“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.

How does a heatwave affect asthma patients?

Summer heat, dust, and pollution can trigger asthma symptoms like cough and breathlessness. Hence, it is the need of the hour to take extra care during the warmer months. Here, the expert also highlights the vital tips to stay healthy. Cough and breathlessness are frequently experienced by asthma patients, and a heatwave can make these symptoms far more severe.

Dr Kadian explains that asthma is also a common occurrence in summer. While many people associate it with winter, summer can also be a challenging time for those living with asthma. So, the rising temperatures, increased air pollution, dust, pollen, and humidity can irritate the airways and trigger symptoms. People may experience coughing, wheezing, shortness of breath, and a feeling of tightness in the chest. During summer, hot air can cause the airways to become dry and sensitive.

At the same time, outdoor allergens like pollen and dust are more common. Air conditioners, if not cleaned regularly, can circulate dust and mold, further worsening symptoms. For children and adults alike, understanding these triggers and taking simple precautions can help prevent flare-ups and keep breathing under control. Even dehydration is another factor that can worsen asthma. When the body lacks fluids, the airways may become more irritated. Sudden temperature changes, like moving from extreme heat outside to very cold indoor air, can also trigger breathing problems.

Tips to manage asthma in summer

Dr Kadian shared some simple tips to help asthma patients deal with the symptoms amid a heatwave. Make sure to stay hydrated by drinking enough water; avoid extreme heat and high-pollution areas; wear a mask; keep the house clean, dust- and mold-free, and well-ventilated. Service air conditioners from time to time and prevent dust and mold buildup. Carry prescribed inhalers and use them as advised by the doctor. It is also necessary to take a bath and change clothes after coming from outdoors. Also, it is essential to take the flu and pneumococcal vaccines as advised by the doctor and stay healthy.

Asthma can be managed with awareness and simple daily care. Staying cautious and prepared is the key to breathing easy even in the heat. This summer, prioritise your respiratory health.

There have been six suspected cases of hantavirus — a rare but potentially deadly virus transmitted primarily by rodents — of which three have died, said the World Health Organization (WHO).

Also Read: WHO Says Suspected Hantavirus Killed 3 on Cruise Ship: Symptoms, Risks, and Prevention

The suspected hantavirus outbreak occurred on the MV Hondius cruise ship, Oceanwide Expeditions, in the Atlantic Ocean. It was travelling to the Canary Islands via Cape Verde from Argentina. The three people dead include a Dutch husband and wife, as well as a German national, according to the operator of the ship.

Speaking to the media, Maria Van Kerkhove, Director (a.i) Epidemic and Pandemic Preparedness and Prevention, WHO, said that the WHO is working with countries involved in the response to the hantavirus cases onboard a ship off Cabo Verde, as well as the ship's operators, and carrying out risk assessments to guide next steps.

“As of the fourth of May, there have been six suspected cases reported. Three cases have unfortunately died. One patient is currently ill in the ICU in South Africa, while two patients remain on board and will be evacuated for medical treatment. About a hundred and fifty people, including passengers and crew, are on the ship,” Van Kerkhove said.

The patient in the ICU is a 69-year-old UK national.

“The patient is still in critical condition in isolation but receiving medical attention,” according to a statement by South Africa’s Department of Health (DoH).

The WHO noted that it is working with countries to evacuate the two sick people on board to the Netherlands for medical care.

“At present, there are no other symptomatic people on the ship, but this is being carefully monitored,” Van Kerkhove said.

Adding that laboratory tests are also ongoing, she stated that “based on current information and what we know about the virus from previous outbreaks, the overall risk to the public is low.”

Also Read: Hantavirus Kills 3 on Cruise Ship: Symptoms, Risks, and Prevention

Hantavirus: How did the outbreak begin?

Some of the passengers onboard the Oceanwide Expeditions, travelling to the Canary Islands via Cape Verde from Argentina, with some 150 passengers, began experiencing serious health complications while the ship was travelling past South African shores. Initially, it was considered a severe acute respiratory infection; later, three people died.

“[The] first patient was a 70-year-old male passenger who suddenly became ill on the ship en route from Ushuaia to St Helena Island. Unfortunately, he passed away on arrival at St Helena Island. His mortal remains are in St Helena, awaiting repatriation to the Netherlands,”," South Africa’s DoH said.

Hantavirus Symptoms

The initial symptoms included:

• fever,
• headache,
• abdominal pain,
• diarrhea.

Hantavirus Alert: 890 US Cases

Meanwhile, the Centers for Disease Control and Prevention (CDC) noted that by the end of 2023, 890 cases of hantavirus disease were reported in the United States since surveillance began in 1993.

Hantavirus pulmonary syndrome (HPS) became a nationally notifiable disease in 1995 in the US.

Read More: CDC Flags Surge in US Tuberculosis Outbreaks, Cases Double Since 2017

What Is Hantavirus?

Globally, an estimated 100,000 to 200,000 hantavirus infections occur each year. The majority of these cases are in Asia, particularly China. Most are sporadic or occur in small clusters, linked to contact with infected rodents.

“Hantaviruses are a group of viruses carried by rodents that can cause severe disease in humans. Infection with hantaviruses is found in many parts of the world. Thousands of infections are estimated to occur each year," Van Kerkhove said.

Infection in people can result in severe illness and often death, although the diseases vary by type of virus and geographical location. In the Americas, infection has been known to lead to hantavirus cardiopulmonary syndrome (HCPS), a rapidly progressive condition affecting the lungs and heart, while in Europe and Asia, hantaviruses have been known to cause hemorrhagic fever with renal syndrome (HFRS), which primarily affects the kidneys and blood vessels.

Notably, the WHO has not specified the type of hantavirus or syndrome in the cruise incident, but did mention respiratory risks.

The hantavirus is primarily spread by rodents through

• exposure to their urine,
• droppings,
• saliva,
• less commonly through a scratch or bite.

According to the CDC, symptoms can appear one to eight weeks after exposure, initially presenting fatigue, fever, and muscle aches. As the disease progresses, it can cause coughing, shortness of breath, and chest tightness as fluid accumulates in the lungs.

The CDC reports that about one-third of individuals who develop respiratory symptoms from the disease may not survive.

How to Protect Yourself: 7 Ways to Reduce Hantavirus Risk

You can reduce your risk by eliminating and minimizing your contact with rodents in your home, workplace, or campsite.

Other effective measures include:

• keeping homes and workplaces clean
• sealing openings that allow rodents to enter buildings
• storing food securely
• using safe cleaning practices in areas contaminated by rodents
• avoiding dry sweeping or vacuuming rodent droppings
• dampening of contaminated areas before cleaning
• strengthening hand hygiene practices.

In an ever-evolving world, people are always looking for something more convenient. Thanks to this never-ending search for an easier way out, even the ways of using medicine have changed. From popping pills to now using nasal sprays for decongestion, the way we deal with a cold or the flu has also changed. But just like all other aspects of life, one must know where to stop. Unsurprisingly, cases of nasal spray addiction have come to light, and the consequences are not pretty.

What happens when nasal sprays are used in excess?

In the UK, the Medicines and Healthcare products Regulatory Agency (MHRA) has stated that excessive use of nasal spray can lead to ‘rebound congestion’ and other major side effects. While people were mindlessly using nasal sprays for seven days in a row, a new advisory limits use to just five days. Brits are reportedly becoming addicted to nasal sprays because of excessive use to relieve blocked noses, thereby causing damage to the tissues inside.

What are the symptoms of overuse of nasal sprays?

Decongestant sprays constrict inflamed blood vessels in the nasal passages, thereby relieving congestion. In the short term, they work well. However, if used too much, the blood vessels in the nasal passages become sensitive to ingredients like xylometazoline and oxymetazoline. These passageways also start to swell when the medication wears off. In the long run, addiction or overuse of nasal sprays can lead to the following symptoms:

1. Damage to the sensitive lining of the nose
2. Dependence on the spray
3. Crusting
4. Dryness in the nose
5. Sleep problems
6. Palpitations
7. Anxiety
8. Irritation
9. Reduced effectiveness of the spray

Consequences of nasal spray addiction

In an interview with Health and Me, Dr Samir Garde, Director of the Department of Pulmonology and Lung Transplant at Gleneagles Hospital, Parel, said, “Many people have a habit of using nasal sprays mindlessly. So, even though they tend to provide that much-needed relief, they can take a toll on well-being. Using nasal sprays too often, particularly decongestant sprays, can do more harm than good. While they give quick relief from a blocked nose, overuse can lead to a problem called rebound congestion. This happens when the nose becomes even more blocked once the effect wears off. This can make people dependent on the spray and even cause addiction. Moreover, excessive use also dries out the nasal lining, causing irritation, burning, or even small nosebleeds.”

Some people may experience headaches or a constant feeling of stuffiness that can disturb peace of mind and interfere with daily routine. In the long run, it can damage the sensitive tissues inside the nose and reduce the spray’s effectiveness. So, use nasal sprays strictly as per a doctor’s advice. Do not overdo it. Anything done in excess can be harmful to health. Take charge of your wellbeing and follow medical advice carefully.