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.

Amid increasing uptake of GLP-1 weight-loss drugs such as Ozempic and Wegovy, FMCG major Nestlé has realigned its nutritional drinks to meet the changing nutritional needs of users.

The company has announced plans to roll out new protein drinks designed for people taking GLP-1 weight-loss medications such as Ozempic and Wegovy in the US, Asia and Australia. Since these drugs curb appetite and can contribute to issues such as muscle loss and “Ozempic face,” Nestlé wants to help users stay healthy while their eating habits change, Reuters reported.

To better understand their nutritional needs, Nestlé is using AI to study clinical research and real-world consumer needs. It is also expanding its high-protein offerings to support muscle health, along with collagen-added products in its Vital Proteins line for skin and hair.

What Are the Protein and Nutrition Needs of GLP-1 Users?

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The number of people using GLP-1 drugs is growing rapidly, with about 16 million Americans currently taking the medications for weight loss. Globally, use remains much smaller than the potential eligible population, with access and affordability still major barriers.

But do GLP-1 users need more protein?

Dr. Navin Gnanasekaran, Longevity Physician, Apollo Hospitals, told HealthandMe that for individuals on GLP-1 receptor agonists, rapid weight loss can lead to a significant reduction in both fat and lean muscle mass. Alarmingly, up to 30-40% of the total weight lost can be muscle.

“Prioritizing protein intake and structured resistance training is absolutely critical to counteract this muscle depletion,” he said.

How Much Protein Do GLP-1 Users Need?

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Dr. Navin said that a daily intake of at least 1.0 to 1.5 grams of high-quality protein per kilogram of body weight is recommended. Lean meats, eggs, dairy and plant-based proteins can help meet these needs.

He also recommended strength training to preserve muscle tissue. Together, adequate protein and resistance training can help support muscle mass and maintain the basal metabolic rate (BMR), which may help prevent weight regain.

Dr. Praveen Gupta, Chairman, Marengo Asia International Institute of Neuro and Spine (MAIINS), Marengo Asia Hospitals, told HealthandMe that a large number of people in India eat vegetarian diets that are already low in B12, iron and vitamin D. These nutritional gaps can quietly widen when food intake is reduced with GLP-1 drugs.

For people following vegetarian diets, familiar kitchen staples such as paneer, dal, soya chunks, hung curd, sprouts and eggs, spread across the day, can help meet protein targets without animal meat.

How Do GLP-1 Drugs Work?

Dr. Praveen said these drugs work by slowing digestion and dialing down “food noise” — the constant mental chatter around eating — which naturally cuts how much a person consumes, sometimes by half.

GLP-1 receptors are located not just in the gut but throughout the central nervous system, including regions such as the hypothalamus and hippocampus that receive direct input from GLP-1-producing neurons in the hindbrain. This is part of why appetite suppression can be so powerful: the drugs act on the brain’s hunger circuitry, in addition to slowing digestion.

Do GLP-1 Drugs Increase the Risk of Nutritional Deficiencies?

The overall appetite suppression caused by these medications can increase the risk of vitamin deficiencies. Constipation is also a common GLP-1 side effect due to decreased dietary fiber intake.

Good hydration, planned nutrient-dense meals and adequate fiber can help offset these effects.

Routine monitoring of essential micronutrients, particularly vitamin D, B12 and iron, is highly advised to ensure patients achieve sustainable, healthy weight loss without compromising their long-term nutritional well-being.

Why Protein Matters

• Reduced food intake: Appetite suppression from GLP-1 drugs can create nutritional gaps, with potential neurological consequences.
• Vitamin B12: Deficiency can cause irreversible nerve damage, including peripheral neuropathy and cognitive impairment.
• Warning signs: Unaddressed deficiencies can cause tingling, numbness, brain fog and unexplained fatigue.
• Muscle loss: A significant share of weight lost on GLP-1 medications can be lean muscle rather than fat if adequate protein intake and physical activity are not prioritised.
• Nutrition matters: Inadequate nutrition can affect both muscle and nerve tissue, making adequate protein and essential micronutrients important during weight loss.

Liver injuries reported to US poison centres increased by nearly 400% between 2000 and 2024, with acetaminophen, sold under brand names such as Tylenol, the most frequently implicated substance, according to a study.

The study analysed poison-centre calls involving liver injuries linked to “xenobiotics”—foreign substances not naturally found in the human body. These include medications, food additives, alcohol and environmental pollutants.

Acetaminophen Among Leading Causes

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Researchers identified 220,160 cases of xenobiotic-related liver injury over the 24 years. Population-adjusted exposure rates increased from 10.9 per million people to 52.9 per million.

More than 80% of the liver injury cases required inpatient care, with medications accounting for the majority of cases. Acetaminophen was the substance most frequently implicated.

“Liver injuries reported to poison centers have increased substantially over the past 25 years, with acetaminophen emerging as a growing contributor,” said Christopher P. Holstege of UVA Health.

Acetaminophen Exposure Trends

The study found that exposures involving acetaminophen-containing combination drugs decreased by 60%-85% after the US Food and Drug Administration capped the amount of acetaminophen allowed in combination prescription products.

However, potentially harmful exposures to acetaminophen alone increased steadily over the 24 years. The findings suggest that regulatory action reduced liver injuries linked to combination products, while acetaminophen alone remained a leading contributor to poison-centre-reported liver injuries.

Females had higher rates of acetaminophen-associated liver injury than males. Suspected suicide was the most common reason for exposure in both sexes.

Alcohol and Other Substances

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Alcohol was the second most common cause of liver injuries, although it was far less common than acetaminophen. Alcohol-related injuries were more frequent in men than women but increased in both sexes during the COVID-19 pandemic.

Researchers also identified increases in liver injuries linked to stimulants and street drugs, herbal and dietary supplements, and environmental toxins. However, these were much less common than injuries associated with acetaminophen and alcohol.

“Medications should always be taken as directed by clinicians and per pharmaceutical label instructions,” Holstege said. He also advised caution with emerging substances that are not regulated.

Why Tylenol Is Linked To Liver Injuries

"Acetaminophen is widely available without a prescription, and it’s contained in many combination medications — more than 600. It’s likely that many people taking acetaminophen do not realize they’re taking too much since, for example, you take acetaminophen tablets for the achy feeling that comes with a cold and also use a combination cough medicine that contains acetaminophen," Howard E. LeWine, Chief Medical Editor, Harvard Health said.

Tylenol and Autism Claims

The debate has also triggered legal action, as Texas sued Kenvue over alleged failures to warn pregnant consumers, and a US appeals court this month revived more than 500 private lawsuits making similar claims.

An immunity-enhancing peptide that has been used in more than 30 countries has gained attention as a possible treatment for Long COVID.

But in the US, the peptide, thymosin alpha-1 remains unapproved. The FDA raising concerns about how the synthetic peptide is developed, formulated and dosed.

Thymosin alpha-1, also known as Tα1 or thymalfasin, is a 28-amino-acid peptide originally derived from the thymus. It is designed to modify the immune response rather than simply suppress inflammation.

Research suggests it can enhance T-cell activity and antibody responses, which has made it particularly interesting in conditions involving immune dysfunction.⁠

Peptide And Long COVID Connection

Research has found that Tα1 may help restore aspects of immune balance in people with post-acute COVID-19.

A 2023 study found that the peptide improved immune homeostasis in blood cells from people with Long COVID. Its effects are particularly evident among patients with more severe initial disease and certain persistent symptoms.

The proposed idea is that rather than simply treating individual symptoms such as fatigue or brain fog, Tα1 could potentially correct some of immune abnormalities underlying them.

The Long COVID findings are still largely based on laboratory and early-stage research. They do not yet establish that injections of Tα1 improve Long COVID symptoms in a large, well-controlled patient population.

Also read: Diabetics Must Undergo Retinal Screening To Protect Eye Health: AIIMS Doctors

So Why Hasn’t The FDA Approved It?

Tα1 has been studied for several conditions, and it is approved in many countries. But FDA approval requires evidence for a specific product, formulation, dose, safety profile and effectiveness.

In the US, thymosin alpha-1 is not FDA-approved for Long COVID or another general medical condition.

The FDA has also raised specific concerns about compounded Tα1. In a 2024 review, the agency evaluated proposed injectable Tα1 products and highlighted concerns including product stability, concentration and the possibility of immune reactions caused by peptide aggregation.

The proposed 3 mg/mL formulation also differed from the 2 mg/mL concentration used in clinical studies reviewed by the agency.

Another crucial distinction is that the biological activity in a peptide does not mean that a particular manufactured product is safe and effective at a specific dose.

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Is The Peptide Truly Capable Of Treating Long COVID?

Some research regarding the peptide’s efficacy on Long COVID is encouraging, but the evidence remains limited. Studies of Tα1 in acute COVID-19 have also produced mixed results.

One clinical study found that it did not alter disease progression or mortality in non-severe COVID-19, although it shortened viral RNA shedding and hospital stay.

Other research has suggested potential benefits in severe disease, but these studies have limitations.

That uncertainty matters even more for Long COVID, where symptoms can vary dramatically between patients and the biological mechanisms remain incompletely understood.

The FDA’s decision does not mean research into Tα1 has been halted. A US clinical trial is currently evaluating thymalfasin as an immune-response enhancer given around COVID-19 vaccination, with the study assessing safety and whether it can improve