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.

India On Alert Against Polio

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.

Lung cancer in people who have never smoked is an increasingly recognized global health concern. A new study found that a rare inherited EGFR mutation may increase lung cancer risk by over 60 times in never-smokers.

Lung cancer in never-smokers is the seventh leading cause of cancer death worldwide. Approximately 60% to 80% of lung cancer cases in never-smokers globally occur in females.

The study, published in Science, found that a rare inherited EGFR T790M mutation can increase lung cancer risk by over 60 times in never-smokers and 25 times in smokers.

Smoking itself increases the risk of developing lung cancer fourfold in the general population.

What Did The Study Find?

To look for the rare mutation, researchers evaluated genotyping data from 3.37 million people and found that it occurs in about 1 in 15,850 people.

Among the 17 cancers and non-pulmonary conditions screened, the mutation showed a strong association only with lung cancer. Researchers also traced its origin to southern Appalachian populations in the US.

“Recognition of individuals more likely to carry EGFR T790M, including those with family history of lung cancer, multifocal lung cancer, or lung nodules or Southeastern US ancestry, may help to inform future screening and prevention strategies for those at highest risk,” said the researchers.

“Smoking is bad for lung cancer. This mutation is bad for lung cancer. When you do both, your risk is the sum of those two risks,” said Alexander Gusev, a quantitative geneticist at Dana-Farber. “So, you definitely don't want to smoke.”

The mutation was not linked to any of the 17 other common cancers studied, suggesting that its effects may be largely limited to lung cancer.

Could Genetic Testing Change Lung Cancer Screening?

“Today, lung cancer screening is driven almost entirely by smoking history,” said Jaclyn LoPiccolo, attending physician and lung cancer researcher at Dana-Farber Cancer Institute, who co-led the study.

LoPiccolo added that the findings raise the possibility that, in the future, screening could also be dictated by inherited genetic risk.

“If further studies confirm the benefit, people with EGFR T790M could be identified through genetic testing and offered personalized CT screening to identify lung cancers when they are at their most curable stage,” she said.

How Does The Mutation Increase Risk?

Although most lung cancers are associated with tobacco use or exposure, the proportion diagnosed in people who have never smoked has been rising. Yet the genetic factors underlying these cancers, particularly the role of inherited risk, are not well understood.

In 2005, researchers identified the rare inherited EGFR T790M mutation in a European family with multiple cases of lung cancer. Since then, the mutation has been reported in other families with unusually high rates of the disease.

In the study, LoPiccolo noted that the mutation occurs in about 1 in 15,000 people in the US population, but in certain areas of the Southeastern US, it can be as frequent as 1 in 2,000 people.

Other Lung Cancer Risk Factors

Lung cancer occurs when abnormal cells grow uncontrollably in the lungs. It remains the leading cause of cancer deaths worldwide, with an estimated 2.5 million new cases and 1.8 million deaths in 2022.

Beyond inherited genetic risk, lung cancer can also develop following exposure to second-hand smoke, air pollution, and workplace chemicals and carcinogens.

These include asbestos, silica dust, diesel exhaust, arsenic and other industrial chemicals.

Radon gas is another lesser-known risk factor. It is invisible and odorless, and prolonged exposure to high levels of radon can increase the risk of lung cancer.

A team of doctors at Mumbai’s Tata Memorial Hospital has identified a chemotherapy regimen that was better tolerated in people with high-risk penile cancer.

Published in the Journal of the National Cancer Institute, the BACuP trial compared paclitaxel with 5-FU (fluorouracil), with both drugs given alongside a platinum drug.

The study found that patients receiving paclitaxel had fewer serious side effects and treatment-related hospitalizations. They were also more likely to complete all four planned chemotherapy cycles.

However, the trial was too small to determine whether paclitaxel reduced cancer recurrence or improved survival.

What Did The Study Find?

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The trial included 49 men under 70 who had undergone surgery for penile cancer that had spread to the lymph nodes and had at least one feature linked to a high risk of recurrence.

They were randomly assigned to receive either 5-FU plus a platinum drug or paclitaxel plus a platinum drug. Both groups were scheduled to receive four cycles, three weeks apart.

Serious treatment-related side effects occurred in 77.3 per cent of patients receiving 5-FU and platinum, compared with 40.9 per cent of those receiving paclitaxel and platinum.

Paclitaxel was also easier to administer. 5-FU is usually delivered continuously through a vein over several days, sometimes using a pump, while paclitaxel can generally be given as an intravenous infusion in a day-care or outpatient setting.

Why Does The Study Matter?

Dr. Sandeep Nayak, Chairman of Oncology, MACS-Renova Oncology Institute, KIMS Hospital, Bengaluru, said that penile cancer carries a significant disease burden in India, yet for decades our adjuvant treatment decisions for high-risk, node-positive disease relied largely on retrospective observational data.

He noted that the goal after definitive surgical resection and lymphadenectomy is to prevent systemic recurrence. However, traditional 5-FU-based chemotherapy regimens have historically been notoriously difficult for patients to tolerate, leading to severe toxicities, frequent hospital admissions, and premature treatment dropouts.

“This trial provides evidence showing that the Paclitaxel-Platinum combination offers a far safer, outpatient-friendly regimen with drastically lower serious toxicities and an impressive completion rate of 83% (compared to 48% with 5-FU). Better patient compliance directly impacts real-world disease control,” said Dr. Nayak, who was not part of the study.

"Combined with early clinical presentation and timely surgical interventions, safer adjuvant options like this will meaningfully improve patient compliance and quality of life," he added while stressing the need for larger research.

What Is Penile Cancer?

Penile cancer is rare and is most common in men over 50. It is an uncommon malignancy in India, accounting for less than 1% of all male cancers.

Common symptoms include:

• A growth, lump or sore that does not heal within four weeks
• Bleeding from the penis or under the foreskin
• A rash or change in skin color
• A smelly discharge
• Difficulty pulling back the foreskin

The disease may be more treatable when found early. Treatment depends on the size and location of the cancer and whether it has spread, and may include surgery, chemotherapy or radiotherapy.

The Union Ministry of Health and Family Welfare has proposed mandatory CCTV surveillance at medical stores as an additional regulatory safeguard for prescription drugs.

The move, proposed under amendments to the Drugs Rules, 1945, through Draft Gazette Notification G.S.R. 791 (E), aims to strengthen regulatory oversight of Schedule H, H1 and X drugs.

Once implemented, it will help strengthen monitoring of the sale and distribution of these drugs and curb their unauthorized access and sale without valid prescriptions.

The proposed CCTV surveillance mechanism will also enhance transparency and accountability across the pharmaceutical supply chain, strengthening safeguards for public health. The draft proposal is now open to public objections and suggestions before it is finalized.

What Are Schedule H, H1 And X Drugs?

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Schedule H: Prescription-only medicines, including many blood pressure, diabetes and anti-infective drugs. They must carry the Rx symbol and cannot be sold without a prescription.

Schedule H1: A stricter category covering certain antibiotics, anti-tuberculosis drugs and sedatives. These medicines carry a red-boxed Rx warning and require medical advice.

Schedule X: The strictest category, covering certain high-risk narcotic and psychotropic drugs such as morphine, amphetamines and strong barbiturates. Their sale requires a specific government licence in addition to a standard retail drug licence.

Why Is CCTV Surveillance Being Proposed At Pharmacies?

India is seeing concerns over spurious and fake drugs, with chemists being the major point of contact for medicines for a majority of people.

A recent nationwide survey by LocalCircles, a community social media platform, showed that 64% of consumers said chemists never or rarely ask for a doctor's prescription, while only 31% mostly got a qualified pharmacist at their chemist.

Only 15% of those surveyed said the chemist mostly or always refused to sell medicines without a prescription.

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The survey also found:

• 13% said someone at the chemist assisted them who was not a qualified pharmacist.
• 15% said medicines were found to be fake or counterfeit.
• Another 15% said they received completely ineffective medicines.
• 26% said they were not provided a GST bill.

Counterfeit Medicines Seized In Bengaluru

In a recent shocking case, investigators in Bengaluru seized large counterfeit cancer medicines, life-saving drugs and injections used in intensive care units (ICUs) that were being supplied to hospitals, clinics and medical stores.

According to investigators, the medicines may have been supplied to more than 90 hospitals and clinics in Bengaluru.

A public interest litigation (PIL) has also been filed in the Supreme Court seeking a comprehensive national framework to check the manufacture and sale of counterfeit and adulterated medicines, including vaccines and cough syrups.

Drug Testing Data Shows Continued Quality Concerns

Data placed before Parliament shows that 1,41,322 drug samples were tested in 2025-26, the highest in five years. Of these, 3,012 were found to be Not of Standard Quality (NSQ) and 283 were found to be spurious or adulterated. A total of 779 prosecution cases were filed during the year, while 3,599 cases were filed over five years.

The Central Drugs Standard Control Organisation (CDSCO) has also continued issuing monthly drug alerts through 2026, flagging 240 NSQ samples in January, 194 in February along with four spurious drugs, 168 in March, 157 in May and 159 in June.