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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.
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.
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.
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Repeated viral infections may play a key role in shaping Parkinson’s disease risk. A new study by researchers at CSIR-Centre for Cellular and Molecular Biology (CCMB), Hyderabad, has found that RNA viruses like influenza and even SARS-CoV-2 can interact with a protein called alpha-synuclein, accelerating the formation of abnormal protein clumps associated with Parkinson’s.
Published in Cell Reports, the study, which was led by Dr Swasti Raychaudhuri’s laboratory at CCMB, also identified a cellular protein that appears to act as a defense against this process.
Alpha-synuclein is a protein that is naturally found in nerve cells. In Parkinson’s disease, the protein can accumulate into abnormal clumps called amyloid aggregates.
These aggregates are a characteristic feature of Parkinson’s and can interfere with the normal functioning of neurons.
The new study looked at what happens to alpha-synuclein when a cell is infected by an RNA virus.
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Flu and COVID viruses contain RNA, which is their genetic material. The researchers found that parts of this viral RNA can fold into unusual shapes called RNA G-quadruplexes (rG4s).
These RNA structures can interact with a protein called alpha-synuclein. Alpha-synuclein normally exists in brain cells, but in Parkinson’s disease it can clump together and form abnormal deposits.
The researchers found that viral RNA structures may encourage alpha-synuclein to clump together more easily.
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The researchers also identified a protein called DDX39A, which counters both viral multiplication and alpha-synuclein aggregation.
Normally found inside the cell nucleus, DDX39A moves into the cytoplasm during an RNA viral infection. There, it can interact with both viral RNA structures and alpha-synuclein.
DDX39A acts as an RNA “unwinding” protein. It breaks apart the rG4 structures in viral RNA, making it harder for the virus to replicate. At the same time, this process appears to slow the formation of alpha-synuclein amyloids.
Study first author Aanchal said, “The virus fails to replicate with its RNA structures dismantled, and thus, the viral load in the cells decreases. At the same time, the unwinding of viral RNA’s secondary structure effectively slows down α-Synuclein amyloid formation.”
The researchers caution against making that conclusion. Not every viral infection will increase amyloid formation, and not everyone who gets influenza or COVID-19 will develop Parkinson’s.
The study suggests that the outcome depends on a complex balance between the virus, viral RNA, alpha-synuclein, and the cell’s defence mechanisms.
There have been previous studies reporting an association between certain viral infections and an increased risk of neurodegenerative diseases. But the biological mechanism behind such associations has remained unclear.
The CCMB researchers are now investigating what happens to these molecular interactions over longer periods.
The concern is that repeated exposure to viral infections could alter the balance between protective cellular mechanisms and protein aggregation. However, this remains an area of investigation and cannot currently be used to predict an individual's Parkinson’s risk.
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During a recent sweep of cancer hospitals in Karnataka where high-cost drugs are used, the Karnataka's Food Safety and Drug Administration (FSDA) found massive price disparity between institutional (landing) prices and the maximum retail price (MRP).
The Karnataka Government urged Union Ministry of Health and Family Welfare and the National Pharmaceutical Pricing Authority (NPPA) to intervene and curb the large gaps between prices hospitals pay and what they charge patients.
The concern is significant for patients admitted to hospitals who may have limited time and opportunity to compare and opt for cheaper alternatives.
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The food and drug regulator has spotted pricing discrepancies of 256 medicines, medical devices and hospital consumables and has asked the National Pharmaceutical Pricing Authority (NPPA) and the Department of Pharmaceuticals to intervene.
It involves Gufipol, that has an institutional acquisition cost was ₹86, while its MRP was ₹4,528, making the MRP about 52.6 times the reported acquisition cost.
Another example is Guficycline-50 injection, reportedly acquired for ₹160 but carrying an MRP of ₹7,110, or about 44 times the acquisition cost.
The gap was also seen with expensive medicines. Taxocare 120 mg, a cancer drug, had a reported acquisition cost of ₹1,000 against an MRP of about ₹21,618.
Across the 256 products examined, the average MRP-to-acquisition-cost multiple was 9.23 times, while the median was 7.58 times. Seventy-three products had MRPs at least 10 times their reported acquisition costs.
The FSDA said, “MRP operates as a ceiling on retail sale to a consumer, but it does not by itself ensure that the MRP is a fair patient-facing price in an institutional setting.”
The regulator added, “The issue is not merely a commercial discount. It is an information-asymmetry and captive-patient problem. The patient, who is generally unable to obtain an immediate substitute during admission, bears the entire benefit of the manufacturer-hospital discount being retained within the supply chain. The patient neither knows the institutional acquisition cost nor possesses an effective choice at the point of use.”
This becomes relevant in emergency care, intensive care, cancer treatment, and other situations where patients may need medicines or medical consumables immediately.
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The state has suggested a framework under which the amount charged to a hospital patient would take into account the actual net acquisition cost, a prescribed service margin and applicable taxes.
It has also proposed that hospital bills disclose details like the MRP, institutional acquisition cost, permitted service margin, taxes and final amount charged to the patient.
The proposal would also consider discounts, rebates, credit notes, free supplies, and other benefits when calculating the hospital's actual acquisition cost.
Drug prices in India are regulated under the Drugs (Prices Control) Order, 2013. The NPPA fixes ceiling prices for medicines listed under the National List of Essential Medicines and monitors drug prices.
Manufacturers cannot increase the MRP by more than 10% over the previous 12 months for formulations not covered by price control.
The government also says no person can sell a formulation above the applicable current price or labelled MRP, whichever is lower.
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The boom in GLP-1 drugs for diabetes and obesity management is not without its drawbacks. From vision loss to hair fall, researchers are increasingly assessing the side effects of popular weight loss medicines, which include semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound).
Recently, a new side effect among GLP-1 users was reported which entails detachment of the nails. Experts believe that using weight loss injections may cause the patient’s fingernails to fall off, raising fresh concerns about the short as well as long-term side effects of these medicines.
Nail detachment, clinically known as onycholysis, is a condition in which nails separate from the skin underneath it.
A new study has found that the risk of fingernails falling off in people taking GLP-1 receptor agonists was almost four times more common than non-users. The findings were presented at the European Academy of Dermatology and Venereology (EADV) Congress 2026.
Researchers, led by Dr. Charles Taïeb, found that 39% of GLP-1 users reported nail detachment, compared to 9% of people in the comparison group. Overall, 66% of people taking GLP-1 drugs experienced at least one nail disorder.
Apart from nail falling off, nail discolouration was also seen frequently among users, affecting 46% compared to 17% of non-users.
Researchers described this as the first controlled study specifically examining the possible effects of GLP-1 receptor agonists on nail health.
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GLP-1 medicines like semaglutide and tirzepatide reduce appetite, which can lead people to eat way less than they normally do. Rapid or significant weight loss can sometimes affect the body's supply of protein and other nutrients needed for healthy hair and nail growth.
But the increased number of nail detachment cases seen among GLP-1 drug users could not be solely attributed to weight loss.
“Until now, nail changes associated with GLP-1 therapies had essentially been anecdotal,” said study author Dr Charles Taïeb. “Our findings show a clear association, but they also underline an important point: not everything that happens during GLP-1 treatment is necessarily caused by the treatment itself.”
The researchers stress that the study cannot establish that GLP-1 receptor agonists caused changes to the nails. Around half of users already had nail problems before the treatment began.
After adjusting dermatological conditions and nutritional deficiencies, the strength of some associations reduced. However, nail detachment and nail discolouration remained around two to three times more frequent among users after adjustment.
Dermatologists already recognise that GLP-1 treatment can cayuse brittle nails and slower nail growth, especially in people who lose substantial weight loss. The American Academy of Dermatology notes that these effects may occur alongside other changes to the skin and hair.
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A companion study also identified unusual changes on the hair and scalp among GLP-1 users. Unusual hair loss was reported by 50% of GLP-1 users compared to 34% of controls.
The study also reported loss of hair volume or density affected 42% versus 19% among controls. Hair loss after the treatment was also more than twice as common among users, i.e. 26% among users compared to 12% in non-users. Redness of the scalp was also around three times more frequent.
Study author Dr Bruno Halioua explained, “This suggests that what is happening on the scalp may go beyond the classical shedding seen after rapid weight loss and involve an inflammatory component.”
The author added, “Scalp inflammation was the rule rather than the exception, which clinicians do not currently look for and which may be treatable. Taken together, our findings suggest that factors beyond weight loss alone may contribute to the hair, scalp and nail changes observed among GLP-1 users.”
He also said that these changes could be temporary and that one should not stop the treatment without discussing it with their doctor.
“These changes are frequent, usually benign, and are not a reason to stop an effective treatment on one’s own initiative,” he said. “Anyone who notices hair shedding, an itchy or red scalp or nail changes should mention it to their doctor rather than discontinue therapy.”
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