Heart attacks and strokes are among the leading causes of death globally, with millions suffering from cardiovascular diseases (CVD) every year. There are more than seven million people in the UK alone, with about 100,000 patients experiencing heart attacks annually. However, a group of researchers at University College London (UCL) estimate that one 'polypill' taken daily day could eliminate a majority of these cases dramatically lowering death tolls.

The proposed polypill, a combination of a statin and three blood pressure-lowering drugs, has been under study for over two decades. Experts argue that introducing this pill universally for individuals aged 50 and above could be more effective than the current NHS Health Check, which assesses risk factors every five years for those aged between 40 and 74.

Studies have repeatedly proven the effectiveness of the polypill in preventing CVD. A groundbreaking 2019 study in The Lancet found that five years' use of the polypill cut the risk of heart attack and stroke by a third. In addition, previous modelling analyses have estimated that if given universally to people over 55, the polypill might be able to prevent 80% of heart attacks and strokes.

Today, the NHS Health Check follows a risk-based model in which patients are tested for CVD risk factors and treated with drugs accordingly. Yet, as per UCL's study, this system has serious flaws:

Low Uptake: Just 40% of those eligible for the NHS Health Check choose to have it, leaving a considerable number of at-risk patients undiagnosed and untreated.

Ineffective Prediction of Risk: The majority of heart attacks and strokes happen to people at average risk levels, thus making it challenging to identify the need for intervention effectively.

Limited Effectiveness: Even at maximum take-up, the NHS Health Check programme is predicted to have fewer health impacts compared to a polypill initiative applied to the whole population.

Simplicity and Affordability of the Polypill Strategy

One of the big benefits of the polypill is that it is so easy. In contrast to the existing screening-based model, the polypill scheme would not involve complicated medical tests or lengthy risk assessments. Instead, people reaching 50 would just have to fill out a few questions to determine possible side effects before they were prescribed.

Professor Aroon Hingorani of the UCL Institute of Cardiovascular Science, one of the strongest proponents of this scheme, says:

"Finally, the time is now to do much better on prevention. A population approach would prevent a lot more heart attacks and strokes than is done today with a strategy of trying to target a smaller group only."

Aside from the possible health implications, the polypill is also an economic solution. The drugs used are off-patent, thus cheap to produce and distribute. With the vast economic cost of managing CVD-related illnesses, a preventive model could result in substantial cost-saving for the NHS in the future.

The polypill has been proven to be effective by numerous international trials. In 2019, a randomised trial in rural Iran discovered that participants who took the polypill for five years had a 34% reduced risk of having a heart attack or stroke compared to non-participants.

Likewise, modelling research has indicated that even if only 8% of people aged over 50 took up the polypill regimen, it would still be more beneficial to their health than the NHS Health Check programme.

Is This a Case of Over-Medicalisation?

One of the main objections to the polypill strategy is the suggestion that it might result in the unnecessary medicalisation of a significant proportion of the population. But, it is argued, it should be considered as a preventative measure, not as mass medication.

Professor Sir Nicholas Wald of UCL's Institute of Health Informatics explains:

"Instead of being a 'medicalisation' of a significant proportion of the population, a polypill programme is a prevention measure to prevent an individual from becoming a patient."

He compares it with public health measures like water fluoridation or compulsory seatbelts—interventions that have been shown to have a significant impact in reducing public health danger at low individual cost.

With the evidence in favour of the polypill's effectiveness and viability overwhelming, experts are calling on the NHS to act now. It is their belief that substituting the NHS Health Check with a polypill-based prevention program could be the UK government's flagship policy under its pledge to put disease prevention ahead of cure.

As Professor Hingorani points out, "The status quo is not a justifiable option." With CVD still a major cause of death globally, taking a population-wide polypill approach could be a turning point for preventative medicine, potentially saving thousands of lives annually. The question now is whether the NHS will take up this call and establish a policy with the potential to transform the prevention of cardiovascular disease on a national level.

As Delhi continues to report above 200 AQI and locals suffer from a wealth of problems, a new IIT Delhi study suggests the air quality may be worse than what conventional surface monitoring stations capture.

During a post winter-haze day in March 2021, the researchers measured the vertical distribution of fine particulate matter at 20-metre intervals from the surface up to 100 meters through drones.

At 100 meters, PM2.5 concentrations were around 160 micrograms per cubic meter which is about 60 percent higher than surface readings on the same days. They also found that humidity levels were also higher by 70 percent, which promoted the concentration of ammonium nitrate and chloride.

Additionally, the study found that PM2.5 levels increased sharply near the top of this shallow layer, leading to higher concentrations at around 100 metres.

Based on these observations, the researchers concluded that residents in 28–30-storey buildings may face higher exposure to pollutants and inorganic material than indicated by ground-based monitors.

They also noted that drone-mounted low-cost sensors are a much better effective tool for studying the lower atmospheric boundary layer to improve air quality monitoring, model evaluation and mitigation strategies in cities such as Delhi.

How To Read AQI?

As per the Central Pollution Control Board (CPCB), here is how you can know what your AQI stands for

• 0 to 50: Good
• 51 to 100: Satisfactory
• 101 to 200: Moderate
• 201 to 300: Poor
• 301 to 400: Very Poor
• 401 to 500: Severe

Air quality is made of dust and small particles like PM2.5 and PM10, along with gases like nitrogen dioxide from car exhaust, sulphur dioxide from factories, and carbon monoxide from vehicles. The levels are measured through specialized machines. In India, the standard of the machines are carried out by the CPCB.

Pollution Could Harm Your Brain

While we all know the harm pollution could do to your lungs, doctors have also highlighted that pollution could also lead to cognitive ailments. Mental health impacts such as risk of depression, anxiety, ADHD, and neurodevelopmental disorders in children could rise.

Dr Deepika Dahima, a psychologist at AIIMS Delhi said that pollution could put mental health at risk. Prolonged exposure to fine particulate matter like PM10 or PM2.5 could lead to a rise in anxiety, depression, cognitive impairment and chronic stress. Children also show disrupted neural development and learning difficulties, while adults experience irritability, emotional fatigue and impaired decision-making.

Medical practitioner Dr Jitender Nagpal, deputy medical superintendent and pediatrician at Sitaram Bhartia Institute of Science, told Press Trust India: “Increasingly, a wide spectrum of behavioural and learning issues such as attention difficulties, irritability, and poor academic performance are being noticed in many children.”

Studies too have linked the exposure of particulate matter or PM2.5 with increased ADHD risk. There are research that show a 1.51 fold increase per 5 μg/m³ increase in PM2.5 and others indicating elevated risks when exposure exceeds 16 μg/m³.

A Environmental Research by Oregon Health & Science University study published in December 18 found that everyday exposure to urban air pollution gradually alters brain development in children and young adults.

The researchers of the Oregon Health & Science University discovered that exposure to air pollutants at ages 9 to 10 was associated with changes in cortical thickness in the frontal and temporal brain regions that are responsible for executive function, language, mood regulation, and socioemotional processing.

Another study published in Nature Communication notes that after four hours of exposure to particulate matter, it was found that people's ability to perform routine tasks and interpret emotions were highly impacted.

Study's co-author, Dr Thomas Faherty said, "Study provides compelling evidence that even short-term exposure to particulate matter can have immediate negative effects on brain functions essential for daily activities.”

Travel Restrictions To Canada: The top court of the land, that is the Supreme Court of Canada ruled that travel restrictions were violative of citizen's right, however, are reasonable during "grave emergency" like pandemic.

Travel Restrictions To Canada: What Happened That Led To Supreme Court Ruling?

During May 2020, in early days of the COVID-19 pandemic, Kimberley Taylor, who was living in Halifax, got the news of her mother Eileen's passing away at the age of 75 of natural causes at St John's, as reported by The Global Mail. Kimberley wanted to attend a small memorial service however was unable to go there due to the Newfoundland government's rejection of her initial request.

The memorial service and the burial was attended by her father, sister and niece. "I was denied the ability to join my family to grieve my mother," she said, as reported.

This is when she along with the Canadian Civil Liberties Association launched a legal challenge. They noted that strict travel restrictions were in violation of the mobility rights within Canada as guaranteed by Section 6 of the Charter of Rights and Freedoms.

Last week, on Friday, a nine judge bench in the Supreme Court of Canada provided an expansive view of the Canadians' Charter mobility rights.

Travel Restrictions To Canada: What Did The Canadian Supreme Court Say?

The top court said that while Kimberley's rights were in fact violated by Newfoundland's pandemic rules, these were within the reasonable limits. The court deemed the pandemic travels rules to be in bounds within the reasonable limits on rights and freedoms in Section 1 of the Charter.

Jessica Kuredjian, a lawyer at Cassels in Toronto, as reported by The Global Mail, said, "This is a great ruling, and an important one. It is very human case. It is a great example of where Charter rights impact the real rights of everyday citizens."

The ruling will serve as a precedent for the ambit of government actions and restrictions during potential health emergencies in the future.

In a majority ruling authored by Justices Andromache Karakatsanis and Sheilah Martin, the court noted that early pandemic deaths and scientific uncertainty created an “extraordinarily difficult situation,” requiring swift decisions to protect public health and prevent further loss of life.

The judgment marks the latest major court effort to define the balance between individual freedoms and government authority stemming from pandemic-era actions. Just last month, the Federal Court of Appeal found the federal government’s 2022 use of the Emergencies Act to curb large protests was not legally justified.

Friday’s ruling also adds to the legal interpretation of the 1982 Charter of Rights. While many Charter provisions have been heavily litigated over the years, Section 6 — mobility rights — has rarely been tested in court.

“There really was a dearth of jurisprudence on the topic,” said Anaïs Bussières McNicoll, director of the Civil Liberties Association’s fundamental-freedoms program.

The pandemic travel-restriction case effectively marks the Supreme Court’s first detailed examination of Section 6 as it applies to Canadians’ general freedom of movement within the country.

In their majority opinion, five judges stressed that Charter rights must receive “generous protection.” On mobility rights, they traced the concept back nearly a millennium, linking it to common-law traditions from the 1200s and even earlier “ancient customs.”

North London Measles Outbreak: 34 children have been infected by a "fast spreading" measles outbreak in several north London schools, confirmed health officials. The cases were first confirmed from Enfield in laboratory tests in January, as is reported by the UK Health Security Agency or the UKHSA.

A local GP, as reported by the BBC said that one in fiver children who contracted the illness had been admitted to hospital. The doctor also said that these children "had not been fully immunized".

Families are now asked to ensure that their children are up to date with their immunizations and vaccinations against this highly contagious disease. Measles could cause serious health complications.

North London Measles Outbreak: Who Can Get The Vaccines?

Measles vaccinations for children are available at the school, however, if they missed it, they can also get it at a number of catch-up clinics around the UK. The vaccinations are for free.

Enfield's NHS Ordnance Unity Centre For Health on its website noted that there is a "fast spreading measles outbreak in several schools" across the borough. The infections were confirmed in "at least" seven schools in Enfield, which means there could be more. Some reports also came from neighboring Haringey.

Enfield Councillor Alev Cazimoglu said that current outbreak had "mainly affected children and some have required additional care with a short stay in hospital". She also said, "Vaccination is the most effective way to protect yourself and your family. We urge everyone who is not fully vaccinated to act now."

The 34 cases of Enfield represent over a third of the 96 total cases which were confirmed in England in the first month of this year as per the UKHSA data.

As per the Enfield Council, it is working closely with UKHSA, the NHS and local partners to limit any further spread.

Read: UK Loses Measles Elimination Status: Why Is This Disease Making A Comeback?

North London Measles Outbreak: Who Are At Most Risk?

As per a UKHSA medical practitioner, Dr Vanessa Saliba, as also reported by the BBC, the "big" outbreak is "mostly affecting unvaccinated children under 10 in schools and nurseries". She also added, "Measles is a nasty illness for any child, but for some it can lead to long term complications and tragically death, but is so easily preventable with two doses of the MMRV [measles, mumps, rubella, chickenpox] vaccine."

Dr Saliba also suggested children to catch-up with their vaccine schedule in case they have missed it and also urged those travelling abroad over the Easter holidays to check their vaccination status.

North London Measles Outbreak: What Is It And What Are The Symptoms?

Measles is a highly contagious disease. It spreads by coughs or sneezes or by touching things that someone with measles has coughed or sneezed on.

Measles, also known as rubeola, is an extremely contagious viral illness that typically causes high fever, cough, runny nose, red and watery eyes, and a characteristic rash that begins on the face and spreads downward across the body. It spreads through respiratory droplets and can lead to severe and sometimes fatal complications, including pneumonia and inflammation of the brain known as encephalitis.

Symptoms include high fever, sore or red and watery eyes, coughing, sneezing, and small white spots in the mouth.