“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.

A US doctor infected with the Ebola virus, while treating patients infected with the deadly disease in Democratic Republic of the Congo has been admitted to Berlin's Charité hospital today.

The German Health Ministry acquiesced to a request from the United States for the patient to be treated in Germany rather than the United States due to the shorter travel time from Uganda and the Charité's experience in dealing with Ebola, Deutsche Welle reported.

The patient was flown to Berlin on a special medical aircraft and was then driven to the hospital in a specially designed vehicle escorted by police. The aircraft also carried six other people with whom the infected man had contact.

The German Health Ministry has reassured the public that there is no danger of the deadly virus spreading to the general population.

The Charité hospital specializes in the treatment of such cases and the patient is being housed in a completely isolated ward, separate from the rest of the clinic, the report said.

The German Health Ministry, however, noted that the mortality rate following modern treatment and specialist monitoring at a clinic like Berlin's Charité drops from around 60 per cent to 20 per cent-30 per cent.

Ebola Cases Rise To Over 130: WHO Considers Use Of Experimental Vaccines

Also read: UK Scientists Begin Drug Trial To Mend Broken Heart Syndrome

Tedros Adhanom Ghebreyesus said there had been at least 500 suspected cases of Ebola and 130 suspected deaths due to the Bundibugyo strain in DR Congo since the new outbreak began in April.

Global health leaders are also considering whether vaccines or medicines still in development could be used to fight Ebola. Dr Mesfin Teklu Tessema, senior director of health at the International Rescue Committee, which works in the DRC’s Ituri Province, where most cases have been reported, told the The Guardian he expected current known cases were “the tip of the iceberg”.

Spread across the porous border to South Sudan, he said, was probably “a matter of when”. He warned that a weak public health infrastructure there meant “we are actually flying blind”.

A WHO official in Ituri province said the outbreak could take a long time to bring under control.

“I don’t think that in two months we will be done with this outbreak,” Anne Ancia, the WHO’s representative for the DRC, told reporters in Geneva at the World Health Assembly, pointing to a recent Ebola outbreak that took two years to end. Nearly 2,300 people died between 2018 and 2020 in the deadliest outbreak in the DRC to date.

“At the international level, [we are] looking at what candidate vaccines or treatment are available and if any could be of use in this outbreak,” Ancia added.

Australia has seen more than 220 cases of diphtheria so far this year, the biggest outbreak of the disease since national records began in 1991.

The Northern Territory has the largest number of positive cases at 133, followed by 82 in Western Australia, six in South Australia, and fewer than five in Queensland.

In response to the outbreak, the federal and state governments have mobilized, and the Commonwealth is preparing a support package to bolster vaccination rates for a disease once considered almost eradicated, ABC News reported.

Authorities are also waiting on the outcome of an investigation into a reported diphtheria-related death in the NT, which would be the first death from the disease in almost a decade.

Federal health minister Mark Butler said the numbers were “very concerning.”

“To put that in context, we've been recording case numbers nationally for about 35 years, and this, by a very big distance, is the biggest outbreak of diphtheria we've ever seen,” he said.

The cases are rising amid falling vaccination rates on the continent.

“I want to say this is not just very serious in terms of its numbers, but the vast majority of new cases we're seeing are respiratory diphtheria, which is far more serious in terms of its potential — about 25 per cent of cases are being hospitalized,” Butler said at a press conference on the NSW Central Coast.

Also read: US Doctor With Ebola Admitted To Hospital In Germany

2 Different Diphtheria Strains Identified

Two strains of diphtheria have been identified in Australia: respiratory and cutaneous. While respiratory diphtheria can affect the nose, throat, and airways, cutaneous affects the skin, causing pus-filled blisters on the skin or large ulcers surrounded by red, sore-looking skin.

The respiratory strain also spreads through droplets from coughing or sneezing, or direct contact with infected wounds.

Even with treatment, one in 10 people with respiratory symptoms die, according to the Australian CDC.

What Is Diphtheria?

As per the World Health Organization (WHO), diphtheria is a disease caused by the Corynebacterium diphtheriae bacterium that affects the upper respiratory tract and, less often, the skin. It also produces a toxin that damages the heart and the nerves. While it is a vaccine-preventable disease, multiple doses are needed to produce and sustain immunity.

Diphtheria has remained a leading cause of childhood death globally. But vaccination has long prevented mortality among children.

Those who are not immunized remain at risk. WHO also mentions that diphtheria can be fatal in 30 per cent of cases, with young children at higher risk of dying if they are unvaccinated and are not receiving proper treatment.

In 2023, an estimated 84 per cent of children worldwide received the recommended 3 doses of diphtheria-containing vaccine during infancy, leaving 16 per cent with no or incomplete coverage.

According to Australia’s Department of Health and Aged Care, between 1926 and 1935, more than 4,000 Australians died from diphtheria.

Vaccination started in Australia in the 1930s, and the disease has rarely been seen since the 1950s. But vaccine coverage has waned since the COVID pandemic, leading to a rising number of cases.

Diphtheria: Signs And Symptoms

Read More: UK Scientists Begin Drug Trial To Mend Broken Heart Syndrome

Within 2 to 5 days after exposure to the bacteria. The symptoms include

• a sore throat,
• fever,
• swollen neck glands,
• weakness.

Diphtheria: How the Disease Is Treated

It is usually treated with diphtheria antitoxin as well as antibiotics. Antitoxin neutralizes the circulating toxin in the blood. Antibiotics stop bacterial replication and thereby toxin production, speed up getting rid of the bacteria, and prevent transmission to others.

How To Prevent Diphtheria

Diphtheria can be prevented by vaccines and routine immunization. The vaccine is given most often combined with vaccines for diseases such as tetanus, pertussis, Hemophilus influenzae, hepatitis B, and inactivated polio.

Cholesterol is not all that bad as long as it is in the right proportion. It is of two types — good and bad cholesterol, the former being HDL and the latter LDL. It is a fatty substance in the blood that is made of essential proteins. While several tests are conducted to ascertain cholesterol levels in the body, there are some types of cholesterol that are not usually detected during routine check-ups. It turns out that this hidden form of cholesterol can quadruple the risk of stroke and heart attack, even if everything else is done right. This form of cholesterol is known as lipoprotein(a), or Lp(a) — it carries fats and proteins in your blood.

How does lipoprotein(a) affect heart patients?

Experts note that roughly 20 per cent of people have high Lp(a). It is similar to LDL, which is often known as bad cholesterol. However, there is a protein known as apolipoprotein(a) that makes Lp(a) twice as harmful. The extra protein leads to plaque build-up that eventually clogs arteries, thereby raising the risk of blood clots.

Both factors mean that someone is more likely to suffer from a stroke or heart disease. Recent research from the National Institutes of Health (NIH), which evaluated blood samples from 20,000 adults aged 40 and above, noted that those with the highest Lp(a) levels were about 30 per cent more prone to suffering a major heart event. These participants were also 50 per cent more likely to die from heart disease and 65 per cent more likely to suffer a stroke.

What are the consequences of high Lp(a) levels?

Researchers found that higher levels of Lp(a) were linked to a higher risk of a heart attack. However, these links were stronger in people who had already suffered from heart disease. Experts also found that one can quantify the specific levels of Lp(a) that can lead to a heightened risk of a major heart event, such as a stroke or heart failure. Researchers noted that, regardless of age, patients can opt for low-cost blood tests to determine their risk of genetic conditions. Lp(a) is not regularly checked in a standard cholesterol test. Instead, experts rely on a specific test to spot this condition.

Should you get Lp(a) levels checked?

According to the British Heart Foundation, it is important to get Lp(a) levels checked if someone in your family has high levels of it, or if there is a family history of coronary heart disease at an early age. The study’s findings also suggest that patients dealing with high Lp(a) levels need aggressive management of heart disease risk factors. If detected, you must work on a routine religiously to lower LDL and manage risk factors as much as possible. Lp(a) in the blood is determined by genes. However, according to researchers at the University of Queensland, other risk factors are:

1. Hypertension
2. High LDL
3. Diabetes
4. Not exercising enough
5. Unhealthy diet
6. Smoking

The good news, however, is that Lp(a) levels can be reduced with the help of drugs available on the market. In early clinical trials, drugs developed by Eli Lilly and Novartis lowered Lp(a) levels by 80–90 per cent. Combining this with a healthy diet and lifestyle can go a long way in the process.