Cold sores are a common and often frustrating skin issue. While they may look like harmless blisters, cold sores are actually caused by the herpes simplex virus (HSV).

What Causes Cold Sores?

Cold sores are caused by the herpes simplex virus (HSV), which comes in two types: HSV-1 and HSV-2.

HSV-1 is the primary cause of cold sores, usually appearing around the mouth.

HSV-2 generally causes genital herpes but can also lead to cold sores.

While the appearance of cold sores caused by both HSV-1 and HSV-2 can look similar, their locations tend to differ. However, it is possible for HSV-1 to cause sores on the genitals and for HSV-2 to appear on the mouth.

How Do Cold Sores Spread?

Cold sores are highly contagious and can spread easily. The virus can be passed on through:

• Kissing or skin contact
• Sharing food, drinks, or cosmetics (such as lip balm)
• Oral sex, which can spread both cold sores and genital herpes

Even when a cold sore isn’t visible, the virus can still be spread through close contact. This makes prevention and management key to reducing outbreaks and the risk of infecting others.

Once someone contracts HSV, it stays in the body for life. While the virus remains dormant most of the time, it can reactivate and cause new sores, especially during periods of:

• Stress
• Illness
• A weakened immune system

Unfortunately, there’s no cure for the herpes virus, but the symptoms can be managed.

Symptoms of Cold Sores

Cold sores don’t just appear out of nowhere. Before the sore is visible, you may notice a tingling or burning sensation around the lips or face, which can occur several days before the sore forms. This is the best time to begin treatment to shorten the outbreak.

When a cold sore does appear, it often looks like a red, raised blister filled with fluid. The blister can be painful to touch, and there may be more than one. Cold sores usually last around two weeks and are contagious until they crust over and heal.

The Five Stages of a Cold Sore

Cold sores go through distinct stages as they develop and heal:

• Tingling and itching: You may feel these symptoms about 24 hours before the blister appears.
• Blisters: Small, fluid-filled blisters form, typically around the mouth.
• Bursting: The blisters burst and form painful sores.
• Scabbing: The sores dry out, scab over, and may itch or crack.
• Healing: The scab falls off, and the cold sore heals.

Risk Factors for Cold Sores

Certain factors can trigger the reactivation of HSV, leading to cold sores. These include:

• Infection, fever, or cold
• Sun exposure
• Stress
• Menstruation
• Dental work or injury
• Weakened immune system due to conditions like HIV/AIDS, eczema, or chemotherapy

Managing and Treating Cold Sores

There’s no cure for cold sores, but several treatments can ease the symptoms and help manage outbreaks.

Topical Ointments and Creams

Over-the-counter antiviral creams like docosanol (Abreva) or prescription ointments like penciclovir (Denavir) can help reduce the duration of an outbreak, especially if applied at the first sign of a cold sore.

Oral Medications

Prescription antiviral medications like acyclovir, valacyclovir, and famciclovir can also help, particularly for people who have frequent or severe outbreaks. Your doctor may recommend taking these medications regularly to prevent future outbreaks.

Home Remedies

There are also some home remedies that may provide relief, such as:

• Applying ice or a cold washcloth to the sore
• Using aloe vera gel or lemon balm lip balms
• Applying petroleum jelly to ease discomfort

Canker Sores vs. Cold Sores: What's the Difference?

While cold sores and canker sores may seem similar, they are quite different:

Cold sores are caused by the herpes virus, appear around the mouth, and are contagious.

Canker sores are not contagious and appear as ulcers inside the mouth or throat.

Preventing the Spread of Cold Sores

To avoid spreading cold sores:

• Wash your hands frequently
• Avoid close contact with others during an outbreak
• Don’t share food, drinks, or personal items like lip balm

Cold sores can be a persistent issue, but with proper care and management, you can reduce the frequency of outbreaks and prevent spreading the virus to others.

Often, we underestimate the way our brain works and daydreaming has long been seen as a major sign of creativity. Many artists have used their imagination to bring their work to life. However, science offers a different perspective.

Coined in 2002 Dr. Eliezer Somer, those who experience “maladaptive daydreaming” often fantasize about celebrities, historical figures or idealized versions of themselves. Their imaginations are more elaborate, diverse, and complex as compared to other daydreamers.

A 2012 Consciousness and Cognition study found that maladaptive daydreamers spend, on average, 57 percent of their waking hours daydreaming far more than their counterparts.

Dr Somer explains: "The greatest difference is the maladaptive daydreamers reported that the activity interfered with their daily life. They also reported higher rates of attention-deficit and obsessive compulsive symptoms, and more than 80% used kinesthetic activity or movement when daydreaming, such as rocking, pacing or spinning"

He further noted that while everyone experiences moments of mind-wandering, it usually does not interfere with daily life. But maladaptive daydreaming does interfere in regular life. The condition has not been classified as a mental illness and there is no treatment for it yet.

What Do People Say?

Many Reddit users have shared their experiences with maladaptive daydreaming, often asking questions such as: “Is it normal to daydream for such long hours?”

While some responses described daydreaming as a form of dissociation when bored, others relied on music or movies to fuel fantasies of being a “better version” of themselves, often struggling to return to reality.

Common Symptoms Of Maladaptive Daydreaming

Here are some early signs of maladaptive daydreaming to keep an eye out for:

• Compulsive need to daydream
• Avoiding social interaction and activities
• An inability to perform work or other daily tasks
• Extreme feelings of shame or guilt
• Feeling a compulsive need to daydream that you can't control
• Making a conscious effort to stop or lessen daydreaming episodes.
• Intense and extremely vivid daydreams
• Complex and elaborate daydreams, often with many people involved
• Daydreams accompanied by repetitive movements such as pacing
• Prolonged daydreams that may last hours at a time
• A feeling of disconnect or dissociation from people and reality during the episode.

What Does Science Say?

Rachel Bennett, a member of Dr. Somer’s online community, shared she usually dreams up new episodes of her favorite Japanese animé characters and TV shows. She’s also created four families of fictional characters which have grown with her over the years.

“I’d much rather stay home and daydream than go out,” she said.

What Causes Maladaptive Daydreaming?

Dr. Somer noted that about one-quarter of maladaptive daydreamers are trauma survivors who use daydreaming as an escape. Many report family members with similar tendencies, as well as being shy or socially isolated.

Meanwhile, a Harvard Medical study found that 80 percent of maladaptive daydreamers have ADHD, followed by anxiety disorders, depression, and OCD. Researchers believe daydreaming often acts as a coping mechanism for pent-up emotions that cannot be expressed in real life, so they are released through imagination instead.

How Do You Cope With Maladaptive Daydreaming?

Experts emphasize that maladaptive daydreaming is not an extreme condition requiring formal diagnosis, but many people have shared strategies that help:

• Exercise: One forum user reported swimming daily, gradually reaching 2,000 meters, which acted as meditation and grounded them in reality.
• Remove triggers: Avoid activities that spark daydreaming episodes.
• Practice mindfulness: Stay present and aware of thoughts.
• Limit music use: Music is a common trigger.
• Scheduled daydreaming: Set aside specific times with a timer, then consciously exit the session.
• Seek professional help: Therapies such as CBT, DBT, and mindfulness-based stress reduction have shown benefits.
• Stay busy: Engage in tasks to prevent wandering thoughts.
• Improve sleep quality.
• Make daydreams less appealing: Reduce instant gratification.
• Self-development and creativity: Channel imagination into productive outlets.
• Journaling: Record thoughts daily or weekly.
• Practice self-acceptance.
• Find group support.

A new review published in The Lancet highlights how close this shift may be. The study underscores a hard truth: despite having effective medicines for years, global blood pressure control remains disappointingly poor. The real challenge, experts say, is not the absence of drugs—but problems with adherence, health systems, and long-term patient engagement.

The Unrelenting Burden of a Silent Killer

Hypertension continues to be the leading cause of heart attacks, strokes and premature deaths worldwide. The World Health Organization (WHO) defines high blood pressure as readings at or above 140 mm Hg systolic and/or 90 mm Hg diastolic. A normal reading is below 120/80 mm Hg.

The numbers are staggering. Between 2024 and 2025, an estimated 1.4 billion adults aged 30 to 79—roughly one in three people in this age group—are living with hypertension globally. Nearly 44 percent do not even know they have it. Among those diagnosed, fewer than one in four have their blood pressure adequately controlled.

India reflects this alarming trend. The ICMR-INDIAB study (2023) estimated that about 315 million Indians—35.5 percent of the population—have hypertension. Data from NFHS-5 further showed that nearly half of hypertensive men and more than a third of hypertensive women in India do not have their condition under control.

Why Daily Pills Are Falling Short

For decades, hypertension treatment has relied on daily oral medications—often combinations of two or more drugs. These may include ACE inhibitors, angiotensin receptor blockers paired with calcium channel blockers, and thiazide diuretics.

On paper, these regimens are effective. In reality, adherence is the weak link.

Many patients with hypertension also manage diabetes, obesity or high cholesterol. The result is polypharmacy—multiple pills, multiple times a day. Over time, missed doses, side effects and simple “treatment fatigue” erode consistency. Therapeutic inertia—where doctors do not intensify treatment despite poor control—further worsens outcomes.

The Rise of Long-Acting Injectables

This is where long-acting injectable therapies come in. According to Dr Mohit Gupta, cardiologist at G B Pant Hospital and UCMS, the field is now moving toward therapies that may be administered just twice a year.

Unlike traditional medicines that work downstream to reduce blood pressure numbers, these new drugs target upstream molecular pathways that drive hypertension.

One promising approach involves small interfering RNA (siRNA) therapies that inhibit angiotensinogen production in the liver. By silencing this protein, they dampen the renin–angiotensin system—central to blood pressure regulation. Zilebesiran, developed by Roche and Alnylam, is currently in global phase 3 trials.

Another candidate, ziltivekimab by Novo Nordisk, targets inflammatory pathways increasingly linked to cardiovascular risk. There are also newer strategies aimed at selectively modulating aldosterone, a hormone that increases blood volume and pressure.

The appeal is simple: durability. A twice-yearly injection could eliminate the daily burden of pill-taking, improve adherence and provide more stable blood pressure control over time.

Promise, But With Caution

However, excitement is tempered by concern. Cost remains a major question. The recent introduction of inclisiran, an injectable cholesterol-lowering therapy priced between Rs 1.8 and 2.4 lakh annually in India, highlights affordability challenges.

Long-term safety is another critical issue. Hypertension is lifelong. Patients may require these treatments for decades. Experts stress the need for robust long-term data across diverse populations before widespread adoption.

The promise is undeniable. A twice-yearly injection that reliably controls blood pressure could transform preventive cardiology. But its true impact will depend not only on scientific success—but on accessibility, affordability and sustained safety.

A new Lancet study titled Burden of MASLD and liver fibrosis: evidence from the Phenome India cohort published in The Lancet Regional Health - South Asia found that nearly four in 10 Indian adults have fatty liver or what scientifically is known as the metabolic dysfunction-associated steatotic liver disease (MASLD), formerly non as NAFLD or non-alcoholic fatty liver disease.

The study also highlights a more worrying condition that a sizeable proportion of the Indian population already show signs of liver fibrosis. This is an early scarring process that could lead to cirrhosis or liver cancer if left unchecked.

Lancet Study: How Was It Conducted?

The study analyzed data from more than 7,700 adults across 27 cities in India. The study found that 38.9 per cent of participants had MASLD. The authors also noted that this figure is similar to the global estimates, however, is deeply concerning for India's population and size of the country, including the ever-rising burden of diabetes and obesity.

The study also found that 6.3 per cent of people who live with MASLD had significant liver fibrosis, as compared to 1.7 per cent of those without fatty liver.

Read: Indians Are At Most Risk Of Having Fatty Liver Disease, According To Doctor

The study also found that 2.4 per cent of the entire population analyzed showed evidence of significant fibrosis. Why is this concerning? Fibrosis is a strong predicator of future complications. With the advancement of scarring, liver failure, cirrhosis, and liver caser risk also rises.

Lancet Study: Who Are At Risk?

The study found that people with obesity, diabetes, and central or abdominal fat were more likely to have MASLD. Obesity also was seen as the strongest risk factor, with likelihood rising steeply from overweight to severe obesity.

Another factor was also age. Liver fibrosis was seen in adults over the age of 60 years and in people with diabetes, among whom nearly one in ten showed fibrotic changes.

The study also showed that there was a presence of "Lean MASLD", which means it could also happen in people who are not overweight and have a normal body mass index. This is often linked to insulin resistance and visceral fat, which is the fat around internal organs. This tend to accumulate abdominal fat even at lower body weights.

Lancet Study: Can MASLD And Other Liver Diseases Be Prevented?

As per the authors of the study, MASLD is highly modifiable, especially at early stages. There are evidence that show that weight loss reduces liver fat and inflammation. Regular physical activity also improves insulin sensitivity, along with balanced diet. The diet must be consumed without or with very low sugar and ultra-processed food, which helps in control of diabetes and cholesterol and slows down disease progression.

Authors also noted that people should get their fatty liver disease scanned regularly. Especially because MASLD is common among people with obesity and diabetes. There are many non-aggressive tools that could also detect fibrosis early.