketamine in four days before his death, reported BBC.

Perry has been open about his personal struggles and this is what the doctors and dealers used against him. Martin Estrada, the US attorney for California’s Central District told the BBC that people took advantage of his condition. They charged him 165 times more than what vials of ketamine cost.

Names that have come up include Dr Salvador Plasencia, drug dealers “Ketamine Queen” aka Jasveen Sangha and Eric Fleming, and Perry’s live-in assistant Kenneth Iwamasa.

Who Are These Names And What Did They Do?

Ketamine Queen or Sangha supplied drugs that led to Perry’s death. Her home was a “drug-selling emporium,” said Estrada. More than 80 vials of ketamine, and thousands of pills including methamphetamine, cocaine and Xanax were allegedly found in her house known as the “Sangha Stash House.”

Sangha is known to deal with high-end celebs and was a “major source of supply for ketamine to others as well as Perry,” said Estrada.

Dr Plasencia called Perry a “moron” while charging him $2,000 for vials that cost only $12. He sold Perry 20 vials of ketamine between September and October 2023, costing $55,000.

He was the one who taught Iwamasa, who had no medical knowledge to inject the drug. This is after he knew that “Perry’s ketamine addiction was spiralling out of control,” as per what the investigators told the BBC.

Another dealer Fleming was told by Sangha to “delete all our messages.” While Fleming pleaded guilty to conspiring to distribute drugs unlawfully, he also allegedly messaged Sangha: “Please call...Got more info and want to bounce ideas off you. I’m 90% sure everyone is protected. I never dealt with [Perry] only his assistant. So the assistant was the enabler.”

The court documents also revealed that he asked Sangha on whether the ketamine stays in your system or “is it immediately flushed out.”

Dr Pepper, Bots, Cans

The people who allegedly exploited Perry used coded language for ketamine and called it “Dr Pepper”, “bots”, or “cans.”

Selling overpriced drugs, taking advantage of Perry’s mental condition and falsifying medical records to make the drugs given to him look legitimate by Dr Plasencia is what took Perry’s life.

Iwamasa is said to have administered more than 20 shots of ketamine and three on the day Perry died. Whereas ketamine is only administered by a physician. Authorities also found that weeks before Perry’s death, Dr Plasencia allegedly bought 10 vials of ketamine and intended to sell to Perry.

He also injected Perry with a large dose, two days later. This caused him to “freeze up” and spiked his blood pressure.

When I Die, I Want Helping Others To Be The First Thing That’s Mentioned

Perry had always been open about his drug addictions, struggles with alcohol and his depression. He said that his openness would help others who are also struggling and wanted to be remembered by his quote which also is on the homepage of the Mattew Perry Foundation that helps others struggling with the disease of addiction: “When I die, I want helping others to be the first thing that’s mentioned.”

Five arrests have been made in the case so far.

The Ebola outbreak, declared an emergency in May, continues to spread in the Democratic Republic of the Congo (DRC). According to the latest update from DRC health authorities, confirmed cases have surpassed 8,000, while the death toll is nearing 4,000.

The World Health Organization (WHO) warned that the outbreak remains large, geographically expanding and marked by sustained transmission.

The DRC “had recorded 8,067 confirmed cases, including 3,901 deaths, with a case fatality rate of 48.4 per cent,” according to the latest government situation report. It has spread to seven health zones.

“The continuously high case fatality ratio, and especially the continuous high rate of deaths occurring in communities, highlights the seriousness of the disease and the persistent challenges in timely case detection and access to early and adequate patient care,” the WHO said in its latest Disease Outbreak News.

However, Dr Janet Diaz of the WHO’s Health Emergencies Program told reporters in Geneva that “we are beginning to see a reduction in transmission in some areas, the number of cases remains high for this outbreak”.

Treatment Delays Remain A Concern

Dr Diaz said that although it is known that “early access to care can significantly improve chances of survival,” “Yet in this outbreak, many people are still dying at home or in their communities because they are unable to reach health facilities on time.”

“Delays in seeking care, together with challenges in access and referral, continue to complicate the response,” she said, adding that WHO and its partners have focused on improving early recognition of illness, rapid referral systems and early supportive care.

“Every patient bed requires a skilled workforce to provide safe, quality care around the clock,” Dr Diaz said.

Oxygen Access A Key Challenge

A key component of supportive care for patients with Ebola, particularly those with severe illness, is oxygen. Yet this life-saving medicine remains “unavailable or unreliable in many health facilities, especially in emergency settings”.

Ensuring access to oxygen requires functioning health systems, reliable infrastructure, trained health workers and sustainable delivery systems “that reach patients wherever they are”.

“Without previous oxygen scale-up efforts in Ebola and Marburg [virus disease] responses, we would not be where we are today in terms of more positive outcomes for patients,” she noted.

Vaccine Trials Underway

While there is currently no approved vaccine against Ebola Bundibugyo virus, vaccine trials are underway.

Clinical trials of specific vaccines and treatments against the Bundibugyo virus are also ongoing. The DRC also received more than 70,000 doses of the Ervebo vaccine last month. Ervebo is approved for protection against the more common Zaire Ebola virus.

DRC’s 17th Ebola Outbreak

The outbreak, caused by the rare Bundibugyo virus, was declared by the WHO on May 15. It is the DRC’s 17th Ebola outbreak since the virus was first identified in 1976.

It is also the second-deadliest Ebola outbreak on record, behind the West African outbreak that lasted from 2014 to 2016.

You can exercise regularly, eat reasonably well and have no obvious symptoms — yet still have plaque building up inside your arteries.

The process called atherosclerosis is often slow and silent, with symptoms appearing only after plaque significantly affects blood flow — sometimes with a heart attack or stroke.

A study published earlier this month in The New England Journal of Medicine (NEJM) found that plaque buildup can begin decades before symptoms appear. Researchers detected atherosclerosis in many apparently healthy young adults, including those in their 20s.

Atherosclerosis Can Start Decades Before Symptoms

The NEJM study showed that signs of hidden atherosclerosis could be detected in approximately one in 13 people aged 18–29. Among those aged 60–70, nine out of 10 showed signs of atherosclerosis.

Dr. Robert Grant, St. George’s University School of Medicine, Grenada, West Indies, told HealthandMe that the most important message is that atherosclerotic cardiovascular disease often begins decades before symptoms appear. Heart attacks and strokes are usually late manifestations of a process that develops gradually over many years.

“Atherosclerosis is not exclusively a disease of older adults. Clinical complications remain predominantly diseases of older adults. The pathological process often starts much earlier than the clinical disease becomes evident," he said.

The study therefore shifts our thinking from "atherosclerosis is an old-age disease" to "atherosclerosis is a lifelong disease that becomes clinically important with advancing age," he added.

Can Exercise And A Healthy Diet Protect?

Regular exercise, a healthy diet, avoiding smoking, maintaining a healthy weight, and good sleep remain important preventive measures, said Dr. Robert.

“These habits lower LDL cholesterol, improve blood pressure, reduce inflammation, improve insulin sensitivity, and substantially reduce cardiovascular event rates," he said. “They are foundational and should not be minimized.”

However, healthy lifestyles do not guarantee the absence of atherosclerosis. Other risk factors include:

• Genetic predisposition and family history
• Elevated lipoprotein(a) [Lp(a)]
• Insulin resistance or diabetes
• Previously elevated LDL levels during earlier life
• Hypertension that has gone undetected or untreated

Dr. Rajat Mohan, Senior Consultant Cardiologist at Sir Ganga Ram Hospital, also stressed that people who exercise and eat in moderation can still develop coronary disease because of other risk factors, including genetic tendencies.

He also emphasized the need to check cholesterol levels and avoid smoking.

Why Indians May Be More Vulnerable

Coronary artery disease has a high burden in the Indian population, with diabetes, family history, smoking and tobacco use among the factors contributing to risk, Dr. Rajat told HealthandMe.

"Diabetes is a precursor for developing coronary artery disease," he said.

Dr. Ramakanta Panda, renowned cardiac surgeon and Chairman, Asian Heart Institute, Mumbai, also pointed to studies suggesting greater vulnerability to early atherosclerosis among Indians.

Referring to the INTERHEART study, he said that Indians get their first heart attack 5-6 years earlier than people from other regions, and a UK study found double the risk compared with Europeans.

Can Normal Cholesterol And Blood Pressure Be Reassuring?

“Yes. The "normal" LDL range is not truly safe for arteries. In US adults without traditional risk factors, coronary atherosclerosis rose from 13.2% when LDL-C was below 70 mg/dL to 48.2% when it was 160 mg/dL or higher. Non-HDL cholesterol and apoB showed similar associations," Dr. Ramakanta told HealthandMe.

He added that beyond standard readings, doctors should consider:

• apoB and lipoprotein(a)
• HbA1c and insulin resistance
• Waist circumference and fatty liver
• hsCRP
• Premature family history
• Kidney disease and pregnancy complications
• Where appropriate, calcium scoring

Should Screening Be Universal?

Dr. Ramakanta said that mass screening has not been shown to reduce death rates significantly. However, targeted screening or testing can be helpful. For an apparently healthy person with no symptoms, a sensible approach is:

• Blood pressure
• Fasting glucose/HbA1c
• Lipid profile, particularly LDL
• Weight/BMI and waist circumference
• Smoking/tobacco, physical activity, diet and family history of premature heart disease
• Assess the person’s overall cardiovascular risk and treat modifiable risk factors accordingly

"The ESC specifically recommends systematic risk assessment in people without known cardiovascular disease. I would not recommend routine ECG, treadmill testing, echocardiography, or coronary CT for every asymptomatic individual unless they have risk factors.”

With the onset of winter, Delhi sees a sharp deterioration in air quality, exposing people across age groups to health risks including respiratory problems and eye irritation, among others.

Ahead of the season, the Delhi government has announced 10 interventions targeting major pollution sources, including vehicles, dust, waste and industrial emissions.

“Delhi Clean Air Action 2026 puts 10 focused interventions at the heart of the fight against pollution, targeting key sources from vehicles and dust to waste and industrial emissions. Cleaner air is a shared goal,” Delhi Chief Minister Rekha Gupta said in a post on X.

“We urge every Delhiite to join this effort through active Jan Bhagidari. Every responsible action counts towards a cleaner, healthier Delhi,” she added.

The measures were discussed during a review meeting with the Commission for Air Quality Management (CAQM) and the Delhi Pollution Control Committee (DPCC).

Also read: World Lung Day: Dry Cough, Breathlessness May Not Always Be Asthma — Could It Be ILD?

What Are The 10 Interventions?

The key measures undertaken include:

1. No PUCC, No Fuel

Enforcement at all 500 ANPR-enabled fuel stations, backed by a city-wide awareness campaign.

2. Public Transport First

Delhi Metro Sarthi App campaign from October 1–10; last-mile connectivity at all 228 Metro stations. Bus fleet: 6,840, including 5,088 e-buses.

3. Hotspot Action

42 of 50 pollution hotspots addressed, with traffic decongestion measures planned for the remaining areas.

4. Dust Control

1,193 km of roads redeveloped; remaining work targeted by November 15. Footpath paving and faster complaint resolution also planned.

5. No Open Waste Burning

Ward-level monitoring and stronger waste collection; 98 MRSMs, up from 76 last year. Dedicated monitoring teams by October 15.

6. Greening Drive

71 lakh plantations completed; 433 of 434 acres of identified brown areas greened.

7. Construction Waste Control

Malba App registration to be mandatory for building-plan approvals. Construction restrictions begin November 1, followed by a complete ban from December 10 to January 20.

8. Winter Protocol

Doubled parking charges, staggered office timings and 50% work-from-home. Restrictions on non-Delhi, below-BS-VI vehicles from November 1, except CNG and EVs.

9. EV Push

Higher incentives for scrapping old vehicles and registration drives under the Parivartan Scheme.

10. Industrial Pollution

Monitoring stations to rise from 47 to 60, with 334 enforcement teams and an AI-enabled Command and Control Centre.

Read More: Can Air Pollution Raise Suicide Risk? Study Finds A Possible Link

Why Does Delhi’s Air Quality Worsen In Winter?

Delhi-NCR’s air quality deteriorates during the colder months as emissions combine with unfavorable weather conditions.

According to CAQM, falling wind speeds, shallow atmospheric mixing, fog and low temperatures reduce the dispersion of pollutants, allowing particulate matter to accumulate near the ground.

How Does Air Pollution Affect Health?

Air pollution contains tiny particles such as PM2.5 and PM10, along with gases including nitrogen dioxide from vehicle exhaust, sulfur dioxide from industrial emissions and carbon monoxide.

PM2.5 is of particular concern because these extremely small particles can penetrate deep into the lungs and, after entering the bloodstream, trigger inflammation and affect other organs.

The health effects of air pollution go beyond respiratory symptoms such as coughing, wheezing and breathing difficulties. Long-term exposure has been linked to a higher risk of heart disease, stroke, lung cancer, diabetes and chronic respiratory diseases. Exposure during childhood can also affect lung development and respiratory health.

Reducing exposure to polluted air remains important, particularly during periods of poor air quality. A balanced diet and adequate nutrition can also support overall health, although nutrition cannot replace measures to reduce exposure to air pollution.