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.

Semaglutide is the hero ingredient in the popular drugs Ozempic (used primarily to treat Type-2 diabetes) and Wegovy (used for chronic weight management).

Semaglutide, a GLP-1 receptor agonist, has shown its prowess in lowering the risk of heart attack, stroke, or death in patients with type 2 diabetes, obesity, and heart or blood vessel disease.

With emerging preclinical evidence suggesting its potential neuroprotective and anti-inflammatory effects, an international team of researchers from the US and Taiwan focused their study on semaglutide and patients whose cancer has spread to the brain.

Cancer in the brain, also known as brain metastases, is an advanced-stage (stage IV) cancer, which is generally associated with an increased risk of morbidity and mortality in patients. Those with comorbidities like type 2 diabetes are likely to have worse outcomes.

The research, published in JAMA Network Open, showed that although the once-weekly semaglutide injections cannot directly treat cancer, they can potentially help some very ill patients live longer.

“The findings of this cohort study suggest that GLP-1 RA use was associated with a significant reduction in all-cause mortality among patients with cancer with brain metastases and type 2 diabetes, with generally consistent association across subgroups," said the team from Albert Einstein College of Medicine in New York and National Cheng Kung University Hospital in Taiwan, in the paper.

How Semaglutide Helped Patients With Brain Metastases?

The teams analyzed medical records from 151 hospitals around the world.

They identified more than 19,000 patients with cancer, brain metastases, and type 2 diabetes. Of these, 866 had been treated with a GLP-1 drug, while over 11,000 had not.

Their final analysis included two groups of 850 patients who were compared for the effects of semaglutide and were followed for up to three years after their brain metastases were first recorded.

The patients taking semaglutide were significantly less likely to die -- about 37 percent -- during the follow-up period than those who were not.

The pattern was fairly consistent across several major cancer types, including lung cancer, breast cancer, and melanoma.

"These results build upon existing evidence that GLP-1 receptor activation modulates pathways relevant to neuro-oncologic health, including attenuation of neuroinflammation, preservation of blood–brain barrier integrity, and reduction of oxidative stress and mitochondrial dysfunction," the researchers said.

However, they also acknowledged limitations, such as the study was retrospectively conducted, which checked medical records and did not test patients in a controlled trial.

Ozempic Goes Generic, To Cost Less By 90%

With Novo Nordisk losing its patent in many countries, the sky-high prices of Ozempic and Wegovy are likely to go down by 90 percent.

This means the drug will be available at cheaper rates to 40 per cent of the world's population.

In India, the patent ended on March 20, and since then, several companies, including Alkem Laboratories, NATCO Pharma, Eris Lifesciences, Dr. Reddy’s Laboratories, Sun Pharmaceutical Industries, and Glenmark Pharmaceuticals, have launched their generic versions of semaglutide at a reduced price.

Also read: Semaglutide Becomes Cheap In India: A Gamechanger Or Health Gamble?

Who Should Avoid Semaglutide?

Semaglutide should be avoided or used with extreme caution in:

• Patients with a history of medullary thyroid carcinoma
• Individuals with a history of pancreatitis
• Those with severe gastrointestinal disease (e.g., gastroparesis)
• Pregnant or breastfeeding women
• Patients with Type 1 diabetes
• Patients with severe eye problems due to diabetes (can be taken with care)
• Individuals seeking purely cosmetic weight loss without a medical indication.

Living in more intensely developed neighborhoods may actually protect you against a stroke, a new University of Michigan study suggests.

Researchers tracked more than 25,000 adults across the US for over a decade and have now found that residents in areas with higher levels of development with more buildings, sidewalks and infrastructure, had a 2.5 percent lower risk of suffering a first-time stroke compared to residents in less developed areas.

Cathy Antonakos, research specialist senior in the U-M School of Kinesiology and first author explained: ""High-intensity development typically includes greater housing density and more commercial/retail outlets.

"These areas are more likely to feature compact land uses with access to health care, food stores, public transport and physical activity infrastructure like sidewalks, bike facilities and parks."

However, the study did not examine these environmental features, but there are some practical applications, Antonakos noted.

"For physicians, the study suggests that neighborhood-level factors may influence first-time stroke risk, in addition to individual-level factors," she said. "For planners, the findings suggest that enhancing environments with features that support cardiovascular health and physical activity may help lower the risk of first-time stroke."

Strokes: A Rising Crisis In India

Heart strokes are also one of the leading global health burdens, causing significant deaths and disability worldwide, including in India. Compared to Western countries, stroke also tends to occur at a younger age and is associated with a higher case fatality rate in the country.

One in seven stroke patients in India are young adults aged below 45 years, with hypertension leading as the major risk factor, according to a study by the Indian Council of Medical Research (ICMR).

The Global Burden of Disease Study 2021 identified hypertension, air pollution, tobacco smoking, high cholesterol, increased salt intake, and diabetes as the leading risk factors of stroke.

Incidence of stroke is increasing significantly in low- and middle-income countries (LMICs), especially in India, due to population growth, aging, and greater exposure to risk factors.

Wine Reduces Your Risk Of Strokes

A new global study suggests that moderately drinking wine can decrease your risk dying from cardiovascular disease by 21 percent.

A group of Chinese researchers who analyzed 340,924 adults in the UK between 2006 and 2022 classified a 12-ounce beer, a 5-ounce glass of wine or a 1.5-ounce shot of liquor each contains about 14 grams of pure alcohol.

Those who consumed less than 20 grams per week, about 1.5 standard drinks, were classified as never or occasional drinkers. The low alcohol consumption group included men who drank more than 20 grams per week but no more than 20 grams per day, and women who drank between 10 grams per day and 20 grams per week.

They found those with high alcohol consumption were 24 percent more likely to die from any cause, 36 percent more likely to die from cancer and 14 percent more likely to die from heart disease.

Additionally, even low intake of spirits such as beer or cider was associated with a nine percent higher risk of dying from cardiovascular disease compared with drinking never or occasionally.

Researchers at the University of California Riverside have developed a low-cost fake drug detector that can detect fake medicines by studying how pills dissolve in water.

Tested on 30+ medicines, the detector identified drugs with about 90 percent accuracy and could even distinguish between brand-name and generic versions.

William Grover, associate bioengineering professor at the University of California, Riverside explained: "Watered-down or illicit versions of drugs like Botox or popular GLP-1 inhibitors have caused serious injuries or death.

"The theory here is that if it's a legitimate medicine, the manufacturer made every pill identical enough that they'll all behave roughly the same way when they dissolve.

"So if you test a suspect pill, and it dissolves at a different rate than the real thing, this suggests the suspect pill is counterfeit."

Talking about the success of the device, Grover said: "We took Bayer aspirin pills and drug-store-brand aspirin - these are basically identical medicines with the same active ingredient and very similar inactive ingredients but when ran through our tests, we could easily tell the difference between the two products."

Costing as little as $5–$30, the device could help tackle the global issue of fake medicines, which the World Health Organization estimates affect 1 in 10 drugs worldwide.

How Does It Work?

The fake drug detector is essentially a low-cost infrared sensor made for use in toy robots able to follow lines drawn on paper. The researchers repurposed the sensors to instead track the rate at which pills dissolve in water.

All pills of a given drug dissolve or ideally should dissolve at roughly the same rate. Legitimate medications don't necessarily dissolve any faster or slower than counterfeit ones however since, the are made by different people at different facilities and with different ingredients, each drug's dissolution rates form a "fingerprint" that makes them identifiable and different from that of a fake drug.

What Else Can The Fake Drug Detector Be Used For?

Grover notes that he would like to use this method to detect fake antimalarial drugs as they are a major cause of death in many tropical regions. Malaria is treatable with the right medications.

"Unfortunately, bad actors know they can make money preying on the need for antimalarials. They sell pills that have the same packaging as authentic antimalarials, but don't contain the active ingredients. If someone gives these pills to their child, they won't cure their infection."

The expert also hopes to get his tool into the hands of those who can use it to fight fake antimalarials and other fake drugs.

"I can't imagine a more despicable person than someone who would sell fake medicine to a child. I hope our work makes those criminals' lives a little harder."