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.

A popular organic applesauce has been recalled in the US after routine testing by the US Food and Drug Administration (FDA) revealed high levels of patulin, a toxin produced by certain molds that can grow on apples.

Wakefern Food Corp. voluntarily recalled select containers of Wholesome Pantry Organic Unsweetened Apple Sauce after the patulin levels were found to exceed food safety limits. No illnesses linked to the toxin have been reported yet.

The recall involves 23-ounce plastic jars with UPC 04119005677 and a best-by date of June 16, 2027. The product was sold through ShopRite, Price Rite Marketplace, The Fresh Grocer, Gourmet Garage and Fairway Market.

What Is Patulin?

Patulin is a mycotoxin, meaning it is a toxic chemical produced by certain species of fungi or mold.

The FDA identifies molds from genera including Penicillium, Aspergillus and Byssochylamys as sources of patulin. Apples are one of the best-known sources, particularly when fruit is bruised, damaged, rotten or improperly stored.

When contaminated apples are used to make products like apple juice or applesauce, the toxin can remain it. The pasteurisation does not eliminate patulin, so simply heating an apple product is not a reliable way to get rid of the toxin.

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How Dangerous Is Patulin?

The health concern depends on the amount and duration of exposure to patulin. According to the FDA, consuming food or beverages containing high levels of patulin may cause nausea and vomiting, while evidence also indicates that the toxin can damage cells. The agency monitors patulin because prolonged exposure to elevated levels may pose a serious health hazard.

The FDA has established an action level of 50 parts per billion (ppb) for patulin in apple juice, apple juice concentrates and apple juice products.

This does not mean that eating a food once above the regulatory limit automatically causes poisoning. Food safety limits are designed to control exposure and reduce potential health risks, particularly when contamination could occur repeatedly.

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Patulin In Applesauce

Molds formed due to patulin can grow on apples that have been bruised, damaged or allowed to rot. Contamination can also happen during storage.

The problem can be difficult to identify simply by looking at the finished food. FDA guidance notes that some contamination can originate from internal problems like core rot that may not be obvious from the outside of an apple. Removing damaged fruit before processing is therefore an important control measure.

So, anyone who has the recalled Wholesome Pantry Organic Unsweetened Apple Sauce at home should not consume it.

Consumers should check the jar for the 23-ounce size, UPC 04119005677 and best-by date June 16, 2027. The company says recalled products can be returned to the store for a refund or replacement.

Stopping GLP-1 drugs such as Ozempic, Wegovy, Mounjaro and Zepbound may cause some of their cardiovascular benefits to fade, a large new study suggests.

Researchers from Washington University in St. Louis found that people who stopped GLP-1 treatment had a progressively higher risk of major cardiovascular events, including heart attack, stroke and death. After two years off treatment, their risk was 22% higher than among those who continued taking the drugs.

The findings, published in BMJ Medicine, are significant as GLP-1 drugs are widely used to treat type 2 diabetes and obesity and have also been shown to provide cardiovascular benefits.

What Did The Study Find?

Researchers analyzed health data from 333,687 US veterans with type 2 diabetes over up to three years. Of these, 132,551 had been prescribed GLP-1 drugs, while 201,136 had been prescribed sulfonylureas, another class of diabetes medicines.

Treatment status was reassessed every six months. About 26% of GLP-1 users stopped treatment completely, while another 23% had a treatment gap of at least six months before restarting.

The longer people remained off treatment, the greater their cardiovascular risk.

After one year without restarting, the risk of major cardiovascular events was 14% higher than among continuous users. After two years, it was 22% higher.

"There is enormous exuberance about starting GLP-1 drugs, but not nearly enough attention to what happens when people stop," said senior author Ziyad Al-Aly, a clinical epidemiologist at Washington University.

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Continuous Treatment Showed Greater Benefit

People who remained on GLP-1 drugs throughout the three-year study had an 18% lower risk of major cardiovascular events than those taking sulfonylureas.

That translated to about four fewer major cardiovascular events per 100 people over three years.

Those who remained on treatment for two or 2.5 years before stopping also had lower cardiovascular risk, by 7% and 15%, respectively.

However, people who stopped before 18 months did not have a significant reduction in cardiovascular risk compared with those taking sulfonylureas by the end of the study.

Treatment Gaps May Weaken Heart Protection

Interrupting GLP-1 treatment and later restarting it was associated with less cardiovascular protection. While continuous users had an 18% reduction in major cardiovascular events, those who stopped and later restarted had an average 12% reduction.

Even a six-month treatment gap was associated with a 4% to 8% increase in cardiovascular risk compared with continuous use.

Al-Aly said many patients stop GLP-1 drugs because of "cost, side effects or shortages."

"When they stop, it's not just weight that comes back; they experience a resurgence in inflammation, blood pressure, and cholesterol. Weight regain is visible; the metabolic reversal is not," he said.

"Our data suggest this metabolic whiplash is detrimental to heart health," Al-Aly added.

Read More: EXCLUSIVE: GLP-1 Drugs Are The ‘New Statins’, Says University Hospital Birmingham Professor

Can Restarting GLP-1 Drugs Restore The Benefits?

Restarting treatment appeared to restore some cardiovascular protection, but not all of it.

The researchers said the findings suggest that cardiovascular benefits gained during GLP-1 treatment may diminish after treatment is interrupted.

"Clinicians should treat adherence to GLP-1 treatment as an important outcome in its own right -- not an afterthought," Al-Aly said.

He added that healthcare systems should help patients manage side effects, address cost barriers and understand that GLP-1 drugs are used to manage chronic conditions.

The human brain has always been considered to be a single organ. But according to Stanford Medicine researchers, the brain's growth history indicates that it originates from two different populations of early cells that follow separate developmental paths.

The findings, published in Nature Neuroscience, suggest that the front and back parts of the brain develop from different types of progenitor cells, questioning the long-believed idea that the entire brain originates from one common cell.

An important point to note is that this does not mean that humans have two completely separate brains. The two developmental systems ultimately fuse together and function as one brain.

Mechanism Of Brain Forming From Two Cell Groups

During early development, cells called progenitor cells enable the production of specialised brain cells, including neurons. Researchers found that the cells that form the forebrain and midbrain follow a different developmental pathway from those that form the hindbrain, which includes the brainstem.

The forebrain is involved in neurological functions like language, consciousness and higher-level thinking. The hindbrain contains structures that control essential functions including breathing, heartbeat, sleep and swallowing.

Kyle Loh, associate professor of developmental biology at Stanford Medicine and senior author, said, “We’ve shown for the first time that the front of the brain arises from a totally different progenitor cell than the back of the brain.”

He added, “Our discovery means that we can now grow neurons from the back of the brain, the hindbrain, in a petri dish and study their functions.”

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A Significant Discovery

Scientists have been able to grow several types of human brain cells in the laboratory, but creating hindbrain neurons has been challenging.

The new findings give some clarity about why some previous approaches were unsuccessful. Researchers were attempting to transform forebrain or midbrain progenitor cells into hindbrain cells, but the Stanford team found that these cells are fundamentally different from the beginning of development.

Jokhai, one of the researchers involved in the study, explained, “Previous attempts to make hindbrain neurons likely tried to coax forebrain and midbrain progenitors into hindbrain cells, which our study shows is not possible.”

He added, “In stem cell biology, people are always fixated with creating the end cell type, like the neuron. But it’s important to begin at the earliest stages of embryonic development.”

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Study's Implications On Brain Disease Research

The discovery could have various practical implications for neurological research. The hindbrain and brainstem contain neurons involved in breathing, swallowing and movement, meaning researchers need reliable human cells to study diseases that damage these systems.

Stanford scientists say the new findings allowed them to understand and generate functional human hindbrain neurons in the laboratory. This could provide new models for studying conditions like amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy (SMA).

Instead of studying these diseases only in animals or using cells that do not accurately represent the affected brain region, researchers may now be able to grow relevant human neurons and investigate how they develop, malfunction and respond to different treatments.

The finding could therefore change not just how scientists understand the human brain's anatomy, but how they understand its origins and how they recreate different brain regions in the laboratory.