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.

In a significant public health move, the All India Institute of Medical Sciences, New Delhi, has deployed India’s first portable MRI for bedside brain scans, marking an important milestone for neurological care across the country.

The MRI system, installed at the AIIMS’ Center for Neurological Conditions, will enable rapid brain imaging for critically ill patients in ICUs, emergencies, and neurosurgical care.

The ultra-low-field device can be wheeled directly to patients, eliminating the need for dedicated MRI suites or risky patient transfers.

“Bedside brain imaging transforms how we care for our most critically ill patients. At AIIMS, we manage thousands of stroke and ICU patients annually, where rapid neuroimaging is essential—yet transport to conventional MRI is often unsafe or impossible,” said Dr. Shailesh Gaikwad, Head, Department of Neuroimaging and Interventional Neuroradiology and Chief of Neuroscience Centre, AIIMS New Delhi, in a statement.

Bedside MRI: The Swoop system

The Swoop MRI system, developed by US-based medical technology company Hyperfine, is the world's first FDA-cleared, portable, and ultra-low-field magnetic resonance brain imaging system capable of providing imaging at multiple points of care.

It is expected to improve rapid diagnosis in stroke, trauma, ICU monitoring, pediatrics, and post-operative neurosurgical care.

Across the world, portable bedside MRI systems are being used in hospitals in the US, Canada, Australia, the UK, New Zealand, and various EU countries.

“The Swoop system eliminates that barrier. Now our clinicians can obtain diagnostic images at the point of care, enabling faster decision-making in neurology, trauma, and critical care," Dr Gaikwad explained.

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He added that as AIIMS Delhi "serves as a referral center across India, this deployment signals what's possible when technology and clinical need align to advance neurological care”.

The technology enables faster decision-making in emergencies, in cases where conventional imaging is difficult or unsafe.

The installation in AIIMS Delhi follows regulatory approval in India, Hyperfine said in a statement.

Experts stated that the development could significantly expand access to brain imaging and strengthen research in point-of-care neurodiagnostics nationwide.

How The Swoop System Is Better Than Conventional MRIs?

Conventional high-field MRI systems require dedicated shielded rooms, specialized infrastructure, and patient transport.

For critically ill patients in ICUs, trauma bays, neurosurgery wards, neonatal units, and emergency departments, transport is often not feasible. These limitations can delay diagnosis and treatment and impact outcomes.

On the other hand, the Swoop system

• Requires no dedicated room,
• No specialized power,
• No patient transfer
• It can be wheeled to the patient’s bedside in the ICU, trauma center, stroke unit, or neonatal ward and obtain brain images when and where they are needed most.

“Bringing the Swoop system to AIIMS New Delhi is an important milestone following regulatory approval last December. India has a significant unmet need for accessible brain imaging. Deployment at the country’s leading institution signals the start of bringing point-of-care brain MRI to sites of care and institutions across India, where it can serve clinicians and their patients across neurological conditions,” said Maria Sainz, President and CEO of Hyperfine.

The Swoop system deployment at AIIMS New Delhi also establishes a foundation for clinical research. The AIIMS New Delhi team plans to document outcomes, contribute to peer-reviewed publications, and advance India’s role in the growing global evidence base for point-of-care brain imaging.

Leprosy will soon be a notifiable disease in India’s national capital, Delhi, in a move to boost surveillance, improve early diagnosis and treatment, the state health department has said.

The Delhi Health Department has submitted the proposal, under the Delhi Epidemic Diseases Act, for necessary approval. Once approved, Delhi will join states like Tamil Nadu, Maharashtra, Karnataka, and West Bengal that have already made leprosy notifiable.

“Leprosy is completely curable. Making it a notifiable disease will help us find hidden cases, stop transmission, and ensure every patient gets standard treatment with dignity. This is a critical step towards honoring our commitment to a leprosy-free Delhi and supporting India’s journey towards the interruption of its transmission by 2030,” Health Minister Pankaj Singh said, in a statement.

Why Notifying Leprosy Is Important?

More than 40 per cent of leprosy patients are managed by private health facilities in India, revealed a recent pan-India study. As a result, most go unreported to the National Leprosy Eradication Programme (NLEP).

Cases that go unreported continue to spike the risk of transmission. The variance in treatment protocols also raises the threat of drug resistance. WHO's Independent Evaluation of the NLEP program in India suggests that leprosy should be included in the list of diseases mandatory for notification.

According to the Ministry, the notification will mandate all government and private healthcare providers, including clinics, hospitals, and individual practitioners, to report every new leprosy case to the District Leprosy Officer.

Mandatory notification will

• boost surveillance
• boost targeted interventions
• lead to early diagnosis
• prompt early treatment with standard Multi-Drug Therapy (MDT)
• reduce disability risk
• prevent transmission through timely contact tracing and post-exposure prophylaxis (PEP),
• reduce stigma and discrimination by normalizing leprosy as a treatable medical condition,
• improve treatment compliance and reduced defaulter rates,
• boost ownership among all healthcare establishments toward the common goal of leprosy eradication.

The proposed notification will be issued following the advice of the Delhi Government as per the GNCTD Act 1991. Detailed reporting formats and guidelines will be shared with all health institutions and practitioners across the National Capital Territory of Delhi.

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What Is Leprosy?

Leprosy is also known as Hansen's disease. It is a chronic infectious disease that is caused by the bacterium Mycobacterium leprae. It affects the skin, peripheral nerves, upper respiratory tract mucosa, and eyes.

If it is not treated promptly, it could lead to permanent nerve damage, disabilities, and social stigma. However, the condition is fully curable with multidrug therapy, and early detection could prevent further complications.

Leprosy is also a neglected tropical disease (NTD), which occurs in more than 120 countries, with around 2,00,000 new cases reported every year.

The Prevalence Of Leprosy In India

India achieved the official elimination of leprosy as a public health problem (less than 1 case per 10,000 population) nationally in December 2005. However, the country still accounts for approximately 59 per cent of global annual new leprosy cases.

As per data from the Health Ministry, till March 2025, 31 states/UTs and 638 districts have achieved less than 1 case per 10,000 population of leprosy, with a prevalence rate of 0.57 per 10,000.

The NLEP now targets "Zero Transmission, Zero Leprosy" by 2027 through early detection, free multidrug therapy (MDT), and stigma reduction.

Under the NLEP, the government provides services such as free diagnosis and treatment (MDT) at all government health facilities, microcellular rubber footwears for patients, free assistive devices for leprosy patients, self-care kits for patients with ulcers, and reconstructive surgery for Grade 2 deformities with a welfare allowance of Rs 12,000.

All services under NLEP are available free of cost at all government health facilities.

The Supreme Court of India has urged the All India Institute of Medical Sciences (AIIMS) to set up an expert panel

to examine how brain death is certified in India.

The apex Court has sought to know whether additional tests, such as electroencephalogram (EEG) and angiogram, are needed to declare a person brain dead.

A bench of Justices Vikram Nath and Sandeep Mehta was hearing a petition filed by Kerala-based medic and activist S Ganapathy, alleging malpractices in brain death certification, Times of India reported.

Ganapathy alleged that patients who may not be brain dead are sometimes declared so to facilitate organ donation. The petition also questioned the reliability of the apnea test—the standard method used to confirm brain death—calling it subjective and claiming that the legal requirement of video graphing the procedure is often not followed.

What is Brain Death?

Brain death, technically referred to as brain-stem death, is the irreversible end of all brain activity.

In India, according to the Transplantation of Human Organs (THO) Act, 1994 (Subsection 6 of Section 3), 'brain stem death' refers to the stage at which all functions of the brain stem have permanently and irreversibly ceased.

This is to be certified by a 'Board of Medical Experts' consisting of:

(1) The medical superintendent (MS)/In-Charge of the hospital in which 'brain stem' death has occurred,

(2) a specialist,

(3) a neurologist or a neurosurgeon nominated by the MS, from a panel approved by the Appropriate Authority, and the doctor under whose care the 'brain- stem' death has occurred.

Amendments in the THO Act 2011 have allowed the selection of a surgeon/physician and an anesthetist, if an approved neurosurgeon or neurologist is unavailable.

“Brain stem death has to be certified by a panel of four independent doctors, including a neurologist or neurosurgeon, and confirmed twice with a minimum gap of six hours. The process is carried out with due diligence and seriousness,” Dr Manjari Tripathi, head of neurology at AIIMS, was quoted as saying.

“While the guidelines require the team of doctors to meet and declare brain death at least twice, we end up doing it sometimes three times for the patients. The current guidelines require various bedside tests for the declaration of brain death. It does not specify the need for tests such as an EEG or angiogram,” added Dr. Tripathi.

Experts said additional tests could add to the system burden. EEG is not routinely recommended for brainstem death certification, while an angiogram is used only in select cases where the apnea test cannot be performed. Globally, the apnea test remains the gold standard. These criteria are clearly laid down and cannot be altered, said experts.

Challenges To Brain Death Certification In India

The Indian Express reported that the lack of knowledge even among physicians is a significant challenge in India.

This leads to several patients never being officially declared and asked to be organ donors.

An AIIMS-led study, published in the journal Neurology India last year, found that more than half the doctors — including neurosurgeons, neurologists, and critical care specialists who are most commonly included in the certification process — did not receive any training on brain death certification at the time of their graduation.