“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.

"Papa, I'm in pain," said the 44-year-old Indian origin man, Prashant Sreekumar to his father, before he died at a Canadian hospital's ER due to delay. He had a cardiac arrest and was rushed to the Grey Nuns Community Hospital in Canada's Edmonton. He had been complaining of severe chest pains at work on December 22. The 44-year-old was also father of three, and was kept in the hospital's emergency room waiting area for over eight hours. This has now sparked serious questions on Canadian healthcare system.

His father, Kumar Sreekumar told the Global News that he was checked in at triage and then seated in the waiting room. When his father reached the hospital, he told him, "Papa, I cannot bear the pain."

The father said that his son felt the pain was a '15 out of 10'. The staff had given him some Tylenol for his pain, but his blood pressure kept increasing.

"It went up, up, and up. To me, it was through the roof," his father said. He was finally called for treatment after more than eight hours of wait."After sitting maybe 10 seconds, he looked at me, he got up and put his hand on his chest and just crashed," his father said.

Nurses raised the alarm and attempted to revive him, but their efforts were unsuccessful. Prashant Sreekumar died from what is believed to be a cardiac arrest. He is survived by his wife and three children, aged three, 10 and 14.

Grey Nuns Hospital, which is part of the Covenant Health network, said it could not comment on individual patient care. In a statement to Global News, the organization confirmed the death is being reviewed by the Office of the Chief Medical Examiner.

“Our thoughts are with the patient’s family and friends. The safety and care of our patients and staff remain our highest priority,” the statement said.

External Affairs Ministry spokesperson Randhir Jaiswal in New Delhi, said that the person who died was a Canadian citizen and the government must look into the matter. “The person is of Indian origin but he happens to be, I understand, a Canadian national. So the Canadian government should take responsibility in the matter,” he said at a media briefing.

What Is A Cardiac Arrest?

As per the Heart Organization, a cardiac arrest is the abrupt loss of heart function in a person who may or may not have been diagnosed with heart disease. It happens because of an electrical issue that makes your heart stop beating. Your heart stops pumping blood and you become unconscious.

Symptoms Of Cardiac Arrest

• Fatigue
• Dizziness
• Shortness of breath
• Nausea
• Chest pain
• Heart palpitations (fast or pounding heart beat)
• Loss of consciousness

Who Are At More Risk Of A Cardiac Arrest?

If you follow a lifestyle heavily indulged in alcohol or drug abuse, or have a family history of heart disease or cardiac arrest, or have a heart disease, high blood pressure, high cholesterol, low potassium or magnesium, obesity or indulge into smoking, you make be more prone to having a cardiac arrest.

The phrases “heart attack” and “cardiac arrest” are often used as if they mean the same thing, but they refer to two distinct heart conditions.

A heart attack happens when a blockage in one or more arteries cuts off blood flow to the heart. This lack of blood and oxygen damages the heart muscle. A heart attack can raise the risk of cardiac arrest because it may disrupt the heart’s electrical signals. When cardiac arrest strikes suddenly in someone without known heart disease, it is often triggered by a heart attack.

H3N2's mutation or the influenza A's subclade K is now the new aggressive virus that has swept the United States with flu cases. This is the culprit in rising flu cases, globally. The World Health Organization (WHO) on its website said that K variant marks "a notable evolution in influenza A (H3N2) viruses". Some are also questioning the effectiveness of this season's influenza vaccine against the strain.

What Are The Common Symptoms This Season For The Flu?

K variant causes more intense flu symptoms, they include:

• Fever
• Chills
• Headache
• Fatigue
• Cough
• Sore throat
• Runny nose

According to a report by the Centers for Disease Control and Prevention (CDC), among 216 influenza A (H3N2) viruses collected since September 28, 89.8% belonged to the subclade K. CDC had been releasing weekly influenza surveillance reports and tracked which states have been seeing the most activity for outpatient respiratory illness.

The highest number of cases were reported from New York. New Jersey, Rhode Island, Louisiana, and Colorado came under 'Very High' category in level 3. Massachusetts, Connecticut, Michigan, Idaho, and South Carolina were under 'High' category level 1, New Mexico, under level 2, and Washington D.C., Maryland, North Carolina, and Georgia under level 3.

The CDC estimates that this flu season has already led to around 4.6 million illnesses, nearly 49,000 hospitalizations and about 1,900 deaths. Health authorities continue to stress that getting the flu vaccine remains the most effective way to protect against the virus.

Are The Old Vaccines Effective Against This New Variant?

"The vaccine remains the most effective means to prevent disease. We still want to encourage people to get the vaccine," said Professor Antonia Ho, Professor and Honorary Consultant in Infectious Diseases at the University of Glasgow. Experts have stressed enough on the immunity that one can receive from the vaccine that that these flu jab remain the best defense against the flu, even though the current strain circulated may have drifted away from the strain included in this year's jab.

Data from the UK Health Security Agency (UKHSA) also show that vaccines is performing as expect, despite the emergence of subclade K.

Also Read: Will The Old Flu Vaccine Protect You Against The New Subclade K?

Why Is This New Strain Hitting Hard?

Doctors explain that subclade K enhances the ability of the virus to slip through our immune protection. However, it does not mean that vaccination offers no protection against the flu. In fact, experts and doctors have been emphasizing the need to get yourself vaccinated to help you protect from the worst effects of the virus.

If you look at deaths and severe illness with flu, the vast majority both in adults and in children are unvaccinated.

Do vaccines give full protection? Doctors have pointed that you may get the flu even if you are vaccinated, it’s that the severity, the chance that you’re going to end up in hospital and worst-case scenario in the ICU or die does seem to be significantly protected against by being vaccinated.

Australia issued a health advisory warning travellers and healthcare providers about counterfeit batches of a rabies vaccine that have reportedly been circulating in India since November 1, 2023. The alert has raised concerns for anyone who may have received the vaccine while travelling or living in the country.

This Is What The Australian Advisory Says:

The warning was issued on December 22 by the Australian Technical Advisory Group on Immunisation. It flagged counterfeit batches of the rabies vaccine Abhayrab. While the vaccine is not supplied or used in Australia, the advisory notes that Australians or other travellers who were vaccinated in India could still be at risk.

The advisory clearly states that people who may have received the counterfeit vaccine might not be fully protected against rabies. As a precaution, it recommends that they receive replacement doses using a rabies vaccine that is registered and approved for use in Australia.

As it can be difficult to verify whether a dose was genuine or fake, the advisory takes a cautious approach. It says that anyone who received Abhayrab in India on or after November 1, 2023, should be considered as potentially having been given a counterfeit vaccine. Such individuals should be offered replacement doses as per Australian guidelines.

Why rabies protection is critical

Rabies is a viral zoonotic disease that attacks the central nervous system. In humans, it is most commonly transmitted through the bite of an infected dog. According to the World Health Organization (WHO), once rabies reaches the central nervous system and symptoms begin to appear, the disease is fatal in almost all cases.

India continues to bear a significant burden of the disease. WHO estimates suggest that rabies causes between 18,000 and 20,000 deaths every year in the country. India alone accounts for about 36 percent of rabies deaths globally, making effective vaccination and timely treatment especially critical.

Vaccine manufacturer responds

Abhayrab is manufactured by the Human Biologicals Institute, which is a division of Hyderabad-based Indian Immunologicals Limited. Responding to the advisory, the company said that it had proactively identified an issue in January related to a specific batch of the vaccine, as reported by Scroll.

According to the company, the issue involved Batch Number KA 24014, which was found in the marketplace with packaging that differed from the original. Indian Immunologicals Limited said it immediately informed Indian regulators and has been working closely with regulatory authorities and law enforcement agencies to address the issue. A formal complaint has also been lodged to support an investigation.

The company stressed that every batch of vaccine it produces is tested and released by the Central Drugs Laboratory under the Government of India before being made available for public use.

Broader concerns around medical quality

The advisory also comes at a time when India-made medical products have faced scrutiny abroad. In recent years, deaths allegedly linked to Indian-manufactured cough syrups were reported in countries like Gambia and Uzbekistan. Separately, Indian-made eye drops were suspected to be linked to infections in Sri Lanka.

Read: After Coldrif, WHO Bans 2 More Drugs, But This Is Not the Only Death from Indian Cough Syrup

Indian Immunologicals Limited, however, reiterated its commitment to safety and quality. It noted that Abhayrab has been manufactured since 2000, with over 210 million doses supplied in India and more than 40 countries. The company said the vaccine holds nearly 40 percent of the market share and assured healthcare professionals and the public that supplies made through authorized distributors are safe and meet quality standards.