“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 US Department of Health and Human Services (HHS) has terminated 16 grants worth a combined $38 million, including programmes focused on maternal and infant health, postpartum care and infant mortality, as the agency shifts funding priorities towards infertility and physical activity.

The grants, administered through HHS’ Office of Minority Health (OMH), were cancelled on August 25, according to reports. The affected programmes had already received funding for the first two years of their four-year grants.

The move has sparked criticism, particularly because some of the cancelled programmes were directly focused on supporting mothers and babies after childbirth.

HHS Shifts Focus To Infertility And Male Reproductive Health

According to the letters sent to grantees, future awards should directly support efforts aimed at “reducing overmedicalization in health care by addressing the root causes of infertility.”

The areas listed by HHS include hormonal imbalances, endometriosis, uterine fibroids, low sperm count, low testosterone levels and erectile dysfunction (ED). Programmes promoting “regular physical activity and exercise” were also listed among the priorities.

For grants dealing with maternal health, officials reportedly acknowledged that maternal and infant health remained important but said the specific projects did not advance minority health within OMH’s current priority are.

Also read: This Common Heart Attack Risk Starts Silently In Healthy People In Their 20s

Which Health Programmes Lost Funding?

Among the affected programmes was an initiative by Illuminate Colorado, which sends nurses to the homes of minority women following childbirth to check on the health of mothers and newborns.

“It was news to us that maternal and infant fatality prevention wasn’t a priority,” Jillian Fabricius, co-executive director of the organisation, told NOTUS.

Another programme administered by Housing Works and EngageWell helped people with hypertension monitor their blood pressure at home and provided fresh produce and eggs to 150 New Yorkers every two weeks.

The cancelled grants also included programmes focused on cancer screenings, suicide prevention among first responders and reducing obesity among Native American youth.

At the University of Arkansas for Medical Sciences, a programme aimed at reducing maternal and infant mortality among Black families in the Arkansas Delta could also end because of the funding loss.

Leslie Taylor, a university spokesperson, said the issue was “certainly a big issue in our state” given Arkansas’ high maternal and infant mortality rates.

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HHS Decision Is Drawing Criticism

The cancellations come amid a bigger shift in US federal health policy under the Trump administration, with HHS increasingly emphasising infertility, chronic disease prevention, exercise and what officials describe as addressing the underlying causes of health problems.

However, critics argue that programmes addressing maternal and infant mortality are also essential preventive healthcare, particularly for minority communities that experience significant health disparities.

“It is shocking that OMH under any leadership would prioritize erectile dysfunction over the health and wellbeing of infants and new mothers,” Representative Diana DeGette, the ranking Democrat on the House Energy and Commerce health subcommittee, wrote to HHS officials.

Atherosclerosis, in which plaque builds up inside the arteries, is a major cause of cardiovascular disease and can lead to heart attacks, strokes and sudden death. A new study published in The New England Journal of Medicine found that plaque buildup can begin decades before symptoms appear.

An international team of researchers found atherosclerosis in many apparently healthy young adults, including those in their 20s.

Dr Borja Ibáñez, Scientific Director of the Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), said the findings point to a new approach to cardiovascular prevention: detecting atherosclerosis through imaging before symptoms appear, rather than relying only on risk factors such as blood pressure, cholesterol and smoking.

Plaque Can Appear In The 20s

The study included 16,808 people aged 18 to 70 from Denmark and Spain. None had a known history of atherosclerotic cardiovascular disease.

Using advanced imaging, researchers examined the carotid, femoral and coronary arteries for plaque. Overall, 57.1% of participants had atherosclerotic plaques, despite having no symptoms or previous diagnosis of cardiovascular disease.

Atherosclerosis was detectable even among the youngest participants. Among those aged 18 to 29, plaque was found in:

• 8.7% of men
• 6.7% of women

The prevalence increased with age, reaching nearly 90% among people aged 60 to 70. By 60–70, only about 1.9% of men and 8.1% of women had no detectable plaque in any of the arteries examined.

Men Develop Plaque Earlier

The study found differences between men and women. Atherosclerosis began increasing at younger ages in men, with their atherosclerotic profile appearing five to 10 years earlier than in women.

In women, the sharpest increase occurred between 40 and 60, broadly coinciding with the menopausal transition.

Could Ultrasound Detect Silent Atherosclerosis?

Conventional cardiovascular risk scores, including SCORE2, identified only a small proportion of people who already had silent atherosclerosis.

Researchers found that people with coronary artery plaque often also had plaque in the carotid or femoral arteries. Because these arteries can be examined using relatively simple, non-invasive ultrasound, the finding could have implications for future screening.

Dr. Ibáñez said portable ultrasound devices could potentially become a tool for detecting atherosclerosis from early adulthood.

“The future of cardiovascular prevention must be more precise and personalized,” he said, adding that early detection could allow earlier intervention and more targeted treatment.

Plaque Does Not Mean A Heart Attack Is Imminent

Dr. Sudhir Kumar, neurologist at Apollo Hospitals, Hyderabad, said atherosclerosis can remain silent for decades before causing a heart attack, ischemic stroke or peripheral arterial disease.

However, having plaque does not mean a heart attack or stroke is imminent. Greater plaque burden and more widespread disease are associated with higher cardiovascular risk.

He also stressed that atherosclerosis is not simply an unavoidable consequence of ageing. Its progression can be slowed by addressing modifiable risk factors.

How To Lower Cardiovascular Risk

• Regular aerobic and strength exercise
• Avoiding tobacco
• Eating a healthy diet and limiting ultra-processed foods
• Controlling blood pressure
• Managing LDL cholesterol/ApoB when indicated
• Preventing and treating diabetes
• Maintaining a healthy waist
• Getting adequate sleep.

15-year-old Tanvi Pariyani’s death at AIIMS Delhi has raised questions about the treatment of a rare and complex congenital heart condition she had been living with since childhood.

Tanvi, from Kota, had been visiting AIIMS since she was two. Her medical records listed ventricular septal defect (VSD) with pulmonary atresia, a combination that can make treatment considerably more complicated than just a 'hole in the heart'.

Tanvi’s family has alleged that corrective surgery was repeatedly postponed. AIIMS, however, said its treating team concluded in 2017 that corrective surgery was not feasible because of the complexity of her cardiac anatomy and advised medical management.

The hospital has now constituted a committee to review her complete clinical records, investigations, treatment, expert opinions and the circumstances surrounding her death. An autopsy is also underway.

What Is Pulmonary Atresia With VSD?

A VSD is a hole in the wall separating the heart’s two lower chambers. The right side of the heart pumps oxygen-poor blood towards the lungs through the pulmonary artery.

In pulmonary atresia, the normal route through which blood leaves the right side of the heart and reaches the lungs is blocked or has not developed properly.

This can severely block blood flow to the lungs and reduce the amount of oxygen entering the bloodstream.

When pulmonary atresia occurs along with VSD, doctors have to deal with multiple abnormalities rather than simply closing the hole.

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Treatment Is Complicated

Some children may initially require procedures to ensure adequate blood reaches the lungs. Doctors may use medicines temporarily and later create an alternative pathway for blood flow through a shunt.

In some patients, the pulmonary arteries remain very small and the body develops additional blood vessels supplying the lungs.

These vessels, called major aortopulmonary collateral arteries (MAPCAs), may need to be brought together through a procedure called unifocalisation.

A conduit may then be used to connect the heart to the lungs, while the VSD may also need to be closed.

The anatomy can also change as a child grows. Small pulmonary arteries, abnormal blood vessels and rising pressure in the lungs can make later surgical repair more challenging.

Also read: Sugar-Free Sweetener Used In Candies May Have A Harmful Metabolic Effect On Liver: Is Sorbitol Really Healthy?

Events Leading Upto The Teen's Unfortunate Death

According to AIIMS, Tanvi was admitted on August 24 after her condition deteriorated and was being evaluated for a possible heart-lung transplant.

On September 1, she developed severe cyanosis, and her oxygen saturation fell to around 48%. AIIMS said she subsequently suffered a hypoxic spell followed by cardiac arrest. Despite oxygen support and resuscitation, she could not be revived and was declared dead at 5:06 am.

“The Director, AIIMS, New Delhi has constituted a committee to examine the matter in detail, review the sequence of events and establish the facts,” the institute said.

The committee’s findings and autopsy report will be important in establishing what happened and whether any intervention could have altered the outcome.