“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.

Environmental and public health scientists have begun warning against the dangers of having free living amoeba in water systems that are capable of triggering severe diseases in humans.

In a recent perspective article published in Biocontaminant, the researchers noted that climate change, deteriorating water infrastructure and limited systems for monitoring and detection are the key factors that have allowed these pathogens to spread and persist.

Corresponding author Longfei Shu of Sun Yat sen University explained: "What makes these organisms particularly dangerous is their ability to survive conditions that kill many other microbes.

"They can tolerate high temperatures, strong disinfectants like chlorine and even live inside water distribution systems that people assume are safe."

The scientists also emphasized that not only can amoebae spread illnesses on its own, it can also act as hidden carriers for other harmful microbes.

By sheltering bacteria and viruses inside their cells, amoeba these unicelled organisms protect these pathogens from disinfection and help them persist and spread in drinking water systems. This so-called Trojan horse effect may also contribute to the spread of antibiotic resistance among humans.

How Dangerous Is Amoeba?

Amoeba are single-celled organisms that naturally live in soil and water. Most species do not cause harm yet some can prove to be fatal.

Some of the diseases caused by this kind of bacteria include Amebiasis (Amoebic Dysentery), an intestinal infection by Entamoeba histolytica, causing diarrhea, cramps and potential liver abscesses as well as Primary Amoebic Meningoencephalitis (PAM) from Naegleria fowleri, a rare but nearly always fatal brain infection from contaminated water entering the nose.

Effects of amoeba-caused infections range from intestinal issues (liver abscesses, anemia, peritonitis) to severe neurological damage (coma, seizures, death) from brain-eating types, with Acanthamoeba causing eye infections (keratitis).

Experts recommend thoroughly washing your hands after toilet use and before handling food, drinking clean water especially in unsanitary conditions and avoiding getting water up your nose in warm freshwater to prevent such infections.

The Indore Crisis

This comes days after the recent Indore sewage water controversy which has claimed the lives 10 people and left over 1,400 people hospitalized, according to Indore Mayor Pushyamitra Bhargava.

However, locals claim that the outbreak has instead caused the death of 17 residents, including a six-month-child. The situation has also left Parvati Bai, 67, with kidney failure, a brain stroke and symptoms of Guillain-Barré Syndrome, or GBS.

GBS is a rare condition where your immune system attacks the nervous system and can cause paralysis as well as death, in certain cases.

The outbreak occurred due to lapses in civic infrastructure. Investigation revealed that a toilet constructed directly above a main drinking pipeline near a police outpost, without a mandatory safety tank resulted in the sewage mixing with drinking water.

The US Food and Drug Administration has approved the use of a blood test which can help diagnose Alzheimer’s disease in adults aged 55 and above.

The blood test, known as Lumipulse, can detect amyloid plaques associated with Alzheimer’s disease and has proven to be a “less invasive option” that “reduces reliance on PET scans and increases diagnosis accessibility.”

FDA Commissioner Martin A. Makary said of the landmark decision, "Alzheimer’s disease impacts too many people, more than breast cancer and prostate cancer combined.

"Knowing that 10% of people aged 65 and older have Alzheimer's, and that by 2050 that number is expected to double, I am hopeful that new medical products such as this one will help patients."

It remains unclear when this test will be available for commercial use across the world.

What Is Alzheimer’s Disease?

About 8.8 million Indians aged 60 and above are estimated to being living with Alzheimer's disease. Over seven million people in the US 65 and older live with the condition and over 100,00 die from it annually.

Alzheimer's disease is believed to be caused by the development of toxic amyloid and beta proteins in the brain, which can accumulate in the brain and damage cells responsible for memory.

Amyloid protein molecules stick together in brain cells, forming clumps called plaques. At the same time, tau proteins twist together in fiber-like strands called tangles. The plaques and tangles block the brain's neurons from sending electrical and chemical signals back and forth.

Over time, this disruption causes permanent damage in the brain that leads to Alzheimer's disease and dementia, causing patients to lose their ability to speak, care for themselves or even respond to the world around them.

While there is no clear cause of Alzheimer's disease, experts believe it can develop due to genetic mutations and lifestyle choices, such as physical inactivity, unhealthy diet and social isolation.

Early symptoms of Alzheimer's disease include forgetting recent events or conversations. Over time, Alzheimer's disease leads to serious memory loss and affects a person's ability to do everyday tasks.

There is no cure to this progressive brain disorder and in advanced stages, loss of brain function can cause dehydration, poor nutrition or infection. These complications can result in death.

How Does The Test Work?

As explained by Dr Abhay Moghekar, an associate professor of neurology at Johns Hopkins University School of Medicine, who helped study and evaluate the test for FDA approval, "If this test is positive, there’s a greater than 90% chance that you have amyloid plaque in your brain.

"Getting a blood test is gonna be far easier, quicker and cheaper,” he said. “It’s going to allow early access to therapy, so it is going to revolutionize care of patients with dementia."

However, the federal agency also noted certain limitations associated with the test such as it can only be used for patients 55 and older who are already experiencing memory problems.

The FDA also cautions that the test is not intended as a standalone diagnostic tool for Alzheimer’s and results should be interpreted based on the patient’s medical history and other assessments, such as cognitive testing.

People who stop using weight-loss medications can regain weight and return their original size within two years, a new BMJ study says.

Researchers have found that those who lose weight using blockbuster GLP-1 drugs such as Ozempic could regain about 0.4kg every month after quitting these treatments. In contrast, those who lost weight through exercise, diet and other factors only gained 0.1kg.

Investigator Dr Susan Jebb, from Oxford University told the BBC, "People buying these need to be aware of the risk of fast weight regain when the treatment ends."

Ozempic (semaglutide) is a prescription injectable GLP-1 medication primarily approved for adults with Type 2 diabetes to manage blood sugar levels. However, the drug has gained immense popularity among those trying to lose weight as it can reduce hunger and help people feel full for longer, which forces the body to burn fat deposits to stay functional.

In clinical trials, people with obesity using semaglutide have shown to lose an average of about 15% of their body weight over 68 weeks. Most people begin to see noticeable results within 8 to 12 weeks of taking the drug.

The official price in India for a once-weekly Ozempic injection pen ranges from approximately ₹8,800 for the 0.25 mg dose to around ₹11,175 for the 1 mg dose per month. Insurance coverage is generally inconsistent for weight loss indications.

What Did The Study Find?

The researchers analyzed 37 studies that included 9,341 participants out of which nearly half had taken had taken GLP-1 medications. This included 1,776 people who received the newer, more effective drugs semaglutide, sold as Ozempic and ‌Wegovy by Novo Nordisk , and tirzepatide, sold ‌as Mounjaro and Zepbound by Eli Lilly.

Apart from discovering that patients could regain all their weight in 1.7 years, the scientists also found that those who lost weight using semaglutide ‍and tirzepatide, cwould gain 0.8 kg per month.

Dimitrios Koutoukidis, Oxford University researcher and senior study author, “But because people on semaglutide or tirzepatide lose more weight ‍in the first place, they all end up returning to baseline at approximately the same time".

Heart health risk factors, such as blood pressure and cholesterol levels, that benefited ⁠from the drugs were projected to return to pre-treatment levels within 1.4 years after stopping the medications.

Why Does The Weight Come Back?

Dr Adam Collins, an expert in nutrition at the University of Surrey, told the BBC that when the body stops receiving a regular dose of appetite suppressants such as GLP-1 drugs, hunger returns and can lead to overeating.

He told the publication, "Artificially providing GLP-1 levels several times higher than normal over a long period may cause you to produce less of your own natural GLP-1, and may also make you less sensitive to its effects.

"That's not a problem when taking the drugs, but as soon as you withdraw this GLP-1 'fix', appetite is no longer kept in check and overeating is far more likely.

"This is further exacerbated if the individual in question has relied solely on GLP-1 to do the heavy lifting... artificially suppressing their appetite without them establishing any dietary or behavioural changes that would help them in the long run."