Polio Outbreak in Pakistan
Pakistan continues to be dealing with a polio outbreak as four fresh cases have emerged, pushing the national tally to 37 this year, according to health officials on October 19, 2024. Health officials said that the regional reference laboratory for polio eradication at the National Institute of Health in Islamabad confirmed wild poliovirus type-1 (WPV1) in two children-one from each Balochistan and Khyber-Pakhtunkhwa.
In recent cases, a girl has been affected from Pishin, and two boys from Chaman and Noshki of Balochistan, and a girl from Lakki Marwat in KP. These are the first detections of the virus within Noshki and Lakki Marwat this year; isolated cases of poliovirus were previously reported within Chaman and Pishin. The province of Balochistan was the worst hit with 20 cases, Sindh had 10, Khyber Pakhtunkhwa had five, and Punjab and Islamabad had one case each.
A gigantic fight against polio has been on going in Pakistan- especially in Balochistan and southern KP-over the last two years. Immunisation campaigns have often been suspended or delayed because of local protests, insecurity, and community boycotts. Consequently, quite a number of children did not get the necessary vaccinations, making existing patches of vulnerability for the virus to flow within those pockets.
Noshki, located near Afghanistan's border, and Lakki Marwat have also recently reported some positive environmental samples that confirm the virus is present here, said a local reference laboratory official. Samples of latest cases are currently under genetic sequencing for checking spread of virus and origin.
As the threat of polio continues to grow, Pakistan has vowed to mount a nationwide campaign against it beginning from October 28. With the zeal to tackle the menace in the most effective manner, over 45 million children under the age of five will be vaccinated across the country.
Today, Afghanistan and Pakistan remain one of the few countries where polio has not yet been eradicated. The WHO said the virus remains a potential serious public health threat in areas with low vaccination coverage and weak surveillance.
The country declared itself polio-free since 2014 and has kept the disease on bay almost a decade with very robust vaccination programs; however, two cases of vaccine-derived poliovirus cases reported in recent days from Meghalaya create some amount of doubts over a possible resurgence. Experts observe that in India, despite these detections taking place, strong coverage of vaccination at 90-95% and mandatory surveillance measures keep the risk of this widespread outbreak at bay.
The experts point out, however, that such stable situation in India requires continued surveillance. "Countries like Pakistan and parts of Africa remain at a high risk because vaccination rates in those areas are much lower," Dr. Siddharth, public health expert, said. Vaccination is an indispensable act in order to avoid the spread of this incapacitating disease that manifests most importantly as a nervous system affliction leading to the paralysis of a long period.
With concerted efforts from health authorities, there is hope someday that the scourge of polio will be completely eradicated from the face of the earth and future generations will never suffer from its effects.
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Eli Lilly's 'Godzilla' weight loss drug retatrutide could offer more than just weight loss. The experimental drug, a once-weekly injection, has shown promising results in easing chronic knee pain among people with obesity and knee osteoarthritis in two Phase 3 clinical trials.
The findings, published in the New England Journal of Medicine (NEJM), suggest that the drug could address obesity and painful knee osteoarthritis, two interconnected health concerns. Participants receiving retatrutide experienced significant improvements in knee pain than those who received a placebo.
The findings are noteworthy as excess bodyweight can aggravate knee osteoarthritis more which can make everyday activities, including walking, climbing stairs and exercising, difficult.
Also read: Stopping Mounjaro & Zepbound May Trigger Hallucinations, Mania & Other Psychiatric Symptoms
Retatrutide is a once-weekly injectable medication which belongs to a newer class of weight-loss drugs known as triple-hormone receptor agonists.
Unlike semaglutide (which targets GLP-1 receptors) and tirzepatide (which targets GLP-1 and GIP receptors), retatrutide activates three hormone receptors:
- GLP-1 (glucagon-like peptide-1): Helps regulate appetite, slow stomach emptying and control blood glucose levels.
- GIP (glucose-dependent insulinotropic polypeptide): Helps regulate insulin production and metabolic regulation.
- Glucagon: Plays a role in energy metabolism and can increase energy expenditure.
By targeting all three, retatrutide helps regulate appetite, food intake and energy metabolism, resulting in substantial weight loss and management of obesity-related illnesses.
Researchers wanted to investigate whether this amount of weight reduction could also help people experiencing chronic knee pain linked with osteoarthritis.
The findings come from two Phase 3 clinical trials, TRIUMPH-4 and TRIUMPH-1-OA, which enrolled 1,019 participants.
Both trials included overweight or obese adults with knee osteoarthritis. Participants did not have diabetes and were randomly assigned to receive different doses of retatrutide or a placebo.
The trial included 445 participants who received either 9 mg or 12 mg of retatrutide or a placebo over 68 weeks.
- Participants receiving 9 mg of retatrutide experienced a 3.96-point reduction in their WOMAC pain score.
- Those receiving 12 mg experienced a 3.74-point reduction.
- The placebo group experienced a 2.12-point reduction.
Participants also experienced substantial weight loss. Those receiving 9 mg lost an average of 20% of their body weight, while the 12 mg group lost 23.7%. The placebo group lost 4.6%.
Also read: Not Everyone With Obesity Is Unhealthy: New Study Challenges BMI
This trial enrolled 574 participants who received 4 mg, 9 mg or 12 mg of retatrutide or a placebo over 80 weeks. The results showed:
- The 4 mg group experienced a 3.22-point reduction in knee pain scores.
- The 9 mg group experienced a 3.48-point reduction.
- The 12 mg group experienced a 3.64-point reduction.
- The placebo group experienced a 1.87-point reduction.
Weight loss ranged from 17.5% to 24.8% across the three retatrutide groups, compared to 4.3% in the placebo group.
One encouraging finding emerged from the trials. Approximately 63% to 70% of participants receiving retatrutide experienced at least a 50% reduction in knee pain. This was compared to 38% of participants receiving a placebo.
Improvements in physical function were also observed, with approximately 64% of participants in the retatrutide groups experiencing at least a 50% improvement, compared to 33.1% in the placebo group.
Also read: Stopping Ozempic or Wegovy May Double Your Risk Of Heart Attack, Death
Despite the promising findings, researchers also identified safety concerns at higher doses of retatrutide. The most common adverse events were gastrointestinal problems, including nausea, diarrhoea and constipation. These symptoms were generally mild to moderate and occurred more frequently when dose was increased.
Another reported side effect was dysesthesia, an abnormal sensation of the skin that can include tingling, burning or unusual sensitivity.
In TRIUMPH-4, serious adverse events affected approximately 10% to 11% of participants receiving 9 mg or 12 mg of retatrutide, compared to 2% in the placebo group.
Furthermore, approximately 15% to 18% of participants receiving the highest dose discontinued treatment because of adverse events.
Osteoarthritis is a degenerative joint condition in which the cartilage cushioning the ends of bones breaks down. This can cause pain, stiffness, swelling and difficulty in movement. Excess body weight can worsen the condition due to increased mechanical pressure on the knees and inflammation related to obesity.
While the findings offer hope for people living with chronic knee pain, researchers caution against interpreting pain relief as evidence that the drug can reverse osteoarthritis. Additionally, people who required knee replacement were excluded from the trials.
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Regaining weight is one of common effects of stopping GLP-1 treatment for obesity. But apart from this, users have reported unusual side effects like hair fall, vision loss and even psychiatric symptoms.
According to two case reports published in the Primary Care Companion for CNS Disorders, stopping GLP-1 weight-loss drugs may ensue serious psychiatric symptoms in some patients like hallucinations, paranoia, mania and severe depression.
The reports describe two men who developed acute psychiatric symptoms after abruptly discontinuing tirzepatide, sold under the brand names Mounjaro and Zepbound. Both patients needed hospitalisation and psychiatric treatment.
The latest findings raise questions about the possible psychiatric effects of stopping GLP-1 medicines on the brain.
What Happened To The Two Patients?
Also read: Semaglutide May Lower Fetal Oxygen Levels During Pregnancy, Sheep Study Finds
The first case involved a 61-year-old man with a history of depression who stopped taking tirzepatide in August 2025 because of nausea.
Around two months later, he was hospitalised with worsening confusion and erratic behaviour. He experienced paranoia, auditory and visual hallucinations, and Cotard's delusion, a rare condition in which a person believes they are dead or no longer exist.
Medical investigations, including brain imaging, an electroencephalogram and tests of cerebrospinal fluid, did not identify a clear explanation for his symptoms. He received antipsychotic medication along with his existing antidepressant treatment.
Although his psychotic symptoms initially improved, he was readmitted weeks later with severe depression and catatonic features, a condition involving symptoms like reduced movement, unresponsiveness and difficulty communicating. He subsequently required electroconvulsive therapy.
The second case involved a 52-year-old man with a history of anxiety who abruptly stopped tirzepatide in September 2025 after losing approximately 100 pounds (45 kg) over six months.
About a month later, he developed significant mood and behavioural changes, including irritability, impulsivity, grandiosity and rapid, disorganised speech. Doctors diagnosed a manic episode. He was treated with an antipsychotic and transferred for psychiatric care.
Can Stopping GLP-1 Drugs Affect Mental Health?
Also read: Stopping Ozempic or Wegovy May Double Your Risk Of Heart Attack, Death
GLP-1 receptors are found not only in the digestive system but also in the brain, including regions involved in appetite, reward processing and mood regulation.
GLP-1 medicines influence these regions, which may partly explain why researchers are investigating their effects on mental health.
The authors of the case reports suggest that abruptly stopping the medication could contribute to sudden changes in mood or behaviour in certain vulnerable individuals. They also point towards dopamine signalling and neuroinflammatory processes.
However, researchers could not establish that withdrawal from tirzepatide was responsible for the psychiatric symptoms.
Both patients had pre-existing mental health conditions, which may have contributed to their symptoms. The second patient also had low vitamin B12 levels and increased marijuana use before developing symptoms.
The authors described the psychiatric symptoms after discontinuation of medication as “an underrecognized clinical phenomenon” and called for further research.
GLP-1 Drugs & Psychiatric Symptoms
The case reports do not mean that GLP-1 medicines cause psychosis, mania or other psychiatric disorders when stopped.
In January 2026, the US Food and Drug Administration (FDA) said its review of 91 clinical trials involving more than 107,000 participants found no increased risk of suicidal thoughts or behaviour with GLP-1 medicines.
It also found no increased risk of other psychiatric adverse events, including anxiety, depression, irritability and psychosis, compared to placebo.
However, that assessment primarily examined risks associated with taking the medicines. It does not settle the question of whether abrupt discontinuation could be linked with psychiatric symptoms in a small, vulnerable group.
The findings, however, indicate that patients should not stop GLP-1 treatment without discussing it with their healthcare provider. People may discontinue these medicines because of side effects, cost, access problems or other reasons, but a clinician can help change treatment plans.
Anyone experiencing new symptoms like confusion, hallucinations, extreme mood changes, paranoia or unusual behaviour after stopping a GLP-1 medication should seek urgent medical intervention.
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A new blood test may help identify microscopic precancerous changes linked to ovarian cancer before a tumour develops, according to a study published in Nature Medicine. Researchers found that the test could detect a molecular signal associated with an early precursor of high-grade serous ovarian cancer, one of the most common and aggressive forms of the disease.
The study, led by researchers at the Hoag Family Cancer Institute in California, identified elevated levels of an RNA molecule called Tu-Stroma in blood samples from women with a condition known as serous tubal intraepithelial carcinoma (STIC).
The findings could eventually help identify women at increased risk of developing ovarian cancer, especially those with inherited genetic mutations.
What Is STIC And How Is It Linked To Ovarian Cancer?
High-grade serous ovarian cancer mostly originates in the fallopian tubes rather than directly in the ovaries. It may begin with microscopic changes in the cells lining the fallopian tubes, known as serous tubal intraepithelial carcinoma or STIC.
These lesions are precancerous, which means they are not invasive cancer but can lead to the development of high-grade serous ovarian cancer.
STIC is difficult to detect because the abnormal cells are microscopic and cannot be identified through routine imaging. They are often discovered incidentally when women undergo surgery to remove their fallopian tubes or ovaries.
How Does The New Blood Test Work?
The researchers found that women with STIC had elevated levels of Tu-Stroma, an RNA molecule related to interactions between abnormal cells and surrounding healthy tissue.
The molecule is linked to a process in which cancer cells weaken neighbouring healthy cells, creating an environment that allows abnormal cells to thrive.
By measuring Tu-Stroma in blood samples, researchers investigated whether this molecular signal could identify STIC before invasive cancer develops.
In a separate validation group, the test detected STIC in 92.3% of women who had the precancerous condition and correctly identified 98.2% of healthy women.
Researchers also modelled how the test might perform in a population of women with inherited risk factors for ovarian cancer. They estimated that approximately 72% of positive results would be accurate, while a negative result would be correct nearly 100% of the time.
Also read: Why Lobular Breast Cancer Can Be Difficult To Detect On A Mammogram?
Could The Test Help Women With BRCA1 And BRCA2 Mutations?
The findings may be relevant to women carrying inherited mutations in the BRCA1 and BRCA2 genes, which increase the risk of ovarian and breast cancers significantly.
Women with these mutations may be advised to consider surgery to remove of their fallopian tubes and ovaries. While this can reduce ovarian cancer risk, it also has consequences like including the loss of fertility and the possibility of early menopause.
Dr Esha Madan, co-author of the study and a researcher at Hoag Family Cancer Institute, said, “For women at high risk, this could transform how we approach prevention.”
She added, “Today, decisions about preventive surgery are largely guided by inherited risk, without knowing whether precancerous lesions are actually present. Our discovery could eventually provide that missing biological information.”
Can This Blood Test Be Used For Ovarian Cancer Screening?
The study analysed previously collected blood samples from women whose diagnoses were already known. It did not test the blood marker prospectively in a large population of women undergoing routine screening.
The test performed well in samples from people with confirmed conditions and may not achieve the same accuracy in the general population.
Researchers are now planning prospective studies involving women with and without inherited risk factors. These studies will assess whether Tu-Stroma can identify precancerous changes before they progress and whether the results can shape clinical decisions.
Dr Rajan Gogna, who led the research, said, “We asked a fundamentally different question: What if we could identify the earliest molecular warning signs before invasive cancer even develops?”
The discovery offers a new direction for ovarian cancer detection, shifting the focus from finding an existing tumour to identifying biological changes that may precede it.
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