Many of us may have taken ibuprofen, sometimes two pills at once, especially when we are struggling with menstrual cramps. Well, as good these pills may be in treating the pain, they are not recommended for your health, especially if you are someone who consumes it on a daily basis or frequently. Gastroenterologist Trisha Pasricha, MD, writes in The Washington Post about why should you avoid taking nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen, naproxen and aspirin.

What happens when you consume pain killers?

She writes that NSAIDs are great in treating short term pain. They comprise of a group of drugs that inhibit the production of prostaglandins, which serve as a variety of purposes in the body. Some of which also includes contracting the uterus during menses and regulating blood flow in our vessels.

While one to two doses every now and then is okay, following a regular dosage routine, which could range from several times a month, or twice in an hour or so could lead to health risk. NSAIDs are well known to increase intestinal permeability. This means, these painkillers could damage the lining of your gut.

A 2018 review by Ingvar Bjarnason et. al., also writes about how NSAIDs can reduce the blood flow in the tiny vessels that feeds our guts. It can also disrupt the intestinal cells forming a barrier between the outside world and your insides.

What can be done?

While people with conditions like migraines, chronic back pain or bad period cramps can find NSAIDs to be helpful. It is always advisable to have a chat with your physicians to explore NSAID alternatives.

Pasricha suggests acetaminophen.

However, if someone is in dire need of NSAID, her tip is to take the pill right at the start of your symptoms. She says that the drug can do a far better job at stopping things at the source than chasing after all prostaglandins.

Why is it a concern?

NSAIDs are available as over the counter drug, which means people do not need a prescription for it and can make medical decision about them without the guidance of a physician.

A 2018 study published in the Official Journal of the International Society for Pharmacoepidemiology by David W Kaufman, et.al., found that 15% of adult ibuprofen users in the US have exceeded the maximum recommended daily dose. The study also mentions that more than a third of ibuprofen users were taking other NSAIDs, like aspirin and naproxen, while consuming ibuprofen at the same time. Out of these, 61% did not realise that they were using NSAIDs.

Pasricha talks about how it ruptures the gut wall, as she herself has rushed to the hospital in the middle of the night "far more times than" she can count "to perform an emergency endoscopy on someone who was bleeding profusely from an ulcer caused by NSAID".

Another 2009 study published in the American Journal of Gastroenterology states that as many as 1 in 4 chronic NSAID users will get an ulcer and about 4% will bleed or rupture through the gut wall.

An older study from 2005 titled A quantitative analysis of NSAID-induced small bowel pathology by capsule enteroscopy, found that as 75 percent of people regularly using NSAIDs develop low-grade inflammation in their small bowels. NSAIDs can also lead to development of fatty liver disease. This happens because your gut lining becomes more permeable, more toxins and bacteria from the outside world enters your liver and leads to inflammation.

A 2011 study titled Haemoglobin decreases in NSAID users over time: an analysis of two large outcome trials, states that as many as 6% of people taking NSAIDs regularly have found their blood count dropping within a few months of starting the medicines, this suggests that this is due to the small, slow amount of bleeding in the gut overtime.

Something as basic as an IV set, syringe, cannula or catheter can make a huge difference in a patient’s essential care and treatment. But a recent FDA survey has raised questions about the affordability of these hospital consumables and whether the lack of transparency in pricing can pose a threat to patient safety.

Maharashtra Food and Drug Administration Commissioner Tukaram Mundhe recently flagged exorbitantly priced hospital consumables and medical devices used in inpatient departments.

The food and drug regulator sought Centre’s intervention to straighten pricing of essential and life-saving medical devices, saying these practices should be ideally “fair, transparent and ethical”.

Maharashtra FDA Chief Tukaram Mundhe Flags Costly Hospital Consumables

The Maharashtra State Price Monitoring Resource Unit, operating under the state FDA, recently conducted the market survey covering medical devices used in inpatient departments, including IV sets, syringes, nebuliser, and oxygen-mask kits, and other consumables.

The survey found that some commonly used medical devices had a gap of up to 2,841% between procurement prices and printed maximum retail prices (MRPs).

For example, an IV infusion set purchased for Rs 11.05 was listed at an MRP of Rs 325. A 10 ml syringe purchased for Rs 6.75 had an MRP of Rs 57.20, while a catheter bought for Rs 29.41 had an MRP of Rs 310.

Maharashtra FDA Commissioner Tukaram Mundhe has sought intervention from the Centre and the National Pharmaceutical Pricing Authority (NPPA), arguing that patients admitted to hospitals are not in the position to bargain over medical products that are essential to their treatment. They may not have the opportunity to compare prices, search for another brand, or simply refuse the product.

In a recent interview, Mundhe said, “A trade margin of 2800 per cent is by any terms not acceptable, either as a consumer or as a hospital or as a regulator.”

Mundhe highlighted this problem in his letter to the Department of Pharmaceuticals, writing, “Because hospitalised patients critically require these non-negotiable surgical consumables during active treatment, they possess zero bargaining power in IPD settings.”

He also described the steep pricing as “completely irrational and unjustified” and argued that the absence of strict statutory price caps for several medical-device categories can leave patients facing large and opaque price differences.

The Centre has now sought a report from the NPPA on the price discrepancies flagged by the Maharashtra FDA.

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Costly Hospital Consumables May Become A Patient-Safety Issue

World Patient Safety Day is observed on September 17 every year to raise global awareness about the safety of patients and reduce preventable harm in healthcare.

As far as patient safety is concerned, it is not only about whether a device is sterile, functional, or medically appropriate. Affordability and transparency can also influence whether patients are able to access and continue necessary treatment.

A fat hospital bill may cause financial burden, discouraging patients from seeking timely treatment. For families paying out of pocket, unexpected costs can affect decisions about where to seek care, whether to continue treatment or whether to delay non-emergency follow-up.

Mundhe has described the issue directly as a patient-protection concern, saying, “This is not merely a pricing issue; it is a patient-protection issue.”

Also read: Ferritin Face: Can Pale Skin Signal Iron Deficiency?

Industry’s Response To The Maharashtra FDA

The procurement price of a device, however, cannot automatically be treated as the final cost of safely delivering it to a patient.

Hospitals may incur costs related to sterile storage, inventory, staff, emergency availability, wastage, expiry, infrastructure, quality checks, and safe disposal.

Industry representatives have therefore argued that pricing frameworks should distinguish between basic commodity consumables and complex medical technologies.

In a statement, the Association of Healthcare Providers of India (AHPI) said, “Price of device or medicine is very small part of overall cost of administering healthcare, which include manpower (doctors, nurses, paramedical, administration etc.) maintaining infection free environment, infrastructure etc.”

They also reacted to Maharashtra FDA’s pricing concerns and said that hospitals play no part in setting up MRPs of these products.

A new social media trend is prompting people to look more closely at their skin, lips, eyes, hair and nails for possible signs of iron deficiency.

The trend, being referred to as “ferritin face,” centers on an appearance that people describe as looking unusually tired — including dull or dry skin, pale conjunctiva, cracked lips, dark circles under the eyes, and brittle hair and nails.

What Is ‘Ferritin Face’?

“Ferritin face” is not a medical term. Ferritin is a protein that stores and releases iron in the body.

Social media users are increasingly sharing photos of changes in their appearance and linking them to low ferritin or iron deficiency. Some are also encouraging others to get their ferritin levels tested.

“Shout out to the person who commented on one of my videos ... ‘you should get your ferritin levels checked because your lips are very pale,’” one woman said in a TikTok video. “It turns out there’s a reason for why I look so tired and crappy all the time.”

Also read: Bryan Johnson's Autoimmune Gastritis Sheds Light On Iron Deficiency In Americans

Can Iron Deficiency Affect Your Appearance?

Although there is no standard medical definition of “ferritin face,” low iron levels can coincide with visible changes in the face and other parts of the body.

“While the catchy name is a social media invention, the idea that depleted iron can affect how someone looks is medically valid,” Anna Komorowski, division chief of hematology and medical oncology at Northwell's Northern Westchester Hospital in Mount Kisco, New York, was quoted as saying to MedPage Today.

“Importantly, these changes typically occur when deficiency has progressed significantly, not from mildly suboptimal levels.”

Why Iron Deficiency Can Be Missed

Iron deficiency is common, affecting nearly a third of adults in the United States. But it can be difficult to recognize because symptoms may be vague and develop gradually. Iron levels are also not routinely checked.

According to research published in JAMA Network Open, about one in four Americans may have inadequate iron intake or absorption. In the study of more than 8,000 Americans, 14 per cent of adults had absolute iron deficiency, reflecting depleted iron stores.

Even after excluding common causes such as anemia, pregnancy, heart failure and chronic kidney disease, 11 per cent remained iron deficient. Another 15 per cent had functional iron deficiency, where iron levels appear normal but the body cannot use the mineral effectively.

“Because some patients may be iron-deficient without being anemic, they may go on for a very long time without being diagnosed,” Imo Akpan, a hematologist at NewYork-Presbyterian and associate professor of medicine at Columbia University Irving Medical Center, was quoted as saying to the Washington Post.

What Are The Common Signs Of Iron Deficiency?

Iron deficiency can cause a range of symptoms, including:

• Constant tiredness
• Weakness
• Pale skin
• Shortness of breath
• Dizziness
• Headaches
• Hair loss
• Difficulty concentrating
• Frequent infections
• Under-eye circles,
• Cracks at the corners of the mouth,
• Brittle or slower-growing nails
• Exercise intolerance,
• Cold hands and feet,
• Brain fog
• Cravings for non-food items such as ice, soap or chalk.

How Is Iron Deficiency Diagnosed?

Iron deficiency can be assessed with blood tests, including a ferritin test, which measures the body's stored iron. Ferritin levels below 30 nanograms per millilitre can indicate iron deficiency.

How Is Iron Deficiency Managed?

Management depends on the underlying cause and the severity of the deficiency. It can include improving dietary iron intake and taking iron supplements when advised by a healthcare professional.

Iron-rich foods include spinach, beans, lentils, nuts and dates. Vitamin C-rich foods, such as oranges and lemons, can also be included in the diet.

When discussing patient safety in chronic disease management, conversations often focus on drug safety profiles, accurate dosing, and acute complication prevention. In long-term conditions like diabetes, which affects over 100 million people in India, patient safety extends far beyond the medicine. It lies at the intersection of patient education, reliable delivery systems, continuous monitoring, and structured medical guidance.

For instance, the recent evolution in diabetes therapies, such as the shift from 365 daily basal insulin injections a year to just 52 once-weekly administrations, marks a major turning point in chronic care. Reducing injection frequency addresses therapeutic fatigue and needle anxiety, factors that have historically delayed necessary insulin initiation by several years in India. As advanced delivery systems make administration simpler, ensuring that the patient continues long-term treatment is a key requirement for chronic care.

This is where a comprehensive system becomes critical. An advanced delivery device or once-weekly formulation is an enabler. As an intuitive delivery system, it offers accurate dosing and convenience, but cannot interpret fluctuating blood glucose trends, adjust for lifestyle changes, or recognize early warning signs of hypoglycaemia on its own. Long-term patient safety views advanced delivery as an integral link of a broader patient-care framework, which includes:

Also read: Ozempic, Wegovy & PMOS: How GLP-1 Drugs Are Changing PMOS Treatment?

Education as the primary step

Patient safety begins with health literacy. Understanding dose titration, storage conditions, hypoglycaemia protocols, and blood glucose monitoring transforms a patient from a passive recipient into an empowered manager of their health.

Reliability in delivery

Delivery mechanisms, whether daily smart pens or weekly formulations, must deliver predictable, mechanical accuracy. Reliable delivery builds patient confidence, minimizes dosing errors, and alleviates administration anxiety.

Continuous follow-ups

Diabetes is a progressive, dynamic condition. While delivery devices ensure precise administration, continuous engagement with healthcare professionals ensures that treatment regimens adapt to ageing, comorbidities, and lifestyle changes over time. In many cases, technology evolves in response to the pain points shared by the patient.

As the world marks World Patient Safety Day, the focus must expand beyond modernizing treatment delivery to strengthening the entire system surrounding the patient. Innovations in drug delivery are major milestones, but their real-world safety and effectiveness depend entirely on the educational and clinical scaffolding supporting them.

Grounding modern delivery solutions in patient education and clinical continuity creates a model where diabetes care is not only less burdensome, but safe for a lifetime.