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.

For years, people with type 2 diabetes who needed insulin had to administer an injection daily. Eli Lilly’s newly approved insulin is set to bring a dramatic reduction in that burden from roughly 365 injections a year to just 52.

The US Food and Drug Administration (FDA) has approved Onswik (insulin efsitora alfa-gobe), a once-weekly basal insulin for adults with type 2 diabetes. It is designed to provide a steady level of insulin over seven days and is used alongside diet and exercise to control blood sugar. Find out how different weekly insulin is from the daily shots that patients are used to?

Lilly's Once-Weekly Insulin Gets FDA Approval

Insulin is a hormone that helps glucose move from the bloodstream into cells, where it can be used for energy. It also helps reduce the amount of glucose produced by the liver. People with type 2 diabetes may eventually need insulin when their bodies do not produce enough of it or cannot use it effectively.

Basal insulin is long-acting insulin designed to work in the background throughout the day and night, helping keep blood sugar levels under control between meals and overnight.

Until now, commonly used basal insulins like insulin glargine and insulin degludec have generally required daily injections.

Onswik is a long-acting insulin analogue designed to remain active for an entire week. Instead of injecting a smaller amount every day, patients receive one subcutaneous injection on the same day each week. That could reduce the number of basal insulin injections by more than 300 a year compared with daily treatment.

For someone who finds daily injections difficult to maintain, that development could be gamechanging.

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Comparison Between Weekly Insulin & Daily Insulin

Lilly's late-stage QWINT programme included more than 3,400 adults with type 2 diabetes across four Phase 3 studies. Onswik met its primary goal in each study, reducing HbA1c, a measure of average blood sugar over time, by an amount that was not inferior to daily basal insulin.

The studies included people who had never previously used insulin as well as people already receiving insulin treatment.

So the significance of the approval is not that weekly insulin necessarily works better than daily insulin. Rather, it offers comparable blood-sugar control with far fewer injections.

Taking insulin every day can become another task in an already demanding diabetes care routine. Missed or delayed doses can make blood sugar management more difficult. A weekly option could simplify treatment for some patients and potentially make it easier to stay consistent. But convenience does not mean the treatment becomes risk-free.

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What Are The Risks & Who Can Take It?

The most important risk remains hypoglycaemia, or dangerously low blood sugar, which is a known risk with insulin.

Severe hypoglycaemia can cause confusion, seizures, loss of consciousness and, in serious cases, death.

Other reported adverse effects of Onswik include allergic reactions, injection-site reactions, changes in fat tissue at injection sites, itching, rash, swelling and weight gain.

The FDA also warns about medication errors and accidental overdose, low potassium levels and fluid retention or heart failure when the medicine is used with certain other drugs.

The FDA approval is specifically for adults with type 2 diabetes. Onswik is not recommended for people with type 1 diabetes due to the risk of severe hypoglycaemia. It is also not a replacement for other aspects of diabetes management.

A new study has identified 485 chemicals used in pesticide products in the US that are linked to breast cancer, raising new concerns about how these chemicals are assessed for safety against serious diseases.

The peer-reviewed research, published in Environmental Health Perspectives, dug beyond the active ingredients in pesticides and examined the inactive ingredients that are often not subjected to the same level of safety scrutiny.

The study identifies chemicals associated with breast cancer risk. It does not establish that exposure to these pesticides causes breast cancer in people.

What Did The Researchers Find?

Of the 485 chemicals identified in pesticide formulations, only 145 were registered with the US Environmental Protection Agency (EPA) as active ingredients. The remaining chemicals were classified as inactive or 'inert' ingredients. These ingredients can serve different purposes, like helping pesticide ingredients spread, penetrate surfaces or become more absorbed.

The researchers argue that focusing primarily on active ingredients may overlook risks from the complete pesticide formulation.

“Our findings highlight a regulatory blind spot around so-called inert ingredients,” lead author Dr Jennifer Kay of the Silent Spring Institute said in a research release.

Also read: FDA Approves New Drug For Rare Disorder That Turns Muscles Into Bone: What Is Fibrodysplasia Ossificans Progressiva?

What Does “Inert” Mean?

An inert ingredient is generally considered 'inactive' as it does not target the pest the product is designed to kill. It does not mean that it has no biological effect on humans. According to the study's researchers, people are exposed to the entire pesticide formulation, not just the active ingredient in the pesticide.

The researchers identified around 4,000 inert ingredients approved for use by the EPA, including some PFAS, commonly known as 'forever chemicals.'

Pesticide Exposure

Pesticide exposure is not limited to agricultural workers or people living near farms. The chemicals identified in the study can also occur in products used around homes, including lawn treatments, flea and tick products and lice treatments. Pesticides can also enter the environment through food and drinking water.

The researchers found that 84 of the identified chemicals were detectable in the general US population based on data from the National Health and Nutrition Examination Survey, although they said this likely underestimates exposure because many of the compounds are not routinely tracked.

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Pesticides & Breast Cancer Link

The researchers classified chemicals based on existing evidence linking them to breast cancer. That is different from demonstrating that pesticide exposure directly causes breast cancer in humans.

Breast cancer is a complex disease that involves multiple genetic, hormonal, environmental and lifestyle factors.

The study does, however, raise a question about whether the combined exposure to multiple chemicals is adequately considered during pesticide safety assessments.

The researchers noted that the EPA generally evaluates individual pesticide ingredients rather than the entire formulation or people's exposure to multiple pesticides.

The research comes as breast cancer rates, including among younger women, continue to rise in the US. According to the American Cancer Society data cited by The Guardian, breast cancer incidence has been increasing by about 1% a year, with a slightly faster increase among women under 50.

reaImagine developing a strange medical condition in which an injury or even a minor fall may trigger a process that may gradually turn muscles, tendons and ligaments into bone.

This is what fibrodysplasia ossificans progressiva (FOP), one of the world’s rarest genetic disorders, looks like.

The US Food and Drug Administration recently approved a new treatment option for FOP called Atebrioz (zilurgisertib), a once-daily pill developed by Mirum Pharmaceuticals.

Adults and children aged 12 years and above with FOP are eligible for this treatment. It is designed to reduce the formation of new bone outside the skeleton.

What Is Fibrodysplasia Ossificans Progressiva?

FOP is a rare genetic disease in which connective tissues like muscles, tendons and ligaments gradually turn into bone. The abnormal bone formation is known as heterotopic ossification, meaning bone starts to develop in places where it should not.

Over time, this can pose restriction in movement, cause deformities and lead to severe disability. The condition could affect quality of life significantly as well as shorten life expectancy.

FOP is usually diagnosed in childhood. According to Mirum, around 300 people in the US and about 900 worldwide are known to have the condition.

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Why Does The Body Starts Making Bone In The Wrong Places?

FOP is caused by mutations in a gene involved in bone growth, especially the ACVR1 gene, which produces a protein called activin A receptor type-1, or ALK2. In people with FOP, this pathway becomes abnormally active. As a result, the body can start producing bone within soft tissues.

This process can occur in episodes called flare-ups. Trauma, surgery or other triggers can sometimes provoke inflammation and subsequent abnormal bone formation. The problem is that once mature bone has formed in these tissues, it can permanently restrict movement.

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More About The New Drug

Atebrioz contains zilurgisertib, an oral drug that blocks ALK2, the protein that is abnormally active in most people with FOP and triggers bone formation outside the skeleton.

The aim is not to remove bone that has already formed. Instead, the treatment is designed to reduce the formation of new abnormal bone.

FDA’s approval was based on a randomised, placebo-controlled trial involving 63 people with FOP. Participants received either zilurgisertib or placebo for 24 weeks, followed by an extension period.

At week 24, patients receiving Atebrioz had an average 3.2 cm³ decrease in the volume of newly formed abnormal bone, compared to a 24.6 cm³ increase in the placebo group. The FDA said the difference supported the drug’s effectiveness in reducing new heterotopic ossification.

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Symptoms & Treatment Of FOP

The disease can vary between individuals, but abnormal bone formation can progressively restrict movement. People with FOP may develop difficulty moving their neck, shoulders, spine, hips and other joints as new bone forms around them.

The condition can eventually affect mobility substantially. Extra bone formation can also interfere with everyday activities and contribute to severe disability.

Another characteristic feature is that people with FOP are often born with abnormalities of the big toes, which can help doctors recognise the rare condition early.

Atebrioz is not the first FDA-approved treatment for FOP. The FDA approved Sohonos (palovarotene) in 2023 as the first treatment for the disease.

More recently, the FDA approved Pasatru (garetosmab-grts) in August 2026, making Atebrioz the third FDA-approved treatment for FOP. The newer options differ in how they target the abnormal bone formation.