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.

The new breast cancer screening guidelines released by the American College of Physicians (ACP) call for mammography screening once every two years in asymptomatic, average-risk adult females, instead of the annual recommendation.

ACP is the largest medical specialty organization in the United States with members in more than 172 countries worldwide.

The guidance statement was developed by ACP's Clinical Guidelines Committee, which defined average risk as females

• who do not have a personal history of breast cancer or a diagnosis of a high-risk breast lesion,
• a genetic mutation such as BRCA 1 or 2 that is known to increase risk,
• another familial breast cancer risk syndrome,
• a history of high-dose radiation therapy to the chest at a young age.

While the annual mammography has long been considered the standard, in a paper published in Annals of Internal Medicine, the ACP authors explained that the changes have been made to tackle the harms caused by false positive results and the resulting psychological distress.

The false positive results can lead to "overdiagnosis, overtreatment, additional testing, and radiation exposure, and may outweigh the uncertain benefits in this population,” said the ACP.

Also read: Breast Cancer Screening: AI May Predict Tumors Before Mammograms Can Detect Them

Mammography For Breast Cancer: What Did The Guidelines Say

• The ACP stated that all average-risk females ages 50 to 74 should receive biennial screening mammography for breast cancer.

• It urged females between the ages of 40 and 49 to discuss with their doctor their risk for breast cancer and the benefits and harms of screening.

• The guidelines stated that asymptomatic, average-risk females who are 75 years or older, or those with a limited life expectancy, can discuss stopping routine screening with their doctor.

"This is because the benefits of screening beyond age 74 are reduced or uncertain, while potential harms, such as overdiagnosis, become more likely with increasing age," it said.

• Further, for asymptomatic, average-risk females who have dense breasts, ACP advises doctors to consider supplemental digital breast tomosynthesis (DBT).

"Decisions should consider potential benefits and harms, radiation exposure, availability, patient values and preferences, and cost," the ACP said, while advising against using supplemental MRI or ultrasound for screening in this population.

Why Experts Are Disagreeing

Breast cancer is one of the leading causes of death in 40–49-year-old women in the United States, and screening is specifically performed to prevent death from breast cancer.

Screening only women ages 50-74 every other year – as called for by ACP – may result in up to 10,000 additional, and unnecessary, breast cancer deaths in the United States each year, said the American College of Radiology (ACR) and the Society of Breast Imaging (SBI) in a joint statement.

Also read: What's The Confusion! Why Most Women Don’t Know When To Start Mammogram Screenings?

Calling the new guidelines “outdated and hyperbolic information”, the statement noted that it will cause continued confusion among women.

"Thousands more women would endure extensive surgery, mastectomies, and chemotherapy for advanced cancers than if their cancers were found early by an annual mammogram,” it said.

Current guidelines from the ACR and the SBI urge women to start annual screening at age 40.

The ACR also recommends that women have a breast cancer risk assessment by age 25. Those at higher risk for breast cancer should talk to their doctor about starting screening before age 40 and additional screening methods -- particularly those with genetic mutations or a strong family history of breast cancer.

The United States Preventive Services Task Force (USPSTF) also urges starting annual screening at age 40 to save lives.

Further, the statement also called out ACP for its failure to recommend exams beyond digital breast tomosynthesis (DBT) for screening women with dense breasts. The statement said this "is also out of step with current research, which shows the need to go beyond DBT to help find cancer in these women".

Three cases of meningitis have been reported among schoolchildren in the Weymouth area in the UK, health officials said.

According to the UK Health Security Agency (UKHSA), of the three cases, two are pupils at Budmouth Academy, Weymouth, and the third attends Wey Valley Academy. The authorities have now rolled out meningitis vaccinations to young people in the region.

The latest outbreak comes after a meningitis outbreak was reported in the Kent region in March, which affected more than 30 people, leaving one sixth-form pupil and a university student dead.

Is the Weymouth Meningitis Outbreak Linked to the Kent Outbreak?

As per the UKHSA, the new cases were confirmed between 20 March and 15 April and are not linked to the deadly Kent outbreak.

The two pupils at Budmouth Academy are contacts of each other, but it is reportedly not epidemiologically linked with the Wey Valley Academy case.

The three cases in Weymouth have been confirmed as Meningitis B (MenB) and are the same sub-strain type, but a different sub-strain to the one detected recently in Kent.

Notably, all pupils in years 7 to 13 in Weymouth, Portland, and Chickerell are to be offered antibiotics and the MenB vaccination.

Close contacts of the cases have already been offered antibiotics as a precaution.

Will The Weymouth Meningitis Spread Further?

Also read: Meningitis claimed 259,000 lives globally in 2023: The Lancet

According to UKHSA deputy director Dr Beth Smout, "it is possible that we will see further cases linked to these latest cases in Weymouth".

He stated that the authorities are widening the "offer of antibiotics and vaccination" as "an additional precaution" to reduce the risk of the infection spreading.

"School pupils and staff should attend school as normal if they remain well," the official said.

What Is Meningitis?

Meningitis is a serious medical condition that affects the protective membranes covering the brain and spinal cord, the meninges. While fever is not always present, it is usually considered one of the classic symptoms of meningitis.

It is important to know the varied symptoms, causes, and treatments of meningitis for early diagnosis and proper management of the disease.

Symptoms Of Meningitis

Also read: Unique Symptoms Of Meningitis That Caused An Outbreak In Kent University

Smout urged everyone to be alert to the signs and symptoms of meningococcal meningitis. Common symptoms of meningitis

• Rash
• Headaches
• Neck stiffness
• Fever
• Drowsiness
• Nausea or vomiting
• Increased sensitivity to light.

"If the disease is suspected, you should seek immediate medical attention as the disease can progress rapidly," Smout said.

"The most important short-term thing and the quickest way for people to protect themselves is the antibiotic.

"The vaccine offers longer-term protection. There are two doses, four to six weeks apart, and you are only protected after the second dose," the official said.

A 2026 target trial emulation has found that glucagon-like peptide, also known as GLP-1, which is used by type-2 diabetes patients, can raise the risk of suffering from erectile dysfunction. According to a report published in the European Medical Journal, the impact of GLP-1s on sexual health outcomes in diabetic men has been inconsistent and limited. Erectile dysfunction, however, has been a prominent complication affecting 50 per cent of men with type-2 diabetes over their lifetime.

The effect of GLP-1 on men with type-2 diabetes

For this, researchers analysed the electronic health records of men aged 18 years and above with type-2 diabetes in the US from January 2019 to September 2024. Participants were started on treatment with either dipeptidyl peptidase-4 inhibitors (DPP4i) or GLP-1, with 5,524 and 4,910 individuals, respectively. Men with a history of erectile dysfunction diagnosis or end-stage renal disease were not part of the study population. The mean age of these men was 63 years, and the average BMI was 32.8—55 per cent of participants were White, and 23 per cent were Black. GLP-1 users were younger and had a higher prevalence of obesity compared to DPP4i users.

Higher rate of erectile dysfunction

Experts involved in the study found that the incidence of erectile dysfunction in the GLP-1 group was about 35 cases per 1,000 person-years. In the case of DPP4i users, the number dropped to 28 per 1,000 person-years. Hence, people in the GLP-1 cohort had a 26 per cent higher risk of developing erectile dysfunction over a three-year follow-up period. Results were consistent across subgroups; however, they lacked statistical significance after adjustment for negative outcomes.

Can GLP-1 cause erectile dysfunction?

Researchers noted that the findings of the target trial emulation suggest that sexual health outcomes must be considered in diabetic men, especially those dealing with type-2 diabetes and undergoing treatment with GLP-1 drugs. These findings also highlight the need for randomised trials with standardised erectile dysfunction assessments to further investigate biological pathways.

What complications does type-2 diabetes cause in men?

Type-2 diabetes can cause the following complications in men:

1. Heart disease
2. Stroke
3. Erectile dysfunction
4. Kidney disease
5. Retrograde ejaculation
6. Lower testosterone levels
7. Urinary retention or frequent urination
8. Vision loss—diabetic retinopathy