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.

Air pollution in India, especially during winter after Diwali, is one of the alarming environmental and health concerns currently. While we are aware about its adverse effects on lungs and respiratory health, a recent review of five decades of Indian research has suggested its damages may extend to other bodily functions too.

A review of five decades of Indian research has found that more than 91% of epidemiological studies examining the health effects of air pollution reported at least one adverse health effect. These health conditions ranged from cardiovascular and metabolic diseases to pregnancy complications and cancer.

The analysis, conducted by the Centre for Research on Energy and Clean Air (CREA), examined 184 peer reviewed epidemiological studies published between 1975 and 2025.

Out of these, 169 reported at least one positive link between air pollution and an adverse health effect. The findings cement evidence linking polluted air to a wider range of health problems.

What Did The Analysis Report?

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Respiratory diseases were the most frequently investigated health outcomes, featuring in 86 of the 184 studies. Sixteen studies examined mortality, while 11 focused on cardiovascular diseases.

Other research investigated connections between air pollution and diabetes, pregnancy complications, low birth weight, impaired child growth, cancers and other neoplasms, blood disorders, neurological and mental health conditions, metabolic disorders, sleep problems, eye diseases and chronic kidney and bone conditions.

The review also found that the evidence was not limited to privately funded or independent research. Of the 46 government-funded studies included, 44 reported increased health risks.

Similarly, 77 of the 81 studies affiliated with government institutions reported adverse health associations. These institutions included the Indian Council of Medical Research (ICMR), All India Institute of Medical Sciences (AIIMS), the Central Pollution Control Board (CPCB) and the Ministry of Health and Family Welfare.

The 91.8% figure represents the proportion of studies that reported at least one positive association with a health outcome.

Indian Air Pollution Crisis

Delhi accounted for the highest number of studies i.e. 26, followed by Punjab with 13, and Maharashtra and Uttar Pradesh with 11 each. However, the review also highlighted a wide gap in research outside urban centres.

Only 40 studies examined rural populations. Of these, 38 reported at least one adverse health effect linked with air pollution exposure.

The studies accounted for several sources of exposure, including outdoor pollution, household cooking and heating fuels, indoor environments like homes and workplaces, and occupational exposure.

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Polluted Air Can Affect Heart And Metabolism

Fine particulate matter, like PM2.5, can travel deep into the lungs and enter the bloodstream. It can cause inflammation and oxidative stress, processes that may affect blood vessels, metabolic regulation and other organs.

Indian research has also examined the relationship between PM2.5 exposure and type 2 diabetes. A study involving 12,064 adults in Delhi and Chennai, published in BMJ Open Diabetes Research & Care in 2023, found that higher long-term PM2.5 exposure was associated with increased fasting blood glucose, HbA1c and the risk of developing type 2 diabetes. The findings were observational and do not establish that pollution alone caused diabetes.

Air pollution has also been associated with cardiovascular conditions, including hypertension, ischaemic heart disease and stroke. Meanwhile, the CREA review included studies examining neoplasms, a category that includes cancers. However, the review does not establish that 91% of studies independently linked pollution to diabetes, heart disease and cancer. These were among several health outcomes investigated.

India Needs A Better Clean-Air Strategy

The review suggests that air pollution policies need to address the wider picture. Studies examined particulate matter, including PM2.5 and PM10, as well as nitrogen dioxide, sulphur dioxide, ozone, carbon monoxide, black carbon and heavy metals.

CREA has called for stronger air-quality standards, better pollution monitoring, stricter emission limits for industries and power plants, and measures to reduce indoor pollution from solid fuels. It has also emphasised the need to include rural populations in the next phase of India's National Clean Air Programme.

Russia has reported a milestone in its experimental personalised cancer vaccine development. The first patient to complete treatment with the country's mRNA-based cancer vaccine is reportedly doing well as the follow-up scans showed no new tumour growth in the four months after completing therapy.

The update was shared by Alexander Gintsburg, scientific director of Moscow's Gamaleya Research Institute of Epidemiology and Microbiology.

According to a report published by Kursiv, the patient is undergoing monthly examinations at Russia's National Medical Research Centre for Radiology, including high-resolution CT scans. Doctors are paying attention to the lymph nodes where cancer is most likely to spread.

The patient will remain under medical observation for the next three years. While the early findings are promising, they are based on a single patient's experience, which is a major limitation.

Russia's Personalised mRNA Cancer Vaccine

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The treatment, known as NeoOncovac, is a personalised cancer vaccine developed with the help of messenger RNA (mRNA) technology.

Unlike preventive vaccines that protect people against infections, therapeutic cancer vaccines are designed to help the immune system recognise and attack existing cancer cells.

The vaccine is customised using the genetic characteristics of an individual's tumour. Researchers analyse tumour samples to identify specific mutations that could help distinguish cancer cells from healthy cells.

The mRNA is then designed to instruct the body to produce these targets related to tumour, prompting the immune system to recognise and attack the cancer cells. It aims to make the immune response more specific to the patient's cancer rather than targeting all cancer cells.

Six Patients Received The Vaccine

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According to reports citing Gintsburg, six patients with melanoma have received the personalised vaccine so far. The first has completed the treatment course, while the second is reportedly halfway through a course involving 10 administrations. Four other patients have also begun treatment.

Russian specialists expect to treat around 20 patients at the Herzen Moscow Research Institute of Oncology by the end of 2026. The country's Health Ministry has reportedly allocated funding for the treatment and follow-up of 120 patients during 2026 and 2027.

Even though the findings are promising, they should not be interpreted as evidence of a cancer cure. The current update concerns one patient with melanoma, a type of skin cancer. Although doctors have reported no new tumour growth during the follow-up period, four months is too short to establish whether the response will last or whether the cancer could return.

There are also currently no results from a large controlled clinical trial that could establish the vaccine's effectiveness, long-term safety or survival benefit.

Outcomes across more patients will be essential to determine whether the treatment can consistently produce similar results.

Personalised cancer vaccines are an active area of research internationally. In October 2026, Moderna and Merck reported positive late-stage trial findings for their experimental personalised mRNA melanoma vaccine, used alongside the immunotherapy drug pembrolizumab (Keytruda).

The trial involved more than 1,100 patients and found a reduction in the risk of melanoma recurrence or death compared with Keytruda alone. However, this is a different vaccine and treatment from Russia's NeoOncovac.

In a major milestone in fetal and paediatric neurosurgery in India, doctors at the All India Institute of Medical Sciences (AIIMS), New Delhi, have performed the country's first open fetal surgery to repair myelomeningocele, the most severe form of spina bifida.

The six-hour procedure was carried out at 25 weeks of pregnancy, in which surgeons were able to repair the baby's spinal defect before birth. The surgery, performed on November 12, entailed repairing a cerebrospinal fluid leak in the lower back while the baby was still in the uterus.

According to AIIMS press release, the operation followed more than five weeks of preparation in multiple disciplines, including detailed fetal imaging, counselling, planning anaesthesia and surgical simulations.

The procedure was done by more than 30 clinicians and nurses from neurosurgery, maternal-fetal medicine, obstetrics, anaesthesia, plastic surgery, radiology and neonatology.

Professor PS Chandra, Head of Neurosurgery at AIIMS, who facilitated the entire surgical execution by the neurosurgery team, said that prenatal surgery could help reduce the incidence of hydrocephalus and Chiari malformations linked with spina bifida.

What Is Myelomeningocele?

Myelomeningocele is an open neural tube defect in which the spinal cord and its protective coverings protrude through an opening in the developing spine. It occurs when the neural tube, which eventually develops into the brain and spinal cord, does not close completely during early pregnancy.

The condition can cause permanent nerve damage, muscle weakness or paralysis, loss of bladder and bowel control, and complications involving the brain and spinal cord. Some affected babies also develop hydrocephalus, a condition in which excess cerebrospinal fluid accumulates in the brain.

In many cases, surgery to close the spinal defect is performed after birth. However, exposure of the spinal cord to the surrounding amniotic fluid during pregnancy can contribute to further neurological injury.

India continues to face a burden of neural tube defects. A 2024 review of 27 Indian studies estimated their pooled prevalence at 9.46 per 1,000 births.

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Is Fetal Surgery The Way Forward?

Unlike conventional postnatal surgery, open fetal repair involves operating on the fetus while it is still inside the uterus. The surgeon accesses the uterus, exposes the affected area of the baby's spine and closes the defect, protecting the exposed spinal cord and its coverings. The aim is to limit further damage to the developing nervous system and improve certain neurological outcomes.

Professor Deepak Gupta, who led the neurosurgical part of the procedure, said, “This establishes an important new capability for fetal care and paediatric neurosurgery in India. In rigorously selected cases, prenatal repair seeks to limit ongoing injury to exposed neural tissue, reduce the subsequent need for cerebrospinal-fluid diversion for hydrocephalus, and improve selected neurological outcomes. It is not a cure, and long-term multidisciplinary care remains essential.”

Evidence for prenatal repair comes from the landmark Management of Myelomeningocele Study (MOMS), an international clinical trial. It found that 40% of children who underwent prenatal surgery required a cerebrospinal fluid shunt by 12 months of age, compared to 82% of those who underwent surgery after birth. Prenatal repair also helped with better motor outcomes and a lower incidence of hindbrain herniation linked with Chiari II.

But fetal surgery comes with its risks. It can increase the chances of premature delivery. It also carries risks related to the opening and subsequent healing of the mother's uterus. It is therefore performed only on carefully selected pregnancies at specialised centres equipped with resources.

Milestone In Fetal Surgery

The AIIMS procedure brings a complex fetal intervention, which is already done in other countries, to India's public healthcare system.

Professor Neena Malhotra, who led the maternal-fetal medicine and obstetric part of the surgery alongside Professor K Aparna Sharma, said, “This accomplishment reflects the collective commitment of an exceptional multidisciplinary team.”

Professor Sharma added, “Fetal intervention in this case is a very well-reasoned and planned decision to optimise the outcomes of both the baby and the mother. The safety of both mother and fetus depends on detailed counselling, high-quality anaesthesia, and coordinated surveillance before and after surgery.”

AIIMS said the procedure was performed free of cost under the Government of India's Janani Shishu Suraksha Karyakram (JSSK). The mother and fetus will continue to receive close monitoring throughout the remainder of the pregnancy, delivery and newborn period.

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Can Spina Bifida Be Prevented?

Prevention of spina bifida remains essential even though the option of fetal surgery is available. Neural tube closure takes place within the first 28 days after conception, often before a woman realises she is pregnant.

Adequate folic acid intake before conception and during early pregnancy can significantly reduce the risk of neural tube defects. Preconception counselling, folic acid intake and dietary interventions with folate are therefore important to prevent spina bifida.