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.

Atherosclerosis, in which plaque builds up inside the arteries, is a major cause of cardiovascular disease and can lead to heart attacks, strokes and sudden death. A new study published in The New England Journal of Medicine found that plaque buildup can begin decades before symptoms appear.

An international team of researchers found atherosclerosis in many apparently healthy young adults, including those in their 20s.

Dr Borja Ibáñez, Scientific Director of the Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), said the findings point to a new approach to cardiovascular prevention: detecting atherosclerosis through imaging before symptoms appear, rather than relying only on risk factors such as blood pressure, cholesterol and smoking.

Plaque Can Appear In The 20s

The study included 16,808 people aged 18 to 70 from Denmark and Spain. None had a known history of atherosclerotic cardiovascular disease.

Using advanced imaging, researchers examined the carotid, femoral and coronary arteries for plaque. Overall, 57.1% of participants had atherosclerotic plaques, despite having no symptoms or previous diagnosis of cardiovascular disease.

Atherosclerosis was detectable even among the youngest participants. Among those aged 18 to 29, plaque was found in:

• 8.7% of men
• 6.7% of women

The prevalence increased with age, reaching nearly 90% among people aged 60 to 70. By 60–70, only about 1.9% of men and 8.1% of women had no detectable plaque in any of the arteries examined.

Men Develop Plaque Earlier

The study found differences between men and women. Atherosclerosis began increasing at younger ages in men, with their atherosclerotic profile appearing five to 10 years earlier than in women.

In women, the sharpest increase occurred between 40 and 60, broadly coinciding with the menopausal transition.

Could Ultrasound Detect Silent Atherosclerosis?

Conventional cardiovascular risk scores, including SCORE2, identified only a small proportion of people who already had silent atherosclerosis.

Researchers found that people with coronary artery plaque often also had plaque in the carotid or femoral arteries. Because these arteries can be examined using relatively simple, non-invasive ultrasound, the finding could have implications for future screening.

Dr. Ibáñez said portable ultrasound devices could potentially become a tool for detecting atherosclerosis from early adulthood.

“The future of cardiovascular prevention must be more precise and personalized,” he said, adding that early detection could allow earlier intervention and more targeted treatment.

Plaque Does Not Mean A Heart Attack Is Imminent

Dr. Sudhir Kumar, neurologist at Apollo Hospitals, Hyderabad, said atherosclerosis can remain silent for decades before causing a heart attack, ischemic stroke or peripheral arterial disease.

However, having plaque does not mean a heart attack or stroke is imminent. Greater plaque burden and more widespread disease are associated with higher cardiovascular risk.

He also stressed that atherosclerosis is not simply an unavoidable consequence of ageing. Its progression can be slowed by addressing modifiable risk factors.

How To Lower Cardiovascular Risk

• Regular aerobic and strength exercise
• Avoiding tobacco
• Eating a healthy diet and limiting ultra-processed foods
• Controlling blood pressure
• Managing LDL cholesterol/ApoB when indicated
• Preventing and treating diabetes
• Maintaining a healthy waist
• Getting adequate sleep.

15-year-old Tanvi Pariyani’s death at AIIMS Delhi has raised questions about the treatment of a rare and complex congenital heart condition she had been living with since childhood.

Tanvi, from Kota, had been visiting AIIMS since she was two. Her medical records listed ventricular septal defect (VSD) with pulmonary atresia, a combination that can make treatment considerably more complicated than just a 'hole in the heart'.

Tanvi’s family has alleged that corrective surgery was repeatedly postponed. AIIMS, however, said its treating team concluded in 2017 that corrective surgery was not feasible because of the complexity of her cardiac anatomy and advised medical management.

The hospital has now constituted a committee to review her complete clinical records, investigations, treatment, expert opinions and the circumstances surrounding her death. An autopsy is also underway.

What Is Pulmonary Atresia With VSD?

A VSD is a hole in the wall separating the heart’s two lower chambers. The right side of the heart pumps oxygen-poor blood towards the lungs through the pulmonary artery.

In pulmonary atresia, the normal route through which blood leaves the right side of the heart and reaches the lungs is blocked or has not developed properly.

This can severely block blood flow to the lungs and reduce the amount of oxygen entering the bloodstream.

When pulmonary atresia occurs along with VSD, doctors have to deal with multiple abnormalities rather than simply closing the hole.

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Treatment Is Complicated

Some children may initially require procedures to ensure adequate blood reaches the lungs. Doctors may use medicines temporarily and later create an alternative pathway for blood flow through a shunt.

In some patients, the pulmonary arteries remain very small and the body develops additional blood vessels supplying the lungs.

These vessels, called major aortopulmonary collateral arteries (MAPCAs), may need to be brought together through a procedure called unifocalisation.

A conduit may then be used to connect the heart to the lungs, while the VSD may also need to be closed.

The anatomy can also change as a child grows. Small pulmonary arteries, abnormal blood vessels and rising pressure in the lungs can make later surgical repair more challenging.

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Events Leading Upto The Teen's Unfortunate Death

According to AIIMS, Tanvi was admitted on August 24 after her condition deteriorated and was being evaluated for a possible heart-lung transplant.

On September 1, she developed severe cyanosis, and her oxygen saturation fell to around 48%. AIIMS said she subsequently suffered a hypoxic spell followed by cardiac arrest. Despite oxygen support and resuscitation, she could not be revived and was declared dead at 5:06 am.

“The Director, AIIMS, New Delhi has constituted a committee to examine the matter in detail, review the sequence of events and establish the facts,” the institute said.

The committee’s findings and autopsy report will be important in establishing what happened and whether any intervention could have altered the outcome.

A new US CDC study has warned of a threefold rise in identifications of Trichophyton indotineae, a skin fungus that causes ringworm and is resistant to standard treatment.

Between 2022 and 2025, T. indotineae was identified in 29 countries, with resistance to terbinafine, a commonly used antifungal medication. The first US case was reported in 2023.

Most cases are treated with terbinafine, either as a cream or a pill.

“Our results reveal a marked global increase in T. indotineae isolation,” the authors wrote in their paper, published in the CDC’s monthly journal, Emerging Infectious Diseases.

What Did The Study Find?

During the study period, 566 users from 54 countries submitted 1,657,334 spectra that led to the identification of fungal agents.

• 123,025 (7.7%) were identified as Trichophyton spp. by 316 users across 44 countries.
• 3,399 (0.2%) were identified as T. indotineae by 183 users across 29 countries.
• Europe accounted for the largest share of users (63.8%), followed by Asia (16.8%), Latin America (15.7%), North America (1.6%), Oceania (1.6%), and Africa (0.5%).
• Most T. indotineae spectra were identified in Europe — 3,040 (89.4%).
• T. indotineae was also identified in countries where no cases had previously been reported, including Bulgaria, Croatia, Colombia, Luxembourg, and Uruguay.

However, the research cannot tell us how many people globally are contracting T. indotineae; it only shows that laboratories are detecting it more often.

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What Is Ringworm?

Ringworm has nothing to do with worms. The misleading name refers to an infection caused by dermatophytes, fungi that thrive in warmth and moisture.

It can affect people of all ages and is highly contagious. Careful attention and immediate treatment are required to control the infection effectively.

Ringworm, also called tinea corporis, is a skin infection caused by fungal spores invading the dead outer layers of the skin. It typically presents as circular, red, scaly patches accompanied by itching or discomfort.

Signs And Symptoms

Symptoms of ringworm depend on where the infection develops:

• Skin: It usually begins as a red, scaly patch or bump.
• Scalp: It may start as small, pimple-like lesions that progress into scaly, patchy areas.
• Nails: The nails may become thickened, discolored, brittle, or crumbly.

How Is Ringworm Transmitted?

Ringworm is highly infectious and can be transmitted through:

• Direct skin-to-skin contact: Touching an infected person can transmit fungal spores.
• Indirect contact: Sharing towels, bedding, or clothes with an infected person can spread the infection.
• Animals to humans: Ringworm can be carried by pets, including cats and dogs, without showing symptoms.

How To Prevent Ringworm

Preventing ringworm is largely about maintaining good hygiene and avoiding contact with infected people or animals.

• Shower regularly, dry thoroughly, and change clothes daily.
• Do not share towels, combs, or bedding.
• Wear flip-flops or sandals in community showers, tanning rooms, locker rooms, and pool areas.
• Consult a veterinarian if your animal displays signs of ringworm.
• Prevent fungal growth by keeping moist areas such as the groin and feet dry.

When To Seek Medical Attention?

Left untreated, ringworm can spread across the body or penetrate further, potentially leading to complications such as secondary bacterial infections.

See a doctor if:

• Symptoms do not go away with treatment.
• The infection affects the scalp or nails.
• You feel very uncomfortable or the affected area is severely inflamed.