“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.

Doctors may soon be able to determine a brain tumour’s type right during the surgery. Doctors remove a tissue sample during surgery to analyse the tumour. Patients undergoing surgery for brain tumour may not have to wait days or weeks to find out.

A new rapid genetic test being tested by the NHS in England promises to shorten the wait time drastically. The technology can find the precise type of brain tumour within about two hours, while the patient is still on the operating table.

Developed by researchers at the University of Nottingham and Nottingham University Hospitals NHS Trust, the test analyses the genetic code of a tumour sample rather than relying only on traditional microscopic examination.

Brain Tumour Diagnosis Takes A Long Time

Brain tumours are not connected to one single disease. There are more than 100 types, ranging from relatively slow-growing tumours to highly aggressive cancers. Knowing the exact type and characteristics of a tumour is important because treatment courses can differ significantly.

Traditionally, doctors take a sample during surgery and send it to a pathology laboratory. The tissue sample is then examined under a microscope. Finding out the tumour type usually takes weeks.

According to an NHS centre, the current average time for a brain tumour diagnosis can be around 26 days, while other reports have estimated up to almost eight weeks in some cases. In case of aggressive tumours, waiting period can be particularly difficult and longer.

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More About The New Test

The rapid genomic test works by analysing a small piece of the tumour which is taken during the surgery and sent to the laboratory, where its DNA is analysed using a shoebox-sized sequencing machine developed by Oxford Nanopore.

Inside the machine, DNA molecules pass through tiny pores. As they move through, the system reads their genetic information and uses the resulting genomic pattern to identify the tumour type.

Marking a significant jump in speed and time taken, the test can help doctors can receive detailed diagnosis during the operation itself instead of weeks.

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Promising Development In Brain Tumour Diagnosis

Not only this test reduces weeks, sometimes months of anxiety, it can also help surgeons make immediate decisions about how much tumour tissue to remove while protecting healthy brain tissue.

Some tumour types require different surgical approaches, and having molecular information immediately could help the surgeon take quick decisions.

A rapid diagnosis can also help patients to begin the appropriate treatment sooner and gain earlier access to clinical trials designed for specific tumour types.

The NHS is piloting the technology to determine how well rapid genomic testing works in routine clinical practice. The initial rollout covers five specialist centres, including Nottingham University Hospitals, University Hospitals Birmingham, Great Ormond Street Hospital, King's College Hospital and Newcastle Hospitals. More centres are expected to be added soon.

The rapid testing is therefore intended to complement the entire diagnostic process rather than make traditional pathology obsolete. If the NHS pilot is successful, rapid genomic testing could eventually make that information available much earlier to brain tumour patients across England.

The early signs of type 2 diabetes could be related to your gut. They may signal a warning risk long before you take a blood sugar test.

New research suggests that changes in the trillions of bacteria living in the gut may accurately predict future diabetes risk.

An analysis of microbiome data from more than 229,000 adults in the UK and US identified hundreds of bacterial changes linked with type 2 diabetes, including changes that appeared before measurable abnormalities in blood glucose.

The findings are being presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in Milan.

What Did Researchers Find?

Researchers from the University of Trento in Italy and collaborators in the UK analysed metagenomic data, which involves examining the DNA of microorganisms living in the gut.

The study included 229,025 people, of whom 3,627 had type 2 diabetes, 14,022 had prediabetes and 211,376 had normal blood glucose levels. The average age was 50, and about 74% of participants were women.

After accounting for factors including age, sex and body mass index, researchers identified 789 bacterial species associated with type 2 diabetes.

Of these, 168 were found at higher levels in people with diabetes, while 621 were present at lower levels.

One example was Enterocloster bolteae, which was more abundant in people with type 2 diabetes. In contrast, Romboutsia timonensis was found at lower levels.

Interestingly, 587 of the 789 bacterial species were also associated with unmedicated prediabetes, suggesting that some of these microbial changes may occur before diabetes is diagnosed.

Also read: Diabetes Linked To 55% Risk Of Kidney Disease, Heart Failure Or Death Within 10 Years: Study

Link Between Gut & Blood Sugar

The researchers looked at 135,093 people who had normal blood glucose and did not have diabetes or prediabetes. They also had information about how their blood sugar responded after eating.

Normally, blood glucose rises after a meal and then falls. If it remains elevated for longer than expected, it can indicate that the body's muscles are not responding properly to insulin, an early feature of insulin resistance.

Researchers found that people whose blood sugar remained elevated for longer were more likely to have the gut bacterial pattern linked with type 2 diabetes. The microbiome changes became more pronounced as insulin resistance increased.

Therefore, it was observed that the gut microbiome carried clues about metabolic problems even when standard blood glucose levels were still normal.

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Future Of Diabetes Testing

Currently, diabetes and prediabetes are diagnosed using tests like HbA1c, fasting blood glucose and oral glucose tolerance tests.

For people who have normal results, doctors generally assess future diabetes risk using factors like age, sex, body mass index and family history. A gut microbiome test is not currently part of routine diabetes screening.

The researchers believe microbiome analysis could eventually provide an additional layer of risk assessment, identifying people who could benefit from earlier lifestyle interventions.

Professor Tim Spector, one of the study's authors, Scientific Co-Founder, ZOE, said, “These latest findings represent a major step forward in understanding how our gut microbiome is linked directly with metabolic disease. Identifying these clear microbial changes before blood sugar levels worsen could lead to earlier intervention with food and lifestyle choices, as well as treatment options, to prevent T2D."

The researchers say that microbiome analysis should not replace existing tests for diabetes or prediabetes. The current findings show associations between particular bacterial patterns and diabetes risk.

The researchers also found that some of the bacteria making up the diabetes-related signature have never been isolated or cultivated in a laboratory and are new in terms of scientific investigation.

Additional research will be needed to assess whether these microbial changes can reliably predict who will develop diabetes and whether changing the microbiome can actually reduce that risk.

A Type 2 diabetes diagnosis increases the risk of developing chronic kidney disease (CKD) or heart failure (HF), or dying, by 55% within 10 years, according to analysis of data from more than 1.6 million patients across the US.

Within the first five years of a Type 2 diabetes diagnosis, the study found that the combined risk of developing CKD or heart failure, or dying, was 33% on average. By year 10, that combined risk rises to 55%.

Key Findings

The study shows within five years of a first diabetes diagnosis, the risk of developing CKD first was more than twice that of developing heart failure first (19.0% vs. 8.3%).

However, among people who developed heart failure first, there was a 42% risk of developing CKD within the following five years.

Conversely, among those who developed CKD first, there was a 23% risk of developing heart failure within the following five years.

"Our findings clearly show how the serious complications associated with type 2 diabetes rise sharply over time as the common combination of obesity, abnormal blood fats, high blood pressure and higher blood sugar damages blood vessels and vital organs," said Professor Naveed Sattar of the University of Glasgow in Scotland, UK.

Why The Findings Matter

Type 2 diabetes is projected to become the world's most prevalent epidemic disease, affecting an estimated 1.3 billion people by 2050.

It frequently occurs alongside obesity, high blood pressure, heart failure, CKD and depression, contributing substantially to the global burden of multi-morbidity.

The researchers say the findings highlight the importance of early, proactive and holistic management of Type 2 diabetes to help reduce the risk of serious complications.

"Our results emphasize the critical importance of detecting and treating type 2 diabetes thoroughly at the earliest opportunity to help reduce the risk of serious complications," Sattar added.

How Was The Study Conducted?

The team included 1,617,508 patients newly diagnosed with diabetes between January 1, 2010, and March 31, 2024, from across the US.

The average age of participants at enrollment was 59, and 51% were female. Among the 13% of patients who had a body mass index (BMI) recorded, the median was 30.9 kg/m².

Almost three-quarters (72%) of participants were living with dyslipidemia, or high levels of cholesterol and other fats in the blood, while more than two-thirds (68%) had high blood pressure.

How Are Diabetes, Kidney Disease And Heart Failure Linked?

The US Centers for Disease Control and Prevention (CDC) explains that diabetes, CKD and heart disease are interconnected.

High blood sugar can gradually damage the kidneys, reducing their ability to filter blood and potentially leading to CKD. When kidney function declines, it can also put additional stress on the heart.

Common Risk Factors

Risk factors that can overlap across diabetes, CKD and heart disease include:

• High blood sugar
• High blood pressure
• Family history
• Obesity
• Unhealthy diet
• Physical inactivity

Tips To Prevent

The CDC recommends lifestyle measures that can help reduce the risk of these conditions and their complications:

• Get active
• Choose healthy foods and drinks
• Quit smoking