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.

Heart diseases cause the highest number of deaths globally every year, and over the past few years, cardiovascular complications have been noted among youngsters as well. Research has long shown that body fat accumulation can lead to harmful changes to heart structure. This can be potentially deadly later, and the risks were earlier thought to increase in middle age. However, as per Finnish and UK scientists, the most critical age for a spike in the risk of cardiac conditions is 17. Yes, this is when high levels of body fat become potentially harmful to heart health.

Why is 17 a critical age for heart health?

According to experts at the University of Eastern Finland, 17 is a critical age for young people, as adolescents often move towards a more independent life after that. From moving away from home to changes in diet and lifestyle habits, there is a likelihood that many may adopt unhealthy habits like drinking and smoking. This social shift can, over time, result in fat accumulation, thus posing heart disease risks in the future.

On the other hand, experts say that adolescence is the best time to adopt a healthy lifestyle and lower body fat in cases of childhood obesity. It is the best time to reduce the risk of heart disease, thereby increasing the chances of a healthy adulthood.

For this, scientists tracked 1,803 children aged 9–24 years. They used dual-energy X-ray absorptiometry (DXA) scans to evaluate fat levels in the abdomen and body and to calculate muscle mass. The children had the scans completed at the age of nine, and then were tested again at ages 11, 15, 17, and 24 years. Echocardiography scans were also done at 17 and 24 years to examine heart function and structure, as well as insulin, blood sugar, and cholesterol levels.

Researchers found that from the age of 17, excessive fat (abdominal fat specifically) was linked to structural changes in the heart. This can lead to excessive pressure to pump blood normally, thereby contributing to a heightened risk of heart disease later. The results were published in the European Journal of Endocrinology.

The role of fat in changing heart structure

Researchers found that the heart’s structure can be altered by fat, and this happens primarily through inflammation and high blood pressure. Experts concluded that BMI is a poor marker for calculating fat mass in adolescents and children because they have four times more lean mass than fat mass, and BMI does not distinguish between the two. The study helps us understand that accumulated total abdominal and body fat in late adolescence can adversely affect a growing heart. Therefore, any lifestyle changes that can help lower body fat in adolescence, as early as 17 years, can be beneficial.

Fatty liver, or non-alcoholic fatty liver disease (NAFLD), refers to the accumulation of excess fat in liver cells in people who consume little or no alcohol. In its early stages, it may seem harmless. However, it is, in fact, the liver’s first warning that the body’s metabolic balance is burdened. What is concerning is who we are now diagnosing. Young adults in their 20s and early 30s, often with no visible signs of illness, are clear evidence of this condition. This is no longer an additional finding but has become routine. Dr Kandarp Saxena, Gastroenterologist, Manipal Hospital, Jaipur, recently spoke about how fatty liver, which is now becoming more common among younger people, may soon become a lifestyle crisis.

A Lifestyle That Directly Impacts the Liver

Irregular eating habits, such as late-night meals or long gaps followed by overeating, can further throw off the body’s natural metabolic balance. Poor sleep adds another layer, affecting insulin sensitivity and fat metabolism. These are not abstract risks but measurable contributors to how and why fatty liver is developing.

Why Most Young Patients Do Not Realise It

Unlike many other conditions, fatty liver does not produce symptoms that prompt early medical attention. In the early stages, the liver continues to function normally, so daily life goes on as usual. There are no obvious signs to suggest that anything is changing beneath the surface.

Most diagnoses in this age group are incidental, detected during routine blood tests showing mildly elevated liver enzymes or through ultrasound imaging done for unrelated reasons. The absence of these symptoms is not a favourable feature. It delays recognition at a stage when the condition is most easily reversible.

The Indian Risk Profile Is Different

The early onset of fatty liver in India cannot be viewed in the same way as in Western populations. South Asians are known to develop metabolic complications at lower body mass indices. This means that even people who appear healthy or not overweight may still carry harmful fat deep inside the body, along with underlying insulin resistance.

When this is combined with rapid urbanisation, less movement in daily life, and a growing dependence on calorie-dense foods, it slowly adds up to a higher overall risk. As a result, fatty liver is appearing earlier and progressing faster in this population.

From Fat Accumulation to Liver Damage

It is important to understand that fatty liver is not a static condition. In some individuals, simple fat accumulation remains stable. In others, it moves beyond fat build-up and starts irritating the liver, leading to a stage called non-alcoholic steatohepatitis (NASH). This is important because the liver is no longer just holding fat; it is getting damaged.

As the damage continues, the liver tries to heal, but this repair leaves behind scar tissue, known as fibrosis. Over time, this scarring can build up and start to affect how well the liver works. If it continues, it can lead to cirrhosis, where the liver becomes heavily scarred and begins to struggle, increasing the risk of liver failure and cancer. This progression does not happen abruptly; it occurs over years, often without clear clinical warning, making early identification critical.

Why Early Intervention Is Being Missed

Despite being detectable and reversible in its early stages, fatty liver is often not addressed with the urgency it requires. Mild elevations in liver enzymes are sometimes overlooked. Imaging findings are not always followed up with structured intervention. More importantly, younger patients are less likely to be counselled about long-term risk. There is also a tendency to delay action because the condition does not immediately affect quality of life. This delay allows progression that could otherwise have been prevented.

Treatment Exists—but Depends on Behaviour

There is no single drug that reverses fatty liver in the way lifestyle modification does. Clinical evidence consistently shows that sustained weight reduction, regular physical activity, and dietary changes can significantly reduce liver fat and, in some cases, reverse early damage. However, these interventions require consistency. Short-term efforts do not produce lasting benefit. Without sustained change, the underlying process continues.

A Shift That Needs Recognition

The increasing prevalence of fatty liver in young Indians is not an isolated clinical observation; it reflects a shift in how disease is presented. When a condition that was once seen later in life starts appearing a decade or two earlier, it changes the health trajectory of an entire population. It raises the chances of long-term complications and means people end up living with the disease for much longer. Fatty liver is now emerging as one of the earliest indicators of this shift.

Fatty liver does not begin with symptoms. It begins with accumulation of excess calories, reduced activity, and sustained metabolic imbalance. By the time it is detected, the process is already in motion. The challenge, therefore, is not just in treating the condition but in recognising it early enough to change its course.

Only months ago, India was declared the 'Diabetes Capital of the World'. And now, according to a recent study, 20 per cent of Indians have also been found to be prediabetic. While the factors responsible can be both diet and genetic-related, doctors say that Indians develop insulin resistance at a relatively younger age, and despite low body weight contrary to the rest of the world. Diabetes, specifically type-2 diabetes, is a lifestyle disorder triggered by poor eating habits and a sedentary lifestyle. Genetics, too, has a role to play in it. However, when it comes to prediabetes, there is a lot that one can do to bring high blood sugar under control.

What is prediabetes?

Prediabetes is a state characterised by high blood sugar levels, and it is the final stage before developing type-2 diabetes. At first, prediabetes does not show many symptoms, but it can, over time, silently become diabetes; therefore, regular check-ups and following a balanced diet are crucial. Prediabetes is usually triggered by obesity, inactivity, and insulin resistance. For diagnosis, fasting plasma glucose and A1C tests are done, and if prediabetic, weight loss, healthy diet are key to prevention.

What are the symptoms of prediabetes?

If your blood sugar count slips towards the risky side of the scale, there may not be prominent symptoms at the start. However, some subtle early symptoms are noteworthy, such as:

1. Blurred vision
2. Dark skin in the armpits or near the neck
3. Intense thirst
4. Excessive hunger
5. Fatigue
6. Frequent urination at night
7. Slow-healing cuts and infections

Why is screening delayed?

In most cases, prediabetes develops without any noticeable early symptoms. Over time, with sedentary lifestyle habits and excessive intake of ultraprocessed foods and refined carbs, belly fat, poor sleep, and stress, younger people also become prediabetic. And because the symptoms do not always stand out as something abnormal. As a result, many do not go for check-ups. But for diabetes prevention or even for its management, it is important to get tests like fasting blood glucose or HbA1c, as they will help you seek treatment depending on the severity of the condition. At present, people with risk factors such as PCOS, excessive weight, sedentary lifestyle, or hypertension, can become prediabetic even in their mid or late 20s.

Diabetes prevalence in India

The stats for diabetes in India are concerning - over 100 million people are living with diabetes, and 130-140 million are likely prediabetic. However, being prediabetic does not mean that it will for sure progress to diabetes. Without proper intervention, 5-10 per cent of prediabetic patients develop diabetes every year.

Reversing diabetes with lifestyle changes

Treating prediabetes is not complicated - all you need to do is make some dietary changes and work out regularly to lose some weight and bring blood sugar under control. Even 150 minutes of moderate-intensity workout can go a long way to improve insulin sensitivity. Even losing 5-7 per cent of your existing body weight can significantly reduce diabetes risk.