“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 six-week-long incubation period of Hantavirus is a matter of concern, but the rat-borne disease is certainly not a large epidemic, said the World Health Organization today.

At a media briefing, the WHO Director General Dr Tedros Adhanom Ghebreyesus, expressed concerns about the time taken for the symptoms of the disease to appear.

He noted that so far the disease has been limited to the 150 people who traveled on board the MV Hondius ship. Of these, only 8 people have been infected - 3 have died, and 5 have been confirmed.

A case has been reported in a person who disembarked from the ship, without having the symptoms, and some have self-isolated to prevent the risk of spreading.

Among those on board the ship, now travelling to the Canary Islands, "currently no one is symptomatic".

However, "with a six-week incubation period, more cases are expected to be reported".

Countries involved in the contact tracing efforts of people who disembarked at St. Helena Islands include Canada, the Netherlands, Singapore, Turkey, the UK, and the US, the WHO chief said.

WHO infectious disease epidemiologist Maria Van Kerkhove reiterated that the disease spreads only among close, prolonged contacts or those providing care, as seen in the case of the doctor who got infected on board.

The WHO also noted that the disease is unlikely to become a large epidemic, as it's an isolated case occurring in a closed environment. However, public health measures like contact tracing and testing are key to preventing any further spread.

According to the WHO, the outbreak of the rat-borne disease among people aboard the MV Hondius ship after it left Argentina on April 1 was caused by the Andes strain.

Speaking to HealthandMe, Dr. Gautam Menon, Epidemiologist and Professor of Physics and Biology, Ashoka University, Delhi-NCR, said that the long incubation period is likely to complicate the spread of the hantavirus.

"What complicates matters is that incubation periods - the time between getting infected and symptoms showing - are large, up to several weeks, so passengers and their contacts will have to be quarantined for a long period before they can be declared safe." The expert said.

Is Hantavirus Similar To COVID-19?

Ven Kerkhove said that hantavirus causes severe respiratory issues, but it is still not the same as SARS-CoV-2.

This is not a new virus and is completely different from SARS-COV-2. It has caused similar outbreaks in Argentina in 2018, where contact tracing and other public health measures contained the spread.

"The outbreak of Hantavirus on a cruise ship has generated significant anxiety around the world, evoking memories of cruise ships affected by COVID-19 in the first phase of the pandemic. However, this is a different virus that is not known to spread efficiently from person to person. Its characteristics are already well-documented, unlike the SARS-CoV-2 virus, which was an unknown organism until then," Dr. Rajeev Jayadevan, Ex-President of IMA Cochin and Convener of the Research Cell, Kerala, told HealthandMe.

"The current cases do not indicate a pandemic threat, but they underline the growing importance of surveillance of zoonotic diseases. Strengthening rodent control, environmental hygiene, and early detection systems remains essential to prevent localized outbreaks and public panic. There is neither a proven treatment for its cure nor is there any vaccine," added Dr.Ishwar Gilada, Mumbai-based infectious disease expert.

How does The Hantavirus Affect The Human Body?

Hantavirus infection is caused by the hantavirus, which belongs to the Hantaviridae family. It is is rare but can be life-threatening.

The infection presents with initial symptoms resembling the flu and has a relatively high mortality of about 40%.

Even though this virus is not believed to spread very efficiently, it would have done so far more easily in the enclosed environment that the ship provided, the experts said.

Dr Neha Rastogi, Senior Consultant, Infectious Diseases, Fortis Memorial Research Institute, Gurugram, told HealthandMe that it can be contracted by coming into contact with rodent saliva, urine, and feces.

Hantavirus can cause infection - 2 syndromes: hantavirus pulmonary syndrome and haemorrhagic fever that may quickly develop into severe respiratory illness, as flu-like symptoms (fever, muscle aches, and fatigue) occur before developing serious respiratory symptoms (dyspnea) that may require respiratory assistance.

"On rare occasions, it can also spread from person to person through close contact. Rapid diagnosis and intensive medical treatment are critical for a successful outcome," Dr Rastogi said.

"Preventative measures include proper personal hygiene, avoiding contact with rodents or rodent-inhabited areas; using PPE when cleaning; and ensuring the area is well-ventilated," she added.

Although hantavirus infections can cause severe respiratory illness with high mortality, confirmed human cases globally remain relatively uncommon, Dr Gilada told HealthandMe

"The pneumonia syndrome caused by the virus is due to excessive permeability of blood vessels, resulting in fluid accumulation. It is managed with expert supportive care while the lungs recover, as there are currently no known antivirals or vaccines available for the Andes virus. By carefully tracking contacts and isolating those who might be infected, the virus can be stopped in its tracks, bringing this outbreak under control," Dr Jaydevan said.

Most people often wrap up their day at work with a sense of stress and severe exhaustion. But if you are part of the group that experiences severe headaches after office hours, it could be because of one common habit that may be causing you discomfort — chronic stress. When the mind keeps racing all day long because of deadlines, tension, and pressure, even during breaks, it leaves behind a sense of urgency. And that sense of urgency does not mitigate or come to an end when the day ends.

Why does stress build up even after work?

Several times, there are difficult or unpleasant situations at work — it could be because of unfinished tasks and conversations that play and replay in the mind. The nervous system, therefore, gets overburdened, thereby leading to headaches. According to doctors, a lot of corporate employees experience this pain after a day at their high-pressure jobs. And while it may sound like something that is out of your control, there is something that you can do.

How to deal with chronic stress after work?

Stress inherently is not bad for you, but only if it occurs in short bursts. In that case, it can improve performance, focus, and may even prepare the body to handle challenges. Problems, however, arise when stress becomes chronic. As a result, the nervous system starts to process both pain and stress at the same time, and while one is built to be highly adaptable, stress starts to respond to external and internal factors. When the brain continues to receive signals without getting ample time for recovery, the body enters a state of prolonged alertness.

In a sensitised state, situations that would otherwise be interpreted as minor may even get ignored. This can increase heart rate and muscle tension, thereby putting the nervous system into a fight-or-flight mode. In cases of constant headaches, sensitisation can lower the pain threshold. Consequently, headaches begin and become much harder to stop. Over time, this constant activation can disrupt the body's natural balance and create an environment for headaches to worsen.

Chronic stress and migraines

Chronic stress acts as a trigger for migraines — it can even worsen the discomfort. The neurological system of people experiencing migraines is more responsive to changes in hormones, environmental factors, and sleep patterns. Constant exposure to a stressor, therefore, can drive the severity and frequency of migraines. To make matters worse, muscle tension in the shoulders, neck, and scalp can also trigger headaches. Extended periods of sustained concentration and sitting can cause headaches later in the day.

Can sleep help reduce stress headaches?

Chronic stress has a debilitating impact on sleep quality as well. People who feel persistently wired at the end of the workday struggle to fall or stay asleep. As a result, the brain fails to recover properly. Poor sleep can therefore worsen the stress cycle, leading to headaches the next day as well. The loop is difficult to break, and excessive fatigue building up over time can make you feel overwhelmed. Over time, this loop leads to a decline in productivity, focus, and the ability to solve problems.

Public health officials in South Wales, UK, have issued an alert on a localized outbreak of hepatitis A, and have urged residents to maintain hygiene as well as vaccinate children.

Cases of hepatitis A involving the same strain have been identified in three separate households in Barry, according to Public Health Wales.

The health body, in a statement, said the strain’s characteristics “suggest the infection may be spreading locally.” Investigations into the “small number” of cases are ongoing.

To curb the outbreak, the officials have also issued an urgent appeal to parents to ensure their children remain “vigilant with their handwashing.”

Those infected are “receiving appropriate care and are recovering well,” Public Health Wales said. As a precaution, close contacts of the affected individuals have also been offered vaccination.

What Is Hepatitis A?

Hepatitis A is a viral liver infection caused by the hepatitis A virus (HAV). It spreads mainly through contaminated food or water, or through close personal contact with an infected person.

The infection can lead to liver inflammation, jaundice, extreme fatigue, and stomach pain. In most cases, it is a short-term illness that clears on its own without specific treatment, although severe cases can occur. Unlike hepatitis B or C, hepatitis A does not usually cause long-term liver damage.

According to the World Health Organization (WHO), vaccination remains the most effective way to prevent infection.

Also read: Hepatitis Infections Claims 1.3 Million Lives Worldwide, India Among Top Contributors: WHO

Symptoms of Hepatitis A

Symptoms usually appear a few weeks after exposure to the virus, although some people may not develop noticeable signs. According to the Cleveland Clinic, symptoms can include:

• Persistent fatigue and weakness
• Sudden nausea, vomiting, or diarrhea
• Pain or discomfort in the upper right side of the abdomen near the liver
• Pale or clay-colored stools
• Reduced appetite
• Mild fever
• Dark-colored urine
• Joint pain
• Yellowing of the skin and eyes (jaundice)
• Severe itching

Can Hepatitis A Be Prevented?

Read More: UK Parliament Bans Smoking For People Born After 2008: Know All About It

“The best way to prevent the spread of hepatitis A is to wash hands thoroughly with soap and water. This is important after using the toilet, changing nappies, and before preparing or eating food,” said Susan Mably, Consultant in Health Protection for Public Health Wales.

Vaccination against hepatitis A is also highly effective in preventing the disease.

Doctors recommend the vaccine for:

• Children older than 12 months
• Adults at risk of exposure at home or work
• Travelers visiting regions where the virus is more common
• People with existing liver conditions

• drinking boiled or bottled water,
• avoiding food from unhygienic sources,
• peeling fruits at home and not getting pre-cut from stores.

If someone in the household is infected, cleanliness becomes even more important. Surfaces should be disinfected, food prepared carefully, and personal items not shared.

Safe sexual practices also matter, as the virus can spread through oral-anal contact. On a broader level, preventing future outbreaks requires more than short-term fixes. Improving water quality, repairing sewage systems, and strengthening public health surveillance are essential to stop the cycle from repeating.